1) **********minimum 3 full pages ( not words)**************************** (cover or reference page not included) 

2)¨**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format and each paragraph must have at least 4 sentences)

3)********** It will be verified by Turnitin and SafeAssign 

4) **********References from the last 7 years  

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The purpose of this Assignment is to help you learn to conduct a review of the literature, correctly identify the level of evidence of primary sources on the evidence hierarchy, and to critique the important aspects of a scholarly research report.

1. Choose a nursing sensitive topic from the list below. Go to the University library and conduct a search of the literature and find 2 scholarly primary research reports that relate to the clinical topic you chose. List of 15 nurse sensitive outcomes:

• Nursing Hours per Patient Day.
• Nursing Turnover.
• Nosocomial Infections.
• Patient Falls.
• Patient Falls with Injury.
• Pressure Ulcer Rate.
• Pediatric Pain Assessment, Intervention, Reassessment (AIR) Cycle.
• Pediatric Peripheral Intravenous Infiltration.
• Psychiatric Physical/Sexual Assault.
• RN Education/Certification.
• RN Survey.
• Restraints.
• Staff Mix.

You may also choose from the following clinical topics:

• Diabetic management.
• CHF management.
• Readmission rates.
• Case management.

1. Write a brief 3-page critical essay paper summarizing the two research studies. This paper should be written in standard American English with proper grammar and spelling. The paper should include a title page, running head, and page numbers; it should be double spaced, have a separate page for references that follows 6th edition APA formatting and citation style. Your paper should include the following:

• *************A title page in APA format
• *************An introductory paragraph which includes a brief discussion of the objectives of your paper.
• ************The body of the paper should include:
  • 1) a summary and critique/appraisal of each article with a discussion of methodology and research design the researchers used. The writing should be well ordered, logical and unified, as well as original and insightful.
  • 2) where you would place the article in the evidence hierarchy (level of research evidence) with rationale.
  • a brief discussion of the findings of the study
  • 3) how these articles contribute to the body of nursing knowledge and supports evidence for clinical practice. (one to two paragraphs for each study).
  • 4) The body of the paper should be a continuous piece of writing that allows for a sustained viewpoint with logical order and organization.
• **********A summary paragraph (conclusion).

The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.

Subjective Data

• Complains of pain and heaviness in her leg.
• States she cannot bear weight on her leg and has been in bed for 3 days.
• Lives alone and has not had anyone to help her with meals.

Objective Data

• Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
• Left leg red from knee to ankle
• Calf measurement on left 3 in > than right
• Temperature: 38.9 degrees C
• Height: 160 cm; Weight: 83.7 kg

Laboratory Results

• WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
• Wound culture: Staphylococcus aureus

Critical Thinking Questions

1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
2. Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
3. What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
4. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

T.J. is a 76-year-old man that recently lost his wife.  He lives alone now in an ALF where he has some friends that he associates with.  They are “good for his overall well-being” claims the administrators of the facility who befriended T.J. when he lost his wife six months ago.  The facility that T.J. lives in is convenient for many aspects of his life, including entertainment and even some of the healthcare associates from neighboring clinics that have partnered with the facility to allow visits with the residents.  

Over the years, the associates from the neighboring clinic have grown close to some residents and have followed them during some of their crisis, both emotional and physical.  Christine, a nurse practitioner from a neighboring clinic, has followed T.J. for many years and is now assessing his fall risk through a tool called the “Hendrick Fall Risk Tool II” a popular means of assessing the fall risk that may exist for an elderly person. 

An entry by the ARNP recently on T.J. demonstrated that there was enough information, recognizing previous and present knowledge to utilize the tool to give T.J. a score representing his fall risk.  the entry reads: “T.J. is a 76-year-old that is evaluated today for his fall risk. He has a MedHx of BPH, COPD, seizures, eczema, and anxiety.  He has been seen monthly and he described some episodes of nocturia that still persists.  A list of his recent mediation includes Alprazolam, Phenytoin, Dutasteride, and ibuprofen prn.  By administering the Get Up and Go Test, we find that he only had a brief episode of not being able to rise but he performed well after that completing it in 12 seconds.  He demonstrates an improvement in his depression experienced in the past exhibited for several months after the loss of his spouse.  His friends at the facility keep him busy and he is much improved in his outlook for the future.”  C. Miller ARNP

Instructions:

1. Read the Fall Risk Assessment for Older Adults article. 
2. Complete the Hendrich II Fall Risk Model tool form completely.
   • Assign the correct scores for the Fall Risk Tool.
   • Summarize the scores derived as per fall risk.
3. Develop a summary of the risks for T.J., so that the facility can respond to those risks and provide a safe environment.
4. Describe the level of safety that the facility should plan to give T.J.
5. Finally, explain whether you feel like the score from the Fall Risk Tool is accurate and if the tool is worth the effort to develop.
6. Your paper should be:
   • One (1) page or more.
   • Use factual information from the textbook and/or appropriate articles and websites.
   • Cite your sources – type references according to the APA Style Guide.
7. Upload your file by clicking “Browse My Computer” for Attach File.

  For a person to become a Family Nurse Practitioner (FNP), they must have advanced academic qualifications. For instance, one must attain a bachelor’s degree first to be considered for a master’s degree program. Some tertiary nursing training institutions usually provide bridge programs, which can facilitate the process of attaining a master’s degree without necessarily having a bachelor’s degree program. FNPs can consider going for a terminal degree, which is the Doctor of Nursing Practice (American Association of Colleges of Nursing [AACN], 2019). Although the master’s degree allows nurses to practice as FNPs, the doctoral qualification equips them with the skills that enable them to provide high-quality, holistic, and patient-centered health services.

            The Coalition for Patients’ Rights determines the scope of practice of FNPs. American Nurses Association (n.d) indicates that this body was formed primarily to address the American Medical Association’s (AMA’s) scope of practice. This scope of practice limited that of other licensed healthcare providers, including FNPs. Although this was a positive move aimed at improving the reputation of physicians, it contributed to restricting access to health services for healthcare consumers. ANA defines the scope of practice of NPs and outlines services that must be provided as per any given qualifications. Professional organizations consider the competencies of nurses before making their inputs in the scope of practice, but political organizations are concerned with access to healthcare services.

            Advanced Practice Nurses (APRNs) face significant restrictions when it comes to delivering patient care. For instance, APRNs must practice under the supervision of physicians (Florida Board of Nursing, 2020). They are also not allowed to prescribe medications without the permission of physicians. Furthermore, they must get two separate licenses. The prescriptive authority can be changed to facilitate independent practice among APRNs. This goal can be achieved by collecting evidence on the efficacy of the practice of APRNs, justifying it to the legislator, and then allowing the legislator to draft a bill to support it.

                                                                                            References

American Association of Colleges of Nursing. (2019). DNP fact sheet. Retrieved from https://www.aacnnursing.org/News-Information/Fact-Sheets/DNP-Fact-Sheet

American Nurses Association. (n.d). Advanced practice registered nurses (APRN). Retrieved from https://www.nursingworld.org/practice-policy/aprn/

Florida Board of Nursing. (2020). Advanced practice registered nurses (APRN). Retrieved from https://floridasnursing.gov/nursing-faqs/advanced-practice-registered-nurse-aprn/

I need a professor to do 750 questions on Pharmacology and Assessment exams before June 31st, 2018. This is done through a website and I will provide  login info. Each exam is 150 questions totaling 750. Each test needs to have a score higher than 85% or else it will count as failed. NO RETAKES.