Monthly Archives: May 2023

Assignment 3: Midterm Progress Check 

At a midway point agreed upon by you and your Chair, you will review (and if necessary, revise) your Term Plan. Review of the Term Plan is a critical step that will allow you to take stock of your progress to date, refocus on achievable goals you have not yet attained, and receive acknowledgment of work you have completed that is currently not captured in your Week 1 Term Plan. While you are required to complete a minimum of one Midway Progress Check, you are encouraged to keep in close contact with your Chair throughout the term. Keep your Chair apprised of anything noteworthy that occurs during the term.

Submission Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “MidtermPlan+last name+first initial.(extension)” as the name.

Click the Assignment 3 link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “MidtermPlan+last name+first initial.(extension)” and click Open.

Click on the Submit button to complete your submission.

To submit your Assignment:

The purpose of this assignment is to draft and submit a comprehensive and complete rough draft of your Nursing Theory Comparison paper in APA format. Your rough draft should include all of the research paper elements of a final draft, which are listed below. This will give you an opportunity for feedback from your instructor before you submit your final draft during week 7.

Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 6–9), select a grand nursing theory.

• After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.

Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 10 and 11), select a middle-range theory.

• After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.

The following should be included:

1. An introduction, including an overview of both selected nursing theories
2. Background of the theories
3. Philosophical underpinnings of the theories
4. Major assumptions, concepts, and relationships
5. Clinical applications/usefulness/value to extending nursing science testability
6. Comparison of the use of both theories in nursing practice
7. Specific examples of how both theories could be applied in your specific clinical setting
8. Parsimony
9. Conclusion/summary
10. References: Use the course text and a minimum of three additional sources, listed in APA format

The paper should be 8–10 pages long and based on instructor-approved theories. It should be typed in Times New Roman with 12-point font, and double-spaced with 1″ margins. APA format must be used, including a properly formatted cover page, in-text citations, and a reference list. The proper use of headings in APA format is also required.

Recommended: Before you begin, review A Pocket Style Manual (APA) and the Writing Resources area of the Student Resources tab.

1 Discussion

1 Journal

1 Reflective Paper

SOAP Note Case , I uploaded an example, you can create your own case, with a person older than 40 years  . Including patient name initials , date of birth and all the examples of personal and medical history provided in the example uploaded, use my example just for guide. I need all the information wrote  in the example, No require references, PLEASE everything must be related because is the same case. 

PLEASE DON’T USE THE FOLLOWING DIAGNOSIS :

NO HYPERTENSION

NO CERVICITIS

NO TUBERCULOSIS EXACERBATION

NO ASTHMA EXACERBATION

NO ACUTE PERICARDITIS

NO Bronchioectasis

Will be a TOTAL OF 4 SOAPS, PLEASE WHEN DONE WHICH EACH ONE, POST IT BY CASE # , NOT TOGETHER , IN SEPARATE DOCUMENTS.

FOR EXAMPLE: SOAP 8, SOAP 9 AND LIKE THAT.

BE AWARE OF THE DEADLINE BECAUSE I HAVE A END TIME FOR SUBMIT IT , IF TIME PASS IM SORRY BUT I WILL NOT NEED THE WORK AND THEN I HAVE TO DISPUTE.

THANKS FOR HELP AND SUPPORT AND DEDICATION

summarise the attached article on one page. 

Module 4 Discussion

Population and community health are extremely important for the well being of our population. Healthcare providers play important roles in improving population health and are also the health educators for their community. Population health is the outcomes of a group of individuals, including the distribution of such outcomes within the group. Community health is a branch of public health which focuses on people and their role as determinants of their own and other people’s health in contrast to environmental health, which focuses on the physical environment and its impact on people’s health. All healthcare professionals can take many actions to promote population and community health. There are many ideas about actions that need to be taken to improve the health among the population in Miami and the communities within the city.

 I went to Broward College for my BSN and the last class we had to take before graduate from the program was community health. The purpose of this class was to integrate us as healthcare provider in the community which allowed us to help the less fortunate people or the vulnerable population. A group of us chose to complete the class with the homeless population in Broward county. We went to the homeless shelters to provide primary care to the homeless individuals by taking their blood pressure, blood sugar, and so on. We literally had an open clinic at each of the homeless shelters. We had doctors and nurse practitioners that volunteer to provide care to them. It is extremely important for healthcare professionals to promote community health to the homeless population because it can help decrease illnesses and many diseases among them.

According to Tsai, Jenkins, & Lawton (2017), individuals who are homeless represent the most vulnerable, indigent group in the United States and thus may have great medical needs that must be addressed to prevent sicknesses and illness. A few studies have shown access to healthcare can improve the health and lives of various patient populations (Tsai et al, 2017). Lack of access to healthcare or lack of health insurance is one of the major issues in the United States. The homeless population is among the vulnerable populations that suffer more due to their lack of healthcare coverage. By volunteering to help, healthcare providers can improve their quality of life. These individuals are not able to purchase or pay for the most basic health insurance and will not be able to get any treatment without us (healthcare providers) volunteering to help at their shelters.

According to Bernstein, Meurer, Plumb, & Jackson (2015), reported rates of diabetes and hypertension in the homeless population range from 2% to 18% for diabetes and 18% to 41% for hypertension. The percentages of homeless individuals being diagnosed with diabetes and hypertension will continue to increase because they do not have access to healthcare. there is also a growing consensus that the adult homeless population in the United States is aging and this trend is cause by multiple economic and social challenges facing individuals in this country.

References

Tsai, J., Jenkins, D., & Lawton, E. (2017). Civil Legal Services and Medical-Legal Partnerships Needed by the Homeless Population: A National Survey. American Journal of Public Health, 107(3), 398-401. https://doi.org/10.2105/AJPH (Links to an external site.). 2016.303596

Bernstein, R. S., Meurer, L. N., Plumb, E. J., & Jackson, J. L. (2015). Diabetes and Hypertension Prevalence in Homeless Adults in the United States: A Systematic Review and Meta-Analysis. American Journal of Public Health, 105(2), e46-60. https://doi.org/10.2105/AJPH.2014.302330

Patient care decisions should be supported by timely clinical information, reflecting the best evidence possible (Institute of Medicine 2013). Present and future professional nurses must be able to use informatics and technology to facilitate critical decision-making for optimal patient outcomes (Massachusetts Department of Higher Education Nursing Initiative 2016). Nursing clinical informatics competencies involve the collection and use of patient data for analysis and dissemination. Nursing informatics with computer science was established to create innovative ways to provide quality care to our patients. Evidence based practice is a cornerstone to making NI better for the future. Without EBP there would be no such thing. 

What I see for the future is that technology would be expanding at a faster rate. There would be less hands on and more robotics. What I mean by this is that robots would be administering meds at the bedside, documenting task, and even doing patient consults. I believe that this would be in the near future to come because it would cut the need for nursing staff in half and it would be cost effective for the company. The only thing that would be the downfall to this is that robots do not pose interpersonal skills so patient questions would go unanswered and in would block the communication to building a rapport. We have already advanced to telemedicine which in some cases can be beneficial to the patient being seen by the physician. 

Another thing that would probably be good for the up and coming future would be if we could use the pyxis like we use Alexa and Siri. If we could give them voice commands where it could dispense patient medications that are due just by giving the first and last name of the patient would cut down on the time spent pulling meds. Instead of your taking 30mins to 1 hour pulling meds could just take about 15 to 20 mins. Modern technology is advancing so much that some of us cannot not keep up with the new demands of the workplace. In nursing we are always learning new things and we must continue to learn as we advance in our careers in order to be successful. New media offer new possibilities in teaching and learning. However, the appropriation of new knowledge and skills in dealing with technology, especially for older adults, is a critical challenge. This needs to be considered against the background of the digital divide. Which describes, among other things, the lack of information on the ability of older adults to use technology among those who have access to ICTs and new media in healthcare. In conclusion informatics will be changing for the better.

Reference 

Institute of Medicine. (2013). Core measurement needs for better care, better health, and lower costs: Counting what counts, workshop summary. Washington, DC: National Academies Press. doi:10.17226/18333 

Massachusetts Department of Higher Education Nursing Initiative. (2016). Massachusetts nursing of the future nursing core competencies. Retrieved from https://www.mass.edu/nahi/documents/NOFRNCompetencies_updated_March2016.pdf (Links to an external site.) 

Reply 2

The origin of health informatics began in the 1950s when computers were introduced into healthcare. Computers allowed new technology to expand the fields of medicine and nursing education (Nelson, 2014, p. 596). Today, health informatics takes the information technology that exists and applies it to systems in place already, creating a more innovative vision for healthcare. This can be accomplished by reviewing the current trends, as well as offering tools for predicting the future. Health professionals and informatics specialists can then prepare their leadership roles in planning effective future healthcare information systems (Nelson, 2014, p. 612).  

Our textbook further explains these changes by dividing the scope of change into three levels. The first level of change makes the process in use more efficient without changing the process or goal. An example of this would be for health care to completely move from paper documentation to an electronic way of inputting patient information. As I have discussed in other posts, this can be achieved by providing organizations that rely on pen and ink with the resources they need to provide all their cases electronic devices for accessing the plan of care for patients and medication administration records. Having patients check in to doctor’s offices with an iPad versus a clipboard and paper is another way the first level of change can occur. Second level changes involve changing how a specific outcome is achieved (Nelson, 2014, p. 614). An example of this today is the rise of telehealth medicine. Allowing patients more access to therapies and physicians through the phone offers more accessibility to those quarantining or social-distancing due to COVID-19. Telehealth medicine allows clinics the opportunity to limit the number of clients that are in a room to minimize risks for other patients and healthcare workers. Another example would be the initiation of apps for accessing health information and scheduling appointments. Phone applications can be downloaded and used at the discretion of patients 24/7 rather than patients calling the doctor for test results, medication refills, appointment scheduling, and taking printouts of visit summaries. The third level of change alters the process and refocuses the goal at the societal and institutional level (Nelson, 2014, p. 614). Phones have had the ability to track location since cell towers were installed. This past summer, location tracking has taken on a new role in the life of coronavirus. Digital contact tracing has become popular with governments of various countries to identify infected individuals and tracing people they have been in contact with. The process uses Bluetooth technology that logs when devices are near another device associated with an infected user for a prolonged period (Frith & Saker, 2020). Changing how phone tracking is used to benefit the community and allowing health agencies to monitor those who should be social-distancing due to a positive COVID-19 virus. The use of technology in this way  shows how a third level change can reflect the changes happening in our society. However, some oppose digital contact tracing because of HIPAA and surveillance concerns. My hope for the future of informatics is to successfully find the balance between technology and patient-centered care. Taking into consideration what nurses need to do their jobs most efficiently, improving patient care to be most accessible, and seamlessly integrate technology into the community to improve health in our neighborhoods is my vision of the future of health informatics.  

References 

Frith, J., & Saker, M. (2020). It Is All About Location: Smartphones and Tracking the Spread of COVID-19. Sage Journals. https://doi.org/10.1177/2056305120948257 (Links to an external site.) 

Nelson, R., & Staggers, N. (2014). Health Informatics: An Interprofessional Approach (2nd ed.). Mosby. 

Edited by Wood, Carmen on Oct 7 at 12:46pm

All replies must be constructive and use literature where possible.

Your assignment will be graded according to the grading rubric.

250 words for each reply

REPLY1

For the topic of asthma, there are six articles on asthma that will help formulate on the project. Each have their strengths and weakness.

Article #1

“Improving care of inner-city children with poorly controlled asthma: what mothers want you to know.”

Strength: The article highlights on the perspectives of parents with children with asthma and the management ability. This is important as it can determine what is needed to help improve care and participation.

Weakness: The study only targeted poor families and asthma is a broad area that can affect all incomes with exposure to different things and circumstances, and it is good to look at other perspectives based on their lifestyles to compare.

Article #2

“Proximity to major roadways and asthma symptoms in the School Inner-City Asthma Study.”

Strength: The article focuses on the effects high traffic and highway areas in relation to asthma. Rates are calculated with those who live in close proximity versus those who are further away from them.

Weakness: The article measured those who live within 100meters of major roadway, but I believe asthma rates should be compared not only to those living within 100meters but also those who live even closer. Then look at the severity of the symptoms based on location.

Article #3

“Asthma-related school absenteeism, morbidity, and modifiable factors.” 

Strength: The articles is a great one to reference as it gives insight on school absenteeism and it’s relation to asthma and its morbidity, while determining which areas can be modified to improve outcome.

Weakness: The study was conducted using a Behavioral Risk Factor Surveillance System Child Asthma Call-back Survey. This is a random-digit dial survey which is made to help assess the health and experiences of children ages 0–17 years with asthma. Although this is a good approach, it also can lead to inaccurate responses by the children or their parents.

Article #4

“A school nurse-led asthma program Reduces Absences: Evaluation of easy breathing for schools.”

Strength: The article helps to understand the importance of school nurses within school setting and the use of asthma programs like Easy Breathing for Schools, in how they impact a reduction in asthma symptoms, more management.

Weakness: Based on the training of nurses in easy program prior to study, application, surveys, and collaboration with physicians and the satisfaction scores, small but very important things for the impact of the study were a bit weak. From 51 nurses only 28 nurses participated, one nurse per school where over 200 children were enrolled, possibly making it difficult to gather information in short period of time. In addition, not all children with asthma were enrolled in the program.

Article #5

“Building bridges for asthma care: Reducing school absence for inner-city children with health disparities.”  

Strength: This is another article that supports nurses in using and assessing the effect of the Building Bridges for Asthma Care Program on improving school attendance and measures of asthma control. The Inhaler Technique Assessment Tool was used to standardize the assessment of inhaler technique by school nurses, and elementary schools from 2 different states were considered, which shows diversity of location and outcomes.

Weakness: Children were enrolled in the Building Bridges Program for 2 consecutive years, but only data from their first year of enrollment were included in the analysis of absenteeism. School absence data were challenging to analyze, due to the variety of age/grade, race/ethnicity, and asthma status.

Article #6

“Solutions for asthma disparities.” 

Strength: Disparities in asthma outcomes have been documented for many years and this is important to recognize as it can help to find solutions to the issues. This article helps to address disparities in the health care sector, evidence-based guidelines detail essential elements that providers and health care organizations should deliver for high-quality asthma care.

Weakness: One limitation of the article it explains that wide-scale payment policies may not affect all systems equally and care must be taken to avoid widening disparities if financial penalties are on the line. And payment systems should incentivize and reward the reduction of disparities not be the cause of.

References

Bellin, M. H., Newsome, A., Lewis-Land, C., Kub, J., Mudd, S. S., Margolis, R., & Butz, A. M. (2018, July-August). Improving care of inner-city children with poorly controlled asthma: what mothers want you to know. Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners, 32(4), 387–398. https://doi-org.lopes.idm.oclc.org/10.1016/j.pedhc.2017.12.009

Hauptman, M., Gaffin, J. M., Petty, C. R., Sheehan, W. J., Lai, P. S., Coull, B., Gold, D. R., & Phipatanakul, W. (2020, January). Proximity to major roadways and asthma symptoms in the School Inner-City Asthma Study. The Journal of Allergy and Clinical Immunology, 145(1), 119–126. https://doi-org.lopes.idm.oclc.org/10.1016/j.jaci.2019.08.038

Hsu, J., Qin, X., Beavers, S. F., & Mirabelli, M. C. (2016, July). Asthma-related school absenteeism, morbidity, and modifiable factors. American Journal of Preventive Medicine, 51(1), 23–32. https://doi-org.lopes.idm.oclc.org/10.1016/j.amepre.2015.12.012

Simoneau, T., Langton, C. R., Kuo, C.-L., Marrero, J., Gherlone, N., Cloutier, M. M., & Hollenbach, J. P. (2020, January-February). A school nurse-led asthma program Reduces Absences: Evaluation of easy breathing for schools. Academic Pediatrics, 20(1), 73–80. https://doi-org.lopes.idm.oclc.org/10.1016/j.acap.2019.07.007

Szefler, S. J., Cloutier, M. M., Villarreal, M., Hollenbach, J. P., Gleason, M., Haas-Howard, C., Vinick, C., Calatroni, A., Cicutto, L., White, M., Williams, S., McGinn, M., Langton, C., Shocks, D., Mitchell, H., & Stempel, D. A. (2019, February). Building bridges for asthma care: Reducing school absence for inner-city children with health disparities. The Journal of Allergy and Clinical Immunology, 143(2), 746. https://doi-org.lopes.idm.oclc.org/10.1016/j.jaci.2018.05.041

Volerman, A., Chin, M.H., & Press, V.G. (2017, March). Solutions for asthma disparities. Pediatrics. Official Journal of the American Academy of Pediatrics. 139(3). DOI: https://doi.org/10.1542/peds.2016-2546

REPLY2

Six article summary on patient safety include:

Heather V., Shin Hye, P., & Sandra, B.-B. (2018). Characteristics of the Nursing Practice Environment Associated with Lower Unit-Level RN Turnover. The Journal of NursingAdministration, 6(1), 31-86.

This article shows the relationship between staff rate turnover and environment. The main advantage of the above article is that it expounded on the linkage between sufficient staffed unit and lower turnover rates. However, the authors failed to show methods of changing work environment to a conducive environment preferred with all nurses.

Buljac-Samardžić, M., & van Woerkom, M. (2018). Severity and workload of nursing.Escola Anna Nery 22(1), 53-134.

The authors of severity and workload of nursing tried to provide as much information on nursing workload and that served as their great strength. However, they failed to consider the wide aspects in the field of nursing and concentrated only on patient safety and its effects on healthcare professionals.

Romig, C. (2016). Health Policy Issues: The nursing shortage demands action now—state and federal legislation passed. AORN Journal,74, 733–738. (06)61776-6

The authors of this article tried to show the need of addressing nursing shortage stating their effects on patient safety and general healthcare. Nonetheless, they did not give examples of the benefits the passed laws to salvage nursing shortage.

Shekelle, P. G. (2015). Nurse-patient ratios as a patient safety strategy: A systematicreview.Annals of Internal Medicine, 15(8), 404–409. -158-5-201303051-00007

Nurse- patient ratios as a patient safety strategy journal was known for using comprehensive data to analyze and support evidence on lower nurse or patient ratios. However, the journal received a lot of criticism from other researchers because it failed to consider the importance of patient acuity in the process of assigning patients to nurses.

Swiger, P. A., Vance, D. E., & Patrician, P. A. (2016). Nursing workload in the acute-caresetting: A concept analysis of nursing workload.Nursing Outlook, 64, 244–254.

The journal of nursing workload in the acute- care setting gain its popularity since it used extensive numerical data supporting the effects of high workloads on both patients and nurses. Nevertheless, the journals main weakness is that it only obtained data from one healthcare facility thus was based on a narrow scope of the required comprehensive for any random sample study.

Wolf, L. A., Perhats, C., Delao, A. M., Clark, P. R., & Moon, M. D. (2016). On the Threshold of Safety: A qualitative exploration of nurses’ perceptions of factors involved in safe staffing levels in emergency departments.Journal of Emergency Nursing 2(5),134-147.

Lastly is the article of Threshhold of safety and it absolute strength is that it can be measured in its perceptive form. However, it has one weakness in that it only based on opinion and assumptions of nursing staff working in emergency rooms.

Reference

Heather V., Shin Hye, P., & Sandra, B.-B. (2018). Characteristics of the Nursing Practice Environment Associated with Lower Unit-Level RN Turnover. The Journal of NursingAdministration, 6(1), 31-86

Buljac-Samardžić, M., & van Woerkom, M. (2018). Severity and workload of nursing.Escola Anna Nery 22(1), 53-134.

Romig, C. (2001). Health Policy Issues: The nursing shortage demands action now—state and federal legislation passed. AORN Journal, 74, 733–738. (06)61776-6

What would spirituality be according to your own worldview? How do you believe that your conception of spirituality would influence the way in which you care for patients?

Due Date: Wednesday 21

 After reading chapters 23 and 24 please answer the following questions. Please follow the discussion protocol and respond to two peers. In addition, follow the guidelines below.

1.   Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

2.   All answers or discussions comments submitted must be in APA format according to Publication Manual

American Psychological Association (APA) (6th ed.) 2009, ISBN: 978-1-4338-0561-5

3.   Minimum of two references, not older than 2015.

Questions

Chapter 23 – Mobility: 1A. Describing two (2) of the normal age-related changes that produce challenges in maintaining physical activity in the elderly. 1B. Discuss two (2) physical activities that can enhance health in this population.

Chapter 24 – Neurologic Function: Identify two (2) signs and symptoms of TIA versus CVA. How are your interventions the same or different?