No Plegarism please,  will be checked with Turnitin. 

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

Topic: Oral Presentation

The goal of any oral presentation is to pass along the “right amount” of patient information to your preceptor(Clinical Instructor) in an efficient fashion. When done well, this enables you and your preceptor to quickly understand the patient’s issues and generate an appropriate plan of action.

As a general rule, oral presentations are shorter than written presentations as they should focus on the most active issues of the day (Chief Complaint).

Subjective– how patient feels and reports to you.

Objective– vital signs and pertinent physical exam findings; what you hear, feel, smell, and see.

Assessment– should include working diagnosis from presenting problem and prior diagnoses that are being actively addressed during the present appointment.

Plan – this is the area that should be very specific as if you are entering the orders.

Some of the most common stumbling blocks for students (other than nerves) include going into too much detail in the subjective and objective sections!

Discussion: Share with your peers your approach to oral presentations in the clinic setting and ways in which you have perfected your approach to communicating information about your patient to your preceptor. Share your PEARLS of Wisdom!

Purpose

In today’s current healthcare settings, the increasing diversity, globalization, and expanding technologies produce complex ethical pressures that influence nursing practice and practice outcomes. To be effective in a master’s-prepared advanced nurse practice role it is important to understand personal values, beliefs, strengths, and limitations. The purpose of this assessment is to promote introspective reflection related to implicit and/or explicit personal biases. Students will develop a plan to reduce bias and promote personal and professional growth.

This is a discussion post, ABOUT 250 WORDS, tittle page not require In- text citation is required original work please, scholarly references are required for this assignment, website source strongly preferred.

QUESTION 1 : Health care organizations continually face challenges from various

Health care organizations continually face challenges from various regulatory and government agencies and are also bound by Managed Care Organization (MCO) standards. View the video “College of Nursing and Health Care Professions: Do we know what our future is?” for insight into the challenges of health care reform. http://lc.gcumedia.com/zwebassets/courseMaterialPages/nur508_healthcare-reform-video-series-v1.1.php. Based on the video, describe, with rationale, two key factors that you feel will need to be addressed by future health care workers and health care leaders. (Note: you can download slides from this video within the media piece itself for ease of review in developing your forum response).

Additionally, what role does adherence to MCO standards play in your future health care vision?

Support your response with a minimum of 3 peer-reviewed article.

                                  I need this project completed in 4-5 hours

Description: 

Reflect on the research articles you have reviewed to date that relate to your clinical question. Please refer to all the unit resources (e.g., readings, recordings, announcements, etc.) to facilitate this process. With these thoughts in mind, post your thoughts on the following:

1. In the articles you have reviewed, what statistical tests are being used for data analysis?
2. Are the statistical tests being used appropriately for the type of data being produced and the question being asked?
3. Do the authors appropriately indicate implications of the data analysis, or do they overstretch?

In the articles that have I reviewed listed below, I need to know what statistical tests are being used for data analysis?

· A key study for my PICOT project is titled “How Accurate are Self-Reports? An Analysis of Self-Reported Healthcare Utilization and Absence When Compared to Administrative Data” (Koerner & Zhang, 2017).  The authors evaluated the data using Pearson’s correlation and multivariate logistic regression models. 

·  Correlation is a statistical method used to assess a possible linear association between two continuous variables, while Pearson’s correlation coefficient is a test statistics measuring the statistical relationship, or association, between two continuous variables (Mahan, Clark, Anderson, Koller, & Gates, 2017).. Pearson’s correlation coefficient (r) is a measure of the strength of the association between the two variables; it is the best method of measuring the association between variables of interest because it is based on the method of covariance, and covariance is a measure of the joint variability of two random variables (Koerner et al., 2017). If the data is normally distributed, in other words, bell-shaped, and symmetrical about the mean, tests such as the histogram, and normality tests may be used to evaluate if the distribution is normal (McCrum-Gardner, 2008). 

· Are the statistical tests being used appropriately for the type of data being produced and the question being asked?

· The majority of studies may be evaluated with the proper evaluation of over 100 statistical tests to choose from. Tests are chosen depending on the type of research questions being asked, the type of data being analyzed, and the number of data sets or groups being evaluated.

· The first question to be asked is what scale of measurement the data will be, nominal, ordinal, or interval. The study in question involves interval data. The second question is the reason for the analysis; as an example, paired groups or independent groups? 

· Yes, the statistical tests are appropriate for the type of data being produced, and for the type of questions being asked.

· Do the authors appropriately indicate implications of the data analysis, or do they overstretch? 

· Based on our readings and videos, I saw no evidence of data-stretching. For example, data was collected over two calendar years, a lengthy, non-selective inclusion period. A potential confounding factor was that all participants had to have been enrolled in the company health insurance program a minimum of 320 days as a condition of inclusion in the study. Another potential confounding factor was that only hourly employees were included in the two-year study. In addition, pregnant employees were excluded from the study, as these employees are atypical of the general employee population in that their healthcare utilization would be temporarily altered. These factors may have influenced the results, by excluding participants with different reporting habits. After recognizing these potential limitations, their findings mirrored multiple studies previously conducted. 

· The authors also noted potential improvements for future studies, including inclusion of a more diverse employee population, and examining why there exists a difference in self-reporting based on participant sex.

                                                                          References

· Koerner, T. K., & Zhang, Y. (2017). Application of linear mixed-effects models in human neuroscience research: A comparison with pearson correlation in two auditory electrophysiology studies. Brain Sciences, 7(3), page 26. doi:http://dx.doi.org.prx-usa.lirn.net/10.3390/brainsci7030026

· Mahan, K.R., Clark, J.A., Anderson, K.D., Koller, N.J., & Gates, B. J. (2017). Development of a tool to identify problems related to medication adherence in home healthcare patients. Home Healthcare Now, 277-82. doi: 10.1097/nhh.0000000000000539

· McCrum-Gardner, E. (2008).  Which is the correct statistical test to use? British Journal of Oral and Maxillofacial Surgery 46 (2008) 38–41 

· Short, M., Goetzel, R., Pei, X., Tabrizi, M., Ozminkowski, R., Gibson, T., & … Wilson, M. (2009). How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data. Journal of Occupational & Environmental Medicine, 51(7), 786-796. doi:10.1097/JOM.0b013e3181a86671

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Types of Statistical use

           There were six articles retrieved on my PICOT question, (3) were quantitative research, (1) is a mixed method, (2) qualitative research, and (1 )integrative review. The (3) quantitative research were critically appraised and used the following statistical analysis; central standard tendency (mean, median, mode), a probability value to test the significance of results, binomial regression, and binomial distribution, chi-square test, Fisher’s exact test, and measures of standard deviation. Lastly, a study about changing Intensive Care Unit (ICU) culture to reduce CAUTI the research study used statistical process control charts to see the process of improvement in the reduction of catheter-associated infection post-implementation (Maxwell, Murphy and McGettigan, 2018). 

Appropriateness of the statistical test 

The purpose or hypothesis of the study is in the introduction of each literature. The research question aims to evaluate the effectiveness of the CAUTI bundle in the pediatric intensive care unit and adult intensive care unit. To provide patient safety, the use of an appropriate statistical tool in research is essential. According to McCrum-Gardner (2007), using the right scale of measurement will convey accurate results in research.  One research study use sample size is 390 (nominal) children ages from 1 month to 18 years old and admitted in the ICU for 48 hours that needed foley catheter insertion. The exclusions are positive urine culture and less than 48 hours of ICU admission. In addition, the Categorial variable is analyzed using X2 or Fisher exact test. The prevalence rate was calculated using the number of disease within the specified time over the population under risk x 100. The research study shows Foley catheter utilization was calculated by dividing the total number of device days by the total number of patient days (Sönmez Düzkaya, Bozkurt, Uysal, and Yakut,2016). Moreover, the three quantitative research use an appropriate tool and results show that daily CAUTI BUNDLE implementation and changing ICU culture regarding the standard practice showed a significant reduction of catheter-associated urinary tract infection in pediatric ICU and adult ICU.

Conclusion

           The implication of the research study indicates that prevention of CAUTI with the use of CAUTI bundle checklist and application of process improvement had a significant impact on the decreasing morbidity, mortality and healthcare cost. Also, the length of study allowed the researchers to see a significant, consistent change in the reduction of CAUTI.  

References

Maxwell,M.,Murphy, K., and McGettigan, M. (2018)Changing ICU culture to reduce catheter-associated urinary tract infections. Canadian Journal of Infection Control,33 (1) ,39-43 . Retrieved from https://ipac-                   canada.org/photos/custom/pdf/Marcia%20Maxwell_Spring2018.pdf

McCrum-Gardner, E. (2007). Which is the correct statistical test to use?British Journal of Oral and Maxiofacial Surgery, 46, 38-41. Retrieved from https://class.esa.edu/bbcswebdav/institution/USA1/201830/MSN/IPE_7050/readings/McCrumGardner_Which_is the_correct_ statistical_test_to_use_pdf        

Sönmez Düzkaya, D., Bozkurt, G., Uysal, G., & Yakut, T. (2016). The effects of bundles  on catheter-associated urinary tract infections in the pediatric intensive care unit.Clinical Nurse Specialist: The Journal For Advanced Nursing Practice, 30(6),341-346. doi:10.1097/NUR.0000000000000246

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Promoting Health Care Quality-  Quality Improvement Issue  

To help you move forward with your Course Project, this week you identify a quality issue that you would like to address and submit a description of this issue for Instructor feedback.   Your proposed issue should reflect a genuine need for improvement within your selected health care organization. Through your Course Project, you will analyze this issue and propose strategies to improve outcome(s), including the redesign of a related process.  

To prepare: •Review the six quality improvement aims from the Institute of Medicine (IOM) presented in Chapter 3 of the Sadeghi, Barzi, Mikhail, and Shabot text. 

•Conduct a search of the literature to help you identify a specific issue that warrants attention and action to promote quality improvement. 

•Consider what you have surmised thus far through your analysis of the organization that you selected. What have you noticed that could help you identify a quality-related need for improvement? For instance: 

•What has captured your attention in meetings, reports, and/or daily activities? 

•Have you noticed discrepancies between activities in the organization and recommendations in the research literature, quality standards, and/or the organization’s stated policies and procedures? 

•If so, what do you think could be the reason(s) for variations or gaps between what you have observed and what is recommended?  

•Identify a quality improvement issue that you would like to investigate for this project.

The instructions for this assignment asks for students to identify a quality improvement issue, and provide a description of the issue they wish to pursue. This can be accomplished in 2 paragraphs.

ReferencesHickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.  

•Chapter 10, “Evaluation of Patient Care Standards, Guidelines, and Protocols” (pp. 207-226)

 •Chapter 12, “Evaluating Populations and Population Health” (pp. 265-280) Chapter 10 reviews methods for using national, local, and organizational standards to evaluate the quality of health care practices. Chapter 12 examines strategies for identifying quality issues through the evaluation of populations.   Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers. 

 •Chapter 3, “General Concepts in Quality” (pp. 45–82) See the six aims for quality proposed by the Institute of Medicine (IOM).   Bellot, J. (2011). Defining and assessing organizational culture. Nursing Forum, 46(1), 29–37.

https://class.waldenu.edu/bbcswebdav/institution/USW1/201870_27/MS_NURS/NURS_6231/artifacts/USW1_NURS_6231_Week04_Bellot_2011.pdf