Head to toe assement

Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). 

INSTRUCTIONS:

Your responses should be in a well-developed paragraph (300-350 words) to each peer. Integrating an evidence-based resource!

Note: DO NOT CRITIQUE THEIR POSTS, DO NOT AGREE OR DISAGREE, just add informative content regarding to their topic that is validated via citations. 

– Utilize at least two scholarly references per peer post. 

Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.

– Minimum of 300 words per peer reply.

– TURNITIN Assignment.

Background: I live in South Florida, I am currently enrolled in the Psych Mental Health Practitioner Program, I am a Registered Nurse, I work in a Psychiatric Hospital.

• Review      the Academic      Writing Expectations Checklist Capstone Level
  • Note       the new expectations for Use of evidence and Credit to       Source
  • Use       a Scholarly Voice
    • http://academicguides.waldenu.edu/writingcenter/scholarlyvoice
    • http://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-2773859
  • Review       the Walden University Writing Center webpage: Using Evidence: Synthesis
• Review      the Week 3 Assignment Rubric

Remember: Each section of the Capstone Paper must meet the Academic Writing Expectations for the Capstone Level.

For this Assignment

• Describe      the quality improvement process and the Quality model that will be used as      a basis for the practice problem. Include a description of a quality      improvement tool(s) that you will use in your quality improvement plan.      See Spath, (2018) chapter 6 for examples.
• Explain      why the specific process was selected and document your explanation with      references.

For the Week 3 Assignment, you will combine your Week 1, 2 and 3 assignments and submit a 3-4-page paper that addresses the following: 

.

• Practice      Problem (Completed in Week 1)=

In hospice, one of the goals is to have skilled nurse visits at least 3 days prior to death and at least 3-6 days prior to death. If we track ESAS it is supposed to help indicate who we can expect to pass away based on changes reported and then be able to increase nursing visits-however to be effective the data has to be accurate. Are we asking the patient or caregivers the 10 symptoms or just guessing based on our assessment

my wk one is totally different because I had to change topicsm so information will need to be added to this section. 

Please include information from discussions and everything below. In the literature review, you don’t have to worry about the bottom 5 that are not relatated to the ESAS but my help and can use it.

I answered the questions above a little and will attach the graphs that should be included

• State       the practice problem in measurable terms.
• State       the data that suggests a practice problem exists
• Include       a purpose statement.
• Analysis      of the Existing Evidence (Completed in Week 2)
  • Summarize       the findings from the evidence analysis that support your practice       problem. Include minimum of at least 5 evidence-based practice sources       that support your practice problem. Identify research, clinical       guidelines, expert opinions, and other relevant information. You must       include two-three research studies in your analysis. Using your own words       synthesize the evidence that supports your identified practice problem.       There should be no quotes or personal opinions included in this section.
• Quality      Improvement Process (Completed this Week) (Approximately 2-3      paragraphs)
  • Describe       the quality improvement process and the quality model that will be used       as a basis for the practice problem. This is not your entire quality       improvement plan, only a description of the quality improvement process       and the quality model you chose. You will develop your specific quality       improvement plan in week 4. Include a description of a quality       improvement tool(s) that you will use in your quality improvement plan.       See Spath, (2018) chapter 6 for examples.
  • Explain       why the specific process was selected and document your explanation with       references.
  • Conclusion

See instruction below, please keep turnitin score to 0% or less than 10%, No grammar error. Only use scholarly articles within the last 5 years.

PLEASE ANSWER THE QUESTIONS BELOW IN APA FORMAT

EACH ANSWER MUST HAVE A MINIMUM OF 4 SENTENCES

PROVIDE 2 CITATIONS AND 2 REFERENCES (AT LEAST)

1. Try taking a different route to class the next time it meets. Before you do this, think about how many changes, large and small, you will have to make to do this.

a-Will you have to leave earlier to be in class on time? 

b-Will you meet different people on your way to class?

c-See different sights?

d-Would you change your route to class on the day of the final exam? 

e-Why or why not? Summarize the positives and negatives of this small change. Relate your responses to this change to the way staff nurses feel when an administrator makes what he or she thinks is a “minor” change. 

2. Think about a change that has occurred in your life. Some examples may be a change of role, a move, a marriage, a birth, a divorce, or a death. 

a-How did you react to the change? 

b-Would you have reacted differently if you had had more information?

c-Using Lewin’s model, describe the basic elements in the situation and how you eventually achieved a comfortable outcome. 

in a 1 page paper not including title page and reference page.

Define race, define ethnicity. Give examples of two races and two ethnicities.

Define cultural norms and give an example of a cultural norm used by a specific race or ethnic group.

Identify how a cultural norm affects the health of a specific race or ethnic group Use APA format. Headings required. Title page and reference pages are not included in the 1 page 

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

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

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.

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.