When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

• Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
• Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

By Day 6 of Week 7

Respond to at least two of your colleagues* on two different days by either supporting or respectfully challenging their explanation on whether there is an evidence base to support the proposed health policy they described.

Discussion 1: Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

To Prepare:

• Review the Resources and examine the leadership theories and behaviors introduced.
• Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
• Reflect on the leadership behaviors presented in the three resources that you selected for review.

By Day 3 of Week 4

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

Learning Resources

Required Readings

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)
Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)
Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194)

Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3

Resources for the StrengthsFinder Assessment Tool

Rath, T. (2007). Strengths Finder 2.0 – with Access Code.
Purchase the access code from the Walden bookstore. Then follow the instructions in the document “How to Access the Strengths Finder 2.0.
 

Document: How to Access Strengths Finder 2.0 (PDF)

 

Required Media

Laureate Education (Producer). (2014). Leadership [Video file]. Baltimore, MD: Author.
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Moore Foundation. (n.d.). Nurses share lessons in leadership. Retrieved from https://www.youtube.com/playlist?list=PLopRJPO6GaifsYPGP_jcWXZzU10H3AaX7

3sources for this discussion

Post a draft of your cultural and ethical inquiry paper for peer review. You should also post your level 1 and level 2 research questions. Identify any questions or challenges you faced with the assignment, or mention something new you learned about the research question and inquiry paper process. Pose specific questions you would like your peers to address.

Over the topic uploaded on patient satisfaction in the ED over cultural and ethical perspective analysis 

in the draft include the level 1 and 2 question like this as an example with 3 scholarly sources for draft 

Level 1 Research Questions/Writing Prompts
ETHICAL Perspective of Inquiry

• What laws govern or pertain to the issue?
• What ethical obstacles affect how the medical community addresses the issue?
• How do ethical theories apply to the issue?
• How do money, power, and control matters relate to the issue and its treatment?

Level 2 Research Questions/Writing Prompts
CULTURAL Perspective of Inquiry

• Which cultural values and/or norms influence the issue?
• How is the issue addressed differently in varying cultural contexts and situations?
• Which cultures or societies are most affected by the issue? Why?
• Which cultural traditions affect the treatment(s)?

 

Part one: explain the differences between clinical and personal mental health recovery and discuss how personal recovery can enhance the wellbeing of people who experience psychotic disorders.

Part two: reflect on how you, as a future registered nurse, can use therapeutic communication skills (e.g. active listening, probing, empathic responding) to assist a consumer living with the effects of a psychotic disorder identify their strengthens and embark on a personal recovery journey. Include no more than two examples of communication skills in your answer.

Support your explanation and reflections with peer-reviewed articles, including nursing literature.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.