Respond  using one or more of the following approaches:

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings, or after synthesizing multiple postings.

 

                                                  INITIAL POST 

             Using evidence-based practice (EBP) is an essential tenant of nursing  practice. Therefore it is imperative to develop the skills necessary to  gather, interpret, and evaluate scientifically based data. To begin my  research for this week’s assignment, I first did a Google search of  nursing research topics to help myself generate ideas and narrow down a  problem that interested me. After considering several topics, I decided  to write about delirium in acutely ill patients.  Acute Delirium is  something that I have a lot of experience with, both personally and  professionally. The aim of my research will be to find out how  non-pharmacological interventions compare to pharmacological treatment  of acute delirium.

Search Results Analysis

             Once my topic was selected, I went to the Walden library to search for  evidence-based literature on delirium management. According to Walden  University (2018), the levels of evidence pyramid determines the quality  and amount of evidence available. The top three sections of the pyramid  are referred to as filtered results. Filtered results are comprised of  systematic reviews at the pinnacle of the pyramid, followed by  critically appraised topics, and critically appraised individual  articles. The next three sections of the pyramid are referred to as  unfiltered results and include randomized controlled trials, cohort  studies, and case-controlled studies. Background information and expert  opinions make up the base of the pyramid (Walden University, 2018). 

           I began searching for resources from the top of the evidentiary  pyramid, systematic reviews. I used the Joanna Briggs Institute EBP  Database, and then limited my search results to systematic reviews, and  set a date range of 2014 to current. I used the keywords “delirium” and  “interventions” this search yielded four systematic reviews. When I  search the term “acute confusion” I found three results. I also utilized  the Cochrane Database of Systematic Reviews, and found two systematic  reviews by searching for “delirium” in the first text box, and “nursing  interventions” in the second text box, again searches were limited to  full text with a date range of 2014 to current. I also used the Joanna  Briggs Institute EBP Database to search for critically appraised topics.  My search for “delirium interventions” yielded just one result.  However, when I searched for “delirium” I found ten results. I also  searched those same terms on Guideline Central and found four critically  appraised topics results. Finally, I searched for critically appraised  individual articles using the Evidence Alerts database, and the terms  “delirium and acute confusion” this search yielded 23 critically  appraised individual articles.

Next,  I searched for nonfiltered resources utilizing the CINAHL Plus  database. I first looked for randomized controlled trials by searching  for the terms “delirium” and “nursing interventions” in the first and  second text boxes respectively; this search query yielded four  randomized controlled trials. To find cohort studies, I typed “delirium”  in the first text box, “interventions” in the second text box, and  “cohort studies” in the third text box, this search resulted in 27  articles. I searched for case studies using the same search terms in the  first and second text boxes and limited the publications to case  studies, this search yielded 56 results.  However, when I adjusted the  filters to include case studies published within the past five years,  the number of results reduced to 14 case studies.  

Comparative Value

             I found congruency between the evidentiary pyramid and my  search results; the further down the pyramid, the more resources I  found; but, the quality of the information decreased concurrently. While  the systematic reviews were not as numerous, they are superior in terms  of scientific rigor and evidentiary support. Moreover, the information I  found within the systematic reviews were very consistent with my chosen  topic compared to information further down the period like cohort and  case studies. When search terms were altered, for example, searching for  “delirium” versus “acute confusion,” the results remained more  consistent when searching for the higher level filtered results whereas  alteration of search terms would create a wide variation in results  further down the pyramid, in the unfiltered resources. 

Polit  and Beck (2017), contend that systematic reviews are the best resources  for EBP because they contained synthesized information about a topic  from numerous evidenced-based studies. However, it is important to  recognize that the quality of evidence can vary significantly regardless  of its position within the evidentiary hierarchy (Pilot & Beck,  2017). Overall, I found greater quality and consistency of information  within the systematic reviews and critically appraised topics and  articles. Nonetheless, I found several high quality randomized  controlled trials and cohort studies that provide high-quality  information for making a comparison between pharmacological and  non-pharmacological interventions for managing delirium. 

Helpful Tips for Literature Reviews

             I found the course guide for this discussion post extremely helpful. I  followed the guide to conduct my searches, find my articles, and  evaluate the information. I also like to use Google Scholar because the  search algorithm pulls a lot of information, it does have some  drawbacks, the main one being that the articles are not always available  in full text. But, it is very user-friendly, and because it casts a  wide net, I can easily find pertinent information. If I see an article  that peaks my interest that is not available in full text, I copy the  title or other vital information and then plug that information into the  Walden University Library. I have always been able to find the article I  want using this method. I also find it helpful to organize my search  results within folders, and to tag my articles with the types of  studies. I also find that the National Center for Biotechnology  Information (2019) is a great resource for locating free, full text,  peer-reviewed, scholarly articles (National Center for Biotechnology  Information, 2019). If I find a study I know that I definitely want to  use in my work, I will create a citation and save it in a word document.  When I begin writing, I can use my reference list that I started during  my literature review as a guide. I have found that this method of  source organization is both helpful and time-saving. 

References 

National Center for Biotechnology Information. (2019). Retrieved March 4, 2019, from https://www.ncbi.nlm.nih.gov/

Polit, D. F., & Beck, C. T. (2017). Nursing research generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer.

Walden  University. (2018). Evidence-Based Practice Research: Levels of  Evidence Pyramid. Retrieved from  https://academicguides.waldenu.edu/healthevidence/evidencepyramid#s-lg-box-8700027

 Diversity among individuals, as well as cultures, provides a challenge for nurses when it comes to delivering meaningful health promotion and illness prevention-based education. How do teaching principles, varied learning styles (for both nurses and patients), and teaching methodologies impact the approach to education? How do health care providers overcome differing points of view regarding health promotion and disease prevention? Provide an example. 

 

A nurse is taking care of an 85-year-old woman in a hospital-based skilled nursing facility. In the report, the nurse is told the patient has not been breathing well for the past 2 days. She has been lethargic, her skin is warm and dry, and she has a decreased urine output. The following laboratory findings were returned from the laboratory immediately after morning report:

• Na: 147
• Cl 110
• K 4.0
• Blood Gases:
• pH 7.33
• PCO2 48
• HCO3 27
• Po2 96
• Urine:
• Urine Specific Gravity 1.040

Address the following:

1. Identify each of the abnormal laboratory findings in the above results. Specify how they differ from a normal range and identify what condition each abnormality indicates.
2. What specific electrolyte disturbance does the patient have?
3. What clinical manifestations would the nurse expect to see with this electrolyte abnormality presented above?
4. If the patient had an increase in her potassium level, what clinical manifestations would the nurse monitor for?
5. What blood gas abnormality is seen in this patient? Discuss the rationale for your answer.
6. What are the three major mechanisms of pH regulation?

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines,

Comment1

Leadership and management are both necessary for the success of any organization.  These terms are often used interchangeably by some while others see them as separate. Leaders are the inspiration, mentors, praises, and give directions to problems. Leaders may be more open with communication and participative in their encouragements of employing new concepts to help resolve a crisis. Managers are the planners, problem finders and solving, communication with team solving the problems. Managers may be known as having a stronger talent in solving problems and making use of scientific methods to come up with substantial solutions they the team may face every day (Huber, 2014).

I believe that the overlap between leadership and management are necessary for success. As a nurse manager and leader, I see this every day. Our nurse managers are also considered part of the leadership team. Our A-team, administration, would be considered the leaders in regards to this question. We are a rural hospital so we all work every close together and have an open communication among us. An example that I witnessed lately in the overlap is the construction on my psychiatry floor. We are in the process of updating our unit. There are construction workers in and out of the unit who does not understand that psychiatry is locked down for a reason.  As a manager, I have spoken with them and explained the rationale; I have spoken with their supervisors and explained the rationale. They all state they understand but I continue to witness the misbehavior entering and exiting the unit on the cameras in my office. I then go to my administration for guidance and help with the outside contractors. I experience guidance, open communication, and the administration goes to “manage” the construction crew.

Comment2

Leadership is the process of influencing people accomplish goals .The key concepts related to leadership are influence, communication, group process, goal attainment and motivation (Huber, 2013). Management is the coordination and integration of resources through planning, organizing, coordinating, directing and controlling to accomplish specific institutional goals and objectives (Huber, 2013).

Leadership is one of the most important factors that determine the survival and success of groups and organizations. Effective leadership is important in nursing because of its impact on the quality of nurses’ work lives, being a stabilizing influence during constant change, and for nurses productivity and quality of care. In leadership quality of life depends on quality of leaders. The leadership focus is on people, human relationship aspects while management focuses on systems, structure and tasks accomplishment (Huber, 2013).

Please provide proper citation with page numbers of the material you are referencing in your Main Post.

Please write 1 paragraph for each of the following (total 3 paragraphs) and each paragraph shall be no less than 3 sentences and no more than 6 sentences.

Main Post

1. Discuss one male reproductive system disorder and relate how you would plan and intervene
2. Discuss one diagnosis related to transgender care and how you would plan and intervene
3. Discuss one sexually transmitted disease in men or women and related few possible treatments