As a former emergency department Registered Nurse for over seven years, I recall the most significant complaints were our long wait times.  For some patients, the wait time could be substantial.  Since emergency departments aren’t on a first-come, first-serve basis, wait times were often unpredictable and lengthy.  Patients are triaged based on their level of acuity.  Long Emergency Department (ED) Length of stay (EDLOS) is associated with poor patient outcomes, which has led to the implementation of time targets designed to keep EDLOS below a specific limit. (Andersson et al., 2020, p. 2)

The method conducted for the concept analysis on EDLOS was the Walker and Avant approach.  They were able to research a way of measuring the concept empirically by identifying all concepts used.  (Andersson et al., 2020) Nurses can use the Walker and Avant approach when there are limited concepts available to a nurse to explain a problem area.  The process of concept analysis for nurses first transpired in 1986. (McEwen & Wills, 2019) Walker and Avant specifically designed an approach to concept analysis to help graduate nurses explain methods to examine phenomena that interests them.  (McEwen & Wills, 2019) The basic concept analysis approach by Walker and Avant is as follows; 1.  Select a concept  2. Determine the aims or purposes of the analysis.  3.  Identify all the concept possible uses possible.  4.  Determine the defining attributes.  5.  Identify the model case.  6.  Identify any borderline, related contrary, invent, and illegitimate cases.  7.  Identify the antecedents and consequences.  8.  Define the empirical referents. (McEwen & Wills, 2019, Tables 3-2)

Authors Aim and Purpose

As a former Emergency Department Nurse, I find it fascinating how the author chose to do the concept analysis on this topic.  According to the author, when patients are forced to stay for extended lengths of time in the emergency department, this leads to poor patient outcomes, overcrowding, and an overall inefficient organization. (Andersson et al., 2020) I recall when a febrile child was left in the Emergency Department for a long time.  The child became so agitated their respiratory status worsened.  The authors aim to clarify the meaning of long EDLOS and identify the root causes of an emergency department length of stay of more than six hours.  (Andersson et al., 2020)

Defining Attributes on the Concept Examined

In the emergency department, length of stay (LOS) is a widely used measurement.  Emergency department length of stay (EDLOS) is defined as the time interval between a patient’s arrival to the ED to the time the patient physically leaves the ED. The defining attributes discovered that waiting in a crowded emergency department was just that, waiting.  Waiting was the most acknowledged attribute associated with EDLOS. (Andersson et al., 2020) If the patients didn’t have to wait, they wouldn’t be a problem/complaint and had no time targets. 

Another attribute that was described as a cause for EDLOS was, crowding.  This led to cause and effect with long EDLOS and crowding. (Andersson et al., 2020)

Benefits

     The problem was that over-crowding and waiting was referred to as an inefficient organization.  This led to the need to search for EDLOS to correct the issues with the system and improve overall patient satisfaction with emergency department visits.  (Andersson et al., 2020)  The benefit of this study is discovering what the root of the cause is for long emergency wait times, therefore improving overall patient outcomes, avoiding overcrowding, and running an efficient organization.  The benefits of completing a concept analysis for nursing theory would be to aim at improvements for better patient outcomes.  This is what we are there for, after all.  As nurses, we are on the front lines of our departments, and we have an opportunity to improve our systems, our organizations, our team, but most importantly, our patients.  When we can all benefit as a team, our profession benefits, and our patients benefit greatly. 

You make a Tik Tok video on your day off, showing photos of a local celebrity that one of your colleagues in telemetry took care of. You figure that most of your contacts would never recognize him anyway. It’s your day off and your personal time, so no harm, no foul, right? 

Choose an ending to the scenario, and construct your paper based on those reflections. Choose one of the following outcomes: 

1. A HIPAA violation occurs, and client data is exposed to the media.

 2. A medication error has harmed a client. 

3. A technology downtime that impacts patient care occurs, and an error is made. 

4. A ransomware attack has occurred, and the organization must contemplate paying the ransom or lose access to patient data. 

 Research, compose, and type a scholarly paper based on the scenario provided by your faculty, and choose a conclusion scenario to discuss within the body of your paper. 

Reflect on lessons learned in this class about technology, privacy concerns, and legal and ethical issues and address each of these concepts in the paper. Consider the consequences of such a scenario. 

Do not limit your review of the literature to the nursing discipline only because other health professionals are using the technology, and you may need to apply critical thinking skills to its applications in this scenario. 

• Use Microsoft Word and APA formatting. Consult your copy of the Publication Manual of the American Psychological Association, as well as the resources in Doc Sharing if you have questions (e.g., margin size, font type and size (point), use of third person, etc.). Take advantage of the writing service SmartThinking, which is accessed by clicking on the link called the Tutor Source, found under the Course Home area.

 • The length of the paper should be four to five pages, excluding the title page and the reference page. Limit the references to a few key sources (minimum of three required).

 • The paper will contain an introduction that catches the attention of the reader, states the purpose of the paper, and provides a narrative outline of what will follow (i.e., the assignment criteria). 

• In the body of the paper, discuss the scenario in relation to HIPAA, legal, and other regulatory requirements that apply to the scenario and the ending you chose. Demonstrate support from sources of evidence (references) included as in‐text citations. 

• Choose and identify one of the possible endings provided for the scenario, and construct your paper based on its implications to the scenario. Make recommendations about what should have been done and what could be done to correct or mitigate the problems caused by the scenario and the ending you chose. Demonstrate support from sources of evidence (references) included as in‐text citations.

 • Present the advantages and disadvantages of informatics relating to your scenario and describe professional and ethical principles appropriate to your chosen ending. Use facts from supporting sources of evidence, which must be included as in‐text citations. 

• The paper’s conclusion should summarize what you learned and make reflections about them to your practice 

 Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions. Include the following sections: 

a. Introduction – 40 points/17% • Catches attention of the reader • States purpose of the paper • Provides a narrative outline of the paper (i.e., the assignment criteria) 

b. HIPAA, Legal, and Regulatory Discussion – 40 points/17% • Presents evidence from recent scholarly publications to address the impact of technology on nursing care related to: • Patient privacy and HIPAA standards • Healthcare regulations • Legal guidelines on appropriate use of technology

 c. Scenario Ending and Recommendations – 50 points/21% • Selects and presents one scenario ending as the focus of the assignment. • Evaluates the actions taken by healthcare providers as the situation evolved. • Recommends actions that could have been taken to mitigate the circumstances presented in the selected scenario ending. • Supports recommendations with evidence from recent scholarly publications.

 d. Advantages and Disadvantages – 50 points/21% • Presents evidence from recent scholarly publications to address the impact of technology on nursing care related to: • The advantages of appropriately using technology in healthcare • Risks of technology use in healthcare • Describes professional and ethical principles guiding the appropriate use of technology in healthcare. 

e. Conclusion and Reflections – 30 points/12% • Summarizes what new information was learned by completing this assignment. • Reflects on how this new knowledge will impact future behavior as a healthcare professional. 

f. Scholarly Writing and APA Format – 30 points/12% 3 NR360 Information Systems in Healthcare RUA: We Can, But Dare We? Guidelines NR360_RUA_We_Can_But_Dare_We_Guidelines Revised: July 2020 3 

• Paper submitted as a Microsoft Word document. • Adheres to current APA formatting guidelines including proper use of: • Title page • Running head • Page numbers • Length is 4-5 pages, excluding title and reference pages. • Includes at least three (3) references that are: • From recent (within the last 5 years) scholarly sources • Cited in text appropriately • Included on an APA formatted reference page • Scholarly writing reflects: • Accurate spelling • Correct use of professional grammar • Logical organization of thoughts (mechanics) For writing assistance (APA, formatting, or grammar), visit the APA Citation and Writing page in the online library 

Construct a detailed outline of one of the readings from Module 1 (your choice. A good outline will include a thesis of the article, as well as the important arguments and points offered in support of that thesis. 

The outline is worth 20 points and should be no less than 250 words in length. 

Outside research is not necessary, but if you use external sources you must provide complete citations. Your outline will automatically be checked for text that matches websites and other submitted outlines. Failure to cite your sources is academic misconduct and will result in a failure of the assignment.

I have provided a copy of how the outline should look!

Asthma and chronic obstructive pulmonary disease (COPD) are significant public health burdens. Currently, more than 25 million people in the United States have asthma (HealthyPeople.gov, 2019). As an advanced practice nurse, you will likely encounter patients who will present with respiratory disorders, including asthma or COPD. Understanding specific treatment protocols as well as the types of pharmacotherapeutics used to treat respiratory disorders is important to ensure the effective and safe delivery of advanced nursing practice.

This week, you will evaluate drug therapy plans for patients who present with asthma and analyze the stepwise approach to asthma treatment and management from a patient in your professional practice.

Reference: HealthyPeople.gov. (2019). Respiratory diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases

Learning Objectives

Students will:

• Evaluate drug therapy plans for asthma
• Assess the impact of asthma treatments on patients
• Analyze the stepwise approach to asthma treatment and management

Learning Resources

Required Readings (click to expand/reduce) 

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 62, “Drugs for Asthma and Chronic Obstructive Pulmonary Disease” (pp. 557–579)
Chapter 63, “Drugs for Allergic Rhinitis, Cough, and Colds” (pp. 580–588)

Document: APA Presentation Template

Required Media (click to expand/reduce) 

Speed Pharmacology. (2020). Drugs for asthma and COPD (Made Easy) [Video]. https://www.youtube.com/watch?v=-DVZ9pl0rGY
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2017). Antihistamines (Made Easy) [Video]. https://www.youtube.com/watch?v=D5PHANcdA_E&t=25s
Note: This media program is approximately 10 minutes.

Optional Resources (click to expand/reduce) 

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This web resource presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.
 

Assignment: Asthma and Stepwise Management

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.  

Photo Credit: Photo Library / Getty Images

One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To Prepare

• Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
• Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
• Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

By Day 7 of Week 3

Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:

• Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
• Explain the stepwise approach to asthma treatment and management for your patient.
• Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

Please answer the questions below:

You are a school nurse in a middle school when Jamal comes to the nurse’s office requesting medication for a headache. You notice that his eyes are red, and it appears as if he has been crying. You ask if he is hurt, but he denies it. The phone rings in the office, and a teacher tells you that a female student has approached her concerned about Jamal. The teacher tells you that Jamal sent her a text message saying that he flunked his biology examination and wished he was dead.

1. If Jamal shared with you a suicide plan that includes harming himself with a weapon, what would be your first nursing intervention?

2. What educational program would you develop for the middle school to educate students about ways to cope with stress and how to respond if a friend needs support?

·      Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

·      All answers or discussions comments submitted must be in APA format according to Publication Manual American Psychological Association (APA) (7th ed.) ISBN: 978-1-4338-3216-1

·      Minimum of two references, not older than 2015.

Please provide plagiarism report.