discussion replies

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Respond to the four colleagues attached below with questions to clarify or suggestions to sharpen or finesse their explanation of their problem-evidence-change initiative linkage. please include at least 2 references each

Interview #2

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INTERVIEW WITH A CULTURALLY DIVERSE CLIENT:
Conduct an interview with either a client or a previous healthcare consumer (this may be a neighbor, a volunteer, or a total stranger). Please be mindful of HIPPA and provide for confidentiality. Do not identify the interviewee.
• What are the client’s origins? Where were they born? Do they speak another language? (10 Points)
• How do they access the healthcare system? What resources are used? (10 Points)
• Do they have a primary care physician/nurse practitioner? (10 Points)
• Identify any healthcare disparities associated with the client. (10 Points)
• Did their socioeconomic status influence their level of or quality of healthcare? (10 Points)
• Have they ever experienced any issues during their care while at a healthcare facility? (10 Points)
• What specific needs would they like to have addressed when visiting a healthcare practitioner/facility? (10 Points)
• Do they require assistance with community resources to improve their level of care? (5 Points)

o If yes, provide a teaching moment and document this in your interview.
o If no, provide a listing of resources for future use if needed. Refer to the following link for Monroe County:
http://monroe.floridahealth.gov/programs-and-services/clinical-and-nutrition-services/_documents/community-resource-guide.pdfLinks to an external site.

PMHNP

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Research the 3 highest priority Differential Diagnoses, the proposed interventions with rationale and respond to the case.  

Evidence-Based Project, Part 3: Critical Appraisal of research

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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.

Module 1 week 2 scenario

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Scenario: 

  • A 49-year-old patient with rheumatoid arthritis comes into the clinic with a chief complaint of a fever.
  • Patient’s current medications include atorvastatin 40 mg at night, methotrexate 10 mg po every Friday morning and prednisone 5 mg po qam.
  • He states that he has had a fever up to 101 degrees F for about a week and admits to chills and sweats.
  • He says he has had more fatigue than usual and reports some chest pain associated with coughing.
  • He admits to having occasional episodes of hemoptysis.
  • He works as a grain inspector at a large farm cooperative.
  • After extensive work-up, the patient was diagnosed with Invasive aspergillosis.

The Assignment

(1- to 2-page case study analysis-this does not include title page and reference page)

Develop a 1- to 2-page case study analysis in which you:

  • Explain why you think the patient presented the symptoms described. (Not a trick question but reflective of a patient on immunosuppressive drugs and a high-risk employment for exposure to Aspergillosis)
  • Identify the genes that may be associated with the development of the disease.
  • Explain the process of immunosuppression and the effect it has on body systems.

Developing answers to these 3 questions, each question 1-2 paragraphs will bring you to the 2-page expected limit. 3 pages will not lose points but learning to synthesize points, provide current references (submissions like this would earn 3 primary references) and citations will garner full credit.

Reminder: Include a title page, introduction, summary, and references, done in APA format. Keep references current, 5 yr. from publication please and from primary references (# references to support your points for full credit) like classroom textbook, peer-reviewed journals. 

Nursing NUR 445 – Week 3 Assignment

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Identify a problem or concern from your selected population. Write a 1-3 page description of your problem and support the need to address this in your population with 3 evidence-based articles. Include title and reference page.

Nursing

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Can you help me with my homework. 

Discussion 250 words. Make sure you provide 2 references and utilize APA style.. . Discussion Rubric

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3

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Learning Activity Content

1.

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Health Promotion in Practice

Since the time of Florence Nightingale, nurses have recognized that they address the spiritual needs of their patients, but this still remains one of the most nebulous aspects of nursing care. When asked about providing spiritual care, most nurses know that they “do it,” but they have difficulty describing what “it” is. Even though major nursing and health care organizations emphasize the importance of nurses addressing the spiritual needs of patients, assessment questions are usually limited to obtaining information about a patient’s religious affiliation. Similarly, interventions often focus on initiating referrals to chaplains or other spiritual advisors for patients who have a religious affiliation. This approach may be adequate for some patient care situations, but it does not necessarily address the need for a spiritual connectedness that all humans experience. This chapter focuses on relatively simple actions that nurses can incorporate as an integral part of usual nursing care to identify and address the spiritual needs of their patients.

It is important to become comfortable discussing spiritual needs of patients because all humans have spiritual needs even though they may not identify with a religion. 

Let us consider the following scenario: 

You are a nurse manager working in a Catholic hospital, and you have been told by some of your nurses that the 'new hire RN' feels uncomfortable discussing religion with their patient because they do not have any religious affiliation. 

Discuss how you would, as the MANAGER of the unit, address their discomfort, and ensure they still feel a part of the team even if their religious affiliations are not the same as that of the institution. 

Key points to remember in your discussion are that many spiritual practices individuals engage in can be adopted to multiple scenarios and it is important to develop an inquisitive and open-minded approach when you listen to patients and colleagues talk about their religious practices.

Please remember for discussion posts: the initial post must be uploaded by the WEDNESDAY of the week and two replies to your peers by Saturday at 2359.

Please note the grading rubric for the discussion board.

As a reminder, all discussion posts must be a minimum of 250 words, references must be cited in APA format 7th Edition and must include a minimum of 2 scholarly resources published within the past 5 years.

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Data Utilization and Presentation

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Your CEO wants to review the benchmarking data used to compare Choice Hospital with other hospitals in the same geographic region. The Board of Directors is looking at expanding the Emergency Department or adding more in-patient beds. The CEO needs to know how Choice Hospital compares with other hospitals in the region to be part of the discussion and inform decisions on expansion in these areas.

As you assume the role the HCA at Choice Hospital, provide the data and analysis requested by your CEO as described below. In this exercise, assume that Choice Hospital is located in Colorado, and use these data provided by the Colorado Hospital Association for Colorado hospitals. If you wish to find data for your own state of residence, you may do that and start your search at your state’s Department of Health Web site.

For comparison of Choice Hospital to others in the state of Colorado of comparable size, you will use the specific data points requested, perform the calculations, and prepare the presentation of the data as follows:

  1. You will first review the data available and summarize the data points as specified for this presentation by placing them in an Excel spreadsheet.
  2. Calculate descriptive statistics for the data, as specified below.
  3. Prepare an Excel spreadsheet of the data.
  4. Review the data in the spreadsheet, and prepare a discussion of the data for Colorado hospitals compared to the data for Choice Hospital.
  5. The table below includes the data for Choice Hospital:
    HospitalLicensed BedsTotal DischargesTotal Patient DaysInpatient SurgeriesBirthsInpatient Admissions for Emergency DepartmentsEmergency Department VisitsTotal Outpatient VisitsChoice Hospital30015,27970,2834,0122564,78113,34298,993
  6. From these data, calculate the average length of stay (ALOS) for Choice Hospital.

Now look at the data for Colorado Hospitals at the link provided. Because Choice Hospital is a 300-bed facility, identify the hospitals that have between 200 and 400 licensed beds. Those are the hospitals that you will use for your comparison to Choice Hospital. In your Excel spreadsheet, do the following:

  1. List the hospitals that have 200–400 licensed beds in the first column, with 1 hospital listed per row.
  2. Next, for each of those hospitals, enter the data in separate columns for Total Patient Days and Total Discharges.
  3. In the next column, enter your calculation for ALOS using the data for Total Patient Days and Total Discharges.
    • At the bottom of the column for ALOS, calculate the mean and standard deviation for the average length of stay for all of the hospitals.
    • Enter the mean and standard deviation in the cells below in that column, and be sure to identify which value is the mean and which is the standard deviation.
  4. You will submit your Excel spreadsheet along with your 600-800 word summary.

Now that you have the data on ALOS for your comparison hospitals, write 600-800 word summary, not including the title page or reference page, and discuss the following:

  • Consider the average length of stay for Choice Hospital that you calculated using the data for Choice Hospital. How does that compare to the ALOS on average for the hospitals in Colorado with similar numbers of licensed beds from your calculation?
  • Identify the range of ALOS for the hospitals, and consider the standard deviation value.
    • Did you calculate the standard deviation of a sample or of the entire population?
    • What is the difference?
    • Explain why you chose the one that you did.
  • Research the ALOS for the United States, and find a statistic that is within the last 5 years. The ALOS may be an overall average or based on the number of beds.
    • State the ALOS for the United States that you found in your research, and be sure to cite the reference source.
    • How does the ALOS for Choice Hospital compare to the national average?

Case study: Family member with alzheimer's disease

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Mark and Jacqueline have been married for 30 years. They have grown children who live in another state. Jacqueline’s mother has moved in with the couple because she has Alzheimer’s disease. Jacqueline is an only child and always promised her mother that she would care for her in her old age. Her mother is unaware of her surroundings and often calls out for her daughter Jackie when Jacqueline is in the room. Jacqueline reassures her mother that she is there to help, but to no avail. 

Jacqueline is unable to visit her children on holidays because she must attend to her mother’s daily needs. She is reluctant to visit friends or even go out to a movie because of her mother’s care needs or because she is too tired. Even though she has eliminated most leisure activities with Mark, Jacqueline goes to bed at night with many of her caregiving tasks unfinished. She tries to visit with her mother during the day, but her mother rejects any contact with her daughter. Planning for the upcoming holidays seems impossible to Mark, because of his wife’s inability to focus on anything except her mother’s care. 

Jacqueline has difficulty sleeping at night and is unable to discuss plans even a few days in advance. She is unable to visit friends and is reluctant to have friends visit because of the unpredictable behavior of her mother and her need to attend to the daily care. 

Reflective Questions 

1. How do you think this situation reflects Jacqueline’s sense of role performance? 

2. How do you think that Jacqueline may be contributing to her own health?

Please provide rationales for your answers. Please provide a citation for your answers.