W5 R see attachment

/in /by

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

 

Pathophysiology week 1 Discussion

/in /by

 

Scenario: 

An 83-year-old resident of a skilled nursing facility presents to the emergency department with generalized edema of extremities and abdomen. History obtained from staff reveals the patient has a history of malabsorption syndrome and difficulty eating due to a lack of dentures. The patient has been diagnosed with protein malnutrition.

The role genetics plays in the disease.

  • Why the patient is presenting with the specific symptoms described.
  • The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
  • The cells that are involved in this process.
  • How another characteristic (e.g., gender, genetics) would change your response.

What might be a characteristic influencing your response?

The scenario reflects this to be an unidentified race, so if this patient was African American would this create characteristics influenced by race? It may or may not just support your point with a citation. 

In this elderly female, there are several contributing factors for her presenting with these symptoms.

If you do not find any genetic factors contributing, provide a citation supporting this. As a student, be sure to support your points until you become the expert.

W4 os

/in /by

 

Using the theory of unpleasant symptoms as a guide, what would you look for in an assessment tool for patient symptoms?

Analyis of social determinants of health

/in /by

What is the best way to analyze social determinants of health on population

Foundations and Essentials for the Doctor of Nursing Practice

/in /by

LOCATING AND CRITICALLY ANALYZING PRIMARY RESEARCH ARTICLES

What steps do you take to locate primary and peer-reviewed research articles when performing a literature search?

What resources are available to you to engage in a meaningful and successful literature search?

As you have explored throughout this course, Walden University provides vast resources for student support to ensure success in their academic program of study. When it comes to research and using Library resources, several support mechanisms are available to you as well.

Taking the first step to think about a research topic or area of interest and filtering that topic using a series of keywords and operations will be a fundamental component for performing a literature search in Walden Library’s databases. While the ultimate goal is to produce a set or results that match your search criteria, you must keep in mind that that the quality of the research articles obtained will likely vary. Thus, you must critically examine and analyze the aims of the research produced and how it aligns, confirms, or negates your topic or area of research. As you develop proficiency in this area, you will discover that you can extract content themes and frameworks to enhance future research and the need to identify additional research support.

For this Assignment, consult the Walden Library webinars and resources provided. These resources serve as a general good first step for performing literature searches and engaging with the databases of research available to you. Think about a research topic or area of interest to focus on for this Assignment. Then, search the Walden Library to locate and retrieve peer-reviewed research articles that pertain to your topic or area of interest. 

 locate three peer-reviewed primary research articles that pertain to your practice area (Mental Health) and are of particular interest to you.

THE ASSIGNMENT: (6 PARAGRAPHS)

Write a 6-paragraph APA-formatted paper in which you do the following:

· Write a 1-pararaph introduction of how you conducted your literature search and the databases consulted in your search in relation to your practice area or area of interest. Be specific and provide examples.

· Write a 1-paragraph summary of each of the articles you have selected (a total of 3 paragraphs).

· Write 1 paragraph that 
synthesizes the three articles using a scholarly voice.

· Write a final paragraph in which you discuss the differences between summarizing and synthesizing research. Be specific and provide examples.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. 

discussion

/in /by

 Dear Students, Health information is data related to medical history.

Health information records include history, lab results, diagnostic information, and notes. It creates data sets that are used for individuals and populations.

Questions:

When thinking about Health Care information and HIT, autonomy is often an ethical issue. What concerns would patients have about their privacy with electronic health records.
How is beneficence and non-maleficence violated with ransomware?

Rubrics:

APA style 7th edition format
Submit it as word document attachments.
Presentation and references pages are required. 

turinitin proof 

Concept Map

/in /by

Module 09 Written Assignment – Concept Map

Top of Form

Bottom of Form

Module 09 Content

Top of Form

In a Word document, develop your own career mapping concept map (which highlights your own stages of progression). Your concept map should include and identify future stages of your nursing career progression, as well.

Be sure to address the following in your concept map:

· Educational status

· Training

· Experience present and future

· Work setting

· Nursing level of practice

· Associations

· Certifications

· Community activities

· Mentoring

· Certifications

Bottom of Form

Cap: 2 and 3 (4900)

/in /by

Assessment 2 (5 -7 pages)

Assessment 3 ( 5-7 pages)

Health Promotion Plan

/in /by

Health Promotion Plan – Template

Complete the following template to outline your Patient Education Brochure that you will create later in the course.

Student Name:

PART I: IDENTIFYING A SHORT-TERM GOAL AND THEORY / MODEL

Title of your patient education brochure

Topic you selected from Healthy People 2030

Objective you selected from Healthy People 2030

Target population for your brochure

Short-term goal for what the reader can accomplish from reading your brochure

Behavioral Change Theory or model you will use to guide the development of your brochure

Continue to the next page to complete Parts II and III.

PART II: OUTLINING OBJECTIVES AND CONTENT FOR YOUR BROCHURE

Learning Objectives

Write 3 SMART objectives below.

Level of Prevention

Identify the level of prevention relevant to the objective.

Rationale

Provide a detailed rationale for each objective supported with evidence. Include in-text citations.

Outline

Provide a detailed outline of the content you will include in your brochure to help the reader achieve this objective.

Evaluation

Plan an evaluation strategy for each objective supported with evidence. Include in-text citations.

PART III: REFERENCES

Include APA-formatted references below for the scholarly or professional sources you used to support your rationales and evaluation strategies.

Nursing

/in /by

Clinical Case Report

Part 2: Case Description and Conceptualization

Part 2 of the clinical case report assignment should be in APA style (title page,

references, etc. but does not require an abstract). This part of the case report will likely

be 6-7 pages, without references. It should include:

(1) The case, with provisional diagnoses (already completed for the paper proposal but

likely modified based on my feedback and any other client information you find helpful in

conceptualization below). See above for guidelines about an effective case. (around 2

pages)

(2) A case conceptualization, to include risk and maintenance factors in the client's

diagnosis(es): (around 4-5 pages)

(2a) Should include a range of etiological factors, based on class readings and

discussions (i.e., cognitive model, memory, emotion, neurobiology,

social/contextual factors),

(2b) These etiological factors should be tied specifically to the case description

(that is, don't speak only generally of risk factors, but how this manifests for the

particular client). In some places (e.g., neurobiology), you may need to use some

conjecture, based on the literature. That is OK. However, your case should

include sufficient detail to be able to relate several risk factors to the

conceptualization.

(2c) Should include discussion of risk factors for, AND maintenance of, PTSD

and/or related symptoms

(2d) Should be integrative, as all risk and maintenance factors intersect (e.g.,

environment affects biology, social context influences both; don't just list

etiological factors)

(2e) Should consider culture and intersectionality of client.

(2f) Should include references to literature (in APA style). NOTE: Please avoid

excessive use of quoted text, instead summarizing/paraphrasing when possible.

Quoted text should be limited to points in which you think the initial wording is

absolutely necessary to convey the author's point, and, in many papers, does not

need to be used at all.

Grading Rubric for Clinical Case Report Part 2: Case Description and

Conceptualization (75 points)

____/22 Case description. Student provides detail on client's background, traumatic

experience(s), symptoms and presenting problems, impairment/distress, and within this

description, sufficient detail to support the case conceptualization.

____/35 Case conceptualization. Student describes risk AND maintenance factors

in the client's diagnosis(es), including a range of etiological factors (i.e., cognitive

model, memory, emotion, neurobiology, social/contextual factors and culture and

identity). These factors are tied specifically to the case description, when possible

and are integrative (i.e., intersections among etiological factors are discussed).

____/9 Incorporation of empirical research. Empirical research and course materials

are incorporated effectively to advance arguments and are cited appropriately in-text.

____/9 Grammar, style, mechanics. Paper is in APA style, includes references, is

proofread, and contains proper grammar, flow, transitions, and headings as appropriate.