Discussion

Discussion: PICOT Question

Over the course of the next eight weeks, we will be examining concepts related to nursing research and the translation of evidence to practice. To help you better understand the process, you will be identifying a practice issue for nurse practitioners.
 You will develop a PICOT question associated with the issue, find evidence to support a change in practice, and present your recommendations for change to your peers. This week, we will work on helping you refine your area of interest so that you will be able to develop a concise question for next week’s assignment. You are encouraged to use the area of interest you chose for the project in NR500NP and/or NR501NP; however, you may choose a different area if you wish.

Select an issue in nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic. In 1-2 paragraphs, describe the scope and relevance of the issue and your recommended change. Provide reference support from at least two outside scholarly sources to support your ideas. 
Please pick something you can do as a NP in your practice that is patient focused. Your intervention needs to relate to a measurable patient health outcome. Please avoid anything that would require a policy or law change, such as full-practice authority. Burnout and satisfaction surveys also are not appropriate topics as they are not patient centered. 

Review this 4-minute video to gain a better understanding of the requirements of a PICOT question. The PICOT question is not a research question, but a quality improvement issue that requires a practice change. 

Hello, my name is Dr. Lynch. Hey, I'm an assistant professor a Chamberlain University College of Nursing. Today we're gonna talk about pico questions and best practices in formulating these questions. There are five parts to a pico question. Patient intervention, comparison, outcome in time. The slides subsequently we will discuss each part of this question. The first ingredient for cooking up a pico question is population. Pick a broad topic, drill down, focus down so that then your population is very specific. Type two diabetic female patients age 30 to 40 who consume over 400 g of carbohydrates per day. A bunch more specific population then patients with diabetes intervention. What intervention do you think will make a difference? Is that supported by the scholarly literature? What is being done in clinical practice today? Are there better alternatives? You must use an intervention based on scholarly literature? Remember the definition of scholarly literature is a US based peer reviewed journal article geared for clinicians published in the past five years, or the latest clinical practice guideline. Comparison. So what is the standard of care currently? Patients without the intervention, patients without a condition, patients without risk factor. This part defines another population who will be used as a comparison against the group receiving the intervention. What is your desired outcome? The outcome should relate directly to the intervention and outcomes should be measurable. Time. This is a specific timeframe to demonstrate the outcome. In quality improvement efforts, the timeframe has to be realistic and manageable. Not over years, may not be even over months, but it could be. But it is usually a short timeframe to make an improvement effort. Many students ask what the differences between pico research and quality improvement questions. This chart will help you understand the difference. The pico question used here is in postoperative kidney transplant adults aged 65 to 75, how does a health coach compared with no health coaching affect hospital readmission rates within 90 days of discharge? This is a perfect pico question compared to the research question or QI question that also could be asked about this matter. Here's an example. In real life, you're a nurse practitioner working in a skilled nursing facility, the rate of false as unacceptable. And your care team has come together to discuss what should be done about this. Your pico question is, in elderly patients between age 65.75 residing in a sniff, how do fall prevention programs with risk assessment compared to fall prevention programs without risk assessment effect fall rates within 90 days after the intervention. So you can see how this question will guide how you view the literature on this topic. You will be looking for fall prevention with risk assessment in the scholarly literature to see what has worked in other places. What are the crucial ingredients in an outpatient fall prevention program? The literature holds the key, holds the answer to these questions. If you need further assistance, please contact your instructor directly. You can also contact the librarians at the Chamberlain library who can be accessed through many means, email, chat on real time. This material comes from Malbec and find out overhauled book evidence-based practice in nursing and health care, a guide to best practice, which is a great addition to your library.

Nursing Week 1 Assignment Ethics

 

#3 Surgeon Uses Ministry in Medical Practice

(Health care and religion)

DALLAS–At 83, Carl Smith faced quadruple bypass surgery and the
real possibility that he might not survive.

Within hours on this spring morning, Dr. Daniel Pool would
temporarily bring Smith’s heart to a stop in an attempt to circumvent
its blocked passages.

And to help his patient confront the uncertainty, Pool did something
unusual in his profession: He prayed with him.

The power of healing: Medicine and religion have had their day, and
they haven’t always been able to coexist. But as today’s medical
treatment becomes more holistic, doctors are increasingly taking
spirituality into account.

Source: Ramirez, M. (2013). Altoona Mirror, August 9, 2013.
 

Discussion 250 words. Make sure you provide 2 references and utilize APA style.. . Discussion Rubric

Many organizations provide educational materials about osteoporosis, physical activity, and other topics pertinent to health promotion for musculoskeletal wellness. Some materials are available in Spanish and other languages, and many of these materials are free.

From the list below select on organization and an intervention that you could implement in your current place of work to promote health development of your patient/client population. State reasons why and the EBP behind your selection.

America on the Move Foundation


https://aom3.americaonthemove.org

American Cancer Society


www/cancer.org

American Heart Association


www.heart.org

Arthritis Foundation


www.arthritis.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases


www.niams.nih.gov

National Cancer Institute


www.cancer.gov

National Osteoporosis Foundation


www.nof.org

Please note the grading rubric for the discussion board.

As a reminder, all discussion posts must be a minimum of 250 words, references must be cited in APA format 7th Edition and must include a minimum of 2 scholarly resources published within the past 5 years.

Introduction and quality of discussion’s Argument

60% of total result

Objectivity of Tone, overall quality & Review of Literature in APA 6th format within past 7 years

10% of total result

Grammar / Writing Skills

7% of total result

Genetics

Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. 

Jane and Jackie, 30 year old twin sisters, adopted when they were two years old, lived mirrored lives to this point. They do everything together, from having a double wedding, living next door to each other, and making any appointments, medical or social together.

Today they made an appointment with their OB/GYN. Information was as follows:

Jane Information: Jackie’s Information:

BP 115/70 BP 165/96

HR 70 HR 96

Resp. 20 Resp, 22

Temp 98.6 Temp 99.2

N/A Normal U/A + Hematuria

+ Proteinuria

Weight No gain Weight +15 pounds

C/O Intermittent Headache C/O Has lower back and stomach

at times relieved with pain at times and is relieved also

Tylenol by Tylenol.

Other: This individual is noted to have

some loss of muscle mass in her

arms and legs and less subcutaneous

tissue overall.

1. At this point, what do your think is the problem with Jackie? Why is this problem co common in women? What test would you request to confirm your diagnosis?

The physician uses the ultrasound to assess Jackie’s back and abdomen. He finds that her kidneys are about 4 times larger than normal and appear to have numerous fluid filled cysts noted. At this point he asks BOTH sisters to see a nephrologist and to be scheduled for MRI’s of the kidneys. The MRI showed that Jackie’s kidneys were indeed larger and filled with cysts. Jane’s kidneys were somewhat larger than normal, and no cysts were present at this time.

2. What problem do you anticipate that Jackie has now? How was it acquired?

3. Why did Jackie gain so much weight over the last year?

4. Why does Jackie have high blood pressure and the UTI?

5. Why were both sisters requested to have this test.

The sisters went to see the nephrologists who requested that they have MRI’s of the brain and an echocardiogram. Jane’s MRI and echocardiogram were normal. Jackie’s brain MRI and echocardiogram were not. Jackie had a cerebral angiogram that followed which confirmed complications of her disease process, an Intracranial aneurysm and Mitral regurgitation. Jackie undergoes a procedure called Coil Embolization Therapy to resolve the aneurysm.

6. What is an Intracranial aneurysm? How does Coil Embolization Therapy resolve the problem.? Please be specific of the procedure.

7. What is Mitral Valve Prolapse and how will it affect Jackie’s health care needs before procedures in the future?

8. What education is needed to be shared with these sisters related to their children having this condition in the future?

Neafsey. P. (2010).Sisters for life:
Case Mysteries in Pathophysiology. Englewood:

Morton Publishing Company

gmt/2015

study guid

unit 4 551

Two-week-old Tabitha has infant respiratory distress syndrome. Eighty-year-old Anthony has emphysema, and 50-year-old Jenny has pulmonary fibrosis.

Why are the mechanics of breathing greatly compromised in all of these cases?

INSTRUCTIONS: This is a discussion post. So, a page in length or a page and a half is enough. Must have at least 3 references and has to be in Apa format. 

Discussion

After reading Chapter 13, respond to the following:

  • What workforce advocacy strategies can Elena use to promote quality patient care and a safe work environment?
  • What is the value of shared governance to Elena’s individual nursing practice?
  • If Elena becomes concerned about floating assignments, what questions can help guide her decision about accepting such assignments?
  • What online resources are available to help Elena learn more about important workplace issues and workforce advocacy?
  • How can Elena improve the marketability of her nursing expertise?

I HAVE UPLOADED CHAPTER 13 PAGES THAT NEED TO BE READ TO COMPLETE THIS ASSIGNMENT

No plagiarism, 7th ed writing style

  

Assignment: Regulation for Nursing Practice Staff Development Meeting

Nursing is a very highly regulated profession. There are over 100 boards of nursing and national nursing associations throughout the United States and its territories. Their existence helps regulate, inform, and promote the nursing profession. With such numbers, it can be difficult to distinguish between BONs and nursing associations, and overwhelming to consider various benefits and options offered by each.

Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice. Understanding these differences helps lend credence to your expertise as a professional. In this Assignment, you will practice the application of such expertise by communicating a comparison of boards of nursing and professional nurse associations. You will also share an analysis of your state board of nursing.

To Prepare:

· Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.

· Review the NCSBN and ANA websites to prepare for your presentation.

The Assignment: (9- to 10-slide PowerPoint presentation)

Develop a 9- to 10-slide PowerPoint Presentation that addresses the following:

· Describe the differences between a board of nursing and a professional nurse association.

· Describe the geographic distribution, academic credentials, practice positions, and licensure status of members of the board for your specific region/area.

o Who is on the board?

o How does one become a member of the board?

· Describe at least one federal regulation for healthcare.

o How does this regulation influence delivery, cost, and access to healthcare (e.g., CMS, OSHA, and EPA)?

o Has there been any change to the regulation within the past 5 years? Explain.

· Describe at least one state regulation related to general nurse scope of practice.

o How does this regulation influence the nurse’s role?

o How does this regulation influence delivery, cost, and access to healthcare?

· Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).

o How does this regulation influence the nurse’s role?

o How does this regulation influence delivery, cost, and access to healthcare?

part 3a 3b

Part 3A: 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. ( Worksheet attached)

Article #1Zhou, 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

Part 3B: 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.

600 w6 p1

What are the benefits of evaluating the role of outcomes in practice change through research? Discuss how you would evaluate the roles of outcomes through a change proposed from research findings.

Expectations

Initial Post:

keep all posts you win on bids in US sources

  • Length: A minimum of 250 words, not including references
  • Citations: At least one high-level scholarly reference in APA from within the last 5 years

Peer Responses: