he Assignment (2-3 pages):

Personal Leadership Philosophies

Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:

A description of your core values

A personal mission/vision statement

An analysis of your CliftonStrengths Assessment summarizing the results of your profile

A description of two key behaviors that you wish to strengthen

A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.

 

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How will you approach your studies? What types of resources are available to you, and how will you access and utilize them? Taking the opportunity to prepare these strategies, tools, and materials will help ensure you can “break ground” without incident and successfully move to the phase where you begin building your vision.

To Prepare:

• Consider your goals for academic accomplishments while a student of the MSN program.
• Reflect on the strategies presented in the Resources for this module.

The Assignment:

In this Assignment, you will continue developing your Academic Success and Professional Development Plan by appending the original document you began in the previous Assignment to develop the second component—academic resources and strategies. To accomplish this:

• Identify and describe at least three academic resources or strategies that can be applied to the MSN program
• Identify and describe at least three professional resources that can be applied to success in the nursing practice in general or your specialty in particular
• Explain how you intend to use these resources, and how they might benefit you academically and professionally.

 Academic and Professional Success Plan Template 

Week 2 | Part 2: Academic Resources and Strategies

I have identified the following academic resources and/or strategies that can be applied to success in the nursing practice in general or my specialty in particular.

Directions: In the space below Identify and describe at least three academic resources or strategies that can be applied to the MSN program, and at least three professional resources that can be applied to success in the nursing practice in general or your specialty in particular. For each, explain how you intend to use these resources, and how they might benefit you academically and professionally.

Academic Resource/Strategy 1

Academic Resource/Strategy 2

Academic Resource/Strategy 3

Professional Resource/Strategy 1

Professional Resource/Strategy 2

Professional Resource/Strategy 3

ADDITIONAL RESOURCES/STRATEGIES

| Part 3: Strategies to Promote Academic Integrity and Professional Ethics

I have analyzed the relationship between academic integrity and writing, as well as the relationship between professional practices and scholarly ethics. I have also identified strategies I intend to pursue to maintain integrity and ethics of my academic work while a student of the MSN program, as well as my professional work as a nurse throughout my career. The results of these efforts are shared below.

Directions: In the space below craft your analysis/writing sample, including Part 1 (The Connection Between Academic and Professional Integrity) and Part 2 (Strategies for Maintaining Integrity of Work).

Part 1: Writing Sample: The Connection Between Academic and Professional Integrity

In the space below write a 2- 3-paragraph analysis that includes the following:

· Explanation for the relationship between academic integrity and writing

· Explanation for the relationship between professional practices and scholarly ethics 

· Cite at least 2 resources that support your arguments, being sure to use proper APA formatting. 

· Use Grammarly and SafeAssign to improve the product.

· Explain how Grammarly, Safe Assign, and paraphrasing contributes to academic integrity

PART 2: Strategies for Maintaining Integrity of Work

Expand on your thoughts from Part 1 by: 

· Identifying and describing strategies you intend to pursue to maintain integrity and ethics of your 1) academic work while a student of the MSN program, and 2) professional work as a nurse throughout your career. Include a review of resources and approaches you propose to use as a student and a professional. 

 

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NewSchool of Architecture + DesignSpring 2017 – Course Syllabus

CM 354 Construction Law Name:

Extra Credit Assignment #1 (Worth an extra homework assignment)

Due 6/4 FIRST OF CLASS

NOTE: It will NOT be accepted after this date

A school hires a contractor to do some remodeling work at the school. Because of the risk of injury to students the school decides to have the contractor perform the work during the summer when the school is shut down. The contract requires:

1. The contractor to remodel the first floor including relocating the restrooms and relocating the underground sewer.

2. The contractor to carry $5 million in insurance

3. The schedule for the project is for 90 calendar days.

4. The cost to perform the work as set at $350,000.

The architect was hired to prepare the plans and to provide project oversight on behalf of the school district including responsibility to visit the site periodically to inspect the work.

The contractor, during the first 10 days had excavated the trenching for the sewer line. The architect had just visited the site to inspect the work and found the work being performed as the contract requires including the proper safety protection. However it also became clear that the contractor was falling behind on his schedule. In an effort to accelerate the schedule the contractor began working Saturdays to catch up.

It was the contractor’s superintendent’s usual practice that he install a barricade around the excavated sewer trench as the bottom of the trench was 6-feet below the surface. Because they had started working six days a week to catch up, this particular Saturday the superintendent did not reinstall the barricade at the end of their shift at 3:30 so they can get a quick start on Monday. He did lock the door before he left.

However that Saturday, at 5:00 the principal of the school wanted to show one of the teachers the work that was being done. He unlocked the door and entered the large room. The space was dark as the permanent power had been shut off for safety of the contractor who was using temporary power for his own lighting and power. The principal, in an effort to find the temporary switch, stepped into the trench and broke several bones. To recover his medical payments he sued the contractor and architect for keeping an unsafe condition.

Discuss this case. Describe the responsibility of each party; contractor, architect and principal. What / whose insurances will play a role? Do you think the principal will collect?

Worth the potential of 20 points based on:

1. Thoroughness of answer

2. Completeness of answer

3. Reasonable conclusion based on legal principles

NOTE: A weak answer will score no points.

1

2

 

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Evidence-Based Project Implementation Issues

Before, during, and after implementation of your DNP Project, or any evidence-based project, it is critical to pay attention to various social, political, technological, and/or financial considerations. Using this framework, you can identify, analyze, and address issues that may affect the implementation of the project.

For this Discussion, you evaluate considerations that may promote or impede successful implementation of your DNP Project or another evidence-based project. As you do so, bear in mind that the specific factors are likely to differ from project to project and may vary given the timing and context in which a project is implemented. During this Discussion, you also evaluate variances between activities, standards and guidelines, and what is considered “best practice” in relation to the project.

To prepare:

• Consider      the issues you have noticed while implementing the intervention and/or      gathering data for your DNP Project or another evidence-based project.      Bring to mind Dr. Mauk’s comments on social, political, technological,      and/or financial considerations in the Weeks 2 and 3 media program.      Reflect on how these considerations have, or may, affect your      implementation.
• Think      about any unexpected developments that arose (or may arise) during the      implementation phase of your evidence-based project. What was the root      cause of each development and its effect on your project?
• Return      to the literature and note any variances between your activities, relevant      standards and guidelines, and what is considered “best practice.”
• Evaluate      your original plan for developing and implementing your DNP project      (regardless of where you are in the process right now) or another      evidence-based project. What, if anything, would you change in order to      improve the process, quality of data, etc.?

By tomorrow Tuesday June 4, 2019 write a minimum of 550 words essay in APA format with at least three scholarly references. Include the level one header as numbered below:

Post a cohesive response that addresses the following:

1) Describe one or more significant issues related to the implementation of and data gathering for an evidence-based project. 

2) Assess the cause and meaning of each issue for your evidence-based project. If applicable, describe how the issue may have compromised your project.

3) What insights related to variances between project activities, relevant standards and guidelines, and what is considered “best practice” are most significant for this evidence-based project?

4) Summarize your evaluation of the planning for and implementation of the intervention, noting opportunities for improvement with future projects.

Required Readings

Oermann, M. H., & Hays, J. C. (2016). Writing for publication in nursing (3rd ed.). New York, NY: Springer Publishing Company.

· Chapter 6, “Review and Evidence-Based Practice Articles” 

Chapter 6 explains types of reviews and EBP articles that are useful to nurses when exploring the literature on clinical issues. This chapter also provides recommendations for preparing articles for disseminating EBP research findings.

In addition to Chapter 6, select and read the chapter that best supports your scholarly product dissemination plan. Apply the information in these chapters and through additional research of your own as you begin the writing process for your DNP Project scholarly product for dissemination. 

Note: For the scholarly product, you should be able to select a journal or other format and write a letter of inquiry. You also should be able to work on the Literature Review section of your scholarly product. The information on pages 142-143 in the course text may be particularly useful for developing that section.

· Chapter 5, “Writing Research Articles”

This chapter provides general principles for writing research papers.

· Chapter 8, “Clinical Practice Articles” 

Chapter 8 revolves around strategies for writing articles about clinical practice.

· Chapter 9, “Other Types of Writing” 

In this chapter, the authors review strategies for writing a variety of articles, letters, reviews, and case studies.

· Chapter 10, “Books and Book Chapters” 

This chapter provides considerations and guidelines for writing books and book chapters.

· Chapter 11, “Writing Process” 

Chapter 11 describes the various steps of the writing process, including asking preliminary questions, the drafting phase, and revising a manuscript.

Brown, C. E., Ecoff, L., Kim, S. C., Wickline, M. A., Rose, B., Klimpel, K., & Glaser, D. (2010). Multi-institutional study of barriers to research utilisation and evidence-based practice among hospital nurses. Journal of Clinical Nursing, 19(13–14), 1944–1951. 

This article details a study that explored the relationship between perceived barriers to research use and the implementation of evidence-based practice among hospital nurses.

Chang, H. C, Russell, C., & Jones, M. K. (2010). Implementing evidence-based practice in Taiwanese nursing homes: Attitudes and perceived barriers and facilitators. Journal of Gerontological Nursing, 36(1), 41–48. 

The authors of this article describe a study that investigated attitudes and perceived barriers and facilitators toward research utilization among registered nurses.

Doran, D., Haynes, R., Kushniruk, A., Straus, S., Grimshaw, J., Hall, L., … Jedras, D. (2010). Supporting evidence-based practice for nurses through information technologies. Worldviews on Evidence-Based Nursing, 7(1), 4–15. 

This article describes a study that sought to evaluate the usability of mobile information terminals to improve access to nursing information resources. The study also explored the relationship between PDA or tablet-supported information resources and outcomes.

Required Media

Laureate Education, Inc. (Executive Producer). (2012d). Factors affecting implementation of an evidence-based practice project. Baltimore, MD: Author.

Note: The approximate length of this media piece is 5 minutes.

Dr. Kris Mauk explores barriers to implementing change and discusses strategies for addressing those barriers.

 

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Pathophysiology of Osteoarthritis

            Osteoarthritis (OA) is a common age-related disorder of synovial joints. One may know OA by “degenerative joint disease” or “joint wear and tear.” OA is characterized by loss of articular cartilage, inflammation, formation of osteophytes, synovitis, and subchondral bone changes (Huether & McCance, 2017). OA commonly affects hands, wrists, knees, feet, hips, shoulders, and spine. OA prevalence increases with age and women generally have worse symptoms. Obesity and trauma are risk factors (Huether & McCance, 2017). Researchers believe that gene expression in chondrocytes affect the incidence of OA (Huether & McCance, 2017). The regulatory action of the proteoglycan pump of cartilage cells is disrupted, and they take in too much water. Increased water content lessens cartilage’s ability to tolerate weightbearing (Huether & McCance, 2017). The breakdown of articular cartilage causes cracks and fissures, leading to osteophytes, inflammation, synovitis, and joint effusion (Huether & McCance, 2017). Pain with weightbearing is the most common symptom. Symptoms can also include stiffness, swelling, limited range of motion, and deformity (Huether & McCance, 2017).

Pathophysiology of Rheumatoid Arthritis

            Another condition that involves synovial joints is rheumatoid arthritis (RA). RA is chronic, systemic, and inflammatory. It leads to disability and premature death (Huether & McCance, 2017). In RA, synovial fibroblasts develop an exaggerated immune response and proliferate abnormally, as well as produce cytokines, enzymes, and prostaglandins (Huether & McCance, 2017). The thickened synovium is called “pannus” and invades the surrounding bone, ligaments, and tendons, causing pain and deformity (Huether & McCance, 2017). RA most commonly affects the fingers, feet, wrists, elbows, ankles, and knees. The lungs, heart, kidneys, and skin can also be involved (Huether & McCance, 2017).

Similarities and Differences

            Both OA and RA result in joint pain and deformity. However, their pathophysiology and disease progressions are markedly different. OA can be present in just one joint. RA is a systemic inflammatory disease that affects multiple joints and possibly organs. OA has a slow onset as the cartilage wears away, occurring over years. In contrast, because RA is inflammatory, it can cause pain within a few weeks or months (Harvard Medical School, n.d.). Pain with OA is generally caused by the inflammation caused by the structural cellular changes, whereas RA pain is caused by both destructive changes and the presence of inflammation from the immune response. There are differences in treatment, but both OA and RA can be treated by intra-articular steroid injections, physical and occupational therapy, and joint replacement.

Impact of Age and Behavior

            The incidence of both RA and OA increase with age. Treatment for severe OA and RA may be limited depending on the age of the patient. Patients are having total joint replacements at younger and younger ages. The younger the person is, the more likely they will need a revision down the road due to implant loosening and infection because of the sheer length of time they will live with their total joint (Rath, n.d.). Although there is no specific guideline on the appropriate age of a patient, orthopedic surgeons are generally hesitant to give younger patients a total joint.  It is recommended they live with the arthritis for as long as they can. In addition, age can be a limiting factor for surgery for the elderly. To prepare for Medicare bundled payments for total joint arthroplasty, facilities should practice risk stratification (Courtney et al., 2018). Therefore, access to arthroplasty may be more and more limited for the older, sicker population.

            Smoking and diet are modifiable risk factors identified for RA (Huether & McCance, 2017). Obesity and activities that put a great amount of stress on joints (such as long distance running, and high impact sports) are behavioral factors that influence OA. These modifiable risk factors do not influence the diagnosis of OA and RA but may impact the treatment options and recommendations. For example, it may be recommended that someone with OA lose weight or stop long distance running before trying any invasive procedures to see if it resolves symptoms. Because of the increased risk of post-surgical complication, some surgeons refuse to do any surgeries if a patient smokes or has a BMI over 40 (J. Nessler, personal communication, May 2, 2019).

References

Courtney, P. M., Bohl, D. D., Lau, E. C., Ong, K. L., Jacobs, J. J., & Della Valle, C. J. (2018).

Risk adjustment is necessary in medicare bundled payment models for total hip and knee arthroplasty. The Journal Of Arthroplasty, 33(8), 2368–2375. doi: https://doi-org.ezp.waldenulibrary.org/10.1016/j.arth.2018.02.095

Harvard Medical School. (n.d.). Explain the pain – is it osteoarthritis or rheumatoid arthritis?

Retrieved on June 1, 2019 from https://www.health.harvard.edu/pain/explain-the-pain–is-it-osteoarthritis-or-rheumatoid-arthritis

Huether, S.E., & McCance, K.L. (2017). Understanding pathophysiology (6th ed.). St. Louis,

            MO: Mosby. 

Rath, L. (n.d.). Knee replacement and revision surgeries on the rise. Retrieved on June 2, 2019 from https://www.arthritis.org/living-with-arthritis/treatments/join surgery/types/knee/knee-replacement-younger-patients.phpNessler, J. (2019, May 2). Personal interview.

 

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