evidence based practice

 

Compare the EBP competencies for Practicing Registered Nurses and Advanced Practice Nurses:

  1. Identify the competencies that you are currently meeting. Provide examples as to how you are meeting them.
  2. Discuss how you will plan to meet the EBP competencies for Advanced Practice Nurses as you are pursuing the nurse practitioner role (Advanced Practice) or seeking advanced nursing practice via the leadership track.  

week11 6053

Assignment: 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

Learning Resources

Required Readings

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
Chapter 8, “Practice Model Design, Implementation, and Evaluation” (pp. 195–246)

Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230. Retrieved from https://medcom.uiowa.edu/annsblog/wp-content/uploads/2012/10/JONA-FINAL-Cullen-2012.pdf

Pollack, J., & Pollack, R. (2015). Using Kotter’s eight stage process to manage an organizational change program: Presentation and practice. Systemic Practice and Action Research, 28(1), 51-66.
Note: You will access this article from the Walden Library databases.

Seijts, G. H., & Gandz, J. (2016). Transformational change and leader character. Business Horizons, 61(2), 239-249. https://doi.org/10.1016/j.bushor.2017.11.005
Note: You will access this article from the Walden Library databases.

Tistad, M., Palmcrantz, S., Wallin, L., Ehrenberg, A., Olsson, C. B., Tomson, G., …Eldh, A. C. (2016). Developing leadership in managers to facilitate the implementation of national guideline recommendations: A process evaluation of feasibility and usefulness. International Journal of Health Policy and Management, 5(8), 477–486. doi:10.15171/ijhpm.2016.35. Retrieved from http://www.ijhpm.com/article_3183_5015382bcf9183a74ef7e79b0a941f65.pdf

Required Media

TEDx. (2013, January). Six keys to leading positive change: Rosabeth Moss Kanter at TEDxBeaconStreet [Video file]. Retrieved from https://www.youtube.com/watch?v=owU5aTNPJbs

GOOD, good

  

PICO and Literature Search

Purpose: PICO questions are used by practicing nurses and researchers to focus research questions and develop an efficient literature search strategy. It is essential that future nurses learn how to do this to develop evidenced-based solutions to patient care problems in a healthcare organization. 

Assessment: This assignment is worth 68 points and represents 20% of your final course grade. It is graded according to the embedded rubric in this submission folder. Late submissions will incur a 10% deduction per day, unless a Late Pass is used.

Instructions:

1. 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.

2. Identify the PICO elements for each question. 

3. 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. 

4. 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. 

5. 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. 

6. 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.

7. 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.

8. Name each document (one Word doc and 4 article pdfs) as follows and upload to the appropriate submission folder in Brightspace: 

· Lastname PICO, 

· Lastname article 1,

· Lastname article 2,

· Lastname article 3,

· Lastname article 4

Attachments

EBP Step by Step 3.pdf

(188.01 KB)

PICO and Lit Search Template with Example.docx

(30.11 KB)

PICO and Literature Search Scenarios.doc

(44.5 KB)

APA and Writing LibGuide

Link to MeSH Terms W

Criteria

Please, Kindly work on Scenario 4 from the PICO and Literature Search Scenarios uploaded. Thank you.

Review of Current Healthcare Issues

PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:

1). ZERO (0) PLAGIARISM

2). ATLEAST 5 REFERENCES, NO MORE THAN 5 YEARS

3). PLEASE SEE THE FOLLOWING ATTACHED RUBRIC DETAILS. 

Thank you.  

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

  • Review the Resources and select one current national healthcare issue/stressor to focus on.
  • Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

Counseling Adolescents

 ZERO PLAGIARISM

FIVE REFERENCES

The adolescent population is often referred to as “young adults,” but in some ways, this is a misrepresentation. Adolescents are not children, but they are not yet adults either. This transition from childhood to adulthood often poses many unique challenges to working with adolescent clients, particularly in terms of disruptive behavior. In your role, you must overcome these behaviors to effectively counsel clients. For this Discussion, as you examine the Disruptive Behaviors media in this week’s Learning Resources, consider how you might assess and treat adolescent clients presenting with disruptive behavior.

Learning Objectives

Students will:
  • Assess clients presenting with disruptive behavior
  • Analyze therapeutic approaches for treating clients presenting with disruptive behavior
  • Evaluate outcomes for clients presenting with disruptive behavior

To prepare:

  • Review this week’s Learning Resources and reflect on the insights they provide.
  • View the media, Disruptive Behaviors. Select one of the four case studies and assess the client.
  • For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.

Post an explanation of your observations of the client in the case study you selected, including behaviors that align to the criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.

nursing research

 I’m working on a health & medical multi-part question and need an explanation to help me learn.

Practice Question 1: Does motivational interviewing during a regularly scheduled well-child visit for children between 5-19 years with a BMI of 30 and above as compared to practice as usual, influence BMI, BP, quality of life, and daily physical activity over 8-10 weeks?

  • Identify the PICOT elements.
  • What are key search terms identified in the practice question?

Conduct a library search using these search terms to locate a research study addressing this practice problem and consider the following.

  • What is the research-evidence based intervention addressed in the study?
  • What is the quantifiable outcome(s)? How will the outcome(s) be measured? What potential reliable and valid measurements/tools may be used to measure this quantifiable data?
  • Is this practice question answerable within 8-10 weeks? Why or why not?

  I need to answer the two picot question the use keywords from the questions,perform a literature search. From the search study answer to the questions. Reference should be in APA 7th 

negligence and malpractice

Topic: Negligence and Medical Malpractice

Reply prompt: Respond to threads posted by your classmates who reached a different conclusion than you did. Identify the points of difference in your analyses and explain how your sources and analysis led you to your conclusion.

The reply assignment asks you to respond to classmates who reached a different conclusion than you did. As often happens on this case, most of the initial threads agree on an overall finding of liability. If you look more closely, however, you will see differences among your threads.

Issues to examine as you write your replies:

  • Look for differences in your analyses, how you reached your conclusions, etc.
  • Where does liability lie? (just the doctor, just the hospital, other caregivers, some combination, etc.) Each entity that you are holding liable must meet all four of the elements.
  • Is the hospital only vicariously liable through respondeat superior for employee negligence, or is it also directly liable for its own actions?
  • If the hospital is liable through respondeat superior for the negligence of its employees, should it seek indemnification (reimbursement) from those employees for money it has to pay the Smiths for the employees’ negligence?
  • How far does liability extend?
  • liability for the initial staph infection is somewhat straight-forward, but was the autoimmune impact a reasonably foreseeable outcome from a breach (failure to change gloves, etc.)
  • i.e., is there proximate/legal cause as well as factual cause for all of the injuries?

You might also consider options for the various parties at this point, including ADR, Biblical dispute resolution models, etc. 450 words . atleast 3 peer reviewed sources in APA format

Ethical and Legal Aspects of Nursing Practice DQ 10 student reply. Irmaylin Duran Parra

 

Less than 10 % similarity

References APA

This is another student post to which i have to react adding some extra information related this post. 

short answers. 

 

The current American model (ACA) is based on private healthcare. Americans lack universal access to health, so they depend on private insurance for health care. There are three ways to get coverage in the US: through a job – companies with more than 50 full-time workers must pay for part of the policy – buying it individually or, in the case of people without resources and older age 65, through two public programs.

In the present year, 2020, the Covid-19 pandemic has brought into sharp focus the need for health care reforms that promote universal access to affordable care.

About half of Americans receive health coverage through their employer, and with record numbers filing for unemployment insurance, millions find themselves without health insurance in the midst of the largest pandemic in a century. Even those who maintain insurance coverage may find care unaffordable. (King, 2020)

Before the pandemic, research showed that more than half of Americans with employer-sponsored health insurance had delayed or postponed recommended treatment for themselves or a family member in the previous year because of cost. The loss of jobs, income, and health insurance associated with the pandemic will greatly exacerbate existing health care cost challenges for all Americans. (King, 2020)

The pandemic has wreaked havoc on the country’s health system but at the same time has exposed the serious shortcomings of the American health system. However, it should not be hidden that before this event a health reform was necessary in which universal access to quality care for all Americans was guaranteed.

An adequate reform could be based on the Canadian health model, much like the British health model. In both countries, the health system is financed by the government and is based on five principles: it is accessible to all regardless of income, it offers complete services, it is publicly managed, and it is universally accessible to citizens and permanent residents. However, in the Canadian model some services such as dental and vision services are not covered. (Thomson, 2012)

Clearly, no health model will be 100% perfect and mishaps may arise along the way that must be addressed and improved, but health is a right that all people must have and a country that is a world power such as the United States, with excellent management can achieve a quality health system that is truly affordable for each and every one of its habitants.

10 essential health benefits in the ACA

  1. Ambulatorypatient services
  2. Emergencyservices
  3. Hospitalization
  4. Maternityand newborn care
  5. Mentalhealth and substance use disorder services, including behavioral healthtreatment
  6. Prescriptiondrugs
  7. Rehabilitativeand habilitative services and devices
  8. Laboratoryservices
  9. Preventiveand wellness services and chronic disease management
  10. Pediatricservices, including oral and vision care (Bagley & Levy, 2014)

Successes of the ACA

More than 20 million previously uninsured people got coverage between 2010 and 2017. In part it was because the economy improved, but many were also able to buy their own coverage thanks to federal subsidies provided by law to pay for part of the cost of insurance. Other provisions of the ACA played an important role, including a ban on restricting access to care for people with pre-existing conditions, expanding the Medicaid program to more low-income adults, and allowing children to remain in the your parents’ health plans up to age 26. (Williams, 2020)

Failures of the ACA

A growing number of insurers that signed up in 2014 – the reform’s first year of implementation – have been leaving the state regulated markets, year after year. (Williams, 2020)

Therefore, competition between policy providers has decreased, there were fewer and fewer options to choose from, reaching the point that in many counties (which act as municipal associations to offer services continuously) there was only one company that offered ACA-type policies.

At the end of October 2016, the Obama Administration announced that the ACA-type policies that insurers were going to offer for the year 2017 incorporated a national average increase in premiums of 25%. This increase was not territorially uniform at all; in states like Arizona, Illinois, Montana, Oklahoma, Pennsylvania and Tennessee it was about 50%. (Williams, 2020)

Overall, the ACA has led to an increased number of individuals with insurance; however, in many ways, it has not improved the coverage. As a result, the quality of care has not been shown to have increased. Further, the majority of the increased insurance enrollment has been with Medicaid expansion. Consequently, ACA does not work well for the working and middle class who receive much less support, particularly those who earn more than 400% of the federal poverty level, who constitute 40% of the population and do not receive any help. Further, as so many individuals don’t do well under the ACA, only about 40% of those eligible for subsidies have signed up and, with multiple insurers declaring losses, the ACA is not financially sustainable because not enough healthy people are on the rolls to compensate for the sick. (Center, 2017)

REFERENCES:

Bagley, N., & Levy, H. (2014). Essential health benefits and the Affordable Care Act: Law and process. Journal of Health Politics, Policy and Law, 39(2), 441-465.

Center, H., Woods, C. A., Manchikanti, L., & Purdue Pharma, L. P. (2017). A critical analysis of Obamacare: Affordable care or insurance for many and coverage for few. Pain Physician, 20, 111-138.

King, Jaime S. “Covid-19 and the need for health care reform.” New England Journal of Medicine (2020).

Thomson, S., Osborn, R., Squires, D., & Jun, M. (2012). International profiles of health care systems 2012: Australia, Canada, Denmark, England, France, Germany, Iceland, Italy, japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States.

Williams, R. A. (2020). Healthcare Reform Law (Obamacare): Update on “The Good, the Bad, and the Ugly” and the Persistence of Polarization on Repeal and Replace. In Blacks in Medicine (pp. 91-95). Springer, Cham.