Health

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Is the magic pill documentary’s by Peter Attia  description of the current food industry accurate? Research at least one other authoritative source that is external to the documentary to defend your answer. Be sure to fully and properly cite your source of information. 

Are the recommendations made by the American Heart Association and the National Institute of Health based on biased research? Find at least one other authoritative source that is external to the documentary to defend your answer.



please review

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 paragraph

Lymphadenitis

Phlebitis

Myocardial infarction

Cardiac arrest

Deep venous thrombosis

 

  • Your assignment will be run through TurnItIn to check for plagiarism. 

WORKPLACE ENVIRONMENT ASSESSMENT

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Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.

In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.

To Prepare:

  • Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
  • Review the Work Environment Assessment Template*.
  • Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
  • Select and review one or more of the following articles found in the Resources:
    • Clark, Olender, Cardoni, and Kenski (2011)
    • Clark (2018)
    • Clark (2015)
    • Griffin and Clark (2014)

*Template completed in the Week 7 discussion should not be submitted with this assignment.

The Assignment (3-6 pages total):

Part 1: Work Environment Assessment (1-2 pages)

  • Review the Work Environment Assessment Template you completed for this Module’s Discussion.
  • Describe the results of the Work Environment Assessment you completed on your workplace.
  • Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
  • Explain what the results of the Assessment suggest about the health and civility of your workplace.

Part 2: Reviewing the Literature (1-2 pages)

  • Briefly describe the theory or concept presented in the article(s) you selected.
  • Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
  • Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.

Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)

  • Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
  • Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.

Nursing Homework

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Purpose

The Topic Search Strategy paper is the first of three related assignments. The purpose of this initial paper is to briefly describe your search strategies when identifying two articles that pertain to an evidence-based practice topic of interest.

Course outcomes: This assignment enables the student to meet the following course outcomes.

1. Examine the sources of knowledge that contribute to professional nursing practice. (PO 7)

2. Apply research principles to the interpretation of the content of published research studies. (POs 4 and 8)

Preparing the assignment:

Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

a. Paper should be 3-4 content pages in length. Title and reference pages are required but are excluded from 3-4 -page length.

2) The paper will include the following sections:

a. Clinical Question

· Describe the problem. What is the focus of your work?

· Explain the significance of the problem in terms of patient outcomes. What health outcomes result from your problem? Or what statistics document this is a problem? You may find support on websites for government or professional organizations.

· PICOT question in support of the group topic.

· State the purpose of your paper. What will your paper do or describe? This is like a problem

statement. “The purpose of this paper is to . . .”

b. Levels of Evidence

· Identify the type of question being asked (therapy, prognosis, meaning, etc.).

· What is the best type of evidence to answer that question (e.g., RCT, cohort study, qualitative study, etc.)?

c. Search Strategy

· List search terms and results.

· Databases used (start with the CU library). Link your search with the PICOT question described above.

· Refinement decisions. As you did your search, what decisions did you make in refinement to get your required articles down to a reasonable number for review? Were any limits used? If so, what?

· Identification of two (2) most relevant articles (primary sources published within the last 5 years).

d. Format

· Correct grammar and spelling.

· Include a title page.

· Use of headings for each section.

· Clinical Question, Levels of Evidence, Search Strategy, and Conclusion

· Adheres to current APA formatting and guidelines.

· 3-4 pages in length, excluding title and reference pages.

NR449 Evidence-Based Practice

RUA: Topic Search Strategy Guidelines

NR449 Evidence-Based Practice

RUA: Topic Search Strategy Guidelines

© 2023 Chamberlain University. All Rights Reserved

NR449_RUA_Topic_Search_Strategy_NOV23 1

© 2023 Chamberlain University. All Rights Reserved

NR449_RUA_Topic_Search_Strategy_NOV23 1

© 2023 Chamberlain University. All Rights Reserved

NR449_RUA_Topic_Search_Strategy_NOV23 1

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Reflection Scenario Template

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 1) Watch the entire scenario. In the scenario assignment, you are asked to reflect on responses to the presented scenario. 

2) Fill out the template attached below

3) Compose the last question on the template reflection in a Word document and be sure to address, at a minimum, the following questions:

*Why do you feel the way you do about the issue presented?

*Of the four responses offered in the scenario, which do you think is the most ethical and why?

*Which ethical theory would you use to support your stance? Why does this theory work?

4)  Support your conclusions with evidence and specific examples from the textbook, including a minimum of one theory of ethics to defend your stance.

m3 discussion

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Discussion(M3)

Watch one of these films and  then discuss anyone of these “dying and death” representations as  presented in movies or plays such as:

  • Bringing Out the Dead
  • Angela’s Ashes
  • Beaches
  • Philadelphia
  • Terms of Endearment
  • Wit
  • Evan Mayday’s Good Death

Address the following questions if pertinent to the film you watched:

  • What were the causes of death?
  • Where did people die?
  • Who cared for the dying?
  • Who was present at the time of death?
  • How did the significant other person respond?
  • How did the community respond?
  • What expectations or beliefs were associated with dying and death?
  • How did people cope with loss?

Envision  yourself as one of the characters in the film, and, according to their  personal or professional (eg. the nurse in: “WIT”) expectations about  death:

  • Dying well
  • Bad death
  • Good death
  • Sad death

reply

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I was really surprised by my results from the essential self-assessment the 2nd time around. I made sure not to look at the 1st one before I completed it. My score was initially 36 and now is 46. I had significantly more excellent than the very good column than before. Two areas that I have learned a great deal in. I have a better understanding of the use of CIS systems to document interventions related to achieving nurse sensitive outcomes. I also recognize the role that information technology plays in improving patient care outcomes and creating a safe care environment.

Understanding the difference between a CIS system and an EHR is important to understand how each work. Knowing now that a CIS system focuses on management of clinical data and information that allows practitioners and patients to use the date. CIS systems provide the infrastructure to bring all applications together.  The goal of an EHR system is to improve quality and safety of patient care by benefits of improved accuracy and completeness of patient health information.   

“Information technology is the process of searching, organizing and managing data supported by the use of computers” (Hebda et al., 2018). With the use of science to support the use of technology in healthcare, our patients can have safer and better outcomes in care.

As I continue my nursing career, I will use the knowledge I have learned to help provide the best care to my patients. I currently use the CIS system at my current position. But now understanding its use better, I plan to help educate my patients on the ability for them to create an account to manage their health. By receiving recent lab results, vital signs, and physician notes on after care summaries, patients can take better control of their health. They can also use the system to make future Dr. appointments and chat with the practitioners. Using information technology has been something my hospital continues to grow on. I will use information technology more to identify areas in our practice that can benefit from updating our nursing practice. Using our charting system, I can identify areas that nursing practice may be lacking such as IV start success rates. “Technology aids the nurse in the collections, analysis and application of data for decision making” (Chamberlain Lesson 8, 2023) By researching, analyzing, and applying what I’ve learned, I can help our nursing staff enhance performance in delivering of safe patient care.

 

Resources:

Chamberlian University. (2023, September).
Week 8 Lesson: Informatics as a specialty [Lecture Notes].

Week 8: Lesson: Informatics as a Specialty: RN Information Systems in Healthcare-Wells-Kersbergen (instructure.com)

 

Hebda, T., Hunter, K., & Czar, P. (2018). Handbook of Informatics for Nurses & Healthcare Professionals (6th ed.). Pearson Learning Solutions.

https://ambassadored.vitalsource.com/books/9781323903148

Implementing Evidence in Clinical

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Please see the attachment for instructions

DISCUSSION: PATIENT PREFERENCES AND DECISION MAKING

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DISCUSSION: PATIENT PREFERENCES AND DECISION MAKING

Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.

What has your experience been with patient involvement in treatment or healthcare decisions?

In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.

To Prepare:

· Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.

· Review the Ottawa Hospital Research Institute's Decision Aids Inventory at 
https://decisionaid.ohri.ca/Links to an external site..

· Choose “For Specific Conditions,” then 
Browse an alphabetical listing of decision aids by health topic.

· After you have chosen a topic (or condition) and a decision aid, consider if 
social determinants of healthLinks to an external site. were considered in the treatment plan Social determinants of health can affect a patient's decision as these are conditions in the patient's environment, such as economic stability, education access, health care access and quality, neighborhood, and social and community context.

·
NOTE: To ensure compliance with HIPAA rules, please 
DO NOT use the patient's real name or any information that might identify the patient or organization/practice.

Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, 
social determinants of health
Links to an external site.
, and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.

(Please Note: The underlined “social determinants of health” in the above content is meant to hotlink to the following Walden webpage and content:

Social Determinants of Health – Social Determinants of Health – Academic Guides at Walden 
Links to an external site.

University)

LEARNING RESOURCES


Required Readings

· Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). 

The connection between evidence-based medicine and shared decision makingLinks to an external site.
. 
Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186

· Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). 

Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statementLinks to an external site.
. 
Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396

· Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). 

Measuring return on investment for professional development activities: Implications for practiceLinks to an external site.
. 
Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483

· Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). 

Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision makingLinks to an external site.
. 
Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.xThe Ottawa Hospital Research Institute. (2019). 

Patient decision aidsLinks to an external site.
. Retrieved from https://decisionaid.ohri.ca/

case study week 9

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Examine 
Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Case

BACKGROUND

Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.

The parents give the PMHNP a copy of a form titled 
“Conner’s Teacher Rating Scale-Revised”. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work.

Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father.

SUBJECTIVE

Katie reports that she doesn’t know what the “big deal” is. She states that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”. She admits that her mind does wander during class to things that she thinks of as more fun. “Sometimes” Katie reports “I will just be thinking about nothing and the teacher will call my name and I don’t know what they were talking about.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time.

MENTAL STATUS EXAM

The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation.

Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation

RESOURCES

§ Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners' Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.

Decision Point One

Begin Wellbutrin (bupropion) XL 150 mg orally daily

RESULTS OF DECISION POINT ONE

·  Client returns to clinic in four weeks

·  Katie’s parents inform you that they stopped giving Katie the medication because about 2 weeks into the prescription, Katie told her parents that she was thinking about hurting herself. This scared the parents, but they didn’t want to “bother you” by calling the office, so they felt that it would be best to just stop the medication as they would be seeing you in two weeks

Decision Point Two

Educate the parents that Bupropion sometimes causes suicidal ideation in children and that this is normal, and re-start the drug at the previous dose

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Katie's parents again report that after about a week of treatment with the Bupropion, Katie began telling her parents that she wanted to hurt herself and began having dreams about being dead. This scared her parents, and they stopped giving her the medication At this point, they are quite upset with the results of their daughter’s treatment and are convinced that medication is not the answer

Decision Point Three

Refer the parents to a pediatric psychologist who can use behavioral therapy to treat Katie’s ADHD.

Guidance to Student

Bupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant.

At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie.

In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues.

The PMHNP should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow the PMHNP to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

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