Cardiovascular Disease Case Study. – nursing homework essays

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Cardiovascular Disease Case Study.

Cardiovascular Disease Case Study.

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NURS 4521 ADULTS WITH COMPLEX NEEDS Cardiac Case Study Assignment Part 1 You are to complete all of the critical thinking questions for each stage and embed typed answers into this document. STAGE 1: Carl Shapiro 64 year old White male admit: 02/15/2021 Height: 71in Weight: 91 kg Allergies: NKDA Chief Complaint & History of Current Illness: Presents to the emergency room with a two-day history of intermittent substernal chest pressure associated with shortness of breath and diaphoresis. The pain had originally awoken Mr. Shapiro from sleep 2 nights ago and has been intermittently relieved with some sublingual nitroglycerin tablets that he had received from his physician 3 years ago. The pain increases with exertion, but now is constant. He rates the pain a “7” on a scale of 0 to 10. Past Medical History: HTN, Type 2 DM Home Medications: Lopressor (metoprolol) 50 mg PO daily Lasix 40 mg PO daily ASA 325 mg PO daily Glucophage 500 mg PO BID Past Surgical History: none Past Social History: denies tobacco, ETOH or illicit drug use. Vital Signs: T-98.9 (O) P 110 R 32 BP 90/60 (70)SpO2 86% on RA Physical Exam: Neuro: Alert and oriented x4, Anxious with a RASS of 2+, GCS 15, PERRLA 4mm Brisk Cardiac: Heart sounds S1, S2, S3 noted rhythmic; point of maximum impulse (PMI) displaced laterally; 2+ pitting edema in lower extremities; 1+ radial and dorsalis pedal pulses, cap refill < 6 seconds with cyanotic nail beds Resp: Breath sounds- rales throughout lung field; effort-labored without use of accessory muscles; chest symmetrical GI: Bowel sounds active x 4 quadrants; abdomen soft/non-tender; liver enlarged; no N/V INTEG: Pale, diaphoretic & intact skin. Lab Results: Chem panel: Na 130 K 5.7 C1 100 CO2 22 BUN 29 Cr 1.8 Glucose183 CBC: WBC 11.2 Hgb 9.2 Hct 27.6 Plt 203 Cardiac panel: BNP 788 LDH 972 Troponin 6 Diagnostic Tests: 12L ECG: Sinus tachycardia with left ventricular hypertrophy & ST elevation leads V1, V2, V3, & V4 Chest XRay: Increased vascular markings in both lungs Critical thinking exercises 1. List ALL OF your primary suspected medical diagnoses and top 5 priority nursing concerns from different body systems with supporting evidence. 2. What area(s) of the left ventricle is affected by this MI? 3. What is your rationale for EACH of the abnormal physical assessment parameters, the abnormal laboratory results, and the abnormal diagnostic tests? List each out by section (VS, physical exam, lab results, diagnostic tests) and explain rationale for why you believe they are abnormal. 4. What are your anticipated nursing interventions for this patient? 5. What patient and family teaching is important? Be specific. STAGE 2: Mr. Shapiro is admitted to the CCU with a diagnosis of Acute MI with acute decompensated heart failure. The following orders are obtained: Vital Signs q1h Continuous ECG monitor Bedrest Foley catheter Heparin IV infusion @ 1000 units/hr PTT q6h and call results if 90 Troponin level q12h x2 O2 at 2 1iters/min per NC—titrate to maintain O2 saturation >91% Lopressor 25 mg PO BID Available form: 25mg immediate release tablet Lovenox 50mg Sub-Q Q 12hrs Available form: 50mg/ml graduated prefilled syringe Bumex 4mg IV Push Daily Available form: 2.5mg/10ml vial Ambien 5 mg PO qHS PRN sleep Available form: 5mg immediate release tablet Dobutamine 2mcg/kg/min (found on IV pump) Range: 2-20 mcg/kg/min Available Form: 500mg/ 500ml D5W Administration Instructions: titrate by 1 mcg/kg/min Q 5 min to maintain CO between 5-6 L/min Nitroglycerin 10 mcg/min (found on IV pump) NURS 4521 Cardiovascular Disease Case Study

Range: 5mcg/min- 50mgc/min Available form: 50mg/250ml D5W in glass bottle Administration Instructions: titrate by 5mcg/min Q 5 min to keep chest pain below a 3 on a scale of 0-10 Precedex 0.4mcg/kg/hr (from IV Pump) Range: 0.1mcg/kg/hr to 0.5mcg/kg/hr Available form: 200mcg/50ml NS Administration Instructions: Titrate by 0.05mcg/kg/hr Q 5 min to keep RASS score 0 to -1 Critical thinking exercises 1. What is your rationale for each of the admitting orders? List out each order and explain why you think they are ordered for this patient. 2. What patient and family teaching is important? Be specific. STAGE 3: Mr. Shapiro’ urine output decreases to 10 ml/hr and he is unresponsive to the IV Bumex. He complains of increased SOB and physical exam reveals increasing rales bilaterally. A pulmonary artery catheter is inserted with the following parameters obtained: CVP 10 PCWP 22 PA pressure 38/20 CO 3.1 CI 1.2 SVR 1872 Critical Thinking Exercises 1. 2. What is the reason for each of the above hemodynamic results and what medication(s) do you anticipate starting? List out each parameter and what you believe caused the result and the medication(s) you believe you will start and specific goal(s) of medication(s). What patient and family teaching is important? Be specific. STAGE 4: You had provided Mr. Shapiro with some IV morphine sulfate for pain. You check on him 30 minutes later and find that he is unresponsive with slow, shallow respirations. He is diaphoretic. An ABG on 2L/NC reveals: pH 7.22 pCO2 50 pO2 82 HCO3 23 SaO2 83% Critical thinking exercises 1. 2. 3. 4. What does the ABG reveal? What is the probable cause? What are the anticipated medical and nursing interventions and why? Separate medical & nursing in list format. What patient and family teaching is important? Be specific. STAGE 5: Mr. Shapiro remains unresponsive is intubated and CXR reveals proper tube placement. His ventilator settings are as follows: Mode: Assist Control rate: 10 Vt: 600ml FiO2: 100% An ABG is drawn 1 hour later and reveals the following: pH 7.13 pCO2 80 pO2 347 HCO3 23 SaO2 100% PEEP: 5 Critical thinking exercises 1. 2. 3. What does the ABG reveal? State Acid-base imbalance & oxygenation status What changes do you anticipate to the ventilator settings and what is the rationale for each change and why? What patient and family teaching is important? Be specific. STAGE 6: You are in Mr. Shapiro’ room and notice that he is unresponsive and does not have a pulse. This rhythm is on his bedside monitor: Critical thinking exercises 1. 2. 3. What is this rhythm? What are the interventions for this rhythm in order of performance and rationale for each intervention? List out in the order they would be performed. What family teaching is important? Be specific. The rhythm changes to this one but he remains without a pulse: Critical thinking exercises 4. 5. What is the rhythm? List ALL the possible treatable causes (Hs & Ts) of this rhythm and what the treatment is for each cause? Mr. Shapiro had return of spontaneous circulation (ROSC) and survives without any neurological deficits but required an internal cardiac defibrillator (ICD) placement prior to discharge to an outpatient cardiac rehab program. Final critical thinking exercises 1. What discharge teaching would this patient/family require? Be specific 2. What additional information would you like to have seen covered in this evolving case study? 3. As you watched this case unfold, how did it make you feel? Provide a list of references utilized to complete this assignment.

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NURS 4030 Databases and Research and Evidence Based Practice Report.

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Create a 1-2-page resource that will describe databases that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP. NURS 4030 Databases and Research and Evidence Based Practice Report.

Introduction

EVIDENCE-BASED PRACTICE (EBP) INTEGRATES THE BEST EVIDENCE AVAILABLE TO GUIDE OPTIMAL NURSING CARE, WITH A GOAL TO ENHANCE SAFETY AND QUALITY. EBP IS CRUCIAL TO NURSING PRACTICE BECAUSE IT INCORPORATES THE BEST EVIDENCE FROM CURRENT LITERATURE, ALONG WITH THE EXPERTISE OF THE PRACTICING NURSE. THE CONCERN FOR QUALITY CARE THAT FLOWS FROM EBP GENERATES A DESIRED OUTCOME. WITHOUT THESE FACTORS, A NURSE CANNOT BE AN EFFECTIVE LEADER. IT IS IMPORTANT TO LEAD NOT ONLY FROM THIS POSITION BUT FROM KNOWLEDGE AND EXPERTISE. TO GAIN THE KNOWLEDGE, YOU REQUIRE A GOOD UNDERSTANDING OF HOW TO SEARCH FOR SCHOLARLY RESOURCES, AS WELL AS IDENTIFY WHICH DATABASES AND WEBSITES ARE CREDIBLE FOR THE PURPOSES OF IMPLEMENTING EVIDENCE-BASED CHANGES IN PRACTICE.

Your Online e-Portfolio

CREATING AN EPORTFOLIO IS NOT REQUIRED IN THE BSN PROGRAM, BUT YOU MAY FIND IT HELPFUL TO CREATE ONE TO ATTACH TO YOUR PROFESSIONAL RESUME WHILE JOB HUNTING. ONLINE EPORTFOLIOS SERVE TWO KEY PURPOSES: 1) TO SUPPORT LEARNING AND REFLECTION, AND 2) TO BE USED AS A SHOWCASE TOOL. YOUR LEARNING JOURNEY CAN BE DOCUMENTED, AND EPORTFOLIOS CONTRIBUTE TO LIFELONG LEARNING AND GROWTH THROUGH REFLECTION AND SHARING. ONLINE EPORTFOLIOS CAN ALSO BE SHARED WITH EMPLOYERS AND PEERS TO PRESENT ARTIFACTS THAT DEMONSTRATE YOUR ACCOMPLISHMENTS AT CAPELLA.

Professional Context

AS A BACCALAUREATE-PREPARED NURSE, YOU WILL BE RESPONSIBLE FOR PROVIDING PATIENT-CENTERED, COMPETENT CARE BASED ON CURRENT EVIDENCE-BASED BEST PRACTICES. YOU WILL BE REQUIRED TO DO RESEARCH, ANALYSIS, AND DISSEMINATION OF BEST EVIDENCE TO STAY ABREAST OF THESE BEST PRACTICES. UNDERSTANDING WHERE TO GO TO FIND CREDIBLE SOURCES AND LOCATE EVIDENCE, AS WELL AS WHICH SEARCH TERMS TO USE, IS THE FOUNDATION OF INCORPORATION OF BEST PRACTICES.

Scenario

YOU ARE SUPERVISING THREE NURSES WORKING ON THE MEDICAL-SURGICAL FLOOR OF A LOCAL TEACHING HOSPITAL. THIS HOSPITAL IS NATIONALLY RECOGNIZED AS A LEADER IN EDUCATION AND HAS A COMPUTER LAB WITH AN ONLINE LIBRARY WHERE STAFF HAS ACCESS TO MEDICAL RESEARCH DATABASES (THAT IS, CINAHL, PUBMED, MEDLINE, AND COCHRANE LIBRARY) AND ONLINE SOURCES OF ALL HOSPITAL POLICIES, PROCEDURES, AND GUIDELINES, AND COMPUTERS AT NURSE WORKSTATIONS THAT ALSO HAVE ACCESS TO THESE RESOURCES. (FOR THIS SCENARIO, USE THE CAPELLA UNIVERSITY LIBRARY TO SIMULATE THE HOSPITAL’S ONLINE LIBRARY.) YOU HAVE GIVEN THE NURSES THEIR PATIENT ASSIGNMENTS AND YOU HAVE ALL PARTICIPATED IN SHIFT REPORT. A NEW NURSE WHO JUST COMPLETED ORIENTATION AND TRAINING A WEEK AGO APPROACHES YOU AND TELLS YOU THAT ONE OF THE ASSIGNED PATIENTS HAS A DIAGNOSIS HE OR SHE IS VERY UNFAMILIAR WITH. KNOWING THAT PATIENT-CENTERED CARE BASED ON BEST PRACTICES IS IMPERATIVE TO POSITIVE PATIENT OUTCOMES, YOU WANT TO ASSIST THIS NURSE TO FIND RESEARCH THAT CAN BE UTILIZED TO PROVIDE THE BEST CARE FOR THIS PATIENT. DESCRIBE HOW YOU WOULD COMMUNICATE WITH THIS NURSE TO ENCOURAGE HIM OR HER TO RESEARCH THE DIAGNOSIS. ASSUME YOU WILL ASSIST IN THE QUEST TO LOCATE EVIDENCE, THEN DESCRIBE WHERE YOU WOULD GO WITHIN THE FACILITY AND WHAT RESOURCES YOU WOULD LOOK FOR. THESE RESOURCES MAY INCLUDE WEBSITES, JOURNALS, FACILITY POLICIES OR GUIDELINES, OR ANY OTHER SOURCES OF ONLINE INFORMATION.

You may choose the diagnosis for the patient in this scenario. Choose something you would find interesting to research or that applies to a clinical problem you would be interested in addressing. Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.

Preparation

To help ensure you are prepared to complete this assessment, review the following resources related to the Capella library. These resources will provide you an overview of the types of tools, resources, and guides available in the library. This may be useful in forming a better understanding of the library to apply to the hypothetical situation laid out in the scenario of this assessment.

BSN PROGRAM LIBRARY RESEARCH GUIDE.

Evidence-Based Practice in Nursing & Health Sciences.

Databases A-Z: Nursing & Health Sciences.

Remember, it is also appropriate to look toward databases and resources outside of the Capella library, such as organizational policies, professional organizations, and government health care resources.

  • You are encouraged to complete the Evaluating the Credibility of Evidence activity. This activity offers an opportunity to practice evaluating the credibility of evidence. These skills will be necessary to complete Assessment 1 successfully and is for your own practice and self-assessment. Completing this activity is also a way to demonstrate course engagement.

Instructions

  • The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.

For this assessment:

  • Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.

Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to this scenario and describe to which of these you would direct a nurse colleague to search for evidence.

Describe where you might go in the clinical setting to complete this research and how you would access the desired, relevant research within research databases or other online sources.

Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.

DESCRIBE COMMUNICATION STRATEGIES TO ENCOURAGE NURSES TO RESEARCH THE DIAGNOSIS, AS WELL AS STRATEGIES TO COLLABORATE WITH THE NURSES TO ACCESS RESOURCES.

Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.

Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.

Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis.

 

 
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Demonstrate knowledge of the nursing research process by critiquing published research articles

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Qualitative Article Critique

Introduction

            There is a significant increase in the nursing shortage here in America and the number is only getting higher. The qualitative research study that was critiqued for the purpose of this paper discussed the reasons for this issue. A phenomenological research method was used to investigate the factors that had an impact on the registered nurses’ decisions to leave the practice, therefore causing a larger nursing shortage in the healthcare field. The investigation yielded results that were consistent with the conceptualizations of the researchers.

 

Phenomenon of Interest

The phenomenon of interest is clearly identified throughout the article as the registered nurses’ decisions to either leave the clinical setting or to leave the field of nursing in general. The underlying problem and reason for the study to be conducted was due to the continuous increase in the shortage of nurses in the clinical field. This shortage is partly because not enough people are going in to the profession in the first place and partly because those that do enter the profession, end up leaving shortly after for whatever reason. The researcher has identified that this phenomenon of interest requires a qualitative format due to the method that was required in order for them to collect their desired data accurately.  ” Because the focus of the research is related to the perceptions of the RNs, and because no definitive research exists about this phenomenon, an interpretive, qualitative study was deemed appropriate” ( MacKusik & Minick, 2010). The qualitative format was the best format to approach this topic with because of the nature of the desired information. The philosophical underpinnings of the research was not identified but the reader can infer that the researchers’ philosophy is based on improving the factors identified that cause nurses to leave clinical practice so that the nursing shortage can be reduced and more competent nurses are available on hospital units to provide quality care. Demonstrate knowledge of the nursing research process by critiquing published research articles

 

Purpose

The researcher has defined the purpose of conducting the research clearly in the beginning of the article. They began by stating statistics regarding the future of nursing and how the shortage of nurses at the bedside is projected to increase  in just 10 years. The researchers went on to describe how the shortage of nurses is attributed things such as job dissatisfaction, difference in salaries to other professions and uncomfortable working environments. They stated that although research has been done to figure out what possible factors could contribute to the shortage, none of them have been directed towards nurses that have been through it and left the field because of it. The purpose of the study is ” to identify the factors or reasons that influenced the decision of the registered nurses to leave clinical nursing practice (MacKusik & Minick, 2010). This study is significant to nursing because investigating the reasons that nurses leave the clinical setting will help nursing leaders and supervisors know what to look out for when bringing new nurses to the unit and how to help them adjust to the job. It will allow for them to increase their retention rate by preventing the problems described by former nurses from happening again. Demonstrate knowledge of the nursing research process by critiquing published research articles

 

Method

The method used to collect the data and the approach that guided the inquiry was semi-structured interviews done with former nurses in the setting of their choice. Burns and Grove define a semi-structured interview as a fixed set of questions with no fixed responses ( Burns & Grove, 2011). There were a list of questions that were asked during the interview and the former nurses were to answer based on their perspective of their experience. This method  is compatible with the purpose of the research because it accurately determines the perceptions of the former nurses’ experiences through their responses to the listed questions. This method is also adequate enough to address the phenomenon of interest because through interviews, the researchers are able to understand the reasons why the participants felt that leaving the clinical practice was the only solution. It allows for the correct data to be obtained in order to further investigate the phenomenon of interest and assess for possible solutions.

 

Sampling

Sampling is defined as the process of selecting subjects who are representative of the population being studied (Burns & Grove, 2011). The researcher identifies the target and accessible population to be nurses working in the clinical setting or ” directly working with the patient” (MacKusik & Minick, 2010). Although it is not clearly stated that this is the target population, the researcher shows that the nursing shortage is the phenomenon of interest and that through this study, nurses will obtain improved strategies for retaining their nurses on their unit. This infers to the reader that the target population is indeed nurses, specifically being nurses that work on units in clinical settings in which there is a shortage. The sampling method used in this study was purposive sampling. Purposive sampling is when the researcher consciously selects certain participants, elements, events, or incidents to include in the study. The ultimate goal in this method is to choose the information rich participants from which they can obtain in-depth information needed for their studies (Burns & Grove, 2011). In this article, the researchers described how they contacted current nurses to help them to find nurses that were once in practice but not anymore. This displays the purposive sampling method because they selectively chose their participants based on their employment status and history.  Recruitment was done through the snowballing technique where currently practicing RNs at various hospitals were contacted and asked if they knew nurses who were no longer in clinical practice (MacKusik & Minick, 2010). The inclusion criteria for the sample included that the nurse had to be licensed and have had no less than 1 year of clinical practice experience. They also had to have had no clinical practice in the 6 months prior to the study ( MacKusik & Minick, 2010). The researcher also included that the nurses that participated in the study could not be in a supervisor or education position, and they had to be RNs not LPNs or anything else other than a registered nurse. They also had to have an active license and not have had it revoked by the board or let it expire without renewal ( MacKusik & Minick, 2010).

 

Data Collection

The data collection for this article focuses specifically on the human experience. The researcher describes in the methods section of the article that the data collection strategies used included interviews and field notes. Ten semi-structured interviews were conducted in 2007. All interviews were audiotaped and field notes were made during the interview process (MacKusik & Minick, 2010). The researcher had the entire interview process written down and following the interview, went over it with the participants in order to ensure accuracy. The study was approved before anything took place and the researcher had the participants sign a consent form before the interview process to ensure that they adequately understood  everything that would take place and that they had the right to bow out at any time. The study participants were recruited after the institutional review board from Georgia State University approved the process. Written informed consent assured the nurses that their participation was voluntary, that they would remain anonymous and that they could end the interview process at any time they wished (MacKusik & Minick, 2010). The participants of this study were well protected and everything they did throughout the process was voluntary. The procedures for collecting the data were explicitly listed as the interview process and the field notes taken during.

 

Data Analysis

The strategies used to analyze the data were clearly identified in the article. The researchers used the written material that described the interview process word for word accurately to interpret the deeper meanings of the responses. They also shared the written notes with research colleagues to ensure that they were adequately interpreting the information without bias or misjudgment ( MacKusik & Minick, 2010). They analyzed the data to determine if there were any reoccurring themes that appeared. Identifying these reoccurring themes will allow for the researchers to make the connection between the answers and the reasons why the participants left clinical practice. The researcher has remained true to the data provided in this article. All of the data provided and the procedures used to collect said data are geared towards the purpose and the phenomenon of interest identified at the beginning of the article. The reader understands that the procedure used to analyze the data is hermeneutics. This procedure is defined as a type of interpretive phenomenological research method that uses textual analysis through emphasizing the social and historic influences in quantitative interpretation and exposing the deeper meanings ( Burns & Grove, 2011). The researchers consulted with their colleagues in order to ensure that the responses were interpreted accurately and used this procedure to evaluate the written conversations.

The participants recognize the experience as their own. During the interview process, they give their personal stories and their reasons why they left the clinical practice. They help to contribute to the future of nursing by sharing their experiences and participating in this study. Being open with the researchers and explaining what happened to them shows that they recognize this experience as their own. The reader can follow the researcher’s thinking throughout the study. The article in its entirety was clearly explained and each part of the study was accurately identified for the reader’s understanding. The researchers went through the process of the study from the beginning when they provided the purpose of the study and background history to the end where the researchers provided the results of the data collection and analysis along with the conclusion. The researcher does document the research process from start to finish so that the readers can adequately understand the procedures. The article is divided into sections with heading to identify which part of the research process is being discussed and when. The findings evaluated in this article can be applicable outside the study situation. The results included that the former nurses’ primary reasons for leaving the clinical practice or the field of nursing in general are because of things such as emotional distress, fatigue/exhaustion, an unfriendly workplace and lack of support from colleagues. These findings can be applied not only to nursing but in most other professions as well as many various aspects of life. Factors such as emotional distress and lack of support from peers are things that could discourage anyone from something they once desired. The results are meaningful to nurses but also to individuals that aren’t nurses. These results can be applied to anyone that has a profession or has something they desire in life. Things like fatigue and exhaustion as well as unfriendly colleagues and peers could affect anyone, not just nurses. The strategy used for analysis, hermeneutics, is compatible with the purpose of the data because hermeneutics explores the hidden meanings of the text that is being analyzed. It is used to increase understanding of human nature (Burns & Grove, 2011). The purpose of the study is to explore the deeper meanings of the reasons that the former nurses left their professions and hermeneutics helps the researchers to do just that.

 

Findings

The findings are presented in sections according to the sample, analysis of the data and the top three themes identified as the reasons why nurses have left their profession. The section identified as sample presented the participants according to things such as their age, level of nursing education and the clinical experience setting in which they worked. The data analysis section reported the negative and positive responses given by the subjects and then the researchers went in depth to explain the three themes that seemed to reoccur in their answers. The reader is able to grasp the essence of the experience from the report of the findings. The way the researchers presented the findings in the article gave an adequate picture to how the participants perceived their nursing experience and why they no longer want to return to the clinical setting. The researchers’ concepts are consistent with the data. They described how there was so much research done on nurses that stay at the bedside and that issues concerning the nursing shortage were investigated but in terms of those that had left the profession, more in depth investigation was necessary (MacKusik & Minick, 2010). The researcher’s concept that nurses were leaving the profession after only a short time and that the reasoning for this could be because of less than appropriate working conditions, stressors and low benefits ( MacKusik & Minick, 2010) was consistent and true to the data. These ideas were similar to the findings. The researcher does not place the report in the context of what is already known about the phenomenon. They simply list the findings based on the demographics  of their participants and the analysis of the data after the interview process but no information about prior knowledge was included in the context of the findings.

 

Conclusions, Implications and Recommendations

The conclusions, implications and recommendations so give the reader a context in which to use the findings. It allows for the reader to use these findings in the context of nursing or healthcare  in reference to the nursing shortage and it also allows for them to use the findings in any other profession or aspects of life in regards to the reasons why the participants felt the need to leave the profession in order to solve their problems. They discuss previous knowledge as to the reasons for the nursing shortage and nurses leaving the clinical practice. It also uses the findings to make suggestions for how the problem can be managed. The conclusions do reflect to study findings because they adequately summarize the responses given by the participants and how nursing managers in clinical nursing can improve their retention strategy by looking at these findings. The researcher suggests that further research is needed to explore the power differential among RNs, its relation to the perception of horizontal hostility and indifference from superiors, and the impact on the nursing turnover (MacKusik & Minick, 2010). The researcher has stated in the nursing implications that the significance of this study is to help the nurses in the clinical setting to be better at recognizing the signs that the nurses are having difficulty and allowing for smooth transition for new nurses. It is also indicated that this study will help the nursing supervisors and leader to establish effective methods for retaining the nurses that they already have.

 

 

References

Burns, N., & Grove, S. (2011). Understanding nursing research: Building an evidence-based    practice. (5th ed.). Maryland Heights, MO: Elsevier Saunders.

 

MacKusik, C., & Minick, P. (2010). Why are nurses leaving? findings from an initial qualitative study on nursing attrition. MEDSURG Nursing, 19(6), Retrieved from             http://www.amsn.org/sites/default/files/documents/practice-resources/healthy-work             environment/resources/MSNJ_MacKusick_19_06.pdf

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Databases and Research and Evidence Based Practice Report.

/in /by

Create a 1-2-page resource that will describe databases that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP. NURS 4030 Databases and Research and Evidence Based Practice Report.

Introduction

EVIDENCE-BASED PRACTICE (EBP) INTEGRATES THE BEST EVIDENCE AVAILABLE TO GUIDE OPTIMAL NURSING CARE, WITH A GOAL TO ENHANCE SAFETY AND QUALITY. EBP IS CRUCIAL TO NURSING PRACTICE BECAUSE IT INCORPORATES THE BEST EVIDENCE FROM CURRENT LITERATURE, ALONG WITH THE EXPERTISE OF THE PRACTICING NURSE. THE CONCERN FOR QUALITY CARE THAT FLOWS FROM EBP GENERATES A DESIRED OUTCOME. WITHOUT THESE FACTORS, A NURSE CANNOT BE AN EFFECTIVE LEADER. IT IS IMPORTANT TO LEAD NOT ONLY FROM THIS POSITION BUT FROM KNOWLEDGE AND EXPERTISE. TO GAIN THE KNOWLEDGE, YOU REQUIRE A GOOD UNDERSTANDING OF HOW TO SEARCH FOR SCHOLARLY RESOURCES, AS WELL AS IDENTIFY WHICH DATABASES AND WEBSITES ARE CREDIBLE FOR THE PURPOSES OF IMPLEMENTING EVIDENCE-BASED CHANGES IN PRACTICE.

Your Online e-Portfolio

CREATING AN EPORTFOLIO IS NOT REQUIRED IN THE BSN PROGRAM, BUT YOU MAY FIND IT HELPFUL TO CREATE ONE TO ATTACH TO YOUR PROFESSIONAL RESUME WHILE JOB HUNTING. ONLINE EPORTFOLIOS SERVE TWO KEY PURPOSES: 1) TO SUPPORT LEARNING AND REFLECTION, AND 2) TO BE USED AS A SHOWCASE TOOL. YOUR LEARNING JOURNEY CAN BE DOCUMENTED, AND EPORTFOLIOS CONTRIBUTE TO LIFELONG LEARNING AND GROWTH THROUGH REFLECTION AND SHARING. ONLINE EPORTFOLIOS CAN ALSO BE SHARED WITH EMPLOYERS AND PEERS TO PRESENT ARTIFACTS THAT DEMONSTRATE YOUR ACCOMPLISHMENTS AT CAPELLA.

Professional Context

AS A BACCALAUREATE-PREPARED NURSE, YOU WILL BE RESPONSIBLE FOR PROVIDING PATIENT-CENTERED, COMPETENT CARE BASED ON CURRENT EVIDENCE-BASED BEST PRACTICES. YOU WILL BE REQUIRED TO DO RESEARCH, ANALYSIS, AND DISSEMINATION OF BEST EVIDENCE TO STAY ABREAST OF THESE BEST PRACTICES. UNDERSTANDING WHERE TO GO TO FIND CREDIBLE SOURCES AND LOCATE EVIDENCE, AS WELL AS WHICH SEARCH TERMS TO USE, IS THE FOUNDATION OF INCORPORATION OF BEST PRACTICES.

Scenario

YOU ARE SUPERVISING THREE NURSES WORKING ON THE MEDICAL-SURGICAL FLOOR OF A LOCAL TEACHING HOSPITAL. THIS HOSPITAL IS NATIONALLY RECOGNIZED AS A LEADER IN EDUCATION AND HAS A COMPUTER LAB WITH AN ONLINE LIBRARY WHERE STAFF HAS ACCESS TO MEDICAL RESEARCH DATABASES (THAT IS, CINAHL, PUBMED, MEDLINE, AND COCHRANE LIBRARY) AND ONLINE SOURCES OF ALL HOSPITAL POLICIES, PROCEDURES, AND GUIDELINES, AND COMPUTERS AT NURSE WORKSTATIONS THAT ALSO HAVE ACCESS TO THESE RESOURCES. (FOR THIS SCENARIO, USE THE CAPELLA UNIVERSITY LIBRARY TO SIMULATE THE HOSPITAL’S ONLINE LIBRARY.) YOU HAVE GIVEN THE NURSES THEIR PATIENT ASSIGNMENTS AND YOU HAVE ALL PARTICIPATED IN SHIFT REPORT. A NEW NURSE WHO JUST COMPLETED ORIENTATION AND TRAINING A WEEK AGO APPROACHES YOU AND TELLS YOU THAT ONE OF THE ASSIGNED PATIENTS HAS A DIAGNOSIS HE OR SHE IS VERY UNFAMILIAR WITH. KNOWING THAT PATIENT-CENTERED CARE BASED ON BEST PRACTICES IS IMPERATIVE TO POSITIVE PATIENT OUTCOMES, YOU WANT TO ASSIST THIS NURSE TO FIND RESEARCH THAT CAN BE UTILIZED TO PROVIDE THE BEST CARE FOR THIS PATIENT. DESCRIBE HOW YOU WOULD COMMUNICATE WITH THIS NURSE TO ENCOURAGE HIM OR HER TO RESEARCH THE DIAGNOSIS. ASSUME YOU WILL ASSIST IN THE QUEST TO LOCATE EVIDENCE, THEN DESCRIBE WHERE YOU WOULD GO WITHIN THE FACILITY AND WHAT RESOURCES YOU WOULD LOOK FOR. THESE RESOURCES MAY INCLUDE WEBSITES, JOURNALS, FACILITY POLICIES OR GUIDELINES, OR ANY OTHER SOURCES OF ONLINE INFORMATION.

You may choose the diagnosis for the patient in this scenario. Choose something you would find interesting to research or that applies to a clinical problem you would be interested in addressing. Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.

Preparation

To help ensure you are prepared to complete this assessment, review the following resources related to the Capella library. These resources will provide you an overview of the types of tools, resources, and guides available in the library. This may be useful in forming a better understanding of the library to apply to the hypothetical situation laid out in the scenario of this assessment.

BSN PROGRAM LIBRARY RESEARCH GUIDE.

Evidence-Based Practice in Nursing & Health Sciences.

Databases A-Z: Nursing & Health Sciences.

Remember, it is also appropriate to look toward databases and resources outside of the Capella library, such as organizational policies, professional organizations, and government health care resources.

  • You are encouraged to complete the Evaluating the Credibility of Evidence activity. This activity offers an opportunity to practice evaluating the credibility of evidence. These skills will be necessary to complete Assessment 1 successfully and is for your own practice and self-assessment. Completing this activity is also a way to demonstrate course engagement.

Instructions

  • The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.

For this assessment:

  • Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.

Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to this scenario and describe to which of these you would direct a nurse colleague to search for evidence.

Describe where you might go in the clinical setting to complete this research and how you would access the desired, relevant research within research databases or other online sources.

Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.

DESCRIBE COMMUNICATION STRATEGIES TO ENCOURAGE NURSES TO RESEARCH THE DIAGNOSIS, AS WELL AS STRATEGIES TO COLLABORATE WITH THE NURSES TO ACCESS RESOURCES.

Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.

Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.

Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis.

 

 
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NURS 4521 Cardiovascular Disease Case Study

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NURS 4521 Cardiovascular Disease Case Study

NURS 4521 Cardiovascular Disease Case Study

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NURS 4521 ADULTS WITH COMPLEX NEEDS Cardiac Case Study Assignment Part 1 You are to complete all of the critical thinking questions for each stage and embed typed answers into this document. STAGE 1: Carl Shapiro 64 year old White male admit: 02/15/2021 Height: 71in Weight: 91 kg Allergies: NKDA Chief Complaint & History of Current Illness: Presents to the emergency room with a two-day history of intermittent substernal chest pressure associated with shortness of breath and diaphoresis. The pain had originally awoken Mr. Shapiro from sleep 2 nights ago and has been intermittently relieved with some sublingual nitroglycerin tablets that he had received from his physician 3 years ago. The pain increases with exertion, but now is constant. He rates the pain a “7” on a scale of 0 to 10. Past Medical History: HTN, Type 2 DM Home Medications: Lopressor (metoprolol) 50 mg PO daily Lasix 40 mg PO daily ASA 325 mg PO daily Glucophage 500 mg PO BID Past Surgical History: none Past Social History: denies tobacco, ETOH or illicit drug use. Vital Signs: T-98.9 (O) P 110 R 32 BP 90/60 (70)SpO2 86% on RA Physical Exam: Neuro: Alert and oriented x4, Anxious with a RASS of 2+, GCS 15, PERRLA 4mm Brisk Cardiac: Heart sounds S1, S2, S3 noted rhythmic; point of maximum impulse (PMI) displaced laterally; 2+ pitting edema in lower extremities; 1+ radial and dorsalis pedal pulses, cap refill < 6 seconds with cyanotic nail beds Resp: Breath sounds- rales throughout lung field; effort-labored without use of accessory muscles; chest symmetrical GI: Bowel sounds active x 4 quadrants; abdomen soft/non-tender; liver enlarged; no N/V INTEG: Pale, diaphoretic & intact skin. Lab Results: Chem panel: Na 130 K 5.7 C1 100 CO2 22 BUN 29 Cr 1.8 Glucose183 CBC: WBC 11.2 Hgb 9.2 Hct 27.6 Plt 203 Cardiac panel: BNP 788 LDH 972 Troponin 6 Diagnostic Tests: 12L ECG: Sinus tachycardia with left ventricular hypertrophy & ST elevation leads V1, V2, V3, & V4 Chest XRay: Increased vascular markings in both lungs Critical thinking exercises 1. List ALL OF your primary suspected medical diagnoses and top 5 priority nursing concerns from different body systems with supporting evidence. 2. What area(s) of the left ventricle is affected by this MI? 3. What is your rationale for EACH of the abnormal physical assessment parameters, the abnormal laboratory results, and the abnormal diagnostic tests? List each out by section (VS, physical exam, lab results, diagnostic tests) and explain rationale for why you believe they are abnormal. 4. What are your anticipated nursing interventions for this patient? 5. What patient and family teaching is important? Be specific. STAGE 2: Mr. Shapiro is admitted to the CCU with a diagnosis of Acute MI with acute decompensated heart failure. The following orders are obtained: Vital Signs q1h Continuous ECG monitor Bedrest Foley catheter Heparin IV infusion @ 1000 units/hr PTT q6h and call results if 90 Troponin level q12h x2 O2 at 2 1iters/min per NC—titrate to maintain O2 saturation >91% Lopressor 25 mg PO BID Available form: 25mg immediate release tablet Lovenox 50mg Sub-Q Q 12hrs Available form: 50mg/ml graduated prefilled syringe Bumex 4mg IV Push Daily Available form: 2.5mg/10ml vial Ambien 5 mg PO qHS PRN sleep Available form: 5mg immediate release tablet Dobutamine 2mcg/kg/min (found on IV pump) Range: 2-20 mcg/kg/min Available Form: 500mg/ 500ml D5W Administration Instructions: titrate by 1 mcg/kg/min Q 5 min to maintain CO between 5-6 L/min Nitroglycerin 10 mcg/min (found on IV pump) NURS 4521 Cardiovascular Disease Case Study

Range: 5mcg/min- 50mgc/min Available form: 50mg/250ml D5W in glass bottle Administration Instructions: titrate by 5mcg/min Q 5 min to keep chest pain below a 3 on a scale of 0-10 Precedex 0.4mcg/kg/hr (from IV Pump) Range: 0.1mcg/kg/hr to 0.5mcg/kg/hr Available form: 200mcg/50ml NS Administration Instructions: Titrate by 0.05mcg/kg/hr Q 5 min to keep RASS score 0 to -1 Critical thinking exercises 1. What is your rationale for each of the admitting orders? List out each order and explain why you think they are ordered for this patient. 2. What patient and family teaching is important? Be specific. STAGE 3: Mr. Shapiro’ urine output decreases to 10 ml/hr and he is unresponsive to the IV Bumex. He complains of increased SOB and physical exam reveals increasing rales bilaterally. A pulmonary artery catheter is inserted with the following parameters obtained: CVP 10 PCWP 22 PA pressure 38/20 CO 3.1 CI 1.2 SVR 1872 Critical Thinking Exercises 1. 2. What is the reason for each of the above hemodynamic results and what medication(s) do you anticipate starting? List out each parameter and what you believe caused the result and the medication(s) you believe you will start and specific goal(s) of medication(s). What patient and family teaching is important? Be specific. STAGE 4: You had provided Mr. Shapiro with some IV morphine sulfate for pain. You check on him 30 minutes later and find that he is unresponsive with slow, shallow respirations. He is diaphoretic. An ABG on 2L/NC reveals: pH 7.22 pCO2 50 pO2 82 HCO3 23 SaO2 83% Critical thinking exercises 1. 2. 3. 4. What does the ABG reveal? What is the probable cause? What are the anticipated medical and nursing interventions and why? Separate medical & nursing in list format. What patient and family teaching is important? Be specific. STAGE 5: Mr. Shapiro remains unresponsive is intubated and CXR reveals proper tube placement. His ventilator settings are as follows: Mode: Assist Control rate: 10 Vt: 600ml FiO2: 100% An ABG is drawn 1 hour later and reveals the following: pH 7.13 pCO2 80 pO2 347 HCO3 23 SaO2 100% PEEP: 5 Critical thinking exercises 1. 2. 3. What does the ABG reveal? State Acid-base imbalance & oxygenation status What changes do you anticipate to the ventilator settings and what is the rationale for each change and why? What patient and family teaching is important? Be specific. STAGE 6: You are in Mr. Shapiro’ room and notice that he is unresponsive and does not have a pulse. This rhythm is on his bedside monitor: Critical thinking exercises 1. 2. 3. What is this rhythm? What are the interventions for this rhythm in order of performance and rationale for each intervention? List out in the order they would be performed. What family teaching is important? Be specific. The rhythm changes to this one but he remains without a pulse: Critical thinking exercises 4. 5. What is the rhythm? List ALL the possible treatable causes (Hs & Ts) of this rhythm and what the treatment is for each cause? Mr. Shapiro had return of spontaneous circulation (ROSC) and survives without any neurological deficits but required an internal cardiac defibrillator (ICD) placement prior to discharge to an outpatient cardiac rehab program. Final critical thinking exercises 1. What discharge teaching would this patient/family require? Be specific 2. What additional information would you like to have seen covered in this evolving case study? 3. As you watched this case unfold, how did it make you feel? Provide a list of references utilized to complete this assignment.

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NURSFPX 4050 Health Promotion Plan Discussion Paper.

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NURSFPX 4050 Health Promotion Plan Discussion Paper.

NURSFPX 4050 Health Promotion Plan Discussion Paper.

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Develop a hypothetical health promotion plan, 3-4 pages in length, addressing a specific health concern for an individual or a group living in the community that you identified from the topic list provided.

  • Bullying.
  • Teen Pregnancy.
  • LGBTQIA + Health.
  • Sudden Infant Death (SID).
  • Immunization.
  • Tobacco use (include all: vaping, e-cigarettes, hookah, chewing tobacco, and smoking) cessation.DEMONSTRATION OF PROFICIENCY
    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
    • Competency 1: Analyze health risks and health care needs among distinct populations.
      • Analyze a community health concern that is the focus of a health promotion plan.
    • Competency 2: Propose health promotion strategies to improve the health of populations.
      • Explain why a health concern is important for health promotion within a specific population.
      • Establish agreed-upon health goals in collaboration with participants.
    • Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
      • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
      • Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
  • PREPARATION
    The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to plan a hypothetical clinical learning experience focused on health promotion associated with a specific community health concern. Such a plan defines the critical elements of who, what, when, where, and why that establish the foundation for an effective clinical learning experience for the participants. Completing this assessment will strengthen your understanding of how to plan and negotiate individual or group participation. This assessment is the foundation for the implementation of your health promotion educational plan (Assessment 4).You will need to satisfactorily pass Assessment 1 (Health Promotion Plan) before working on your last assessment (Assessment 4).To prepare for the assessment, consider various health concerns that you would like to be the focus of your plan from the topic list provided, the populations potentially affected by that concern, and hypothetical individuals or groups living in the community. Then, investigate your chosen concern and best practices for health improvement, based on supporting evidence.As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Effective Interpersonal Communications activity. The information gained from completing this activity will help you succeed with the assessment. Completing activities is also a way to demonstrate engagement.For this assessment, you will propose a hypothetical health promotion plan addressing a particular health concern affecting a fictitious individual or group living in the community. The hypothetical individual or group of your choice must be living in the community; not in a hospital, assistant living, nursing home, or other facility. You may choose any health issues from the list provided in the instructions.In the Assessment 4, you will simulate a face-to-face presentation of this plan to the individual or group that you have identified.Please choose one of the topics below:
    • Bullying.
    • Teen Pregnancy.
    • LGBTQIA + Health.
    • Sudden Infant Death (SID).
    • Immunizations.
    • Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (MUST address all tobacco products)INSTRUCTIONS
      Health Promotion Plan
      • Choose a specific health concern as the focus of your hypothetical health promotion plan. Then, investigate your chosen concern and best practices for health improvement, based on supporting evidence.
        • Bullying.
        • Teen Pregnancy.
        • LGBTQIA + Health.
        • Sudden Infant Death (SID).
        • Immunizations.
        • Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (MUST address all tobacco products).
      • Describe in detail the characteristics of your chosen hypothetical individual or group for this activity.
      • Discuss why your chosen population is predisposed to this health concern and why they can benefit from a health promotion educational plan.
      • Based on the health concern for your hypothetical individual or group, discuss what you would include in the development of a sociogram. Take into consideration possible social, economic, cultural, genetic, and/or lifestyle behaviors that may have an impact on health as you develop your educational plan in your first assessment. You will take this information into consideration when you develop your educational plan in your fourth assessment.
      • Identify their potential learning needs.
      • Identify expectations for this educational session and offer suggestions for how the individual or group needs can be met.
      • Health promotion goals need to be clear, measurable, and appropriate for this activity.
      • Document Format and Length
        Your health promotion plan should be 3-4 pages in length.Supporting Evidence
        Support your health promotion plan with peer-reviewed articles, course study resources, and Healthy People 2030 resources. Cite at least three credible sources published within the past five years, using APA format.Graded Requirements
        The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
      • Analyze the health concern that is the focus of your health promotion plan.
        • Consider underlying assumptions and points of uncertainty in your analysis.
      • Explain why a health concern is important for health promotion within a specific population.
        • Examine current population health data.
        • Consider the factors that contribute to health, health disparities, and access to services.
      • Explain the importance of establishing agreed-upon health goals in collaboration with hypothetical participants.

 

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Root Cause Analysis & Safety Improvement PPT.

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Slide 1 of 5

Assessment 2 Instructions (NURS-FPX4020)
“Root-Cause Analysis and Safety Improvement Plan”
For this assessment, you will use a supplied template to conduct a root-cause analysis of a quality or safety issue in a health care setting of your choice and outline a plan to address the issue.
As patient safety concerns continue to be addressed in the health care settings, nurses can play an active role in implementing safety improvement measures and plans. Often root-cause analyses are conducted and safety improvement plans are created to address sentinel or adverse events such as medication errors, patient falls, wrong-site surgery events, and hospital-acquired infections. Performing a root-cause analysis offers a systematic approach for identifying causes of problems, including process and system-check failures. Once the causes of failures have been determined, a safety improvement plan can be developed to prevent recurrences.  NURS FPX4020 Root Cause Analysis & Safety Improvement PPT.
Scenario:
For this assessment, you may choose from the following options as the subject of a root-cause analysis and safety improvement plan:
• The specific safety concern identified in your previous assessment.
• One of the case studies from the previous assessment.
• A personal practice experience in which a sentinel event occurred.
Instructions:
The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the concern based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.
Use the Root-Cause Analysis and Improvement Plan Template [DOCX] to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
• Analyze the root cause of a patient safety issue or a specific sentinel event in an organization.
• Apply evidence-based and best-practice strategies to address the safety issue or sentinel event.
• Create a feasible, evidence-based safety improvement plan.
• Identify organizational resources that could be leveraged to improve your plan.
• Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
• Assessment 2 Example [PDF].
Additional Requirements:
• Length of submission: Use the provided Root-Cause Analysis and Improvement Plan template to create a 4–6 page root cause analysis and safety improvement plan. A title page is not required but you must include a reference list as per the template.
• Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
• APA formatting: Format references and citations according to current APA style.

Demonstration of Proficiency:
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 1: Analyze the elements of a successful quality improvement initiative.
• Apply evidence-based and best-practice strategies to address a safety issue or sentinel event.
• Create a feasible, evidence-based safety improvement plan.
• Competency 2: Analyze factors that lead to patient safety risks.
• Analyze the root cause of a patient safety issue or a specific sentinel event within an organization.
• Competency 3: Identify organizational interventions to promote patient safety.
• Identify existing organizational resources that could be leveraged to improve a plan.
• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
• Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.

 

 
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Traumatic Stress in Pediatric Nurses Quantitative Critique

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NSG 3036: Introduction to Nursing Research
Quantitative Critique Paper

Points
(100) Sections to be Addressed Areas for Consideration
10 Points 1. Research problem/hypothesis
The purpose and significance of the study.
Is the research question or hypothesis clearly stated?
Are the theories and concepts clearly defined? Explain
10 Points 2. Review of the literature (ch.5)
Types of literature used in the review (primary, secondary, seminal). Are the studies used within the article conducted within the last 5 years? How are the studies in the literature review related to the topic of interest? How does the review provide support for the need for the present study? Compare and contrast the major findings in the literature review).
10 Points 3. Research design
(ch.12)
Identify the research design and why was the design most appropriate to study the topic of interest?
10 Points 4. Sampling
(ch.7)

Identify the sampling strategies. How were the subjects selected? How many of the sample participated? Were the inclusion and exclusion criteria clearly stated?
5 Points 5. Ethical consideration How were human rights protected?
10 Points 6. Data collection Explain the data collection process.
10 Points 7. Data analysis
(ch. 9 & 13)
How was the data analyzed? What statistical test was used any why was it appropriate? Did the researcher identify type 1 error (p value) or type 2 error?
10 Points 8. Validity and Reliability
(ch.9)
How was the validity and reliability of the instrument maintained?
10 Points 9. Findings What are the study findings? Are study limitations identified? If a hypothesis was identified was it supported?
10 Points 10. Nursing implications What are the strengths and weaknesses of this study? How will this study impact your nursing practice?
5 Points 11. APA 7th ed. Format The paper, cover & reference pages must follow APA 6th ed guidelines & include correct spelling, grammar & sentence structure.

 

 
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NURS FPX4020 Root Cause Analysis & Safety Improvement PPT.

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Slide 1 of 5

Assessment 2 Instructions (NURS-FPX4020)
“Root-Cause Analysis and Safety Improvement Plan”
For this assessment, you will use a supplied template to conduct a root-cause analysis of a quality or safety issue in a health care setting of your choice and outline a plan to address the issue.
As patient safety concerns continue to be addressed in the health care settings, nurses can play an active role in implementing safety improvement measures and plans. Often root-cause analyses are conducted and safety improvement plans are created to address sentinel or adverse events such as medication errors, patient falls, wrong-site surgery events, and hospital-acquired infections. Performing a root-cause analysis offers a systematic approach for identifying causes of problems, including process and system-check failures. Once the causes of failures have been determined, a safety improvement plan can be developed to prevent recurrences.  NURS FPX4020 Root Cause Analysis & Safety Improvement PPT.
Scenario:
For this assessment, you may choose from the following options as the subject of a root-cause analysis and safety improvement plan:
• The specific safety concern identified in your previous assessment.
• One of the case studies from the previous assessment.
• A personal practice experience in which a sentinel event occurred.
Instructions:
The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the concern based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.
Use the Root-Cause Analysis and Improvement Plan Template [DOCX] to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
• Analyze the root cause of a patient safety issue or a specific sentinel event in an organization.
• Apply evidence-based and best-practice strategies to address the safety issue or sentinel event.
• Create a feasible, evidence-based safety improvement plan.
• Identify organizational resources that could be leveraged to improve your plan.
• Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
• Assessment 2 Example [PDF].
Additional Requirements:
• Length of submission: Use the provided Root-Cause Analysis and Improvement Plan template to create a 4–6 page root cause analysis and safety improvement plan. A title page is not required but you must include a reference list as per the template.
• Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
• APA formatting: Format references and citations according to current APA style.

Demonstration of Proficiency:
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 1: Analyze the elements of a successful quality improvement initiative.
• Apply evidence-based and best-practice strategies to address a safety issue or sentinel event.
• Create a feasible, evidence-based safety improvement plan.
• Competency 2: Analyze factors that lead to patient safety risks.
• Analyze the root cause of a patient safety issue or a specific sentinel event within an organization.
• Competency 3: Identify organizational interventions to promote patient safety.
• Identify existing organizational resources that could be leveraged to improve a plan.
• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
• Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.

 

 
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Ethical Dilemma Truth Telling in Health Care.

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Ethical Dilemma Truth Telling in Health Care.

Ethical Dilemma Truth Telling in Health Care.

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ETHICAL DILEMMA

Truth-Telling in Health care.

  • Important Resources
    • American Nurses Association Code of Ethics for Nurses
    • APA text
  • The ethical dilemma that the student
    • I learned about it through professional literature
  • Ethical dilemma
    • Describe situation
    • Write about different courses of action to choose from
    • There is no perfect solution to dilemma
  • Additional data
  • Multiple options for solutions
  • Identification of moral reasoning
    • Identify which person(s) is experiencing this
    • Page 144 in Black (2020)
  • Ethical Theories
  • Ethical Principles
  • Course of action or solutions
  • Professional values – include all
    • Human dignity
    • Integrity
    • Autonomy
    • Altruism
    • Social Justice
  • American Nurses Association Code of Ethics for Nurses
    • How this could be violated
  • Opinions/assumptions
  • Title page
  • Organization of paper
    • Encourage use of headings
  • APA formatting
  • Supporting details
  • Writing mechanics
  • Writing clarity
  • Professional journals
  • American Nurses Association Code of Ethics for Nurses
  • Black (2020)
  • Paper length
    • Minimum of 5 pages without title page or reference list
  • Many APA resources available in NURS 300 table of contents
  • Ethical Dilemma Draft Review – optional but encouraged

The ethical dilemma I would like to discuss is _Truth- Telling in Health care.

An example I have learned about in the literature regarding this ethical dilemma is – fill in the blank

An example I have learned from literature:

In the health care system, can lying be justified if it saves a life? Or if it can eliminate harm to a patient? This paper proposes that health care professionals should always tell the truth because it is a moral obligation. However, it does not refute the fact that concealing patients’ information can be used to prevent harm. It elucidates the value of telling the truth and the challenges encountered when telling the truth.

__________________________________________________________________________________. A couple of actions that can be taken, that I know about, in this situation are _____________________.

 

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