The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control with sodium restriction. He current works at a catalog telephone center.

Objective Data

1. Height: 68 inches; Weight 134.5 kg
2. BP: 172/96, HR 88, RR 26
3. Fasting Blood Glucose: 146/mg/dL
4. Total Cholesterol: 250mg/dL
5. Triglycerides: 312 mg/dL
6. HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL      PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
2. Ranitidine (Zantac) 300 mg PO at bedtime.
3. Sucralfate/Carafate 1 g or 10ml suspension (500mg /      5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

1. Assess each of Mr. C.’s functional health patterns      using the information given. (Hint: Functional health patterns include      health-perception – health management, nutritional – metabolic,      elimination, activity-exercise, sleep-rest, cognitive-perceptual,      self-perception – self-concept, role-relationship, sexuality – reproductive,      coping – stress tolerance.)
2. What actual or potential problems can you identify?      Describe at least five problems and provide the rationale for each.

 1 PAGE REPONSE NEEDED APA STYLE REFERENCE MUST BE LESS THAN 5 YEARS OLD  FOR ADVANCE NURSING INFORMATICS CLASS

Without the various roles and expertise of professional nurses in the development of nursing informatics, clinical information systems would not be able to have a foundation based on evidence-based practice. Evidence based practice is essential to developing clinical information systems in order to further the generation of nursing knowledge. Evidenced based practice is a process that uses the current best evidence in the care of patients as an approach to problem solving (McEwen & Wills, 2017). By nature, nurses gather data and record and collect clinical data that is objective on a daily basis. Professional nurses will gather this clinical data and identify trends seen across groups of patients (McGonigal & Mastrian, 2017). A solution to a problematic trend may be identified, implemented and seen to improve or make a positive impact on such trend which would be an example of evidence-based practice.

            The use of nursing informatics through the electronic medical record, which is one of the most widely used clinical information systems in nursing today, has been heavily dependent on evidence-based practice. The EMR can be broken down to professional nurses chronicling their daily clinical challenges and queries (McGonigal & Mastrian, 2017). Documenting in an EMR includes using clinical practice guidelines which have been generated through evidence-based practice. For example, a patient can be identified as a fall risk using a basic fall risk assessment that has been previously synthesized to tailor specific criteria in identifying fall risks through daily nursing practice. This will usually would include age, previous fall incidence, medication, mobility and cognition. Once this fall risk has been identified, the nurse would open a clinical practice guideline parameter to document implemented patient centered care and focused interventions in the real-world setting (Vance, 2012). This is merely one example of knowledge brought into the CIS through research conducted by nurses. Evidence based practice was founded only to be useful in integrating into clinical information systems when is it used in clinical workflow (Bakken, Currie, Lee, Roberts, Collins & Cimino, 2008).  Hence, the implementation of the CPG driven support system. Every clinical practice guideline has been developed through the use of evidence-based practice and then brought into the clinical information system of EMR.

            The use of an info button is another example of evidence-based practice incorporated into CIS. The primary advantage of the info button approach from the clinician perspective is that the information provided is context-specific (Darvish, Bahramnezhad, Keyhanian & Navidhamidi, 2014). Info buttons actually serve as an additional source of evidence-based practice which can be accessed within another clinical information system, such as an EMR. They can be used to determine critical lab results and possibly their perspective treatments or they can be used to gain access to medication inquisitions. In both instances, the use of evidence-based practice is the foundation of the knowledge and information used.

           Incorporating the use of informatics through clinical information systems such as electronic health records and info buttons allows for information to be computed on a daily basis. Through research, nurses become experts on analyzing and synthesizing knowledge and furthermore put the knowledge to practice with patients and family members. Clinical information systems are a vessel of nursing evidenced based practice put into clinical workflow which allows the continuous and further generation of nursing knowledge. Since clinical information systems are used widely throughout the nursing practice from bedside nurses, nurse practitioners to nurse researchers, it is imperative that the information being provided by such systems stay evident and factual, through evidence based practice.

 

PICOT Question Paper

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

1. Evidence-based solution
2. Nursing intervention
3. Patient care
4. Health care agency
5. 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.

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

RUBRIC

Attempt Start Date: 24-Feb-2020 at 12:00:00 AM

Due Date: 01-Mar-2020 at 11:59:59 PM

Maximum Points: 60.0

 

Benchmark – Capstone Change Project Objectives

Review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale.

After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations.

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 not required to submit this assignment to LopesWrite.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.5:  Advocate for autonomy and social justice for individuals and diverse populations.

RUBRIC

Attempt Start Date: 24-Feb-2020 at 12:00:00 AM

Due Date: 01-Mar-2020 at 11:59:59 PM

Maximum Points: 5.0

 

Professional Capstone and Practicum Reflective Journal

Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. Health disparities

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation 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 not required to submit this assignment to LopesWrite.

RUBRIC

Attempt Start Date: 24-Feb-2020 at 12:00:00 AM

Due Date: 01-Mar-2020 at 11:59:59 PM

Assessment Type: PRACTICE

Maximum Points: 0.01

What is the difference between a group “at risk” for poor health and a group considered a “vulnerable” population? Provide an example of an “at risk” or “vulnerable population” group in the United States and one in another country (or immigrants within the United States).

 1.Explain why members of these groups cannot advocate for themselves or why advocating for these groups would be beneficial.

 2.What would you advocate for? 

3.Identify ethical issues that need to be addressed when working with these individuals. 

4.Provide information about the selected “at risk” group. How many individuals fall into this group and what are some issues they face.

 3 page paper This assignment requires proper APA format. This includes a title page, reference page, and proper headings.  

 Please use AHRQ , an organizational evidence-based standard and/or  applicable education Best Practice to guide your topic development. The introduction gives some history of the topic, the reason it is important to nursing practice and/or nursing education.

Include title page and reference page addressing the following:

• Background of a clinical practice problem or educational problem related to your practice.  The PICO(T) format is used to organize research evidence to address clinical problems. You will use the PICO(T) question to identify relevant studies needed to develop evidenced based practice or best practices in nursing education. 
•  This assignment is the first step in completing the final paper on a researchable topic in either nursing practice or nursing education.