The Case of Mrs. G.
Mrs. G. is a 75 year old Hispanic woman who has been relatively well all of her life. She had been married for 50 years and had five children. Her children are grown with families of their own. All but one of her children live in other states. Mrs. G.’s husband passed away last year, which was devastating for her. She had been very close to him and relied upon him for everything. He was “the life of the party” she always said and was a loving and caring man. Since his passing, Mrs. G. has continued to live in the house they shared for 35 years. In the last month, Mrs. G. has fallen twice sustaining injuries, though minimal. Her home health nurse comes weekly to check in on her. Mrs. G. likes her very much and wishes she could come more often. Mrs. G.’s daughter who lives in the next town over, has been worried and decided with the urging of her siblings and the doctor to start looking for an assisted living facility for her mother. She found one last week and talked with the Director who said she would be happy to help in whatever way was best. The daughter decided to tell her mother that it was time for her to move, so she can be cared for and be safe. When she told her mother, Mrs. G. cried and said, “This will not happen ever. I plan to stay in this house of loving memories for the remainder of my life.”

In 3 – 4 pages answer the following questions:

1. How would you best describe Mrs. G.’s feelings about her life, her family, her traditions, and her future?
2. Did Mrs. G.’s response to her daughter surprise you? Please explain your answer.
3. In what way do you believe her culture might be influencing her decision?
4. If you were Mrs. G.’s daughter what would you say to her that shows you are caring and have compassion for her situation? What nonverbal communication would support that level of communication?
5. Suppose Mrs. G. stands firm about not leaving her house. What resources and collaborations might be available and helpful so the daughter and other healthcare providers can keep her mother safe and make the most effective decision?

  

Evidence-based medicine (EBM), previously translational medicine, can be defined as improving care based on empirical research and/or hands-on practice. The EBM’s approach is based on either direct patient care (bottom-up) or an experiment translated into guidelines (top-down). EBM is used in either in conjunction or as quality assessment tool(s) for continuous quality improvement (CQI). The healthcare leader must utilize the evidence to promote healthcare quality. 

Explain the process of evidence-based analysis. 

Highlight the major players and their roles in EBM policy (i.e., government, providers, patients, etc.).

Explain the EBM “Levels of Evidence” as defined in your course text. 

Review the case “Constraints of the ACA on Evidence-Based Medicine.” Provide a written analysis of the case “Constraints of the ACA on Evidence-Based Medicine” in Chapter 9 of your textbook. (Utilize the “Levels of Evidence and Grades of Recommendations” as defined by the University of Minnesota) Clearing house. 

Summarize the policy of EBM in your conclusion. 

Your paper Must be four to six double-spaced pages in length (not including title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center. Must include a separate title page with the following: Title of paper Student’s name Course name and number Instructor’s name Date submitted Must use at least four scholarly sources in addition to the course text. Must document all sources in APA style as outlined in the Ashford Writing Center. Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center

   

DO NOT USE THE SAME EXAMPLEOR EVENT  THAT THE TEACHER GIVES US

Step 1 Choose an event in the history of nursing that has shaped how the profession of nursing has developed.

Step 2 Address the following questions in your post:

• What event did you choose? Using research, describe your event.
• What lead to this event? Be specific.
  • For example, if you chose the increase in ADN programs in the 1950s as your event, you would describe how the aftermath of WWII led to a shortage of RNs.
• In what way did the event change the course or affect the way nursing developed?
• Did the event have a positive or negative effect on nursing?
• For this post, you must show research in your writing using in-text citations and show your reference in 7th. ed. APA.

 

Reflect on the focus area – lungs, thorax, vascular and peripheral systems

• What challenges might you anticipate in completing this assessment?
• What differences might you anticipate when assessing patients across the lifespan?
• Share findings from scholarly resources that help in the performance of this assessment.

Grading Rubric

 

Discussion Question Rubric

Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Note: The value of each of the criterion on this rubric represents a point range. (example: 17-0 points)

Discussion Question Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsQuality of Initial PostProvides clear examples supported by course content and references.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

All instruction requirements noted.

40 pointsComponents are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints.

Meets all requirements within the discussion instructions.

Cites two references.

35 pointsComponents are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development.

Is missing one component/requirement of the discussion instructions.

Cites one reference, or references do not clearly support content.

Most instruction requirements are noted.

31 pointsAbsent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No references cited.

Missing several instruction requirements.

Submits post late.

27 points40Peer Response PostOffers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

2 points5Total Points100 

Discuss the events that have contributed (or will continue to contribute) to the nursing shortage, or that contribute to a shortage in a region or specialty. Discuss at least one way that the nursing profession is currently working toward a resolution of this problem. In replies to peers, offer different examples of how the nursing shortage has been addressed in your state, community, or specialty area.

Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. Discuss ways in which health care will continue this trend and explain the role of nursing in supporting and facilitating this shift. In replies to peers, provide an example of wellness and prevention initiatives your organization or specialty area has in place.