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.

 

The case study I was presented was “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 lack of dentures. The patient has been diagnosed with protein malnutrition”. 

When looking into protein malnutrition, protein energy-malnutrition is the most commonly seen terminology, or PEM, that is the result of starvation (with or without catabolic stress). PEM is considered a disease and is the result of chronic inadequate protein or energy intake not meeting the body’s needed intake of nutrients. In some cases, the loss of fat is reduced due to a slowed energy use accomplished by decreasing the metabolism and instead using the body’s storage of lean protein. Typically, the majority of the protein is released from muscle tissues and the kidneys, blood, immune cells, GI tract and liver are spared for the most part. In cases where the ration of energy and protein are not obsolete, the body can adapt to the environment by decreasing the energy and protein needed to sustain homeostasis. PEM results in “a lowered metabolic rate and reduced muscle mass (including reduced cardiac and respiratory muscle mass); its clinical consequences include muscle weakness and functional disability, reduced cardiac and respiratory capacity, mild hypothermia and a reduced body protein reserve” (Hoffer, 2001). In PEM, the extracellular fluid also shifts and can cause generalized edema. 

In consideration of protein malnutrition, there are two conditions that come up in various articles, Kwashiorkor and marasmus. “Kwashiorkor is predominantly a protein deficiency, while marasmus is a deficiency of all macronutrients — protein, carbohydrates and fats. People with marasmus are deprived of calories in general, either because they’re eating too little or expending too many, or both. People with kwashiorkor may not be deprived of calories in general but are deprived of protein-rich foods” (C.C. Medical, n.d.). In this case study, though the primary diagnoses is protein malnutrition, marasmus may be more fitting and in align with the physiologic problems this patient is facing. “For older adults, adverse health outcomes associated with malnutrition can often be more complex and disproportionally worse than outcomes associated with overweight or obesity. Malnutrition in older adults can lead to weight loss. Functional recovery from this weight loss is unlikely to occur due to the loss of skeletal muscle mass, even with full nutritional support” (Dent et. al, 2023).  “Marasmus is equally distributed between the genders, however, as a result of cultural differences in some parts of the world women may be at an increased risk of marasmus” (NCBI, 2023).

 

• Respectfully agree or disagree with your colleague’s assessment and
• Explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not. Support each of your replies with at least 0ne citation and reference.

 

Go back to the discussion topic in Week 1 and review your discussion posts.

Have any of your thoughts or concepts of trends in nursing have changed since week 1.  Please share specific examples.

BELOW IS MY POST FROM WEEK 1:

 

When I think of issues and trends in nursing, I think of how there are constant changes in the management of patients and healthcare facilities based on the prevailing social, technological and economic changes. Issues and trends in nursing are patterns, development and changes that occur in the healthcare sectors to enhance the delivery of care services. Nursing issues and trends encompass a wide range of issues depending on the challenges the nursing sector faces at a particular time.

Issues and trends have affected nursing regulations and policies, particularly in the United States. Constant amendments and changes of policies and laws affecting nurses are crucial to ensure that healthcare personnel work within the framework of the law. The national, state and country are changed to fit international laws and policies. Nurses across the globe should be updated on the current issues and trends in nursing policies and regulations to comply with patient care.

Due to technological advancement, nurses must continue implementing new technologies to enhance data storage and real-time retrieval of patients’ medical care to facilitate care based on evidence-based information. The current trends in implementing advanced technologies in the nursing sector are in the right direction. For instance, implementing electronic health records (EHR) has improved communication and collaboration between nurses, particularly during patient complications and medical errors through the Internet.

I understand that the nursing sector is dynamic and influenced by other factors such as social, economic and politics of not only countries but the entire world. In this regard, nurses keep changing their methods, laws, policies, and techniques to handle patient challenges. 

Complete Parts 1 and 2 of your Assignment:

• Part 1: Literature Review: Be sure you have completed all required sections of the template (PDF) document.(attached below)
• Part 2: Critical Assessment p aper: look at the rubric for instructions. keep in mind to also Apply feedback of value to you in completing your synthesis of evidence to inform a practice change initiative focusing on quality improvement

RUBRIC:- The Assignment: Part 1: Literature Review of at least 10 scholarly articles:• Using the Walden university Library as your source, search to select at least 10 scholarly articles that represent current literature (i.e., published within the previous 5 years) with evidence that addresses your critical question (I will send you the critical question) and could inform a practice change initiative for quality improvement. Using the Individual -Evidence Summary/Synthesis Tool template document, complete all sections for each article.

-The Assignment: Part 2: (example attached below) Critical Assessment In a p a per of at least 7 pages, plus cover page and references page, include the following:• Write a critical assessment of your search outcomes that synthesizes the evidence from your literature review.

-Demonstrate clear connections between the practice problem that informs your critical question, your appraisal of evidence that addresses the critical question, and resulting clarification on the need for a practice change initiative focusing on quality improvement. Be specific and provide examples.

-Written Expression and Formatting: Paragraph/Sentence StructureParagraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.

-Written Expression and Formatting: The assignment contains parenthetical/in-text citations, and at least 10 evidence-based references are listed.

this is based off the week one evidence based 600 assignment 

Discuss the theoretical framework or model that you intend to use for your capstone project. How does your chosen framework relate  to your phenomenon of interest and research?

Expectations

Initial Post:

• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA from within the last 5 years