Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question  

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA 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.

Please answer with two paragraphs and two references no more than 5 years. for tomorrow, no plagiarism.

Evidenced-Based Practice is utilized to improve patient safety and outcomes in the workplace. It also has a positive impact to improve employee engagement and job satisfaction. Evidence-Based practice coexists with having policy and procedures in the workplace to help with patient values and clinician’s expertise when making decisions with patient care (Hameed, 2021).

This approached is utilized every day in healthcare. Policies and procedures are implemented everyday especially when an incident occurs. For example, maternal death or fetal demise in the Obstetric unit is a way to implement policies to help improve the workplace. Morbidity and mortality, the goal is to improve the environment which can improve patient outcomes. If there is a policy that is not implemented and can benefit the workplace, the CNO and chairman of the department will assist with making this happen to improve the environment.

I think that Evidence-based practice is not used apart from or in conjunction with the other approaches. However, on the contrary, it coexists with research and QI. All of these are needed to help improve patient outcomes. Patient safety is very important in the healthcare setting as it can impede patient care. Having a policy in place, researching improvement can assist with patient care and making the healthcare organization a better place by decreasing morbidity and mortality. 

Case Study #1

25-year old Caucasian female 5’6” 110 pounds

Allergic to wheat

No medications currently taken

CC:  Glossitis and diarrhea

Patient noticed over the past week her tongue has become sore and inflamed.   She feels the pain is constant, aggravated by eating and alleviated by “not letting anything touch it.”  Patient states tongue feels “tender.”  She has no idea what is causing it.  No other treatments have been attempted.  Severity/significance is a 9 out of 10.  She also states she has had diarrhea “worse than usual for the past 6 months.”  When asked if she has an chronic conditions, she states she has Celiac Disease but has a “tendency not to avoid pastries – her favorite!” Currently, her diarrhea is worse after she eats going up to 6 times per day.  She does notice the frequency increases when she eats any bread product and it is stops when she stops eating bread products.  On occasion, she takes over the counter diarrhea medication.  The severity is 5 out of 10.  Blood work shows red blood cells are larger than normal (macrocytic).

Case Study #2

70-year old Black male 5’10” 200 pounds.

No Known Drug Allergies

Currently taking Lisinopril and Crestor

CC:  Dysphagia

Patient has noticed he has had difficulty swallowing food over the past 8 months.  He has noticed that in the beginning it only occurred with solid food but now it has progressed to include really any type of food.  Nothing appears to alleviate the condition.  He is only reminded of it “when he starts to eat.”  He has tried no other treatments.  Severity is 8 out of 10.  When asked if he has noticed anything else, he mentioned he has lost 10 pounds without trying in the last month and feels he has lost his strength.  Also, he notices when he actually “decides to eat” he does not eat much and feels full quickly.  CT scan shows epigastric mass.

Case Study #3

57-year old female

5’5” 300 pounds

No Known Drug Allergies

Current medications – none

CC:  Sudden one-sided facial paralysis

Patient states that her family noticed during Thanksgiving dinner that one side of her face became “frozen.”  Patient became extremely upset and wanted to be taken to the emergency room.  Family took her to the emergency room and the following exams were done:

CT – negative for infarct but to be sure MRI was done and was also negative for infarct, mass lesion or hemorrhage.  Facial paralysis went away within the hour.  However, patient was kept in the hospital for observation.

please improve this job, correct mistakes and follow this instructions 

I have reviewed your Health History submission and would like to go over it with you so you may improve your assignment before the due date. You can edit your assignment and resubmit it before the due date. 
Under obstetrics, you want to ask your patient if they have children, how many, how were they delivered, if they suffered any miscarriages, when was their last menstrual period, are they in menopause, has she gotten a pap smear, what were the results of the pap smear. 
I noticed you were missing your genogram. Do not forget to include that. 
Under the Review of symptoms, you will use the same format as the guide provided but you would not just include “none” or only what she had. It should properly be written as ” Skin: Denies or reports rashes, lumps, sores, itching, dryness, color changes in hair or nails” if your patient suffered from something and not the other you can say ” Skin: reports rashes, lumps, sores, itching, dryness. Denies color changes in hair or nails”
According to APA, the bold titles such as “Review of systems” should be indented left and not in the middle. In your second page you should add a “Health History” (unbolded) in the center of the page and that is your title. 
Under Patterns of healthcare, you want to include if your patient actively participates in preventative care such as annuals or going to the dentist, etc. 
Remember to include identified risk factors and any health promotion activities. Also include what suggestions to made to their diet and what is their evaluation of their own diet (excellent, good, fair, poor). 
If you have any questions, please do not hesitate to contact me. 

The management of resources is one of the most critical, yet complex and time-consuming activities that nurse managers are challenged to execute in their role.  Budgets detail how time, money, supplies, and people should be acquired and used to support planned services.  The demand for patient safety, quality care, acceptable reimbursement, technological advancement, and adequate staffing ratios requires that managers budget and schedule staff as accurately and efficiently as possible.

You will learn about the budget process and staffing considerations.  Your discussion will link the decisions made when managing these resources to the cost, safety, and quality of services provided.

Upon successful completion of this discussion, you will be able to:

• Discuss the management of personnel and financial resources and its relevance to the quality, safety, and cost of healthcare.
• Correlate successful approaches for coaching, mentoring, and performance appraisals to optimal patient outcomes.

Resources

• Textbook: Leading and Managing in Nursing

Instructions

1. Review the rubric to make sure you understand the criteria for earning your grade.
2. In your textbook Leading and Managing in Nursing, read:
   
   1. Chapter 20, “Managing Costs and Budgets”
   2. Chapter 13, “Staffing and Scheduling”
   3. Chapter 21, “Selecting, Developing, and Evaluating Staff”
3. Prepare to discuss the following prompts:
   1. Describe specific ways that nurses impact an organizational budget.
   2. Describe the variables that managers consider when creating a staffing plan.
   3. Discuss realistic strategies to address inadequate staffing numbers on a patient care unit.
   4. Why is it important for nurses to receive effective feedback through methods such as proper coaching, staff development opportunities, and accurate performance evaluations?  What impact do these have on nurse satisfaction and patient outcomes?
4. Find at least two current scholarly sources to support your explanations and insights. OCLS resources are preferred sources and can be accessed through IWU Resources. Wikipedia is not permitted, as it is not a peer-reviewed, scholarly source.