Competency

Explain care for the client with lower respiratory disorders.

Instructions

Read the scenarios below and answer the questions. If you use sources, site them using APA format.

Case # 1

An elderly woman comes into the ER with severe dehydration after spending the day at the beach. The client is weak and feels like she is going to faint. An IV is started, and the RN hangs 0.9% Normal Saline. There are no IV pumps available. The client begins to feel better after 500 mL’s are infused, and the rest of the IV bag is infused. The client begins to have difficulty breathing. Auscultation of the lungs reveals crackles to ½ of the lower lung fields. The provider diagnoses pulmonary edema, and the client is treated with Lasix. She is stabilized but needs to be admitted to the ICU.

Question # 1: What nursing action could have prevented the client from having pulmonary edema? (5-10 sentences)

Question # 2: What makes this client at risk for pulmonary edema? (5-10 sentences)

Case # 2 

A 22-year-old special-needs client comes to the ER with fever and difficulty breathing. The client weighs 66 LBS. The client is admitted with pneumonia and IV fluids, antibiotics, and respiratory treatments are started. The client is dehydrated, so she receives several bags of IV fluids over three days. On the third day, the client has worsening shortness of breath, and an X-ray is ordered which shows pulmonary edema. An echocardiogram is ordered. It shows normal cardiac function. The client is given Lasix, and the shortness of breath resolves.

Question # 3: How did the client’s size (body weight) put her at risk for pulmonary edema? (5-10 sentences)

Question # 4: How could pulmonary edema have been prevented in this client? (5-10 sentences)

Case # 3

A 32-year-old male with a history of cardiomyopathy is admitted to the medical-surgical floor with a diagnosis of flu. The client has a high fever and receives multiple bags of 0.9%NS. One day into the admission the client develops severe shortness of breath. An X-ray shows pulmonary edema.

Question # 5: What puts this client at risk for pulmonary edema? (5-10 sentences)

Format

• Standard American English (correct grammar, punctuation, etc.)
• Logical, original, and insightful
• Professional organization, style, and mechanics in APA format
• Submit document through Grammarly to correct errors before submission.

 

Assignment: Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

• Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
• Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
• Consider the best method of disseminating the results of your presentation to an audience. 

The Assignment: (Evidence-Based Project)

Part 4: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:

• Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
• Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
• Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
• Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
• Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
• Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
• Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
• Add a lessons learned section that includes the following:
  • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
  • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

 

Assignment Content

1. Review all of the work that you have dedicated for your Gemba and data collection.

   Select one short-term executable project supported by the Gemba and data collection.

   Create a 1- to 2-page SBAR Proposal.

   Note: Be mindful of the proper protocols required to submit SBARs at your place of employment. Be sure to follow up with your employer to ensure that your SBAR has been received.

   Cite any resources you may have used in your SBAR.

   Format your assignment according to APA guidelines.

  

Abstract

         The nursing preceptor rotates throughout various clinical units within healthcare facilities to meet nurse staffing needs to improve quality patient care. Preceptors encounter numerous challenges to understand their roles and support to support newly hired nurses in the transition process. Taking the novice nursing preceptors through effective education programs may reduce gaps between preceptees knowledge and skills and unit/department expectations (Joswiak, 2018). This project aimed to develop an educational program for nursing preceptors in a hospital setting to promote newly hired nurses ensuring high-quality patient care. Benner’s From Novice to Expert Theory was utilized as the theoretical frameworks for this project. Five content experts voluntarily participated in the review of the educational PowerPoint for content validity.

 

Chapter I

           Lippincott Solutions (2017) defined nursing preceptor as an assistant, clinical resource, experienced nurse who boost and evaluate nursing skills for newly hired nurses to work independently and confidently.( Consider changing the first sentence to one that doesn’t start immediately with a reference ) The preceptor is responsible supporting newly hired nurses. This creates challenges such as patient safety, professional attitude, workload, policies, and support. (How does this create challenges? ) These challenges can result in increased turnovers for both preceptors and new nurses (Why is the turnover a concern? A sentence describing the why here is relevant, then go into the statistics of it )) (Valizadeh, Borimnejad, Rahmani, Gholizadeh, & Shahbazi, 2016). This is can be costly: one study estimates an up to $58,400 cost for turnover per nurse (What does this mean for the institution? For patient safety? ) (Kennedy, 2019). A developed preceptor program can help manage these challenges and decrease the turnovers rate by understanding the preceptor’s roles and learning skills to increase the confidence, which is essential to train newly hired nurses (Kennedy, 2019). (Does the preceptor program understand the role, or do you mean the nurses understand their role because of the program? )