Pain in Gerontology

Directions:
With the realization that pain is highly prevalent among older adults, please answer the following questions.

150+ words at least per question

Cite resources

Questions:
1. What are some ways you as the nurse can utilize to determine pain in the older adult?
2. What are some of the potential barriers related to self-reporting of pain in the older adult?
3. What is the prevalence of pain in the older adult?
4. Describe and compare your findings for each of the following:
a. Numeric rating scale
b. Visual analog scale
c. McGill pain questionnaire
d. Pain in dementia patients

article

 

  • Look through several major newspapers for articles that discuss care for the elderly in the community or care for those at the end stage of a life-threatening illness. Then answer the following questions:

A) What is the role of a community health nurse in assisting families in the care of the elderly in their homes?
B) What are some of the barriers related to the initiation of home care services in communities?
C) How does living in an urban area versus a rural area affect home care services?

Article should not be older than 2015 and attach article or provide link. 1 page 

healthcare administration

Upon reviewing the multiple facilities offering healthcare administration support and services, discuss the following:

  • What are the healthcare administrative/management job opportunities in these organizations?
  • How are these organizations interrelated?
  • What type of support do these organizations offer direct care facilities?
  • Identify one available position in which you are interested and discuss the KSAs needed to secure the position.

1000 words atleast 3 references in APA format not more than 5years. 

Ethical Case Study Discussion

Sue T. is the nurse manager for medical-surgical units at a community hospital.  She is currently enrolled in a nursing master’s degree program at the local university.  As part of the requirements for a Nursing Management course, Sue proposes to conduct a study linking nursing interventions and nursing outcomes.  She returns to her place of employment at night for two weeks to audit patient charts and collect the data she needs for her assignment.  She makes copies of the patient records that are particularly helpful and takes them home to write the final paper.  

As Sue is developing her paper, she realizes that the information she has collected may be helpful in completing her nursing staff performance evaluations due next month.   She decides to collect further patient outcome data for individual nurses to monitor their performance.

Consider the following 

  1. Has Sue violated ethical principles by collecting data for a college assignment? Why or Why not? 
  2. Has Sue violated ethical principles by collecting patient data for employee performance evaluations? Why or Why not? 
  3. What, if anything, should Sue have done differently in completing her college assignment? 
  4. What, if anything, should Sue have done differently in completing her employee performance evaluations? 

Health assessment

End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.

CRITICAL THINKING

 Consider the question: “Why do physicians and nurses kill more people than airline pilots?” Apply your critical thinking skills to this argument and critique the statement. First, do you think it’s true? If it is, what do you think about their rationale? How would you address it if the question were posed to you in a forum?  PLEASE INCLUDED IN-TEXT CITATION AND REFERENCE

Reply 1 INF

Implementation systems are used to allow the necessary changes in an organization to take place. Kurt Lewin described change into three phases: unfreezing, moving and refreezing (Nelson, 2014, p. 29). Determining which parts of an organization need change falls under the first phase of change called unfreezing. According to Lewin’s theory, limiting the amount of resistance would result in the most successful implementation. During phase one, allowing employees to have an input on what they wish could be improved would create a more harmonious decision-making process and therefore result in the least resistance. My work environment does not include the working nurses in this portion of change. In my opinion, this is the reason that most of the nurses are not happy with all the adjustments brought about in the workplace. The second phase “is the most unstable period for the system. Anxiety levels can be expected to increase, and this is when resistance can be felt” (Nelson, 2014, p. 29). Management can use this time to sway the system users with incentives, words of encouragement and requests for feedback. For me, I do not see this occurring when a new system is added. We receive emails explaining the new protocol, how to use the system and disciplinary actions if not used properly. Ideally, I believe that a test 

run of new systems would be an effective way to prepare nurses for what to expect and fine tune hiccups before threatening repercussions. The last phase occurs after implementation and involves maintaining the change. This refreezing process encourages resistance to change (Nelson, 2014, p. 29). There have been occasions when I noticed faults in the system and places where improvement can happen. At that point I usually call the office and explain what is going on. My concerns are met with understanding and they work with me when they can afford to do so, however it does not usually go beyond verbal support over the phone. Over time, small changes have been made to the system and emails sent out to review expectations with nurses. Reading about effective change in the textbook explains that this way of doing things will most likely bring about the most resistance. “An information technology in and of itself cannot do anything, and when the patterns of its use are not tailored to the workers and their environment to yield high quality care, the technological interventions will not be productive” (AHRQ, 2019). In the healthcare setting, nurses should be voices in the change that occurs and management should be supportive and open to an interdisciplinary way of establishing information systems. Until this occurs, negative reactions to change will continue to make the process difficult and challenging for all employees.  

References 

AHRQ. (2019). Barriers to HIT Implementation | AHRQ National Resource Center; Health Information Technology: Best Practices Transforming Quality, Safety, and Efficiency. Retrieved from https://healthit.ahrq.gov/health-it-tools-and-resources/health-it-costs-and-benefits-database/barriers-hit-implementation (Links to an external site.) 

REPLY 2

Training, New Information System, & Evaluation

Modern healthcare systems are characterized by the utilization of sophisticated information systems to facilitate critical care provision. Healthcare organizations that focus on improving the quality and cost of care through information systems realize their relevance after implementation. The inadequacy of effective and reliable infrastructures is among the factors that facilitate poor performance in healthcare. The integration of different information systems enables excellent management of patient data, funds, and healthcare-related projects. The complexity of an information system affects its implementation process, hence attaining anticipated results (Gomes & Romao, 2018). It is essential to engage healthcare nurses in implementing and evaluating different information systems; however, such activities require adequate training.  

Most nurses are unfamiliar with the newly implemented information systems that aim to improve the quality of care. Notably, the unfamiliarity is commonplace in healthcare facilities in the country and abroad. In my current organization, nurses are acquainted with new skills to utilize the existing information systems through training.  Most of the activity occurs through attending workshops where nurses interact with experts or through simulated programs. The nursing workshops acquaints the nurses with the basics, outlook, and functionality of the newly implemented infrastructure. The simulation models involve interacting with the new technologies artificially. The simulation approach is highly effective in information systems such as the EHR, one of the technologies that continue to change patient data management in healthcare.

After the training, it is essential to engage the nurses in implementing and evaluating the information system. Davidson et al. (2020) note that the implementation of new information systems is characterized by ultimate complexity; however, they are essential when improving the quality of services rendered to patients. Although the designs are highly effective, it is necessary to ensure that there are constant evaluations. Several evaluation criteria can be used in healthcare facilities that require the engagement of nurses. For instance, the current organization utilizes an evaluation model that assesses the impacts of the information system. Nurses are engaged in data collection and analysis. The evaluation model is among the reputable tools used in the assessment stage.

Secondly, a visualization tool is also essential in evaluating an information system; however, its effectiveness associates with the evaluation model—the tool helps map the progression of an information system. Additionally, the performance of the device depends on the contribution of healthcare nurses. The commonly used visualization tools include Google Analytics and R language that also require a resourceful foundation for evaluating an information system’s performance. Several aspects affect the performance and effectiveness of visualization tools in healthcare facilities. One is that the device requires individuals who are conversant with different computer software. Therefore, nurses who help evaluate information systems must undergo thorough training to increase their competence in the evaluation procedure.

 Summing up, current information systems in healthcare systems are among the promising initiatives for improving the quality of care and increasing affordability. Information systems provide a reputable framework for effective data management and execution of multiple activities within the healthcare facility. However, it is essential to engage the healthcare nurses as they play various significant responsibilities when handling patient’s data and other critical information. These professionals should also be involved in evaluating the effectiveness of the newly implemented systems. Such engagements serve as a motivating factor improving the quality of services rendered to patients.

References

Davidson, B., Dewan, M. A., Kumar, V. S., Chang, M., & Liggett, B. (2020). Visualizing benefits: Evaluating the healthcare information system using the IS-impact model. IEEE Access8, 148052-148065. doi:10.1109/access.2020.3015467

Gomes, J., & Romão, M. (2018). Information system maturity models in healthcare. Journal of Medical Systems42(12). doi:10.1007/s10916-018-1097-0

 All replies must be constructive and use literature where possible.

Your assignment will be graded according to the grading rubric.

200 words each reply

Clinical presentation for today

Clinical case presentation should be in a SOAP format. Same SOAP format you use to submit your notes on Typhon. But you must make sure the information provided bellow is included or added for the purpose of this paper.

It should be written in correct gramma, no APA but the references.

References must be on APA format at the end of your papers corresponding to the citations throughout your paper.

An unusual case means a challenging case to you.

From the soap you will use:

  • Chief complain and history of present disease 
  • Exam and diagnostic tests ( labs , images)
  • Dx impression supported by signs and symptoms 
  • Management as on soap I sent : meds, tests if any ordered, education, follow up
  • Evidence based rationale for treatment. Like aspirin is an antiplatelet use to … and it’s reference 
  • Epidemiological data with reference. For example angina. Go to the CDC website and look for percent of populations affected, distribution with USA population. 
  • Analysis of self care and family issues r/t diagnosis and tx plan related to your Dx. Ex. Patient is poor compliant with medication and no family support. First choice of antianginal tx not use because lack of insurance coverage and use —-instead 
  • Evaluate parameters to determine outcome. Use same as the shorts and long term goals on our RN care plans but more treatment and prevention related. 
  • Major lesson learned from the case and how may affect your future practice. This analysis is your experience. 

Attached it is the Soap Note template

and information that can be use to do the soap note

Nursing critical incident paper

Write a  2- 3 page paper with double spaced text about OB delivery with shoulder dystocia. Write about the experience of this delivery. Doctors nurses, how were they acting and doing their stuff. Find One “Aha” moment in the experience.

Community Nursing DQ week 6 student reply Irina Ruiz

 

Less than 10 % similarity

References APA

This is another student post to which i have to react adding some extra information related this post. 

short answers.

 

Cannabis is one of the most frequently used illicit substance in the U.S; with a mixed effect on the health of the population. Despite potential benefits, the use of cannabis has been linked with various adverse effects, especially among adolescents (Hall & Lynskey 2016). Classic negative effects include increased risk of using other drugs, diminished life satisfaction, cognitive impairment, and impaired short-term memory. Although the laws and regulations that have been enacted both at the state and federal levels have been to regulate cannabis use, there are waves or movements that seek to decriminalize and legalize the use of cannabis.

Cannabis legalization affects public safety issues. About 79% of U.S residents believe that the legalization of cannabis in the country would increase the number of car accidents caused by cannabis-user drivers (Young, Padwa & Bonar 2019). Public health will also be affected when cannabis is legalized. Various studies have shown that the legalization of cannabis is associated with lower rates of opioid-related overdose, harm, and death. This could significantly improve health for the general population in the present environment of the opioid epidemic. While most Americans opposing the legalization of cannabis maintain that it would lead to individuals using more addictive and stronger drugs, there has not been enough support for this belief.

In several states with legalized cannabis, it has been reported that the use of cannabis among the youth has not changed with respect to the states where the substance is not legalized. Research has not indicated any effect of cannabis legalization on the graduation or dropout rates. In conclusion, so far, research findings have shown that the legalization of cannabis can have several positive social effects, and more would definitely come with additional states considering legalizing cannabis.

References

Hall, W., & Lynskey, M. (2016). Evaluating the public health impacts of legalizing recreational cannabis use in the United States. Addiction111(10), 1764-1773. https://doi.org/10.1111/add.13428

Young, S., Padwa, H., & Bonar, E. (2019). Social Big Data as a Tool for Understanding and Predicting the Impact of Cannabis Legalization. Frontiers in public health7, 274. https://doi.org/10.3389/fpubh.2019.00274