1-Qualitative data are words, instead of numbers. According to Burns, Gray and Grove (2015) “Qualitative research is a systematic approach used to describe experiences and situations from the perspective of the person in the situation. The researcher analyzes the words of the participant, finds meaning in the words, and provides a description of the experience that promotes deeper understanding of the experience”. Initially you want to state the purpose of the study. In a Qualitative study there are different types of perspectives that can be associated with a qualitative study.  Phenomenological, grounded theory, ethnographic, exploratory-descriptive, qualitative and historical are types of research (Grove, 2015).  To assist with the management of the study, according to White, Oleke, and Friesen (2012) they had eight recommendation as follow

• Have      one person manages and organize the study.
• Provide      a through documentation collection and analysis details
• Strict      timeline for data collection, coding and analysis
• Use      of iterative process for data collection and analysis
• Comprehensive      internal audits
• communications      among all members of the team
• resources      are to be utilized to meet dead line
• re-assess      and determine if any changes need to be made.

According to Burns, Gray and Grove (2015) when collecting research, a way to manage the data is by organizing the information into themes and subthemes to form meaning from the data. Data analysis and interpretation allows the researcher to place the findings into the correct category, finding correlation or the non-correlation of the data being obtained.  They must be consistent with the method and the philosophy of the study, allow the data and meaning to be revealed, thus demonstrating the rigor of the study.

Reference

Grove, S., Gray, J., Burns, N., (2015). Understanding Nursing Research, 6th Edition. Retrieved from https://viewer.gcu.edu/DPBXHG

White, D., Oleke, N., & Friesen, S. (2012, July). “Qualitative Data Has Been Described As Voluminous And Sometimes Overwhelming To The Researcher In What Ways Could A Researcher Manage And Organize The Data” Essays and Research Papers. Retrieved from https://doi.org/10.1177/160940691201100305

2-Qualitative data can be difficult to process and analyze if not organized properly but the organizing itself is often a difficult task because qualitative data by its very meaning has no numerical data that can be placed in any order or sorted. For this very reason, the data almost always has to be separated and sorted by a human being rather than a computer system that would have to be programed to search for a numerical characteristic that doesn’t exist. In the place of these numerical characteristics, the researcher would need to sort their data into themes based around patterns found in their work. These patterns would differ based on the nature of their research. Once these patterns were decided upon they would be used to create groupings for the data.

References

Grove, Susan, Jennifer Gray, Nancy Burns.(2015). Understanding Nursing Research, 6th Edition. Saunders, VitalBook file.

3-“Qualitative research is multimethod in focus, involving an interpretive, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them” (Mcleod, 2008). What this means is that the point of qualitative research is to understand the reality of the subject matter and participants that are being studied, which is why these test subjects are studied in their natural setting. I agree that qualitative data can be voluminous and overwhelming, so organizing large amounts of data in to smaller groups would be preferable. One way you could start would be to divide up the data into the different environments in which they are being studied. For example, if you are assessing fall risks in the elderly in the healthcare setting, there are three different categories you can divide into in themselves. To further break down the data, you could organize any of these groups into different facilities, such as assisted living facilities, hospital, nursing homes, rehabilitation facilities, and adult foster homes. The division of data is all dependent on what the focus of your study is and what end goal you are attempting to achieve. If you are seeking safe staffing ratios, you  could begin by dividing fall risk patients by facilities with higher staffing ratios than those with lower ones to compare and contrast. There really is no “exact answer” on how to organize the data. The development of technology is very helpful in the organization of data in recent years. I believe that professor Mcdonald made a comment earlier about a study that she was once involved in that did not use computers for the organization of data. It would definitely speed up the process of sifting through the information you have for the information that can be used. When it comes to organization, in any capacity, I find that lists and spreadsheets help me to focus my mind and not leave out any important information. This method may not work for everyone, but if I don’t write something down, chances are, it will get forgotten in the end.

References:

Mcleod, S. (2008, February 5). Qualitative vs Quantitative Research | Simply Psychology. Retrieved from https://www.simplypsychology.org/qualitative-quantitative.html

M4:Braden Scale Dropbox

Please read the article and answer:
1. Why did the author access the PubMed system and then what for?

2. What is the incidence of pressure ulcers between 1999 and 2004?

3. When was the Braden scale developed?

4. What are the six factors that are considered for the Braden scale?

5. Which government agency is responsible for clinical practice guidelines?

6. List at least three reasons that a hospital would be interested in identifying a pressure ulcer

       early in the patient’s hospital stay.

7.  What does the term nosocomial mean?

8. What is risk assessment and why is it such an important aspect of hospital management?

9. Why is the selection of a proper surface to lie on an important part of wound management? (be

        specific)

10. Which analysis was utilized in the results section and why?

11. Is the hospital that you are working for using the Braden scale? If so, then state if it appears  

         to be working and if not then give a reason that they may not want to use it. (If not working

        then just give the main reason that an institution would want to use the scale).

Go to the following website by clicking on the provided link, http://www.countyhealthrankings.org/ 

– select a county and a state (this may be the county/state in which you reside, attend school, or plan to live and work). 

After reviewing the website and the health outcomes in the County Health Rankings for the area, answer the following questions in a few short sentences as part of your discussion.

1-Select one area in need of improvement and list the general statistics pertaining to the specific problem.

2-How does the creation of the community health center program help to address this public health problem. 

3-What can you as a nurse practitioner do to influence policy innovation to resolve the problem?

APA style. 2 references (less than 5-7 years). 250 words. 

Peer 1

The Institute of Medicine (IOM) nursing reports from 2010 to 2016 are the summarized findings of the IOM committee that examined changes in the field of nursing since the publishing of “The Future of Nursing: Leading Change, Advancing Health” (Shalala et al., 2011). The summarized findings found in our class reading assignments outline recommendations and provide an essential path for the individuals involved to implement the changes outlined in these works. Some of the direct “take away” from the IOM nursing reports align with the nursing scope of practice. They identify that nurses should practice to the full extent of their education and training, achieve higher levels of education through an improved educational system, gain rights as full partners with physicians and other health care professionals and require effective workforce planning and policy making through better data collection and an improved information infrastructure.

Throughout my career, I will directly be addressing these main points as I work to achieve and work with full practice autonomy. I recently moved from Maryland, which is one of 28 states that allow nurse practitioners full practice authority to treat and prescribe without formal oversight (Weiland, 2015). This report calls all advanced practice nurses to practice to their full extent, meaning we should implement all necessary and appropriate interventions within our scope of practice as defined by the American Nurses Association. In Maryland, this is an expected outcome in my daily practice where I use my full power to treat patients for the optimal health outcomes. Another area I will strongly indulge in is the necessity for continuing education. As a health care professional, we take on the role of a lifetime learner as we continue to learn best practices and evidence-based practice updates that form as time goes on. Health care is an everchanging field and staying up to date on your education and health understandings can be the difference between patient outcomes. We have a professional duty to our patients to learn everything we possibly can to make the best decisions when developing a plan of care for our patients who expect nothing but competent care. Overall, these nursing reports do a phenomenal job of outlining how nurses in advanced roles can best prepare themselves to provide optimal patient care and how to protect the health of the community through policies and best practices.

References:

Shalala, D., Bolton, L. B., Bleich, M. R., Brennan, T. A., Campbell, R. E., & Devlin, L. (2011). The future of nursing: Leading change, advancing health. Washington DC: The National Academy Press. doi: 10.2956.

Weiland, S. A. (2015). Understanding nurse practitioner autonomy. Journal of the American Association of Nurse Practitioners, 27(2), 95-104.

Peer 2

Describe how you will utilize and implement the IOM Nursing Reports from 2010 and 2016 in your role as an Advanced Practice Nurse.

In 2008, The Institute of Medicine (IOM) along with The Robert Wood Johnson Foundation (RWJF) comprised a report that would made recommendations for an action-oriented blueprint for the future of nursing. This was in response to a need to assess and transform the nursing profession. Nurses have an important role in transforming our current health care system (IOM, 2010). The IOM nursing reports have several recommendations that will propel us into the future of nursing.  

There are eight total recommendations and it is important for all advanced practice nurses to focus on the recommendations to provide better practices. There is a lot of focus on education for nurses. IOM states that nurses should have lifelong continuing education, the number of nurses with a DNP should double by 2020, and the number of nurses with a baccalaureate degree should be increased to 80% by 2020 (IOM, 2010). I will have my master’s degree as an advanced practice nurse and depending on the setting of my practice, I will encourage other registered nurses to complete continuing education courses as well as pursue a higher degree in nursing. I, myself, plan to obtain a doctorate of nursing in 2020 if not before that time. Continuing education will help prepare nurses to lead change in advancing health and providing positive patient outcomes, another recommendation of IOM. It is my plan to participate in any continuing education course that is pertinent to my patients and specialty.

            According to the IOM (2010), implementing nurse residency programs will be extremely helpful to nursing. This not only applies to new graduate nurses but nurses going from one position to another. As a nurse practitioner, I will make myself available to participate in these residency programs. If there is a nurse advancing from a staff nurse position to nurse practitioner, I will volunteer to be a mentor or preceptor to them just as I have with nursing students. I currently work at a teaching facility and recently a nursing residency program was implemented. Many advanced practice nurses function in helping this program succeed by teaching and mentoring. Nurse residency programs improve nurses’ work experiences, increase retention of new nurses, and show financial return for organizations investing in nurses as resources. Residency evaluations show increases in leadership and communication skills and decreases in stress and turnover (Kosman, 2011).

            Collaborating with an interdisciplinary team is also a recommendation of the IOM. As a nurse practitioner it will be my duty to collaborate with others so that my patient receives adequate care. The patient should be treated holistically so if there is a service that I can not provide, it would be wise of me to collaborate with other people so that the patient gets the best care possible. Collaboration could include working with other physicians, physical therapists, occupational therapists, case managers, or social workers. 

            As a nurse practitioner, with my knowledge and experience, I should be able to practice to the full extent of my education. Working in Georgia, I will be aware of what my scope of practice allows me to do in this state. If there is something outside of my scope of practice, I will be sure to refer my patient to someone more appropriate. Along with my contributions, congress and legislative members should be diligent in allocating funds to research and appropriate technology as well as making sure that nurse practitioners get proper insurance reimbursements.

With recommendations from the IOM, nurses should be able to provide effective and efficient care. Patients will receive the best care because the nurses will be up to date on current evidence based practices.

References

Institute of Medicine of the National Academies. (2010). The Future of Nursing Leading Change, Advancing Health, Report Recommendations. Retrieved from https://myclasses.southuniversity.edu/content/enforced/16337-2360697/media/transcripts/Future%20of%20Nursing%202010%20Recommendations.pdf?_&d2lSessionVal=Zo3eS3GHNjkvUMYMbPaQtri9Y

Kosman, S. (2011). Nurse Residencies: Building a Better Future for Patients and Nurses. Robert Wood Johnson Foundation. Retrieved from https://www.rwjf.org/en/culture-of-health/2011/10/nurse-residencies-building-a-better-future-for-patients-and-nurses.html

1. What are the skills necessary for the provider to identify, address, and assess this clinical ethical issue?
2. What are the provider’s obligations when a patient discloses does he not intent to follow the treatment?
3. What are the ethical considerations in evaluating a patient’s failure to adhere to a prescribed therapy?
4. Will you terminate care for this patient? What are the implications?
5. Case Study Rubric
       Criterion
     Outstanding  (25)
     Very Good  (22)
        Average (18)
     Unacceptable (15)
     Score
       Completeness
     Complete in all respects; reflects all requirements
     Complete in most respects; reflects most requirements
     Incomplete many respects; reflects few requirements
     Incomplete in most respects; does not reflect requirements
      
       Understanding
     Demonstrates excellent understanding of the topic(s) and issue(s)
    
     Demonstrates an accomplished understanding of the topic(s) and issue(s)
     Demonstrates an acceptable understanding of the topic(s) and issue(s)
     Demonstrates an inadequate understanding of the topic(s) and issue(s)
      
       Analysis
     Presents an insightful and through analysis  of the issue (s) identified
     Presents a thorough analysis of most of the issue(s) identified
     Presents a superficial analysis of some of the issue(s) identified
     Presents an incomplete analysis of the issue(s) identified.
      
       Evaluation
     Makes appropriate and powerful connections between the issue(s) identified and the concept(s) studied
     Makes appropriate connections between the issue(s) identified and the concept(s) studied
     Makes appropriate but somewhat vague connections between the issue(s) identified and the concept(s) studied
     Makes little or no connection between the issue(s) identified and the concept(s) studied.
      
       Opinion
     Supports  opinion with strong arguments and evidence; presents a balanced and  critical view; interpretation is both reasonable and objective
     Supports opinion with reasons and evidence; presents a fairly balanced view; interpretation is both reasonable and objective
     Supports opinion with limited reasons and evidence; presents a somewhat one-sided argument
     Supports opinion with few reasons and little evidence; argument is one-sided and not objective.
      
       Recommendations
     Presents  detailed, realistic, and appropriate recommendations clearly supported  by the information presented and concepts studied
     Presents specific, realistic and appropriate recommendation supported by the information presented and the concepts studied
     Presents realistic or appropriate recommendation supported by the information presented and the concepts studied
     Presents realistic or appropriate recommendation with little, if any, support from the information and the concepts studied.
      
       Grammar and Spelling
     Minimal spelling and grammar errors
     Some spelling and grammar errors
     Noticeable spelling and grammar errors
     Unacceptable number of spelling and grammar errors
      
       APA guidelines
     Uses APA guidelines accurately and consistently to cite sources
     Uses APA guidelines with minor violations to cite sources
     Reflects incomplete knowledge of APA guidelines
     Does not use APA guidelines
      
        
      
      
      
                 Total