Describe your clinical experience for this week as APRN student. 

• Did you face any challenges, any success? If so, what were they?
• Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
• Mention the health promotion intervention for this patient.
• What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?
• Support your plan of care with the current peer-reviewed research guideline.

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

• Focusing on women’s health:
  • Name and describe the components and rationale of the gynecological health history.
  • Define and describe each component of the GTPAL system used to document pregnancy history.
• Following the guidelines of the United States Preventive Service Taskforce (USPSTF) what screening recommendations would you do to G.R. a 66-year-old female patient who visits you at the office for the first time (last visit to her PCP 5 years ago) with only positive health history of hysterectomy 10 years ago due to fibroids.
• A 35-year-old women with a BMI of 40 comes in asking about combined hormonal contraception’s. You explain the contraindications for hormonal contraception include (name more than 4 contraindications).

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. 

1. For this discussion, you will use the PICO question you generated for the previous discussion (Use the PICO worksheet attached to this discussion).
2. Select the most appropriate databases using information from the MDC Library databases.  Explain in a short paragraph why you selected each one.
3. Find synonyms for Population, Problem, Intervention, Comparison, Outcome. Fill out the list with synonyms. 
4. Using the advanced search feature, conduct separate searches for each of the above PICO, using “OR” with synonyms. Check for the number of hits for each search and revise as necessary.
5. Using the search history feature, combine PICO searches, using “And.”
   1. Make note of the number of hits. 
   2. Revise the searches combined, if necessary.
6. Use methodological filter terms, first for systematic reviews, randomized control trials, cohort studies, etc. Note the number of studies found after applying the exclusion and inclusion criteria).
7. Limit your searches to five (5) years.
8. Write a paragraph describing the process ( this is the method section of the literature review). 
9. Title the discussion with the PICOT question.
10. Initial post: Your post should be within a range of 200-300 words.
    1. Cite your references APA 7th  ed. (not included in the length of the post). 

  

P – Patient or Problem:

Neonates in NICU who are at risk of sepsis include; premature birth, low birth weight, and the need for invasive therapeutic devices such as central lines or ventilators.

I – Intervention:

Implementation of evidence-based sepsis prevention bundles like hand hygiene protocols, sterile technique during invasive procedures, and antibiotic stewardship.

C – Comparison:

Standard care, which consists of care without the full sepsis prevention bundle or components of the bundle, such as current hand hygiene practices without auditing and reinforcement.

O – Outcome:

Reduction in the incidence rate of neonatal sepsis in the NICU.

PICOT Question

Among neonates in the NICU (P), does the implementation of evidence-based sepsis prevention bundles (I), compared to usual care practices (C), decrease the incidence of neonatal sepsis (O) within six months of implementation?

Select an existing healthcare program or policy evaluation or choose one of interest to you.

Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.