Comment1

In labor & delivery we have recently adopted a research-based or evidence-based practice, which is the use of the Peanut Ball during labor. It is a tool used for promoting the progress of labor, by facilitating normal fetal descent (bringing the baby down) for an easier delivery, and to prevent the patient from having to have a primary C-section. Failure to progress during labor is the most common indication for a first time C-section (Tussey, et al., 2015). Before last year, my hospital had let the mother labor down on their own without any assistance, other than letting the patient reposition themselves in bed as needed. Needless to say the hospital primary C-section rate was high and needed to be lowered. According to, Reducing Length of Labor and Cesarean Surgery Rate Using a Peanut Ball for Women Laboring With an Epidural 2015, “The ball promotes spinal flexion, increasing the uterospinal angle, and increasing the pelvic diameters to facilitate occiput posterior rotation, which results in a widened pelvic outlet.” Now, once the patient comes in and it has been established that she is in labor, we utilize the peanut ball on all patients by placing it between their legs to keep the pelvis open and rotating the patient from side to side to help shorten the length of labor and to help decease the primary C-section rate.

Comment 2

Evidence-based practice is utilized to promote quality, cost-effective outcomes for patients as well as the healthcare professionals and healthcare system (Burns & Grove, 2011). Evidence-based practice is the action of implementing best evidence-based care, supported by research, and integrating the care with patient’s needs and values as well as clinical expertise (Burns & Grove, 2011). Nurses utilizing evidence-based care began as the profession began. Florence Nightingale realized that cleanliness to air, water and diet promoted health to her wounded soldiers and aided in their recovery (Burns & Grove, 2011).  Examples of evidence-based practice include better management of patient’s blood pressure on a primary care level to better avoid heart attack, stroke and kidney disease, as well as understanding risks factors for diabetes leading to earlier screening for patients who possess the risk factors, or the appropriate guidelines for IM medication administration to promote effectiveness of medication delivery and patient’s comfort (Burns & Grove, 2011). In Singapore, 64% nurses expressed positive attitude towards evidence based practice and bettering their patient’s outcomes, however also expressed concern on their already heavy workload while attempting to keep up with data and new evidence (Majid & et. al, 2011). The main barriers in implementing evidence-based care to this facility in Singapore was found to be lack of time, lack of ability to understand the statistical data as well as jargon used in the research articles (Majid & et. al, 2011).

APA style

700 words

1.  Click on the link and read the Health People 2020 topic (goal and objective) regarding substance abuse.                                            https://www.healthypeople.gov/2020/topics-objectives/topic/substance-abuse

2.  Identify current events a the local or national level related to substance use/abuse laws, policies lawsuits or other legal issues.  Discuss the application of such laws/policies to the individual freedom of people.

3.  In your own words define the term violence and the role of the nurse in responding to acts of violence outrages.

4.  Do you think is there any relationship between substance abuse and violence.  Give at least one example.

As stated in the syllabus the assignment must be presented in an APA format word document, Arial 12 font attached to the forum on the discussion board.  A minimum of 3 evidenced-based references must be used and 2 replies to any of your peers sustained with the appropriate references must be posted.  Only the assignment must be attached in a word document in the forum, replies do not.  References must be no older than 5 years.  A minimum of 700 words is required.  

For this week’s forum, read through the article that you chose for your research paper. In your initial post, discuss what types of bias the researchers were or should have been concerned with. What measures did the researchers use to reduce bias? If the researchers had not accounted for the bias, what would have been the consequences? Remember to attach the .PDF or Word doc of your chosen article to your initial post. Please see the attached file

TURNITIN ASSIGNMENT!!! 

Please be aware that the percentage of plagiarism for this assignment is 25%.  

1.  Go to http://www.healthypeople.gov/2020/default.aspx and review the Healthy People 2020 initiative.  Pay close attention to the objectives, goals and the indicators.    

2.  Using your city or county public health department: http://miamidade.floridahealth.gov/  You can choose any of these two counties(Miami-Dade County, Florida, or Broward County, Florida) identify an epidemiological and surveillance data related to population based communicable illnesses.     

Illnesses chosen:    

1. Tuberculosis  

2. Hepatitis B  

3. Gonorrhea     

4.  Based on these chosen communicable illness prepare an analysis discussing how this 3-communicable illness affect your community, and how they were identified and a plan of action to contained them base on healthy people 2020.       

– Presentation must be in APA format.   

– Arial 12 font attach to the forum/thread in the assignment tab and turnitin with a minimum of 1000 words (excluding first and references page)   

– A minimum of 3 evidence based references no older than 5 years are required.    – The assignment must include the zip code of the city or county chosen.         

Once again, the assignment will be posted in turnitin to verify originality!

FREE OF PLAGIARISM!!!!

No Plagiarism please.

Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and and Include: 3 references (2015-2018) with intext citations.  

* You are to discuss the incidence and prevalence of Arthiris Rheumatoid.

* Pathophysiology from an advanced practice perspective.

*Physical assessment and examination, evidence-based treatment plan and         patient education, 

as well as follow up and evaluation to assess the efficacy and outcomes of the evidence-based treatment plan for management of an episodic, acute, and chronic case involving the pathology(s) you are sharing. (Rheumatoid Arthritis)

• Arthritis rheumatoid