With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

• By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
• How would your communication and interview techniques for building a health history differ with each patient?
• How might you target your questions for building a health history based on the patient’s social determinants of health?
• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
• Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
• Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

List the objective(s) met and briefly describe 8 activities you completed during each time period. for that week in the Total Hours for This Time Frame column. Journal entries are due in Weeks; include your Time Log with all hours logged (for current and previous weeks) each time you submit a journal entry.

Full text research article based of quality improvement for Acute care setting such as an ER or ICU.

a) Examining the nursing problem (Nurse:Patient ratios)

b) Correlating the clinical problem to clinical significance 

c) Describing the significance towards implication for practice 

d) Formulating interventions based on the best evidence available 

e) Describing and producing the outcome of the interventions 

f) Disseminating evidence-based recommendation for practice

Must be APA style, must contain proper citations, minimum 6 pages long. All articles to use are attached.

A. Choose a current medical procedure, medication, or therapy. Discuss the scientific/medical rationale for its effectiveness, history of its development, the research related to its safety and effectiveness, and any controversies over its use.

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REQUIREMENTS: 

Your essay must cite at least 3 sources (all independent: none from the class reading list).

— No Wikipedia or general encyclopedias (on-line or print)

— Try to find articles designed for the general reader, as opposed to articles in professional medical journals.

–Be sure to consistently (in every paragraph) document your sources (APA Style) as we have learned to do throughout our work during the semester.

–All sources must be listed on the References page according to standard APA guidelines.

–Note the proper formatting for direct quotations in your text.

–Paraphrase and quote accurately. All drafts will be screened for plagiarism. Plagiarism on this project will result in your failing this course (as noted on the syllabus).  Be especially scrupulous in using Internet sources. Websites offering ready-made research papers are absolutely off-limits; using them in any manner will be considered plagiarism.

–You may be required to submit links to your source materials.

–Use the Model Research Essay, “Are Organic Foods Healthier Than Conventional” (on Canvas/Files) as a model to your writing, documentation, and formatting.

THE COMPLETED PROJECT: The final draft is expected to display writing skills worthy of a second-semester college student, including competence with APA style of documentation and formatting. (For a guide to APA Style, see your handbook or a website such as the Purdue Owl). The finished essay should be 4-5 pages of text, not including the References page. 

Translation Models

Diabetes is an international crisis and considered to be one of the Global Burden Diseases (The U.S. Burden of Disease Collaborators, 2018). In the primary care setting, translating the evidence of preventing Diabetic Foot Ulcers is done by introducing self-care education to primary care patients with a transitional Model. Almost 1/3 of people with diabetes acquire foot ulcers, and of these ulcers, 3/4 are avoidable (Bus & Van Netten, 2016). Therefore, it is incredibly essential to translate this evidence into action to prevent foot loss by amputation and, ultimately, early mortality. The Knowledge to Action Model (KTA) is used to translate all the evidence-based research knowledge on diabetic foot care into action in the clinic setting. KTA has two main components, “Knowledge Creation” and the “Action Cycle.” Using KTA, we already have numerous research available on diabetic foot care, funneled to identify a knowledge gap or problem. Knowing the problem, we must implement the second phase, which has seven stages called the Action Cycle. It can be continuous and go in either direction if necessary.

Stage One: The problem of poor diabetic foot care education on one-third of diabetics has been identified, and a knowledge gap exists between patients and caregivers.

Stage Two: The local setting of primary care with a high population of Hispanic patients with diabetes.

Stage Three: One of the possible barriers to this self-care program will be staffing and proper nurses’ training as educators. Also, the time it takes to teach patients. Another obstacle will be the patient’s willingness to learn and perform appropriate foot care daily.  This project’s facilitators will be the primary care providers and management at a micro, meso, and macro-level. The facilitators would help ensure proper staffing and more time allotted in the clinic for foot care sessions during diabetic visits.

Stage Four: Implement the project by educating nurses on diabetes and its effect on the body. The second part of implementation would be having the nurses teach foot care to Hispanic Diabetic patients at every visit. Using a transtheoretical Change Model at this stage would be appropriate.

Stage Five: In this stage, we would monitor the nurses’ knowledge using surveys and observation. We would measure the patients learning with a teach-back method and questionnaire.

Stage Six: Evaluating the outcomes might take a little longer to see results. Still, we should assess feedback from the nurses, podiatrist providers, and patients on the knowledge and care provided through surveys and questionnaires.

Stage Seven: This stage is not a final step but rather a step where knowledge is sustained with continuous updates and reassessments. This stage would keep the program fresh, and the key stakeholders would play the role of being receptive to the new norm and not become disengaged.

The resources needed for this project would be a clinical educator to train nurses on the effects and care of diabetic patients, mostly on foot self-care: foot care literature, handouts, and a small foot care kit for patients.  The kit would consist of a lotion, liquid soap, Emory boards, monofilament, and a mirror. This kit would cost about 12-15 dollars per unit. Key stakeholders such as pharmaceutical companies or diabetic organizations and community leaders would be instrumental in funding each diabetic patient with a self-care kit.

References

Bus, S. A., & van Netten, J. J. (2016). A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable. Diabetes/metabolism research and reviews, 32 Suppl 1, 195–200. https://doi.org/10.1002/dmrr.2738

The U.S. Burden of Disease Collaborators. (2018). The state of U.S. health, 1990–2016 burden of diseases, injuries, and risk factors among U.S. states. JAMA, 319(14), 1444–1472. https://doi.org/10.1001/jama.2018.0158 (Links to an external site.)

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