Explain academic integrity and how you are prepared to meet the academic integrity standards at this school.

Discussion: The Role of the RN/APRN in Policy Evaluation

In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

To Prepare:

• In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
• Review the Resources and reflect on the role of professional nurses in policy evaluation.

By Day 3 of Week 9

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.

The following post is from another student to wish I have to reply adding some extra information related to the post

APA

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short answer

Investigate normal changes of aging related to the heart. 

Part two: Complete the project started in Part One (Educational Pamphlet) by adding factors that promote cardiovascular health to your pamphlet.

Older adults are vulnerable to cardiovascular diseases because of the heart muscles’ changes and blood vessels such as arteries, causing increased blood pressure. The cardiovascular system consists of the heart and the blood vessels, which pumps blood, carries nutrients and oxygen to all parts of the body, and releases carbon dioxide and other waste products from the body. Therefore, it is essential to maintain a healthy lifestyle to keep the cardiovascular system healthy and maintain a healthy weight (Mongraw-Chaffin et al., 2018). With the changes in arteries becoming stiffer and thicker, older adults must manage their blood pressure because it is a significant risk factor for heart disease; hence it should be checked regularly. Blood pressure should be checked at least once a year and even more frequently for an older adult with high blood pressure. Cessation of smoking if one is a heavy smoker may also help promote cardiovascular health since the smoke is harmful to the body. Older adults should stop smoking and practice a healthy lifestyle and promotion measures.

Other factors that promote cardiovascular health include eating a well-balanced diet, physical exercises, and maintaining a good weight. Massive weight causes obesity, which is another significant risk factor in heart diseases because of too much fat (Sacks et al., 2017). Physical activities are essential in reducing weight and also keeps one engaged and active. Physical activity should be scheduled at least three times a week, and intense workouts can be practice for approximately 45 minutes. Eating a well-balanced diet also helps maintain a healthy weight, mostly by eating green vegetables and fresh fruits. One should increase calories out and decrease calories in. Lastly, controlling cholesterol and reducing blood sugar is essential in maintaining cardiovascular health since too much blood sugar is likely to cause diabetes, which is sometimes a comorbidity of heart disease. The above mentioned are the ideal factors that promote cardiovascular health as recommended by the American Heart Association, which should be embraced by older adults and everyone.

References

Mongraw-Chaffin, M., Foster, M. C., Anderson, C. A., Burke, G. L., Haq, N., Kalyani, R. R., … & Vaidya, D. (2018). Metabolically healthy obesity, transition to metabolic syndrome, and cardiovascular risk. Journal of the American College of Cardiology, 71(17), 1857-1865 https://doi.org/10.1016/j.jacc.2018.02.055

Sacks, F. M., Lichtenstein, A. H., Wu, J. H., Appel, L. J., Creager, M. A., Kris-Etherton, P. M., … & Stone, N. J. (2017). Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association. Circulation, 136(3), e1-e23 https://doi.org/10.1161/cir.0000000000000510

· Describe the selected problem from two of the three systems levels (micro-, meso-, and macro).

The selected problem I would like to discuss currently affects the microsystem and the mesosystem level. I work in a pediatric gastroenterology clinic that has 9 attending physicians, 3 fellows, 1 NP, and 4 nurses. Currently we have clinic Monday-Friday with many satellite clinics, about 85 percent of patients get blood work done outside our facility. Our lab slip currently states to fax results to providers once finalized, we were having a hard time receiving results for a long time. We often received junk faxes, or faxes that were not intended for our providers which turned into so much wasted paper. We came up with an idea to start using an efax system that could decrease the amount of lost faxes and also decrease the amount of wasted paper.  With an effective efax machine means we can receive faxes directly to our emails and this can mean a faster turnaround for patient treatment.

· Explain how the outcomes of one system level effect the other level?

Delays in test results can lead to patients not receiving appropriate care in a timely fashion and often times require an admission and or readmission. Both admission and readmission can be very costly. With delayed results patients and physicians will likely complain and these complaints will be directed at the mesosystem level. With decreased patient satisfaction comes poor survey scores; which is never a good thing.

· How is a systems approach beneficial in improving healthcare quality and safety?

This system approach is helpful in improving patient care by ensuring patient results are received in a timely fashion. This will also help patients be treated sooner for infections and GI disorders. This system approach will also decrease the amount of wasted paper on junk faxes. Efaxing allows for a quicker turnaround time for physicians to view results.

References:

Pandhi, N., Kraft, S., Berkson, S., Davis, S., Kamnetz, S., Koslov, S., Trowbridge, E., Caplan, W. (2018). Developing primary care teams prepared to improve quality: A mixed-methods evaluation and lessons learned from implementing a microsystems approach. BMC Health Services Research 18(1), 847. https://doi.org/10.1186/s12913-018-3650-4.

I NEED A COMMENT FOR THIS POST WITH AT LEAST TWO-THREE  PARAGRAPH AND TWO SOURCES NO LATER THAN FIVE YEARS

USING THE TOPIC MEDICATION ERROR IN  A LONG TERM CARE FACILITY

Create an 8- to 9-slide PowerPoint presentation in which you do the following:

• Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)MY FACILITY IS A LONG TERM CARE FACILITY FOR OLDER PATIENTS ABOVE 65YEARS OLD.ISSUE INCLUDE POLY-PHARMACY AND LONGTERM USE OF MEDICATIONS.
• Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
• Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
• Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
• Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
• Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
• Add a lessons learned section that includes the following:
  • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
  • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

The purpose of Reflection-in-Action is to reflect upon what one has learned or how one has performed as compared with one’s expectations or goals. This assignment will provide an opportunity for students to share their experiences, thoughts, feelings and learning moments from this course. 

Self understanding through reflection on life experiences, feelings, etc., is a core concept in Dr. Jean Watson’s Theory of Human Caring.  

The Reflection for this course must address at least three (3) of the following topics:

• Learning moments or activities from this course
• Thoughts on evidence-based practice
• Evidence supporting Jean Watson’s Theory of Human Caring
• Ethics in research
• Protecting human subjects in quality improvement or evidence-based practice projects
• Understanding or comfort level with statistics in nursing research and other research reports
• Perception of MSN graduates’ role in nursing research
• Creating and sustaining an Evidence-Based nursing environment
• Asking compelling, clinical questions
• Lessons learned while conducting evidence-based literature review

Expectaton

Length: 3 pages (excluding the title and reference pages).  Submissions not meeting the minimum and maximum page requirements will receive a grade of zero. 

• Format: Formal paper, APA 7th ed format for body of paper and all citations.  
• The purpose of Reflection-in-Action is to reflect upon what one has learned or how one has performed as compared with one’s expectations or goals. This assignment will provide an opportunity for students to share their experiences, thoughts, feelings and learning moments from this course. 
• The Reflection for this course must address at least three (3) of the following topics:
•  

Medication errors can lead to adverse drug events, which are associated with increased total hospitalization cost and length of stay (McCarthy, Tuiskula, Driscoll, & Davis, 2017), with an estimate of 44,000 Americans from medical errors (Hanifin, & Zielenski, 2020). Slight, Seger, Franz, Wong, & Bates (2018) estimated a national cost projection of $871 million to $1.8 billion to treat avoidable adverse drug events. Hanifin and Zielenski (2020) found that addressing the medication error problem with initiatives supported by an interdisciplinary team has resulted in a successful decrease in medication error rates.

At the clinic where I work, I would have the therapist, nurses, clinic manager, pharmacist, physician/advanced practice provider, and information technologists on my team. The nurses are responsible for making sure the medications are sent properly and the client understands  and  must be sure that the correct medication is dispense to the patient as ordered by the provider. The provider’s role is to order the correct medication as appropriate for each patient’s clinical condition. The pharmacist is available to consult if a provider is unsure of what to order, or if a nurse has questions about dose safety or how it is to be administered. The information technologist’s role is to provide medication entry/charting in the patient’s electronic medical record and relay the findings to the clinic manager. The nurse’s role is to review the IT-generated report for accuracy and report results to the practice.

Teamwork is best achieved through communication and understanding, as well as respecting each team member’s roles, responsibilities, and concerns (White, 2016). Each member of the team should come together initially to delineate his/her unique responsibilities. With the clarity of each other’s roles and responsibilities, members should hold one another accountable and collectively answer to the leader of the collaboration, which typically would be the nurse and the provider who holds responsibility for the safety initiative and tasking clinical staff to find evidence-based solutions to the problem.  My workplace has 5-minute, daily huddles that take place at 8 in the morning before our workday begins. Each huddle session summarizes issues from the previous workday and highlights essential events/patients for the same day and the day after. This huddle session would be a great way to follow-up on divided tasks outlined in the paragraph above.

White & Dang (2018) highlighted a critical barrier – time. Each member of the team will need uninterrupted time to think about and discuss the problem. Biweekly or weekly staff meetings, spanning 30-60 minutes, are ideal for each team member to have the opportunity to voice their concerns.  Also, the team leader should encourage everyone to voice their concerns publicly and privately for effective communication and collaboration. Above all, the team leader must encourage each team member to value one another’s professions, interests, concerns, and responsibilities (White & Dang, 2018).

I need a comment for this discussion board at least 2 paragraphs and use 2 sources no later than 5 years. 

 The case study demonstrates a role related and ethical conundrum when the nurse is taking care of an end stage aggressive lung cancer patient, Mr. Wilson, who expressed suicidal intentions to the nurse and asked to keep the secret from his family and the hospital staff. 

If the nurse knows of Mr. Wilsons’ plan for rational suicide, would the nurse be obligated to intervene? If so, what actions could the nurse take at this point? Does a nurse have the right to try to stop a person from committing rational suicide (to act in the best interest of the patient)? Is a nurse supposed to support the person’s autonomous decision to commit rational suicide? even when that decision is morally and religiously incompatible with the nurse’s perspective? What is the nurse’s role? 

The case study must be typed in APA format with a minimum of 750 words (excluding first and references page) with a minimum of 4 evidence-based references using the required Arial 12 font. 

Literature Review Paper Due Week 7

• Select a recent Health Care Legislature (within 5 years)

• Literature review regarding issue (3 peer reviewed articles)

• Statistical data related to issue: population impacted, and health outcome of issue and legislature

• Nursing role in passing the legislature

• APA Format

• References within 5 years

• 5-Page Maximum

As an advanced registered nurse, you will serve as a leader within your organization. Part of this role will entail being a change agent, and spurring positive change on behalf of patients, colleagues, and the industry.

Consider a situation you experienced previously where change did not go as planned in your health care organization. Create a 10-15-slide PowerPoint presentation in which you will assess the situation and the steps that should have been taken to successfully implement change.

1. Describe the background of the situation, including the rationale for and goal(s) of the change.
2. Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.
3. Discuss an appropriate change theory or model that could be used to achieve results.
4. Outline how you would initiate the change.
5. Describe the impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take if the change is unsuccessful.

Make sure to include slide notes of 100-250 words for each slide.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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.

You are not required to submit this assignment to LopesWrite.