New Works 11/02

Work #1:

In 500 words or more, compare DNS failover and cloud failover. 

Use at least three sources. Use the Research Databases available from the Danforth Library not Google. Include at least 3 quotes from your sources enclosed in quotation marks and cited in-line by reference to your reference list.  Example: “words you copied” (citation) These quotes should be one full sentence not altered or paraphrased. Cite your sources using APA format. Use the quotes in your paragaphs.  Stand alone quotes will not count toward the 3 required quotes.

Copying without attribution or the use of spinbot or other word substitution software will result in a grade of 0. 

Write in essay format not in bulleted, numbered or other list format. 

It is important that you use your own words, that you cite your sources, that you comply with the instructions regarding length of your post. Your goal is to help your colleagues write better. Do not use spinbot or other word replacement software. It usually results in nonsense and is not a good way to learn anything. I will not spend a lot of my time trying to decipher nonsense. Proof read your work or have it edited. Find something interesting and/or relevant to your work to write about. 

Work #2:

1) Please describe the weighted average cost of capital.  How do firms use the weighted average cost of capital for decision making?

2) How are the costs of debt and equity calculated?   

Change Implementation and Management Plan

 

Change Implementation and Management Plan

It is one of the most cliché of clichés, but it nevertheless rings true: The only constant is change. As a nursing professional, you are no doubt aware that success in the healthcare field requires the ability to adapt to change, as the pace of change in healthcare may be without rival.

As a professional, you will be called upon to share expertise, inform, educate, and advocate. Your efforts in these areas can help lead others through change. In this Assignment, you will propose a change within your organization and present a comprehensive plan to implement the change you propose.

To Prepare:

  • Review the Resources and identify one change that you believe is called for in your organization/workplace.
    • This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.
  • Reflect on how you might implement this change and how you might communicate this change to organizational leadership.

The Assignment (5-6-minute narrated PowerPoint presentation):

Change Implementation and Management Plan

Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose.

Your narrated presentation should be 5–6 minutes in length.

Your Change Implementation and Management Plan should include the following:

  • An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)
  • A description of the change being proposed
  • Justifications for the change, including why addressing it will have a positive impact on your organization/workplace
  • Details about the type and scope of the proposed change
  • Identification of the stakeholders impacted by the change
  • Identification of a change management team (by title/role)
  • A plan for communicating the change you propose
  • A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

wk 10 6052 DQ

Discussion: Developing a Culture of Evidence-Based Practice

As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

  • Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
    • This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
  • Reflect on which type of dissemination strategy you might use to communicate EBP.

By Day 3 of Week 10

Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 10, “The Role of Outcomes on Evidence-based Quality Improvement and enhancing and Evaluating Practice Changes” (pp. 293–312)
Chapter 12, “Leadership Strategies for Creating and Sustaining Evidence-based Practice Organizations” (pp. 328–343)
Chapter 14, “Models to Guide Implementation and Sustainability of Evidence-based Practice” (pp. 378–427)

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence-based practice change. American Journal of Nursing, 111(3), 54–60. doi:10.1097/10.1097/01.NAJ.0000395243.14347.7e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2011/03000/Evidence_Based_Practice,_Step_by_Step_.31.aspx  

Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552–557. doi:0.1097/01.NNA.0000302384.91366.8f
Note: You will access this article from the Walden Library databases.

Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nursing Administration Quarterly, 36(2), 127–135. doi:10.1097/NAQ.0b013e318249fb6a
Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e
Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A test of the ARCC© model improves implementation of evidence-based practice, healthcare culture, and patient outcomes. Worldviews on Evidence-Based Nursing, 14(1), 5–9. doi:10.1111/wvn.12188
Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e
Note: You will access this article from the Walden Library databases.

NRS-410V-0L191 Pathophisiology and Nursing Management of Client Health.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

  1. Temperature: 37.1 degrees C
  2. BP 123/78 HR 93 RR 22 Pox 99%
  3. Denies pain
  4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

  1. WBC: 19.2 (1,000/uL)
  2. Lymphocytes 6700 (cells/uL)
  3. CT Head shows no changes since previous scan
  4. Urinalysis positive for moderate amount of leukocytes and cloudy
  5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mr. M.
  2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
  3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
  4. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
  5. Discuss what interventions can be put into place to support Mr. M. and his family.
  6. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

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

Mental Health Clinical Presentation – Part 1 and 2 on SOCIAL ANXIETY DISORDER

   

Week 6: Mental Health Clinical Presentation – Part 1

    

Purpose  

The purpose of this assignment is for learners to: 

  1. Have the opportunity to integrate knowledge and skills learned throughout all core courses in the FNP track and previous clinical courses.
  2. Demonstrate an advancing understanding of the patient with a mental health disorder in primary care.
  3. Demonstrate the ability to analyze the literature/ previous patients seen in the clinical setting be able to perform an evidence-based review of their case, diagnosis, and plan, while guiding and taking feedback from peers regarding the case.
  4. Demonstrate professional communication and leadership, while advancing the education of peers. 

Activity Learning Outcomes 

Through this discussion, the student will demonstrate the ability to:

  1. Develop management plans based on current scientific evidence and national guidelines. (CO4)  
  2. Prioritize treatment based on relevant clinical presentation. (CO6)

 

Requirements:  

For Week 6 of the course, there will not be a case study given to you by the faculty. Instead, you will be assigned a  mental health disorder commonly seen in primary care and you will create a case study based on that disorder.  You may create a case study either from a previous clinical patient experience or if you have not had a patient in clinical that represents your assigned topic you may research your disease using the week’s classroom material and the evidence-based literature in the field. The case should be clear and include all elements of a normal case that might be presented in class  (subjective, objective, assessment, and full 5 point plan).  The clinical practicum documentation will be helpful for this process, or notes you have taken in clinical regarding cases.  The case should be  clear, organized, and meet the following guidelines: 

Week 6 Part One: 

This part goes in part one and should begin with subjective and objective data just like we do in your weekly case study discussion.  Do not put a diagnosis until your peers respond. 

WEEK 6 Part One: The case should lead the class toward the mental health diagnosis assigned to you by your instructor. 

WEEK 6 Part One Specific Guidelines

If this is an actual patient from clinical- Include their actual chief complaint, demographic data, HPI,  PMHX, PSHX, medications, allergies, subjective and objective findings without identifying the patient’s name. 

If this is a fictitious case you’ve created from the literature/readings you should design an example patient and include chief complaint, demographic data, HPI, PMHX, PSHX,  medications and allergies, subjective and objective findings. Be mindful that the background data for the case should bear some relevance to the diagnosis. 

The case should not be overly simple. Like your weekly case studies, it should include subjective data that loosely represents the diagnosis you have been given, but includes some elements of the pathophysiology/presentation of the disease. 

You must include the following elements in part one: subjective: chief complaint/HPI, demographic data, HPI, PMHX,  PSHX, subjective and objective findings. 

NEXT: 

Leading the discussion in part one:   You must respond to any student who posts regarding your case with a  substantial response, either answering their questions or noting their  response and acting as leader. You also must respond to any faculty  responses to your initial posting. Use references to support your  responses. Remember: Your response to your peers is part of where you  demonstrate your knowledge of the disease you were assigned. You should  be discussing hallmark symptoms, diagnostic tools etc along with  discussing the student’s impressions and conclusions.  Once your peers  respond you can share the primary diagnosis and treatment plan that  actually occurred if it is a live patient, and the ideal treatment plan  if it is an invented case. Your treatment plan should address any  national guidelines as appropriate for the diagnosis. 

Participating in part one: As a student you will be required to respond to at least one other student, whom has no responses to their posting**. In your response to your peer you must include the  following: Your top three (3) differentials based on the information  provided, the primary diagnosis you are leaning toward, and first line  treatment for how you would treat that diagnosis. Use references to  support your response. *DEADLINE – YOUR ONE REPSONSE TO A STUDENT IN DISCUSSION #1 IS DUE BY THURSDAY AT 11:59 p.m. MT SO THAT THE STUDENT CAN INTERACT WITH YOU AS WE DO IN OTHER CASES.  **If all students have a response, then choose the student with the least responses to their posting. 

**To  see view the grading criteria/rubric, please click on the 3 dots in the  box at the end of the solid gray bar above the discussion board title  and then Show Rubric.

       

DISCUSSION CONTENT 

 

Description 

Application of Course Knowledge  

Post contributes clinically accurate perspectives/insights applicable to the results from the physical exam and diagnoses. Initial post includes the most likely diagnosis/specific treatment plan given case study information supported by rationale  and answers all questions presented in the case. Demonstrates course  knowledge/assigned readings by: linking tests/interventions accurately to diagnoses, applies learned knowledge specifically to the symptoms and patient information using original dialogue i.e., little to no direct quotes.  

 

Evidence Based resources 

Discussion post supported by  evidence from appropriate sources published within the last five years.  Focus of journal articles represents a logical link between the article  content and the case study information.  In-text citations and full  references are provided. 

 

Organization  

Discussion post presented in a  logical, meaningful, and understandable sequence. Headings reflect  separation of criterion outlined in assignment guidelines.  

**Direct quote should not exceed 15 words & must add substantively to the discussion 

 

APA/Grammar/Spelling 

Discussion post has minimal  grammar, spelling, syntax, punctuation and APA* errors. Direct quotes  (if used) is limited to 1 short statement** which adds substantively to  the post.  

* APA style references and in text  citations are required; however, there are no deductions for errors in  indentation or spacing of references. All elements of the reference  otherwise must be included. 

 

          Week 6: Mental Health Final Treatment Plan/Analysis – Part 2         

Purpose  

The purpose of this assignment is for learners to: 

  1. Have the opportunity to integrate knowledge and skills learned  throughout all core courses in the FNP track and previous clinical  courses.
  2. Demonstrate an advancing understanding of the patient with a mental health disorder in primary care.
  3. Demonstrate the ability to analyze the literature/ previous patients  seen in the clinical setting be able to perform an evidenced-based  review of their case, diagnosis, and plan, while guiding and taking  feedback from peers regarding the case.
  4. Demonstrate professional communication and leadership, while advancing the education of peers.

Activity Learning Outcomes  

Through this discussion, the student will demonstrate the ability to:

  1. Interpret  subjective and objective data to develop appropriate diagnoses and  evidence based management plans for patients and families with complex  or multiple diagnoses across the lifespan. (CO 1)  
  2. Develop management plans based on current scientific evidence and national guidelines. 

Part 2- Turning in your final treatment plan and Analysis  

The final treatment plan will include the  primary diagnosis, diagnostic testing recommended by National  Guidelines. Medications, interventions, education, labs, follow up,  referrals. After completing the treatment plan include the following  sections in a large area called ANALYSIS:

  1. Pathophysiology and Pharmacology: For the  primary diagnoses in the case, write a brief summary of the underlying  pathophysiology and tie pharmacological treatment chosen in the reversal  or control of that pathology. 
  2. Additional analysis of the case: This includes national guidelines  that were or should have been used to make diagnosis or treatment and  review how they applied or how care was unique but based in guidelines.
  3. Follow-up/Referrals: This means how the patient was doing when seen a  second time if this applies. This would be their response to your plan  of care. OR when Follow up will occur and what actions will be taken on  the follow up visit. Referrals if indicated.
  4. Quality: Include anything that should have been considered in  hindsight or changes you would make in seeing similar patients in the  future with the same complaint, history, exam, or diagnosis. Add  anything you learned from discussion in the class that shed new light on  this patient.
  5. Coding and Billing. Any or all CPT and ICD-10 codes that should have been used (List them and name them only.

Written in a word document and submitted in the Week 6 case study summary submission box.

       

DISCUSSION CONTENT 

Description 

 

Application of Course Knowledge  

Post contributes clinically accurate perspectives/insights applicable to the results from the physical exam and diagnoses. Initial post includes the most likely diagnosis/specific treatment plan given case study information supported by rationale  and answers all questions presented in the case. Demonstrates course  knowledge/assigned readings by: linking tests/interventions accurately to diagnoses, applies learned knowledge specifically to the symptoms and patient information using original dialogue i.e., little to no direct quotes.  

 

Evidence-Based resources 

Discussion post supported by  evidence from appropriate sources published within the last five years.  Focus of journal articles represents a logical link between the article  content and the case study information.  In-text citations and full  references are provided. 

APA/Grammar/Spelling 

Discussion post presented in a  logical, meaningful, and understandable sequence. Headings reflect  separation of criterion outlined in assignment guidelines.  

**Direct quote should not exceed 15 words & must add substantively to the discussion 

Discussion post has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post.  

* APA style references and in text  citations are required; however, there are no deductions for errors in  indentation or spacing of references. All elements of the reference  otherwise must be included. 

 

 

Drug Abuse Assignment

Write a full 1-2 page paper with references…

Choose a drug to research on healthypeople, CDC, medline plus, drugabuse.org, etc

What are the health disparities? Who is more affected by that substance?

How addictive is it? What are the health consequences?

What could we do to increase prevention of that substance?

LIRN Annotated Bibliography Assignment

Attached are the instructions for this work. Please read well before the bid.

This is the article: Spinal Flexibility and Individual Factors that Influence It

Read the grading rubric, so everything should be the way they want.

Discussion Question

1- Discussion Question:  Suppose you are going to conduct a study utilizing Qualitative Research Design: which type of research would you use, and which method would you utilize to collect data and select your sample. 

2- 3 paragraphs 3 sentences each

3- APA style

4- 2 references not older than 2015

topic 2/2

**Please see attached assignment**

**Must use the the new APA 7th Edition.  Please reference this guide when completing assignments.

***Also, use the Link Address info to complete assignment**