The Role of the DNP Scholar in Leading Change

Reflect upon the selected practice problem (CANCER)* in Weeks 1 and 2 to address the following.

• Which translation model provides a framework for practice change?
• What is the value of an interprofessional team to address this practice problem?
• In influencing improvement outcomes to address this problem, what strategies can you implement to inspire others to embrace change?  
• What are some barriers to implement changes and what is the paper of the DNP scholar on the implementation of change?

Instructions:

Use an APA style and a minimum of 200 words. Provide support from a minimum of at least three (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply. 

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website,s or blogs should not be used.

Adolescent pregnancy is viewed as a high-risk situation because it poses serious health risks for the mother and the baby. Describe various risk factors or precursors to adolescent pregnancy. Research community and state resources devoted in adolescent pregnancy and describe at least two of these resources. Research the teen pregnancy rates for the last 10 years for your state and community. Has this rate increased or decreased? Discuss possible reasons for an increase or decrease.

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 Mrs. J., 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

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of three 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,  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. 

Interprofessional Collaboration

As a practice scholar, you are called to respond to a recurring medication administration error at your workplace setting and identify strategies to prevent future recurrence through interprofessional collaborative practice. Your first step is to assemble the interprofessional team. Consider the following.

• Who is on your team? What are the roles, responsibilities, and abilities of the team members?
• How will you work together? How will you determine accountability and task distribution?
•  Identify ways to distribute and follow up on tasks among interprofessional team members. 
• What strategies will you use to facilitate effective communication and collaboration?  

Instructions:

Use an APA style and a minimum of 200 words. Provide support from a minimum of at least three (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply. 

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website,s or blogs should not be used.  

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Education-Resources/AACN-Essentials (Links to an external site.)

Dang, D., & Dearholt, S. L. (2018). Johns Hopkins nursing evidence-based practice: Model and guidelines (3rd ed.). Sigma Theta Tau International.

• Chapter 9: Creating a Supportive EBP Environment

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2016). Translation of evidence into nursing and health care (2nd ed.). Springer Publishing Company.

• Chapter 13: Interprofessional Collaboration and Practice for Translation

Dang, D., & Dearholt, S. (2018). Johns Hopkins nursing evidence-based practice model and guidelines (3rd ed.). Sigma Theta Tau International.

Hagemeier, N. E., Hess, R., Hagen, K. S., & Sorah, E. L. (2014). Impact of an interprofessional communication course on nursing, medical, and pharmacy students’ communication skill self-efficacy beliefs. American Journal of Pharmaceutical Education, 78(10), 186. https://doi.org/10.5688/ajpe7810186

Vertino, K. (2014). Effective interpersonal communication: A practical guide to improve your life. OJIN: The Online Journal of Issues in Nursing, 19(3), 1

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2016). Translation of evidence into nursing and health care (2nd ed.). Springer Publishing Company.

Instructions are attached bellow. For one of the answers you have to use a template which is also attached bellow in a word document. Please use the rubric and follow each instruction

 Compare two leadership theories. Provide an overview of each and discuss the strengths and weakness in relation to nursing practice. 

Post your answers to the following:

• Explain why a developmental assessment of children and adolescents is important.
• Describe two assessment instruments and explain why they are used for children and adolescents but not adults. 
• Describe two treatment options for children and adolescents that may not be used when treating adults.
• Explain the role parents play in assessment and treatment.

Paper on direct patient care. All directions are located in the uploaded document

Powerpoint involved

Complete the “Health Assessment Check-Off Project” template using a patient that you have previously worked with. Ensure that you have adequately completed the assessment steps and given a proper recommendation.

APA style is not required, but solid academic writing is expected.

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. 

Health Assessment Check-Off Project 

Physical Exam Documentation

Chief Complaint:

History of Present Illness:

Past Medical History (Hx):

Past Surgical Hx:

Family Hx:

Social Hx:

Allergies:

Medications:

Review of symptoms by system:

Physical Exam:

Assessment:

Treatment Plan:

Topic Proposal and Problem Statement Paper

The purpose of this assignment is to develop a strong, working foundation for your final paper. You will identify a topic area and develop a problem- or issue-related topic within that area of interest. As you develop this specific topic, keep in mind that your eventual goal is to formulate and present a solution to the healthcare issue or problem you identify.

Your topic proposal should include the following items and address the following:

Describe the topic you wish to pursue. 

• It may be somewhat broad at this point and it may imply a problem. Use the Additional Resources in your course materials to help you search for ideas.

Identify your purpose: Why are you interested in this topic? (Narrow your topic.)

• Specifically explain what it is that fascinates you or draws you to this topic.
• Clearly describe the topic’s relevance in the field today.
• Identify a purpose for a paper on this topic: 
  • What might you accomplish in exploring this problem?
  • What is your intended goal?
    • To evoke change
    • To make new connections (new cause and effect)
    • To introduce a new theory, solution, or idea
  • Is this goal realistic?

Identify a problem within the topic and draft a problem statement. (It will likely evolve and be revised as you progress through your research.)

• Identify a problem related to your topic and state it.
• The problem statement should be specific and indicate the focus of your final paper.
  • Not too narrow, not too broad
  • Intellectually challenging (a simple solution is not apparent)
• Who would benefit from a solution to this problem (who is the target population)?

Your paper should be 1–2 pages. Adhere to APA Style throughout.