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This week’s first assignment is STEP 3 – Literature Review and Critical Appraisal.

The student will complete the following items and submit a Word doc to the assignment link. 

1. Provide a title that conveys or describes the assignment.
2. Literature Review – Provide the key terms used to guide the search for the evidence and provide at least five (5) summaries of research studies to support the evidence.
3. Critical Appraisal of Literature – Discuss the strengths and weaknesses of the evidence, what is known from the evidence and any gaps in knowledge from the research evidence.
4. References – Cite a minimum of five scholarly references in APA 6th ed format.
5. 4-5 PAGES

Expectations

• Format: Completed paper with references in APA 7th ed. format
• File name: Save the file with Student First Name_Last Name_Part 3  

(PICOT Question;

For elderly patients above 60 years with pressure ulcers (P), will negative pressure wound therapy (I) as opposed to standard moist wound therapy (C) improve the healing of the pressure ulcer (O) during their two-week stay at the hospital (T)?)

IMPORTANT NOTICE

See attached paper as it has everything you are to do in this paper and you MUST use the Critical Analysis article to guide you in your analysis that is also attached; the EBP pyramid paper also attached.

• Use the paper you submitted in week 5 (part 2) as this may reflect what you will do for your capstone project. In this version of that paper, you are to do the following: (PUT THE PAPER IN A WORD DOCUMENT NOT PDF and NO APA templates as edits cannot be made to help you learn in either format)
  • Make sure your title page is accurate with a proper title of the project, your name, US University, MSN 563, your faculty name
• Title the first section on page one: Introduction –
  • Restate the CON approved list of subjects
  • Restate your PICOT question
  • Then you MUST give a one to two paragraph discussion of the key terms you used to guide the search for the evidence and the search engines you used to obtain the articles you will discuss.
• Title the next section Critical Analysis of Five Research Articles: all articles have to be within the last 5 years of publication
  • then present summaries of five (5) of the research studies you used to support your project and use the appraisal criteria below to do this part of the paper.
    • Title of the article and the journal
    • Author and Date of publication – has to be within the past 5 years to be used as evidence
    • Type of article published: systematic review, meta-analysis, random clinical trials, cohort studies, etc
    • EBP pyramid level of evidence (Ranks are levels I – VII)
    • Include what was the purpose, process, and outcomes of that research
    • Was the study appropriate and valuable to improve health
    • Who were the participants, how many, was a power analysis done to determine if statistical analysis should be performed
    • Was randomization or volunteer, or specific sample selection used
    • If a systematic review or meta-analysis, how did the authors determine what articles to choose to review?
    • What was the intervention?
    • Were the instruments used to analyze the data valid and reliable
    • What were the results? This includes the stats findings
    • What were the strengths and weaknesses of the published article?
    • This includes the EBP pyramid, the instruments reliability/validity, sample size, type of analysis done, results, limitations, etc
    • Did the strengths or weaknesses predominate and should the article be used to support your project and practice change?
    • Just because it is a level 1 on the EBP pyramid does not mean that it is a quality paper

 Title the next section: Summary of What is Known

• In this section discuss what is known from the evidence you presented and identify any gaps in knowledge from the research evidence you discussed.
• Give a closing statement

References – Cite a minimum of five scholarly references in APA 6th ed format. (7th edition is OK if that is what you have been using). This MUST be in proper APA format.

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 Write a 3-4 page paper describing an evidence-based quality improvement project, based on your PICOT question, and your organization (page count does not include title and reference pages).

1. Structure the paper as follows:
   1. Create a title page.
   2. Introduce your topic to the reader.  Tell why the clinical issue or patient outcome needs to be improved.
      1. Why is current practice in the area of interest being questioned? (provide data)
      2. State your PICOT question, and describe what makes up the P, the I, the C, the O, and the T parts of it.
      3. Define the purpose of the project (connect the evidence and the project). What is going to be studied/addressed? Why?
   3. The next several sections (use headings and subheadings as appropriate)  should address the following points. Use the evidence that you have gathered so far from the research studies you reviewed in Modules 2 and 3.
      1. Summarize the evidence with a focus on implications for practice (from the 10 articles you reviewed in Modules 2 and 3). This section will look similar to a review of the literature that you have seen in the research studies you have analyzed.
      • Indicate how the research studies are applicable to the project
      • Identify how similar methods might be applied to this project to be successful
      • Identify who will be involved in the study.
      • What is the process for getting this project/study approved for implementation?
      • Describe who would need to know about the project. Does approval need to be received from the institutional review board (IRB)? When do the person/people need to know? How will the person/people be informed?
   4. Assume that this project/study was proposed to be done at your place of employment.
   5. Describe the process for including stakeholders
   6. Define baseline data collection sources (such as existing datasets, electronic health records, etc.), methods (questionnaires, observation) and measures (how will the results be evaluated). What will be needed to conduct the study?
   7. Define the post-project outcome indicator of a successful project (i.e., how would those doing the project, or researchers, know if the project were successful)?
   8. Summarize the proposed project/study.
   9. Include a reference page in APA format.

Work with your preceptor to perform a needs assessment of the organization and community for your practicum. Review the needs assessment to identify possible project topics. In preparation for the capstone change project proposal, compile a list of three to five possible topics for your project and submit to the assignment instructor in LoudCloud.

You are not required to submit this assignment to LopesWrite.

 QUESTION

After sharing information about the e-intensive care unit (E-ICU) concept to a nurse who is new to the setting, the nurse asks how the system can affect the quality and improve safety of patient care. How should you respond? 

NOTE: Focus on how E-ICU affects the quality and improve safety of patient care.

1. You are a nurse caring for a 58-year-old ironworker who has been admitted to your unit with acute hypertension. He became extremely symptomatic at work and was brought to your emergency department (ED) via ambulance. After receiving a report from the ED nurse, he is brought to your unit asymptomatic (other than his BP of 178/106) and seems in good spirits. After completing his admission paperwork, he settles in and awaits his health care provider. Four hours later, you answer his call light and he reports headache (rated 6 on a 0-to-10 scale) and dizziness. 

a. Outline the pertinent information within this case study.

b. How often would you expect to measure the patient’s vital signs based on his history?

c. What would be your first intervention upon his reporting increased symptoms? Include rationale.

d. What is the patient’s pulse pressure?

e. Describe risk factors that could be contributing to your patient’s hypertension.

2. As a nurse in a critical care unit, your newest admission is a 24-year-old victim of a motor vehicle accident (MVA). Report from the OR nurse indicates that the patient has several surgically repaired fractures, a closed head injury, and elevated temperature. Additionally, he has IV fluid running postoperatively and dressing changes scheduled every shift. The patient is intermittently alert and disoriented, with his pain adequately controlled by IV analgesics. 

a. Outline the pertinent information within this case study.

b. What factors could be causing the patient’s elevated body temperature?

c. Why is determining the fever’s cause important?

d. Indicate areas that are important to monitor in a patient with elevated body temperature.

e. Describe cause-specific interventions useful in treating the patient’s elevated body temperature.

The purpose of this assignment is to create an educational risk management presentation.

Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.

Keep in mind that the PowerPoint is meant to serve as a visual aide to bolster your presentation and is intended to highlight main ideas and key points. Do not use dense blocks of text or more than 7 bullet points of text per slide.  However, you may include supplementary images, graphs, and data where relevant.

To successfully complete this assignment, include the following sections as per your outline from Topic 2, though you may include any additional sections as needed:

1. Introduction
2. Rationale
3. Support
4. Implementation
5. Challenges
6. Evaluation
7. Opportunities

You are required to support your statements with a minimum of six citations from appropriate credible sources.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style. 

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.

Having examined health information technology, it is important to also be thinking about the related ethical implications of these innovations.  

To begin this discussion, let’s first make a distinction between morality and ethics.

When we talk about morality, we are talking about our beliefs in right and wrong. So for example, most of us believe it is morally right to give everyone a fair chance and it is wrong to discriminate based on race, ethnicity, or gender.

But while ethics also deals in the realm of right and wrong, it doesn’t really come up until I am asked precisely WHY I think it is morally right to be fair.

In other words, whereas morality is all about right and wrong, ethics is all about the underlying logical reasons why we should act in a certain way.

Or:  Ethics is the thinking behind our morality that gives us the solid REASONS for believing our behavior is morally right.  

So, with that distinction in mind, this week’s discussion is asking us to do more than simply state our feelings about the rights and wrongs of healthcare technology. Rather – We need to be looking at the underlying ethical reasons for WHY we think that way.

As an example, consider the whole issue of personal privacy and then ask whether the Government has the right to collect health-related information about each of us through a special ID number issued at birth?

Off the top of your head, what do you think:  Yes or no?

Your answer to that question reflects your moral sense about the rights of the individual versus the rights of the government as a representative of the larger society.  

But now, let’s look at the “ethics” of your answer. To do that, you must explain WHY you have come to your particular judgment about the relative rights of the individual, the government, and the society as a whole.

Saying such things as “Because I think so,” or “Because it’s obvious,” and “Because I don’t like the government mucking around with my personal information” are all insufficient answers. We need to dig much deeper to actually explain WHY we think that the centralized collection of health data by the government is an ethically good or bad idea.

So how do we do that?

To start, we need to develop some basic rules of ethical thinking.

The good news is that a lot of really thoughtful people have already done a lot of work on developing these rules AND they had the good graces to write them down for us to read.

The most general rules for ethical thinking in health are called “Clinical Ethics.” There are four basic principles or pillars of clinical ethics that you can learn about here: Clinical Ethics.

A more specific set of ethical principles designed just for healthcare managers has been developed by the American College of Healthcare Executives (ACHE). You can read about the specific ethics governing our profession here: ACHE Ethics.

After reading both sets of ethical principles, let’s now revisit the question about government collection of health information by identifying why we think it is right or wrong BASED ON CLINCIAL ETHICS AND THE ETHICAL CODE OF OUR PROFESSION. In other words, why do we think it is right or wrong based on the application of clinical and ACHE ethics to this situation?

So that’s what this week’s discussion is all about – an ethical discussion about health information technology.

Let’s discuss two ethical questions.

First, let’s continue our thinking about the government’s right to healthcare information. More specifically, does the government have the right to assign each person born in the US a unique health identifier and then collect and store all your personal health information in a centralized data base? To help your thinking, consider how useful such a data base could be in determining the effectiveness of different clinical techniques, controlling epidemics, and strategic planning to best meet a community’s healthcare needs. On the other hand, are such benefits outweighed by the risk that such personal information might be misused to discriminate against people who might have cancer, HIV/AIDS, or a genetic disposition towards extremely high cost illnesses?

After that, let’s shake the government out of our heads, and think about a very different type of ethical issue – Mobile apps.

Apple has included a health app with its most recent iPhone and operating system update. This means that in the not too distant future, anyone with an iPhone will have the ability to monitor basic vital signs like blood pressure and heart rate.

What if someone buys an iPhone in Nepal or Sierra Leone, finds out they have dangerously high blood pressure, but does not have access to medical treatment? Does Apple have an ethical responsibility to help arrange treatment to that person? And further – since we now know about such a person, do we also have an ethical responsibility to help provide treatment ourselves? Or – are we are on ethically sound ground to stand back and just let that person die? 

-Power Point

– Approval Paper

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Clinical problem statement.
3. Purpose of the change proposal in relation to providing patient care in the changing health care system.
4. PICOT question.
5. Literature search strategy employed.
6. Evaluation of the literature.
7. Applicable change or nursing theory utilized.
8. Proposed implementation plan with outcome measures.
9. Discussion of how evidence-based practice was used in creating the intervention plan.
10. Plan for evaluating the proposed nursing intervention.
11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Refer to the PICOT Question Paper, and Literature Review: 

https://www.homeworkmarket.com/questions/literature-review-19863969

https://www.homeworkmarket.com/questions/picot-question-paper-19831505

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.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1:     Exemplify professionalism in diverse health care settings.

2.2:     Comprehend nursing concepts and health theories.

3.2:     Implement patient care decisions based on evidence-based practice.