Discussion Board. 

250 words minimum,  APA style. 2 references.

Reflect on the various settings in which family nurse practitioners are able to work. Currently in primary care, specifically community health centers, there is a significant need to hire more advanced practice nurses to meet the care needs of patients in both rural and urban populations. Read the article attached below and examine what role does the Community Nursing Practice Model have in achieving better access, care delivery and outcomes to patients living in underserved communities. 

Identify 1 (one) MSN Essential most correlates to this discussion related to community nursing practice.

Nurse Practitioners in Community Health Settings Today Article: http://clinicians.org/images/upload/wessel_nurse_practitioners.pdf 

I have also attached additional information pertaining to community health from the Center for Disease Control (CDC).

CDC Community Health Improvement Navigator: https://www.cdc.gov/chinav/  

In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:

1. The purpose of the quality improvement initiative.
2. The target population or audience.
3. The benefits of the quality improvement initiative.
4. The interprofessional collaboration that would be required to implement the quality improvement initiative.
5. The cost or budget justification.
6. The basis upon which the quality improvement initiative will be evaluated.

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. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

A nursing conceptual model is an abstract way of showing the way concepts interrelate which include the 4 basic nursing concepts which are; nursing, person, health, and environment (Cherry and Jacob, 2017). These concepts are defined differently by various theorist, resulting in varying theories due to the different perspectives of how these concepts relate to one another (Cherry and Jacob, 2017). It is from the conceptual model that a hypothesis is created (Cherry and Jacob, 2017) Through research and testing, a nursing theories validity is strengthened (Mock et al., 2007). According to McKenna, Pajnkihar, and Murphy, “Theory exists at different stages of development and a conceptual model is a stage of development on the way to becoming a theory” (2014, p.106). The purpose of nursing theory application is to improve nursing practice (Whitney, 2018).

Richard Lazarus’ theory of stress, coping, and adaptation addresses the psychological coping mechanisms that are due to stress (Whitney,2018). “Psychological stress is a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being” (Lazarus & Folkman, 1984, p. 19). Coping is defined by Lazarus and Folkman “as constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person” (1984, p. 179).

This theory can be used in practice with every client admitted to the hospital or any client that encounters a healthcare professional. Simply going to receive a physical can induce a stress response and elevate the blood pressure in a phenomenon known as white coat syndrome. On the other end of the spectrum there is the stress responses from illness or trauma that have effects on the body such as elevated blood glucose levels, elevated cortisol levels, heart rate, and so on. Additionally, the psychological responses clients use for coping such as becoming withdrawn, angry, needy, aggressive, passive aggressive, depressed, afraid, nervous, and so on. By being cognizant about these coping mechanisms related to the stressors the client is facing, as nurses, we can assess, identify the problem, and seek necessary resources if needed, in order to intervene so that the client can cope more effectively or so that the initial stress can be removed. For example, if a client is afraid of having to go spend the night in the hospital, and is coping by yelling out on the unit, the nurse can intervene by addressing the stressor (fear of sleeping in hospital), and by resolving the stressor, the negative coping mechanism will resolve as well.

The interpretation of research in health care is essential to decision making. By understanding research, health care providers can identify risk factors, trends, outcomes for treatment, health care costs and best practices. To be effective in evaluating and interpreting research, the reader must first understand how to interpret the findings. You will practice article analysis in Topics 2, 3, and 5.

For this assignment:

Search the GCU Library and find three different health care articles that use quantitative research. Do not use articles that appear in the Topic Materials or textbook. Complete an article analysis for each using the “Article Analysis 1” template.

Refer to the “Patient Preference and Satisfaction in Hospital-at-Home and Usual Hospital Care for COPD Exacerbations: Results of a Randomised Controlled Trial,” in conjunction with the “Article Analysis Example 1,” for an example of an article analysis.

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, which can be found in the APA Style Guide, located in the Student Success Center.

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

AttachmentsHLT-362V-RS2-ArticleAnalysisExample-1.docx
HLT-362V-RS2-ArticleAnalysis-1-Template.docx

Ethical Dilemna

Please reply to the following discussion with one reference.  

Professor and fellow classmates,

I viewed the documentary titled “The Invisible Patients documentary” and an ethical dilemma that was experienced by the nurse practitioner is the decision about hospice care. The patient has a right to decide how they want their life to end in regard to resuscitation, and it is one of the nurse practitioner duties to educate the patient on what a do not resuscitate (DNR) means and the  accept their terminal prognosis or to have do-not-resuscitate (DNR) order (Bhatnaga & Lagnese, 2019). Patients should be allowed to receive all the care needed until the end of their life. The nurse practitioner in the video appears to be giving her personal views and wanting to listen to the patient and his wishes. Roger verbalizes his desire to live even on a respirator and it is not the duty of the nurse practitioner to discourage the patient from the right to desire life.

The nurse practitioner in the documentary as a disruptive innovator was her desire of delivering and have more nurses in primary care because they reach patients that are in unfortunate situations and needs the help of the nurse practitioner to provide care and advocate on their behalf whether by calling doctors or coordinating care on their behalf. An awareness of personal values generates more consistent choices and behaviors; it can also assist APNs to be aware of the boundaries of their personal and professional values so that they can recognize when their own positions may be unduly influencing patient and family decision making (Hamric, 2014). The nurse practitioner should separate their personal beliefs from situations that where an ethical dilemma is involved and follow the nurses code of conduct to make appropriate decisions.

Overcoming barriers when faced with ethical dilemma is being an active listener with good communication skills. We must listen to the patients concern and wishes and communicate with them at a level that is understandable and open to answer questions with clarity.

References

Bhatnagar, M., & Lagnese, K. R. (2019). Hospice Care. In StatPearls [Internet]. StatPearls Publishing.

Hamric, A.B., Hanson, C.M., Tracy, M. F. & O’Grady, E. T. (2014). Advanced Practice Nursing:  An Integrative Approach, (5th ed.). Saunders. ISBN: 9781455739806

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