Art Media Types

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Instructions: On the following slides there are six different images representing different types of art media used to create artwork – painting, drawing, sculpture, photography, mixed media, and printmaking. Using these images, create a PowerPoint presentation (one image on each slide) identifying the type of media used. In the notes section (below slide), write a script for a presentation where you identify the genre and analyze how the different types of media materials affect the style and technique

Art Media Types

Grading Rubric:

Your project will be graded using the rubric below:

F

F

C

B

A

0

1

2

3

4

Did Not Submit

No Pass

Competence

Proficiency

Mastery

Did not identify the genre or analyze how the different types of media materials affect the style and technique for all six images

Identified the genre and provided basic analysis of how different types of media materials affect the style and technique for each of the six images

Identified the genre and provided thorough analysis of how different types of media materials affect the style and technique for each of the six images

Identified the genre and provided advanced and in-depth analysis of how different types of media materials affect the style and technique for each of the six images

Did not write a presentation script in the notes section for all six images

Presentation script is written in a style that is generally appropriate for the intended audience and an attempt is made to use a consistent style

Presentation script is written in a style that is appealing and appropriate for the intended audience and an attempt is made to use a consistent style

Presentation script is written in a style that is exceptional and appropriate for the intended audience and an attempt is made to use a consistent st

 
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According to SARH (2019), “San Antonio Regional Hospital is an outstanding critical guidance hospital that offers medical care for patients throughout the Inland Empire district. The hospital offers medical, surgical, and obstetrical services; services that include vascular, neurosurgery, urgent care, and open heart. This hospital helps over two hundred thousand individuals every year, this is the busiest paramedic receiving center in San Bernardino District. San Antonio Regional hospital has a reputation and history for having quality care with a personal touch. San Antonio offers suitable medical services through an additional three medical plazas expanding care even more throughout these areas.

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Abstract

According to SARH (2019), “San Antonio Regional Hospital is an outstanding critical guidance hospital that offers medical care for patients throughout the Inland Empire district. The hospital offers medical, surgical, and obstetrical services; services that include vascular, neurosurgery, urgent care, and open heart. This hospital helps over two hundred thousand individuals every year, this is the busiest paramedic receiving center in San Bernardino District. San Antonio Regional hospital has a reputation and history for having quality care with a personal touch. San Antonio offers suitable medical services through an additional three medical plazas expanding care even more throughout these areas.

I focused my Gemba Walk on our Registration Department and Emergency Department, focusing on John Doe patients’ medical records merging together. We had a patient that came in unresponsive, no identification, no family members found on the street that had to be transferred by life flight. Luckily this does not happen often at our facility that we are unable to identify a patient before we discharge or transfer them out. We needed to find a way to keep unidentified patient record separated from each other. This also brought up question if more than one John Doe patient came in on one specific day, we couldn’t just use the date as an identifier, which is what we have done in the past. Once these problems were identified and discussed the meeting was called for all the departments involved in admission and care dealing with the identified patient and coming up with a new system.

The collaboration of the team of the emergency room, medical records, and patient access came up with a new system consisted of coming up with alias name and using the date of service as the birth date. We decided that keeping Doe as the last name and adding alphabet letter to the first name Jane or John. example: Doe, AJohn/Doe, AJane – date of birth 02/01/2019, and once the alphabet has been completed adding a second letter. Example: Doe, AAJohn/Doe, AAJane and so forth. This will allow the names to stay together in our system and allow the registrars to see the last one used, eliminating a paper trail to refer to. We thought about using numbers with the name but with our system it does not allow us to add numbers within the name. When the patient is transferred a patient face sheet with demographics will go with the patient and the receiving hospital has our information to call/fax us any updated information on the patient the find and allow us to then go back in to that patient’s chart and update to the correct name and date of birth.

We are now in the process of writing up the new policy for not only our hospital but also our sister hospitals. The transition to the new process should have little resistance and will be simple to use resulting in less confusion for all involved, patient, admission, medical records and Emergency Staff. This is a simple but effective method for a rapid assignment of a unique alias for unknown patients.

References

SARH. 2019. About San Antonio Regional Hospital. Retrieved from. https://www.sarh.org/about_us/

 
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, you will propose a quality improvement initiative for your hospital that could easily be implemented if approved.

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In this assignment, you will propose a quality improvement initiative for your hospital that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:

  1. The purpose of the quality improvement initiative.
  2. The target population or audience.
  3. The benefits of the quality improvement initiative.
  4. The interprofessional collaboration that would be required to implement the quality improvement initiative.
  5. The cost or budget justification.
  6. The basis upon which the quality improvement initiative will be evaluated.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 
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Labor Management

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Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.

How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?

 
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1-According to ahrq.gov website resource, the communication techniques play the most crucial part in disseminating message across the communication channels, and that active strategies are the most effective.

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1-According to ahrq.gov website resource, the communication techniques play the most crucial part in disseminating message across the communication channels, and that active strategies are the most effective. Active strategies include posting information on the developer’s website, publishing in scientific publications, and searchable databases.

In my case, the results of my research will be available for all interested in our unit’s wall. My mentor is already interested in using it for her work to prepare educational materials for future in-service. I could also use the hospital website, or email, or could develop a presentation for the management.

To reach people externally, email would be the best method to reach educators in the community. Talking to pediatricians visiting the children with NAS, for example as well. I think the networking style is the best to reach the people interested in change and improvement.

Background and objectives for the systematic review. (2012) Retrieved from

https://effectivehealthcare.ahrq.gov/topics/medical-evidence-communication/research-protocol

2-The updated SBAR/ audit form that has been constructed has had good feedback thus far from rural hospitals as well as within my own organizations trauma program manger, director, risk management, forms committee, etc. There are many steps that have to be taken to implement such a tool especially since we will be handing it out to the community/ rural hospitals to utilize as well. If they follow our SBAR/audit tool and there is a poor outcome that could fall back on the organization so we must get approval by our trauma surgeons internally first. Externally it would be valuable to share with the Trauma Nursing Society and the American College of Surgeons which is who verifies our trauma center to review as well as they may have already implemented and seen such a form developed. I have already gotten some push back within my own organization but important to persevere and keep the ultimate goal on grounding EBP and utilizing it appropriately to improve communication and patient outcomes. Attached is a rough draft that is currently being edited by the trauma team and external resources. I am working closely with the trauma clinical nurse leader to make appropriate changes and ensure EBP guidelines for each of the rows.

Attached FilesUpdated SBAR.docx

 

3-I agree that communication is vital in the implementation process. Email is effective for the first initial contact; however I find implementation efforts to be more productive when face to face or skype meetings are initiated to have open discussions. Building trust and a foundational relationship is important. Electronic communications can save time, so can face-to-face meetings, particularly when trust needs to be established. It is difficult to communicate genuineness and a sense of being heard with digital communications, especially those that don’t occur visually and in real time. “But even video conferences limit the remarkable capacity we humans have to sense and feel and discern the other when we are fully present to each other,” says  Kevin Armstrong, Chief of Staff and Executive Vice President of Mission and Values at Indiana University Health.    

Health Management. (2018). Face to Face Communications. Retrieved from: https://healthmanagement.org/c/hospital/news/does-face-to-face-communication-always-work-best

 
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Identify & evaluate resources

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Identify & evaluate resources

Being able to identify resources is an important part of the research process. When you locate an article or a webpage that you would like to use in your research how do you know if it is peer reviewed? How do you know that it is trustworthy and accurate?

The information on this page will help you recognize parts of an article, learn to verify if an article is peer reviewed, and provide you strategies for evaluating resources.

Citations

A citation is similar to an address in that it provides all of the information a person would need to locate the document. Searching in the databases will provide you a list of results. Each result will contain all of the information that you need to create an APA formatted citation. Results may appear different in different databases, but they will always have all of the information you need to create your APA formatted citations.

When you select an article to view in the databases you will often see a link labeled Cite. When available, this link will provide you with a completed APA citation of the article you are viewing.

Even though this is a handy feature, be sure to double-check all of the citations for accuracy.  Sometimes the citations are not correct APA style as in the following example.

Note: For more information on retrieving full text visit the Searching & Retrieving section of this guide.

Abstracts

An abstract is a detailed summary of the item you are viewing. Abstracts for research articles will include information about the study, and may mention the methodology used, the population studied, or the most important results of the study. Often, abstracts are included with search results to help researchers identify relevant articles without having to read the full text.

Note: Nearly all articles in the databases will contain abstracts. Within the databases the presence of an abstract does not necessarily indicate peer-reviewed status.

The following is an example of an abstract in one of the Walden Library databases.

The way that you access an abstract may be slightly different depending on the database. 

In some databases you can click the article title or hover your mouse over the image of a paper and magnifying glass.

In other databases you may see a link that says Abstract.

Peer-reviewed articles will contain an abstract within the article itself. When you view the PDF of the article you will often see a description of the article before the article introduction. It will often be labeled with Abstract but not always. In the articles below you can see an example of each.

· Wright, C., Madrid, G. (2007). Contesting Ethical Trade in Colombia’s Cut-Flower Industry: A Case of Cultural and Economic Injustice. Cultural Sociology, 1. 255-275, doi:10.1177/1749975507078190

· Gould, D., Gammon, J., Ben Salem, R., Chudleigh, J., and Fontenla, M. (2004). Flowers in the clinical setting: Infection risk or workload issue? Nursing Times Research, 9 366-377. doi:10.1177/136140960400900507

Peer review

Peer review refers to the process of peers reviewing content. In the case of peer-reviewed journals, this means that when articles are submitted they are sent to professionals in the field (peers of the author) to review the article for things such as validity, significant contributions to the field, and originality. The peer review process can be very time consuming, sometimes taking a year from the time an article is submitted to when it is published.

While each article in a journal will be peer reviewed, it is the journal that is considered peer reviewed as it is the journal that makes the choice to use the peer review process or not. When you need to verify whether an article is peer reviewed, you will actually need to look for information that will tell you if the journal is peer reviewed. 

Types of periodical publications

Periodicals are published at certain intervals. They may be published weekly, monthly, annually or quarterly. Periodicals can fall into three categories, Scholarly (peer reviewed), Trade, and Popular. Each type of periodical will serve certain functions and will be aimed at certain populations. The following information shows some of the main features and differences between these types of periodicals.

AuthorsPurpose
Scholarly – Experts, scholars, specialists          Scholarly – Report on research studies, advance knowledge
Trade – Professionals, staff writersTrade – Provide news and industry related information
Popular – JournalistsPopular – Inform, entertain, current events 
ContentWriting Style/Language
Scholarly – Research reports, methodology, theoryScholarly – Scholarly, technical, assumes a scholarly background 
Trade – Industry trends, products, association news Trade – Industry jargon
Popular – News, opinions, general interestPopular – Informal, journalistic, conversational

See the Publication Comparison Chart for more information.

· Publication Comparison Chart

Test your periodical publication knowledge

View the PDFs of the following three articles. Can you identify which is peer reviewed, which is popular, and which is from a trade publication? (You may need to log in with your Walden username and password.)

Roberson, R. (2006). Cotton defoliation tied to fruiting characteristics. Southeast Farm Press, 33(23), 12-13.

Yang, T., Stoopen, G., Thoen, M., Wiegers, G., & Jongsma, M. A. (2013). Chrysanthemum expressing a linalool synthase gene ‘smells good’, but ‘tastes bad’ to western flower thrips. Plant Biotechnology Journal, 11(7), 875-882.

Doiron, R. (2008). Wild About dandelions. Mother Earth News, (227), 34-36.

· Check your answers

Evaluating Resources

Evaluating resources is an important part of the research process. Using unreliable or incorrect information will weaken your research. How do you know that the resource you are looking at is credible? There are several methods you can employ to evaluate a source. The evaluative process requires critical thinking and considering multiple viewpoints.

Regardless of the method you choose it is imperative that you read and think critically. 

Think CARP when evaluating: Credentials, Accuracy, Relevance, Purpose.

As you review the resources that you have found, you can ask yourself the following questions to help determine the credibility.

CredentialsAccuracy
· What information can you find about the author?· Is the author’s educational institution or organization listed?· Is an email or physical address listed?· Do you notice any spelling, grammar, or punctuation errors?
· Has the author written anything else? Are other authors citing their work?· Does the information in the article seem to align with other information you know or have read about the topic?· Can you find information about the publisher or organization making the resource available?
· Are there any statements made in the resource that you know are false?· Is the author citing other resources to support their statements?
RelevancePurpose
· Does the information in the resource seem to meet the level you would expect for your degree level? Is it overly simplified or far too technical?· Can you tell what the purpose of the resource is?· Is it trying to sell something?· Is it trying to persuade you?· Is it trying to educate?
· Does the resource help to add to your knowledge on the topic and contribute to answering your research question(s)?· Is the information current? What is the date of publication? If the information is older would it be considered foundational?· Does the resource seem to be primarily facts or primarily opinions?
· If the resource is a website does it have a recent copyright or publication date? If there are links within the website are they all working?· Who is the intended audience? The general public? Other scholars?

Two other methods for evaluating resources are the CARS Checklist and the Three C’s. You can view more information about each of these methods using the links below. The Academic Skills Center also provides guides that will prepare you with the knowledge and frame of mind to effectively evaluate resources.

· Meola, M. (2004). Chucking the Checklist: a contextual approach to teaching undergraduates web-site evaluation. Portal 4(3). 331-341.

· Evaluating Internet Research Sources

· Strategies for Thinking Critically

· Critical Reading

Practice evaluating resources

Practice evaluating the following resources using the information that you just learned.

· The Pacific Northwest Tree Octopus

· Save the Monarch Butterfly

· Bee Deaths Reversal: As Evidence Points Away From Neonics As Driver, Pressure Builds To Rethink Ban

Ulrich’s Periodicals Directory

Search Ulrich’s Periodicals Directory to verify peer review.

· Ulrich’s Periodicals Directory

The database has publisher and publication information for more than 300,000 journals of all types from around the world. Use the database to find out if a journal is peer reviewed by searching for the journal title.

What is peer review?

Peer review is a scholarly form of review used by journals only for journal articles. After an article is sent to an academic journal, the editor sends it to several  peer reviewers —typically scholars in the field—for evaluation.

These peer reviewers examine the paper’s methodology, literature review, and conclusions. They note the existence of bias or other flaws. The peer reviewers may accept the article, require rewrites from the authors, or reject the article.

If you are asked to find articles that are peer-reviewed, what you are really looking for are articles from a peer-reviewed journal.

Peer review can also be called: 

· blind peer review

· scholarly peer review

· refereeing or refereed

Search Tip:  Peer-reviewed journals may also contain items that are not peer reviewed, such as letters to the editor, opinion pieces, and book reviews. Even if you check the peer-review limiter box, you still need to examine the items carefully to be sure they are articles.

Check the journal’s website

Journal websites will typically discuss editorial processes, including peer review.

This information is often listed in the following areas:

· about us

· editorial policies

· instructions for authors

· submission guidelines

A simple Google search for the journal will usually locate the journal’s website.

Examples of Editorial Policies:

· APA’s review policy for authors

· Management Science Journal’s Submission Guidelines

· Journal of the American Medical Association Instruction for Authors

Are dissertations peer reviewed?

No. While dissertations are closely supervised by a dissertation committee made up of scholars, they are still considered student work.

Dissertations are often included in scholarly writing, although they are used sparingly. If you are unsure if you can use a dissertation in your assignment or literature review, talk with your instructor or ch

 
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Case Study on Death and Dying

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Case Study on Death and Dying 

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.

Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.

Provide a 1,500-2,000-word ethical analysis while answering the following questions:

  1. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world?
  2. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?
  3. As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person?
  4. What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?
  5. Given the above, what options would be morally justified in the Christian worldview for George and why?
  6. Based on your worldview, what decision would you make if you were in George’s situation?

Remember to support your responses with the topic study materials.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

RUBRIC

Attempt Start Date: 08-Jul-2019 at 12:00:00 AM

Due Date: 14-Jul-2019 at 11:59:59 PM

Maximum Points: 200.0

Case Study on Death and Dying – Rubric

No of Criteria: 11 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory0.00 %Less than Satisfactory65.00 %Satisfactory75.00 %Good85.00 %Excellent100.00 %Content 70.0     Suffering and Fallenness of the World12.0Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is insufficient or not supported by topic study materials.Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is unclear or vaguely supported by topic study materials.Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is clear and supported by topic study materials.Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is clear and skillfully supported by topic study materials.Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. Suffering and the Hope of Resurrection12.0Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is insufficient or not supported by topic study materials.Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is unclear or vaguely supported by topic study materials.Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is clear and supported by topic study materials.Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is clear and skillfully supported by topic study materials.Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. Value of Life12.0Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is insufficient or not supported by topic study materials.Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is unclear or vaguely supported by topic study materials. Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is clear and supported by topic study materials. Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is clear and skillfully supported by topic study materials. Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. Euthanasia12.0Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is insufficient or not supported by topic study materials.Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is unclear or vaguely supported by topic study materials.Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is clear and supported by topic study materials.Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is clear and skillfully supported by topic study materials.Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.Morally Justified Options12.0Evaluation of which options would be justified in the Christian worldview for the man is insufficient or not supported by topic study materials.Evaluation of which options would be justified in the Christian worldview for the man is unclear or vaguely supported by topic study materials.Evaluation of which options would be justified in the Christian worldview for the man is clear and supported by topic study materials.Evaluation of which options would be justified in the Christian worldview for the man is clear and skillfully supported by topic study materials.Evaluation of which options would be justified in the Christian worldview for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.Personal Decision 10.0Reflection hypothesis of which personal choices would be made if faced with ALS based on personal worldview is insufficient.Reflection hypothesis of which choices would be made if faced with ALS based on personal worldview is lacking a personal connection.Reflection hypothesis of which personal choices would be made if faced with ALS based on personal worldview is clear.Reflection hypothesis of which personal choices would be made if faced with ALS based on personal worldview is clear and thoughtful.Reflection hypothesis of which personal choices would be make if faced with ALS based on personal worldview is clear, relevant, and insightful.Organization, Effectiveness, and Format 30.0     Thesis Development and Purpose7.0Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction8.0Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use)5.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.Writer is clearly in command of standard, written, academic English.Paper Format (use of appropriate style for the major and assignment)5.0Template is not used appropriately, or documentation format is rarely followed correctly.Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.Appropriate template is used. Formatting is correct, although some minor errors may be present. Appropriate template is fully used. There are virtually no errors in formatting style.All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)5.0Sources are not documented.Documentation of sources is inconsistent and/or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Percentage  100

 
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Educational theortical Framwork

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Running head:

Apn

FAQ Brochure

Student

University

07/18/2017

Introduction

The project will analyze how does the use of antiseptic barrier caps compare with the use of manual alcohol swabs in the prevention of central line infections in adult hospitalized students.

Overview of the Problem

The microorganisms aim to access a central venous catheter through the catheter hub which should be appropriately disinfected in order to prevent central line-associated bloodstream infections (CLABSIs). But, compliance with the manual disinfection process is very time-consuming. Therefore, antiseptic barrier cap is used as an alternative to this problem to prevent central line infections.

Project purpose statement

Spotlight on the use of antiseptic barrier caps as compared with the use of manual alcohol swabs in the prevention of central line infections in adult hospitalized students.

Background and significance

“Reducing to zero” the rate of central-line–associated bloodstream infections (CLABSIs) are needed optimizing to catheter insertion as well as to maintaining the catheters. One currently invented approach to decrease CLABSI rates is the use of catheter-port antiseptic barrier caps which contain an antiseptic-impregnated sponge to disinfect the port hub during placement and thereafter physically covers the hub. The investigators have conducted a multiphase prospective trial in order to assess the efficacy of antiseptic barrier caps in reducing rates of CLABSIs and blood culture contamination in a single tertiary-care cancer center. Therefore, the use of an antiseptic barrier caps for intravenous catheter ports aims to reduce rates of central-line–associated bloodstream infections in a high-risk cancer unit.

Literature Review

According to the current study, the catheter hub should be appropriately disinfected to prevent central line-associated bloodstream infections (CLABSIs) (Blood diseases and conditions – sepsis, 2017). The news reporters obtained a quote from the research from Sophia Children’s University Hospital, “However, compliance with the time-consuming manual disinfection process is low. An alternative is the use of an antiseptic barrier cap, which cleans the catheter hub by continuous passive disinfection. To compare the effects of antiseptic barrier cap use and manual disinfection on the incidence of CLABSIs. Systematic review and meta-analysis.

The primary outcome, reduction in CLABSIs per 1000 catheter-days, expressed as an incidence rate ratio (IRR) was analysed with a random effects meta-analysis. The studies were included if that are conducted in a hospital setting or used antiseptic barrier caps on hubs of central lines with access to the bloodstream and reported the number of CLABSIs per 1000 catheter-days when using the barrier cap and when using manual disinfection.

According to the study (Blood diseases and conditions – sepsis, 2017), a total of 1537 articles were identified as potentially relevant and after exclusion of duplicates, 953 articles were screened based on title and abstract, 18 articles were read full text. Eventually, nine studies were included in the systematic review, and seven of these nine in the random effects meta analysis. The pooled IRR showed that use of the antiseptic.

Critical appraisal of Literature

The following quote has been received by the news editors from the background information supplied by the inventors: “The present invention relates to disinfectant caps for medical devices. More specifically, the present invention relates to disinfectant caps for luer access devices that provide direct contact with antiseptic fluid stored therein.

“Intravenous (IV) devices are widely used to administer fluids to patients, such as through the use of a catheter inserted into a patient. Usually, the catheter is connected to an injection site, such as a luer access device, which provides fluid communication from a fluid source (e.g., IV bag, syringe, etc.) to the patient. The connectors are frequently separated from each other (e.g., when a patient needs to use the bathroom), which exposes the connectors to the environment, which can result in contamination.” (Excelsior medical corporation, 2016)

“To reduce the risk of contamination, the connectors are usually disinfected between uses. Current procedures include swabbing the connectors with a disinfecting pad, which is prone to human error and not often implemented. Existing antiseptic caps utilize the corresponding female luer thread geometry to secure the capto the injection site. However without the additional tapered luer tip geometry, which secures these types of connections between syringes and injection sites, the antiseptic caps do not securely fit on the injection site, and are prone to falling off inadvertently.”

In addition to the background information obtained for this patent application, VerticalNews journalists also obtained the inventors’ summary information for this patent application: “The present invention relates to disinfectant caps and packaging for use with a medical device (e.g., connector, luer access device, etc.). The disinfectant caps apply the antiseptic fluid (e.g., disinfectant) directly onto the surface of the medical device. The disinfectant caps incorporate specific thread geometry to provide a secure fit to threaded access sites.

Develop an EBP standard

The American health care system is under intense scrutiny as national reform efforts are directed toward decreasing costs and improving accessibility to services for all citizens. Quality and efficiency are crucial to the sustainability of both the profit margin and the mission of organizations, with the elimination of preventable hospital-acquired conditions being a major focus. Avoidable infections are a source of increased morbidity and inflated costs, causing longer lengths of stay and needless human suffering.The Centers for Medicare and Medicaid Services stopped reimbursing facilities for the treatment of certain preventable infections, urging greater accountability to higher standards of patient safety. (Smith, et al., 2012)

Catheter-related bloodstream infections (CRBSIs) are among these largely preventable conditions. According to the Centers for Disease Control and Prevention, a total of 80,000 cases of CRBSI occur annually in the United States in intensive care units alone. If entire hospitals are assessed, the number increases to 250,000. O’Grady et al1 reported an approximate cost of $25,000 per episode and an attributable mortality rate of 12% to 25%. These alarming statistics call for the concerted and sustained effort of health care providers to prioritize and maximize patient safety through the reduction or elimination of CRBSI.

Implications

Background. Needleless connectors (NC) are used on virtually all intravascular devices, providing an easy access point for infusion connection. Colonization of NC is considered the cause of 50% of postinsertion catheter-related infections. Breaks in aseptic technique, from failure to disinfect, result in contamination and subsequent biofilm formation within NC and catheters increasing the potential for infection of central and peripheral catheters. Methods. This systematic review evaluated 140 studies and 34 abstracts on NC disinfection practices, the impact of hub contamination on infection, and measures of education and compliance. Results. The greatest risk for contamination of the catheter after insertion is the NC with 33-45% contaminated, and compliance with disinfection as low as 10%.

The optimal technique or disinfection time has not been identified, although scrubbing with 70% alcohol for 5-60 seconds is recommended. Studies have reported statistically significant results in infection reduction when passive alcohol disinfection caps are used (48-86% reduction). Clinical Implications. It is critical for healthcare facilities and clinicians to take responsibility for compliance with basic principles of asepsis compliance, to involve frontline staff in strategies, to facilitate education that promotes understanding of the consequences of failure, and to comply with the standard of care for hub disinfection.

References:Blood diseases and conditions – sepsis; findings from sophia children’s university hospital in the area of sepsis reported (antiseptic barrier cap effective in reducing central line-associated bloodstream infections: A systematic review and meta-analysis). (2017, Jun 08). Blood Weekly Retrieved from https://search.proquest.com/docview/1904578850?accountid=34574Excelsior medical corporation; “disinfectant caps” in patent application approval process (USPTO 20160045629). (2016, Mar 10). Politics & Government WeekRetrieved from https://search.proquest.com/docview/1770949112?accountid=34574

Smith, Judy S, MSN,R.N., C.R.N.I., Irwin, Gwen, RN,C.R.N.I., V.A.-B.C., Viney, Mary, MSN, RN,C.P.H.Q., N.E.A.-B.C., Watkins, Lynda, MPH, BSN,R.N., C.I.C., Morris, Shonnie Pinno, BSMT,A.S.C.P., S.M., PhD, K. M., & Brown, A., PhD. (2012). Optimal disinfection times for needleless intravenous connectors.Journal of the Association for Vascular Access, 17(3), 137-143. Retrieved from https://search.proquest.com/docview/1173329977?accountid=34574

Voor In ‘t Holt AF, Helder OK, Vos MC, Schafthuizen L, Sülz S, van den Hoogen A, Ista E. (2017). Antiseptic barrier cap effective in reducing central line-associated bloodstream infections: A systematic review and meta-analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28130997

 
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Pender’s theory of health promotion is use as a guide to delivery care and disease prevention and health maintenance

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Marie Germain Case Study: 2 

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          Pender’s theory of health promotion is use as a guide to delivery care and disease prevention and health maintenance. Through Pender’s theory, we have learned that health is not the absence of disease (Masters, 2015). But with lifestyle changes, one can improve their overall health and wellness. The major components of Pender’s model concentrate on individual characteristics and experiences, the factors affecting the behavior, and behavioral outcomes (Master’s 2015). Individual characteristics and experiences include the analysis of prior related behavior, which is based on perceived benefits of action, perceived barriers of action, perceived self-efficacy, and activity related affect (Masters 2015).

           Base on Pender’s theory, the advanced nurse practitioner can use the nursing process to plan care for Mrs. Richards. The nurse will use the nursing process to care for the patient holistically, base on her symptoms, and history of hypothyroidism, depression, substance abuse, and the emotional turmoil of losing her children and husband. The best way to care for Mrs. Richard, it is imperative that different consult and referrals must be made, in order for her to get the proper help she needs to address all the health issues she is dealing with, for instance, psychologist, psychiatrist, and essentially be referred to drug rehabilitation. All the aspect of her health concerns must be dealt with, so she can function throughout life physically, psychologically and emotionally. The figure below is a Health Promotion Model with a description of all its three different components on how Mrs. Richard can be assisted.

References

Masters, K. (2015). Nursing Theories: a framework for professional practice (2nd ed.).

            Burlington. MA: Jones & Bartlett Learning

 Priya, J. (2016). Conceptual Application of Pender’s Health Promotion Model in The Promotion

Of Adolescent Mental Health and Coping Abilities Through School Teachers      International Journal of Innovative Research and Advanced Studies (IJIRAS) Volume 3 Issue 11

Rosie Jean Louis 

Rosie Jean Louis: Case Study 2

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Based on the details of the provided case scenario, it is evident that the individual characteristics that a person displays are significant when it comes to the analysis of the health-promotion model. It is through the accurate observation of such individual characteristics that the physicians attending to such a victim will be able to have a rough idea on what diagnostic steps that they should take when it comes to the tackling of the health condition of the victim. The health promotion model thus emphasizes on the observation of the external characteristics that point towards what the patient is suffering from since this is the beginning point when it comes to treatment (Wills et al. 2019). For this case, Mrs. Richards, a 39-year-old has been severely affected by drugs and substance abuse since this must be the phenomenon that is responsible for depression that she is a victim too. It is common for drugs and substance abuse victims to suffer from depression by all standards. It is from this point that the physicians can come up with the best approach that is effective when dealing with the patient in such a condition.

The health promotion model also provides for the personal factors from a biological, physiological and cultural approach that may have contributed to the current medical or health predicament that the patient may be suffering from. This is equally an important consideration given the fact that the social-learning theory holds that people learn behavior from others based on the environment in which they are brought up. This is the reason as to why the families where parents are drugs and substance abusers will always have the immediate members suffer the same fate (Hubley & Copeman, 2018). At the same time, biological and physiological factors can also make one to develop health condition hence the need for the healthcare professionals to have such information at their disposal. For this reason, the drugs and substance addiction suffered by Mrs. Richards is likely to derive from the immediate environment within which she lived.

References

Hubley, J., & Copeman, J. (2018). Practical health promotion. John Wiley & Sons.

Lease, S. H., Shuman, W. A., & Gage, A. N. (2019). Incorporating traditional masculinity ideology into health promotion models: Differences for African American/Black and White men. Psychology of Men & Masculinities, 20(1), 128.

Wills, J., Kelly, M., & Frings, D. (2019). Nurses as role models in health promotion: Piloting the acceptability of a social marketing campaign. Journal of advanced nursing, 75(2), 423-431.

Nam, S., Jung, S., Whittemore, R., Latkin, C., Kershaw, T., Redeker, N. S., … & Vlahov, D. (2019). Social Network Structures in African American Churches: Implications for Health Promotion Programs. Journal of Urban Health, 96(2), 300-310.

Wills, J., Kelly, M., & Frings, D. (2019). Nurses as role models in health promotion: Piloting the acceptability of a social marketing campaign. Journal of advanced nursing, 75(

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Case Study 2: Week 11

Muller Sanon

Nursing Theory

Health Promotion Model

            The goals of the Health Promotion Model include helping the patient seek and perform health promoting behaviors which “result in improved health, enhanced functional ability and better quality of life”. It based on the assumptions that people want to regulate their behavior; they interact with their environment and, in the process, change and are changed by the environment; health care professionals influence the patient as they are part of the interpersonal environment; and in order for behavior to change, the patient must start the process of re-adapting to the environment (“Health Promotion Model”, 2011). This theory asserts that one of the driving forces of certain positive behaviors is a perceived benefit from engaging in said behaviors. According to this theory, there is a relationship between perception and reality. Positive perception of competence, self-efficacy, attitudes and emotions increase likelihood of commitment and acting out a certain behavior, especially health-promoting behavior.

            One article sought to determine the effect the Health Promotion Model had in improving nutritional behavior of overweight and obese women. The results showed that this model did improve nutritional behaviors. This model is one of the most commonly used to promote lifestyle changes and behaviors in order to improve health. The assessment of perceived benefits, barriers, self-efficacy, behavior-related affect, interpersonal influences, situational influences, and commitment to action was done. The experimental group went through three sessions. One session was about the benefits of healthy nutritional behaviors. The second session was about the barriers to healthy nutritional behaviors ways to overcome, and the third session was about ways to promote efficacy and commitment to healthy nutritional behaviors. These results of this study showed that those in the experimental group had increased positive perceived benefits, self-efficacy, and behavior-related affect. Also, results showed decreased barriers after the intervention of the sessions. Increased knowledge about barriers and the methods to overcome them increased the motivations and interpersonal influence positively. This model can positively affect the commitment and performance of health-promoting behaviors (Khodaveisi, Omidi, Farokhi & Soltanian, 2017).  

Prior Related Behavior-Assess readiness to change behavior of seeking help for substance abuse-Assess past attempts to seek help and change behavior-Encourage/reinforce strengths and positive behavior
Personal Factors-Assess positive and negative biological factors influencing change-Assess positive/negative psychological factors-Assess positive/negative socio-cultural factors
Benefits-Assess patient’s perceived benefits of cessation of substance abuse-Help reinforce or create better understanding of benefits
Barriers-Assess possible barriers to changing behaviors-Discuss how to overcome the barriers
Self-Efficacy-Assess perceived self-efficacy-Have pt attempt cessation of substance abuse-Focus on positive sensations
Activity-related Affect-Assess what pt enjoys doing-Have pt swap negative activity for positive activity-Present activity as unattractive
Interpersonal Influences-Assess pt’s social support-Involve family, friends, support system in treatment, goal setting-Refer to support group-Plan increased interaction with positive role models or sponsor for substance abuse group
Situational Influences-Present positive, attractive, safe locations for activity-Assess ties between supply of substance and pt access to it
Commitment-Assess level of commitment to following through on plans-Include pt in setting attainable, realistic goals and find ways to integrate to pt daily life-Provide education of symptoms and management of disease processes
Competing Demands and Preferences-Work with patient to develop plan to avoid competing demands-Reduce competing stimuli

References

Health Promotion Model. (2011). Currentnursing.com. Retrieved 10 July 2018, from http://currentnursing.com/nursing_theory/health_promotion_model.html

Pender, N. The Health Promotion Model Manual. Research2vrpractice.org. Retrieved 15 March 2018, from http://research2vrpractice.org/wp-content/uploads/2013/02/HEALTH_PROMOTION_MANUAL_Rev_5-2011.pdf

Khodaveisi, M., Omidi, A., Farokhi, S., & Soltanian, A. (2017). The Effect of Pender’s Health Promotion Model in Improving the Nutritional Behavior of Overweight and Obese Women. PubMed Central (PMC). Retrieved 12 November 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385239/

Yindra Isaac Amador

Nursing Theory

In a nutshell, the health-promoting behavior in the case of Mrs. Richards is precisely quitting the drug and substance abuse. That is the end game in her nursing care program. To do that, however, the nurse must consider the fact that prior related behavior, that is, what is making her abuse illicit drugs is the tragic loss of her husband and children in a road accident. That is what makes up her individual characteristics and experiences. The perceived barrier is the fact that her lost family cannot be brought back to her. The nurse should, therefore, build the patient’s perceived self-efficacy by building around her a caring second family. They should keep her company and help her overcome the memories of her loved ones which are driving her into depression. This is a simultaneous invocation of interpersonal influences and breaking of the perceived barriers.

The situation which makes Mrs. Richards’ health open to the charge of deteriorating is the loneliness which envelopes her after the demise of her family. The nurse has to; therefore, put her in a situation that encourages her well-being. This is the situational influences and includes what is moral support. The nurse can achieve this by developing a semi-formal relationship with the patient. A cultural knowledge of the patient based on the fact that she is Caucasian is handy here. In all these, the nurse should focus on keeping the patient committed to the plan of setting her free from the power of illicit drugs and ultimately improve her health.

References

Masters, K. (2012). Nursing theories: a framework for professional practice. Sudbury, MA: Jones & Bartlett Learning.

Pender, N. J., & Pender, A. R. (1996). Health promotion in nursing practice. Stamford, CT: Appleton & Lange.

Planning in Health Promotion Work. (2010). doi:10.4324/9780203842522

Manuel Cabrera 

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Case Study 2: Manuel M Cabrera 

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Case Study applying Health Promotion Model

The case focuses on a 39-old female that has to deal with a series of issues including hypothyroidism, depression, and substance abuse. The situation is challenging because the patient experiences psychological trauma because her husband and children passed away due to a traffic accident. The patient notes that she started to use illicit substances after the accident. It is appropriate to utilize Pander’s model because it predicts health-promoting behaviors when applied in clinical practice (Aqtam & Darawwad, 2018, p. 485). The model consists of three key dimensions focused on the patient’s individual characteristics, associated cognitions, and behavior outcome (see Figure 1).

Figure 1. Pander’s Model. This figure illustrates the elements of the theory.

            The model may be utilized to develop a plan of care that would maximize the effectiveness of treatment. First of all, it is evident that a traumatic event has influenced the patient’s decision to use illicit drugs. However, it is also possible that the patient was susceptible to drug abuse because of the history of depression. Moreover, depression is also viewed as one of the symptoms of hypothyroidism. Therefore, all of the patient’s behaviors are interconnected, and depression has influenced the patient’s cognitions. It may be difficult for the patient to deal with the loss because of depression. It is appropriate to address these biological and psychologic factors and treat hypothyroidism and depression. Furthermore, it is necessary to alter interpersonal influences and communicate with the patient’s friends to establish an environment that would discourage drug abuse (Nursing Theories, n.d.). It is imperative to highlight the benefits of treatment while eliminating the barriers that make it challenging for the patient to accept changes. This approach should make it easier for the patient to commit to the plan of action. The strategy is expected to be particularly effective if the therapy helps to eliminate the symptoms of depression, and all the elements of the plan would support health-promoting behavior.

References

Aqtam, I., & Darawwad, M. (2018). Health Promotion Model: An integrative literature review. International Journal of Adolescent Medicine and Health, 8(7), 485-503. doi:10.4236/ojn.2018.87037

Nursing Theories. (n.d.). Health Promotion Model. Retrieved from http://currentnursing.com/nursing_theory/health_promotion_model.html

  Week 11

                                                                                           Laura Saldivar

         The purpose of Nola Penders Health Promotion model is to help nurses to interpret the factors of health

behaviors as a basis for behavioral counseling to promote healthy lifestyles. This can be used as preventative or coincide

with the health care plan. Pender’s theory focuses on variables that impact health behavior. Evidence base practices from

nursing, psychology, and public health were placed into a model of health behavior. The model can be used to

structure nursing protocols and interventions. In practices, nurses should focus on discovering and focusing on the

variables most apparent of given health behaviors.      Pender’s model focuses on three areas: individual characteristics and experiences, behavior-specific cognitions and 

affect, and behavioral outcomes. Relating these 3 areas to our Patient begins by questioning the patient to determine

patterns of behavior to prioritize what to address first. We need an better understanding of the patient overall health state 

by gathering info regarding the diagnosis of hypothyroidism and if she has been compliant with medication. During the

initial assessment we must take into account her mental status as she has experienced a devastating trauma recently. Also,

in regards to the heroin usage, is addiction something she has struggled with throughout her lifespan, or has this recent

trauma triggered it. We must consider that any information or education may be difficult for this patient to process at this

time, and patience, and basic life needs may be priority at this time of distress. Everything else will be put in place

secondary to that.

                By assessing these major questions we can prioritize and focus on where to begin with said patient. It is the

nurses job to assist in consulting proper health care team members to ensure she has an endocrinologist, Psychiatrist,

counselor, and social worker on the case assisting in long term care as this may not be a quick fix for the patient. After the

three  areas have been addressed we can provide resources and assist the patient on getting back to the right track,

physcially, mentally and emotionally and that is what the Health Promotion Goal is, overall.

                                                                                   References

Srof, B. J., & Velsor-Friedrich, B. (2006). Health Promotion in Adolescents: A Review of Pender’s Health Promotion Model. Nursing Science Quarterly, 19(4), 366–373. https://doi.org/10.1177/0894318

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Prevention of Central Line-Associated Bloodstream Infections (CLABSIs)

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Prevention of Central Line-Associated Bloodstream Infections (CLABSIs)

Submitted by

Kerry Sean Murphy

Direct Practice Improvement Project Proposal

Doctor of Nursing Practice

Grand Canyon University

Phoenix, Arizona

Prevention of Central Line-Associated Bloodstream Infections (CLABSIs) 1

June 26, 2019

Appendix A

Ten Strategic PointsComments or Feedback
Broad Topic Area1. Broad Topic Area:The topic is the Prevention of Central Line-Associated Bloodstream Infections (CLABSIs).
Literature Review2. Literature Review:Summary Comment by Kathryn Flynn: summarya. Background of the problem/gap:· There arises an urgency to intervene and develop effective measures to curtail the incidence of CLABSIs (Yaseen, et al., 2016).· The use of proper hand hygiene and skin aseptic techniques over the insertion site is necessary for preventing microbial infections (Dick et al., 2015).· The nurses need to have significant knowledge associated with evidence-based practices for the prevention of central line-associated bloodstream infections (CLABSIs), their attitude towards the guidelines and the utilization of the hygienic measures for the Central Venous Catheter in adult Intensive Care (ICU) units with (CVC) patients (Kadium, 2015). Comment by Kathryn Flynn: prevention of Comment by Kathryn Flynn: make this another clear sentence.· Research has shown the existence of variations in the practice of nursing regarding the prevention of CLABSI, thus stressing the need for monitoring and education/training (Elbilgahy et al., 2015).· There is a need for implementation of educational interventions to deal with the practice and knowledge gaps about CLABSIs prevention as well as ensuring that nurses apply prevention interventions which are evidence-based (Esposito et al., 2017).· The Quality Health Outcomes Model (QHOM) Investigating Prophylactic measures to eradicate the incidence of Central line-associated bloodstream infections (CLABSIs), based on the opinions of the experts as well as the analysis of the research literature (Hentrich et al., 2014) Comment by Kathryn Flynn: Use primary sources (as many as you have) and not one author who synthesized the synthesis.b. Carrying out a review of literature topics with a key theme for each one.c. Prevention of Central Line Associated Blood Stream Infection (CLABSI) (Masse, Edmond, & Diekema, 2018).· The Quality Health Outcomes Model (QHOM) is used to study healthcare quality and outlines relationships existing between interventions, characteristics, and outcomes of patients, and the characteristics of the healthcare system. This model/framework has been used by various researchers to test the effectiveness of infection prevention measures (Gilmartin & Sousa 2016). Comment by Kathryn Flynn: &Setting· Adult ICU (Elbilgahy, et al., 2015).· The incidence of Catheter-Related Infections (CRIs) in cancer patients at the hospital (Hentrich et al., 2014).Summary· Gap/Problem: There is a need to implement evidence-based methods of improving health outcomes and CLABSIs prevention through nursing education (Dombecki, Vercher, Valyko, Mills, & Washer, 2017).· Quantitative application: the Quantitative project is to establish a relation between the occurrence of CLABSIs and staff training, reinforcement, and proper hygiene for Central Venous Catheters (CVCs) inserted in the hospital setting. There seems to be a problem regarding the training and education regarding the procedures which should be followed when carrying out catheter-related procedures. The objective of this study is to address this issue (Dombecki, Vercher, Valyko, Mills, & Washer, 2017). Comment by Kathryn Flynn: The authors probably didn’t refer to your study. Clarify..· Significance: The use of proper hand hygiene and skin aseptic techniques over the insertion site are necessary for preventing microbial infections. Therefore the necessity to maintain insertion site hygiene consistently is determined to be the best practice in preventing infections that can lead to sepsis and septicemia (Yaseen, et al., 2016)2.a. Background of the problem/gap:Even though earlier CVCs were associated with mechanical complications such as leaks, air embolisms, and hub separation, CLABSIs quickly became a serious problem when it came to the use of catheters. Studies indicate that elementary infection control steps may reduce incidences of CLABSIs significantly(Owings et al. 2017). Comment by Kathryn Flynn: cite with all the studies that indicate it, authors separated by ;a. Theoretical Foundations (models and theories to be the foundation for the project). Specifically, the model proposed is the Quality Health Outcomes Model (QHOM), which is used to study healthcare quality and outlines relationships existing between interventions, characteristics, and outcomes of patients, and the characteristics of the healthcare system. (Gilmartin & Sousa, 2016).The theoretical model is associated with the strategies deployed and operational processes linked to the prevention of Central Line Association Bloodstream Infection. A meta-analysis review of randomized control and quasi-experimental studies (Moody, 2019). Comment by Kathryn Flynn: make this a full sentence.b. Review of literature topicRapid Dissemination of Universal Decolonization in Adult Intensive Care Units (ICUs) reduces healthcare-associated (HA) central line-associated bloodstream infections (CLABSI) in over 100 Community Hospitals (Hickok et al., 2015).a. Single Healthcare Systemc. Prevention of Central Line Associated Blood Stream Infection (CLABSI).
Problem StatementThere are several safety measures to follow during a procedure involving the insertion of a central line catheter. Despite this, there still exist many cases of infections resulting from such insertions, especially in adult ICUs. For example, a study conducted in an ICU in northern India indicates that in spite of there being several guidelines for CLABSIs prevention, cases of such infections are still high (Mishra et al., 2016).
Clinical/PICO Questions3. Clinical/PICOT Questions:“In Patients > 65 years of age with central line catheters, how does staff training of key personnel and reinforcement of central line catheter observe hygiene after its insertion, along with the apt cleansing of the insertion site, reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections) compared to standard care over a one-month period?” In thiscase, standard care refers to the typical procedures which should be followed during a central line catheter insertion procedure. These include regularly monitor and assess the central line insertion site, looking for signs like redness, swelling, pain, and discharge (Painter & Painter Law Firm, 2018). While central lines are convenient for doctors and nurses, and more comfortable for patients, they increase the risk of infection. Any time a foreign body is present inside the human body, it provides a place for bacteria to grow (Painter & Painter Law Firm, 2018). Comment by Kathryn Flynn: Word Doesn’t seem to flow Comment by Kathryn Flynn: Think of more specific word. Comment by Kathryn Flynn: You should mention that there is a gap between how they are doing it now and best practice Comment by Kathryn Flynn: Find primary source, original studies. There should be many.P: Patients > 65 years of age with a central lineI: Staff training and reinforcement of central catheter, hub hygiene. Along with teamwork and communication strategies such as structured multidisciplinary rounds and daily goal settings that educate staff on the utilization of The Central Line (CL) Bundle with a target of at least 100% compliance Successful implementation of CL Bundle can help in reducing the rates of CLABSI and achieving zero CLABSI events for a period of one month (Yaseen et al.). Comment by Kathryn Flynn: , along… find another way to break this sentence up. Comment by Kathryn Flynn: Is this the best way to get your point across to staff? This process will have to be justified by the literature that it improves outcomes. Comment by Kathryn Flynn: This last sentence should be broken into two.C: Compared to standard care. The aim is to identify any discrepancies between the skills gained by trained staff and the standard care procedure. Comment by Kathryn Flynn: This should be part of your lit review to answer why is the project necessary.O:  Reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections). Pre and post intervention outcomes will be measured by counting the number of CLABSIs cases before and after the intervention. Using various questionnaire types (true/false, short answers, and fill in the blank. Comment by Kathryn Flynn: There should be two questions in this, one measurement should be increased knowledge, second is less infections. Consider both in questionsairre.T: A period of one-month
Sample4. Sample (and Location):a. Location: ICU Clear Lake Regional Medical Center, Webster, Texasb. Sample: The study seeks to sample 120 nurses from the adult intensive care unit department.
Define Variables· Define Variables:· Independent Variables: training and education on various safety measures when carrying out a central line catheter insertion. Comment by Kathryn Flynn: Good; have PICOT question align with both variables.· Dependent Variables: number of cases of infections resulting from central line catheter insertion.
Methodology & Design· Review of past research will form the core basis of collecting data for this project. Data on new infections related to the insertion of the central line catheter will be collected. Also, nurses working in adult ICUs will be surveyed, and the total number of infections resulting from their central line catheter procedures recorded. These cases will be recorded before and after an intervention to determine the effect of the intervention. The intervention will be a short training on how to apply various guidelines during central line catheter insertion. The likelihood of causing an infection post or pre-training will be determined by monitoring the number of infection cases recorded by each nurse before and after the training. Comment by Kathryn Flynn: What kind? In person? Slide deck? You mention up above you’ll do daily rounds. All parts should be aligned.
Purpose Statement5. Purpose Statement:The purpose of this project is to establish a relation between the occurrence of CLABSIs, and staff re-education of hub hygiene for Central Venous Catheters (CVCs) inserted patients at the hospital and to explore the preventive measures being taken by the healthcare staff Clear Lake Regional Medical Center in Webster, Texas for the prevention of CLABSIs.
Data Collection Approach6. Sample (and Location):a. Location: ICU Clear Lake Regional Medical Center, Webster, Texasb. Population: The population being sampled in the study is 120 adult ICU nurses.7. Determining the Sample Size· A sample population is often selected based on the PICOT question the evidence-based study is being held on people who are 65 years and more. The patients are with a Central line catheter hub hygiene.· The sample population is targeted from the ICU unit at Clear Lake Regional Medical Center, Webster, Texas.· After a focused consideration of the required population, a random sampling of nurses from the target group will be picked. Comment by Kathryn Flynn: so will there be 120? Or will they be randomly sampled from 120.· The selection of a sample population should not be haphazard for it will lead to biased results. Furthermore, a large sample size helps in having precise results (Nayak & Singh, 2015).· To avoid oversampling to have a minimal sample size that we are targeting are the 120 adult nurses out of the 300 (Andersomn, Kelley, & Maxwell, 2017).· The proposed intervention is training on the basic guidelines on safety measures to follow when conducting central line catheter insertions. With the confidence level of 95% calls upon the usage of 120 nurses to have an error of 5% only. This population will be equally divided between the treatment group and the control group. The particular ratios of gender are not necessary, yet the ration of re-trained and those left without that are of significance.· This population will be equally divided between the treatment group and the control group. Comment by Kathryn Flynn: Ok, so the question would compare the intervention group with the control group. Align this in all sections.The formula below will help determine the population to be sampled. The sample size is 120 nurses.8. Inclusion/exclusion criteria of the subjects· People who are 65 or above and are from ICU Lake Regional Medical Centre, the central line catheter hub clinic section.· The nurses who are not core staff of the ICU at Clear Lake Regional Medical Center will be excluded (Patino & Ferreira, 2018).· Those who will have signed consent will be included in the study because of having fulfilled the research ethics standards.· When the interviews and questionnaires have been conducted, the incomplete questionnaire forms will be excluded while the interview subjects who have not attended the interview will not be considered.· Questionnaires that are entirely filled and interview subjects who will turn for the interview and response will be included in the findings. Comment by Kathryn Flynn: Rephrase to clarify.
Data Analysis ApproachComment by Kathryn Flynn: Address validity and reliability9. Data Collection Instruments· The sample of nurses operating within adult intensive care units will be subjected to a training and their efficiency to insert the central line catheter without causing infections tested before and after the training.· The training will be as much comprehensive and intensive as possible. This is to make sure that the participants have undergone a process that would impact their skills regarding the insertion of the central line catheter.
Ethical Consideration· A valid research design will be created while taking into account the methods used, the theories, and the findings on crisis management from different organizations. Comment by Kathryn Flynn: How? Move to data analysis.· Since crisis management as a subject matter is very sensitive to the organization, compliance with confidentiality agreements is paramount (Mkunga, 2017). Comment by Kathryn Flynn: Clarify why this topic is coming up now.· In this research study, any details that the respondent will not want it disclosed will be removed and deleted from any written or oral records, while others are candidly presented.· Before the recruitment process, the participants will be contacted and be informed of the research and its significance (Castillo-Montoya, 2016).· They will then beasked to declare their readiness to partake in the study and the free times they have for the interview process or questionnaire filling process.· The form will have the clinical question, the usability of results, assurance of anonymity and confidentiality in which the researcher will indicate how the results will be exposed, to whom they will be exposed and how the subjects will be prevented from harm. Comment by Kathryn Flynn: In methodology and analysis, write how you will deidentify any data collected by using assigned numbers to each participant..· The only harm could be labeling the nurses as unhygienic, hygienic, effective or ineffective, and mentioning their particular names. Comment by Kathryn Flynn: See above. You might want to analyze the cohort, and not individuals. Talk to the methodologist about this. You should pick one way and stick to it.· Since the study is checking on evidence-based care and its impact, the subjects will not be mentioned, and the results will be written in a manner that they do not openly show which health care has a particular condition (Kamat, 2018). Comment by Kathryn Flynn: Which health care what?· It is necessary that health care centers be informed of the study.Before the study, the researcher will seek the participants’ permission through formal e-mails, which will be sent to the administration for approval. Comment by Kathryn Flynn: Kerry, The project is coming along; this version is very much improved. There are some minor adjustments, then you can submit for a grade. Let’s review comments over phone tomorrow in case I can clarify any. Great work.

References

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I, Kerry Murphy, verify that I have completed (30) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.

 
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