Assume you are a nurse manager on a unit where a new nursing documentation system is to be implemented. You want to ensure that the system will be usable and acceptable for the nurses impacted. You realize a nurse leader must be on the implementation team.

To Prepare:

• Review the steps of the Systems Development Life Cycle (SDLC) and reflect on the scenario presented.
• Consider the benefits and challenges associated with involving a nurse leader on an implementation team for health information technology.

The Assignment: (2-3 pages not including the title and reference page)

In preparation of filling this role, develop a 2- to 3-page role description for a graduate-level nurse to guide his/her participation on the implementation team. The role description should be based on the SDLC stages and tasks and should clearly define how this individual will participate in and impact each of the following steps:

• Planning and requirements definition
• Analysis
• Design of the new system
• Implementation
• Post-implementation support
• Use APA format and include a title page and reference page.
• Use the Safe Assign Drafts to check your match percentage before submitting your work.

Assignment

Choose one of the groups  listed below (see attachment) and describe the physical, psychosocial, and cognitive changes that are associated with the group that you have chosen. Your paper should be between 3-5 pages (Not including the title and reference pages) and should include at least 4 scholarly sources besides your textbook. Your references should be in APA format (I will take points off if it is not in that format). This assignment is due at the end of week 7 and  is 10% of your grade. 

Prenatal Period

Early childhood 

Adolescence 

Middle Adulthood 

Response to 2 Peers

1. Consider your peer responses.  Are they similar or different than yours?

2. How do other’s perspectives on ethical considerations impact your view?

**When I accept the bid I will be sending you the two peer posting which to respond to. Please use their name at least twice but not excessively. Do not compare the two peers with each other only compare their individual post with mines. 250 words each with two references each, the references are not included in the word count. 

MY POST:

How often do healthcare providers encounter ethical dilemmas in end of life care?

            Medical practitioners come across moral dilemmas more frequently in their professional careers and practice (Odgers, 2019). In these situations, the no-correct response is stark evidence. This is particularly true in end-of-life treatment, where clients and families may be dealing with intense feelings, sadness, and tragedy.

What is the source of the ethical dilemma?

Communication problems, clinical confidentiality being harmed, inadequate treatment control, non-beneficial treatment, and joint decision-making can all lead to ethical dilemmas. Communication is a key model in the moral quagmire (Liu, 2017). It affects how patients perceive information about the prevailing health conditions.

What is the nurse’s role in this situation?

Immunology clinicians can help patients, close relatives, and guardians overcome ethical dilemmas by providing the best quality treatment while helping them to encounter EOL with integrity (Liu, 2017). Nurses can keep the patients in terms of the current health status while offering solace and guidance.

What legal and ethical standards must health care personnel be expected to consider in end of life care?

The medical personnel should provide full information to the patients. Another standard is confidentiality where the clinical person should disclose the details to the patient only.

The information on the health of the patient can only be disseminated to other parties with his or her consent (Tahan, 2020). Another standard is disclosure. The patient should be briefed on all matters concerns his or her health.

If you did not agree with the decision being made, can you excuse yourself from caring for the patient?

The medical practitioner can express dissatisfaction with the exercise. This can be contained in the fact that an incorrect decision may be made (Croxon, 2018). The clinical expert can decide to part ways with the therapy for it may result in a negative outcome.

Ultimately, who should make a decision about end of life care? Explain your rationale.

The patient can make a judgment about the end of life care. This is because they are the consumers of health products and dictate their preferences (Tahan, 2020). In the case, the patient feels incapable of continuing with the therapy they can request termination. The medical personnel is bound to offer guidance and facilitate the process.

Post/Response #1 Respond to one of your peers in your discussion group. Identify the additional workup that is needed to rule in or rule out these differential diagnoses. What clinical signs/symptoms would you expect to see with these two differential diagnoses?

Peer 1

Describe the pathophysiologic process of Anemia.
Identify two differential diagnoses and provide the pathophysiology of these two differential diagnoses.

Anemia is a reduction in the total circulating red cell mass or a decrease in the quality or quantity of hemoglobin. Anemia develops from the following: 

• Blood loss (acute or chronic)
• Impaired erythrocyte production 
• Increased erythrocyte destruction 
• A combination of these factors (McCance et al., 2019 p. 922).

Anemia develops because of an imbalance in erythrocyte loss relative to production; this can be due to ineffective or deficient erythropoiesis (Ex. nutritional deficiencies, inflammation, or genetic Hb disorders) and/or excessive loss of erythrocytes (due to hemolysis, blood loss, or both) (Chaparro & Suchdev, 2019). All factors cause negative outcomes for patients, anemia is the decrease of oxygen to major organs. Example: in iron deficiency anemia, decreased iron availability has well-established negative effects on brain development and functioning even prior to anemia development (Chaparro & Suchdev, 2019).

Differential Diagnosis:

• Iron Deficiency Anemia: IDA is a hypochromic- microcytic anemia, most common type of anemia and can be caused by nutritional factors (McCance et al., 2019 p. 935). Anemia occurs when iron stores are depleted. With inadequate dietary intake or excessive blood loss, there is no intrinsic dysfunction in iron metabolism, both conditions deplete iron stores and reduce hemoglobin synthesis (McCance et al., 2019 p. 935). Iron in the form of hemoglobin is in constant demand by the body and is recycled, the body maintains a balance between iron that is contained in hemoglobin and iron that is in storage and available for future hemoglobin synthesis (McCance et al., 2019 p. 935). There are 2 stages of IDA:
  • Stage 1- the body’s iron stores are depleted, Erythropoiesis proceeds normally
  • Stage 2- Iron transportation to the bone marrow is diminished causing iron deficient erythropoiesis.
  • Stage 3- Small hemoglobin deficient cells enter the circulation to replace the normal aged erythrocytes that have been removed from the circulation (McCance et al., 2019 p. 935). There is depletion of iron stores and diminished hemoglobin production (McCance et al., 2019 p. 935).

Signs and symptoms include: Early symptoms are nonspecific and include fatigue, weakness, shortness of breath, and pale earlobes, palms, and conjunctivae. As the condition progresses and becomes more severe, structural and functional changes occur (McCance et al., 2019 p. 935).

• Acute upper or lower GI bleed (peptic ulcer disease, use of NSAIDs, Crohn’s disease): Upper GI bleeding includes bleeding that started from the esophagus to the ligament of Treitz, at the duodenojejunal flexure. Lower GI bleeding means bleeding that started from a site distal to the ligament of Treitz (Kim et al., 2014). Long term bleeding without detection can lead to Iron deficiency anemia. IDA is a common problem in gastroenterology practices and is associated with lethargy, weakness, dyspnea, and a decreased quality of life (Grooteman, van Geenen, Kievit, & Drenth, 2017). Correction of underlying condition is needed, as well as iron supplements and blood transfusion to restore hemoglobin levels (Grooteman, van Geenen, Kievit, & Drenth, 2017).

Reference:

Chaparro, C., & Suchdev, P. (2019, August). Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Retrieved April 30, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697587/

Grooteman, K., Van Geenen, E., Kievit, W., & Drenth, J. (2017, November). Chronic anemia due to gastrointestinal bleeding: When do gastroenterologists transfuse? Retrieved May 01, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676546/

Kim, B., Li, B., Engel, A., Samra, J., Clarke, S., Norton, I., & Li, A. (2014, November 15). Diagnosis of gastrointestinal bleeding: A practical guide for clinicians. Retrieved May 01, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231512/

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2019). Cellular Biology . In Pathophysiology: the biologic basis for disease in adults and children (8th ed., p. 922, 935). essay, Elsevier. 

Turner, J. (2020, September 10). Anemia. Retrieved April 30, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK499994/

Discuss the correlation between nursing education and positive patient outcomes. Include current research that links patient safety outcomes to advanced degrees in nursing. Based on some real-life experiences, explain whether you agree or disagree with this research.

  

Discuss the difference between a DNP and a PhD in nursing. Discuss which of these you would choose to pursue if you decide to continue your education to the doctoral level and explain why.