Monthly Archives: May 2023

For this assignment, you will locate two research studies related to the topic and PICOT questions that you developed in Week 2. The articles must be current (within the last five years), and one article must be quantitative, and one article must be qualitative.

Article choice is very important, therefore:

• Articles used for this assignment cannot be used for the other assignments. The selected articles should be original research studies. Review articles, concept analysis, meta-analysis, meta-synthesis, integrative review, and systemic review articles should not be used.
• Mixed-methods studies should not be used.

There are two parts to this assignment.

Part 1: Complete a Rapid Critical Appraisal Checklist

• Select one each: qualitative and quantitative research articles.
• Create a Rapid Critical Appraisal Checklist for the two research articles (one column per article).
• Complete with brief, concise, summarized information.

Part II: Write a summary (one- to two- pages)

• Identify differences between quantitative and qualitative designs and research methods.
• Use current APA Style for your summary paper and to cite your sources.
• Submit the checklist and summary.

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this assignment.

1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
3. The PICOT question will provide a framework for your capstone project.
4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles.  Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Purpose

The purpose of this activity is to deepen learning through reflective inquiry. It will allow for expansion in self-awareness, identification of knowledge gaps, and assessment of learning goals.

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

• Compare and contrast differences and similarities of qualitative, quantitative, and mixed method designs. (POs 3, 9)
• Analyze qualitative and quantitative data for the purposes of critical appraisal of evidence. (POs 3, 9)
• Appraise systematic reviews for translation science. (POs 3, 5, 9)
• Differentiate selected statistical methods for the purposes of translation science. (POs 3, 5, 9)
• Evaluate selected statistical methods for the purposes of critical appraisal of evidence. (POs 3, 5, 9)
• Synthesize literature relevant to practice problems. (POs 3, 5, 9)
• Formulate PICOT/PICoT questions relevant to advanced nursing practice. (POs 3, 4, 5, 6, 9)

Due date: Sunday, 11:59 p.m. MT at the end of Week 7. The Late Assignment Policy applies to this assignment.

Total points possible: 100 points

Preparing the Assessment

Follow these guidelines when completing this assignment. Contact your course faculty if you have questions. It is each student’s responsibility to save and maintain all artifacts required in the e-Portfolio.

1. Write a brief 1–2 paragraph weekly reflection addressing the questions posed in the Reflect section of each week. Edit your Reflection to include each weekly reflection.
2. Include the following sections in your Reflection.
   1. Week 1
      • Provide one specific example of how you achieved the weekly objectives.
      • What did you learn about your capacity to read and appraise original qualitative research? What changed, if anything, following the week’s activities?
      • How will this skill improve your effectiveness as a practice scholar?
   2. Week 2
      • Provide one specific example of how you achieved the weekly objectives.
      • What did you learn about your capacity to read and appraise original quantitative research? What changed, if anything, following the week’s activities?
      • How will this skill improve your effectiveness as a practice scholar?
   3. Week 3
      • Provide one specific example of how you achieved the weekly objectives.
      • What did you learn about your capacity to read and appraise summaries of research evidence? What changed, if anything, following the week’s activities?
      • How will this skill improve your effectiveness as a practice scholar?
   4. Week 4
      • Provide one specific example of how you achieved the weekly objectives.
      • How has the course information influenced your understanding of descriptive statistics?
      • How can you bring this information of statistical analysis to practice?
   5. Week 5
      • Provide one specific example of how you achieved the weekly objectives.
      • In what ways did course information influence your understanding of parametric statistics?
      • What goals will you set in accordance with what you have learned this week?
   6. Week 6
      • Provide one specific example of how you achieved the weekly objectives.
      • What was the most rewarding learning experience you had this week?
      • How could you amplify the effectiveness of your skill in evidence synthesis and translation science?
   7. Week 7
      • Provide one specific example of how you achieved the weekly objectives.
      • How has course information changed your ways of knowing?
      • How does the knowledge gained advance your professional formation as a practice scholar?
   8. Writing Organization and Mechanics
      • Grammar and mechanics are free of errors.

Reply1

In my nursing experience, I have encountered an ethical dilemma about “healthcare needs vs. resource allocation.” At my previous facility, their budget was limited, and we were a lack of medical supplies, such as blood pressure monitors, needles, foley catheter, etc. Doctors ordered medical treatments for patients, but due to the lack of the supplies, we were not able to carry out the orders on time. As a nurse, I wanted to follow the principle of beneficence, which is clinicians have a duty to provide appropriate care and benefit to a patient. (Bann & Parke, 2018) However, I was not able to follow it several times and felt patients did not get quality care from us. I reported the issue to managers, but the issue was not solved right away. According to Duquesne University (2020), the rising cost of healthcare is increasingly putting nurse managers at odds with budgeting constraints and patient needs. A large number of medical facilities have scarce resources, which puts patients at risk for not getting the care they need. (Duquesne University, 2020) 

Several months later, a new DON came to the facility, and she listened to our concerns. She hired a person who managed medical supplies of the facility. After that, the issue was improved. I learned that the management is very important for nurses and staff to provide quality care to patients. Also, nurses need to speak up the issues that affect patient’s safety. According to Haddad & Geinger (2020), it is important that the patient is protected by reporting any misconduct or potential safety concern. Also, the code of ethics for nurses from American Nurse Association states that the nurse promotes, advocates for, and protects the rights, health, and safety of the patient. (Haddad & Geinger, 2020)

reply2

Nurses are in a unique position when it comes to ethics in healthcare because of their close relationships with patients. As a nurse not only is it important for protecting your patient but coping with dilemmas and feeling confident enough to speak up when it is critical for your well-being. The most frequently occurring and stressful ethical situations are protecting patient’s rights, staffing, advanced care planning, and decision making (Rainer, Schneider, & Lorenz, 2018). In my nursing career, the ethical dilemma that has affected me most is honesty and withholding information. A young boy was brought in and admitted to the hospital and I was the one taking care of him. The tests were done and the boy was diagnosed with cancer. When the boy’s parents got the news they withheld the information from the boy to protect his emotions. However the boy’s age, he deserved to know about his medical condition. Even after a long conversation with the parents about the issue they still froze-off my opinions. Nursing ethics advocates for truth-telling or veracity, as a key factor in nurse-patient relationships while on the other hand decided to share the information with the patient would be going against the parent’s decision.

In the end, I ended up not telling the boy anything. I had to respect the decision of the parents despite the need to tell the boy of what he is suffering from. 

Last week, you identified challenges related to informatics and recommended strategies for overcoming them. In this Assignment, you address common challenges applied in a specific informatics scenario. Then, you extend your thinking by addressing another common challenge: resistance to change. The rapidly evolving world of informatics means departments and institutions must evolve in ways that make some professionals uncomfortable, and this Assignment focuses on overcoming that real-world circumstance.  

To Prepare For this Assignment, consider the following scenario:

The radiologist at your hospital reports to the administrator that 30 patients have been diagnosed with brain tumors during the past 2 months. The administrator requests a report detailing the number of patients diagnosed with brain tumors during the past 6 months. However, the radiology department uses a free-text entry for their diagnoses, and their system does not communicate with the larger electronic health record (EHR) system installed at the hospital. You recognize an opportunity to address challenges with the EHR system in your hospital and decide to also write a proposal for a solution to improve your hospital’s EHR system.

• Based on this scenario, analyze each of the challenges described below that the hospital may need to address:
  • Vocabulary standards
  • Interoperability
  • Workarounds
  • Patient safety
  • Patient privacy and security when pulling reports
• Reflect on potential solutions to each of the challenges described. 
• Research change theories in the Walden Library (or other academic sources) that might assist in your convincing the institution to implement potential solutions.
• The Walden Library recommends the following resources:
  • SAGE Knowledge: a collection of specialized encyclopedias in several subject areas that includes many types of theories. 
  • Computers and Applied Sciences Complete: journals covering engineering, computer theory and systems, new technologies, and social and professional context.
• Reflect on how an electronic health record system analytic API could help interpret the data found in the scenario.

The Assignment

• Write a proposal for how the hospital in the scenario might overcome each of the following challenges related to the scenario:
  • Vocabulary standards
  • Interoperabiliy
  • Workarounds
  • Patient safety
  • Patient privacy and security when pulling reports
• Recommend a change theory that might assist in your convincing the hospital administration to implement the EHR solution and improvements you propose. Be specific and provide examples.
• Support your proposal by explaining how the EHR solution might benefit data analysis for the promotion of improved health outcomes.
• Note: The title page, introduction, summary, and references are in addition to the required page count.

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

Peer 1

Savannah, Georgia is the oldest city in the state of Georgia and is a popular tourist spot that have a population of 145, 754. Of that population, 38.7 % is Caucasian, 54.4 is African American, 3$ two or more races, 3.92% Asian, Another race, Native American, Native Hawaiian, or Pacific islander. More than half of the population is African Americans. African Americans have a higher prevalence of things such as hypertension which increases a person’s risk for stroke and heart disease. African Americans are also disproportionally affected by Obesity. African Americans are also more likely to have diabetes which can lead to stroke or cardiovascular disease. A lot of these are influenced by modifiable and non-modifiable factors. Yes, I am African American and that’s something that will stick with me for the rest of my life. But on the other hand, I can eat right, exercise, and drink plenty of water so that I won’t get any of these things. As a nurse, I have seen many patients and sometimes a little education goes a long way.

Another population that interests me is the homeless community. Savannah has the second-highest number of homelessness in Georgia. There are over 1000 individuals that are not including the 800 kids that are enrolled at schools throughout Savannah, GA. There are many reasons a person or family may experience losses. I could be because of lost wages or income, substance abuse, domestic violence, low wages, and many more. In savannah, we do have the homeless authority which provides resources to those who are homeless. We have shelters and soup kitchens. One of the things that are going on is the tiny house project. It is something in place to help homeless veterans that not only provides them with a community but also affordable housing. There is something called Tent city, it is a community of homeless people that live in tents in savannah, Ga. My unit in the hospital chose them to do our own separate community outreach. We are doing things like giving them water, and things that will help them as winter is approaching.

References

About Homelessness. (2020, May 06). Retrieved September 22, 2020, from https://www.homelessauthority.org/about-homelessness/

African Americans and Heart Disease, Stroke. (n.d.). Retrieved September 22, 2020, from https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/african-americans-and-heart-disease-stroke

Savannah, Georgia Population 2020. (n.d.). Retrieved September 22, 2020, from https://worldpopulationreview.com/us-cities/savannah-ga-population

Peer 2

When discussing an aggregate, or target population you are pointing out a collection of people who have one or more personal or environmental traits in common (Stanhope & Lancaster, 2020). In my community two targeted populations that are of interest to me are migrant farmworkers in our county and migrant children of migrant farmworkers. My rationale for these targeted populations is primary prevention.

On average, the level of education completed by a migrant farmworker is 6th grade (Student Action with Farmworkers, 2020). This tells me that education needs to take priority about prevention of diseases and what they can be taught about it. Migrants face a higher rate of urinary tract infections, heat stress, tuberculosis and other illnesses, as their children have higher rates of dental diseases and malnutrition (Student Action with Farmworkers, 2020).

If migrants are taught about health promotion services they can utilize in the community that can reduce the risk of disease, it could give them a sense of empowerment. Having the knowledge and control over their own health may entice them to educate others about what they can do. Primary prevention is the first step that should be made in order to begin care for not just this aggregate group, but for any aggregate.

References

Stanhope, M. & Lancaster, M.S.J. (2020). Public health nursing: Population-centered health care in the community. (10th ed.). St. Louis, MO: Elsevier.

Student Action with Farmworkers. (2020). United States farmworker fact sheet. Retrieved from https://saf-unite.org/content/united-states-farmworker-factsheet

Zero Plagiarism

5 references

While cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) have many similarities, they are distinctly different therapeutic approaches. When assessing clients and selecting one of these therapies, you must recognize the importance of not only selecting the one that is best for the client, but also the approach that most aligns to your own skill set. For this Assignment, as you examine the similarities and differences between CBT and REBT, consider which therapeutic approach you might use with your clients.

Learning Objectives

Students will:

Compare cognitive behavioral therapy and rational emotive behavioral therapy

Recommend cognitive behavioral therapies for clients

To prepare:

Review the media in this week’s Learning Resources.

Reflect on the various forms of cognitive behavioral therapy.

The Assignment

In a 1- to 2-page paper, address the following:

Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.

Explain at least three differences between CBT and REBT. Include how these differences might impact your practice as a mental health counselor.

Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature.

I need these questions answered in about 120 words each, with references

1. If there are gaps in a published literature, what evidence might be able to be used?

2. Can you provide an example of a statistically significant finding but not clinically significant?

Click on the following link and read the article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061635/
Arabi, A., Rafii, F., Cheraghi, M., & Ghiyasvandian, S. (2014, May). Nurses’ policy influence: A concept analysis. 
1. Look up your local nursing state organizations in this case New York.
3. Find out what policies they are working on  
4. choose a policy of your choice pertaining to the nursing field and write a 200-300 words post about the policy that you are interested in learning more about.
APA format, with intext citation and citing the source. Please use the above link for the a for references and plagiarism free. DO NOT TURNITIN.

 types of Variables