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Step 1 Read the article in Appendix A “Example of a Randomized Clinical Trial” (Nyamathi et al.,2015),

Step 2 Discuss the following questions related to the article found on ~p. 162 under Critical Appraisal Criteria:

1. Is the type of design used appropriate? Your rationale?

2. What are the threats to internal and external validity?

3. Is the design appropriately linked to the evidence hierarchy?

EPSLO 5: Apply principles of leadership to advocate for the unique role of the nursing profession within the healthcare system.

In your Journal summarize personal and professional achievements and accomplishments that you have completed throughout the baccalaureate nursing program at EC that refer to EPSLO 5: Apply principles of leadership to advocate for the unique role of the nursing profession within the healthcare system.

Attach a minimum of at least two examples of your work that supports EPSLO 5 noted above. Save your Journal entry as your Self-Appraisal for each module in your word document. The professor will request that you submit your journal entries for informal feedback at the end of each module. A Title page of this assignment with a summary of accomplishments (no more than 2 pages in length) is required with attached files as supportive evidence for each EPSLO. A minimum of one or two examples is required to support each EPSLO.

 Review and discuss the goals identified by Healthy People 2020 that are related to reducing violence. 

https://www.healthypeople.gov/2020/

This week, you will complete the Research Clinic simulation from the perspective of Dr. Richard Sowers, the Principal Investigator (PI), and then reflect on the experience.

Go to the following website:

https://ori.hhs.gov/the-research-clinic

• Click the Play Full Video button and watch the opening introduction video. After you finish the video, in the lower right corner, click Next > to see the characters. Select Dr. Richard Sowers.
• Proceed through the simulation as Dr. Richard Sowers, noting the different decisions you make along with their effects. Go through the simulation a few times and make different decisions to see the different effects they cause.
• Write a reflective paper describing the process you went through and the results you received based on the different decisions you made as Dr. Richard Sowers. Recall your previous experience with this simulation as Jan Klein, RN, the clinical research coordinator. Discuss how both roles can affect a research study depending on which decisions are made.
• Your paper should be 2 to 3 pages in length, not including the cover page or reference page, written in current APA format, using Times New Roman 12-point font, double-spaced with 1-inch margins. Use a minimum of one peer-reviewed or scholarly reference published within the last five years to support your findings on the research process and ethics.

 Differentiate the concepts of cost and revenue and assess the benefits and limitations of the major form of reimbursement on the delivery of health care services.

discussion  post most be 100 to 300 word maximum.

APA format with in text situation, and references maid use more then one reference if you like. references most be with in the last 5 years.

The book being use is 

Financial Management for nurses manager and executives 5 edition chapters 8 and 9 if you have assess to it. 

There is two different case studies and their plan of action all you need to do is respond back to both students because these are discussion board. like 1 and 1/2 paragraphs for each study

The client who I chose to do a mini nutritional assessment on is an 84-year-old male Caucasian male with a late stage of dementia. He is my grandfather and lives in my house with my family and I. He has been living with us for at least five years up to this point. This person is not at risk for malnutrition and is not malnourished. The MNA shows that he is actually in a normal range for his nutritional status. As you can see from the form attached, he is pretty much all within good ranges for each concept in regards to his nutrition. He has no pressure ulcers, he can feed himself, and with him living her with us we are constantly taking care of him and making sure he is getting enough of the needed nutrients and is safe and moving around frequently. He is in good spirits, just needs a little extra help sometimes.

Care Plan: Short-term Goals

1. First short term goal would be to limit his sugar intake in the mornings. He has been seen consuming too much coffee cake/desserts/pie in the morning with his coffee while reading the paper.
2. He is often uninterested in drinking water, so I think it would help him if he were to incorporate more glasses of water in his day/diet.

Care Plan: Long-term Goal

1. One long-term goal that would be crucial for this person would be what will his future nutrition going to look like? Right now, with him being here constantly around a family member, he is getting his medications on time with water and food, he is getting at least 3 square meals a day, and he is getting good healthy meals during the day with snacks intermittently. At some point, he will require the need for professional help either in an assisted living center or a nursing home. It is a concern that he will not be given the proper amount of attention or adequate nutrition when in a place like that. So, a long-term goal for him in regards to his nutrition, would be to make sure that if he ever changes locations, he is monitored and helped very frequently in this area.

Education 

For right now, this patient does not need to be educated on how to feed himself and on how to eat/chew/swallow. He is sufficient in that area. He needs to be educated on why it is important to eat three meals a day and why it is important to drink enough water. The problem with him though is that with his dementia he forgets to do so, but if he has the help of our family he will continue to have adequate nutrition levels as he does now. Again, if he were to change locations, the staff would need to make sure he is being taken care of as we take care of him here. If this happens, I have no doubt he will meet these goals listed above and he will be able to successfully maintain optimum nutrition. He should be sure to stay away from beer, processed meats and cheeses, microwavable popcorn,  and white foods specifically since these foods are not good for dementia patients (Mole, 2018).

Follow-up Care

As stated earlier, right now this patient is not at nutritional risk. However, in a few weeks it would make sense to check again his levels and make sure he is still within proper range. When doing so, we can check to see if he is more hydrated, has clear urine, and this would help indicate that he has been drinking more water. Also, we can try to take away the coffee cakes in the morning to reduce the sugar intake. Giving him once slice and putting it away would be helpful and this could be a part of his education, as well as a part of the follow-up care. Lastly, follow-up care would involve checking with a professional to see if his nutrition is still normal if he switched locations. If he was still living with my family in a few weeks, we would check at his next doctor’s appointment to see if we are making sure we are doing a good job to keep his nutritional levels where they need to be.

The person that I interviewed is a 69 year old male. He is relatively active and does not show much if any signs of cognitive decline. His total MNA assessment score was 20, which puts him at risk for malnutrition. The main factors placing him at a risk for malnutrition are a moderate decrease in food intake leading to a loss of 4.5 lbs in the past 3 months. The patient does not have adequate intake of legumes or vegetables in his diet either. 

Short Term Goals

Increase his intake of legumes, fruits and vegetables to at least 2 servings per day. Especially his intake of vegetables as he has expressed that he does not eat very much vegetables at all.

Increase his overall food intake including well rounded, nutritious meals.

Long Term Goal

Gain back the 4.5 pounds that were lost due to decreases in food intake over the next 3 months.

Education

Research has showed a direct link between the intake of fruits and vegetables to a reduced risk of mortality among older adults (Nicklett & Kadell, 2013). The patient should increase his intake of green, leafy vegetables as this will give him vitamin K which promotes blood clotting and reduce bone fragility. Increasing the patients intake of legumes will also be helpful to supply him with good energy for his daily activities as they are filled with carbohydrates. Increasing his legume intake will also provide him with his daily fiber which will help with digestion. The patient should continue being active as this will keep his mind sharp and promote healthy cognitive function. 

Follow Up Care

In 3 months, revisit the patient to see if he has accomplished his long term goal in gaining back the 4.5 pounds that he had lost from decreased food intake. Also, assess his diet and ensure that he is taking at least 2 servings of fruits and vegetables per day. 

Death and Dying. Understanding the Process of Dying.

a. Research Paper must comply with APA writing standards:

· Title page (1), 

· Abstract (1), 

· Content pages (5), 

· Conclusion (1), 

· References page (1). 

• Explain the following related to this case study:  Anemia and the different kinds of anemia (i.e., micro and macrocytic). 
• Why a patient would need a splenectomy after a diagnosis of ITP.

 Case Study:

A 14-year-old female is brought to the urgent care by her mother, who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. PMH not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.

Labs at urgent care demonstrated normal hgb and hct with normal WBC differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at urgent care referred the patient and her mother to the ED for a complete work-up of the low platelet count, including a peripheral blood smear for suspected immune thrombocytopenia purpura.

At least 250 words with at least 1 scholarly article within the past 5 years.  APA format, no plagiarism.

 Define clinical significance, and explain the difference between clinical and statistical significance.

How can you use clinical significance to support positive outcomes in your future practice change project?

In this course, you will be complete a 2-part assignment in which you conduct research about a population of focus, develop a PICOT statement, and write a Literature Review. The PICOT statement and Literature Review you write in this course can be used for your evidence-based practice project in the next course so be sure to select an issue you want to continue working on in your next course.

PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) is a method that helps clarify the qualities needed to create a good question out of a practice issue or problem affecting the population of focus. Additionally, the information derived from a good PICOT makes it easier to perform a literature search in order to find translational research sources that can be used to address the clinical problem.

Use a national, state or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Use this indicator to begin to formulate a PICOT and conduct research on the population.

Write a 750-1,000-word paper that analyzes your research and focuses on the population you have chosen. Describe the population’s demographics and health concerns, and explain how nursing science, health determinants, and epidemiologic, genomic, and genetic data may impact population health management for the selected population. Provide an overview of a potential solution for solving the health issue related to your population and the intended PICOT statement. Describe how the solution incorporates health policies and goals that support health care equity for the population of focus.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MS Nursing: Public Health

MS Nursing: Education

MS Nursing: Acute Care Nurse Practitioner

MS Nursing: Family Nurse Practitioner

MS Nursing: Health Care Quality and Patient Safety

4.1: Synthesize nursing science, determinants of health, and epidemiologic, genomic, and genetic data in the management of population health.

RUBRIC

Due Date: 09-Dec-2020