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What is the patient’s medical problem?

What is the patient’s medical problem? 150 150 Nyagu

Westcoast nurs521 Ethical Frameworks Essay
Westcoast nurs521 Ethical Frameworks Essay

Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below). Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way? Does this seem like a valid process for you to apply in your practice?

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Your paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.

Review the rubric for further information on how your assignment will be graded.

Optional: You may download this pdf, complete it using correct grammar and APA, and submit it as your assignment in lieu of writing a paper. *You will need Adobe Acrobat in order to utilize this fillable .pdf form.

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 60

TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Medical Indications: The Principles of Beneficence and Nonmaleficence

1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?

2. What are the goals of treatment?

3. In what circumstances are medical treatments not indicated?

4. What are the probabilities of success of various treatment options?

5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?

Patient Preferences: The Principle of Respect for Autonomy

1. Has the patient been informed of benefits and risks, understood this information, and given consent?

2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?

3. If mentally capable, what preferences about treatment is the patient stating?

4. If incapacitated, has the patient expressed prior preferences?

5. Who is the appropriate surrogate to make decisions for the incapacitated patient?

6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?

Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy

1. What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?

2. On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?

3. Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?

4. What ethical issues arise concerning improving or enhancing a patient’s quality of life?

5. Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?

6. What are plans and rationale to forgo life-sustaining treatment?

7. What is the legal and ethical status of suicide?

Contextual Features: The Principles of Justice and Fairness

1. Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?

2. Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?

3. What are the limits imposed on patient confidentiality by the legitimate interests of third parties?

4. Are there financial factors that create conflicts of interest in clinical decisions?

5. Are there problems of allocation of scarce health resources that might affect clinical decisions?

6. Are there religious issues that might influence clinical decisions?

7. What are the legal issues that might affect clinical decisions?

8. Are there considerations of clinical research and education that might affect clinical decisions?

9. Are there issues of public health and safety that affect clinical decisions?

10. Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?

Westcoast nurs521 Ethical Frameworks Essay

Identify the model of nursing care that you observed.

Identify the model of nursing care that you observed. 150 150 Nyagu

Nursing Care Models Paper
Nursing Care Models Paper

Purpose
The purpose of this assignment is to identify nursing care models utilized in today\’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction.

Course Outcomes – Nursing Care Models Paper

Completion of this Nursing Care Models Paper assignment enables the student to meet the following course outcomes.

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CO1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2)

CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)

CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)

CO6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. (PO7)

CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO2, and 3)

CO8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)

Nursing Care Models Paper Due Dates

Submit by Sunday, 11:59 p.m. MT, end of Week 5.

Rubric

Click to view and download the NR447 Nursing Care Models Paper Rubric (Links to an external site.)Links to an external site..

Points

This Nursing Care Models Paper assignment is worth 200 points.

Nursing Care Models Paper Directions

Read your text, Finkelman (2016), pp- 111-116.
Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.
Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model.
Write a 5-7 page Nursing Care Models Paper that includes the following:
Review and summarize two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting.
Review and summarize two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.
Discuss your observations about how the current nursing care model is being implemented. Be specific.
Recommend a different nursing care model that could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
Provide a summary/conclusion about this experience/assignment and what you learned about nursing care models.
Write your Nursing Care Models Paper using APA format using Microsoft Office 2010 or later.

What is the most likely genetic disease that this presents and why?

What is the most likely genetic disease that this presents and why? 150 150 Nyagu

NR507 Advanced Pathophysiology Quiz -Exam Questions and Answers
NR507 Advanced Pathophysiology Quiz -Exam Questions and Answers

PART 1:

You are contacted by an attorney representing a client who has been charged with child abuse and whom faces loss of her child and 15 years in prison. The record indicated that the child was 4 years old and presented to the ER room with a broken arm and a broken leg. There also appeared to be multiple previous fractures. Now, you examine the child and find blue sclera, a sunken chest wall, severe scoliosis, and you observe a triangular face and prominent forehead. You confirm that there have been multiple previous fractures by evaluating the previous X-rays. This is a genetic disorder.

What is the most likely genetic disease that this presents and why?
What is the molecular basis of this disease?
Before, calling the police what should the initial clinician have done?
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The presenting genetic disease is most likely osteogenesis imperfecta (OI), also known as brittle bone disease. OI consists of a diverse group of symptoms related to genetic mutations found in type 1 collagen biosynthesis (Golshani, Ludwig, Cohn, & Kruse, 2016). The Sillence classification system delineates OI based on the severity of the disease. Types II and III are the most severe, are characterized by autosomal recessive inheritance, can cause severe deformity in the neonate, stillbirth, and these patients have a short life expectancy (McCance, Huether, Brashers, & Rote, 2013). Types I and IV are considered less severe forms, are characterized by inherited autosomal dominant trait, and the onset varies in age from childhood to adulthood (McCance et al., 2013). The main characteristics of OI include low bone mass and elevated bone fragility that leads to fractures and deformities (Golshani et al., 2016). The classic manifestations associated with OI are osteoporosis like and include an increased incidence of fractures, triangular facies, possible bony deformations, poor dentition, possible blue sclera, and possible vascular weaknesses (McCance et al., 2013).

To fully understand the disease process, it is important to know what happens at the molecular level in regards to the biosynthesis of type 1 collagen. First, procollagen is created via rough endoplasmic reticulum as triple helix that form two collagen chains, a1(I) and a2(I), which are encoded by the COLIA1 and COILA2 genes (Golshani et al., 2016). Both chains have C and N terminal peptides (Golshani et al., 2016). These chains also have domains with repetitive amino acid sequence that contain glycine by every third amino acid, which permits the triple helix arrangement (Golshani et al., 2016). Once post-translational modifications and folding occurs, the procollagen molecule is carried to the extracellular matrix, cleavage of the terminal propeptides takes place, and the collagen molecule forms (Golshani et al., 2016). When the collagen molecule forms, it forms fibrils via covalent bonding inside and in the middle of triple helix molecules (Golshani et al., 2016). Additionally, the fibrils formed will accumulate and produce type 1 collagen fibers (Golshani et al., 2016).

Upon examination, medical professionals may find evidence of bone fractures in various stages of healing, including fractures of the skull, metaphysis bones, and ribs, leading to the suspicion of child abuse (Golshani et al., 2016). While OI is rare, it should still be included in ones differential diagnosis (Golshani et al., 2016). Evaluation and treatment of OI is established by the presence of clinical manifestations, therefore it is very important clinicians are able to recognize them (McCance et al., 2013). In all types of the disease process, serum alkaline phosphate levels will be elevated (McCance et al., 2013). Another way to evaluate OI is by culturing skin fibroblast collagen via electrophoresis; 95 percent of people tested who have OI show a decreased amount of collagen (McCance et al., 2013). The initial clinician should have questioned the child’s symptoms; diagnosis of OI is distinct when some key elements exist including blue sclera, scoliosis, wormian bones, and a family history (Golshani et al., 2016). Without these features, diagnosis can be difficult (Golshani et al., 2016).

Golshani, K.R., Ludwig, M.R., Cohn, P.L., & Kruse, R. (2016). Osteogenesis Imperfecta. Delaware Medical Journal, 88(6), 178-185. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=27506061&site=eds-live&scope=site

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby.

PART:

Johnny is a 5-year-old Asian boy who is brought to a family practice office with a “runny” nose that started about 1 week ago but has not resolved. He has been blowing his nose quite frequently and “sores” have developed around his nose. His mother states, “The sores started as ‘big blisters’ that rupture; sometimes, a scab forms with a crust that looks like “dried maple syrup” but continues to seep and drain.” She is worried because the lesions are now also on his forearm. Johnny’s past medical and family histories are normal. He has been febrile but is otherwise asymptomatic. The physical examination was unremarkable except for moderate, purulent rhinorrhea and 0.5- to 1-cm diameter weeping lesions around the nose and mouth and on the radial surface of the right forearm. There is no regional lymphadenopathy.

Write a differential of at least three (3) possible diagnoses and explain how each may be a possible answer to the clinical presentation above. Remember, to list the differential in the order of most likely to less likely.
Based upon what you have at the top of the differentials how would you treat this patient?
When would you allow the student back to school? Elaborate on your reasoning?

Impetigo is a bacterial skin infection seen in infants and children and is more commonly seen in mid to late summer, especially in climates that are hot and humid(McCance, Huether, Brashers, & Rote, 2013). Impetigo is prevalent in settings like daycare or in crowded areas with poor sanitary conditions (McCance et al., 2013). Impetigo pustules or vesicles may be seen anywhere however, the face and extremities are the more common sites (Allmon, Deane, & Martin, 2015). Predisposing factors for impetigo include anemia and malnutrition however, healthy children are also affected (McCance et al., 2013).

Bullous impetigo – Bullous impetigo is a highly contagious bacterial infection caused by Staphylococcus aureus and is carried in the anterior nares, the fingernails, and the perineal area (McCance et al., 2013). The pathogen is transmitted via contact with an infected individual or by non-direct contact, such as equipment that is contaminated (McCance et al., 2013). A person becomes infected because the Staphylococcus aureus produces exfoliative toxins (ETs) that inoculate into the dermis and epidermis causing blisters to form (McCance et al., 2013). The blisters are usually located around the patient’s nose or mouth however, the hands and other exposed regions such as the extremities can also be affected (McCance et al., 2013). The blisters can amalgamate, forming superficial bullae that can be localized or spread over different areas of the skin (McCance et al., 2013). When the bullae break open, a honey colored crust will form around the area; this crust is a hallmark sign of impetigo (McCance et al., 2013). In bullous impetigo, regional lymphadenopathy is uncommon (McCance et al., 2013).

The treatment of choice for impetigo is antibiotics, either topical or systemic. Topical antibiotics, such as mupirocin or fusidic acid, are recommended for localized areas of impetigo (Watkins, 2013). Topical antibiotics need to be rubbed on the lesions and the skin area around the lesion 3 times a day for 7 to days or until the lesions are healed (Watkins, 2013). If a patient has an allergy to mupirocin or fusidic acid, an alternative antiseptic such as hydrogen peroxide, chlorhexidine, or iodine may be used (Watkins, 2013). If topical antibiotics are ineffective, the lesion should be swabbed to determine the causative pathogen and the pathogens sensitivity to antibiotics (Watkins, 2013). Systemic antibiotics may be needed for severe cases or for those that did not respond to topical antibiotics (Watkins, 2013). Systemic antibiotic options include flucloxacillin and clarithromycin, if the patient is allergic to penicillin (Watkins, 2013). Phenoxymethylpenicillin should be added to the treatment if erysipelas is present (Watkins, 2013). Patients with MRSA or glomerulonephritis need to be referred to a specialist for care (Watkins, 2013). Education should include proper hand hygiene and seclusion of the child’s items that could spread the infection such as wash cloths, linens, towels, clothes, and utensils and glasses used for eating and drinking (McCance et al., 2013). Children should not return to school or daycare until the lesions are completely crusted over and healed, or for at least 48 hours after beginning antibiotics because antibiotics reduce the infection period (Watkins, 2013).

Johnny fits the presentation for impetigo, most likely bullous impetigo, based on his clinical manifestations, especially the lack of lymphadenopathy. However, a diagnosis of nonbullous is also conceivable. I would start Johnny on topical antibiotics and advise his mother to keep him home until the lesions have healed or for at least 48 hours after starting the antibiotic treatment. I would also educate her on hygiene precautions so the infection does not spread to others. Also, she must thoroughly bathe him with soap and water, carefully removing any crust around the lesions (Watkins, 2013).

Nonbullous impetigo – Nonbullous impetigo, the more common of the types, is also a highly contagious bacterial infection caused by Staphylococcus aureus or group A Streptococcus pyogenes. A person can become infected with either pathogen via direct physical contact or via insect bites (McCance et al., 2013). Nonbullous impetigo forms superficial, acute, vesicles with honey like serum; when the vesicle ruptures, yellow to white-brown crust will form (McCance et al., 2013). These lesions can look similar to herpes simplex lesions and therefore a distinction should be made (McCance et al., 2013). Unlike bullous impetigo, it is common to see regional lymphadenopathy in nonbullous (McCance et al., 2013). Treatment and education are the same for both types of impetigo (McCance et al., 2013).

Even though nonbullous is the more common of the two types, based on clinical manifestations, nonbullous does not completely fit the presentation. However, the presentation between the two types is so similar it cannot be fully ruled out.

Herpes simplex virus – Herpes simplex virus (HSV) are usually caused by two different strains of the virus, HSV 1 and HSV 2 and can occur all over the body (McCance et al., 2013). The only way to distinguish between the two is laboratory testing. HSV type 1 is transmitted via infected saliva (McCance et al., 2013). The first infection is referred to as the primary infection where the virus travels to the dorsal ganglion root and remains latent (McCance et al., 2013). In the secondary phase, reactivation of the virus occurs and the virus travels via peripheral nerves to the original site of infection, where it sheds (McCance et al., 2013). Reactivation of the virus can occur related to stress, skin irritation, fatigue, ultraviolet light, and fever (McCance et al., 2013). HSV-1 lesions present as inflamed, painful vesicles in rash like patterns or clusters and in children are typically located on the lips, in and/or around the nose, on the tongue, and within the mouth (McCance et al., 2013). When the vesicle ruptures, a crust will form over the area (McCance et al., 2013). Lesions can last up to 6 weeks if left untreated (McCance et al., 2013). Generally, topical antivirals can help resolve the lesions in 2 weeks (McCance et al., 2013). Additionally, oral antivirals can be given for acute infections or for daily use as a suppressive therapy (McCance et al., 2013).

Impetigo can be mistaken for herpes simplex virus because their lesions can look similar. However, HSV does not fit the presentation. I do not believe Johnny has HSV.

Allmon, A., Deane, K., & Martin, K.L. (2015). Common skin rashes in children. American Family Physician, 92(3), 211-216. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=26280141&site=eds-live&scope=site

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby.

Watkins, J. (2013). Bullous and non-bullous impetigo. Practice Nursing, 24(2), 95-96. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=108026722&site=eds-live&scope=site

PART 3:

Keisha, a 13-year-old female, has come into your urgent care center. She has red conjunctiva, a cough and a fever of about 104 F, She also has a rash on her face a possibly the beginning of a rash on her arms. About 10 days ago she was around another student who had similar symptoms.

Write three (3) differential diagnoses?
What are some of the complications of this disease, assume that the top of your differential is the definitive?
Assume that the second item you place on your differential is the definitive diagnosis. What are some complications of that disease?

Rubeola – Rubeola is an acute, viral disease seen in children that is very contagious (McCance, Huether, Brashers, & Rote, 2013). A specific RNA virus containing the paramyxovirus causes rubeola, it is transmitted via droplets from individuals already infected with the virus (McCance et al., 2013). This means Rubeola can be spread via sneezing, breathing, and coughing (Grif Alspach, 2015). The virus can remain on surfaces and in the air for up to 2 hours (Grif Alspach, 2015). Rubeola has an incubation period that lasts 7 to 12 days; during this time, the infected person will not have any symptoms (McCance et al., 2013). The virus is introduced via the respiratory tract where it latches onto alveolar macrophages and dendritic cells, the virus increases in size in the lymphatic tissue, and then advances to systemic disease (McCance et al., 2013). Early symptoms include high fevers (up to 105 degrees), skin rash, koplik spots, conjunctivitis, cough, malaise, and coryza (Grif Alspach, 2015). Approximately 1 to 4 days after being exposed to the virus, a maculopapular rash will appear, it begins on the forehead and spreads to the trunk, extremities, hands, feet and even the palms and soles of the hands and feet (Grif Alspach, 2015). It is important to know that patients are contagious 4 days prior to the development of the rash and 4 days after it begins (Grif Alspach, 2015). Immunocompromised patients may not develop a rash so providers should be able to recognize symptoms without the rash development (Grif Alspach, 2015). The rash will gradually begin to fade, beginning from the head down, and will typically resolve on it’s own within 7 to 10 days (Grif Alspach, 2015). One way to distinguish Rubeola from Rubella is conjunctivitis is present in Rubeola but not in Rubella (Grif Alspach, 2015). Confirmation via lab work can be achieved by serum or swabbing of nasal cavity or oropharyngeal cavity (Grif Alspach, 2015). Even though most people will resolve the disease on their own, some people can have serious complications such as encephalitis and pneumonia (Grif Alspach, 2015). The best way to prevent Rubeola is through the MMR vaccine (Grif Alspach, 2015). Additionally, hand hygiene is essential in helping to decrease the spread of disease.

Rubella – Rubella is a communicable disease seen in children and young adults, it is caused by an RNA virus that enters via the respiratory tract and invades the bloodstream (McCance et al., 2013). Rubella is contracted via droplets, maternal-fetus transmission, or contact with nasopharyngeal secretions (Chan, MacFadden, & Leis, 2016). The virus has an incubation period of 14 to 23 days; patients are thought to be contagious one week prior to the onset of the rash and 4 days after the rash begins (Chan et al., 2016). Early symptoms include a low grade fever (which usually presents 1 to 5 days before the rash), possible enlarged postauricular and cervical lymph nodes, sore throat, headaches, cough, and runny nose (McCance et al., 2013). Other clinical manifestations may include arthritis, arthralgias, and cold symptoms (Chan et al., 2016). When the rash develops, it is characterized by pinpoint pink macules; the rash will begin on the head and spread down to the trunk and extremities in 24 hours (Chan et al., 2016). The rash with Rubella is absent on the palms and soles on the hands and feet (McCance et al., 2013). Once someone contracts the disease, a lifelong immunity develops against the disease (McCance et al., 2013). The diagnosis is typically made via lab work (Chan et al., 2016). Preventative treatment for Rubella is vaccination (Chan et al., 2016). Treatment for Rubella is supportive and includes using a vaporizer, fluids, and rest (McCance et al., 2013). Some patients may develop mild encephalitis or peripheral neuritis (McCance et al., 2013). Significant mortality occurs in people who do not vaccinate against Rubella with encephalitis, pneumonia, and croup causing the largest number of deaths related to the disease (McCance et al., 2013).

Chickenpox – Chickenpox affects most patients in the first decade of their life (McCance et al., 2013). It is spread via airborne droplets and contact with an infected person (McCance et al., 2013). Patients are contagious at least one day prior to the development of lesions and about 5 to 6 days after the lesions appear (McCance et al., 2013). Prodromal symptoms include itching, then vesicles will begin to appear (McCance et al., 2013). Fever may be present, up to 104 degrees and typically lasts 2 to 3 days (McCance et al., 2013). The vesicles usually appear on the face, scalp, or trunk first then will spread to the extremities later (McCance et al., 2013). In chickenpox, the lesions will characteristically heal in various stages therefore macules, papules, and vesicles can all be seen; there can be anywhere from 100 to 300 lesions present and all in different stages of development and healing (McCance et al., 2013). On occasion, vesicles may appear in the mouth, on the palms of hands, soles of feet, pharynx, and conjunctiva (McCance et al., 2013). Complications are unusual in children and more common in adults, complications can include epistaxis, hematuria, varicella pneumonia, and laryngeal edema (McCance et al., 2013). Once someone contracts the virus, immunity is developed (McCance et al., 2013). There is a vaccine to help prevent chickenpox (McCance et al., 2013). For uncomplicated cases, supportive care includes wet dressings, baths, and oral antihistamines (McCance et al., 2013). Oral antiviral medications can be given to reduce symptoms, especially in immunocompromised patients (McCance et al., 2013).

Chan, T., MacFadden, D.R., & Leis, J.A. (2016). Rubella in a returned traveller. CMAJ: Canadian Medical Association Journal = Journal De L’association Medicale Canadienne, 188(5), 363-366. doi: 10.1503/cmaj.150574 http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=26622002&site=eds-live&scope=site

Grif Alspach, J. (2015). Measles: Eliminated but not eradicated. Critical Care Nurse, 35(4), 9-13. doi: 10.4037/ccn2015629. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=109826168&site=eds-live&scope=site

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby

INSTRUCTOR:

Whitney,

Thank you for your discussion. The good (maybe) thing about this condition is that as the child grown, the fractures tend to decrease in severity. Why might a thorough hearing examination be helpful in its diagnosis?

Dr. Winters7382

Hi Dr. Winters,

Thank you! One of my article does address the auditory issues that can arise, as well as our text, and I completely missed it! Per Swinnen, De Leenheer, Goemaere, Cremers, Coucke, and Dhooge (2012), skeletal conditions related to OI can improve when the patient enters into adulthood, unfortunately about 50 percent of these patients develop hearing loss sometime during adulthood. Hearing impairment is related to disease of the soft tissue in the ear as well as the middle ear bone (Golshani, Ludwig, Cohn, & Kruse, 2016). Hearing exams should begin in the teen years and continue regularly into adulthood (Golshani et al., 2016). Hearing impairment is usually related to a conductive hearing problem at first and typically advances to mixed hearing loss later; some patients may develop pure sensorineural hearing loss (SNHL) (Swinnen et al., 2012). Conductive hearing loss is usually related to otosclerosis-like lesions, which produce a fixed and thickened stapes footplate (Swinnen et al., 2012). Additionally, conductive hearing loss can also be related to ossicular discontinuity, particularly by atrophied or fractured stapes crura and replaced with fibrous threads (Swinnen et al., 2012). If or when the disease advances to a mixed hearing loss, a CT scan will show pericochlear demineralization (Swinnen et al., 2012). A thorough hearing exam could show middle ear abnormalities and/or conductive hearing loss, which could help lead to the diagnosis of OI.

Golshani, K.R., Ludwig, M.R., Cohn, P.L., & Kruse, R. (2016). Osteogenesis Imperfecta. Delaware Medical Journal, 88(6), 178-185. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=27506061&site=eds-live&scope=site

Swinnen, F.R., De Leenheer, E.R., Goemaere, S., Cremers, C.J., Coucke, P.J., & Dhooge, I.M. (2012). Association between bone mineral density and hearing loss in osteogenesis imperfecta. The Laryngoscope, 122(2), 401-408. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=22252604&site=eds-live&scope=site

PEER:

Hi Amber,

Thank you for your post! I also had a hard time distinguishing between bullous and non-bullous impetigo. Ultimately, I went with bullous because the patient did not show any regional lymphadenopathy. However, the clinical manifestations are so similar I was not 100 percent sure I chose the correct type. According to Lewis (2016), bullous is less contagious than nonbullous and its lesions are more likely to affect the face, extremities, the trunk, axillae, and perianal areas. Bullous differs from nonbullous in two ways, bullous can affect buccal mucous membranes but rarely causes regional lymphadenopathy (Lewis, 2016). In the clinical setting, a bacterial culture may be obtained from fresh exudate (found under the scab) or a gram stain and culture of blister fluid may be performed (Lewis, 2016). The gram stain will show gram-positive cocci in clusters for Staphylococcus aureus and gram-positive cocci in chains for Streptococcus pyogenes (Lewis, 2016). The good news, per McCance, Huether, Brashers, and Rote (2013), is that the treatment for both is the same. Therefore, antibiotic therapies chosen have to provide coverage against Staphylococcus aureus and Streptococcus pyogenes (Lewis, 2016).

Lewis, L. (2016). Impetigo. Medscape. Retrieved from http://emedicine.medscape.com/article/965254-overview

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby.

QUIZ:

Considering the pathophysiology of osteoporosis, which cytokines and hormones decrease receptor activator of RANKL expression?(Points : 2)
IL-4 and transforming growth factor-beta (TGF-ß)
IL-1 and tumor necrosis factor-alpha (TNF-)
IL-11 and glucocorticoids
IL-17 and parathyroid hormone (PTH)

Rhabdomyolysis is characterized by (Points : 2)
paralysis of skeletal muscles resulting from impaired nerve supply.
smooth muscle degeneration resulting from ischemia.
lysis of skeletal muscle cells through the initiation of the complement cascade.
release of myoglobin from damaged striated muscle cells.

Which type of osteoporosis would a person develop after having the left leg in a cast for 8 weeks to treat a compound displaced fracture of the tibia and fibula? (Points : 2)
Iatrogenic
Regional
Idiopathic
Osteoblastic

Considering the pathophysiology of osteoporosis, what are the effects of extracellular signal regulated kinases (ERKs) and receptor activator of RANKL on osteoblasts and osteoclasts? (Points : 2)
ERKs increase the life span of osteoclasts and RANKL decreases the life span of osteoblasts.
ERKs and RANKL increase the life span of osteoclasts and decrease the life span of osteoblasts.
ERKs and RANKL increase the life span of osteoblasts and decrease the life span of osteoclasts.
ERKs increase the life span of osteoblasts and RANKL decreases the life span of osteoclasts.

What is the diagnosis of a person who has tennis elbow characterized by tissue degeneration or irritation of the extensor carpi brevis tendon? (Points : 2)
Lateral epicondylitis
Medial tendinitis
Bursitis
Lateral tendinitis

Which statement is false about giant cell tumors? (Points : 2)

They are an overexpression of genes including osteoprotegerin ligand (OPGL).
They are malignant, solitary, irregularly shaped tumors.
They are typically located in the epiphysis in the femur, tibia, radius, and humerus.
They are slow-growing tumors that extend over the articular cartilage.

What pattern of bone destruction is described as not well defined and not easily separated from normal bone? (Points : 2)
Moth-eaten
Permeative
Geographic
Porous

The pain experienced in Legg-Calvé-Perthes disease is referred to as involving (Points : 2)
elbows and upper and lower arms that is aggravated by activity and relieved by rest.
knees, inner thighs, and groin and is described as a continuous ache and relieved by anti-inflammatory drugs.
knees, inner thighs, and groin that is aggravated by activity and relieved by rest.
elbows and upper and lower arms and is described as a continuous ache and relieved by anti-inflammatory drugs.

In osteomyelitis, bacteria gain access to the subperiosteal space in the metaphysis, which is considered the “path of least resistance.” What factor makes this route for bacteria the path of least resistance? (Points : 2)
Cortex of the bone in this area is porous or maze-like.
Blood supply to the metaphysis is easily compromised.
Macrophages and lymphocytes have limited access to the subperiosteal space.
Bacteria usually spread down the medullary cavity of the bone.

Molecular analysis has demonstrated that osteosarcoma is associated with (Points : 2)
TP53.
src.
myc.
TSC2.

Ewing sarcoma arises from (Points : 2)
bone marrow.
bone-producing mesenchymal cells.
metadiaphysis of long bones.
embryonal osteocytes.

Which serum laboratory test is elevated in all forms of osteogenesis imperfecta? (Points : 2)
Phosphorus
Calcium
Alkaline phosphatase
Total protein

The _____ is cartilage that retains the ability to form and calcify new cartilage and deposit bone until the skeleton matures. (Points : 2)

epiphyseal line
physeal plate VIA ENDOCHONDRAL OSSIFICATION
epiphyseal cartilage
metaphyseal plate

Osteochondrosis is caused by a(n) (Points : 2)
imbalance between calcitonin and parathyroid hormone.
nutritional deficiency of calcium and phosphorus.
bacterial infection of the bone.
vascular impairment and trauma to bone.

An insufficient dietary intake of vitamin _____ can lead to rickets in children. (Points : 2)
C
B12
B6
D

In latex allergies, which immunoglobulin is associated with an immediate reaction? (Points : 2)
A
E
G
M

Chickenpox may be followed years later by (Points : 2)
erysipelas.
cytomegalovirus.
warts (verrucae).
herpes zoster.

Cutaneous vasculitis develops from the deposit of _____ in small blood vessels as a toxic response allergen. (Points : 2)
immune complexes
IgE
complement
T lymphocytes

Which malignancy is characterized by slow-growing lesions that usually have depressed centers and rolled borders and are frequently located on the face and neck? (Points : 2)
Squamous cell carcinoma
Kaposi sarcoma
Malignant melanoma
Basal cell carcinoma

Scleroderma is more common in women and is associated with a(n) (Points : 2)
X-linked recessive gene.
X-linked dominant gene.
virus.
autoantibodies.

Thrush is a superficial infection that commonly occurs in children and is caused by (Points : 2)
Staphylococcus.
Streptococcus.
herpesvirus.
Candida albicans

What is the cause of chickenpox? (Points : 2)
Poxvirus
Varicella-zoster virus (VZV)
Adenovirus
Human papillomavirus

Which vascular anomaly is a congenital malformation of dermal capillaries that does not fade with age? (Points : 2)
Cutaneous hemangioma
Port-wine (nevus flammeus) stain
Strawberry hemangioma
Cavernous hemangioma

What is a common source of tinea corporis? (Points : 2)
Mites
Kittens
Fleas
Ticks

Which contagious disease creates a primary skin lesion that is a pinpointed macule, papule, or wheal with hemorrhagic puncture site?(Points : 2)
Pediculosis
Tinea capitis
Scabies
Rubeola

NR507 Advanced Pathophysiology Quiz -Exam Questions and Answers

Discuss how headlines such as this affect your opinion of politicians.

Discuss how headlines such as this affect your opinion of politicians. 150 150 Nyagu

NURS521 Virtue Ethics Essay
NURS521 Virtue Ethics Essay

Respond to one of the following three “news clippings” related to virtue ethics from your Pozgar text. Write a 1- 2 page essay addressing the discussion questions posed for the one you selected. Be sure to clearly identify the news clipping you selected.

Adhere to APA formatting and cite all sources. Review the rubric for further information on how your assignment will be graded.

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 40

Watch the following 3 videos and choose one to address for your assignment.

#1. Wrong-Operation Doctor

Download Script

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Find Out More: You may use these and other outside sources to frame your discussion.

The Pain of Wrong Site Surgery

Judgment Upheld in Arkansas Brain Surgery Lawsuit

National Quality Forum

Assignment Discussion Questions

1. Discuss the issues of integrity in this case.

2. Should criminal charges be considered in this case, if accurately reported? Discuss your answer.

3. Why did you choose to respond to this story?

4. How is integrity displayed in your clinical setting?

#2. Cheney’s Staff Cuts Testimony on Warming

Download Script

Find Out More: You may use these and other outside sources to frame your discussion.

The full story Cheney’s Staff Cut Testimony On Warming

CDC on Air Quality

NURS521 Virtue Ethics Essay Assignment Discussion Questions

1. Discuss how headlines such as this affect your opinion of politicians.

2. At the end of our days, the most basic principles of life–trust and survival–are on trial. What is your verdict, if you believe there was a cover-up?.

3. Why did you choose to respond to this story?

4. How are government and political trust displayed in your clinical setting?

#3. Surgeon Uses Ministry in Medical Practice

Download Script

Find Out More: You may use these and other outside sources to frame your discussion.

The full story: Praying with patients: A Dallas surgeon finds a way to put ministry into practice

Should Your Doctor Pray With You?

South Korean Hospitals Shut Over MERS Fears; 11th Person Dies

Note the picture in this article

NURS521 Virtue Ethics Essay Assignment Discussion Questions

1. Discuss the pressure, if any, placed on the patient to responding to the suggestion of prayer prior to surgery.

2. Describe how you, as the surgeon, or nurse, would address a patient’s religious or spiritual needs if the risks of a complex surgical procedure appear to be threatening.

3. Why did you choose to respond to this story?

4. How is religion or faith displayed in your clinical setting?

NURS521 Virtue Ethics Essay

Discuss those areas that are strengths (higher scores) and those areas that need further development (lower scores).

Discuss those areas that are strengths (higher scores) and those areas that need further development (lower scores). 150 150 Nyagu

Rasmussen nur2058 – Balancing School and Life – My Quality of Life Self-Care Plan
Rasmussen nur2058 – Balancing School and Life – My Quality of Life Self-Care Plan

Balancing School and Life – My Quality of Life Self-Care Plan. The purpose of developing this Plan is to set a framework and a plan to maintain wellness and to stay motivated and engaged throughout your Program. Doing this will help you achieve success during your coursework and as a professional nurse.

The goal of the Project is to help you become self-aware and reflective as a means of identifying personal self-care strategies that will increase your energy and help you manage your stress. The Project will give you a chance to learn how this is accomplished as you will be doing similar work with clients during the Program and as a professional nurse to assist them in the same way.

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Use the Quality of Life Self-Care Wheel to assess your current state. After you determine your scores, in a 2-3 page paper complete the following:

Discuss those areas that are strengths (higher scores) and those areas that need further development (lower scores).

Identify two strategies you can use to maintain or maximize each identified strength.

Identify two strategies you can use to strengthen each area needing development. Explain how you will put these strategies into action. Be specific. For example, instead of stating, “I need to exercise,” your action should state “I will begin to walk 20 minutes a day, 3 days a week.” The action should be SMART- Specific, Measurable, Attainable, Realistic, Timeframe

Also attach your completed form

Minimum length 2-3 pages not including cover or referencing. APA formatting

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

rasmussen nur2058 – Balancing School and Life – My Quality of Life Self-Care Plan

Identify a problem or issue from within your specialty area that you feel needs to be improved upon.

Identify a problem or issue from within your specialty area that you feel needs to be improved upon. 150 150 Nyagu

Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools
Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Week 1 -Assignment 2 Discussion

Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

Identify a problem or issue from within your specialty area that you feel needs to be improved upon. The Doctor of Nursing Practice site (http://www.doctorsofnursingpractice.org/resources/dnp-scholarly-projects/) provides many examples of these projects. The list below may help focus your thoughts.

Educational program

Evidence-based healthcare policy change

Evidence-based clinical issue or protocol for specific disease/condition

Discuss the relevance of the issue from your perspective (not the literature at this juncture) in relation to your selected advanced role option.

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What piqued your interest about this issue or problem?

How does it relate to your area of specialization?

What gave you the idea that evidence exists to support this change? See “note” below.

Provide a rationale as to why this will be an evidence-based project to improve outcomes and not generate new evidence (research). Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Please remember that the project will not be implemented during this course and no data will be collected. The outcome of this course is to complete a project proposal only.

Week 2 – Assignment 1 Discussion

Melynk and Fineout-Overholt (2011) note that there are seven steps to the evidence-based practice (EBP) process. The first step is to cultivate a spirit of inquiry. To encourage this spirit of inquiry, you are asked in this discussion to:

Briefly describe the problem or issue that you have decided to be the topic for your project proposal in order to orient your classmates and faculty

Indicate how it relates to your area of specialization

State your PICOT question. Indicate in parentheses after each segment, what part of PICOT the preceding words represent. For example: In patients recently discharged from the hospital following care for heart failure (P), do hand-off calls by the nurse to the primary care provider using the SBAR format (situation, background, assessment, recommendation) (I) compared to no calls (C) decrease readmission rates (O) over a one year period (T). Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Discuss which process model resonates with you and will help keep you focused during the project. Process models included in your text (Melnyk & Fineout-Overholt, 2011) are:

Clinical scholar model

Stetler model of evidence-based practice

Iowa model of evidence-based practice to promote quality care

Model for evidence-based practice change by Rosswurm and Larrabee

Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model

Provide feedback to your classmates that focuses on:

The use of correct PICOT format for the question to guide the literature search.

Does the question reflect a clinical research question or one appropriate for an evidence-based practice project?

Week 3 – Assignment 1 Discussion

In this discussion, you will share your search strategies that you have employed to find evidence for your study. For this discussion:

State your PICOT question. Did using the terms used in this question lead you to useful research studies?

What MESH terms have you tried? Did they help you find additional studies? Are you finding MESH terms useful to expand or delimit your search?

Are you finding relevant articles? If not, how did you modify your search to increase productivity?

Indicate which databases you used—those you found useful and those that were not.

What levels of evidence do the studies you are finding represent?

Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

Use the Search Tracker to keep track of search terms. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Using the appropriate Rapid Clinical Appraisal (RCA) Tools, appraise one or two articles and add the information to your Evaluation Table to receive feedback from faculty. At this juncture, your table is a work in progress. You will complete it in Week 4. The RCA Tools and Evaluation Table in Word for you to complete can be found in the Week 3 Overview section.

Week 4 – Assignment 1 Discussion

Discuss your experience completing the rapid critical appraisal process.

Was it really “rapid” or was it more of a laborious process?

Did reading the abstract help you make quick decisions about including or excluding the study?

What worked best for you in terms of the approach you decided to use to complete the appraisal and Evaluation Table? What didn’t work?

Post any questions or concerns you may have and provide feedback and recommendations to your classmates. Working together and sharing search strategies is very helpful.

Week 5 – Assignment 1 Discussion

This week the discussion focuses on creating a Synthesis Table(s) as a means to summarize and organize the body of evidence from the Evaluation Table. The Synthesis tables will be included in your formal proposal in the Appendix. In the body of the paper, you will describe the “keeper” studies in narrative format.

For this discussion, include the following:

Share your approach to synthesizing the evidence. What were the variables of interest you identified?

Learning to write in a scholarly fashion requires that you are able to succinctly summarize an article in a sentence or two and cite it appropriately using APA format. In this discussion, practice summarizing 2 articles you have identified from the Synthesis Table as pertinent to your proposal. Include the level of evidence, study design, and evidence of rigor. Use appropriate APA citation in text and references. Incorporate feedback from peers and faculty in your Dropbox assignment for this week.Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

In addition to research studies, patient preference and clinical expertise should also be considered. Discuss how you will incorporate these important perspectives into your project proposal.

Week 6 – Assignment 1 Discussion

For this week’s discussion, please address the following:

Briefly describe the clinical issue or problem for your project, the setting, and population of interest to orient classmates and faculty

Write your clinical question

Describe the intervention you plan to test

What type of study will you conduct? Will it be experimental? Quasi-experimental? Provide a rationale for your answer.

Provide feedback on the clinical questions of your colleagues

Week 7 – Assignment 1 Discussion

This discussion will focus on the measurement tools you will use to evaluate change from the intervention. The purpose of this discussion is to fine-tune your thinking about evaluation by receiving feedback from colleagues and faculty. Include in your discussion:

Write a brief description of your project that starts by stating your clinical question and succinctly explaining your planned intervention in order to orient everyone.

Will you need to develop your own evaluation tools or are valid and reliable tools available?

If you create your own tools, what are your thoughts on pilot testing them? How will you go about this? Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Will you gather baseline data? Will you use pre- and posttests? How will you measure change?

How will you identify the participants for your study? How does the sampling method chosen further define the type of study you will be doing?

How will you ensure confidentiality of study participants?

Week 8 – Assignment 1 Discussion

The discussion for this week will revolve around the analysis phase of your project. Include the following points in your discussion:

Begin with a brief description of your project that includes your clinical question, your planned intervention, the type of study you will conduct and how you plan to evaluate the outcomes. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

What type of statistical analysis will be done?

What is a reasonable timeline for your project?

What expenses should be considered? Include both obvious expenses, such as materials, as well as those that are hidden, such as time, which equates to part of your salary.

Will you need to consider a funding source for your project?

Week 9 – Assignment 1 Discussion

Although you will not implement your project during this course, it is important that you understand the various steps that are necessary to do so. As you begin to formulate your strategic plan for implementing your change project, discuss the following specific to your proposed project:

Who are the stakeholders? Please identify them by role or job within the organization, not by name. Can you identify any “champions” or people within your organization that you can convert to champions?

What potential barriers do you foresee and what strategies do you envision to prevent or overcome these barriers?

What change theory will you use to guide you?

Week 10 – Assignment 1 Discussion

For this discussion question, you are asked to review the student learning outcomes for this course and discuss how you met these outcomes. The intention here is to provide you an opportunity to “reflect” on the learning achieved during this term and how you successfully met these learning outcomes. If you do not feel you successfully met the objective, discuss your plans to successfully complete the objective in the future.

By the end of the course, the student should be able to:

Demonstrate synthesis of the knowledge and skills acquired in preceding graduate nursing core and specialty curriculum content. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Evaluate current health policy and legal and ethical considerations in addressing the health promotion and disease prevention of a target population.

Integrate this synthesis in the creation of a scholarly project of either an evidenced-based practice proposal or a research proposal that generates new nursing knowledge. Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools

Disseminate significant components of the project through a written paper and oral presentation.

Evidence-Based Practice (EBP) Process, PICOT Question and Rapid Clinical Appraisal (RCA) Tools.

What questions have you thought about in a particular area of care such as a procedure or policy?

What questions have you thought about in a particular area of care such as a procedure or policy? 150 150 Nyagu

Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions
Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Week 1 discussion

Nursing Research and Evidence-Based Practice

In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.

Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).

To prepare:

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Consider a recent clinical experience in which you were providing care for a patient.

Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?

What questions have you thought about in a particular area of care such as a procedure or policy?

Review Chapter 2, pages 36—39 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.

Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.

Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.

By Day 3

Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional strategies for addressing barriers to EBP based on readings and evidence.

Week 2 discussion – Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Literature Searches

An important step in the EBP process is reviewing the current body of literature to better understand the subject or topic in which you are interested. By conducting a review of the literature, you are building foundational knowledge about the topic; later, you can use this background to build new insights. Developing a strong grasp of a topic can only be garnered by taking the time to thoroughly search for relevant information and resources.

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. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

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?

By Day 3

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.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings, or after synthesizing multiple postings.

Week 3 discussion- Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Theory, Research, and Evidence-Based Practice

As they explore the world around them, young children often want to know the “why” and “how” of the things they observe. This is similar to what researchers do when they approach a new problem. Researchers develop new theories or build on old ones to explain the “why” of the world around them. They use models and conceptual frameworks to help explain “how” the processes and events they observe occur. Together, theories and models provide an understanding of the world and allow researchers to explore it in meaningful ways.

Virtually all research questions can benefit from the use of an existing theory or model. Researchers should consider their research questions and select the most suitable theory or model, which then serves as a foundation for the research design. The selection of a theory or model is an important part of the research process.

In this Discussion, you focus on the role of theory and models in research and evidence-based practice.

To prepare:

Review the information in Chapter 6 of the course text. Focus on the various conceptual theories and models that are currently used in nursing research.

Select one of the theories or models described that is of interest to you.

Using the Walden Library, search for and identify a research article that uses the theory or model you selected.

Reflect on how the theory or model provides structure to the research study described in the article.

Now, think about an issue in your practice area that you would be interested in exploring through research.

Review this week’s media presentation and consider strategies for locating and identifying a relevant theory or model for a research study.

By Day 3

Post a summary of the article that you located and explain how the theory or model that you selected was used in the research study. Assess the value of basing research on an established theory or model.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Week 4 discussion – Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Ethical Dimensions of Research Studies

In the best-selling book, The Immortal Life of Henrietta Lacks (Skloot, 2010), the author highlights the true story of an African-American woman who died in 1951 from cervical cancer. What makes her story unique is that prior to her death, cells from her tumor were removed and successfully grown in a petri dish. This was the first time scientists were able to successfully replicate cells outside the body, and it is estimated that billions of Lacks’ cells have been used in medical research. However, Henrietta Lacks was never asked for permission to take a sample and her family was never made aware of the widespread use of her cells. Although the culturing of her cells has been pivotal for advancing research, strong ethical concerns later arose about using these cells without patient or family approval.

This week’s readings describe historical examples of unethical research, such as a study of syphilis among African-American men in which treatment was withheld and a study in which live cancer cells were injected into elderly patients. Today, stricter controls that seek to protect study participants are placed on researchers, but breaches still occur. Careful attention must be given toward preventing unethical behavior. In this Discussion, you explore ethical considerations and issues in research. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

To prepare:

Select a current health-related case involving research ethics. (If none come to mind, browse the Internet to familiarize yourself with recent cases.)

As you review the case that you have selected, reflect on the ethical principles discussed in “What Are the Major Ethical Issues in Conducting Research?” article found in this week’s Learning Resources. Which principles were breached in the case you have identified?

By Day 3

Post a description of the case that you selected and the ethical issues involved. Analyze the ethical principles that were breached by the researchers or organizations in your selected case as well as the possible cause of the breach(es). Suggest how the research might have been conducted differently to avoid or minimize the ethical problems. Discuss how research can be done on sensitive issues while still protecting the rights of the research subjects.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Week 5 discussion -Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Quantitative Research Designs

In order to find the best information on a topic, not only should you develop a question and search for resources, but you should also know how to analyze the value of the resources that you identify. There are different ways to evaluate resources, such as using the hierarchy of evidence, which you explored in Week 4 of this course. Another way to evaluate resources is to consider the appropriateness of the research design. Understanding how research designs contribute to the quality of a study is essential for being able to analyze resources when conducting a literature review or locating evidence for practice.

In this Discussion, you consider the different research designs and evaluate how these designs have been used to research a specific topic. You also consider strategies for selecting an appropriate research design. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

To prepare:

Review the information in the course texton quantitative research designs. Focus on the information in Box 9.1, “Guidelines for Critiquing Research Designs in Quantitative Studies” located on page 230 of the course text.

Select a topic from the list below and search the Walden Library to find two different quantitative research studies addressing that issue:

Caregiver stress

Anxiety in children

Sleep apnea

Depression in college freshmen

Rural health care issues

Post-traumatic stress syndrome

Traumatic brain injury in veterans

Health effects of environmental contaminants

Bipolar disorder

End-of-life ethical issues

Alternative medicine

For each of the sources that you select, identify the type of quantitative research design used, and evaluate whether it is the most appropriate approach to the research. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Consider the ramifications of choosing an inappropriate design for a research study.

By Day 3

Post the topic you selected, references for the two sources you identified, and the quantitative research design used in each. Critique the appropriateness of the design used and justify your comments with information from the Learning Resources. Discuss the ramifications of choosing an inappropriate design for a research study.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the following ways:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Week 6 discussion- Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Validity in Quantitative Research Designs

Validity in research refers to the extent researchers can be confident that the cause and effect they identify in their research are in fact causal relationships. If there is low validity in a study, it usually means that the research design is flawed and the results will be of little or no value. Four different aspects of validity should be considered when reviewing a research design: statistical conclusion validity, internal validity, construct validity, and external validity. In this Discussion, you consider the importance of each of these aspects in judging the validity of quantitative research.

To prepare:

Review the information in Chapter 10 of the course text on rigor and validity.

Read the method section of one of the following quasi-experimental studies (also located in this week’s Learning Resources). Identify at least one potential concern that could be raised about the study’s internal validity. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.

Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.

Yuan, S., Chou, M., Hwu, L., Chang, Y., Hsu, W., & Kuo, H. (2009). An intervention program to promote health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.

Consider strategies that could be used to strengthen the study’s internal validity and how this would impact the three other types of validity.

Think about the consequences of an advanced practice nurse neglecting to consider the validity of a research study when reviewing the research for potential use in developing an evidence-based practice.

By Day 3

Post the title of the study that you selected and your analysis of the potential concerns that could be raised about the study’s internal validity. Propose recommendations to strengthen the internal validity and assess the effect your changes could have with regard to the other three types of validity. Discuss the dangers of failing to consider the validity of a research study.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Week 7 discussion – Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Qualitative Research Designs

For the past 2 weeks, you have focused on the features and considerations of quantitative research designs. However, quantitative designs are not appropriate for all research questions. Perhaps you are concerned with how patients react when confronted with negative test results, or you wish to study how views on a certain health topic change over time. In each of these cases, the emphasis is more on understanding the thinking and experiences of an individual or group than on numerical measurements. For these types of questions, a qualitative or mixed methods research design is the most appropriate.

For this Discussion, you focus on the different types of qualitative research designs, when they are used, and why they are important.

To prepare:

Reflect on the comments made by Dr. Mauk in this week’s media presentation on the value of qualitative research in nursing. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Locate the journal Qualitative Health Research in the Sage Premier database in the Walden Library.

From this journal, select an article of interest to you that was published within the last 3 years.

Review the information on different qualitative research designs in Chapter 21 of your course text.

Determine what qualitative research design was used in your selected article and evaluate whether it was the best choice.

Consider ethical issues involved in the study and how the researchers addressed them.

Think about how using a quantitative design would have affected the type of data gathered.

By Day 3

Post an APA citation for the article that you selected and provide a brief summary of the content and the qualitative research design used. Evaluate the appropriateness of the design, and explain how ethical issues in the study were addressed. Analyze how the study would have been different if a quantitative design had been used.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Week 8 discussion – Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Planning for Data Collection

Data collection is an important part of both quantitative and qualitative research. Although the actual approach to gathering information may vary, for either research design, researchers need to plan in advance how the data will be gathered, reported, and stored, and they need to ensure that their methods are both reliable and valid. As nurses review research when considering a new evidence-based practice, it is important to be familiar with sound collection practices in order to ascertain the credibility of the data presented.

Consider the following scenario:

Nurses and other health care professionals are often interested in assessing patient satisfaction with health care services. Imagine that you are a nurse working in a suburban primary care setting that serves 10,000 patients annually. Your organization is very interested in understanding the patient’s point of view to help determine areas of care that can be improved. With this focus in mind, consider how you would create a survey to assess patient satisfaction with the services your organization provides. You may wish to consider variables such as the ease of accessing care, patient wait time, friendliness of the staff, or the likelihood that a patient would recommend your organization to others.

For this Discussion, you generate questions and an overall plan for data collection that would be appropriate for a patient satisfaction survey in relation to the above scenario. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

To prepare:

Consider the guidelines for generating questions presented in this week’s Learning Resources.

Review the scenario and formulate at least five questions that you could use to evaluate patient satisfaction.

Reflect on the different methods or instruments that can be used for gathering data described in Chapter 13 and Chapter 22 of the course text. Which methods or instruments would work well for the scenario?

Determine an appropriate sample size for the scenario.

By Day 3

Post the questions that you created for gathering information about patient satisfaction based on the above scenario. Explain which method or instrument you would use to gather data. Describe the sample size appropriate for the population and how you would select participants. Provide a rationale for your choices, and explain how you can ensure high standard of reliability and validity.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from the readings or after synthesizing multiple postings.

Week 9 discussion- Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Data Analysis—Small Group Discussion

As a nurse engaged in evidence-based practice, it is important to recognize how statistics and other data analysis tools are used to generate and assess evidence. Most nurses need only a foundational understanding of statistical tools and terminology to understand the majority of research studies. As a nurse, you should be able to recognize the most commonly used statistical tests, how and when they are used, and how significance is determined.

In this Discussion, you examine different types of statistics and statistical tests, when and why these particular tests would be selected for use, and, most importantly, what the results indicate. To this end, you will be assigned to a group by Day 1 of this week. Each group will be assigned one of the five chapters listed in this week’s Learning Resources and will develop a study sheet on their chapter that will be shared with the other groups. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

To prepare:

Review the information in your assigned chapter.

As a group, develop a 1-page study sheet that includes the following:

The key concepts of the chapter: Focus on the basic concepts that are important for nurses to understand as they review research studies.

A description of the statistical methods covered in the chapter, what they measure, and under what circumstances they are used. Identify examples of how the statistical methods have been used in research studies.

An explanation of the key statistical tests and how they measure significance (if applicable).

Note: This should be a collaborative effort, with each member of the group making contributions to the design and content of the study sheet. Use the Groups link on the left navigation bar to collaborate with your group. When you have developed your 1-page study sheet, select one member to post it to the Week 9 Discussion Forum so that the rest of your colleagues can access it.

By Day 5

Post your group’s study sheet. Discuss why it is important for nurses to understand the basics of these statistical methods.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two other groups on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Week 10 discussion – Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Weighing the Evidence

When conducting original research, the final step researchers must complete is weighing the evidence and interpreting the meanings of their data, statistics, and analyses. This is the culmination of the research process in which all of the research methods and designs can be synthesized into a meaningful conclusion. In this stage, researchers should formulate explanations for what their data indicates, determine whether the data answers their initial research question, identify areas of uncertainty, and consider directions for further research.

In this Discussion, you focus on one of the research articles that you identified for Part 2 of the Course Project (Literature Review). You then explore the process of how the researchers generated conclusions based on their data, consider other possible interpretations of their data, and formulate ideas for further research.

To prepare:

Review this week’s Learning Resources, focusing on how researchers find meaning in their data and generate sound conclusions. Pay particular attention to Table 2 in the article, “Study Design in Medical Research.”

Revisit the 5 articles that you identified in Part 2 of the Course Project. Select one to consider for the purpose of this Discussion.

Read sections of the chosen article where the data is presented, analyzed, and interpreted for meaning. What reasoning process did the researchers use to formulate their conclusions? What explanation did they give to support their conclusions? Were there any weaknesses in their analysis or conclusions?

Consider possible alternate conclusions that the researchers could have drawn based on their data.

Examine the findings that the article presents and consider how well they addressed the researcher’s initial question(s). What additional research could be done to build on these findings and gain a fuller understanding of the question?

By Day 3

Post an APA citation and brief summary of the research article that you selected. Describe the data and the results of any statistical tests or analyses presented in the article. Explain how the researchers formulated their conclusion, any weaknesses in their analysis or conclusions, and offer at least one alternate interpretation of their data. Propose at least one additional research study that could be done to further investigate this research topic.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Week 11 discussion- Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Creating a Culture of Evidence-Based Practice

An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.

In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.

To prepare:

Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?

Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.

Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?

Reflect on how nurses can disseminate findings from evidence-based practice research.

By Day 3

Post an evaluation of your organization’s use of EBP and how it is furthered or hindered by organizational culture and policies. Describe how you could disseminate the findings. Propose a strategy for strengthening the culture of EBP within the organization. Discuss a nurse’s responsibility to further the use of EBP, providing a rationale supported by specific information from the Learning Resources. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Week 2 project

Introduction to Course Project

Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, nurses can connect the results of relevant research studies to their nursing practice.

For the Course Project, you identify and apply relevant research to a specific nursing topic or problem. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. In later weeks of this course, you continue the Course Project by conducting a literature review and then determining how the evidence from the literature can be applied to nursing practice.

Before you begin, review the Course Project Overview document located in this week’s Learning Resources.

Note: This Course Project will serve as the Portfolio Assignment for the course. In addition to submitting portions of this Project in Weeks 2 and 5, you will turn in all three deliverables in Week 10. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Course Project: Part 1—Identifying a Researchable Problem

One of the most challenging aspects of EBP is to actually identify the answerable question.

—Karen Sue Davies

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.

In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.

To prepare:

Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.

Review the section beginning on page 71 of the course text, titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.

Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.

Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.

Formulate a preliminary PICO question—one that is answerable—based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?

Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

To complete:

Write a 3- to 4-page paper that includes the following:

A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice

The 5 questions you have generated and a description of how you analyzed them for feasibility

Your preliminary PICOT question and a description of each PICOT variable relevant to your question

At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

By Day 7

Submit your Project. It will also be a component of your Portfolio Assignment for this course, which is due by Day 7 of Week 10.

Reference:

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

Submission and Grading Information

To submit your completed Project for review and grading, do the following:

Please save your Project using the naming convention “WK2Proj+last name+first initial.(extension)” as the name.

Click the Week 2 Project Rubric to review the Grading Criteria for the Project.

Click the Week 2 Project link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Proj+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

Week 5 project

Course Project: Part 2—Literature Review

This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

To prepare:

Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.

Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.

Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

To complete:

Write a 3- to 4-page literature review that includes the following:

A synthesis of what the studies reveal about the current state of knowledge on the question that you developed

Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.

Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry

Your literature review summary table with all references formatted in correct APA style

Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

By Day 7 of Week 5

This part of the Course Project is due. It will also be a component in your Portfolio Assignment in this course, which is due by Day 7 of Week 10.

Week 7 assignment – Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Assignment: Critiquing Quantitative, Qualitative, or Mixed Methods Studies

Critiquing the validity and robustness of research featured in journal articles provides a critical foundation for engaging in evidence-based practice. In Weeks 5 and 6, you explored quantitative research designs. In Week 7, you will examine qualitative and mixed methods research designs. For this Assignment, which is due by Day 7 of Week 7, you critique a quantitative and either a qualitative or a mixed methods research study and compare the types of information obtained in each.

To prepare:

Select a health topic of interest to you that is relevant to your current area of practice. The topic may be your Course Portfolio Project or a different topic of your choice.

Using the Walden Library, locate two articles in scholarly journals that deal with your portfolio topic: 1) Select one article that utilizes a quantitative research design and 2) select a second article that utilizes either a qualitative OR a mixed methods design. These need to be single studies not systematic or integrative reviews (including meta-analysis and metasynthesis). You may use research articles from your reference list. If you cannot find these two types of research on your portfolio topic, you may choose another topic.

Locate the following documents in this week’s Learning Resources to access the appropriate templates, which will guide your critique of each article:

Critique Template for a Qualitative Study

Critique Template for a Quantitative Study

Critique Template for a Mixed-Methods Study

Consider the fields in the templates as you review the information in each article. Begin to draft a paper in which you analyze the two research approaches as indicated below. Reflect on the overall value of both quantitative and qualitative research. If someone were to say to you, “Qualitative research is not real science,” how would you respond? Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

To complete this Assignment:

Complete the two critiques using the appropriate templates.

Write a 2- to 3-page paper that addresses the following:

Contrast the types of information that you gained from examining the two different research approaches in the articles that you selected.

Describe the general advantages and disadvantages of the two research approaches featured in the articles. Use examples from the articles for support.

Formulate a response to the claim that qualitative research is not real science. Highlight the general insights that both quantitative and qualitative studies can provide to researchers. Support your response with references to the Learning Resources and other credible sources.

As you complete this Assignment, remember to:

Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Combine all three parts of this assignment into one Word document including both critique templates and the narrative with your references. Submit this combined document.

By Day 7 of Week 7

Week 10 course project- Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Course Project: Part 3—Translating Evidence Into Practice

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.

Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.

To prepare:

Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?

With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.

Explore possible consequences of failing to adopt the evidence-based practice that you identified.

Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

To complete:

In a 3- to 4-page paper:

Restate your PICOT question and its significance to nursing practice.

Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.

Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

By Day 7 of Week 10

This part of the Course Project is due. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course.

Note: In addition, include a 1-page summary of your project.

For this final iteration, you will need to:

Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary. Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

Nursing Research and Evidence-Based Practice Essay Assignment Papers and Discussions

Write a 3- to 4-page Qualitative Health Research Discussion Essay

Write a 3- to 4-page Qualitative Health Research Discussion Essay 150 150 Nyagu

NURS347 Professional Beliefs Paper: Northern Illinois University
NURS347 Professional Beliefs Paper: Northern Illinois University

Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice
Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

Course Project: Introduction to Course Project

Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, nurses can connect the results of relevant research studies to their nursing practice.

For the Course Project, you identify and apply relevant research to a specific nursing topic or problem. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. In later weeks of this course, you continue the Course Project by conducting a literature review and then determining how the evidence from the literature can be applied to nursing practice.

Before you begin, review the Course Project Overview document located in this week’s Learning Resources.

Course Project: Part 1—Identifying a Researchable Problem

ORDER A CUSTOM-WRITTEN PAPER NOW

One of the most challenging aspects of EBP is to actually identify the answerable question.

—Karen Sue Davies

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.

To prepare:

Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.

Review the section beginning on page 71 of the course text, titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.

Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.

Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.

Formulate a preliminary PICO question—one that is answerable—based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?

Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

To complete:

Write a 3- to 4-page Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice paper that includes the following:

A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice

The 5 questions you have generated and a description of how you analyzed them for feasibility

Your preliminary PICOT question and a description of each PICOT variable relevant to your question

At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

By Day 7

WEEK 5

Course Project: Part 2—Literature Review

This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

To prepare:

Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.

Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.

Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

To complete:

Write a 3- to 4-page literature review that includes the following:

A synthesis of what the studies reveal about the current state of knowledge on the question that you developed

Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.

Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

Your Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice literature review summary table with all references formatted in correct APA style

wEEK 7

Assignment: Critiquing Quantitative, Qualitative, or Mixed Methods Studies

Critiquing the validity and robustness of research featured in journal articles provides a critical foundation for engaging in evidence-based practice. In Weeks 5 and 6, you explored quantitative research designs. In Week 7, you will examine qualitative and mixed methods research designs. For this Assignment, which is due by Day 7 of Week 7, you critique a quantitative and either a qualitative or a mixed methods research study and compare the types of information obtained in each.

To prepare:

Select a health topic of interest to you that is relevant to your current area of practice. The topic may be your Course Portfolio Project or a different topic of your choice.

Using the Walden Library, locate two articles in scholarly journals that deal with your portfolio topic: 1) Select one article that utilizes a quantitative research design and 2) select a second article that utilizes either a qualitative OR a mixed methods design. These need to be single studies not systematic or integrative reviews (including meta-analysis and metasynthesis). You may use research articles from your reference list. If you cannot find these two types of research on your portfolio topic, you may choose another topic.

Locate the following documents in this week’s Learning Resources to access the appropriate templates, which will guide your critique of each article:

Critique Template for a Qualitative Study

Critique Template for a Quantitative Study

Critique Template for a Mixed-Methods Study

Consider the fields in the templates as you review the information in each article. Begin to draft a paper in which you analyze the two research approaches as indicated below. Reflect on the overall value of both quantitative and qualitative research. If someone were to say to you, “Qualitative research is not real science,” how would you respond?

To complete this Assignment:

Complete the two critiques using the appropriate templates.

Write a 2- to 3-page Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice paper that addresses the following:

Contrast the types of information that you gained from examining the two different research approaches in the articles that you selected.

Describe the general advantages and disadvantages of the two research approaches featured in the articles. Use examples from the articles for support. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

Formulate a response to the claim that qualitative research is not real science. Highlight the general insights that both quantitative and qualitative studies can provide to researchers. Support your response with references to the Learning Resources and other credible sources.

As you complete this Assignment, remember to:

Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

Combine all three parts of this assignment into one Word document including both critique templates and the narrative with your references. Submit this combined document.

week 10

Course Project

By Day 7

Submit your Course Project. Reminder: You will combine Parts 1, 2, and 3 of your Course Project (assigned in Weeks 2, 4, and 8 respectively) into one cohesive and cogent paper.

Note: In addition, include a 1-page summary of your project.

For this final iteration you will need to:

Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on then Grammarly and SafeAssign reports, revise your paper as necessary. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

Note: The Course Project will be your Portfolio Assignment for this course.

Submission and Grading Information. Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

To submit your completed Project for review and grading, do the following:

Please save your Project using the naming convention “WK10Proj+last name+first initial.(extension)” as the name.

Click the Week 10 Project Rubric to review the Grading Criteria for the Project.

Click the Week 10 Project link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Proj+last name+first initial.(extension)” and click Open.

If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

Click on the Submit button to complete your submission.

Qualitative Health Research Discussion Essay Assignment Papers – NURS 6052 – Essentials of Evidence-Based Practice

Identify two or three goals for this week that you have established for yourself related to Practicum I.

Identify two or three goals for this week that you have established for yourself related to Practicum I. 150 150 Nyagu

NSG6620 Discussion Essay Assignments: Quantitative Skills in Nursing Administration
NSG6620 Discussion Essay Assignments: Quantitative Skills in Nursing Administration

Week 1 – Assignment 3

Assignment 3: Practicum I Journal Entry 1

In this course, you will write six journal entries. These journal entries are reflective exercises to facilitate academic learning and self-development as a nurse leader. Reflective journaling provides the opportunity to increase self-awareness as a nurse leader. The journal also offers you an opportunity to reflect on nonacademic components of the practicum experience, including emotions, decision making, critical thinking, and stress associated with the nurse leadership role. There is no “right” or “wrong” in reflective journaling; however, the Practicum I Journal will create a link between the application of course concepts and the content of your specific practicum experience. Practicum journals may be written in first person.

Practicum I Journal entries are graded assignments. They will not be viewed by or shared with other students, only with course instructors.

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Write a 300–500-word journal entry covering the following:

Where are you completing your Practicum I experience? Be certain to include the name, location, and contact information of the healthcare organization in which you are completing your practicum experience.

Identify your preceptor. Be certain to include the preceptor’s name, title, and contact information (including telephone number and e-mail address).

Identify two or three goals for this week that you have established for yourself related to Practicum I.

Review and reflect on how you met these goals this week.

Explain how you integrated two concepts or content areas from Week 1 into your practicum experience this week.

Identify your area of greatest learning this week.

Week 2 – Assignment 2

Assignment 2: Practicum I Journal Entry 2

This is your second out of six journal assignments in this course.

Write a 300–500-word journal entry covering the following:

Identify two or three goals for this week that you have established for yourself related to Practicum I.

Review and reflect on how you met these goals this week.

Explain how you integrated two concepts or content areas from Week 2 into your practicum experience this week.

Identify your area of greatest learning this week.

Week 4 – Assignment 2

Assignment 2: Practicum I Journal Entry 3

This is your third out of six journal assignments in this course.

Write a 300–500-word journal entry covering the following:

Identify two or three goals for this week that you have established for yourself related to Practicum I.

Review and reflect on how you met these goals this week.

Explain how you integrated two concepts or content areas from Week 4 into your practicum experience this week.

Identify your area of greatest learning this week.

Submit your journal entry to the Journal area by Tuesday, September 26, 2017. Name your journal entry SU_NSG6620_W4_A2_LastName_FirstInitial.

Week 6 – Assignment 2

Assignment 2: Practicum I Journal Entry 4

This is your fourth out of six journal assignments in this course.

Write a 300–500-word journal entry covering the following:

Identify two or three goals for this week that you have established for yourself related to Practicum I.

Review and reflect on how you met these goals this week.

Explain how you integrated two concepts or content areas from Week 6 into your practicum experience this week.

Identify your area of greatest learning this week.

Submit your journal entry to the Journal area by Tuesday, October 10, 2017. Name your journal entry SU_NSG6620_W6_A2_LastName_FirstInitial.

Week 8 – Assignment 2

Assignment 2: Practicum I Journal Entry 5

This is your fifth out of six journal assignments in this course.

Write a 300–500-word journal entry covering the following:

Identify two or three goals for this week that you have established for yourself related to Practicum I.

Review and reflect on how you met these goals this week.

Explain how you integrated two concepts or content areas from Week 8 into your practicum experience this week.

Identify your area of greatest learning this week.

Submit your journal entry to the Journal area by Tuesday, October 24, 2017. Name your journal entry SU_NSG6620_W8_A2_LastName_FirstInitial

Week 9 – Assignment 2

Assignment 2: Practicum I Journal Entry 6

This is your sixth and final journal assignment.

Write a 300–500-word journal entry covering the following:

Identify two or three goals for this week that you have established for yourself related to Practicum I.

Review and reflect on how you met these goals this week.

Explain how you integrated two concepts or content areas from Week 9 into your practicum experience this week.

Identify your area of greatest learning this week.

Submit your journal entry to the Journal area by Tuesday, October 31, 2017. Name your journal entry SU_NSG6620_W9_A2_LastName_FirstInitial.

NSG6620 Discussion Essay Assignments: Quantitative Skills in Nursing Administrati

What is the trend or issue that they represent?

What is the trend or issue that they represent? 150 150 Nyagu

NUR409 CONTEMPORARY ISSUES ANALYSIS PAPER
NUR409 CONTEMPORARY ISSUES ANALYSIS PAPER

Using APA Style 6th Edition, develop a paper, 8 – 10 pages maximum including references, which delineates and analyzes one contemporary health related issue.

PART I

v From the current news media, select a contemporary health related issue or trend or chronic illness by the second week of class and follow it for the next four consecutive weeks.

NUR409 contemporary issues analysis paper

v Select one report on your topic from each of the four weeks.

v Write a brief summary of each of the four news reports.

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v Analyze these four news reports:

o What is the trend or issue that they represent?

o In what way does this issue or trend relate to primary & community health care?

o How does the media represent the issue in each report?

o How does this representation shape public opinion on this issue or trend?

PART II

v Conduct a professional scholarly literature search (CINAHL or MEDLINE) on this issue or trend within a historical context.

v Analyze the issue in relation to any of these perspectives philosophical/ethical perspectives, social/political concerns, economic considerations, and historical change. NUR409 contemporary issues analysis paper

v Identify your own points of agreement or disagreement with these perspectives (listed in previous bullet).

v Does this issue or trend hold any significance for the profession of nursing?

PART III

v Compare your analysis of this issue in the media reports with your analysis of this issue in the professional nursing literature (if this is available).

v Identify the similarities and differences

v Based on your findings in this comparative analyses identify the implications for nurses or nursing students, health care policy, and/or health care delivery systems.

DUE DATE:

November 14, 2017-Tuesday Section /November 15, 2017-Wednesday Section

CONTEMPORARY ISSUES ANALYSIS – GRADING CRITERIA

PART I

1. Identification of contemporary health related issue. 5%

2. Summaries of four reports and relevance. 10%

3. Analysis of the four reports (Include all four components) 15%

PART II

4. Conduct a professional literature search within an historical context

Submits a copy of literature search 15%

5. Analyze the issue or trend (Include all the necessary components) include in this analysis a discussion of your own points of agreement and/or disagreement (Include all the necessary components) 15%.

NUR409 contemporary issues analysis paper

6. Significance to contemporary nursing 5%

PART III

7. Comparison of the analysis of issue as presented in the media reports with

your analysis of the issue or trend in the professional nursing literature.

Include in this analysis the identification of similarities and differences. 15%

8. Implications for nursing profession or students, health care delivery system, etc 10%

9. Scholarly writing and adherence to APA format (6th edition) 10%

NUR409 contemporary issues analysis paper