Nursing assignment 1 due in 5 -6 days

/in /by

MD1Assgn_LastName_Firstinitial

communication discussion 4

/in /by

 

View the TED Talk “Your Body Language Shapes Who You Are”Links to an external site. by Amy Cuddy (TEDGlobal, 2012). In light of her talk, your personal experiences, and what you have learned thus far from the course, write a response in which you:  

  • State what it is about her talk that strikes you as most interesting. 
  • Share something from your reading of the course text on nonverbal communication that made an impression on you. 
  • Share what it is that you will take from her talk and/or the text as a way of improving your own nonverbal communication competence. 

Be sure to respond to your peers as well. As a reminder, connect to a scholarly source beyond the TED Talk. 

Reference 

TEDGlobal. (2012). Your body language shapes who you are. http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are 

safety

/in /by

click links  to answer questions

Advocacy letter

/in /by

Please it should be community issues around howard county in maryland

Theoretical and Scientific Foundations of Nursing

/in /by

FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

Throughout this course you have focused on practice problems to address in applying nursing and interdisciplinary theories, and in the  application of evidence-based practice for quality improvement. This week you begin exploring the components of evidence-based practice by framing a practice problem as a critical question. You will begin a search of the literature for evidence to answer the question and inform a practice change for quality improvement.

Respond to  two of your colleagues  by suggesting a different way of framing their critical question. Cite sources to support your posts and recommend to colleagues.

PEER #1


Shaunagay Kenney

Week 7 Discussion Main Post

A Critical Question with Measurable Outcomes

Question: Will adding pharmacological interventions to nonpharmacological treatments improve post-traumatic stress disorders in adults?

Article Selection

A total of six articles were discovered and appraised using the “Adapted Rating System for the Hierarchy of Evidence” (Dang & Dearholt, 2017; Fineout-Overholt et al., 2010). The type of article and information that supported the purpose statement were used in the selection process.

Critical Question Explanation

            Post-traumatic stress disorder (PTSD) has long been associated with military members

exposed to combat. Before PTSD was coined, Charles Myers used shell “shock” to describe injured soldiers during World War I (Horwitz, 2018). According to Friedman (2019), PTSD is defined as direct or indirect exposure to a traumatic event where a person is severely traumatized based on that event. According to the National Center for PTSD (2021), 60% of men and 50% of women will experience at least one traumatic event in their lives, 6% of the population will have PTSD at some point in their lives, and about 15 million adults have PTSD during a given year. For most individuals, psychotherapy is a sufficient treatment for PTSD, but not for others. Could pharmacological interventions assist individuals where psychotherapy alone does not work?       

Article Synthesis

            For some individuals, psychotherapy alone does not work. Similarly, pharmacological use alone can be ineffective (Raskind et al., 2018; Rasmusson et al., 2017). However, combining SSRIs or other medications with CBT or other therapies may reduce PTSD symptoms in some individuals (Mithoefer et al., 2019; Wagner et al., 2017). Mithoefer et al. (2019) found that MDMA- assisted psychotherapy effectively treated PTSD. According to Wagner et al. (2017), MDMA increases oxytocin, facilitates openness, and enhances the therapy's effectiveness. In the prolonged exposure and sertraline trial conducted by Rauch et al. (2020), PTSD subjects were given strict instructions on collecting their saliva for testing. They made a ground-breaking discovery about cortisol, finding that cortisol levels were lower in individuals with PTSD than those without PTSD (Rauch et al., 2020). Not only was this discovery made, but following the combination treatment of sertraline and prolonged exposure, significant improvements were noted for one year (Rauch et al., 2019). While combining psychotherapy with some drugs improved PTSD symptoms, others did not.

References

Dang, D., & Dearholt, S. (2017). 
Johns Hopkins nursing evidence-based practice: Model and     guidelines (3rd ed.). Sigma Theta Tau International.

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B. & Williamson, K. M. (2010). Critical   

           appraisal of the evidence: Part I. 
American Journal of Nursing, 110(7), 47-52. 

https://doi.org/10.1097/01.NAJ.0000366056.06605.d2Links to an external site.

Friedman, M. J. (2019, October 14). 
PTSD History and Overview. U.S. Department of Veterans Affairs. 

https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.aspLinks to an external site.

Horwitz, A. (2018). 
PTSD: A short history. Johns Hopkins University Press

Mithoefer, M. C., Feduccia, A. A., Jerome, L., Mithoefer, A., Wagner, M., Walsh, Z., Hamilton,     S., Yaza-Klosinski, B., Emerson, A., & Doblin, R. (2019). MDMA-assisted psychotherapy for treatment of PTSD: Study design and rationale for phase 3 trials based   on pooled analysis of six phase 2 randomized controlled trials. 
Psychopharmacology,            236(9), 2735-2745. 

https://doi.org/10.1007/s00213-019-05249-5Links to an external site.

PTSD: National Center for PTSD. (2021, September 10). 
How common is PTSD in adults? U.S.       Department of Veterans Affairs.        

https://www.ptsd.va.gov/understand/common/common_adults.aspLinks to an external site.

Raskind, M. A., Peskind, E. R., Chow, BB., Harris, C., Davis-Karim, A., Holmes, H. A., Hart, K.    L., McFall, M., Mellman, T. A., Reist, C., Romesser, J., Rosenheck, R., Shih, M. C.,           Stein, M. B., Swift, R., Gleason, T., Lu, Y., & Huang, G. D. (2018). Trial of prazosin for     post-traumatic stress disorder in military veterans. 
The New England Journal of         Medicine, 378(6), 507-517. 

https://doi.org/10.1056/NEJMoa1507598Links to an external site.

Rasmusson, A. M., Marx, C. E., Jain, S., Farfel, G. M., Tsai, J., Sun, X., Geracioti, T. D.,    Hamner, M. B., Lohr, J., Rosse, R., Summerall, L., Naylor, J. C., Cusin, C., Lang, A. J.,         Raman, R., & Stein, M. B. (2017). A randomized controlled trial of ganaxolone in   post-traumatic stress disorder
. Psychopharmacology, 234(15), 2245-2257.            

https://doi.org/10.1007/s00213-017-4649-yLinks to an external site.
 

Rauch, S. A. M., Kim, M., Powell, C., Tuerk, P. W., Simon, N. M., Acern, R., Allard, C. B.,         Norman, S. B., Venners, M. R., Rothbaum, B. O., Stein M. B., Porter, K., Martis, B.,            King, A. P., Liberzon, I., Luan Phan, K., & Hoge, C. W. (2019). Efficacy of prolonged        exposure therapy, sertraline hydrochloride, and their combination among combat veterans             with post-traumatic stress disorder. 
JAMA Psychiatry, 76(2), 117-126.             

https://doi.org/10.1001/jamapsychiatry.2018.3412Links to an external site.

Rauch, S. A. M., King, A., Kim, H. M., Powell, C., Rajaram, N., Venners, M., Simon, N. M.,   Hamner, M., & Liberzon, I. (2020). Cortisol awakening response in PTSD treatment:     Predictor or mechanism of change. 
Psychoneuroendocrinology, 118, 1-16.             

https://doi.org/10.1016/j.psyneuen.2020.104714Links to an external site.

Wagner, M. T., Mithoefer, M. C., Mithoefer, A. T., MacAulay, R. K., Jerome, L., Yazar-      Klosinski, B., & Doblin, R. (2017). Therapeutic effect of increased openness:  Investigating mechanism of action in MDMA-assisted psychotherapy. 
Journal of  Psychopharmacology, 31(8), 967-974. 

https://doi.org/10.1177%2F0269881117711712Links to an external site.

PEER # 2

Samir Moneer Nawaf Hamed

 

Critical Question: Nursing burnout and its impact on nurses and patient care.

Nursing burnout is a state of emotional, physical, and mental exhaustion resulting from prolonged and intense stress in the nursing profession. It significantly impacts nurses by causing increased job dissatisfaction, higher turnover rates, and adverse mental and physical health effects (Mudallal et al., 2017). Moreover, burnout has a direct and detrimental impact on patient care, leading to decreased quality, increased medical errors, and reduced patient satisfaction due to compromised nurse-patient interactions and reduced attention to detail (Garcia et al., 2019). Addressing nursing burnout is crucial for maintaining a resilient nursing workforce and ensuring high-quality patient care outcomes.

Synthesis of Scholarly Articles

1. Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis

This study comprehensively analyzed existing research and found compelling evidence that burnout among healthcare professionals significantly impairs patient safety. The meta-analysis synthesized data from multiple studies, revealing a strong association between burnout and increased risks of medical errors, compromised quality of care, and adverse patient outcomes, highlighting the critical importance of addressing burnout as a crucial factor in ensuring patient safety in healthcare settings (Garcia et al., 2019).

2. Relationship between nurse burnout, patient and organizational outcomes: Systematic review

This study examined a broad range of studies and revealed a clear and intricate relationship between nurse burnout, patient outcomes, and organizational effects. It found that higher levels of nurse burnout are consistently linked to adverse patient outcomes such as increased mortality rates, longer hospital stays, and decreased patient satisfaction. Additionally, burnout has detrimental organizational consequences, including higher nurse turnover and lower overall workplace performance. This study underscores the interconnectedness of nurse well-being, patient care quality, and organizational success, emphasizing the urgency of addressing burnout to improve healthcare outcomes and workplace environments (Jun et al., 2021).

3. Nurse Burnout and Quality of Care: Cross-National Investigation in Six Countries

This study conducted a comprehensive cross-national analysis and identified a consistent and alarming pattern: nurse burnout substantially negatively impacts the quality of patient care across different healthcare systems and countries. The study's findings highlighted that high levels of nurse burnout were associated with lower perceptions of care quality among both nurses themselves and patients. This suggests that addressing nurse burnout is imperative not only for the well-being of healthcare professionals but also for maintaining and improving the quality of care delivered in diverse healthcare settings globally (Poghosyan et al., 2021).

4. Association of resident fatigue and distress with perceived medical errors

This study demonstrates a significant correlation between resident physician fatigue and distress levels and the perception of medical errors. The research findings suggest that higher levels of resident fatigue and distress are associated with increased instances of perceived medical errors. This indicates that addressing the well-being and mental health of healthcare providers, including reducing fatigue and distress, can play a crucial role in improving patient safety and reducing the likelihood of medical errors in healthcare settings, emphasizing the need for interventions and policies aimed at mitigating these factors to enhance patient care quality. (West, 2019)

Value for Stakeholders

Addressing nursing burnout is a moral imperative and a strategic quality improvement initiative. The identified articles provide compelling evidence that nurse burnout directly impacts patient satisfaction, healthcare outcomes, and organizational effectiveness (Mudallal et al., 2017). By investing in interventions to reduce burnout, healthcare organizations can enhance patient care quality, increase staff retention, reduce medical errors, and ultimately improve their bottom line. Moreover, addressing nursing burnout aligns with the mission of healthcare organizations to deliver safe, effective, and patient-centered care, enhancing their reputation and competitiveness in the healthcare industry (Jun et al., 2021).

 

References

Garcia, C. de L., Abreu, L. C. de, Ramos, J. L. S., Castro, C. F. D. de, Smiderle, F. R. N., Santos, J. A. D., & Bezerra, I. M. P. (2019, August 30). Influence of burnout on Patient Safety: Systematic Review and meta-analysis. Medicina (Kaunas, Lithuania). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780563/

Jun, J., Ojemeni, M., Kalamani, R., Crecelius , M., & Tong , J. (2021, March 26). Relationship between Nurse Burnout, patient and organizational outcomes: Systematic review. International Journal of Nursing Studies. https://www.sciencedirect.com/science/article/abs/pii/S0020748921000742

Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017, January 1). Nurses’ burnout: The influence of leader empowering behaviors, work conditions, and demographic traits. Inquiry : a journal of medical care organization, provision and financing. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798741/

Poghosyan, L., Clarke, S. P., Finlayson, M., & Aiken, L. H. (2021, August). Nurse Burnout and quality of care: Cross-national investigation in six countries. Research in nursing & health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908908/#:~:text=Across%20countries%2C%20higher%20levels%20of,quality%20of%20care%20in%20hospitals.

West, C. (2019, September 23). Association of resident fatigue and distress with perceived medical errors. JAMA. https://jamanetwork.com/journals/jama/article-abstract/184625

Nursing ASSIGNMENT 5

/in /by

APPLYING EI TO SALUTOGENESIS IN COLLEGIAL RELATIONSHIPS

Collegial relationships, based on professional role interaction and shared values, commitment, and hardship can also be salutogenic. Two nurses who don’t “get along” may find common ground (meaning) in shared commitment to solving a particularly difficult patient problem. A doctor and nurse may find new respect and a deeper level of effectiveness when they use their different approaches together to achieve a common goal, deepening their partnership at the same time patient goals are achieved. The effectiveness of excellent mentors, teachers, and supervisors often rest with their ability to form salutogenic relationships that are very different from friendships or other relationships of equal power.

In collegial relationships, EI ability feeds the salutogenic qualities of a relationship. Identifying emotions, especially those related to conflict like competitiveness, jealousy, defensiveness, and resistance leads to an opportunity to move beyond them and set shared meaning as the primary goal. This is illustrated in a relationship between two ICU nurses who openly acknowledged their dislike of each other. Head-to-head over a deep open wound in their patient’s leg, they finally looked at each other and said, “You will never be my friend, but we both want this thing healed.” This identification of emotions, along with the spoken commitment to a common goal, enabled them to set aside the emotions that were keeping them from working well together. They never did become friends, but their professional relationship, built on their mutual respect and professional work together, nourished them both.

EI, SALUTOGENESIS, AND NURSING RESEARCH

Little research examines EI ability as it affects salutogenesis in nurses specifically, but a great deal of evidence supports the relationship between EI and related concepts, physical and emotional health, self-efficacy, and emotional self-care in moral and spiritual distress. Meta-analysis of general population (including samples greater than 19,000), concluded that EI correlated with emotional and physical health (Kotsou et al., 2018; Martins et al., 2010). Development of EI ability has been correlated with health outcomes in nurses, and several studies identified EI as a mediator in nurses’ stress responses and burnout (Afsar et al., 2017; Hurley et al., 2020; Jurado et al., 2019) (see Chapter 15 for research summary). It is particularly interesting that countries as culturally dissimilar as the United States, Pakistan, Greece, Spain, and China report similar findings.

DEVELOPING EMOTIONAL INTELLIGENCE AND CULTIVATING SALUTOGENESIS

THE PRACTICE OF REFLECTION AND USING THE RELAXATION RESPONSE

As the stories in this chapter suggest, identifying emotions in professional practice—and ways of understanding them, that have particularly rich meaning—is a great way to begin. 

Let us consider the following questions for our writing assignment this week that can start us off on this practice. 

1-When you are at the bedside, what emotional experiences make you feel more human, more deeply alive? 

2-What emotions have the opposite effect, diminishing your humanity?

3-The ability to use emotions to reason is particularly important in this work. 

4-How does what I feel deepen my understanding of this emotion? 

5-How does my understanding of this emotion change how I feel?

APA FORMAT 

NO PLAGIARISM MORE THAN 10%

DUE DATE SEPTEMBER 25, 2023

4 PAGES

REFERENCES NO OLDER THAN 5 YEARS IN APA FORMART

bad 4,1

/in /by

Describe a change initiative  that was implemented in a healthcare setting (your own work setting, from the literature or from the experiences of other professional nurses) that resulted in conflict, chaos or crisis (use fictitious names for people and organizations). Discuss the change initiative,  how the change was implemented, by whom, and the outcome.

In consideration of this week’s readings, describe how you as a nurse leader, would have managed the change initiative.

Expectations

Initial Post:

  • us one US source from the last 5 years, Also pick topic in a Critical care setting 
  • Length: 150 – 250 Words

pico

/in /by
  • Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.  
  •  Article #1 Zhou, X., Guo, J., Lu, G., Chen, C., Xie, Z., Liu, J., & Zhang, C. (2020). Effects of mindfulness-based stress reduction on anxiety symptoms in young people: A systematic review and meta-analysis. Psychiatry Research, 289, 113002. https://doi.org/10.1016/j.psychres.2020.113002

Article #2 Porter, B., Oyanadel, C., Sáez-Delgado, F., Andaur, A., & Peñate, W. (2022). Systematic Review of Mindfulness-Based Interventions in Child-Adolescent Population: A Developmental Perspective. European Journal of Investigation in Health, Psychology and Education, 12(8), 1220–1243. https://doi.org/10.3390/ejihpe12080085

Article #3 Cohen, Z. P., Cosgrove, K. T., Akeman, E., Coffey, S., Teague, K., Hays-Grudo, J., Paulus, M. P., Aupperle, R. L., & Kirlic, N. (2021). The effect of a mindfulness-based stress intervention on neurobiological and symptom measures in adolescents with early life stress: a randomized feasibility study. BMC Complementary Medicine and Therapies, 21(1). https://doi.org/10.1186/s12906-021-03295-1

Article #4 Peter, A., Srivastava, R., Agarwal, A., & Singh, A. P. (2022). The Effect of Mindfulness-based Cognitive Therapy on Anxiety and Resilience of the School Going Early Adolescents with Anxiety. Journal of Indian Association for Child and Adolescent Mental Health, 18(2), 176–185. https://doi.org/10.1177/09731342221127959

 PICOT  question- The clinical issue of interest is the management of anxiety symptoms in adolescents aged 13-18 years. Adolescents often prevalent anxiety concern due to unique stressors and challenges. Addressing anxiety symptoms during this developmental stage can essential to promote healthy psychological development and improve short- and long-term quality of life.

  • Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
  • Consider the best method of disseminating the results of your presentation to an audience. 

Part 4: Recommending an Evidence-Based Practice Change

  • 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.)
  • 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.
  • Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
  • 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)

Health Assessment 9

/in /by

Details on reflection

/in /by

Details on reflection