The following is another student DQ post to wish a have to reply adding some other information related to the post. Remember APA and less than 20 % similarity. 

Professor instructions:

All your postings should have references and citations

All your postings should have three paragraphs with three sentences

Student Post:

 

Question 1

Boundaries exist in every context whether it is professional or personal. As stated by Masters, professional boundaries draw a line between the nurse’s power and the patient’s vulnerability (2020). A nurse has power because of the knowledge and the role she plays in the patient’s care and the amount of information she has access to regarding their health. The balance must be maintained for the integrity of nurse-patient relationship to be intact (Masters, 2020).

A violation of a professional boundary occurs when said balance is altered from either part. This creates a lack of trust and puts in jeopardy the relationship. There are many ways in which a nurse can cross or violate professional boundary such as lying, disrespecting, altering information and more serious ones include sexual misconduct or exploitation (Masters, 2020).

Patients are often extremely grateful for the hard work nurses do. In their effort to show this they can engage in gift giving. However, nurses allowing or receiving compensation of some sort such as monetary for the services given constitutes a violation of boundary (Masters, 2020). Also sharing personal information, intimate details or behaviors such as flirting can be considered a violation or crossing of boundaries (NCSBN, 2018).

Question 2

Terminal sedation is usually considered for terminal patients. As the term implies, these patients have reached a stage in their disease where relief of symptoms such as pain and agitation are not obtained despite attempts (van Delden, 2007). Along with other decisions, the decision to artificially feed or provide fluids has ben also withheld. Terminal sedation refers to a sedation that precedes an expected death (van Delden, 2007). Terminal sedation is another way of ensuring compassionate end-of-life care and not just hastening death (Masters, 2020).

Rational suicide differs from suicide in the sense that the person involved in it is not emotionally disturbed, understand the magnitude of the situation and would seem logical to anyone not related to her (Masters, 2020). This continues to be an ethical issue because the idea of encouraging suicide despite circumstances goes against a nurse’s oath. In understanding the situation as a nurse, we are honoring a patient’s right to decide what to do at the end of life.

Assisted suicide brings many negative connotations and outrage. Assisted suicide means to facilitate a patient’s death by providing a doe of medication that is lethal. In this case the patient administers the medication provided by a physician. The Oregon Death with Dignity Act was the first law that allowed for this method of dying to be used (Masters, 2020).

Question 3

End of life care can be conflictive for many disciplines in the health care field. Personal philosophies and beliefs often seem to influence the way it is viewed. One of the many moral dilemmas experienced by nurses during end-of-life care is their perception that by sharing the truth they are taking hopes of recovery away from the patient (Masters, 2020). This affects how information is relayed.

A fundamental concern during end of life is pain relief. Many people die without proper relief because practitioners fear they are contributing to their death or aiding an addiction. Adequate doses are not provided in many cases because it is thought to contribute to a rapid decline and death (Masters, 2020).

Another moral dilemma and perhaps a very heavy one is the fact that nurses feel their moral integrity is at stake when these modalities contradict their own views (Masters, 2020). There needs to be a thorough assessment of one’s personal beliefs and ideas as to not have them impair or shape the experience of caring for a patient at the end of their life. However, if this becomes distressful for the nurse and alternative could be to have another nurse provide the care for the patient while assisting in other aspects that can benefit the patient.

Reference

A Nurse’s Guide to Professional Boundaries (2018). National Council of State Boards of Nursing, Inc. Retrieved from https://www.ncsbn.org/ProfessionalBoundaries_Complete.pdf

van Delden J. J. (2007). Terminal sedation: source of a restless ethical debate. Journal of medical ethics, 33(4), 187–188. https://doi.org/10.1136/jme.2007.020446

Masters, K. (2020). Role development in professional nursing practice (5th ed.) Burlington, MA: Jones & Bartlett Learning

  

Please carefully read all the instructions below and use the attached Prospectus Checklist and Template to complete this assignment in APA format with a minimum of 15 to 20 scholarly references less than five years old.

The facility recently transitioned to a new and better electronic health record system and also purchased standardized care plans which are supposed to be more efficient, unfortunately, the compliance with using the standardized care plans by the inpatient nurses is only 40%. Also, the facility recently had a visit of the Joint Commission and received a negative mark for the nurses not adding care plans based on the patients’ primary problem (s) or diagnosis in the patients’ charts upon admission. 

Title: Educating Inpatient Nurses to use Standardized Care Plans (Based on this title, please formulate a PICO question which gear on educating the nurses to use the hospital standardized care plans)

Main Problem with the nurses in the Hospital.

(1)   There’s poor compliance with the nurses not adding the standardized care plans to the patient’s chart based on the patients’ diagnosis or primary problem(s) upon admission to the facility.

(2)    Nurses are not using the already built in standardized care plans in the electronic health record system of the hospital to include individualized standardized care plans to the patients’ chart based on the patients’ diagnosis or primary problem(s) upon the patients’ admission to the hospital.

(3)   The hospital recently had a visit of the Joint Commission and got penalized for the nurses not adding care plans to the patients’ chart based on the patient’s diagnosis or primary problem(s) to the already built-in individualized patient care plans in the hospital electronic health record system.

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What are the benefits of adding and documenting on individualized standardize care plan in patient’s chart? 

               ___ Set of care plans are available and nurses do not have to develop a care plan

               ___ If nurse selects and adds care plan, it will automatically populate into patient’s chart

               ___ Patient’s educational tablet is dependent on nurses’ completion of adding care plan to the

patient’s chart.

               ___ Decreases nurses’ workflow time because preset care plan

               ___Nurses do not have to do any follow up teaching on care plan 

Revised PICO Question: Will an educational tool increase the inpatient nurses’ knowledge about the use of the hospital newly built-in standardized care plans system as compared to not using the standardized care plans?   (based on all the above, I came up with this question, but you can correct it or formulate a better one which gears towards educating the inpatient nurses to use the standardized care plans)

Problem: 

1) Poor compliance, just 40% of the hospital inpatient nurses are using the hospital newly built-in standardized care plans.

2) The Joint Commission (JHACO) penalized the hospital during a recent visit to the hospital because only a small percentage of the admitted patient had a care plan upon admission based on their diagnosis or primary problem(s).

3) The hospital recently transitioned to a new and better electronic health record system (EHRs) and some nurses are stating that they haven’t received enough education on how to use the standardized care plans on the hospital new EHRs.

 

Below is the Joint Commission Standard for Care Plans

Joint Commission Standard

• The      medical record contains the following clinical information:

– The reason(s) for admission for care, treatment, and services

– The patient’s initial diagnosis, diagnostic impression(s), or condition(s)

– Any findings of assessments and reassessments 

– Any allergies to food

– Any allergies to medications

– Any conclusions or impressions drawn from the patient’s medical history

and physical examination

– Any diagnoses or conditions established during the patient’s course of

care, treatment, and services (including complications and hospital acquired

infections). 

– Any consultation reports

– Any observations relevant to care, treatment, and services

– The patient’s response to care, treatment, and services

– Any emergency care, treatment, and services provided to the patient

before his or her arrival

– Any progress notes

– All orders

– Any medications ordered or prescribed

– Any medications administered, including the strength, dose, route, date

and time of administration

– Any access site for medication, administration devices used, and rate of

administration

– Any adverse drug reactions

– Treatment goals, plan of care, and revisions to the plan of care 

– Results of diagnostic and therapeutic tests and procedures

– Any medications dispensed or prescribed on discharge

– Discharge diagnosis

– Discharge plan and discharge planning

• The hospital plans the patient’s care      based on needs identified by the patient assessment, reassessment, and      results. The written plan of care is based on patient goals and time      frames required to meet goals. Patient care plan is based on established goals where      staff evaluate the patient progress Patient’s care plan is revised with      goals based on patient’s needs

POPULATION: Inpatient Nurses

INTERVENTION: (Will an educational tool?) Best method on educating inpatient nurses on identifying appropriate patient’s diagnosis or primary problem upon admission to select individualized care plan and document on the interventions / progress toward patient goals each shift in Epic EHRs. 

COMPARISON: Regular Care plan

OUTCOMEs: 

• Patient      Outcome: 
  • Reduced       variability in patient care delivery. Accurate monitoring of progression       toward evidence-based care plan interventions and goals. 
  • Accurate       monitoring of patient education progression driven from correct diagnosis-based       care plan added on admission to       the patient’s chart.
    • Metrics: nursing documentation on education,        interventions, and care plan goals
• Process      Outcome: 
  • Nurse       will increase correct application of evidence-based care plan based on       identification of correct diagnosis or primary problem upon admission       Increase documentation of evidence-based interventions and patient       progress toward care plan goals in EPIC each shift. . 
  • Increase       completion of education/learning assessment upon admission and each shift. 
    • Metrics’        compliance: correct application of care plan based on admitting        diagnosis, shift documentation of evidence-based interventions and care        plan goals, patient education/learning assessment documentation

 

1. Define and describe a coalition.

2. Select at least one coalition active in your own community.

3. How does your selected coalition operate?

4. How is the coalition governed?

5. What impact do you believe this coalition has on your community?

6. Utilized two quality references (current – within 5 years),

7. Accurate spelling and grammar, correct APA formatting(Bold and center criteria)

RE: ROLE OF OPIOID EDUCATION FOR THE YOUTHS

 Data from the participants in this study were collected using a case study approach. A case study is usually a descriptive observation qualitative research method that focuses on evaluating and or investigating a phenomenon in real-life situations (Hennink, Hutter & Bailey, 2020). In the study, data or information from the participants were collected using various tools and approaches. Primary tools of data collection were both structured and unstructured interviews. The choosing of these two tools was informed by the study design, which focuses on obtaining detailed information about a phenomenon which, in this case, was the experience of the youths who abuse drugs and substance. The sampled group reported being using cannabis and other opioids on many occasions. Therefore, the objective of this case study was to evaluate the real-life experiences of the youth when they were using drugs.

    Case study research design is preferred for studying such a phenomenon because of so many reasons. First is that employees random sampling of participants to provide responses that would answer the research questions. Data from the interviews were stored or recorded in books, journals, and digital forms where video and audiotapes were used. Different forms of collected data were analyzed using different methods. Prior to analysis, data were cleaned to ensure validity and accuracy. Video and audio recordings were transcribed before the final analysis. The final analysis of data was done using descriptive statistics where the variables of research were measured in the frequency in which they occurred. Correlational analysis was used to determine the relationship between different variables in the study (Lune & Berg, 2016). Therefore, the findings of this qualitative research were presented as descriptive information detailing the experiences of the youths who use drugs and other substances.

References

      Hennink, M., Hutter, I., & Bailey, A. (2020). Qualitative research methods. SAGE Publications   Limited.

        Lune, H., & Berg, B. L. (2016). Qualitative research methods for the social sciences. Pearson Higher Ed.

Reply

what the professor said:
Re: RE: Role of Opioid Education for the Youth (2)You have incorrectly formulated this section. Please fix and resubmit.

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Discussion Forum: Writing the Discussion Section

Substance use results into vast majority of life years lost due to illnesses, disability and premature deaths among those aged 15 to 24. It is arguably the most important modifiable health behavior that has impacted the youth. Due to the times we are in, youth are faced by a vast landscape of more potent products, new delivery methods, and synthetic alternatives such as electronic cigarettes, fentanyl, codeine products and potent cannabinoids. These are far more addictive than psychoactive substances that were available to teenagers in the past (Reid, Wild, & Bozarth, 2020). Marijuana, alcohol and tobacco products are more commonly used in high school students as compared to opioids abuse thus the secondary prevention that is to say, initiating treatment of other substance use way before the use of opioids ever begin as logical strategy.

 The American academy of pediatrics has called on pediatricians to screen all young adults as well as adolescents for use of substance use and manage the whole spectrum, starting from preinitiation to SUD. Integrating SUD treatments within a pediatrics primary care, as well as engaging primary care providers in managing of substance use as they do to people with other disorders, it has the potential to radically revise as well as dramatically increasing access to SUD treatment for the youths (Drake, 2017).

Among adolescents, Opioid Use Disorder (OUD) are not as common as tobacco, marijuana and alcohol disorders although the death rate of patients with untreated OUD is high. The treatment of OUD include prescription medications, there is use of model that combines both primary care management as well as an integrated behavioral health specialists while at the same time having an expert backup which has demonstrated as being acceptable in the pediatric primary care as well as being feasible with the subspecialist support (Pfeiffer, 2019).

Reply

what the professor said 

Re: Role of Opioid Education for the YouthYou need to compare the Results with your initially stated Hypothesis and interpret them.