Evidence-Based Practice Model and Change Model

Create a PowerPoint presentation that addresses each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with at least three (3) sources using APA citations throughout your presentation. Make sure to cite the sources using the APA writing style for the presentation. Include a slide for your references at the end. Follow best practices for PowerPoint presentations related to text size, color, images, effects, wordiness, and multimedia enhancements. Review the rubric criteria for this assignment.

Part 1: Choose and explain one Evidence Based Practice Model from Chapter 13 of the textbook (Melnyk and Fineout-Overholt, 2015). Then, related to your research topic from Mod 1, describe in detail how you would utilize the model to implement an evidence-based practice change in your personal clinical practice environment. Models to choose from include: Stetler Model of EBP, Iowa Model of EBP, A Model for EBP Change, ARCC Model, PARIHS, Clinical Scholar Model, John Hopkins Nursing EBP, ACE Star Model of Knowledge Transformation

Part 2: Choose one Change Model/Theory from Chapter 14 of the textbook (Melnyk and Fineout-Overholt, 2015). Then, related to your research topic from Mod 1, describe in detail how you would utilize the model/theory to implement an evidence-based practice change in your personal clinical practice environment. Models/theories to choose from include: Change Curve, Kotter and Cohen’s, Roger’s Theory of Diffusion of Innovations, The Transtheoretical Module of Health Behavioral Change

• Title Slide (1 slide)
• Objective Slide (1 slide)
• Choose and explain one Evidence Based Practice Model from Chapter 13 of the textbook (Melnyk and Fineout-Overholt, 2015). (1-2 slides)
• Related to your research topic from Mod 1, describe in detail how you would utilize the model to implement an evidence-based practice change in your personal clinical practice environment (2-3 slides)
• Choose one Change Model/Theory from Chapter 14 of the textbook (Melnyk and Fineout-Overholt, 2015). (1-2 slides)
• Related to your research topic from Mod 1, describe in detail how you would utilize the model/theory to implement an evidence-based practice change in your personal clinical practice environment. (2-3 slides)
• References (1 slide)

Assignment Expectations:

Length: 9-13 slides
Structure: Include a title slide, objective slide, content slides, reference slide in APA format. Title/Objective/Reference slides do not count towards the minimum slide count for this assignment.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required for this assignment.

Assignment: Evidence-Based Project, Part 4: Critical Appraisal of Research

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

• Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
• Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
• Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 4A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 4B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

Select two grand nursing theories and discuss how each theorist addresses the metaparadigm for nursing. Discuss briefly the similarities and differences of the two. 

Do you agree or disagree with the following statement:

“There is an important difference between intentional and unintentional plagiarism, and all judgments about plagiarism, along with any punishments for plagiarizing, should be adjusted to account for that difference.”

Respond by either supporting or opposing this statement. List your reasons and cite at least two sources. You may use Internet or library search sources for this discussion.

Case scenario to be completed (in file attached) 

–APA Format.

-Introduction or abstract page

-Summary or Conclusion page

–Four Pages Minimum, not included Introduction or abstract, Conclusion or Summary , and Bibliographic pages.

–Completely unacceptable Copy and Paste from Internet, or other resources.

– Bibliographic have to be in APA Format, minimum 3 references citations with 3 years old or less.

Need a 100-300 words post Identifying healthcare FINANCIAL MANAGEMENT ISSUES for nurse managers. It can be about staff shortage to save the facility money or to stay within the budget.

You may use Google scholars or any other nursing journal. 

Make sure all reference sources are within 5 years. 

APA format and not Turnitin but plagiarism-free.

. 

#1)  Write down sample nursing diagnoses, interventions, and expected outcomes for the following client:

Elaina, 27 years old, visits a prenatal clinic to confirm a positive pregnancy test. Elaina tells the nurse that she is not married and has no support system. She also states that she is making minimum wage at a restaurant with no health insurance and cannot afford prenatal care. She intends to keep the baby and would rather not tell her partner because “they don’t have that kind of a relationship.” Elaina asks the nurse “If I take good care of myself, why do I need prenatal care?”

#2) Explain how the fetus is affected by tobacco use during pregnancy.  Keeping in mind the 2020 National Health Goals, what are some things you can do as a nurse to promote these goals and carry your ideas out into the community.

#3) You are asked to perform an assessment of a pregnant  woman and her family. Prior to the assessment, devise a list of interview questions to use to assess the woman’s readiness for parenthood and current health status as well as her goals for the pregnancy.

#4) For each of the following QSEN competencies write a list of nursing interventions for promoting fetal and maternal health related to each competency:

         Patient centered care

        Teamwork and collaboration

         Evidence-based practice

        Quality improvement

         Safety

         Informatics.

#5)  List the four major hormones produced in early pregnancy.  Describe what each one does.

Scenario

The United States continues to experience challenges with respect to health reform. There is considerable agreement on the need for health reform; however, there is an appreciable divide with respect to how to best achieve reform. Discussions on strategies for reform include a repeal of current legislation (the ACA), the implementation of a universal plan, and various “fixes” to the ACA.

Many would suggest that a repeal of the current system would be most appropriate, while others support efforts to “fix” the current ACA. The health organization you work for has asked you to develop a comprehensive proposal for healthcare reform.

The U.S. expends more of its Gross Domestic Product on healthcare than any other developed nation. However, the superior amount of spending has not resulted in superior outcomes when compared to other countries. In addition to higher costs, the U.S. is the only developed country that does not offer universal health to its citizens. There has been a significant amount of discourse with respect to the pros and cons of universal coverage. Those who oppose universal coverage often refer to the Canadian, single-payer system and its challenges, such as high tax liabilities for citizens, its long wait times, and the perception of the single payer system as socialized medicine. However, those in favor of universal coverage argue that the single payer system is not socialized medicine and its costs relative to the current system in the U.S. is more cost effective. Moreover, the single payer system is only one form of universal coverage. Countries that consistently rank high in terms of positive health outcomes often employ a multi-payer universal system as opposed to a single-payer system.

Instructions

You will analyze the current literature on the health system in the U.S. Your final project will include a paper, a voiceover PowerPoint presentation, and an infographic of your proposed solution. Possible solutions include a single payer universal plan, a multi-payer universal plan, a potential enhancement to the ACA such as adding a public option, Medicare for all, or a complete repeal of the current law.

The three (3) deliverables are:

1. A paper that includes the challenges facing the U.S. in terms of balancing the iron triangle of health – Costs, Access, and Quality. Please address the following:
   1. An examination of current policy
   2. A discussion of whether healthcare should be considered a right or a privilege
   3. A discussion of the role of special interest groups on health reform
   4. Articulate the significance of the involvement the Congressional Budget Office in determining the cost effectiveness of reform
   5. Explain the importance of considering existing privacy laws in reform efforts
   6. Describe and justify your potential solution to current challenges facing the U.S., including resource allocation
2. A voiceover PowerPoint presentation that summarizes the major challenges facing the U.S. in terms of balancing the iron triangle of health, a comparison of various possible solutions, and your proposed solutions.
3. An infographic that outlines your final proposed solution to the current challenges facing the U.S. in terms of balancing the iron triangle of health.

Needs to be at least 250 words with at least 1 scholarly article within the past 5 years.  No plagiarism.  Due tomorrow.

There is much written about implementation fidelity in the design and implementation phases of a practice change project.  What does implementation fidelity mean and how does it influence the translation of a research-proven intervention in your future practice change project? 

As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.

Photo Credit: Getty Images/Ingram Publishing

Week 1: Basic Pharmacotherapeutic Concepts/Ethical and Legal Aspects of Prescribing

How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow?

Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat.

This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors.

Learning Objectives

Students will:

• Analyze factors that influence pharmacokinetic and pharmacodynamic      processes in patients
• Assess patient factors and history to develop personalized plans of      care
• Evaluate ethical and legal implications related to prescribing      drugs
• Analyze ethical and legal practices of prescribing drugs
• Analyze strategies to address disclosure and nondisclosure
• Justify advanced practice nurse strategies to guide prescription      drug decision-making
• Analyze the process of writing prescriptions to avoid medication      errors

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

· Chapter 1, “Prescriptive Authority” (pp. 1–3)

· Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)

· Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)

· Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)

· Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)

· Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767

American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

Required Media (click to expand/reduce)

Discussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.

Photo Credit: Getty Images/Ingram Publishing

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare

• Review the Resources for this module and consider the principles of      pharmacokinetics and pharmacodynamics.
• Reflect on your experiences, observations, and/or clinical      practices from the last 5 years and think about how pharmacokinetic and      pharmacodynamic factors altered his or her anticipated response to a drug.
• Consider factors that might have influenced the patient’s      pharmacokinetic and pharmacodynamic processes, such as genetics (including      pharmacogenetics), gender, ethnicity, age, behavior, and/or possible      pathophysiological changes due to disease.
• Think about a personalized plan of care based on these influencing      factors and patient history in your case study.

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

At Least 3 citations with 7th edition APA Format

Assignment: Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

Photo Credit: Getty Images/Caiaimage

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

• Review the Resources for this      module and consider the legal and ethical implications of prescribing      prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by      your Instructor for this Assignment.
• Search specific laws and standards      for prescribing prescription drugs and for addressing medication errors      for your state or region, and reflect on these as you review the scenario      assigned by your Instructor.
• Consider the ethical and legal implications      of the scenario for all stakeholders involved, such as the prescriber,      pharmacist, patient, and patient’s family.
• Think about two strategies that      you, as an advanced practice nurse, would use to guide your ethically and      legally responsible decision-making in this scenario, including whether      you would disclose any medication errors

Write a 3-page paper that addresses the following:

• Explain the ethical and legal implications of the scenario you      selected on all stakeholders involved, such as the prescriber, pharmacist,      patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as      identified in the scenario you selected. Be sure to reference laws      specific to your state.
• Explain two strategies that you, as an advanced practice nurse,      would use to guide your decision making in this scenario, including      whether you would disclose your error. Be sure to justify your      explanation. 
• Explain      the process of writing prescriptions, including strategies to minimize      medication 

At Least 3 citations using 7th edition APA format