Module 06 Discussion – Prevention of Shock

Your patient is a 42-year-old female that arrives in the ED with complaints of fever and not feeling well. She is currently undergoing chemotherapy for bladder cancer. She has an indwelling urinary catheter with a scant amount of dark, foul-smelling urine. She has a temperature of 102.2F, HR 136, BP 110/50, and RR 28. She is allergic to penicillin and Sulfa.

What type of shock is she experiencing?

What interventions do you anticipate the doctor will order?

What can you teach this patient about the prevention of infection?

The doctor orders Bactrim. What should you be concern about? Why?

Include in-text citation and 3 references

Apa format.. Scholar authors only.. 3 paragraphs. Please read all instructions. THIS WILL BE Need to be CLABSI THAT OCCURS IN INTENSIVE CARE UNIT. Read all instruction.

Choose a Quality Improvement Model from Chapter 5 in the Spath (2018) textbook, and apply this model to your practice problem. Please do not choose Lean or Six Sigma as your quality model unless you have an expert in these quality models in your organization to guide you through the process.

PDSA (p.124).
RCI (p.127).
FOCUS PDCA (p.128).
FADE (p.129).

Discussion:

 Discussion entry describing the model that you selected and how each step of the model will be used to develop the plan for the Practice Experience Project. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project, and share this information with your group.

Reference

Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.
Chapter 4, “Evaluating Performance” (pp. 79-118)
Chapter 5, “Continuous Improvement” (pp. 119-142)
Chapter 6, “Performance Improvement Tools” (pp. 143-174)
 

Note: Although Chapter 4 is previously assigned reading, please review it in preparation for this week’s material.
 

Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). St. Louis, MO: Mosby.
Chapter 19, “Building Effective Teams” (pp. 335-356)
 

Microsoft. (2016). Use charts and graphs in your presentation. Retrieved from https://support.office.com/en-gb/article/Use-charts-and-graphs-in-your-presentation-c74616f1-a5b2-4a37-8695-fbcc043bf526

  

Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality and Safety, 20(1), 46–51.
 

Document: Patient Satisfaction with Pain Management Run Chart (PDF)

 

Answer the following questions in three well-developed paragraphs (450–500 words) using APA formatting, integrating two evidence-based resources to include clinical practice guidelines as well as the course textbook.

RR is 48-year-old Hispanic woman who comes to see you at the V. A. homeless clinic. The major complaint is a six-day history of worsening cough, productive of green sputum. There have been fever and chills with complaints of pain in the right mid-back with deep breathing or coughing. Further history reveals a history of tobacco use of one pack of cigarettes a day for 30 years. There is an incontainent health history as a result of Post Traumatic Stress Disorder (PTSD) and homelessness. On examination, the skin is warm and clammy, pale; RR appears to not feel well; the temperature is 100.5° F; respiratory rate is 24 breaths per minute; pulse is 98 beats per minute; blood pressure is 120/75 mm Hg; and saturation of oxygen is 96 percent on room air by pulse oximetry.

Auscultation of the lungs reveals rales in the right lower-posterior lung field. The remainder of the examination is within normal limits.

1. What organism(s) do you most suspect and why?
2. What antibiotic would you recommend to treat RR with and why?
3. What is the mechanism of action of this antibiotic? Provide rationale
4. Do you have any counseling points for RR?

USE APA format atleast 2 references 

RUBRIC

 

iscussion Question Rubric

Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Note: The value of each of the criterion on this rubric represents a point range. (example: 17-0 points)

Discussion Question Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsQuality of Initial PostProvides clear examples supported by course content and references.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

All instruction requirements noted.

40 pointsComponents are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints.

Meets all requirements within the discussion instructions.

Cites two references.

35 pointsComponents are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development.

Is missing one component/requirement of the discussion instructions.

Cites one reference, or references do not clearly support content.

Most instruction requirements are noted.

31 pointsAbsent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No references cited.

Missing several instruction requirements.

Submits post late.

27 points40Peer Response PostOffers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

2 points5Total Points100 

  

Instructions:

Read the evidence representing the three forms of nursing inquiry (QI, research, and EBP) on provided articles (attached). selected problem/ articles: (Improving the control of blood sugar in diabetic patients). Analyze the aim, methods used, and outcomes sought for each type of inquiry. Determine how teamwork and critical thinking processes were implemented. Create a PowerPoint presentation using Microsoft PowerPoint. 

Material provided (attached): three articles related to Diabetes using QI, research, and EBP approach: 

– American Diabetes Association. (2018). Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2019. doi: 10.2337/dc19-S015 Link (Links to an external site.)

– Russell, N.M., Vess, J., Durham, C., & Johnson, E. (2017). Text-messaging to support diabetes self-management in a rural health clinic: A Quality Improvement project. Online Journal of Nursing Informatics, 21(2). Link (Links to an external site.)

– Whitehead, L.C., Crowe, M.T., Carter, J.D., Maskill, V.R., Caryle, D., Bugge, C., & Frampton, C.M.A. (2017). A nurse-led education and cognitive behavior therapy-based intervention among adults with uncontrolled type 2 diabetes: A randomized controlled trial. Journal of Evaluation in Clinical Practice, 23(4). 821-829. doi: 10.1111/jep.12725 Link (Links to an external site.)

Purpose: The purpose of this assignment is to analyze the differences and similarities between the three forms of nursing inquiry: quality improvement (QI), research, and evidence-based practice (EBP). This assignment will allow for a discovery into the aim, methods and outcomes associated with each type of inquiry, including how these forms of inquiry are distinct yet similar in addressing a nursing practice problem. Formulation of a PowerPoint presentation which is inclusive of comprehensive speaker notes that supports professional formation, communication, and dissemination skills relevant to the DNP practice scholar. 

Include the following sections addressing the three forms of nursing inquiry (detailed criteria listed below and in the Grading Rubric).

– Introduction (1-2 slides)

– Describes purpose of the presentation

– Identifies selected nursing problem

– Includes significance and scope of the practice problem (including citation)

– Differentiation of the three forms of nursing inquiry (2-4 slides)

– Compares and contrasts QI, research, and EBP as forms of nursing inquiry

– Discusses the impact of each form of inquiry on nursing practice

– Describes how the DNP practice scholar applies each form of inquiry

– Analyses of the evidence representing the three forms of nursing inquiry (5-7 slides)

–  Identifies selected evidence representing the three forms of nursing inquiry (including citations)

– Compares and contrasts the aims of the selected evidence in addressing the practice problem

– Compares and contrasts the methods used in the selected evidence

– Examines the impact of teamwork, when used, in the selected evidence

– Compares outcomes in the selected evidence

– Conclusion (2-3 slides)

– Includes an evaluation of the impact of the three forms of evidence on the selected nursing practice problem /

– Includes a summative statement of the impact of the forms of inquiry on nursing

– Includes a summative statement of the impact of the forms of inquiry on the role of the DNP practice scholar

– References (1-2 slides). Includes all references cited in the presentation. Can be the three provided for analysis (attached material) and at least another to address the differences between quality improvement (QI), research, and evidence-based practice (EBP). 

PowerPoint Requirements:

– Includes 10-18 PowerPoint slides

– Maintains the 6 x 6 rule for a professional PowerPoint presentation: (no more than 6 lines per slide, 6 words per line).

–  Include speaker notes that support professional formation, communication, and dissemination skills.

– Grammar and mechanics are free of errors 

– Uses appropriate APA format (6th ed.) and is free of errors