Demonstration Speech

API FORMAT.

They check for plagiarism.

Instructions in attachments.

Advocacy letter

Preparation for writing the Advocacy Letter

1. Choose a topic that interests you.

2. If you are unsure what to advocate for or against, look at professional organizations for inspiration:

a.
APHA

b.
ANA

c.
Maryland Public Health Association

3. Look for advocacy groups that are working on the issue. We don't have to recreate the wheel.  See what strategies the advocacy groups are supporting. For example: Brady and Gifford non-profits focus on gun policy. 

4. Decide if you want to make change within an agency, at the local, state or federal level. Find the decision maker appropriate to that level. Click here to
find your elected official.

5. If you are writing to a legislator, look at that person’s website to see their position on the issue. Please do not ‘preach to the choir’—that is, if they already support the issue, it does no good to throw more facts at them.

6. If you are addressing a national issue, and your legislator aligns with your proposed action, consider looking at the committee that would hear a bill about your issue.

a. If there is a proposed bill that has not been active, you can ask the chair of the committee to bring it back up in committee.

b. Click here to
check for federal bills.

7. If you are addressing a state issue, the Maryland General Assembly meets January- April of each year.

a. You can see if state bill on your issue was unsuccessful in 2018, and ask your legislator to re-introduce it in 2019.

b. Click here to
check for state bills.

8. For evidence to support your proposed action, use the One Search through HS/HSL for the broadest results. If you are still having trouble finding articles, the premier journal for public health research is called The Nation's Health.

9. Reminders from the rubric:

a. Include your ‘Ask’ clearly and concisely in the first paragraph. In busy offices, staff may not read the entire letter.

b. In the same vein, keep the letter one page. References can be on a second page.

c. Include your credentials. All of you are BSN Candidates (and add whatever other credentials you have). This adds a professional weight to your voice.

10. As always, please let me know of any questions.
KGR

Informed Consent and Cultural Competence

3-5 pages 

Case Study:Dr. Emily Clark, a seasoned cardiologist at Mercy General Hospital, is presented with a challenging case involving Mr. Rajan Patel, a 58-year-old man who recently immigrated from India. Mr. Patel has been diagnosed with a significant heart condition that requires a surgical procedure. While the surgery has a high success rate, like all medical procedures, it comes with its own set of risks and benefits. Mr. Patel, whose primary language is Gujarati, has limited proficiency in English. He nods and smiles politely during consultations, giving Dr. Clark the impression that he understands. However, when asked to explain the procedure back to her, it becomes evident that he does not fully grasp the intricacies of the surgery or its potential complications. Dr. Clark recognizes the importance of informed consent and wants to ensure that Mr. Patel truly understands the procedure, its risks, and its benefits. She believes in the ethical principle of autonomy, which dictates that every patient has the right to make decisions about their own body and health. However, she also acknowledges the principle of beneficence, which compels her to act in the best interest of her patient.  

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:1. briefly summarize the facts surrounding the case study. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.

  • Identify who is involved or affected by the ethical problem or issue.
  • Access and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
    • Apply the three components outlined in the Ethical Decision-Making Model media.
  • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
    • Describe the factors that contributed to the problem or issue and explain how they contributed.
  1. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
    • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
      • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
      • Review the Think Critically About Source Quality resource.
        • Assess the credibility of the information source.
        • Assess the relevance of the information source.
  2. Discuss the effectiveness of the communication approaches present in a case study.
    • Describe how the health care professional in the case study communicated with others.
    • Assess instances where the professional communicated effectively or ineffectively.
    • Explain which communication approaches should be used and which ones should be avoided.
    • Describe the consequences of using effective and non-effective communication approaches.
  3. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
    • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
    • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
    • Discuss the key lessons this case provides for health care professionals.
  4. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
    • Describe the proposed solution.
    • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
    • Discuss how likely it is the proposed solution will foster professional collaboration.
  5. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
    • Apply the principles of effective composition.
    • Determine the proper application of the rules of grammar and mechanics.
  6. Write using APA style for in-text citations, quotes, and references.
    • Determine the proper application of APA formatting requirements and scholarly writing standards.
    • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

evidence based



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discussion reply

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional strategies your colleague could implement to bring about needed change in their community.use 3 reference each.

 1.    I am currently employed at a freestanding psychiatric hospital located on the south shore of Massachusetts.  We provide inpatient psychiatric services to adolescents, adults, and geriatric patients who suffer from mental illness.  Since the Covid-19 pandemic, we have seen an increase in the community’s need for mental health services.  A recent study conducted by Blue Cross Blue Shield of Massachusetts found that the need for services has increased exponentially due to the effects of the pandemic.  Currently,  “one in three Massachusetts residents over the age of 19 reported needing behavioral health care for themselves or a close relative; however, 26% percent said they were not able to get it” (Becker, 2022).  As an organization, we need to find a way to increase access to mental health services in our community.

How the Doctor of Nursing Practice (DNP) Prepared Nurse Can Increase Access to Mental Health Services

 As a DNP-prepared nurse, it is my goal to serve as an agent of positive change at the local level to the patients who are under my organization’s care as well as the community at large.  In order to reduce accessibility issues as a DNP-prepared nurse, it will be critical for me to consider the American Association of Colleges of Nursing essential number 8 and “conceptualize new care delivery models that are based in contemporary nursing science and that are feasible within current organizational, political, cultural, and economic perspectives” (American Association of Colleges of Nursing, 2006).  One thought I have for my organization would be to integrate outpatient services such as partial hospitalization programs so that we can increase accessibility to mental health services in the community.  One significant challenge, both nationally and for my organization, is the shortage of nursing staff.  In order to increase the services we provide, it will be imperative for my organization to build partnerships with local agencies.  Wegner et al. (2000) determined that “groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise in the area by interacting on an ongoing basis” will have more success.  In order to recruit nurses to my organization, I aim to partner with local universities and colleges to provide a site for their psychiatric clinical rotations.  If student nurses have a positive clinical experience at my organization, they will be more likely to consider employment with us in the future which will, in turn, allow us to expand the services we provide and increase accessibility to mental health care.

References

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Becker, D. (2022). The pandemic has led to a surge in mental health need in Mass., survey finds. https://www.wbur.org/news/2022/02/08/massachusetts-pandemic-mental-healthLinks to an external site.

Wenger, E., McDermott, R., & Snyder, W. M. (2000). A guide to managing knowledge: Cultivating communities of practice. Harvard Business School.

2.There is a very large homeless population within my community, and with that unfortunately comes high rate of substance use disorders. The most recent census of this six hundred plus square mile county was approximately 170,000 individuals, ten percent of whom were living below the poverty level (United States Department of Commerce, 2023). Despite the known concerns for homelessness in Monroe County, there remains to be only three small shelters that are seasonally available to those in need, open between the hours of 7:00pm and 5:00am EST. As a very rural area, the lack of available resources leaves individuals living in homeless communities in wooded areas. Multiple individuals have been found to be passed away due to exposure in the winter months. While community members are also aware of the concern for substance use disorders, there have been very direct and disheartening efforts preventing the opening of treatment centers in the area. Signs have been posted in front yards with slogans such as ‘no drug addicts in our back yard.’

            Addressing socioeconomic determinants of health and the wellness of this community is one of many roles of the Doctor of Nursing Practice (DNP) (American Association of Colleges of Nursing, 2006). These two community health issues are very much related. The ongoing gap in access to substance use disorder treatment perpetuates the cycle of substance-related crime, associated health concerns treated in the local emergency department, and inability to treat the often-underlying mental health concerns leading to self-medication (Mitchell et al., 2023). As a social change agent, the DNP can not only research evidence-based interventions to provide community-based care to individuals in need but also educate community members on why this is important, and how their efforts to prevent this from happening harms not only those in need but the populace as a whole (American Association of Colleges of Nursing, 2006).

            The DNP acts as an expert support when advocating for health policy in local, state, or federal government. Meeting with members of local government to provide evidence-based testimony regarding the detrimental impact the blocking of substance use treatment facilities has on the community is one step in creating increased access to care. Individuals in need of substance use treatment often experience shame and ambivalence to seek the support they so greatly need; it is essential to educate lawmakers about how the additional stigma placed upon individuals by the formal supports who should be enabling their ability to access treatment severely impedes community wellness (Stewart et al., 2023).

            Engaging directly with the homeless shelters currently available to review current barriers to availability is the first step to increasing accessibility. Two of the three shelters are run by volunteer organizations, and the third is a locally funded organization that is a part of the community health department. As a DNP, gathering data and evidence to support the implementation of an intervention is essential to buy in from any stakeholder and can be achieved by evaluating the number of individuals who seek shelter at these resources, and those who are able to stay the night (McEwen & Wills, 2019). Presenting this data to local officials to along with evidence-based data regarding the benefits of this community initiative, such as reduction in deaths associated with exposure and the current use of law enforcement to relocate homeless individuals from areas deemed inappropriate for their inhabitation, can support approval for shelter expansions.

References

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.  

Mitchell, E., Waring, T., Ahern, E., O’Donovan, D., O’Reilly, D., & Bradley, D. T. (2023). Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review. BMC Public Health23(1), 1610. https://doi.org/10.1186/s12889-023-16503-z

Stewart, R. E., Cardamone, N. C., Schachter, A., Becker, C., McKay, J. R., & Becker-Haimes, E. M. (2023). A systematic review of brief, freely accessible, and valid self-report measures for substance use disorders and treatment. Drug and Alcohol Dependence243, 1–11. https://doi.org/10.1016/j.drugalcdep.2022.109729

United States Department of Commerce. (2023). QuickFacts: Monroe County Pennsylvania. https://www.census.gov/quickfacts/fact/table/monroecountypennsylvania/PST045222

customer service ip 3

 This soft drink brand is recognized worldwide. The drink has one of the most recognized corporate logos and is sold in over 200 countries through 250 bottlers throughout the world.

This company’s story began in Atlanta, Georgia, in 1886, when pharmacist John Pemberton was experimenting with a recipe that he later mixed with carbonated water and began to sell at his drugstore. Two years after its invention, Pemberton sold his secret formula to a businessman by the name of Asa Candler, who formed a corporation to bottle and distribute the trendy drink. He later sold the rights to two other businessmen who wanted to bottle the drink to enhance distribution. Candler sold syrup that his company produced to these distributors, but not his secret formula. They simply mixed the syrup with carbonated water and bottled it. From there, the product became a household name as more people began to take the drink home to enjoy.

Competitors soon emerged. To ensure that people could tell the original from the competition, the distributors created the trademarked contour bottle in 1916 so that customers would recognize the original product. Candler ultimately sold his company in 1919 to a group of investors, with Robert Woodruff as the president. The new group wanted to make the drink available anytime and anyplace. To accomplish this, the new company started adding bottling plants all over the world.

The six Ps of the company vision statement highlight its purpose and desired future objectives—people, portfolio, partners, planet, profit, and productivity.

To assist in accomplishing its vision, the company established a foundation in 1984. This entity focuses on helping and giving back to communities worldwide. Some of the issues supported in various countries include water stewardship (providing safe, clean drinking water), lifestyle and behavioral change programs (e.g., nutrition, exercise, and behavior modification), recycling, and education.

Assignment Details

Answer the following questions 

  1. What is your opinion of this company? Explain.
  2. Based on what you know or what you read on the Internet or in other sources, do you believe that the company is customer-focused? Why or why not?
  3. How does the company’s community involvement potentially affect its image in the eyes of customers or potential customers?

Pico

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
  • Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
  • Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
  • Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

PICO QUESTION 

The PICO(T) question would be: “In adolescents aged 13-18 years, do mindfulness-based interventions, compared to standard or no interventions, lead to a significant reduction in symptoms of anxiety within 6 months?”

Ethical Dilemma

 

Today’s health care environment gives nurses many reasons to be conflicted. Genetic testing, abortion, and end of life care are just some of the areas in which nurses may face ethical dilemmas. Consider how you feel about the following issues:

  • Respecting the wishes of a suffering client that he is permitted to die with dignity,
  • Respecting the health surrogate’s wishes regarding termination of life support,
  • Or even observing another nurse take two tablets of oxycodone as ordered but keeping one for herself.

Then give an example of an ethical dilemma you may have confronted in your own clinical experience or workplace. How did you come to the decision you made? What feelings did you experience while coming to that choice? (If you have not yet faced an ethical dilemma, research one and comment on it, answering the same questions.)

At least 2 pages with reference 

Reflection Scenario

 1) Watch the entire scenario. In the scenario assignment, you are asked to reflect on responses to the presented scenario. 

2) Fill out the template attached below

3) Compose the last question on the template reflection in a Word document and be sure to address, at a minimum, the following questions:

*Why do you feel the way you do about the issue presented?

*Of the four responses offered in the scenario, which do you think is the most ethical and why?

*Which ethical theory would you use to support your stance? Why does this theory work?

4)  Support your conclusions with evidence and specific examples from the textbook, including a minimum of one theory of ethics to defend your stance.