Weekly objective

1. Explore an area of interest through patterns of knowing (CO 1)
2. Examine the components of the nursing metaparadigm.
3. Examine different patterns of knowing in nursing. (CO 2)
4. Analyze the benefits of reflection for shaping and understanding theory. (CO 2)
5. Differentiate between the received and perceived schools of scientific thought. (CO 2)

Course Outcomes

1. Demonstrate logical and creative thinking in the analysis and application of a theory to nursing practice. (PO 2 and 5)
2. Apply nursing theory as a framework to guide the development of new knowledge and implementation of evidence-based practice in future professional settings. (PO 1 and 4)

The above is just additional information for the question below.

 Write 1-2 paragraphs reflecting on ways of knowing and the use of metaparadigm in the NP role 

• Provide one specific example of how you achieved the weekly objectives.
• What do you value most about your learning this week?
• What else about the weekly topics do you need to explore to grow further as a future NP?

Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .

Lili Ketema

Clinical Decision Support Systems

Pros	Cons
Patient Safety. Clinical Decision Support Systems empower Advanced Practice Nurses to make decisions in a timely and informed manner by detecting diseases early and managing them effectively (Ayed Aloufi, 2020). CDSS has reminder systems for medical events different from the ones related to medicine. For example, CDSS for measuring blood glucose in the ICU can decrease the frequency of hypoglycemia events (Sutton et al., 2020). This CDSS automatically prompts nurses to take glucose measurements with respect to the local glucose monitoring protocol that specifies particular patient demographics and previous glucose trends.	Overreliance. CDSS may increase patient safety but increase reliance on the system, resulting in a decrease in critical thinking capabilities since the APN does not feel impelled to utilize their clinical judgment capabilities. This development is undesirable because the APN becomes less equipped for a task that they can execute in the absence of a CDSS. Sutton et al. (2020) compare overreliance on CDSS to using a calculator in math; the authors indicate that the user’s mental math skills decline with extended use. Therefore, APNs may end up less equipped to execute the services they should execute with ease.
Improved Accuracy and Efficiency. CDSS can process significant quantities of patient data swiftly and precisely, empowering providers of care to effectively diagnose and plan for treatment (Ayed Aloufi, 2020). This decreases the possibility of errors by providing computerized consultation. The Diagnostic Decision Support Service provides data/user selections and then outputs a list of possible diagnoses (Sutton et al., 2020). These developments enhance EHR-integration as well as standardized vocabulary such as Snomed Clinical Terms.	System and Content Maintenance. Maintenance is an often neglected aspect of the lifecycle of the CDSS. Maintenance encompasses technical and content of the systems that power the CDSS. The applications and knowledge-base of the CDSS should always be apace with the shifting nature of clinical guidelines and medical practice. Failure to stay updated may limit the CDSS’ capacity to maintain the desired levels of accuracy and efficiency. Sutton et al. (2020) assert that even the healthcare institutions that are highly advanced experience challenges keep9ing abreast with keeping their systems updated due to the inevitability of changes in medical knowledge bases.
Cost Containment. The capacity of CDSS to decrease the length of stay for in-patients, provide clinical interventions, decrease test duplication, and suggest cheaper alternatives of medicine makes the systems more efficient (Sutton et al., 2020). For example, a CPOE-integrated has the capacity to limit the scheduling of blood count to a 24-hr interval when implemented in a paediatric cardiovascular intensive care unit. This laboratory resource utilization cost-reduction has a predictable cost discount of $717,538 every year, minus increasing mortality or length of stay. These advantages reveal the highly capabe nature of the CDSS to contain costs associated with hospital procedures and the overall ROI associated with CDSSs.	The system is predicated on computer literacy. Decreased proficiency in technology can be limiting when a person is engaging with CDSS. The high design details associated with CDSS may be exceedingly complicated, decreasing the capacity of some APNs to use them to reach the advantages associated with the implementation of the system within a hospital setting (Sutton et al., 2020). Although some systems stay as close to close functionality as possible, every new system has a learning period, meaning the baseline of the technological competence of users is appropriate. Further training for APNs increase on the costs that the institution was aiming at cutting in the first place.

Future role as an APN and clinical patient and scenario 

A 68 year old man who has a history of diabetes, hypertension, and chronic renal disease shows up at the clinic complaining of fatigue, increased thirst, and frequent urination. Since I feel the patient's symptoms might be brought on by uncontrolled diabetes, I have made the decision as a prospective APN healthcare professional to ask for a blood test to confirm the diagnosis.

Impact of CDSS: Before prescribing any new medications, the system alerts me about the patient's current medications, which include metformin and lisinopril. The CDSS also prompts  to consider the patient's renal status.

After noting the CDSS alert, I decide to review the patient's most recent lab results, particularly the estimated glomerular filtration rate (eGFR). The patient has substantial renal impairment, as seen by their eGFR, which is less than 30 mL/min/1.73m2, as I learned after examining the lab results.

In light of the CDSS alert and the patient's test results, I decide to alter the patient's prescription regimen. As opposed to providing a conventional oral anti-diabetic prescription like sulfonylureas, which may be contraindicated in patients with severe renal impairment, as APN i would consider alternate choices such insulin treatment or a newer family of anti-diabetic pharmaceuticals that are safe for patients with renal impairment.

Based on the patient's renal function and the medications they were taking at the time, the CDSS made recommendations. This let the medical practitioner make a more informed decision and avoid any side effects or drug interactions.

This scenario demonstrates how a CDSS might influence a provider's decision by providing timely reminders and cautions based on the patient's specific clinical data. It guarantees that the healthcare provider considers all relevant information and selects the best course of action for the patient's unique needs.

References

Ayed Aloufi, M. (2020). Effect of clinical decision support systems on quality of care by nurses. 
International Journal for Quality Research, 
14(3), 665–678. https://doi.org/10.24874/ijqr14.03-01

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: Benefits, risks, and strategies for Success. 
Npj Digital Medicine, 
3(1). https://doi.org/10.1038/s41746-020-0221-y

 

Conc of Pathophys Case Study 1

***This assignment utilizes TurnItIn.  When you submit this assignment to the assignment drop box, it will automatically be submitted to TurnItIn.  You will receive an Originality Score along with an Originality Report that should be carefully reviewed.  If revisions need to be made to your assignment, you will be able to make additional submissions, and you will quickly receive updated Originally feedback. 

Assignment Instructions: 

· Review the case study scenario below and the client's family history and medical profile information from unit 1.  

· Next, write a 6-8-page paper analysis of the client (including title and reference page) according to the assignment specifications, outline, and grading rubric. 

Case Study 1 Scenario:

Client, Sarah Collins, has chronic kidney disease. She receives dialysis twice a week. Today when Mrs. Collins arrives at the dialysis clinic, the nurse assesses Mrs. Collins and notes her blood pressure is 145/90 mm Hg and she has gained three pounds since her last visit. Mrs. Collins tells the nurse she was trying earlier to walk to her mailbox at the end of the driveway and couldn’t because she was out of breath. Mrs. Collins' husband and 16-year-old grandson are at the clinic with her. 

Case Study Analysis Assignment Outline: 

 The case study analysis paper should include the following sections with responses and rationales for all the prompts.

Introduction (3-5 paragraphs) 

Provide an overview of the pathophysiology of the disease exhibited by the client. Include: 

· What additional assessment findings would you look for? 

· What lab abnormalities would you expect to see? 

· What diagnostics would you anticipate the healthcare team ordering? 

· Provide a rationale for your answers. 

Implications for Self-Care (2 paragraphs) 

· Consider Maslow’s hierarchy of needs and describe where the client falls in that hierarchy and how this will impact care and healing.  

· How does this disease process impact the client’s and/or their care provider’s ability to care for themselves? 

Patient Education Strategy (2-3 paragraphs) 

· Identify 3-5 appropriate nursing interventions and teaching points for your client based on the pathophysiology and assessment findings. 

· Describe the educational strategies that should be incorporated when building a plan of care for your client. 

· Support with rationale. 

Interdisciplinary Collaboration (2-3 paragraphs) 

· Identify 2-4 interdisciplinary team members who need to be included in the care of the client. Include rationale. 

· Consider the care the client will need while inpatient and upon discharge.  

· Consider nutrition, community services, and financial implications. 

Conclusion 

· Summarize the key concepts of this disease process and client case study scenario.  

References 

· A minimum of three references should be used in this paper.  

· References should be no more than five years old. 
Exceptions include seminal works, such as original publications by nurse theorists.  

· One reference must be your textbook, 

· One reference must be from a peer-reviewed journal,  

· One reference must be from an authoritative website such as the CDC, NIH or Healthy People 2030.

Assignment Specifications: 

· Name the paper with a File Naming Protocol: When you save the paper, name it: LastName_NSG 3300_CaseStudyAnalysis_1.docx 

· Paper reflects clinical and professional client/cases, and no references to personal or family issues.

APA Formatting 

· All papers should be written in APA formatting. This paper should include: 

· Formal components, such as a title page, and APA formatting with an introductory and conclusion paragraph that summarizes the key concepts 

· APA-formatted 
level headings 

· APA margin, font, and paragraph spacing 

· Include page numbers 

· Appropriate in-text reference citations 

· A reference page, in correct APA format 

Present your approved intervention to the patient, family, or group and record a 10–15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Baccalaureate-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

For this assessment, you’ll present your approved intervention to the patient, family, or group and reflect on various aspects of your capstone practicum experience. Such reflection will give you a chance to discuss elements of the project of which you are most proud and aspects of the experience that will help you grow in your personal practice and nursing career.

Reference

Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos—An innovative and creative approach to assessment. 
Sciedu International Journal of Higher Education, 7(4).

Complete this assessment in two parts: (a) present your approved intervention to the patient, family, or group and (b) record a video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program.

Part 1

Present your approved intervention to the patient, family, or group. Plan to spend at least 3 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Be sure you've logged all of your practicum hours in Capella Academic Portal.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the
 BSN Practicum Campus page for more information and instructions on how to log your hours.

Use the 
Intervention Feedback Form: Assessment 5 [PDF]
 Download Intervention Feedback Form: Assessment 5 [PDF]as a guide to capturing patient, family, or group feedback about your intervention. You’ll include the feedback as part of your capstone reflection video.

Part 2

Record a 10–15 minute video reflection on your practicum experience, the development of

your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. A transcript of your video is not required.

You’re welcome to use any tools and software with which you are comfortable, but make sure you're able to submit the deliverable to your faculty. Capella offers Kaltura, a program that records audio and video. Refer to 
Using Kaltura for more information about this courseroom tool.

Note: If you require the use of assistive technology or alternative communication methods to participate in these activities, please contact 
[email protected] to request accommodations. If you’re unable to record a video, please contact your faculty as soon as possible to explore options for completing the assessment.

The assessment requirements, outlined below, correspond to the scoring guide criteria, so address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for supporting evidence.

· Assess the contribution of your intervention to patient or family satisfaction and quality of life.

· Describe feedback received from the patient, family, or group on your intervention as a solution to the problem.

· Explain how your intervention enhances the patient, family, or group experience.

· Describe your use of evidence and peer-reviewed literature to plan and implement your capstone project.

· Explain how the principles of evidence-based practice informed this aspect of your project.

· Assess the degree to which you successfully leveraged health care technology in your capstone project to improve outcomes or communication with the patient, family, or group.

· Identify opportunities to improve health care technology use in future practice.

· Explain how health policy influenced the planning and implementation of your capstone project, as well as any contributions your project made to policy development.

· Note specific observations related to the baccalaureate-prepared nurse's role in policy implementation and development.

· Explain whether capstone project outcomes matched your initial predictions

·

· Discuss the aspects of the project that met, exceeded, or fell short of your expectations.

· Discuss whether your intervention can, or will be, adopted as a best practice.

· Describe the generalizability of your intervention outside this particular setting.

· Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

· Assess your personal and professional growth throughout your capstone project and the RN-to-BSN program.

· Address your provision of ethical care and demonstration of professional standards.

· Identify specific growth areas of which you are most proud or in which you have taken particular satisfaction.

· Communicate professionally in a clear, audible, and well-organized video.

Additional Requirements

Cite at least three scholarly or authoritative sources to support your assertions. In addition to your reflection video, submit a separate APA-formatted reference list of your sources.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

· Competency 2: Make clinical and operational decisions based upon the best available evidence.

· Describe one's use of evidence and peer-reviewed literature to plan and implement a capstone project.

· Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.

· Explain whether capstone project outcomes matched one's initial predictions and documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Document the completion of nine hours of practicum time.

· Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.

· Assess the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group.

· Competency 5: Analyze the impact of health policy on quality and cost of care.

· Explain how health policy influenced the planning and implementation of one’s

·

· capstone project, as well as any contributions the project made to policy development.

· Competency 7: Implement patient-centered care to improve quality of care and the patient experience.

· Assess the contribution of an intervention to patient, family, or group satisfaction and quality of life.

· Competency 8: Integrate professional standards and values into practice.

· Assess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.

· Communicate professionally in a clear and well-organized video.