Week 3_METHODS USED IN QUANTITATIVE RESEARCH
Please review the complete instructions
Discussion Response to 2 posts
Mr. Nguyen is a 58-year-old patient that had septic shock and developed Acute Respiratory Distress Syndrome. He is orally intubated and on a mechanical ventilator. He is paralyzed and sedated.
- What manifestations might you observe for a patient with ARDS?
- What complications can Mr. Nguyen develop from being mechanically ventilated?
- List priority nursing interventions to prevent complications associated with ventilatory support.
- What interventions can be implemented specifically to prevent the development of Ventilator Acquired Pneumonia (VAP)?
- You are orienting in the ICU, the nurse you are working with is not implementing the VAP interventions. What would you do?
Initial Post 1:(A.T)
Severe respiratory distress and low oxygenation are characterizations of ARDS. Manifestations of ARDS include severe dyspnea (difficulty breathing), shallow, rapid breathing, Low oxygen concentrations or hypoxemia, cyanosis (bluish lips or skin as a result of low oxygen levels), reduced lung compliance, increased effort of breathing, bilateral infiltrates seen on the X-ray of the chest, altered mental state as a result of hypoxia. A number of complications can develop for Mr. Nguyen from being on mechanical ventilation, such as ventilator-associated pneumonia (VAP), oxygen toxicity, ventilator-induced lung injury (VILI), barotrauma (high airway pressure-induced lung damage), and ventilator-associated events (VAEs). Priority nursing interventions to prevent complications with ventilatory support include regular evaluation of Mr. Nguyen’s respiratory condition, to avoid self-extubation and lessen agitation continue to administer appropriate sedation and analgesics, keep an eye on and maintain the proper ventilator alarm settings, changing positions frequently to avoid pressure sores and atelectasis, oral hygiene to stop VAP, ensure appropriate ventilation circuit and endotracheal tube hygiene, trials of weaning to evaluate preparedness for extraction. The following are some interventions to avoid ventilator-associated pneumonia (VAP): To lessen the chance of aspiration, raise the bed’s head to a position between 30 and 45 degrees. using chlorhexidine for oral hygiene to stop the growth of microorganisms, routine evaluation of endotracheal tube (ETT) suctioning requirements, To reduce contamination, use a closed suctioning system. To avoid microaspiration, the ETT cuff pressure should be regularly assessed. Reduce the amount of time that patients need mechanical ventilation by using a sedative strategy. Sedation vacations are interrupted every day to evaluate preparation for extubation. It would be imperative to take immediate action if I saw an ICU nurse failing to apply VAP preventative treatments. I would document the circumstance and your activities for my charge nurse or unit manager and If the problem persists, I would talk to my nurse manager or supervisor to make sure that best practices and procedures are followed and maybe consider reeducation for the nurse. In the ICU, patient safety is the top priority.
Initial Post 2:(B.M.)
Acute Respiratory Distress Syndrome, or ARDS, is a dangerous lung condition that can develop in people who are critically ill and necessitates frequent mechanical ventilation to maintain breathing. One of the symptoms of ARDS identified in Mr. Nguyen was a cluster of respiratory and systemic symptoms. The underlying lung tissue injury and inflammation that obstruct the lungs’ ability to exchange oxygen and carbon dioxide are reflected in these signs and symptoms. Extreme shortness of breath, rapid breathing (tachypnea), cyanosis (bluish skin color), restlessness, fatigue, decreased urine output, tachycardia, low blood pressure (hypotension), and altered mental status are a few of the main symptoms.
When caring for critically ill patients, nurses must consider the potential difficulties of mechanical ventilation, as in Mr. Nguyen’s case. The process of mechanical ventilation requires placing a tube in the patient’s airway in order to deliver oxygen and remove carbon dioxide. Even while treatment can save lives, there are risks and a chance of problems. Ventilator-associated pneumonia (VAP), barotrauma (high air pressure lung damage), ventilator-associated lung injury (VALI), ventilator-associated events (VAE), pressure ulcers, cuff-related tracheal injury, sedation-related complications (such as excessive sedation or inadequate pain management), and infection at the site of the endotracheal tube insertion are a few potential side effects of mechanical ventilation.
Priority nursing interventions include regular evaluations of the patient’s vital signs, oxygen saturation, and respiratory status to gauge how they are responding to mechanical ventilation. Maintaining proper ventilation settings and keeping an eye out for signs of high or low airway pressures are necessary to prevent lung injury and maximize respiratory assistance. The patient must be moved frequently to lessen the chance of pressure sores and to improve lung expansion, which may be compromised in ARDS patients. Regular sedation intervals and assessments of extubating readiness are necessary to avoid prolonged artificial breathing and reduce the risk of sedation-related issues.
In order to prevent the emergence of Ventilator-associated Pneumonia (VAP), nurses should implement specific measures. Among them are regular suctioning of the endotracheal tube to remove secretions and reduce the risk of aspiration, maintaining proper positioning of the endotracheal tube to prevent micro aspiration of gastric contents, and routine oral hygiene using antiseptics to lessen bacterial colonization in the oropharynx. Raising the head of the bed by at least 30 degrees can prevent aspiration, and closely following infection control protocols such hand hygiene and sterile procedures lowers the risk of infection.
While orienting in the ICU, if I see a nurse not using VAP treatments, I would do the following:
I would speak to the nurse politely and respectfully to express my worries on the lack of VAP interventions. I want to underline how important VAP prevention is for patient safety and outcomes, and how it is our responsibility to adhere to best practices in the ICU.I would share my knowledge and understanding of the importance of VAP prevention, emphasizing how it may significantly impact patient recovery and minimize the likelihood of issues. I would give the nurse the tools and knowledge she needs to carry out the VAP interventions, or I would volunteer to help her. Accurate documentation is essential for maintaining a culture of cooperation and stability in our healthcare system and delivering high-quality care to our patients.
Nursing Assignment
Week 2 Ethical Health Promotion Paper
Find a scholarly, peer-reviewed article no more than four years old that discusses an ethical health promotion-related issue.
In your paper:
· Briefly summarize the presented issue.
· Describe your thoughts on the role health care professionals should play in resolving the ethical issue.
· Provide specific theories and refer to specific ethical codes to support your position.
Your paper should be 2–3 pages long. Use APA to cite and reference the article and any other optional sources you use. Adhere to APA formatting throughout your paper.
Rubric
NURS_561_DE – Paper/Essay Rubric
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NURS_561_DE – Paper/Essay Rubric |
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Criteria |
Ratings |
Pts |
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This criterion is linked to a Learning OutcomeContent |
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40 pts |
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This criterion is linked to a Learning OutcomeFocus and Detail |
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30 pts |
|||
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This criterion is linked to a Learning OutcomeOrganization |
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20 pts |
|||
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This criterion is linked to a Learning OutcomeMechanics and APA |
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10 pts |
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Total Points: 100 |
part 3 work
part 3 work
Nursing Assignment
Week 2 Ethical Health Promotion Paper
Find a scholarly, peer-reviewed article no more than four years old that discusses an ethical health promotion-related issue.
In your paper:
· Briefly summarize the presented issue.
· Describe your thoughts on the role health care professionals should play in resolving the ethical issue.
· Provide specific theories and refer to specific ethical codes to support your position.
Your paper should be 2–3 pages long. Use APA to cite and reference the article and any other optional sources you use. Adhere to APA formatting throughout your paper.
Rubric
NURS_561_DE – Paper/Essay Rubric
|
NURS_561_DE – Paper/Essay Rubric |
|||||
|
Criteria |
Ratings |
Pts |
|||
|
This criterion is linked to a Learning OutcomeContent |
|
40 pts |
|||
|
This criterion is linked to a Learning OutcomeFocus and Detail |
|
30 pts |
|||
|
This criterion is linked to a Learning OutcomeOrganization |
|
20 pts |
|||
|
This criterion is linked to a Learning OutcomeMechanics and APA |
|
10 pts |
|||
|
Total Points: 100 |
evidence based
NUR640 Week 3 Assignment 3.1 Page 1
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Assignment Title: Sampling Methods
Step 3 for your Evidence-Based Practice Mini-Project (Research Proposal)
Assignment Overview:
For your Research Proposal Step 3, you will submit your target population listed and a clearly stated and though description of your study population with scholarly sources. There is a sampling plan that identifies the sampling method. There is a clear and thorough description of the sample. There is a precise procedure detailing how participants will be selected. There is a thorough description of the research setting, and a detailed description of the recruitment plan. There is a clear and thorough description of all ethical considerations related to your mini-research project.
Deliverables:
The final copy of your Step 3 Research Proposal assignment is on or before Sunday at 11:59pm just before Week 4 begins at the latest. Be sure to use the file naming protocol: NUR640_EBP Step 3_last name_mmddyyyy.
Assignment Details:
For this assignment, you will write part of Step 3 of your Research Proposal. Use the discernment gained from your Human Subjects Certificate Discussion Board regarding ethical considerations for your own EBP Proposal.
Sampling Plan: Describe your sampling plan that identifies the sampling method you will utilize. Describe your sample in detail.
Research Setting: Describe your research setting. For example, is your setting where you work?
Recruitment Plan: Describe your recruitment plan in detail.
Ethical Considerations: Describe whether your EBP Proposal could go through an expedited IRB approval. Why or why not?
Note: In your Step 3 state what instrument you will be using for your EBP proposal.
Grading: Each part of your EBI proposal has a grading rubric. All submissions should have a title page and reference page. Each Step of the EBP Proposal will then be added together in Week 5 assignment which will be graded again based on a new rubric that includes your best revision based on weekly instructor detailed feedback. Points will be lost if suggestions are not incorporated into the final Week 5 Submission of your EBP Proposal. (See Week 5 Assignment rubric).
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Discussion Post
What do you think nursing contributes to health care? How can a robotic system incorporate the clinical judgment that nurses use? Be as creative as you wish!
If you can, listen to the following audio clip from National Nurses United’s “Insist on a Registered Nurse” campaign:
https://soundcloud.com/national-nurses-united/radio-ad-robocare
While this is an attempt at humor about a serious situation, it drives a fundamental question: What would health care be without nurses?
Minimum of 250 words.
Nursing
To Prepare:
- Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
- Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
- Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
reply
Post an explanation of how you anticipate enacting personal and professional commitment for advocacy to positively impact your patients, communities, and the profession. Be specific. Then, explain how your role as a DNP-prepared nurse contributes to advocacy for positive social change.
1.
My personal and professional commitment to advocacy includes both short and long-term goals within the nursing profession. From a professional standpoint, I am afforded the opportunity to offer input on ways to continuously improve the patient care experience and care delivery. Providing feedback offered directly from patients as well as discussing barriers I experience as a prescriber, including but not limited to coordination with other members of the care team or barriers within technology, will be at the forefront. Openly discussing setbacks provides the opportunity to brainstorm improvements, ultimately improving patient care outcomes.
Personal commitments to the nursing profession and patient advocacy include the accountability to remaining current within my knowledge of medications and therapies available to treat the mental health population. The formal education provided within the Doctor of Nursing practice (DNP) program provides the structure and skills needed to employ within professional practice. These skills ensuring that the DNP is seeking out and utilizing quality, evidence-based measures to treat patients with interventions supported by adequate science and research (American Association of Colleges of Nursing, 2006). Networking with other mental health professionals both within the nursing field and in other capacities will also expand and enact my commitment to patient advocacy and social change. Learning from other professionals, hearing their perspectives on current events, and in exchange offering my perspective will offer a broad view of treatment approaches and current topics (Hann et al., 2020).
The Doctor of Nursing as a Social Change Agent
As a DNP, I would like to employ my skills as a social change agent by engaging in educational opportunities within the mental health community, driven by research opportunities. Engaging in the research that guides evidence-based practices improves outcomes for the millions of patients impacted by care delivery and would exercise the practice-based research skills formed in DNP education (Iwama et al., 2023). Utilizing the terminal DNP degree to its utmost while continuing to engage in patient care would combine the aspects I found most rewarding of my MSN-PMHNP career and the completion of the DNP program. Advocating for improved treatment measures within the mental health community, as well as for increased access to appropriate care and diagnostic assessments, are all ways in which I would like to engage in DNP research opportunities. Providing education, facts, and data related to how patients are impacted by lack of access to specialized psychiatric care due to barriers such as telehealth restrictions and lack of full practice authority for nurse practitioners will continue to increase awareness of these topics and lobby for change. The DNP offers specialized insight into these topics as a professional working not only for but within the field, and holds significant weight when discussing these topics with both other professionals as well as non-professionals.
References
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Hann, K., Heather Pearson, Campbell, D., Sesay, D., & Eaton, J. (2020). Factors for success in mental health advocacy. Global Health Action, 8(0), 1–9. https://doi.org/10.3402/gha.v8.28791
Iwama, K., Travis, A., Nowlin, S., Souffront, K., Finlayson, C., Gorbenko, K., & Cohen, B. (2023). Barriers, facilitators, and opportunities for Doctor of Nursing Practice engagement in translational research. Nursing Outlook, 71(5). https://doi.org/10.1016/j.outlook.2023.102031In the nursing profession, advocating for our patients is something that is deeply ingrained in us. One of the five key areas of the social determinants of health is access to healthcare (Centers for Disease Control and Prevention, 2021). Unfortunately, approximately one in ten patients do not have health insurance (Berchick et al., 2018). In the field of mental health, we often see patients who are too disorganized to navigate the health insurance system and experience lapses in insurance. In Massachusetts, we are required to abide by the Expedited Psychiatric Inpatient Admissions (EPIA) Policy, which mandates that “no individual boarding in an ED waiting placement in a psychiatric hospital will wait more than 96 hours before Department of Mental Health has been notified, regardless of whether the individual is uninsured or has coverage not regulated by Division of Insurance” (Executive Office of Health and Human Services, 2023). The pressure to decompress emergency rooms and move psychiatric patients out as quickly as possible means that we often receive patients who are uninsured. In order to help our patients get the services they need, nurses and social workers assist our patients in taking the necessary steps to obtain health insurance. This often means lengthy phone wait times on phone calls, but as advocates, we do what is necessary to ensure positive outcomes for our patients.
Advocacy in my Community
As an agent of positive change, I will advocate at the community level for residents who suffer from mental illness. In spite of the “growing recognition of the burden associated with mental illnesses and the availability of cost-effective treatments, they are not yet afforded the same policy or program priority as comparably disabling physical conditions” (Stuart, 2017). I aim to increase access to mental health services by expanding my organization’s service lines to include outpatient services for mental health and substance use disorders. In order to gain buy-in from the community, I plan to attend town meetings to advocate for increased services as well as partnering with local Emergency Departments to educate them about the mental health services that my organization offers. I plan to seek meetings with local politicians to advocate that resources be invested into increasing services for mental health and substance use disorder services.
Advocacy in my Profession
According to a recent survey conducted by the American Psychiatric Nurses Association (APNA), “only 4% of licensed registered nurses (RNs) work in psychiatric-mental health, If that percentage is still consistent, then there are approximately 154,000 RNs working in psychiatric-mental health, which is not nearly enough to meet the demand” (APNA, 2018). As a doctorally prepared nurse, it is critical that I take steps now to increase the number of nurses who specialize in mental health. I aim to do this on the local level by partnering with local nursing schools to invite them into my organization for their psychiatric clinical rotations. Additionally, I will attend local universities’ career fairs so that I can provide information to nursing students about the advantages of working in the field of mental health.
Advocacy and Social Change
As a doctorally prepared nurse, I aim to help close the gaps in the inequities of access in the field of mental health. To do so, I must first identify opportunities to advocate for my own patients by assisting them in obtaining health insurance so that they are able to have access to outpatient services. At the community level, I aim to increase access to mental health services by expanding my organization’s service lines to include more outpatient services for psychiatry and substance use disorders. With regard to the profession of nursing, specifically psychiatric nursing, it is imperative that I identify ways to increase interest for newly graduated RNs to join the field by promoting the field at local nursing schools. By acting as an advocate on all three levels, I will be able to effect positive social change in the field of psychiatric nursing.
References
American Psychiatric Nurses Association. (2018). Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey. https://journals.sagepub.com/doi/abs/10.1177/1078390318777873?journalCode=japa
Berchick, E.R., Hood, E., & Barnett, J.C. (2018). Health Insurance Coverage in the United States: 2017. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2018/demo/p60-264.pdfLinks to an external site. [PDF – 1.4 MB]
Centers for Disease Control and Prevention. (2021). Social determinants of health: Know what affects health. https://www.cdc.gov/socialdeterminants/index.htmLinks to an external site.
Executive Office of Health and Human Services. (2023). Expedited Psychiatric Inpatient Admissions (EPIA) Policy. https://www.mass.gov/info-details/expedited-psychiatric-inpatient-admissions-epia-policyLinks to an external site.
Stuart, H. (2017). Reducing the Stigma of Mental Illness. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314742/
2.
My personal and professional commitment to advocacy includes both short and long-term goals within the nursing profession. From a professional standpoint, I am afforded the opportunity to offer input on ways to continuously improve the patient care experience and care delivery. Providing feedback offered directly from patients as well as discussing barriers I experience as a prescriber, including but not limited to coordination with other members of the care team or barriers within technology, will be at the forefront. Openly discussing setbacks provides the opportunity to brainstorm improvements, ultimately improving patient care outcomes.
Personal commitments to the nursing profession and patient advocacy include the accountability to remaining current within my knowledge of medications and therapies available to treat the mental health population. The formal education provided within the Doctor of Nursing practice (DNP) program provides the structure and skills needed to employ within professional practice. These skills ensuring that the DNP is seeking out and utilizing quality, evidence-based measures to treat patients with interventions supported by adequate science and research (American Association of Colleges of Nursing, 2006). Networking with other mental health professionals both within the nursing field and in other capacities will also expand and enact my commitment to patient advocacy and social change. Learning from other professionals, hearing their perspectives on current events, and in exchange offering my perspective will offer a broad view of treatment approaches and current topics (Hann et al., 2020).
The Doctor of Nursing as a Social Change Agent
As a DNP, I would like to employ my skills as a social change agent by engaging in educational opportunities within the mental health community, driven by research opportunities. Engaging in the research that guides evidence-based practices improves outcomes for the millions of patients impacted by care delivery and would exercise the practice-based research skills formed in DNP education (Iwama et al., 2023). Utilizing the terminal DNP degree to its utmost while continuing to engage in patient care would combine the aspects I found most rewarding of my MSN-PMHNP career and the completion of the DNP program. Advocating for improved treatment measures within the mental health community, as well as for increased access to appropriate care and diagnostic assessments, are all ways in which I would like to engage in DNP research opportunities. Providing education, facts, and data related to how patients are impacted by lack of access to specialized psychiatric care due to barriers such as telehealth restrictions and lack of full practice authority for nurse practitioners will continue to increase awareness of these topics and lobby for change. The DNP offers specialized insight into these topics as a professional working not only for but within the field, and holds significant weight when discussing these topics with both other professionals as well as non-professionals.
References
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Hann, K., Heather Pearson, Campbell, D., Sesay, D., & Eaton, J. (2020). Factors for success in mental health advocacy. Global Health Action, 8(0), 1–9. https://doi.org/10.3402/gha.v8.28791
Iwama, K., Travis, A., Nowlin, S., Souffront, K., Finlayson, C., Gorbenko, K., & Cohen, B. (2023). Barriers, facilitators, and opportunities for Doctor of Nursing Practice engagement in translational research. Nursing Outlook, 71(5). https://doi.org/10.1016/j.outlook.2023.102031
Reflection Journal – Health assessement
Reflect on your laboratory experience. How Can nurses include the community population and interprofessional? collaboration to advance health equity? Provide one example.
We Accept
