W3R see attachment

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Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .



Jacqueline Kenney

Good Evening Professor,

 

              I work in one of the largest hospital systems in Atlanta. The facility I work for has the bed capacity for 686 patients. The hospital specializes in cardiovascular procedures (the implantation of the LVAD) and transplantation of liver, and kidneys. The hospital attracts people from across the country. People coming from literally every state, and sometimes from out of the country.

            The area where I see the EHR impeding patient care, and again this might be in part, due to end-user negligence, are providers not utilizing the information and data contained within the patient's EHR frequently enough.  We run off a system called EPIC (EHR). I have come to realize most hospitals in the state of Georgia, and other states use EPIC as well.  Embedded within the EPIC system is a hyperlink called Care Everywhere. The Care Everywhere tab allows all providers on the EPIC system to see notes, documentation, tests results, frequency of visits, and more. This data covers every hospital, clinical, urgent care, and office visit the patient has encountered so as long as the facility is on the EPIC system. I believe the shear amount of medical information becomes overwhelming and time consuming to comb through, especially for medical providers who are already seeing numerous patients at the bedside and in specialty offices. 

          Despite medical documentation being readily available to providers across the healthcare spectrum, there seems to be little time for a busy Cardiologist to review necessary documentation from the patient's Pulmonary doctor, or the notes placed from Endocrinology. Often a patient comes for a visit due to CAD, but the patient is also a diabetic with uncontrolled elevated blood glucose. We know one disease process feeds the other, but in spite of the EHR containing valuable patient data, providers are still missing imperative clinical information required to treat the patients holistically. 

          The one department which I see consistently using chart review to coordinate care with patients, providers, and families are RN Case Managers within the hospital setting.  RN Case Managers, and Care Coordinators are responsible for knowing what is missing in the patient continuum of care. The RNCM interfaces with the providers, and assists in providing education to both medical MDs and patients regarding critical clinical information which will advance the clinical process and bring better patient outcomes. McBride & Tietze (2018) discussed unintended harm, or consequences suffered by patients with the implementation of the EHR. One such consequence has to do with physicians required to research, and review copious amounts of previous documentation, as well as being required to spend greater amounts of time entering documentation.  Such time consuming tasks often create information, and important patient data not being read, or documented in an effort to save time, and so providers can physically see more patients. 

 

Resources

                FAAN, S.M.P.R. C., & FAAN, M.T.P.R. F. (2018). 
Nursing Informatics for the Advanced Practice Nurse (2nd ed.). Springer Publishing LLC. 

https://ambassadored.vitalsource.com/books/9780826140555Links to an external site.

           Williams, M. D., Asiedu, G. B., Finnie, D., Neely, C., Egginton, J., Finney Rutten, L. J., & Jacobson, R. M. (2019). Sustainable care coordination: a qualitative study of primary care provider, administrator, and insurer perspectives. 
BMC health services research, 
19(1), 92. https://doi.org/10.1186/s12913-019-3916

 Reply

3w1zero

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Discuss the role of advanced nursing leadership in creating and building an organizational culture that supports innovation.

Expectations

Initial Post:

  • Length: 150 – 250 Words
  • apa format and at least one source with in the last five years 

please use easy to find US sources 

Qualitative Research Article Critique

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Theoretical and Scientific Foundations of Nursing

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SEARCH-BASED QUESTIONS

Nursing journal 2

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see attached, same as last one need last 2 sections completed. see starred items that must be included.

presentation

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on a PPT with voiceover no longer than 30 minutes Provide a brief statement introducing the selected practice problem. • Identify three social determinant risk factors for the selected practice problem. • Based on the health risk/problem identified, describe the strategies/methods that you will implement. Focus on primary and secondary prevention strategies. Refer to Healthy People 2030 Topics and Objectives. You may access the website at: https://www.healthypeople.gov. • Describe a related Healthy People 2030 Goal and how it correlates with the selected practice problem. • Describe one evidence-based intervention to address the Healthy People 2030 goal. • Define one measurable objective to address the Healthy People 2030 goal. This is a GROUP assignment. Groups have been randomly assigned and the group assignments have been posted in Moodle. Submissions will be made via Moodle link. Only one submission  

NUR 445 – Week 3 Discussion: Researching and Recommending Evidence-Based Research Resources

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tep 1 Read the case scenario.
You are part of an interprofessional team working on an evidence-based project to look at falls in patients with dementia in the long-term care setting. The team was brought together in response to a noted increase in the incidence of falls in residents with dementia over the past three months. One of the recent changes before the increase in falls was a mandate to no longer use physical restraints on residents. Several staff members feel that the use of restraints is a must, and they do not have time to use the restraint alternatives that have been suggested. They also feel they do not have enough time to continuously check on residents. This has caused major issues of concern and has compromised the quality and safety of the residents.

When the team meets together, one of the first items discussed is the clinical question. The team uses the PICO question format to develop the following question:

In patients with a diagnosis of dementia in the long-term care setting (P), how does the use of a comprehensive falls assessment prevention plan that includes restraint alternatives (I) compare with the use of a fall prevention protocol that includes the use of restraints (C) affect the number of falls that occur (O)?

Step 2 Post to the discussion forum.
In your initial response, address the following questions:

  1. Determine the best resources to use when conducting a search on the topic. Consider these questions: What databases would be most appropriate? Where would you locate clinical practice guidelines that could be used in the EBP process for this issue?
  2. Conduct a search using the resources you identified in Step 2a. What key search terms did you use? What filters did you use?
  3. From your search, identify at least three articles that you would consider using in an EBP project such as the one described in the case scenario. If possible, suggest resources that meet the highest level (Level I) of evidence. Why would these sources be most appropriate in determining best practices and supporting clinical decision-making for this issue?

Replies 5300

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 Ineed replies of those works  with 200 words  each ones.Reference within 5 years.

1.Research methods commonly used in nursing can be classified in different ways. The following is a discussion of the most common classifications. First, research methods are classified as quantitative, qualitative, or mixed. This is the most common classification.

Quantitative Research

Quantitative research involves the collection and analysis of numerical data. It is used to confirm a hypothesis. This method’s ontology can be described as objective, material, and structural. Quantitative methods rely on scientific realism justified by empirical confirmation. According to Creswell and Creswell (2023, pp. 45-46), the most common research objectives are numerical description, causal establishment and explanation, and prediction. Quantitative research relies on precise measurement using validated and structured tools. Common quantitative methods in nursing research include surveys, experiments, and observational studies. Conclusions are drawn from statistical analysis.

Qualitative Research

Qualitative research involves the construction of knowledge hypothesis and grounded theory from the data collected during fieldwork. The ontology can be described as subjective, mental, personal, and constructed. It delves into understanding human experiences, behaviors, and social phenomena. According to Creswell and Creswell (2023, p. 46), this research method involves collecting qualitative data such as in-depth interviews, participant observations, and open-ended questions. Qualitative methods in nursing research include interviews, focus groups, content analysis, and ethnographic studies. Qualitative designs include descriptive methods, narrative, phenomenological, grounded theory, ethnography, and case studies.

Mixed Methods

Mixed-methods research combines aspects of quantitative and qualitative approaches within a single study. It allows researchers to comprehensively understand a research question by collecting and analyzing numerical and contextual data. In nursing research, mixed-methods studies are often employed to explore complex healthcare issues from multiple angles.

Second, research can be classified as experimental or non-experimental. Experimental research involves the manipulation of one or more variables to determine the effect of an outcome. An example is a Randomized controlled study. On the other hand, there are non-experimental research methods that focus on the observation of phenomena as they occur. Examples include observational studies, case-control studies, and cohort studies. Finally, nursing research can be classified based on the time of data collection. When the data is collected at a single point in time, this is called cross-sectional research, while data collection for an extended period creates a longitudinal study (Butler et al., 2021).

2. Research approaches in nursing can be divided into a number of groups, each with its own specific traits and goals. Quantitative research is one of the main categories, and it entails the systematic collection and analysis of numerical data in order to establish cause-and-effect correlations or characterize patterns (Griffiths et al., 2020). Descriptive and correlational research, which are subsets of quantitative research, concentrate on describing phenomena or looking for links between variables, respectively, whereas experimental research uses controlled studies to modify variables. In nursing research, conducting large-scale surveys, evaluating the efficacy of interventions, and tracking patient outcomes are all made possible by quantitative research.

Another well-known subcategory is qualitative research, which aims to investigate people’s viewpoints and real-world experiences. Aspects of this methodology include phenomenology, which aims to comprehend a phenomenon from the perspective of the participants, grounded theory, which develops hypotheses based on actual facts, and ethnography, which explores the cultural backdrop of healthcare practices (Griffiths et al., 2020). For acquiring an understanding of the subjective facets of nursing, such as patient experiences, emotional reactions, and cultural impacts on healthcare, qualitative research is crucial.

Using a combination of quantitative and qualitative methods, mixed-methods research provides a thorough grasp of intricate nursing phenomena. Both numerical and narrative data are gathered by researchers through surveys, experiments, observations, or in-person discussions (Griffiths et al., 2020). When a researcher wants to triangulate findings or offer a more comprehensive viewpoint on a study subject, this strategy can be quite helpful.

Systematic reviews and meta-analyses are vital methodologies in nursing research because they serve a critical role in integrating and appraising current studies related to a specific healthcare condition. A systematic review employs a rigorous and organized approach to locating, selecting, and evaluating relevant research studies. These studies aim to provide a comprehensive review of the available data on a certain healthcare topic. Researchers painstakingly assemble information from multiple sources, evaluate the quality of each study, and then summarize the findings to provide a transparent and objective picture of the current state of knowledge in the subject (Griffiths et al., 2020). Meta-analysis, on the other hand, goes a step further by statistically combining the data of multiple studies to derive more solid and broadly applicable conclusions. These strategies collectively provide a substantial addition to nursing’s use of evidence-based practice by presenting a complete body of research.

Action research is a popular methodology in clinical practice and nursing education. It stands out for its inclusive teamwork style that includes both scholars and practitioners. This approach’s main objective is to pinpoint specific obstacles or problems in the healthcare setting, and then work together to develop and provide solutions. By incorporating researchers and practitioners in problem-solving, data collecting, analysis, and improvement implementation, action research emphasizes a cycle of continuous improvement (Griffiths et al., 2020). It is especially helpful in clinical practice, where it can motivate efforts to improve quality, and in nursing education, where it can trigger curriculum modifications and creative teaching methods. Action research seeks to make positive changes that enhance patient care and outcomes in the healthcare environment by concentrating on practical, real-world concerns and encouraging cooperation between researchers and practitioners.

In conclusion, there are several different types of nursing research methodologies, including quantitative, qualitative, mixed-methods, systematic reviews/meta-analyses, and action research. With the ultimate goal of advancing nursing knowledge and enhancing patient care, researchers choose the most suitable approach depending on their research objectives, ethical considerations, available resources, and the nature of the phenomenon under examination.

Nutrition in Healthcare

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Discussion 1

Every day, people make choices that affect their physical health and wellness. Some choices are influenced by the environment and social factors, which in turn contribute to people’s health outcomes. Healthcare professionals (i.e., physicians, nurses, dietitians, sports medicine, etc.) are responsible for their own health by making decisions and practicing behaviors that enhance their wellbeing. Healthcare professionals also have a responsibility to their clients. While responsibilities may vary among healthcare professionals, it is important the healthcare team is alert to clients’ nutrition problems and needs.

After studying 

Module 1: Lecture Materials & Resources
, answer the following:

1. In one paragraph, give at least 2 examples of how culture, society, politics, or religion influences your nutrition. Discuss the role that food plays in your family or personal life.

2. Navigate to 
Your Digestive System and How it Works: 

https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-worksLinks to an external site.
 View the webpage and share in 1 paragraph at least 1 example of something your learned about the digestive system.

3. Search the internet for 1 example of an over-the-counter medication designed to treat common digestive problems such as heartburn, constipation, diarrhea, and hemorrhoids. Write 1 paragraph describing a) appropriate and inappropriate uses for this medication, and b) adverse health implications associated with misuse and/or overuse of this product.

Discussion 2

Carbohydrates have received a bad reputation, especially when it comes to their role in weight gain. All carbohydrates are not bad and the primary role of carbohydrates in the body is to supply the cells with glucose for energy. One type of carbohydrate is sugar. Some people are unaware that instead of avoiding all sugars, they can choose to include natural sugars found in vegetables, whole grains, legumes, and fruit. On the other hand, most people know that too much fat poses health risks, but may be surprised to learn that too little does, too.

After studying 

Module 2: Lecture Materials & Resources
, answer the following:

1. Navigate to My Plate: 

https://www.myplate.gov/Links to an external site.
 and to the Diabetes Plate: 

What is the Diabetes Plate Method?Links to an external site.
 (diabetesfoodhub.org) then, submit at least 1 paragraph comparing both for

A. similarities

B. differences

C. share who should follow MyPlate and who should follow the Diabetes Plate method?

2. Navigate to the American Heart Association: 

http://www.heart.org/HEARTORG/Links to an external site.
 and to the National Cancer Institute: 

http://www.cancer.govLinks to an external site.
, submit a 1 paragraph analysis on the relationships between dietary fats and the risk of heart disease, cancer, or type 2 diabetes (choose one).

3. Choose a food label from your favorite snack, and take a picture of the Nutrition Facts on the food label. Navigate to the U.S. Food & Drug Administration, “Interactive Nutrition Facts Label: 

https://www.accessdata.fda.gov/scripts/InteractiveNutritionFactsLabel/#introLinks to an external site.
 Choose one ingredient from your label. Share with the class one (1) health fact and (1) action step you learned about that ingredient in the interactive site.

4. Explain the differences between high-quality and low-quality proteins, and well-balanced vegetarian diets.

Discussion 3

The body manages its energy supply with amazing precision. Consider that many people maintain their weight within about a 10- to 20-pound range throughout their lives. How do they do this? How does the body manage excess energy? How do bones, muscle, fat, fluid, and other tissue influence our body composition? However, overweight, and underweight both result in energy imbalance. Almost 42% of adults aged 20 and above are overweight placing them at risk of developing chronic diseases that affect quality of life.

After studying 

Module 3: Lecture Materials & Resources
, answer the following:

1. Conduct a nutrition/survey interview with 2 athletes and ask them a) what protein or amino acid supplements they use in their diet? and b) why do they use those supplements? Then, navigate to: 

www.quackwatch.orgLinks to an external site.
 and enter the name of the supplement. Provide 1 paragraph with your analysis of the products and what you found out about the products’ nutritional characteristics (see Chapter 5, page 132 of your textbook).

2. Search the internet for a popular weight-loss program (i.e., Jenny Craig, Weight Watchers, etc.), and submit 1 paragraph with the following:

A. describe the diet plan

B. evaluate whether the plan offers a nutritionally reliable way to lose weight or is it a Fad Diet (see Chapter 7, Table NP7-1, page 193 of your textbook)

3. In 1 paragraph, describe type 1 diabetes, type 2 diabetes, and gestational diabetes by providing:

A. characteristics

B. definition

C. causes & symptoms (see Chapter 20, Table 20.2, page 564 of your textbook).

 

wk 1 disc 1

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After completing the cultural assessment evaluation for self-reflection, share the results with your classmates. How did you rate based on the scoring system?  Is there any room for improvement? There is nothing to be shy about if your score was not optimal. 

  • In your own words, how do you define culture? 
  • What strategies do you plan to implement to enhance your cultural understanding? 
  • Do you have any thoughts on the social determinants of health?

I HAVE ATTACHED THE ASSESSMENT EVAL FORM I COMPLETED WITH THE SCORE, PLEASE USE THAT TO ANSWER THE POST ABOVE.