To Prepare:

• Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization. 

Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

 Discussion: Safe Prescribing

In 1915, the Drug Enforcement Administration was formed, known then as the Bureau of Internal Revenue. Recognizing the variance in state laws and the process for completing applications for prescriptive authority and DEA registration is essential to the role of the NP as a prescriber. Within the last decade, safe prescribing of opioids has also become a national concern. For this Discussion, you will focus on the process for obtaining prescriptive authority after successfully completing your program of study and passing a National Certification Exam. You also will explore safe prescribing.

To prepare:

• Review your state’s process for obtaining prescriptive authority and associated fees
• Review the DEA website and review the process for obtaining a DEA number and associated fees.
• Review and select one of the following case studies and analyze the provider information:
  • Case Study One: Lori, FNP-BC, is a new graduate and has recently passed her certification exam. She has just been hired to work for a Primary Care Clinic in a small town. She will be working with one physician at one site.
  • Case study Two: James, FNP-BC, works with a physician who specializes in pain control. He works in several clinics in the large urban city where he practices.

By Day 3

Post a brief summary of your case study and an explanation of the appropriate prescriptive authority and DEA registration process needed for the case study you selected. Then, explain the safe prescribing practices that these providers should use for these settings.

Topic 1: Child and Adolescent Health Risks

As you discovered in this week’s lectures and readings, several populations face multiple health risks across their lifespan. Children and adolescents are a population that is at a higher health risk for obesity. A national movement is underway to reduce risk factors for developing obesity in children. Part of this movement is the “Let’s Move!” campaign, which is a comprehensive and coordinated initiative to prevent childhood obesity. The initiative emphasizes four primary components: healthy schools, access to affordable and healthy food, raising children’s physical activity levels, and empowering families to make healthy choices.

• Review Healthy People 2020. Identify objectives that will combat childhood and adolescent obesity.
• Provide suggestions on how community health nurses can contribute to these national health objectives and accomplish the goal of decreasing obesity among this population.

                                  I need this project completed in 4-5 hours

Description: 

Reflect on the research articles you have reviewed to date that relate to your clinical question. Please refer to all the unit resources (e.g., readings, recordings, announcements, etc.) to facilitate this process. With these thoughts in mind, post your thoughts on the following:

1. In the articles you have reviewed, what statistical tests are being used for data analysis?
2. Are the statistical tests being used appropriately for the type of data being produced and the question being asked?
3. Do the authors appropriately indicate implications of the data analysis, or do they overstretch?

In the articles that have I reviewed listed below, I need to know what statistical tests are being used for data analysis?

· A key study for my PICOT project is titled “How Accurate are Self-Reports? An Analysis of Self-Reported Healthcare Utilization and Absence When Compared to Administrative Data” (Koerner & Zhang, 2017).  The authors evaluated the data using Pearson’s correlation and multivariate logistic regression models. 

·  Correlation is a statistical method used to assess a possible linear association between two continuous variables, while Pearson’s correlation coefficient is a test statistics measuring the statistical relationship, or association, between two continuous variables (Mahan, Clark, Anderson, Koller, & Gates, 2017).. Pearson’s correlation coefficient (r) is a measure of the strength of the association between the two variables; it is the best method of measuring the association between variables of interest because it is based on the method of covariance, and covariance is a measure of the joint variability of two random variables (Koerner et al., 2017). If the data is normally distributed, in other words, bell-shaped, and symmetrical about the mean, tests such as the histogram, and normality tests may be used to evaluate if the distribution is normal (McCrum-Gardner, 2008). 

· Are the statistical tests being used appropriately for the type of data being produced and the question being asked?

· The majority of studies may be evaluated with the proper evaluation of over 100 statistical tests to choose from. Tests are chosen depending on the type of research questions being asked, the type of data being analyzed, and the number of data sets or groups being evaluated.

· The first question to be asked is what scale of measurement the data will be, nominal, ordinal, or interval. The study in question involves interval data. The second question is the reason for the analysis; as an example, paired groups or independent groups? 

· Yes, the statistical tests are appropriate for the type of data being produced, and for the type of questions being asked.

· Do the authors appropriately indicate implications of the data analysis, or do they overstretch? 

· Based on our readings and videos, I saw no evidence of data-stretching. For example, data was collected over two calendar years, a lengthy, non-selective inclusion period. A potential confounding factor was that all participants had to have been enrolled in the company health insurance program a minimum of 320 days as a condition of inclusion in the study. Another potential confounding factor was that only hourly employees were included in the two-year study. In addition, pregnant employees were excluded from the study, as these employees are atypical of the general employee population in that their healthcare utilization would be temporarily altered. These factors may have influenced the results, by excluding participants with different reporting habits. After recognizing these potential limitations, their findings mirrored multiple studies previously conducted. 

· The authors also noted potential improvements for future studies, including inclusion of a more diverse employee population, and examining why there exists a difference in self-reporting based on participant sex.

                                                                          References

· Koerner, T. K., & Zhang, Y. (2017). Application of linear mixed-effects models in human neuroscience research: A comparison with pearson correlation in two auditory electrophysiology studies. Brain Sciences, 7(3), page 26. doi:http://dx.doi.org.prx-usa.lirn.net/10.3390/brainsci7030026

· Mahan, K.R., Clark, J.A., Anderson, K.D., Koller, N.J., & Gates, B. J. (2017). Development of a tool to identify problems related to medication adherence in home healthcare patients. Home Healthcare Now, 277-82. doi: 10.1097/nhh.0000000000000539

· McCrum-Gardner, E. (2008).  Which is the correct statistical test to use? British Journal of Oral and Maxillofacial Surgery 46 (2008) 38–41 

· Short, M., Goetzel, R., Pei, X., Tabrizi, M., Ozminkowski, R., Gibson, T., & … Wilson, M. (2009). How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data. Journal of Occupational & Environmental Medicine, 51(7), 786-796. doi:10.1097/JOM.0b013e3181a86671

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Types of Statistical use

           There were six articles retrieved on my PICOT question, (3) were quantitative research, (1) is a mixed method, (2) qualitative research, and (1 )integrative review. The (3) quantitative research were critically appraised and used the following statistical analysis; central standard tendency (mean, median, mode), a probability value to test the significance of results, binomial regression, and binomial distribution, chi-square test, Fisher’s exact test, and measures of standard deviation. Lastly, a study about changing Intensive Care Unit (ICU) culture to reduce CAUTI the research study used statistical process control charts to see the process of improvement in the reduction of catheter-associated infection post-implementation (Maxwell, Murphy and McGettigan, 2018). 

Appropriateness of the statistical test 

The purpose or hypothesis of the study is in the introduction of each literature. The research question aims to evaluate the effectiveness of the CAUTI bundle in the pediatric intensive care unit and adult intensive care unit. To provide patient safety, the use of an appropriate statistical tool in research is essential. According to McCrum-Gardner (2007), using the right scale of measurement will convey accurate results in research.  One research study use sample size is 390 (nominal) children ages from 1 month to 18 years old and admitted in the ICU for 48 hours that needed foley catheter insertion. The exclusions are positive urine culture and less than 48 hours of ICU admission. In addition, the Categorial variable is analyzed using X2 or Fisher exact test. The prevalence rate was calculated using the number of disease within the specified time over the population under risk x 100. The research study shows Foley catheter utilization was calculated by dividing the total number of device days by the total number of patient days (Sönmez Düzkaya, Bozkurt, Uysal, and Yakut,2016). Moreover, the three quantitative research use an appropriate tool and results show that daily CAUTI BUNDLE implementation and changing ICU culture regarding the standard practice showed a significant reduction of catheter-associated urinary tract infection in pediatric ICU and adult ICU.

Conclusion

           The implication of the research study indicates that prevention of CAUTI with the use of CAUTI bundle checklist and application of process improvement had a significant impact on the decreasing morbidity, mortality and healthcare cost. Also, the length of study allowed the researchers to see a significant, consistent change in the reduction of CAUTI.  

References

Maxwell,M.,Murphy, K., and McGettigan, M. (2018)Changing ICU culture to reduce catheter-associated urinary tract infections. Canadian Journal of Infection Control,33 (1) ,39-43 . Retrieved from https://ipac-                   canada.org/photos/custom/pdf/Marcia%20Maxwell_Spring2018.pdf

McCrum-Gardner, E. (2007). Which is the correct statistical test to use?British Journal of Oral and Maxiofacial Surgery, 46, 38-41. Retrieved from https://class.esa.edu/bbcswebdav/institution/USA1/201830/MSN/IPE_7050/readings/McCrumGardner_Which_is the_correct_ statistical_test_to_use_pdf        

Sönmez Düzkaya, D., Bozkurt, G., Uysal, G., & Yakut, T. (2016). The effects of bundles  on catheter-associated urinary tract infections in the pediatric intensive care unit.Clinical Nurse Specialist: The Journal For Advanced Nursing Practice, 30(6),341-346. doi:10.1097/NUR.0000000000000246

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One of the pivotal goals of consumer health literacy efforts is to design educational materials that attract as well as educate users. In this Assignment, you design a health information document on a topic that is of interest to you.

To prepare:

Select a health issue of interest to you.

Identify the audience or population that you seek to educate about this issue.

Search the Internet to find credible sites containing information about your selected topic.

Review the two health literacy websites listed in this week’s Learning Resources. Focus on strategies for presenting information.

To complete:

Design an educational handout on the health issue you selected.

Include a cover page.

Include an introduction that provides:

An explanation of your issue and why you selected it

A description of the audience you are addressing

In the handout itself:

Develop your handout in such a way that it attracts the attention of the intended audience.

Include a description of the health issue and additional content that will enhance your message (i.e., key terms and definitions, graphics, illustrations, etc.).

Recommend four or five sites that provide clear, valuable, and reliable information on the topic.