HIV screening

 Find a nursing journal article in the Keiser Library related to HIV screenings and present it for us as a reply. You might also look for some interesting information from the Murdaugh et al. (2019) text to share! 

The Role of the DNP Scholar in Preparing for Change

  

I want to start by saying I love the word cadre in this week’s discussion post! If we consider its definition as a group of people specially trained for a particular purpose or profession it works, OR if we assume it to be a group of activists or other revolutionary organization it works!  Both fit in the role of the DNP as we consider their role in health care.

Melnyk et. al (2012), states that EBP gives nurses a voice, supports nurses as individuals and as a collective, and encourages patient advocacy with the intent to assure quality care.  The research, EBP, and QI processes that give nurses this voice is driven by terminal degree Registered nurses such as the DNP.  The DNP can lead not only by example but by shared advocacy. Whether it be a grassroots campaign to speak with local and state representatives to advocate for nursing or patient initiatives, or by being involved in a task force, activity, or key committees in health systems, our collective accomplishments speak much louder than individual ones.

The DNP cohort can lead the charge to translate evidence into practice by applying quality improvement strategies, heading interprofessional teams, mastering health information technologies, and championing patient-centered care through existing EBP principles (Melnyk, et.al, 2012)

The DNP cohort can lead clinical innovation by using the theories we reviewed in Scientific Underpinnings to inform and change EBP assuring quality patient-centered care. The DNP cadre can also advocate for legislative changes, curriculum changes, and lead research teams looking to address a knowledge gap.  It will be important for the DNP army to be mindful of the interworking of the microsystems, mesosystems, and macrosystems in the organization they are trying to innovate.

Successful change is difficult, and many change initiatives ultimately fail.  Patient care is too important to not overcome those barriers to effective change. As a DNP, my first step prior to implementing the change would be to review my organization’s structure and culture to identify challenges I will be facing regarding staff motivation for change.  It will important that I recognize my own hesitations or transferences, and deal with those prior to addressing the team.  I believe educated employees are empowered employees, so assuring they understand the evidence behind the change movement, and how it will impact the team’s daily tasks will be crucial.  Elisabeth Kubler-Ross taught us many years ago that change is not a linear process, but a curved one where the team goes through shock, fear, acceptance, and commitment. Throughout the informed process, I will need to be consistent and transparent as I lead and coach the change to completion. I will need to ensure adequate communication that is clear, concise, and not overwhelming to staff.  Once the change is implemented, it will be important I give and take feedback on the process and debrief the team.  If the team can witness my dedication and passion to EBP and patient-centered care, they will be more trusting with future initiatives I bring forth.

REFERENCE

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410–417. https://doi.org/10.1097/NNA.0b013e3182664e0

I NEED A COMMENT FOR THIS POST WITH AT LEAST TWO-THREE  PARAGRAPH AND TWO SOURCES NO LATER THAN FIVE YEARS

N431: Health Policy and Professional Leadership

https://www.youtube.com/watch?v=iZHJjf9oYZk&feature=youtu.be

Discussion 05: Ethical Development

HA3300D – Healthcare Policy and Ethics

 Discussion 05: Ethical Development

Imagine you’re the CEO of a major hospital system that’s recently come into a large endowment from a recently deceased philanthropist. The conditions on the endowment are that the hospital must use it for the ethical development of its staff members. You decide to use the money to create a professional development seminar that “fills the gaps” you see in your staff’s ethics education.

.What ethical issues or topics will your seminar address? Write 3 – 5 sentences describing it and the ethical questions at stake.

.Why is this the most important issue or topic to address? How will this “fill the gaps” in your staff’s training?

Your initial post should be 8 – 10 sentences in length and include an APA-style references list.

You may wish to get ideas for your presentation from these websites:

.National Center for Ethics in Health Care

.“Five Top Ethical Issues in Healthcare”

NRS-410V-0L191 Pathophisiology and Nursing Management of Client Health.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

  1. Temperature: 37.1 degrees C
  2. BP 123/78 HR 93 RR 22 Pox 99%
  3. Denies pain
  4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

  1. WBC: 19.2 (1,000/uL)
  2. Lymphocytes 6700 (cells/uL)
  3. CT Head shows no changes since previous scan
  4. Urinalysis positive for moderate amount of leukocytes and cloudy
  5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mr. M.
  2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
  3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
  4. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
  5. Discuss what interventions can be put into place to support Mr. M. and his family.
  6. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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

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

NRS-410V-0L191 Pathophisiology and Nursing Management of Client Health.

Benchmark – Nursing Process: Approach to Care

The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

  1. Describe the diagnosis and staging of cancer.
  2. Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
  3. Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
  4. Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
  5. Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
  6. Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.

You are required to cite to a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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

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

Discussion 1: Evidence Base in Design

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

  • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

This also comes with two posts that will each need a reply and at least two references all in APA 7 format. the rubric is attached below please meet the standards.  

Discussion 1 TY

Health Policy: COVID Research Act of 2020

MAIN QUESTION POST- Health policy is essential in nursing. According to Liao (2019), “policies reflect public opinion as well as evidence-based data” (p.90). The health policy I want to discuss is the COVID Research Act of 2020 or also known as the Computing Opportunities to Vanquish Infectious Diseases Research Act of 2020 (“H.R.6599 – 116th Congress (2019-2020): COVID research Act of 2020,” 2020). This policy is to help address the issue of infectious diseases and how to prepare for them. COVID-19 has taken a toll on the health and economy throughout the world. This policy would create a group to be responsible for dealing with pandemics.  A group to prepare for pandemic outbreaks and to help create strategies to address challenges during a health crisis is essential (“H.R.6599 – 116th Congress (2019-2020): COVID research Act of 2020,” 2020). Using evidence-based research will allow this policy to help prepare for upcoming pandemics.

I believe there is no better time in society to address this policy than now. The research done by healthcare professionals can help policymakers understand essential information (Hebda, 2019). APRNs and research groups can work together to help address and improve health policies. With COVID-19 being a significant concern, this supports why this policy needs addressed. Evidence-based research is required to help create a plan of action for the current and emerging pandemics. By creating a group dedicated to this policy will help the overall health of the population. For example, there is a need for a vaccine for COVID-19. With this policy in place, they could have predicted COVID-19 and been preparing a vaccine. Research on the spread and severity could have begun before the COVID-19 pandemic and helped decrease worldwide exposure rates. There is strong evidence to support the COVID Research Act of 2020 based on the worldwide pandemic status. Throughout history, pandemics have taken a toll on the health of the country. For example, the Influenza pandemic has led to annual flu shots starting in October (the peak season).  The COVID Research Act of 2020 health policy would benefit healthcare now and in the future.

References

Hebda. T.. (2019). The impact of EHRs, big data, and evidence-informed practice. In J. A. Milstead,  & N. M. Short (Eds.), Health policy and politics: A nurse’s guide (6th ed., pp 133-150). Burlington, MA: Jones & Bartlett Learning

H.R.6599 – 116th Congress (2019-2020): COVID research Act of 2020. (2020, April 23). Congress.gov | Library of Congress. https://www.congress.gov/bill/116th-congress/house-bill/6599?q=%7B%22search%22%3A%5B%22health+policy%22%5D%7D&s=3&r=86 

Liao, C. (2019). Public policy design. In J. A. Milstead,  & N. M. Short (Eds.), Health policy and politics: A nurse’s guide (6th ed., pp 87-99). Burlington, MA: Jones & Bartlett Learning

Discussion 2 ML

Week 7 Discussion Post

            I found and reviewed the Sexual Assault Victims Protection Act of 2019 on the congress.gov. The summary includes,

“This bill requires the Department of Health and Human Services (HHS) to conduct a series of activities relating to sexual assault evidence and treatment. Among other things, HHS must establish a task force to improve forensic evidence collection related to sexual assault, maintain a website with resources and best practices related to the treatment of individuals for sexual assault, and host an annual meeting to address gaps in health care relating to sexual assault. In addition, the Centers for Medicare & Medicaid Services must require Medicare-participating hospitals, in their community call plans relating to on-call coverage, to specifically delineate coverage responsibilities with respect to screening and treatment related to sexual assault.”( Congress,2020).

As a nurse in the emergency room I find that this proposed health policy would be beneficial in the way healthcare teams are required to treat possible sexually assault victims. I know that my hospital in the past did not have any specially trained individuals to conduct the assessment and collection of forensics in these cases. With this being the case, nurses were not comfortable at doing this and things could get missed or mishandle with patient. Policy and procedures have changed for much improvement in this practice that now we have SANE nurses who conduct all assessments and collection of forensics. “Sexual Assault Nurse Examiners (SANE) are registered nurses who have completed specialized education and clinical preparation in the medical forensic care of the patient who has experienced sexual assault or abuse. “(International Association of Forensic Nurses,2014-2020). I believe that there is evidence based on the need for the policy and changes in the health care practice from personal experience. For example, I had a pediatric patient in ER that mother brought in with possible sexual abuse. I do not feel properly trained to conduct this investigation on this child and would not want to say or do the wrong thing during such a sensitive time. At that point I call the SANE nurse on call that comes in and does everything needed for that patient. Even the provider does not go see the patient before the SANE nurse arrives and collection all information and data. Having policies in place for facilities to provide access to specialty trained nurse will provide better patient care and less traumatic care.

References

Congress.gov. (2020). H.R.4758 – Sexual Assault Victims Protection Act of 2019. Retrieved on October 11, 2020 from  https://www.congress.gov/bill/116th-congress/house-bill/4758/all-info?r=5&s=7

International Association of Forensic Nurses. (2014-2020). Sexual Assault Nurse Examiners. Retrieved on October 11, 2020 from https://www.forensicnurses.org/page/aboutSANE

Group therapy

zero plagiarism

five references

please follow the information below

Students will:
  • Create progress notes
  • Create privileged notes
  • Justify the inclusion or exclusion of information in progress and privileged notes
  • Evaluate preceptor notes
To prepare:
  • Reflect on the client family you selected for the Week 3 Practicum Assignment.

Assignment

Part 1: Progress NoteUsing the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following:

  • Treatment modality used and efficacy of approach
  • Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the treatment plan for progress toward goals)
  • Modification(s) of the treatment plan that were made based on progress/lack of progress
  • Clinical impressions regarding diagnosis and or symptoms
  • Relevant psychosocial information or changes from original assessment (e.g., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job)
  • Safety issues
  • Clinical emergencies/actions taken
  • Medications used by the patient, even if the nurse psychotherapist was not the one prescribing them
  • Treatment compliance/lack of compliance
  • Clinical consultations
  • Collaboration with other professionals (e.g., phone consultations with physicians, psychiatrists, marriage/family therapists)
  • The therapist’s recommendations, including whether the client agreed to the recommendations
  • Referrals made/reasons for making referrals
  • Termination/issues that are relevant to the termination process (e.g., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
  • Issues related to consent and/or informed consent for treatment
  • Information concerning child abuse and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
  • Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged NoteBased on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment.In your progress note, address the following:

  • Include items that you would not typically include in a note as part of the clinical record.
  • Explain why the items you included in the privileged note would not be included in the client family’s progress note.
  • Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why.

soap note

chronic decease  

Defining Injuries

Produce a written document defining the injury and setting in the geographical area of their choice

Geographical area: (South Asia)

Injury of Interest: Fire, heat, and hot substances

Direction 

Discuss how this injury varies by age and sex.

No plagiarism

Use APA format 

1 cite sources (internet)

1 1/2 page

Textbook : Global Health 101

4th Edition

Author: Richard Skolnik

Publisher: Jones and Bartlett Learning

Year: 2019