Comment 1

  Evidence-based practice (EBP) promotes quality, safe, and cost-effective outcomes for patients, families, healthcare providers, and the healthcare system. It evolves from the integration of the best research evidence with clinical expertise and patients’ needs and values (Grove, Gray & Burns, 2015. 5th ed).

       EBP incorporates the needs and values of the patient and the patient’s need(s) might focus on health promotion, illness prevention, acute or chronic illness management, rehabilitation, and/or a peaceful death. In addition, patients bring values or unique preferences, expectations, concerns, and cultural beliefs to the clinical encounter. With EBP, patients and their families are encouraged to take an active role in the management of their health values (Grove, Gray & Burns, 2015. 5th ed).

Infection control in cancer patient with low immunity using evidence-based practice: Hand hygiene using soap and water or an antiseptic hand rub for all patients and their caregivers.

 Wearing protective gowns for expected body fluid contamination, use of gloves when contact with blood, body fluids, excretions, or secretions are expected.

 Limitation in the number of visitors and restrictions in visitors with symptoms of respiratory infection should be allowed. Environmental interventions such as keeping windows closed, using negative-pressure rooms, and using high-efficiency particulate air (HEPA) filters

 Contact precautions for patients known to be colonized or infected with resistant organisms (American Nurse Today, 2011).

Evidence-based practices related to central-line patency: Needleless connectors with neutral/zero fluid displacement during access and de-access, prophylactic antimicrobial lock solutions instead of heparin or saline solution and standing orders for managing catheter occlusions (American Nurse Today, 2011).

Comment 2

Through nursing research, empirical knowledge can be developed to improve nursing care, patient outcomes, and the healthcare delivery system. For example, nurses need a solid research base to implement and document the effectiveness of selected nursing interventions in treating particular patient problems and promoting positive patient and family outcomes. Also, nurses need to use research findings to determine the best way to deliver healthcare services to ensure that the greatest number of people receive quality, safe care.

Our Hospital is currently trying to achieve the Magnet status. There has been a big push for nurses with an associate degree to earn their bachelor’s degree.

You may be required to review the literature as part of a course assignment or project in the clinical setting, especially projects in Magnet hospitals. Nurses in Magnet hospitals must implement evidence-based practice, identify problems, and assist with data collection for research studies (American Nurses Credentialing Center [ANCC], 2013). Reviewing the literature is a first step in implementing evidence-based practice and identifying problems.

Discussion: Diversity and Health Assessments

In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”

Case 2

TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

Case 3

MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.

To prepare:

· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

· Select one of the three case studies. Reflect on the provided patient information.

· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

By Day 3

Write Plsease include subheading

an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. 

Explain the issues that you would need to be sensitive to when interacting with the patient, and why. 

Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Personal Philosophy of Nursing

In a 6- to 7-page paper in APA format describe your personal approach to professional nursing practice. Be sure to address the following:

• Which philosophy/conceptual framework/theory/middle-range theory describes nursing in the way you think about it? Discuss how you could utilize the philosophy/conceptual framework/theory/middle-range theory to organize your thoughts for critical thinking and decision making in nursing practice.
• Formulate and discuss your personal definition of nursing, person, health, and environment.
• Discuss a minimum of two beliefs and/or values about nursing that guide your own practice.
• Analyze your communication style using one of the tools presented in the course. In your paper, discuss the strengths and weaknesses associated with your style of communication and the impact on your ability to collaborate as part of an interdisciplinary team.
• On a separate references page, cite all sources using APA format.
  • Use this APA Citation Helper as a convenient reference for properly citing resources.
  • This handout will provide you the details of formatting your essay using APA style.
  • You may create your essay in this APA-formatted template.

For this Discussion, you will practice searching the literature to find evidence on a specific topic.

To prepare:

· Choose a simple search term(s) relating to a topic of your PICOT question.

· Review the information on the evidence hierarchy discussed in Chapter 2 of the course text, in the article, “Facilitating Access to Pre-Processed Research Evidence in Public Health,” and in the multimedia presentation “Hierarchy of Evidence Pyramid,” found in this week’s Learning Resources.

· Review the information on the Walden Library’s website, “Levels of evidence.” Take a few minutes to explore the different types of databases available for each level of evidence and focus on the meaning of filtered and non-filtered resources.

· Conduct a literature search in the Walden Library on your selected topic using the databases that you reviewed. Use at least one database for each of the three levels of filtered information and at least one unfiltered database. Record the number of hits that you find at each level of the hierarchy of evidence.

· Select one article from the results at each level of the hierarchy. Compare the articles based on the quality and depth of information. What would be the value of each resource if you were determining an evidence-based practice?

Post a summary of your search. Describe what topic you selected, the search term(s) that you used, and the number of results found at each level of the hierarchy. Compare the types of information found in the articles from different levels and the value of the information from each level. Highlight a useful tip that you could share with your colleagues about conducting an effective literature search.

In this assignment, you will be exploring actual and potential health problems in the childhood years using a functional health assessment and Erickson’s Stages of Child Development. To complete this assignment, do the following:

1. Using the textbook, complete the “Children’s Functional Health Pattern Assessment.” Follow the instructions in the resource for completing the assignment.
2. Cite and reference any outside sources used in your answers. Include in your assessment a thorough discussion of Erickson’s Stages of Child Development as it pertains to the development age of the child.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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 not required to submit this assignment to Turnitin.

NRS-434VN-R-Childrens-functional-health-pattern-assessment-Student.docx