Post a clinically relevant research question using the PICOT format.  How did you arrive at this topic and question?  Why is it important?  ( “what are the new and appropriate wound care methods?”  This question’s uniqueness is to develop an evidence-based practice supported with current knowledge about a proper and new way of wound care, treatment ) 

 P: Population/patient – elderly patient with pressure ulcers I: Intervention/indicator- The main intervention is the use negative pressure wound therapy C: Comparison/control – standard moist wound therapy O: Outcome – the expected result or outcome would be based on the quality and duration of wound healing based on the intervention and comparison .T: Time – two weeks’ stay in hospital

Expectations

Initial Post:

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

Please read below for  guidelines and instructions.See USU NUR Discussion Board Rubric for additional details and point weighting.PICOT stands for:

• Population/ Patient Problem: Who is your patient? (Disease or Health status, age, race, sex)
• Intervention: What do you plan to do for the patient? (Specific tests, therapies, medications)
• Comparison: What is the alternative to your plan? (ie. No treatment, different type of treatment, etc.)
• Outcome: What outcome do you seek? (Less symptoms, no symptoms, full health, etc.)
• Time:  What is the time frame? (This element is not always included.)

Your PICOT question will fall under one of these types:

• Therapy/Prevention
• Diagnosis
• Etiology
• Prognosis

Use the PICOT format to break down your question into smaller parts and identify keywords:

P

I

C

O

T

Patient / Population

Intervention / Indicator

Compare / Control

Outcome

Time / Type of Study or Question

Who are the relevant patients? Think about age, sex, geographic location, or specific characteristics that would be important to your question. What is the management strategy, diagnostic test, or exposure that you are interested in? Is there a control or alternative management strategy you would like to compare to the intervention or indicator? What are the patient-relevant consequences of the intervention? What time periods should be considered?  What study types are most likely to have the information you seek?  What clinical domain does your question fall under? If you have questions, let me know Attachment(s):   563 PICO and determing the evidence to answer y… (346.59 KB) 563 Approved Clinical Question For PICOt Develo… (65.78 KB) The clinic questions are very doable capstone projects. Prior students have pursued both. 

An interesting blog on wound care in 2020: https://www.todayswoundclinic.com/articles/how-wound-care-may-change-better-and-worse-2020  

A public Health Discovery Paper.

3/4-page review 

Design a PowerPoint presentation for high school aged students discussing normative aging changes, sexuality, STDs, and prevention.  

• Discuss normal body changes that occur through puberty into young adulthood
• Discuss specific STDs, causes, symptoms, complications, and treatment: 

                        **You should include a slide or two for each of the following:  Gonorrhea, Chlamydia, Herpes, HIV, Syphillis, HPV

• Discuss pregnancy and prevention

The assignment should be submitted in PowerPoint format, with at least 10 content slides (in addition to a title slide and reference slide) and include at least two scholarly sources other than provided materials.

The Omnibus Budget Reconciliation Act (OBRA), also known as the Nursing Home Reform Act of 1987, has dramatically improved the quality of care in the nursing home over the last twenty years by setting forth federal standards of how care should be provided to residents. 

This Act is interpreted with the U.S. Code of Federal Regulations (42 CFR Part 483). Such improvements include less use of antipsychotic drugs, a reduction in chemical and physical restraint use, and a reduction in inappropriate use of indwelling urinary catheters.

Mandates

The quality of care mandates contained within OBRA, and the regulations, require that a nursing home must provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care. 

In order to participate in Medicare and Medicaid programs, nursing homes must be in compliance with the federal requirements for nursing homes.

The mandates of OBRA are regarded in the nursing home setting to represent minimum accepted standards of care. The failure of a nursing home to comply with the OBRA quality of care mandates in caring for a resident represents a failure to exercise the degree of reasonable care and skill that should be expected.

Penalties

The Indiana State Department of Health is responsible for ensuring that nursing homes follow these mandates through the state survey process. The Department of Health and Human Services (DHHS) and the states may apply penalties against nursing homes for failure to meet the minimum standard of care as defined in the OBRA regulations. 

Such penalties may include fines, appointment of administrative consultants to run the nursing home while deficiencies are remedied, and even closure of a nursing home.

• Residents must be assessed to identify their medical problems and their abilities to perform basic self-care activities. The DHHS established a uniform data set, referred to as the minimum data set (MDS), to document this assessment.
• The nursing home is responsible for the safety of each resident. This includes being responsible for orders written by the resident’s primary physician or other medical provider. If the physician writes an order that does not comply with the federal regulations, the nursing home is responsible for making sure the physician changes such order. The mere presence of a physician’s inappropriately written order does not absolve the nursing home of responsibility in providing safe care.
• Provide services that will enhance each resident’s quality of life to its fullest (42 CFR §483.15).
• Maintain the dignity and respect of each resident (42 CFR §483.15).
• Develop a comprehensive care plan for each resident (42 CFR §483.20).
• Conduct a comprehensive and accurate assessment of each resident’s overall health upon admission and at each required interval (42 CFR §483.20).
• Prevent a decline in activity of daily living (ADL) activities, including the ability to eat, toilet, bathe and walk. Staff must provide for ADL care when necessary (42 CFR §483.25).
• Prevent the development of pressure sores, and if a resident has pressure sores, provide the necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing (42 CFR §483.25).
• Provide appropriate care to those who have urinary incontinence and restore bladder function if possible. This also includes only using urinary catheters when appropriate as outlined in the regulations to prevent adverse consequences related to such use (42 CFR §483.25).
• Prevent accidents, including falls, accidental poisonings and other incidents that could cause injuries (42 CFR §483.25).
• Maintain adequate nutrition to prevent unnecessary weight loss (42 CFR §483.25).
• Provide each resident with sufficient fluid intake to prevent dehydration (42 CFR §483.25).
• Ensure that residents are free from significant medication errors (42 CFR §483.25).
• Have sufficient nursing staff (42 CFR §483.30).
• Ensure that each resident’s rights to choose activities, schedules, and health care are maintained (42 CFR §483.40).
• Provide pharmaceutical (medication) services to appropriately meet the physical and psychological needs of each resident (42 CFR §483.60).
• Maintain accurate, complete, and easily accessible clinical records for each resident (42 CFR §483.75).

Please read the OBRA guidelines and do the paper base on this question .APA style .Thank you  

CASE STUDY: Mrs. J is repeatedly asking for a nurse; other patients are complaining, and you simply cannot be available to Mrs. J for long periods.  Considering the setting and the OBRA guidelines, what would you do to manage the situation?

Write  a PICO question based on a scenario you choose from the list of  scenarios attached below.  Use the templates in the EBP Step by Step 3  article to help create your questions. You may need to do a pre-search  to finding an intervention (the “I”) that has been studied and published  to solve the problem.

• Identify the PICO elements for each question. 
• Develop  a search strategy using at least 3 keywords from the P, I, and O parts  of your PICO, 1 synonym for one of the keywords, and 1 MeSH term for one  of your keywords. 
• Locate 4 articles that help answer your PICO question.  The articles must meet the following requirements:  
• must be primary source quantitative research articles.  
• No article can be older than 2016. 
• Obtain  pdfs of the four articles you selected from the ResU database.  If not  available for the ResU database, you may request access from  the ResU Library, or you can email me the citation for the article, and I  will attempt to locate a pdf of it. 
• On  a Word document, include your scenario; write your PICO question as a  sentence; identify the P, I, C, and O for each question; and list the  search terms (3 keywords, 1 synonym, 1 MeSH term) for each. You may use  the template attached here. See also the link to the MeSH terms website  below.
• Provide  a properly formatted APA reference page for your selected articles from  Step 4 of these instructions. See the link to the APA and Writing  LibGuide below.

Power point with 15 slices, 

Choose a nursing theory(Florence nightingale) 

Explain the nursing theory including the 4 paradigms of major assumptions

·         Explain the role the selected nursing theory has/had in the evolution of healthcare

·         Explain if the selected nursing theory relates to transcultural and holistic care

·         Explain how the selected nursing theory is utilized in nursing education, practice, or nursing research.

·         Connect the theory to the provision of safe and effective patient care, provide examples

·         Minimum /maximum 3 slides per student including speaker notes, excluding the title and reference slides

Reply to this discussion post (site sources if applicable)

For my capstone project, I will be implementing a sepsis handoff communication tool to help increase patient outcomes and decreased mortality. In my facility, we have a mortality rate of 11.2% and a compliance of only 52-58% with our sepsis protocol, which is believed to be due to poor communication. One internal method of disseminating my evidence-based change proposal can be by putting tri-fold posters in each break room for staff members to read when they have a time, whether changing or eating their meals. Here nurses and physicians will be able to see the reasoning why change is needed, background statistics and what the tool entails. It is important that this group understands the evidence-based change proposal because nurses and physicians are the two main healthcare professionals that play a role in sepsis care. Nurses and physicians work together to implement interventions and treatments to fight a septic infection. They are the one’s who will be using this sepsis tool in hopes of improving communication.

Like all aspects of nursing, sepsis is a dignosis that is rapidly changing as the years go on. Evidence-based practice (EBP) is constantly changing how we do things in our daily practice. As healthcare professionals, we rely on data from other facilities to implement new changes in our facility. The same goes from us. Data that we find can get put together in a research journal that other hospitals can use. If this quality initiative is proven to be effective in promoting communication through a sepsis handoff tool, other facilities may begin to implement this tool and save more lives. 

Instructions:

1. Answer the following questions below:
   1. How do public health policies and interventions affect your daily life?  Use examples.
   2. What are some examples of primary prevention, secondary prevention, and tertiary prevention for specific disease conditions?  
      • When would each type of prevention be appropriate?
2. Your paper should:
   • be typed in WORD, double spaced.
   • be three (3) or more pages.
   • include a Title page and a Reference page.
     • use one reference besides the textbook that is 5 years or newer (2013-2018). 
     • follow APA format according to the APA Style Guide
     • See NUR4667 – Library APA Citation Style web page for additional information.
   • use factual information from the textbook and/or appropriate articles and websites.
   • be original work, and will be checked for plagiarism.

Responses to at least two classmates’ postings should be approximately 200 words and should be thoughtful, substantial, polite and more extensive than a simple “well done” phrase or “I agree.” Consider points of agreement, disagreement, assumptions, and value judgments. You will be able to respond to others after you submit your initial post. Your grade will be affected by how thoughtful your replies and initial questions are answered.

Discussion: Importance of Strategic Planning Framework

Module 1 discusses the importance of model or framework as it relates to strategic planning. As we progress, you will see that there are many theories that may be used to address health concerns and each has its benefits and limitations. Respond to the following questions:

1. Discuss the importance of framework in relation to strategic planning.
2. How do you decide which theories/frameworks to use when developing a program?
3. What things can go wrong when a framework is not applied?