1)After you read the module information regarding new technologies, answer the following questions: What are the issues surrounding selection and implementation of new types of technology? Focus on public demand, physician reaction, and issues of cost, among other concerns.

2)Discuss your thoughts and ideas about the newer trend of pharmaceutical and medical supply companies marketing directly to the consumer (e.g., ads about new medications, billboards for new hip and knee implants, etc.). What do you see as the pros and cons?

Use any of these as references  

answer thes dqs in 250 words including intext cite and apa references

https://www.ahrq.gov/research/findings/ta/index.html

“Barriers to Electronic Health Record Adoption: A Systematic Literature Review,” by Kruse, Kristof, Jones, Mitchell, and Martinez, from Journal of Medical Systems (2016).

“Too Much or Too Little? How Much Control Should Patients Have over EHR Data?,” by Bhuyan, Bailey-DeLeeuw, Wyant, and Chang, from Journal of Medical Systems (2016).

“Use of Electronic Health Record Data for Quality Reporting,” by Abernethy, Gippetti, Parulkar, and Revol, from Journal of Oncology Practice (2017)

Comment 1

I work on a Labor and Delivery/Postpartum unit. I work the night shift for the past 19 years and I have seen the high rate of nurse turnover and struggle with nurse retention. Of the varied reasons for discord is the perception and role that the new nurses are expected to jump into after a harried orientation. I also see the inability to conform or endure the role of a night nurse on a very busy unit. 

Expectations seem to be unrealistic and not well defined when progressing through the orientation process that begins on the “day” shift when a orientee is hired for a night shift position.  According to Mazhindu, D. M., Griffiths, L., Pook, C., Erskine, A., Ellis, R., & Smith, F. (2016), the resilience and devotion to performing the job hired for is not clear or misinterpreted. Also the financial aspect of training or orienting nurses is always increasing. According to Colosi (2018), the 2018 National Health Care Retention & RN Staffing Report shows that the average cost of RN turnover ranges from $38,000 to $61,000 which translates into the hospital cost for turnover  ranging from $4.4M – $7.0M. 

Comment 2

I currently work in a sub-acute unit of a long term care center. The center has two units, the senior nursing facility (SNF) and sub-acute unit. My unit is very different from the SNF side because they all have tracheotomies, require total care, most of them have PEG tubes, and their acuity is higher. It is a 27-bed unit and each nurse is usually responsible for 6-8 patients over an 8 hour shift. The unit is divided into four different carts and some carts are more difficult than others. We are not only responsible for medication pass, but we also need to assist our CNAs with ADLs. A major problem the organization is facing is the high turn-over rate. I have only worked at the facility for a year and it took me about 4 months to finally get used to the unit. It is a very difficult unit to work on and many nurses have quit because they are not adequately trained. The length of training is only 1-2 weeks and at most 8 shifts total. Most of the time it is usually less until the nurse is put on the floor by themselves. Luckily, most of the nurses are very nice and helpful, but everyone is busy so it can be hard to stop what you’re doing to help the new nurse. The major problem is the inadequate training that new nurses receive.

Two implications for nursing involve adequately training nurses to improve retention. Providing adequate training to new nurses is vital because not only increases their chances of staying with the organization, but improves their competency in giving their patients the most appropriate care. Another implication is the cost for turn-over and according to Maryniak, Markantes, & Murphy (2017), the cost of turn-over for a clinical RN ranges from $37,700 to $58,400. Training new nurses is not only very costly, but also time consuming as well. Fixing the problem of inadequate training of nurses is vital because if a nurse feels overwhelmed, they are more likely to leave and find a place that prepares them better.

Comment 3 (Abigail)2 DQ 2

I think that the main issue that my organization is addressing is providing patient safety through quality care. There have been many in-services dedicated to making sure that we keep our patients safe by making sure we follow correct protocols in regards to moving and transferring. The also made sure that the residents that are a fall risk have an armband. Some of them even have mats placed by the bedside as well. According to van Gaal, Schoonhoven, Vloet, Minties, Borm, Koopman, & Achterberg (2010), educating staff and about proper interventions increases patient safety. They also mentioned that passive education (written material and large-scale educational meetings) is less effective than education that is personal and interactive. A great way for an organization to address and resolve patient safety and quality care issues, would be to require the employees to stay-up-to date on evidence-based practices. This can be accomplished by providing the information and requiring them to read the material, answer some questions based on the material, and go through a skills check off list and demonstrate how tasks should be completed. This way, the employee will read the information, be able to write or say the answers based on questions, and implement them in a clinical setting.

Book : Role development for professional nursing practice. 

Personal Philosophy of Nursing Essay

Use the questions from Box 3-2 on page 111 of your textbook as a guide as you write your personal philosophy of nursing. The essay is to be typewritten and double-spaced (1,000 words) and should include the following:

1. Introduction that includes who you are and where you practice nursing
2. Definition of nursing
3. Assumptions or underlying beliefs
4. Definitions and examples of the major domains of nursing
5. Summary that includes answers to the following questions:

 a. How are the domains connected?

   b. What is your vision of nursing for the future?

 c. What are the challenges that you will face as a nurse?

 d. What are your goals for professional development?

As adolescents separate from their parents and gain a sense of control, sometimes they are unable to balance stresses. As a result, depression may occur, and, at times, suicide may be the outcome. Choose the topic of either adolescent depression or adolescent suicide. Discuss contributing factors and signs and symptoms that may be observed or assessed in these clients. Describe primary, secondary, and tertiary methods of health prevention for this topic. Research community and state resources and describe at least two of these for your chosen topic. What nursing interventions could you use to assist an adolescent you suspect is depressed beyond referring the adolescent to a state or community resource?

Please, respond to the following discussion in one  paragraph, using only one reference from peer-reviewed Nursing Journal not older than  years. APA format required, no need for cover page.

Changes in Eyes Due to Certain Medical Conditions and Ear Changes Caused by Aging Process

The eyes are our windows to the word. Different medical conditions can cause changes to the eyes. In this discussion I will write about Cataracts, Glaucoma, Diabetes Mellitus, and Chronic Hypertension.

Cataracts is when protein clumps up and clouds the lens, this reduces the light that reaches the retina. The easiest symptom to see objectively is clouded eyes. The patient complains of sensitivity to light and glares. Difficulty with night vision and halos around lights is also a complaint. Blurred vision is reported due to seeing thru clouded eyes.

Glaucoma causes damage to the optic nerve and gets worse over time. It can cause vision loss and blindness overtime. Early treatment can protect from vision loss. Symptoms can be hazy or blurred vision, rainbow colored circles around bright lights, severe eye and head pain, nausea and vomiting with eye pain and sudden eye loss.

Diabetes Mellitus can lead to Diabetic Retinopathy which affects vessels in the light sensitive tissue called the retina. This is the leading cause of blindness among the working age. Symptoms can be wavy vision, color changes, spots or floaters, trouble with night vision. Increase in sugar level causes the lens of the eye to swell which affects vision. Decrease in sugar level causes blurriness and double vision.

Chronic Hypertension can cause damage to the blood vessels in the retina, the area at the back of the eye where images focus, this is known as hypertensive retinopathy. This can lead to blindness. Symptoms can be fluid oozing from blood vessels, double vision, blurred vision, swelling of the optic nerve or macula, and spots on retina known as cotton wool spots.

These conditions can be managed and prevented in some cases if not most with proper attention and education.

There are changes to the ears due to the aging process. Older adults should be asked about hearing loss, vertigo, ringing in the ears ( tinnitus), and even dizziness.

Otoslerosis is a possibility especially in older adults. Otoslerosis happens due to slow fusion of ossicles in the middle ear, this obstructs sound waves. This can cause difficulty with distinguishing sounds when it is noisy. Mumbled speech can also be a symptom.

Presbycusis happens over time and it is a natural sensor neural loss. The hair cells in the cochlea become less flexible. Hearing deficiency is a symptom.

During Review of Systems these conditions should be asked about. Sometimes patients are not even aware of these changes and need to be educated so they can seek help.