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NURS 6051 Health Insurance Portability and Accountability

January 22, 2022/in Uncategorized /by cone

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Week 9 NURS 6051 Transf Nursing Tech DISCUSSION

Module 5: The Nurse Leader and the System Development Life Cycle (Weeks 9-10)

Learning Objectives

Students will:

Analyze how inclusion of the nurse in the purchasing of health information technology systems impacts healthcare organizations
Analyze the impact of nurse inclusion on each step of the systems development life cycle

In the media introduction to this module, it was suggested that you as a nurse have an important role in the Systems Development Life Cycle (SDLC). With a focus on patient care and outcomes, nurses may not always see themselves as contributors to the development of new systems. However, as you may have observed in your own experience, exclusion of nurse contributions when implementing systems can have dire consequences.

In this Discussion, you will consider the role you might play in systems development and the ramifications of not being an active participant in systems development.

To Prepare:

Review the steps of the Systems Development Life Cycle (SDLC) as presented in the Resources.
Reflect on your own healthcare organization and consider any steps your healthcare organization goes through when purchasing and implementing a new health information technology system.
Consider what a nurse might contribute to decisions made at each stage of the SDLC when planning for new health information technology.

Post a description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system. Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues. Then, explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice or healthcare organization and explain potential impacts of being included or not in the decision-making process. Be specific and provide examples. NURS 6051 Health Insurance Portability and Accountability

Name: NURS_5051_Module05_Week09_Discussion_Rubric

	Excellent		Fair	Poor
Main Posting	45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.		35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	10 (10%) – 10 (10%) Posts main post by day 3.		0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not post by day 3.
First Response	17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.		13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	.	12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	0 (0%) – 0 (0%)	0 (0%) – 0 (0%)	0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

Name: NURS_5051_Module05_Week09_Discussion_Rubric

Required Readings

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 9, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making” (pp. 175–187)
Chapter 12, “Electronic Security” (pp. 229–242)
Chapter 13, “Workflow and Beyond Meaningful Use” (pp. 245–261)

Agency for Healthcare Research and Quality. (n.d.a). Health IT evaluation toolkit and evaluation measures quick reference guide. Retrieved September 27, 2018, from

https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/health-it-evaluation-toolkit-and-evaluation-measures-quick-reference

Agency for Healthcare Research and Quality. (n.d.b). Workflow assessment for health IT toolkit. Retrieved September 27, 2018, from https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit

Required Media

See below

Louis, I. (2011, August 17). Systems development life cycle (SDLC) [Video file]. Retrieved from https://www.youtube.com/watch?v=xtpyjPrpyX8

Laureate Education (Producer). (2018). Interoperability, Standards, and Security [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Managing Health Information Technology [Video file]. Baltimore, MD: Author.

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Assignment: Cognitive Function & Early Life Experiences Research Article

January 22, 2022/in Uncategorized /by cone

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Article outline

The article discusses the impact that mental awareness of nurses has on the empathy and care quality, on patience. The way nurses view or perceive mental illnesses can significantly affect the type of treatment a patient receives. Mental illness put patients in a susceptible position to obtain other physical illnesses, if a nurse is more aware of these impacts, it could prevent the prolongation of the treatment for the patient.

Published in final edited form as:

Arch Psychiatr Nurs. 2016 Dec; 30(6): 788–796.

Published online 2016 Jul 12. doi: 10.1016/j.apnu.2016.07.004

PMCID: PMC5127450

NIHMSID: NIHMS805252

PMID: 27888976

The Variability of Nursing Attitudes Toward Mental Illness: An Integrative Review

Krystyna de Jacq, NP, Allison Andreno Norful, MSN, RN, ANP-BC, and Elaine Larson, PhD, RN

Author information Copyright and License information Disclaimer

The publisher’s final edited version of this article is available at Arch Psychiatr Nurs

See other articles in PMC that cite the published article.

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Abstract

Mental illnesses are common worldwide, and nurses’ attitudes toward mental illness have an impact on the care they deliver. This integrative literature review focused on nurses’ attitudes toward mental illness. Four databases were searched between January 1, 1995 to October 31, 2015 selecting studies, which met the following inclusion criteria: 1) English language; and 2) Research in which the measured outcome was nurses’ attitudes toward mental illness. Fifteen studies conducted across 20 countries that 4,282 participants met the inclusion criteria. No study was conducted in the United States (U.S.). Studies reported that nurses had mixed attitudes toward mental illness, which were comparable to those of the general public. More negative attitudes were directed toward persons with schizophrenia. Results indicate the need for further research to determine whether attitudes among nurses in the U.S. differ from those reported from other countries and to examine potential gaps in nursing curriculum regarding mental illness.

Mental illnesses are common worldwide and represent the fifth leading disorder globally (Whiteford et al., 2013). About 450 million people suffer from mental illnesses worldwide (World Health Organization, 2001). In the United States (U.S.) alone, over 43.7 million of adults, 18.6% of all the population, have a mental illness diagnosis (National Alliance for the Mentally Ill, 2013). Effective treatments exist, but only 39% of people with diagnosed mental illness receive treatment and among those who receive treatment, one in five terminate treatment prematurely (NIMH, 2001, Olfson et al., 2009).

Various factors play a role in decision-making as it pertains to seeking help for mental illness. Those factors include financial concerns, poor self-perception, limited access and stigma (Mojtabai et al., 2011). Goffman (1963) defines social stigma as an attribute that is discredited by society. Hatzenbuehler, Phelan, & Link, 2013, suggested in a recent review that stigma related to mental illness causes health inequalities by preventing people from seeking help that they need. People with depression are more likely to suffer from physical health comorbidities and are reported to be twice as likely as non-depressed patients to have two or more physical illnesses (Smith et al., 2014). According to the Anxiety and Depression Association of America (ADAA), anxiety disorders cost the U.S. more than $42 billion per year, representing almost a third of total mental health spending (ADAA, 2010). People who suffer from anxiety disorders are three to five times more likely to visit primary care and gastroenterology than people without the disorder, resulting in increased health care costs (Hoffman, Dukes, & Wittchen, 2008).

Delaying treatment for mental illness may result in negative consequences. The longer the duration of untreated illness, the worse the outcomes in psychosis, mood disorders and anxiety disorders (Dell’osso, Glick, Baldwin, & Altamura, 2012). Furthermore, after initiation of treatment, non-adherence and drop out rates may result in unfavorable outcomes (Barrett et al., 2008).

A negative patient-provider relationship, or personal and professional characteristics of the providers, may compel the patient to leave treatment (Reneses, Munoz, & Lopez-Ibor, 2009). Hoge et al., (2014) performed a study at a U.S. Veterans Administration Hospital and reported that dissatisfaction with the provider was one of the reasons for patients to drop out of treatment. Furthermore, in a recent integrative review, Newman, D., O’Reilly, P., Lee, S. H., & Kennedy, C. (2015) underlined the importance of relationships between the providers, such as nurses, and the patients who were seeking help for mental health problems. In addition to the patient-provider relationship, the impact of provider stigma is emerging in the literature, and has been identified as the strongest barrier toward help seeking behavior of individuals with mental illness (Clement et al., 2015, Corrigan, 2004; Evans-Lacko, Brohan, Mojtabai, & Thornicroft, 2012; Hinshaw & Stier, 2008; Kim, Britt, Klocko, Riviere, & Adler, 2011). Newman et al., (2015) re-iterated the importance of stigma, affirming that negative nursing attitudes toward mental illness have a profound impact on the delivery of care. Similarly, McDonald et al. (2003) confirm that the nurses’ care of patients is negatively impacted if the patient has a mental illness. The investigators presented vignettes that represented three patients admitted to the emergency room with a possible myocardial infarction. 1) The patient was taking an antipsychotic medication; 2) The patient was taking alprazolam (Xanax), a medication used to treat anxiety disorder; and 3) The patient had no history of psychiatric treatment (control). A significant difference in symptom recognition was found. Only 31% of nurses who read the first vignette identified a possibility of myocardial infarction in a patient taking antipsychotic medications compared to 51% of nurses in the control group. Additionally, when patients were experiencing increased anxiety, 78.9% of nurses in the control group stated that they could be having a heart attack versus 45.5% only in the psychotic patient group. This study highlights a general tendency of nurses to stereotype patients with mental illness thereby responding differently to them (McDonald et al., 2003). Corrigan et al., (2014) found that providers’ attitudes were different toward patients with a diagnosis of mental illness than toward those without. Assignment: Cognitive Function & Early Life Experiences Research Article

Although the factors that influence attitudes regarding mental illness have been studied for many years (Ajzen, 2005; Ajzen & Fishbein, 1980; Fishbein, 2010; Fishbein & Ajzen, 1975; Fishbein, Ajzen, Albarracin, & Hornik, 2007), to our knowledge, there has been no integrative literature review exploring nursing attitudes toward patients with mental illness. Obtaining a clear understanding of nursing attitudes may, inform policy and be used to implement change to ensure optimal patient care. Assignment: Cognitive Function & Early Life Experiences Research Article

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Aim

The aim of this integrative review is to explore nurses’ attitudes toward patients with mental illness. Assignment: Cognitive Function & Early Life Experiences Research Article

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Methodology

Defining Mental Illness

The Centers for Disease Control and Prevention (2013) defines mental illness as “disorders generally characterized by dysregulation of mood, thought, and/or behavior, as recognized by the Diagnostic and Statistical Manual, 4^th edition, of the American Psychiatric Association.” People with mental illness have impaired thinking, and their feelings may affect their ability to function on a daily basis. For the purpose of this review, we used the terms mental illness, mental disorders, and psychological problems interchangeably, which included, but not limited to, mood and psychotic disorders, as well as anxiety. Given the change in mental illness criteria introduced by DSM IV in 1994, only studies that used DSM IV and DSM V were included (American Psychiatric Association, 1994, 2013).

Literature Search

The conduct of this integrative review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement (Liberati, Altman, Tetzlaff, & Mulrow, 2009). We searched the following databases: Ovid MEDLINE, PsycINFO, CINAHL, and PubMed in September, 2015. The following Medical Subject Heading (MeSH) terms were searched: (‘mental illness’ OR ‘mental health’) AND (‘nurses’ OR ‘nurs*’) AND (‘stereotyp*’ OR ‘stigma’ OR ‘prejudice’ OR ‘discrimination’ OR ‘attitudes” OR ‘beliefs’).

Data were initially extracted from the four databases by the first author who screened all articles’ titles and abstracts. Two authors independently assessed selected full text articles for eligibility, and the discrepancies were resolved by discussion. The inclusion criteria were studies published between January 1, 1995 and October 31, 2015 in English and included nurses as participants in which the measured outcome was nursing attitudes toward mental health and/or illness in patients. Personal accounts, editorials, and/or single case studies, studies not written in English, and studies that explored attitudes of other professionals were excluded.

Quality Appraisal

The methodological quality of the studies was assessed using Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies (QATOCCS) from the National Institute of Health, National Heart, Lung, and Blood Institute. The QATOCCS was modified to fit the needs of cross-sectional studies, as many questions were relevant to cohort studies only. Two researchers appraised the quality of the studies and 100% consensus of each study’s quality was achieved. Studies were rated in tertiles: low quality (0 – 33%), moderate quality (34 – 66%), and high quality (67 – 100%).

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Results

The initial database search yielded 2,615 articles, and 2,343 remained after duplicates were removed. Following title screening, 770 papers were identified as potentially eligible and 701 articles were excluded after title and abstract review, leaving 69 articles for full text screening. Fourteen articles met the inclusion criteria. A search of the reference lists of the 14 final articles yielded an additional five articles eligible for inclusion in the study. A full text review by two researchers was performed again and one of the five articles was included in the final review yielding 15 studies that met initial eligibility criteria. Assignment: Cognitive Function & Early Life Experiences Research Article

Quality Appraisal

Two researchers reached consensus on the quality of each study. Twelve studies were determined to be of high quality (Arvaniti et al., 2009; Chambers et al., 2010; Foster et al., 2008; Hamdan-Mansour & Wardam, 2009; Hsiao et al., 2015; Linden & Kavanagh, 2012; Magliano et al., 2004; Munro & Baker, 2007; Nordt, 2006; Scheerder et al., 2011; Serafini et al., 2011; Sevigny et al., 1999). One study score within the moderate quality range (Kukulu & Ergun, 2007). Two studies received lower quality scores because some key methodological elements were not reported, including sampling, sample recruitment and size, and lack of information about study measures. One of these lacked sufficient methodological rigor to be included, leaving 14 studies remaining in the final synthesis of the review. A PRISMA flow diagram is presented in Figure 1. Assignment: Cognitive Function & Early Life Experiences Research Article

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Figure 1

Flow Diagram

The studies were conducted across 20 countries. None of the studies were performed in the U.S. Eight of the studies were conducted in Europe (two of which included more than one country), four in Asia, and three in the Middle East. Of the 14 studies, six focused on attitudes toward schizophrenia and/or depression, while the remaining nine concentrated on mental illness in general. All of the studies had a cross-sectional design. Twelve studies included mental health nurses who worked with mentally ill inpatients or outpatients. Aydin, Yigit, Inandi, & Kirpinar, (2003) conducted a study in an outpatient, non-psychiatric setting. Arvaniti et al., (2009) and Scheerder et al., (2010) performed their studies on medical rather than psychiatric units. Study characteristics and key findings are presented in Table 1. Assignment: Cognitive Function & Early Life Experiences Research Article

Table 1

Study Characteristics

Study	Country	Sample	Measures	Key Findings
Arvaniti et al., 2009	Greece	130 nurses 76 physicians 140 other staff 239 medical students 10 medical wards and one psychiatric ward of a general hospital	The Level of Contact Report (LCR) Opinion about Mental Illness (OMI) The Authoritarianism Scale (AS)	*(% Nurse Agreement)* *Social discrimination* Mentally ill patients are dangerous (24%) Mentally ill patients should not marry (53%) Mentally ill patients should be separated from patients without mental illness (60.7%) *Social restriction: Mentally ill patients should not vote (31%) Nurses endorsed more restrictive attitudes than physicians More knowledge about mental illness was associated with more positive attitudes. Assignment: Cognitive Function & Early Life Experiences Research Article Social integration*: Nurses were more negative than physicians but less authoritarian than medical students
Aydin et al., 2003	Turkey	40 nurses 40 academicians 40 physicians 40 hospital employees Medical clinics	Schizophrenia and depression vignettes measures: Social distance Burden of illness	Nurses exhibited more negative attitudes toward a person with schizophrenia than depression 100% of respondents said they would be disturbed by having a sister marrying a mentally ill person with schizophrenia and depression, but less bothered by working at the same place
Chambers et al., 2010	Finland Italy Lithuania Portugal Ireland	810 nurses Psychiatric Hospitals (n=21)	Community Attitudes toward the Mentally Ill (CAMI)	Nurses exhibited positive attitudes toward mentally ill across all countries Most positive attitude toward mental illness (Portugal) Most negative attitude toward mental illness (Lithuania)
Foster et al., 2008	Fiji	23 nurses 48 orderlies Psychiatric hospital	Attitudes Toward Acute Mental Health Scale	**Etiology(% agreement) “Mental illnesses are caused by genetic factors” (65.2%) Attitudes** “Psychiatric illness deserves as much attention as physical illness” (86.9%) “Mentally ill have no control over their emotions” (30.5%) “Manner in which you talk to patients affects their mental state” (91.3%). Assignment: Cognitive Function & Early Life Experiences Research Article
Hamdan-Mansour and Wardam., 2009	Jordan	92 nurses Acute and chronic mental health inpatient and outpatient facilities	Attitudes Toward Acute Mental Health Scale	Significant difference in attitudes between older and younger nurses Special training in psychiatric nursing led to more positive attitudes Higher level of education was associated with more positive attitudes. Nurse Agreement (%) “Psychiatric Illness deserves as much attention as physical illness” (5.4%) “Depression occurs in people with weak personality” (68.5%) “Mentally ill patients have no control over their emotions” (84.8%) “Mental illnesses are genetic in origin” (76.1%).
Hsiao et al., 2015	Taiwan	180 nurses. Psychiatric hospitals (n=3)	Jefferson Scale of Empathy-Health Profession version (JSE-HP) Attitudes of Mental Illness Questionnaire (AMIQ)	More negative attitudes towards schizophrenia than depression (p <.001) The older the nurse, the more positive attitude (p <.01) The more experience the more positive attitudes (p <.001) There was a positive correlation between empathy and attitudes toward mental illness (p <.01) There were no gender difference (p =.84) Staff nurses endorsed more negative attitudes than nurse managers (p <.02) Nurses on acute psychiatric units endorsed more negative attitudes toward schizophrenia than nurses who worked in community-based outpatient clinics (p =.006). Assignment: Cognitive Function & Early Life Experiences Research Article
Kukulu and Ergun, 2007	Turkey	543 nurses Psychiatric wards of teaching hospitals	Questionnaire reported in Turkish language	*Etiology(% Agreement) Schizophrenia present from birth (93.2%) Schizophrenia caused by social problems (51.4%) Social distance* “People with schizophrenia should be free in society” (31.9%) Could work with people with schizophrenia (56.7%) Could marry a person with schizophrenia (8.3%) Have a neighbor with schizophrenia (42.9%) Rent home to a person with schizophrenia (63.2%)
Linden and Kavanagh 2012	Ireland	121 nurses 66 student mental health nurses Inpatient and Community Setting (n=2)	Community Attitudes toward Mental Illness Scale (CAMI) Social Interaction Scale (SIS)	*CAMI* Nurses disagreed with social restrictiveness and authoritative attitudes toward mental illness Nurses agreed with integrating mentally ill into the community Nurses agreed with exhibiting benevolent attitudes toward those with mental illness Community mental health nurses showed more positive attitudes than those who worked in inpatient setting *SIS* Inpatient mental health nurses showed more socially restrictive attitudes than nurses in a community setting.
Magliano et al., 2004	Italy	190 nurses 110 psychiatrists 709 patient relatives Mental health services (n=30)	Opinions About Mental Illness Questionnaire	*Etiology of schizophrenia* (% Nurse agreement) Heredity (74%); Stress (53%); Alcohol (42%), Drugs (48%); Family conflict (48%), Trauma (36%) *Social functioning* “Patients with mental illness should work as other people” (79%) “Patients with schizophrenia are unpredictable (86%). Assignment: Cognitive Function & Early Life Experiences Research Article *Civil rights* Patients with schizophrenia should be responsible in court (72%) Patients with schizophrenia should vote (66%) Patients with schizophrenia should not get married (63%) Patients with schizophrenia should not have children (72%) Wife of patient with schizophrenia should be allowed to divorce upon diagnosis (50%)
Munro and Baker 2007	England	141 nurses Acute mental health unit	Attitude Toward Acute Mental Health Scale	*Positive Attitudes (% Nurse Agreement)* “Psychiatric illness deserves at least as much attention as physical illness” (80%) “Depression occurs in people with a weak personality” (20%) *Negative Attitudes* Psychiatric drugs are used to control disruptive behavior” (67%) *Neutral Attitudes* “Mental illness is genetic in origin” (46.4%) “People are born vulnerable to mental illness” (45.7%)
Nordt et al., 2006	Switzerland	684 nurses 204 psychiatrists 185 other professionals Psychiatric wards of hospitals (n=29) Outpatient clinics (n=3) 1737 members of the general public	Computer Assisted Telephone Interview Social Acceptance	Nurses and Psychiatrists reported similar negative attitudes Nurses endorsed higher social distance toward people with schizophrenia than toward people with depression. *Social restrictiveness (% Nurse Agreement)* Mentally ill people should have driver’s license revoked (46%) In favor of withdrawing the right to vote (2.8%) Mentally ill should abort when pregnant (9.8%) In favor of compulsory admission (98.2%). Assignment: Cognitive Function & Early Life Experiences Research Article
Scheerder et al., 2011	European Alliance Against Depression Belgium Estonia France Germany Hungary Ireland Italy Scotland Slovenia	887 nurses 334 nursing assistants 169 mental health professionals (physicians and mental health professionals) 968 community facilitators (clergy, social workers) from a training program and professional associations	Adaptation of 3 tools Depression Attitude Questionnaire Defeat Depression Questionnaire Instruments of EAAD partner countries	Mental health professionals had the least negative attitudes toward people with depression and the use of antidepressants. Nurses had more negative attitudes toward people with depression *Positive Attitudes toward mental health (% agreement)* “Depression is a real disease” (60% nurses; 95% physicians) “Depression can be treated” (81.9% nurses; 95.8% physicians) *Negative attitudes toward treatment (% agreement)* Antidepressants (AD) are addictive (67.8% nurses; 24.8% physicians) AD is effective in treating depression (47.9% nurses; 83.1% physicians) AD can change one’s personality (66% nurses; 28.6% physicians) *Etiology of mental illness* Heredity (In agreement) 56.5% nurses; 65.1% physicians
Serafini et al., 2011	Italy	50 nurses 50 medical physicians 50 medical students 52 psychiatric outpatients from a university hospital	Responses to questions about vignettes Standardized Stigmatization Questionnaire (SSQ), (Part 1)	Vignettes (% Nurse Agreement) *Positive attitudes* Genetic basis of schizophrenia (80%) *Negative attitudes* Most people think that people with schizophrenia are unpredictable (75%) Most people want to keep their distance from people with schizophrenia (80%) *Neutral attitudes* Most people thought that people with schizophrenia are dangerous (50%) SSQ Significant response difference between medical doctors and nurses (p.038)
Sevigny et al., 1999	China	74 nurses 26 physicians Psychiatric hospital	Community Attitudes Toward the Mentally Ill	**Nurses endorsed mostly negative attitudes(% Nurse Agreement) “Mental illness is an illness as any other” (38%) “Most women who were once patients in a mental hospital can be trusted to take care of babies” (30%) “Mental patients need the same kind of control and discipline as a young child” (63%) “Anyone with a history of mental problems should be excluded from taking public office” (71%) “The mentally ill should not be given any responsibility” (78%) Nurses endorsed more negative attitudes than physicians**

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Study Measures

Numerous measures were utilized across countries. Three studies used the Attitudes Toward Acute Mental Illness Scale (ATAMH33) (Baker, Richards, & Campbell, 2005) and four studies used Community Attitudes towards Mental Illness (CAMI) (Taylor, Dear, & Hall, 1979; Taylor & Dear, 1981). The following measures were in at least one study: The Level of Contact Report (Holmes, Corrigan, Williams, & Canar, 1999), the Opinion about Mental Illness (Madianos, Madianou, Vlachonikolis, & Stefanis, 1987), the Authoritarianism Scale (Adorno, 1950), Social Distance (Arkar, 1991), Burden of Illness (Eker & Arkar, 1991), Jefferson Scale of Empathy-Health Profession version (Hojat, Gonnella, Nasca, Mangione, & et al., 2002), Attitudes of Mental Illness Questionnaire (Luty, Fekadu, Umoh, & Gallagher, 2006), Social Interaction Scale (Kelly, St Lawrence, Smith, & Hood, 1987), Social Acceptance Scale (Angermeyer & Matschinger, 1997), and Standardized Stigma Questionnaire (Haghighat, 2005). Kukulu and Ergun, (2007) utilized an adaptation of multiple instruments, but the researchers were unable to assess its validity because the instruments’ descriptions and psychometric testing were only being available in studies published in the Turkish language.

Findings

In these studies, attitudes toward mental illness were compared between psychiatric nurses and nurses working in non-psychiatric settings as well as between nurses and the general public. Finally as discussed below, four common themes emerged: 1) etiology of mental illness; 2) social restrictiveness and distance; 3) perceived dangerousness; 4) attitudes specific to schizophrenia and depression. Assignment: Cognitive Function & Early Life Experiences Research Article

Attitudes of psychiatric nurses compared to nurses working in other settings

Nursing attitudes were examined first by comparing nurses that were working on psychiatric wards compared to non-psychiatric nurses working on a medical ward or outpatient clinics. However, no study compared directly psychiatric versus non-psychiatric nurses. Authors of three studies reported the attitudes of non-psychiatric nurses (Arvantini et al., 2009; Aydin et al., 2003; Scheerder et al., 2010). Arvantini et al., (2009) reported both positive and negative nursing attitudes toward mental illness. For example, 60.7% of nurses in this study agreed that mentally ill patients should be separated from patients without mental illness. On the contrary, 76% of psychiatric and non-psychiatric nurses in this study viewed mentally ill patients as not being dangerous. Aydin et al., (2003) reported that nurses endorsed social discrimination more than the doctors and showed low support for social integration. They also endorsed social restriction more than other professionals, such as doctors and medical students. However, nurses endorsed social care questions at a higher level than other groups. Negative nursing attitudes toward patients with schizophrenia and depression were also reported. This finding was consistent among studies that examined both psychiatric and non-psychiatric nurses.

Scheerder et al. (2010) found that non-psychiatric nurses held mostly positive attitudes toward people with depression. Sixty percent of nurses considered depression as an illness and 81.9% of respondents agreed (n=1533) that depression was treatable. However, nurses’ attitudes were less positive compared to other mental health professionals, such as clinical social workers, psychologists, and counselors, which can be explained by lack of specialty training among nurses as compared to professionals in mental health.

There was a variability of psychiatric nurses attitudes across studies. Three studies reported positive attitudes (Chambers et al., 2010; Linden & Kavanagh, 2012; Munro & Baker, 2007) and four studies exemplified negative attitudes (Hamdan-Mansour & Wardam, 2009; Hsiao et al., 2015; Magliano et al., 2004; Sevigny et al., 1999). The remaining studies were a combination of both positive and negative (Foster et al., 2008; Kukulu & Ergun, 2007; Nordt et al., 2006; Serafini et al., 2011).

In a large European study, Chambers et al. (2010) assessed attitudes of 810 mental health nurses and reported that respondents rejected authoritarian attitudes as well as the desire for social distance toward people with mental illness and not only displayed benevolent attitudes, but also endorsed community integration. Linden and Kavanagh (2011) reported similar results. Munro and Baker (2007) reported that their respondents mostly agreed with positive statements, such as “psychiatric illness deserves at least as much attention as physical illness” (95.7% agreement) and disagreed with negative statements, such as “depression occurs in people with weak personality” (90% disagreed). It is important to mention, that even in studies that reported mostly positive attitudes, there were some negative attitudes, such as consideration that psychiatric drugs were used to control disruptive behavior (61.7% agreement), and that nurses perceived mentally ill patients with pessimism (semantic differential: pessimism – optimism).

Authors of four studies reported that psychiatric nurses had mostly negative attitudes (Hamdan-Mansour & Wardam, 2009; Hsiao et al., 2015; Magliano et al., 2004; Sevigny et al, 1999). Majority of nurse respondents considered that psychiatric illness did not deserve as much attention as physical illness (94.6%, 87/92), 84.8% (78/92) considered that a person with mental illness had no control over her or his emotions, and 68.5% (63/92) agreed that depression was occurring in people with weak personality (Hamdan-Mansour & Wardam, 2009). Hsiao et al., (2015) found that psychiatric nurses had significantly more negative attitudes toward patients with schizophrenia than nurses who worked in community-based clinics, and that nurses had more negative attitudes toward people with schizophrenia than those with depression. Magliano et al., (2004) reported that 86% (163/190) of nurses considered people with schizophrenia as unpredictable, and 87% (165/190) considered that people were keeping away from patients with schizophrenia. Nurses also agreed that patients with schizophrenia should not have children (72%, 137/190), and that they should not get married (63%, 119/190), (Magliano et al., 2004). Even though most responses were negative, nurses also agreed with positive statements and considered that patients with schizophrenia should be allowed to vote (63%, 119/190), and that they were as able to work as other people (79%, 150/190), (Magliano et al., 2004). Sevigny et al., (1999) reported that nurses mostly held negative attitudes toward mentally ill people and generally more negative than physicians. Thirty eight percent of nurses considered a mental illness as any other illness (n=74) and 63% displayed authoritarian attitudes toward mentally ill patients. Nurses in Sevigny et al., (1999) also reported positive attitudes. Almost 60% of respondents disagreed that lack of discipline and will power was causing mental illness. Assignment: Cognitive Function & Early Life Experiences Research Article

Four studies reported mixed attitudes (Foster et al., 2008; Kukulu et al., 2007; Serafini et al., 2011; Nordt et al., 2006). The authors of all four studies reported results that showed negative and positive attitudes toward mental illness. Nordt et al., (2006) reported that nurses endorsed negative stereotypes of mentally ill people, but opposed restriction of civil rights of the mentally ill. Serafini et al., (2011) reported that while 75% of nurses believed that people with schizophrenia were unpredictable and 80% expressed a desire for social distance, 60% did not believe that people with schizophrenia were dangerous (n=50). Kukulu and Ergun, (2007) also confirmed the desire for social distance: while 56.7% of nurses said that they could work with a person with schizophrenia, 91.7% would not marry a person with that disorder (n=543). Foster et al., (2008) also reported mixed attitudes among their respondents: while 91.3% of nurses considered that people with a psychiatric history should be given jobs with responsibilities, 91.3% said that psychiatric medications were used to control disruptive behavior instead of being used to control the symptoms (n=23).

Attitudes of nurses compared to the general public

Three studies compared nurses’ attitudes toward mental illness with non-healthcare professionals such as family members and the general public, with mixed results (Magliano et al., 2004; Nordt et al., 2006; Scheerder et al., 2011). Magliano et al. (2004) reported that nurses (n=190) had more negative attitudes than the relatives (n= 709) of patients with mental illness. For example, 86% of nurses believed that patients with schizophrenia were unpredictable compared with only 65% of relatives having the same attitude. In addition, 72% of nurses compared to 32% of relatives considered that mentally ill patients should be punished for wrong behavior in the same manner as other people. In regards to personal civil rights, nurses and relatives had similar attitudes about whether those with schizophrenia should have children (29%) or have the right to vote (66%). Finally, while almost half of the relatives (44%) considered that mentally ill people could work as other people, 79% of nurses disagreed.

In a second study, Nordt et al., (2006) compared five groups, including nurses and 253 members of the general population. The nurses and the general population agreed with negative stereotypes of the mentally ill at a similar level. However, while 54% of nurses opposed revocation of the Driver’s License, 65.7% of the general public endorsed that restriction. More members of the general public than nurses considered that the mentally ill people should not vote (19.6% vs. 2.8%), and while almost all nurses agreed to compulsory admission (98.2%), 67.5% of general public respondents endorsed this option.

In the third study (Scheerder et al., 2010), community facilitators (clergy, police, youth workers, pharmacists, social workers and volunteers) were asked their opinions about depression and were compared with mental health professionals and nurses. While 77% of community facilitators considered that depression is a real disease, 60% of nurses endorsed that opinion. Both groups agreed that depression could be treated (83.4% of community facilitators vs. 81.9% of nurses).

Specific themes

Etiology of mental illness

Seven studies reported nurses’ beliefs about the etiology of mental illness (Foster et al., 2008; Kukulu & Ergun, 2007; Magliano et al., 2004; Munro & Baker, 2007; Scheerder et al., 2011; Serafini et al., 2011; Sevigny et al, 1999). Nurses predominantly have the attitude that mental illness is a disease of a hereditary nature (range: 65%–93%). Additional attitudes about the etiology of mental illness included personal weakness, result of alcohol and/or drug use, and stress and family conflict. Most nurse respondents (59–90%) did not consider mental illness as emanating from a lack of will power (Munro & Baker, 2007; Sevigny et al., 1999).

Social restrictiveness and distance

Social restrictiveness in mental illness stigma literature measured the desire to restrict people with mental illness from roles in society. Social distance refers to the proximity that one desires between self and a mentally ill person in a social situation. Nine studies reported nurses’ attitudes toward social restrictions that should be imposed on the mentally ill as well as the social distance that the respondents preferred to maintain from this population (Arvaniti et al., 2009; Aydin et al., 2003; Chambers et al., 2010; Kukulu et al., 2007; Linden & Kavanagh, 2012; Magliano et al., 2004; Munro & Baker, 2007; Nordt et al., 2006; Sevigny et al., 2011. Attitudes toward social restrictions and distance were measured through questions that examined attitudes toward right to vote, revocation of one’s driver’s license, isolation of the mentally ill from the residential neighborhoods, mandatory abortion for women with diagnosed schizophrenia, and opposition to marrying people with mental disorders. Almost half of the nurses (46%, 311/676) in one study agreed that people who suffered from any mental health issues should have their driver’s license revoked (Nordt et al., 2006). The majority of respondents would oppose a marriage of a family member to a person with mental illness. Almost two-thirds (63%) of nurses in one study agreed that patients with schizophrenia should not marry at all (Magliano et al., 2004). Similarly, in another study, 100% of respondents agreed that they would not want their sister to marry someone with a mental disorder (Aydin et al., 2003). The majority of these respondents (76.2%, 32/42), also agreed that they would not rent their apartments to mentally ill people (Aydin et al., 2003).

Perceived dangerousness

Studies presented mixed attitudes and beliefs regarding the level of dangerousness, unpredictability, and emotional instability of mentally ill. Serafini et al., (2011) reported that 16 of 40 nurses (40%) considered patients with schizophrenia to be dangerous, while Munro and Baker (2007) reported that 85% of respondents did not. Kukulu and Ergun (2007) reported that over half of nurses (53%) agree they would be frightened if people with mental illness lived close by.

Severely mentally ill people were perceived as unpredictable (from 75% to 86% agreement). Questions concerning the lack of control over emotions showed mixed opinions. Hamdan-Mansour and Wardam, (2009) reported that 84.8% of the 92 nurses agreed with the statement that: “mentally ill have no control over their emotions”, while Foster et al., (2008) reported the opposite with almost 70% of nurses disagreeing with the following statement: “mentally ill patients have no control over the emotions”. Assignment: Cognitive Function & Early Life Experiences Research Article

Schizophrenia and depression

Three studies compared specific attitudes toward schizophrenia and depression (Aydin et al., 2003; Hsiao et al., 2015; Nordt et al., 2006). Attitudes were generally more positive toward patients with depression. The comparisons included discrimination toward housing, use of services, work and proximity in social settings, such as their comfort level working with someone who has a mental illness. Aydin et al., (2003) reported that more nurses would be disturbed if they had to shop at a market run by a person with schizophrenia (33.3%) rather than the depression (11.1%). While 38.1% of nurses would be disturbed to work with a person with schizophrenia, only 5.9% would feel that way working with a person with depression. However, in some social situation, discrimination toward people with depression or schizophrenia were at the same level: 100% of respondents would not want their sisters to marry either one, 76% would not go to a hairdresser with either disorder and 76% would not rent a house to any of them. Hsiao et al., (2015) and Nordt et al., (2006) findings supported that nurses had more negative attitudes toward patients with schizophrenia rather than major depression.

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Discussion

The studies included in this review examined nurse attitudes toward mental illness across 20 countries. Globally, nurses tend to have mixed attitudes toward different aspects of mental illness. Evidence about the difference in attitudes of psychiatric nurses and non-psychiatric nurses was contradictory. However, one study determined that the higher the education level of the nurse, the more likely the nurse would have a more positive attitude about mental illness. This suggests that education regarding mental illness could potentially alleviate negative attitudes associated with mental illness among nurses. Furthermore, the mixed attitudes found in this review may be partially explained by different cultural beliefs. Among the eight studies conducted in one or more European countries, both positive and negative nursing attitudes were reported, both within and across countries (Arvaniti et al., 2009; Chambers et al., 2010; Linden & Kavanagh, 2012; Magliano et al., 2004; Munro & Baker, 2007; Nordt et al., 2006; Scheerder et al., 2011; Serafini et al., 2011). In contrast, the majority of studies conducted in Middle Eastern or Asian countries, reported more negative than positive nursing attitudes, suggesting that culture may play an influential role in nursing perception of mental illness.

Another factor that might have contributed to the finding that nurses’ attitudes toward the mentally ill were quite mixed was the fact that various measurement tools were used. More than half of the studies (8/14) used different tools. Three tools alone were questionnaires adapted by researchers. This makes the comparisons of results across studies difficult.

Finally, the results of this study were surprising in that professional nurses’ attitudes toward mental illness were comparable to attitudes among the general public rather than reflective of professional expertise (Al-Krenawi, Graham, Dean, & Eltaiba, 2004; Angermeyer & Dietrich, 2006; Ozmen et al., 2004; Schomerus et al., 2012; Tsang, Tam, Chan, & Cheung, 2003). One would anticipate that professional training would have an impact on attitudes toward these patients. The fact that nurses who worked on psychiatric units did not express more positive attitudes toward their patients as compared to nurses who worked in general medicine might be due to perception bias. These nurses often see patients readmitted for care with multiple psychiatric hospitalizations, which may influence their attitude toward mental illness capacity and prognosis. Linden and Kavanagh (2011) support this explanation, in that nurses from mental health community settings who worked with more stable patients endorsed more positive attitudes than those who worked on acute inpatient wards. If nurses have clear guidelines regarding how to approach patients with various mental illnesses, how to address their symptoms, and what therapeutic interventions are most effective, they may feel more empowered in their nursing roles, thus promoting a more positive outlook on mental illness. Further, management can be influential by providing explicit and overt support for culture change toward more supportive attitudes of patients diagnosed with mental illness.

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Limitations

This review has some limitations. The English language limitation as well as the limited number of databases searched might have led to omission of relevant studies. Furthermore, we did not include the grey literature in this review.

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Conclusions and Future Research

In summary, this review found that nursing attitudes toward people with mental illness varied, both within and across countries and mimicked attitudes similar to the general public. Since no studies were conducted in the U.S., there is a need to examine the attitudes of nurses toward those with mental illness and compare the U.S. to other countries. It is crucial to assess nurses’ attitudes toward mental illness and explore the factors associated with positive beliefs. A better understanding of mental illness and related nursing attitudes will help to inform delivery of care to those patients who suffer from mental illness.

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Acknowledgments

Funding Source

This review was funded by the Jonas Center For Nursing and Veteran Healthcare and the National Institute of Nursing Research (NINR) Comparative and Cost-Effectiveness Research Training for Nurse Scientists, T32 NR014205.

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Footnotes

Publisher’s Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Population Health Planned Intervention and Christian Worldview Project.

January 22, 2022/in Uncategorized /by cone

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Annotated Bibliography

Ayers, J. W., Westmaas, J. L., Leas, E. C., Benton, A., Chen, Y., Dredze, M., & Althouse, B. M. (2016). Leveraging Big Data to Improve Health Awareness Campaigns: A Novel Evaluation of the Great American Smokeout. JMIR Public Health and Surveillance, 2(1), e16. https://doi.org/10.2196/publichealth.5304

The authors aim to determine the effectiveness of awareness campaigns. They do this by observing cessation related news reports, Twitter postings, cessation related google searches, Wikipedia, and government sponsored quit lines. The Great American Smokeout, which is an annual event that encourages and offers support to smokers and takes place every third Thursday of November, was used as a case study in the article.

Chaiton, M., Diemert, L., Cohen, J. E., Bondy, S. J., Selby, P., Philipneri, A., & Schwartz, R. (2016). Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ Open, 6(6), e011045. https://doi.org/10.1136/bmjopen-2016-011045

The authors seek to improve on literature estimating the number of attempts it takes to successfully quit smoking. Through the use of a population based longitudinal panel survey of smokers known as the Ontario Tobacco Survey, they used statistical analyses to determine the average number of quit attempts before quitting successfully. They find that the average number of quit attempts is likely significantly higher than what is generally communicated to smokers, suggesting that a current smoker tries to quit on average about 30 times or more before successfully quitting for 1 year or longer. Population Health Planned Intervention and Christian Worldview Project.

Hersi, M., Traversy, G., Thombs, B. D., Beck, A., Skidmore, B., Groulx, S., Lang, E., Reynolds,

L., Wilson, B., Bernstein, S. L., Selby, P., Johnson-Obaseki, S., Manuel, D., Pakhale, S., Presseau, J., Courage, S., Hutton, B., Shea, B. J., Welch, V., … Stevens, A. (2019). Effectiveness of stop smoking interventions among adults: protocol for an overview of systematic reviews and an updated systematic review. Systematic Reviews, 8(1), 8–28.

The authors focus on interventions used to help with smoking cessation. This evidence review provides the reader with an overview of systemic reviews evaluating the benefits and harms of interventions used to influence smoking cessation. These interventions include approved pharmacotherapies, electronic cigarettes, behavioral therapies, exercise, and alternative therapies.

Liu, J., Zhao, S., Chen, X., Falk, E., & Albarracín, D. (2017). The influence of peer behavior as a function of social and cultural closeness: A meta-analysis of normative influence on adolescent smoking initiation and continuation. Psychological Bulletin, 143(10), 1082–1115. https://doi.org/10.1037/bul0000113

The authors discuss the influence of social and cultural closeness on cigarette smoking and the continuation of smoking being the lead cause of preventable death and disease in the United States. They delve into the fact that smoking begins and is established usually during adolescent years and relate it to the fact that this age group is more sensitive to the influence of others.

Martin, C. T., Gao, Y., Duchman, K. R., & Pugely, A. J. (2016). The Impact of Current Smoking and Smoking Cessation on Short-Term Morbidity Risk After Lumbar Spine Surgery. SPINE, 41(7), 577–584. https://doi.org/10.1097/brs.0000000000001281

The authors aim to discover the likelihood developing an infection or morbidity post-surgery depending on smoking status of patients. They focused on current and prior cigarette smokers and concentrate on their healing process for thirty days after lumbar spine surgery. Through their findings, they were able to conclude that there is a correlation between cigarette smoking and systemic morbidity and wound complication.

Śliwińska-Mossoń, M., & Milnerowicz, H. (2017). The impact of smoking on the development of diabetes and its complications. Diabetes and Vascular Disease Research, 14(4), 265–276. https://doi.org/10.1177/1479164117701876

Śliwińska-Mossoń & Milnerowicz detail the effects that cigarettes have on the body. They focus on its impact on the development of diabetes as well as the development of vascular complications. They shed light on the importance of smoking cessation for the prevention of micro- and macrovascular disease and complications. They believe that those with diabetes who continue to smoke cigarettes lack effective patient education and live a generally unhealthy lifestyle.

West, R. (2017). Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychology & Health, 32(8), 1018–1036. https://doi.org/10.1080/08870446.2017.1325890

West provides a detailed review about the nature of harm caused by smoking, the benefits of smoking cessation, patterns seen by those who smoke, the effectiveness of methods used to lower the harm caused by continued use of tobacco/nicotine, pharmacological and social factors that contribute to the uptake of smoking, and the effectiveness of population and individual level interventions intended on combatting smoking. The article concludes with several suggestions of ways to increase the rate at which smokers try to quit including raising taxes, implementing national programs, and providing behavioral and pharmacological support.

Zhou, C., Wu, L., Liu, Q., An, H., Jiang, B., Zuo, F., Zhang, L., & He, Y. (2017). Evaluation of smoking cessation intervention in patients with chronic diseases in smoking cessation clinics. Medicine, 96(42), e7459. https://doi.org/10.1097/md.0000000000007459

Numerous contributing authors apply their expertise to discussing psychological interventions verses drug combined psychological interventions. They focus on male smokers with single chronic diseases and find more success with drug combined psychological interventions. The psychologic interventions take place in smoking cessation clinics where doctors answer any questions the patients may have, provide mental support and assistance, and provide education.

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PICO Question Does limited use of sedation drugs with limited length of stay in critical care reduce delirium in critically ill patients compared to patient who are not on sedation drugs in the ICU

January 22, 2022/in Uncategorized /by cone

My research question:

In critically ill patients in the ICU (P), with limited use of sedation drugs (I), compared to not using sedation drugs (C), reduce delirium (P)?

Places to search for information:

School online library, and google scholar

List of sources searched:

Date of search

Search strategy used, including any limits

Total number of results found

Comments

1. Lee, J., Choi, S., Park, Y., Lee, C. H., Lee, S. M., Yim, J. J., … & Kim, Y. (2017). C53 CRITICAL CARE: DELIRIUM AND THE EXPECTED AND UNEXPECTED CONSEQUENCES OF SEDATION/ANALGESIA IN THE ICU: Effect of Recent Alcohol, Smoking and Psychotropic Drug Use on Delirium In ICU. American Journal of Respiratory and Critical Care Medicine, 195.

2. Lyons, P. G., Snyder, A. M., Edelson, D. P., Mokhlesi, B., & Churpek, M. M. (2016). C50 CRITICAL CARE: DELIRIUM AND SEDATION IN THE ICU: The Association Between Opioid and Benzodiazepine Use on Clinical Deterioration in Hospitalized Patients On The Wards. American Journal of Respiratory and Critical Care Medicine, 193, 1.

3. Djaiani, G., Silverton, N., Fedorko, L., Carroll, J., Styra, R., Rao, V., & Katznelson, R. (2016). Dexmedetomidine versus propofol sedation reduces delirium after cardiac surgery, a randomized controlled trial. Anesthesiology: The Journal of the American Society of Anesthesiologists, 124(2), 362-368.

13 February 2019 Boolean operators 15,700 Using the AND operator was very useful in narrowing the research to only include sedation use and delirium. 1. Salluh, J. I., Wang, H., Schneider, E. B., Nagaraja, N., Yenokyan, G., Damluji, A., … & Stevens, R. D. (2015). Outcome of delirium in critically ill patients: systematic review and meta-analysis. bmj, 350, h2538.

2. Vallabhajosyula, S., Kanmanthareddy, A., Morrow, L. E., & Esterbrooks, D. J. (2016). C50 CRITICAL CARE: DELIRIUM AND SEDATION IN THE ICU: Role of Statins in Delirium Prevention in Critically Ill and Cardiovascular Surgery Patients: A Meta-Analysis. American Journal of Respiratory and Critical Care Medicine, 193, 1.

13 Feb 2019 Truncation 15, 000 This strategy was useful in restricting the search to a word stem. 1. Lyons, P. G., Snyder, A. M., Edelson, D. P., Mokhlesi, B., & Churpek, M. M. (2016). C50 CRITICAL CARE: DELIRIUM AND SEDATION IN THE ICU: The Association Between Opioid And

2. Benzodiazepine Use on Clinical Deterioration in Hospitalized Patients on The Wards. American Journal of Respiratory and Critical Care Medicine, 193, 1.

3. Lee, J., Choi, S., Park, Y., Lee, C. H., Lee, S. M., Yim, J. J., … & Kim, Y. (2017). C53 CRITICAL CARE: DELIRIUM AND THE EXPECTED AND UNEXPECTED CONSEQUENCES OF SEDATION/ANALGESIA IN THE ICU: Effect of Recent Alcohol, Smoking and Psychotropic Drug Use on Delirium In ICU. American Journal of Respiratory and Critical Care Medicine, 195.

14 Feb. 2019 Parentheses 15,600 This strategical was helpful in making the search logical by pacing sedation use and delirium appear on the same search. 1. Jackson, P., & Khan, A. (2015). Delirium in critically ill patients. Critical care clinics, 31(3), 589-603.

2. Traube, C., Silver, G., Reeder, R. W., Doyle, H., Hegel, E., Wolfe, H. A., … & Buttram, S. D. (2017). Pediatric delirium in critically-ill children: An international point prevalence study. Critical care medicine, 45(4), 584.

14 Feb 2019

Phrase searching 15, 000 This method was pivotal in searching all the documents with sedation and delirium phrases

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The Positive Expectation of What the Future Holds Analysis

January 22, 2022/in Uncategorized /by cone

4 attachments

Reviewers/Editor Comments:

Reviewer #1: Introduction/Problem: The research problem of bullying in the US if fairly well specified, although references to world-wide rates are less compelling. The problem in terms of children and adolescents in the US, in schools and other venues, should be the focus for this manuscript. Unfortunately, this problem not described in the context of school nursing, school-based health, or pediatric nurse practitioner practice until the implications. It would be more effective to introduce early on the setting for addressing the problem and who might carry that out, in order to further establish the importance of the problem. This would add to the importance established by the description of concurrent and long-term consequences of bullying and make it more clear what can be done about it. The Positive Expectation of What the Future Holds Analysis
There is no theoretical framework identified. The various types of bullying are well defined, and include cyber-bullying. Rates of cyber-bullying should be found. The characteristics of bullies are nicely reported as is the nature of the interpersonal dynamics that attend bullying. The central concepts are adequately defined and discussed in relation to the problem, as separate sections in the introduction. Evidence for future expectations and attitudes towards violence in relation to bullying are supported with limited evidence (2 sources each) that these personal characteristics contribute to bullying but the argument is plausible. The introduction would benefit from a review of more literature to speak to interventions that have been developed for bullying and what they target, as well as how effective they have been found. In this way, critique of the literature could be integrated as well. Then to introduce what little is known about future expectations and attitude toward violence serves an argument for the study but suggests how these two characteristics may have a role. In other words, given how little is known, there needs to be a more clear argument for researching this gap to find out how the characteristics relate and perhaps point to an arena for intervention. The purpose and hypotheses flow logically from the introduction. The Positive Expectation of What the Future Holds Analysis

Design/Method: The setting for the study is a middle school setting. Again, the manuscript would be stronger if the problem and introduction addressed the school setting and middle school-aged adolescents as the population of interest, as specific developmental dynamics characterize this age group and an understanding of the phenomenon. The sample and the population from which it was drawn needs description; it is not possible to know how representative this sample is of the middle school. I was struck by there being more female participants than male, although the evidence suggests boys bully more, especially physically. Did more boys refuse to participate? How representative are the proportions of African American and Caucasian middle school students? Were repeated opportunities provided for participation? It would have been better to address this imbalance during the recruitment and data collection phase, perhaps including more schools. Also, the n’s of the various sample characteristics need to be provided either in the text or in the table; it is fine to report proportions for race and socioeconomic status but the n’s need to be reported as well in at least one place in the manuscript. Again, how representative this sample was of the school is not evident and generalization is limited. The Positive Expectation of What the Future Holds Analysis

The procedures are fairly precisely detailed, although it would help to know the range of time it took to complete the survey as well as the average (with SD). The measures and their items and response formats are adequately described. Sources for items are also provided. The internal consistency estimates are reported and adequate, although the attitude toward violence is a little lower. Some estimate of test-retest reliability would have been advisable. The descriptive statistics for the measures were included in the table with the sample characteristics; these should be separated or included in the text describing the measures. The demographic variables are described but may be better described with the sample? How they are coded really does not need to be described here. Maternal education is reported as a variable although not addressed to make it relevant to the topic; in fact, socioeconomic context was not addressed in the introduction.

The description of the approaches to data analysis should be integrated with the results. In other words, integrate what analysis was used before the specific results are reported.

Results: The sample needs to be described in the method, with the table referenced and data included as appropriate in that text specific to the sample OR do not report descriptive data in the method and include it here; a choice needs to be made. Again, n’s are not included in the text or the table; they should be in one or the other. Given there were no gender differences (or at least no association between variables and gender), why not collapse the genders and expand the sample?
The lack of correlation between demographic characteristics and the study variables nicely supports that these personal characteristics are otherwise developed. The multivariate analysis was fairly clearly described.

Discussion: The discussion proceeds nicely although a lot of new literature is introduced. The introduction needs to be expanded by including the literature that is reported in the discussion; doing so may solve the problems of the literature review in the introduction and strengthen the problem. There are suggestions for future research and the methodological limitations are noted (although not the gender imbalance). In the discussion, risk and promotive factors are introduced; this suggests a theoretical framework that is not uncommon in school-based or public health research and could be presented as an organizing framework up front.
Implications: The implications may be better integrated with the discussion of findings so the recommendations or implications for practice are more closely aligned with the findings and related literature. As written separately here, they seem a bit global and not tightly linked—so more speculative.

Summary/Conclusions: This section is missing.

Reviewer #2: This manuscript presents a mediation analysis of attitudes towards violence on the relationship between future expectations and bullying behavior during early adolescence. The manuscript is nicely written, but the topic does not fit the aim and scope of this journal—”to circulate scientific papers in nursing to improve care, alleviate suffering, and advance well-being.” I would like to suggest the authors submit it to an educational, psychological, or behavioral journal. Meanwhile, I would also like to provide a few methodological comments and suggestions for improving the manuscript as follows, by page numbers:

1) Page 4, Lines 20-21: Physical bullying and relational bullying were analyzed separately. Such approach lacks justification. The separate (or univariate) analyses increase the type I error because physical bullying and relational bullying were highly correlated with r = .71 (p < .05), the highest among all the correlations between the study variables (see Table 2). I would recommend using a multivariate approach analyzing all variables simultaneously in one structural equation model.

2) Page 4, Line 6: It is not clear whether a mean or total score was calculated as “a composite score.”

3) Page 4, Line 7: it is not clear whether alpha = .77 is the reliability for your study sample or Wyman et al.’s (1993). Also, you need to report reliability for both your sample and ones published in the literature for all of your key variables.

4) Page 7, Line 19: Here you mentioned that Cohen, Cohen, West, and Aiken’s (2003) method was used to deal with missing data for the variable of mother’s education. But, the whole Cohen, Cohen, West, and Aiken’s (2003) book is about regression/correlation analysis; and it is not clear what method was used and how the missing data were treated. Also, a description of whether or not all other variables had missing data and how the missing data were dealt with is needed. Furthermore, Cohen, Cohen, West, and Aiken’s (2003) is not in the reference list. Please double check the reference citations in the text and make sure all reference citations are listed in the reference list. The Positive Expectation of What the Future Holds Analysis

5) Page 10, Line 7: The section heading is misleading because the analyses reported in this section are not multivariate, but univariate. See the first comment above.

Reviewer #3: Overall this is a well-written paper that appears to offer new information to our understanding of bullying, especially as the bulk of the research has focused on the recipients and there has been little research done on perpetuators. There are, however, some major limitations in the study’s design and execution.

A major concern that this reviewer has is the failure to include cyberbullying in their study, especially as it now viewed as (arguably) the most common bullying leading to the most pernicious outcomes. The reason for this exclusion needs to be addressed.
A second concern is the failure to discuss the role socio-economic status plays in future expectations, although there is a significant body of literature that has investigated these relationships. This is important from a theoretical perspective but also considering the sample and demographic variables described.

A third concern is there is conceptual confusion (or at least word selection) with selected terms used throughout the manuscript. Direct bullying goes beyond physical altercations. The terms physical bullying and direct bullying are used interchangeably throughout the paper. Tables 1 & 2 uses the terms relational and physical ‘aggression’ where the text uses bullying. There is of concern as aggression does not encompass all the same components (i.e., power differential) as does bullying. Table 3 and Figure 1 use the terms physical and relational bullying. There needs to be consistency throughout.
Specific comments by section are listed below.

Introduction
* Page 1, line 22—page 2, line 2: Would be specific about the audience when discussing the short- and long-term impacts of bullying. Many of the factors listed affect both the recipient and instigator.
* Page 2, lines 2-12: Should also address age/developmental level as there is interplay between age and gender with types of bullying and their instigators and recipients and age appears in your demographics. Ethnicity was not referenced…was there a reason?

Methods
* More description on the development, preliminary psychometrics, and utility of the total survey is needed as this information is foundational to the rest of the study. The researcher needs to be explicit that there were 5 separate measures included in a single survey and why there is no single measure specific to bullying. It should be specified that the alphas reported for each measures are Cronbach’s alphas. It appears from the references that some of these questions used in selected measures were taken from previous work that is fairly old. As there has been significant work done on bullying measurement over the past decade, further explication is needed.
* A reference as to why mother’s educational attainment alone was considered a good proxy measure of SES is needed; usually a minimum of two factors (ed and employment) is used.

Results
* It is unclear why bullying isn’t initially handled as a single variable as the overall concept being investigated is bullying perpetration (see overall study purpose). This goes back to the intro where the concepts are introduced and where physical and relational are considered bullying subtypes.. The relationships with the overall concept should be explored prior to investigating relationships with among the sub-constructs.
* Under the Multivariate Model heading: Were all of the demographic variables not significant? How was that determined? This information is not in evidence. I question the validity of including gender if this was non-significant in the univariate model (assuming this was first done).

Discussion
* The discussion leads off by describing the community as ‘economically distressed’. There was no information provided earlier that that was the case. In fact, the authors state that the sample was highly diverse.
* The discussion focuses on bullying as a single construct yet this does not match the analysis.
* The authors introduce social skill training in this section although this is not discussed earlier. There is literature to support the lack of social skills is an important component of bullying, particularly in bully-victims, but this discussion is outside of the information presented.
* Another limitation that should be added is that of ‘self-report’. While this is always an issue, it is more so with bullies where self-aggrandizement is common.

References
* The following references were not noted in the reference list:
o Bentler, 1990
o Brown & Cudeck, 1993
o Cohen, Cohen, West & Aiken; 2003
o Kline, 2011
Other
* The word ‘youth’ not ‘youth’s is used for the plural form throughout this paper; although this is coming into more common usage.
* There are some relatively minor departures in APA style throughout.

—

ADDITIONAL COMMENTS FROM THE EDITOR
TITLE
Please revise to include all variables in the mediation model, and to identify the approach as a mediation evaluation. Clarify that bullying perpetration (not victimization by bullying) is the outcome of interest. Then in the paper, it would add clarity to always use the term “bullying perpetration” (physical or relational, as appropriate for context).

RELEVANCE TO NURSING SCIENCE
Please address relevance to nursing science in the background and discussion.

MEDIATION HYPOTHESES
The review of literature defines variables in the mediation system (future expectations, attitude towards violence, bullying perpetration) and cites literature finding associations among the variables. The argument for the mediation hypothesis is weak theoretically and empirically (“Yet, few, if any, researchers have examined the potential mediating role of attitude towards violence to solve problems on the link between adolescents’ future expectations and bullying behavior.”) Essentially, this thought needs to be extended to explain why it makes sense to examine the mediation model. This argument is essential because mediation analysis is designed to “extract information about the causal mechanism(s) by which a predictor affects an outcome” (Preacher, 2015, p. 826; and many others). The strong claim made in any mediation hypothesis deserves a strong foundation. This is especially true when a cross-sectional design is used to suggest an essential feature of a fundamentally time-based process. With that in mind, it would be helpful to explain (on the basis of logic, theory, or existing data) at least how the temporal precedence of the variables can be justified (future expectations precedes attitude towards violence precedes bullying perpetration). Another important issue is to consider alternative explanations, or at least acknowledge that they exist and are important lines of investigation in future studies.

MEDIATION ANALYSIS
Overall, the analysis was well done and clear.

It wasn’t obvious why two separate models were estimated (for bullying perpetration–physical and bullying perpetration–relational). Within the SEM framework, it should be relatively easy to set one model with both outcomes, and incorporate the relationship between the outcomes in the model as well.

Can you explain why gender was used as a covariate, rather than setting up the model as a multiple group analysis? Use of equality constraints could then highlight similarities and differences in the mediation model for girls and boys (essentially, allowing a moderated mediation hypothesis to be examined).

Address the statistical assumptions; especially that errors in prediction for M and Ys are uncorrelated (again see Preacher (2015) (who noted that this issue was not mentioned in Baron & Kenny, 1986).

QUESTIONS ABOUT YOUR REVISION
Please contact me using email via Editorial Manager (“send letter to editorial office”).

References
Preacher, K. J. (2015). Advances in mediation analysis: A survey and synthesis of new developments. Annual Review of Psychology, 66, 825-852. doi: 10.1146/annurev-psych-010814-015258

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CHECKLIST FOR STYLE

TITLE PAGE —
–Supply credentials and/or highest earned degree for Varela.
–Supply running head of less than 50 characters (no abbreviations).

TEXT —
–When your revision has been completed, run a final spell check. Also, proof to be sure that spelling errors not picked up by the spell check have been corrected.

REFERENCES —
–When your revision has been completed, verify consistency between references cited in the text and references included on the reference list.

Update REFERENCE LIST using APA 6th Ed. format. In particular:
–The following reference is not cited in the text. Remove from reference list or add to text: Vernberg et al., 1999.

Update IN-TEXT CITATIONS using APA 6th Ed. Format. In particular:
–On first citation of a reference, list all authors if there are less than 6. For subsequent citations, use first author followed by et al. (i.e., Crapanzano 2011).

–Add IN-TEXT citations of the following references to the reference list:
— Cohen, Cohen, West & Aiken, 2003
–Brown & Cudeck, 1993
–Kline, 2011

–Please do not introduce sources/citations in the Discussion (e.g., Borntrager et al., 2009). They should be included in the Background initially.

TABLES —
–Bolding is not necessary, please remove.

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Qualitative Analysis on Patient Satisfaction with Maternity Wards, healthcare article review

January 22, 2022/in Uncategorized /by cone

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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Nursing Soap Note Template for Tina Jones Question

January 22, 2022/in Uncategorized /by cone

Nursing Soap Note Template for Tina Jones Question Nursing Soap Note Template for Tina Jones Question ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Throughout this course, you were encouraged to practice conducting various physical assessments on multiple areas of the body, ranging from the head to the toes. Each of these assessments, however, was conducted independently of one another. For this DCE Assignment, you connect the knowledge and skills you gained from each individual assessment to perform a comprehensive head-to-toe physical examination in your Digital Clinical Experience. Nursing Soap Note Template for Tina Jones Question Photo Credit: Getty Images/Hero

The post Nursing Soap Note Template for Tina Jones Question appeared first on nursing homework essays.

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NURS 440 Patient Safety Culture Pamphlet.

January 22, 2022/in Uncategorized /by cone

NURS 440 Patient Safety Culture Pamphlet.

ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS

Create a pamphlet using any type of publisher software you choose to educate clients on a current patient safety issue.

For example:

How aging adults can care for themselves at home
Medication–polypharmacy and how a patient cannot make a self-medication error,
Or other appropriate safety issues.

If you have a question about a specific topic, check with your instructor. It is recommended that you save your pamphlet as a PDF for submission.

Your pamphlet must include the following items:

At least five tips for preventive care for the patient.
Information that should be shared with family or caregivers.
Local resources in the community that might be available for this type of safety concern.
At least three APA-formatted references published within the last five years.

Need help? Here’s a YouTube video on creating a trifold brochure that you can use as a guide:https://youtu.be/2-wuhi2W-Yc

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7/1/2021 Week 3: Patient Safety Culture Pamphlet NURS 440 Week 3 Rubric – Patient Safety Culture Pamphlet Criteria Critical Analysis view longer description Content view longer description Mechanics view longer description APA Format view longer description Ratings Pts 40 to >35.6 pts Communicates purpose of project with superior understanding of material, shows insight and engages patients or reader. Style is appropriate for intended audience. Presents an exemplary articulation and insightful analysis of significant concepts and/or theories presented for the chosen topic. Ideas are professionally sound and creative; they are supported by scientific evidence that is credible and timely. 35.6 to >30 pts Presents an accurate understanding of the chosen topic, but might be missing a detail or two or miss the intended audience. Ideas are mostly supported by scientific evidence that is credible and timely. 30 to >23.6 pts Provides insufficient explanations of significant concepts for the chosen topic. Ideas are generally unsupported by scientific evidence, but some attempt has been made. 23.6 to >0 pts Does not, or incorrectly, portrays insufficient explanations for the chosen topic. Information is not scientifically sound. 40 to >35.6 pts Offers detailed and specific examples to educate on the chosen topic. Includes a minimum of five tips for preventive care for the patient. Includes information that should be shared with family or caregivers. Includes local resources in the community that might be available. Includes at least three references. 35.6 to >30 pts Offers specific examples to educate on the chosen topic, but might be missing one or two details. Response indicates a more general understanding of the concepts to educate on the chosen topic. Either missing the full five preventative tips, information for family or caregivers, or an important local resource. 30 to >23.6 pts Provides several insufficient or inaccurate examples, although attempts are made to address some key points on the topic chosen. Response indicates an introductory understanding of the concepts to educate on the chosen topic. 23.6 to >0 pts Information is inaccurate or inadequate. Response indicates little or no understanding of the concepts for the chosen topic. 15 to >13.35 pts Information is well organized and clearly communicated. Assignment is free of spelling and grammatical errors. 13.35 to >11.25 pts Answers are well written or orally presented throughout, and the information is reasonably organized and communicated. Assignment is mostly free of spelling and grammatical errors. 11.25 to >8.85 pts Answers are somewhat organized and lacks some clarity. Contains some spelling and grammatical errors. 8.85 to >0 pts Answers are not well written or orally presented and lack clarity. Information is poorly organized. Assignment contains many spelling and grammatical errors. 5 to >4.45 pts Follows all the requirements related to format, length, source citations, and layout. 4.45 to >3.75 pts Follows length requirement and most of the requirements related to format, source citations, and layout. 3.75 to >2.95 pts Follows most of the requirements related to format, length, source citations, and layout. 2.95 to >0 pts Does not follow format, length, source citations, and layout requirements. / 40 pts / 40 pts / 15 pts / 5 pts Submit Assignment https://canvas.westcoastuniversity.edu/courses/5357/assignments/56322?module_item_id=219791 2/3

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AACN Essential in Nurse Leadership Discussion.

January 22, 2022/in Uncategorized /by cone

Slide 1 of 4

Week 9 Assignment: AACN Essentials Summary Paper Submit your final thoughts on the nine AACN Essentials compiled from your Discussion Board posts and discussions with peers and faculty. Incorporate ideas and concepts you learned from your discussions. For each essential include the following: • A brief summary explanation of the essential that is cited with at least one scholarly source • At least one example of how you met the essential during your nursing program Use APA Style. Review the rubric for more information on how your assignment will be graded. Points: 80 Due: Sunday, 11:59 p.m. (Pacific time) PAGES 5 W f w 1,093 JAN 3D 10 2 F12 F11 FIO F9 F8 F7 OOO F6 000 F4 F5 80 F3 F2 + // $ & 7 * 00 0 % 5 < 0 9 # 3 4. 8 O U T Y Upload X learn.westcoastuniversity.edu/webapps/rubric/do/course/gradeRubric?mode=grid&isPopup=true&rubricCount=1&preľX=_395213_1&co… M learn. Meets or Exceeds Expectations Mostly Meets Expectations ESTU VERS Below Expectations Does Not Meet Expectations udent Resources FO Content 12.16 (15.20%) – 14.24 (17.80%) 9.6 (12.00%) – 12 (15.00%) nary Paper 0 (0.00%) – 9.44 (11.80%) Most or all summary descriptions are not provided. Scholarly sources are not used. Nursing Capst 14.4 (18.00%) – 16 (20.00%) The student provides an accurate and concise summary paragraph for each Essential. All summary descriptions expertly identify key aspects of each essential. Every essential is supported with at least one scholarly source. 7 Nursing he 202011FAll Ol A summary paragraph is provided for each Essential. The summary descriptions satisfactorily identify key aspects of each essential, however 1 or 2 descriptions may be vague. One or two essentials may not be supported with at least one scholarly source. AACN Essential in Nurse Leadership Discussion.

A summary paragraph is not provided for each Essential. Several summary descriptions vaguely identify or inaccurately identify key aspects of each essential. Most essentials are not supported with at least one scholarly source. ng Started incements US al Office ussion Board 26.4 (33.00%) – 33 (41.25% Examples & Reflection urse Materials 39.6 (49.50%) – 44 (55.00%) At least one detailed and explicit example of how the student met each essential during the nursing program is provided for all nine Essentials. The student expertly synthesizes and incorporates signments 33.44 (41.80%) – 39.16 (48.95%) At leastiem Bubciample of how the student met each essential during the nursing program is provided for all nine Essentials, but some examples may be vague. The student satisfactorily incorporates some 0 (0.00%) – 25.96 (32.45%) The student provides two or fewer examples of how they met essentials during the nursing program. No reflection is provided. The student does not provide an example of how they met each of the nine essentials during the nursing program. The student incorporates little feedback, concepts, and ideas from the week’s discussion orksheets, Forms, and emplates Submit Doc Sharing Blog w Grades PAGES I w W f 1,093 JAN 10 .@@ D F12 Fll FO File Edit View History ViewC x + Rubric Detail – NURS 497 Nursing Capstone 202011FAII OL-U learn.westcoastuniversity.edu/webapps/rubric/do/course/gradeRubric?mode=grid&isPopup=true&rubricCount=1&prefix=_3952131_1&co… Upload x M learn. Examples & Reflection 39.6 (49.50%) – 44 (55.00%) udent Resources VERS F 0 (0.00%) – 25.96 (32.45%) The student provides two or fewer examples of how they met essentials during the nursing program. No reflection is provided hary Paper Nursing Capst o At least one detailed and explicit example of how the student met each essential during the nursing program is provided for all nine Essentials. The student expertly synthesizes and incorporates significant feedback, concepts, and ideas from the week’s discussion into the assignment. It is evident that the student has thoroughly reflected upon and met the nine essentials. 7 Nursing e 202011FAll Ol 26.4 (33.00%) – 33 (41.25%) The student does not provide an example of how they met each of the nine essentials during the nursing program. The student incorporates little feedback, concepts, and ideas from the week’s discussion into the assignment. It is evident that the student did not fully reflect upon or provide evidence of meeting each essential. 33.44 (41.80%) – 39.16 (48.95%) At least one example of how the student met each essential during the nursing program is provided for all nine Essentials, but some examples may be vague. AACN Essential in Nurse Leadership Discussion.

The student satisfactorily incorporates some feedback, concepts, and ideas from the week’s discussion into the assignment. It is evident that the student has satisfactorily reflected upon and met the nine essentials. 3 Started ncements IS Office ssion Board 6.08 (7.60%) – 7.12 (8.90%) rse Materials Organization 4.8 (6.00%) – 6 (7.50%) The writing lacks clarity, conciseness, and organization in many places. 7.2 (9.00%) – 8 (10.00%) The assignment is organized in a clear, concise, and well- organized manner. gnments 0 (0.00%) – 4.72 (5.90%) The writing is unfocused and contains serious errors with organization. Most of the writing is concise and organized, but there may be one or two minor instances where it is not. ksheets, Forms, and nplates c Sharing Blog Submit 0 (0.00%) – 7.08 (8.85%) 7.2 (9.00%) – 9 (11.25%) rades 9.12 (11.40%) – 10.68 (13.35%) Mechanical errors 10.8 (13.50%) – 12 (15.00%) The student doac not Mechanics and APA Format ly Grades PAGES W f ali m -A w 1,093 JAN 210 30 O 10 Indow me File Edit View CX Bb Upload X LIITUU VIJU VITICU LIS learn. View History Bookmarks People Тар петр Rubric Detail – NURS 497 Nursing Capstone 202011FAII OL-U learn.westcoastuniversity.edu/webapps/rubric/do/course/gradeRubric?mode=grid&isPopup=true&rubricCount=1&prefix=_3952131_1&co… UCU LUC MOJISWCHL. Lupun VI assignment. It is It is evident that the provide evidence of evident that the student has meeting each student has satisfactorily reflected essential. thoroughly reflected upon and met the upon and met the nine essentials. nine essentials. udent Resouro VERS Fd nary Paper Nursing Capst 4.8 (6.00%) – 6 (7.50%) 0 (0.00%) – 4.72 (5.90%) 7.2 (9.00%) – 8 (10.00%) Organization 7 Nursing ne 202011FAll Ol The assignment is organized in a clear, concise, and well- organized manner. 6.08 (7.60%) – 7.12 (8.90%) Most of the writing is concise and organized, but there may be one or two minor instances where it is not. The writing lacks clarity, conciseness, and organization in many places. The writing is unfocused and contains serious errors with organization. g Started ncements 9.12 (11.40%) – 10.68 (13.35%) Mechanics and APA Format IS Office ssion Board 10.8 (13.50%) – 12 (15.00%) The student uses APA Style accurately and consistently. The assignment meets all formatting requirements (length and style) Punctuation, spelling, and capitalization are all correct. There are minimal to no errors. 7.2 (9.00%) – 9 (11.25%) The student does not use APA Style consistently and there are 3-4 errors. The assignment meets half of the formatting requirements (length and style). Errors in punctuation, spelling, and capitalization detract from the readability of the assignment. The student uses APA Style, but there are 1- 2 errors. The assignment meets most formatting requirements (length and style). Punctuation, spelling, and capitalization are generally correct with a few minor errors. 0 (0.00%) – 7.08 (8.85%) Mechanical errors significantly interfere with the readability of the paper. No attempt to follow the required format is indicated. There are many distracting errors in punctuation, spelling, and capitalization se Materials nments

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Pastas R Us Inc Database Supplementary Questions Statistical Analysis

January 22, 2022/in Uncategorized /by cone

Pastas R Us Inc Database Supplementary Questions Statistical Analysis Pastas R Us Inc Database Supplementary Questions Statistical Analysis ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS In preparation for writing your report to senior management next week, conduct the following descriptive statistics analyses with Excel®. Answer the questions below in your Excel sheet or in a separate Word document: Insert a new column in the database that corresponds to “Annual Sales.” Annual Sales is the result of multiplying a restaurant’s “SqFt.” by “Sales/SqFt.” Calculate the mean, standard deviation, skew, 5-number summary, and interquartile range (IQR) for each of the variables.

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NURS 6051 Health Insurance Portability and Accountability

Learning Objectives

Students will:

Name: NURS_5051_Module05_Week09_Discussion_Rubric

Name: NURS_5051_Module05_Week09_Discussion_Rubric

Required Readings

Required Media

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Discussion Questions (DQ)

Weekly Participation

APA Format and Writing Quality

Use of Direct Quotes

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Communication

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NURS 440 Patient Safety Culture Pamphlet.

NURS 440 Patient Safety Culture Pamphlet.

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AACN Essential in Nurse Leadership Discussion.

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Pastas R Us Inc Database Supplementary Questions Statistical Analysis

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