Evidence-Based Project

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course. 
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
  • Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
  • Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

  • The full citation of each peer-reviewed article in APA format.
  • A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
  • A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
  • A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
  • A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

  • 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.

Human anatomy is the study of structure and form of the human body; Read the following case study and complete the questions.

 

Human anatomy is the study of structure and form of the human body; human physiology is the study if its functions. Understanding how the body is constructed and how the body operates is essential.

Read the following case study and complete the questions. Please do not copy and paste the case study into your assignment.

The Case of Kenji Oshima: Is Heartburn Dangerous?

Introduction

          Kenji Oshima (called KO) is a 58-year-old man who has not been to the doctor’s office for many years. He hasn’t had a physical exam by a healthcare provider in over 15 years, which is not uncommon for men of his age. He has had insurance provided by his employer, but he hasn’t used it because he hasn’t been sick. Unfortunately, over the last 8 months this has changed. In this period, KO inexplicably lost almost 20 pounds, and he just didn’t feel very well. He frequently become short of breath and nauseated, which was followed by frightening episodes where he became almost feverish and sweaty. He finally decided, with pressure from his wife and daughter, that he needed a full checkup.

          The history and physical exam (H&P) is a critical tool in the initial evaluation of the healthcare needs of the patient. If the healthcare provider asks the patient the right questions and pays close attention to their answers, the patient will often tell the provider what is wrong with them. There is no substitute for the relationship between patient and healthcare provider. The complete H&P is just as important a tool as x-rays, magnetic resonance imaging (MRIs), lab work, and the multitude of other advanced technological studies available to modern medicine. This case follows KO through his first visit with his new primary care provider.

 After KO filled out a medical history questionnaire in the waiting area, it didn’t take too long for him to be called back to an examination room. The medical assistant took KO’s vital signs (blood pressure, temperature, heart rate, and respiratory rate) and measured his height and weight, and then ushered him into a small examination room. KO was given a gown to wear and instructed to disrobe completely under the gown, and then to have a seat on the exam table.

          Ms. Young, advanced registered nurse practitioner (ARNP), introduced herself as the nurse practitioner who would be asking KO many questions in addition to those on the questionnaire. She said she would also be performing the physical portion of his exam. Miss Young noticed that KO’s father had died of gastric cancer at the age of 64.

          When KO asked if he wasn’t supposed to see a doctor rather than a nurse practitioner, Ms. Young explained her role in the family practice medical group, something she explained regularly to new patients. KO wasn’t that familiar with the changes in healthcare and the types of providers that were practicing these days. He admitted that he was nervous about the appointment in general and meant no disrespect, but he was curious about Ms. Young’s qualifications and her educational background. Seeing KO’s apprehension, Ms. Young encouraged him to ask questions about anything that he felt would put his mind at ease.

          It is critical to develop a rapport with a new patient that is built on mutual respect and trust. This is the foundation that allows a healthcare provider to ask for and collect sensitive information that patients are sometimes unwilling to discuss even with close family members. In this same way, the study of anatomy and physiology is an important educational foundation to which aspiring healthcare providers must commit themselves. Without a solid foundation, the obligation to lifelong learning that all professions within the healthcare field advocate is a hollow oath.

KO’s unexplained weight loss, palpable right upper quadrant pain, history of stomach pain made worse by eating, and persistent heartburn were concerning. The nausea could be associated with heartburn, but periodic hot flashes and shortness of breath were out of context with these mostly gastrointestinal symptoms. Ms. Young thought they were all related, but she thought a referral to a specialist was the correct intervention for this patient. She did not feel comfortable formulating a treatment plan without more information than her H&P had provided. KO’s Japanese heritage and the fact that his father had died from complications of gastric cancer made the decision to refer KO to a specialist simple.

          The gastroenterologist, a specialist of the gastrointestinal system, would want several baseline labs prior to seeing KO in his or her office. Ms. Young discussed her plan with KO, as she would need his consent to make these arrangements and she wanted to make sure that he understood why she was referring him to a specialist. KO was disappointed and more than a little frightened, but he understood Ms. Young’s rationale. She discussed her concerns about his family history of gastric cancer, and that his symptoms were beyond her scope of practice to diagnose and treat. She would be happy to continue to see him as a primary care provider nonetheless. KO signed the consent form and was to report to the local clinical laboratory with the list of his lab results that the specialist required for their first visit.

  1. Ms. Young recalls her Anatomy & Physiology (A&P) course that initially inspired her to pursue an advanced degree after her Associate of Science in Nursing (ASN). She saw how she began by learning about the smallest building blocks of life and worked her way through increasingly more complex organizational levels of the human body. Define the six levels of organization of the body.  Describe each level and explain how it is related to the next higher level.  Explain the eleven major organs systems in the body.
  2. Anatomical position is assumed when using directional terms to describe, document, and discuss the findings of the examination of different regions of the body. Describe how the body is situated in anatomical position and why it is considered important.
  3. Ms. Young is concerned about KO’s heartburn symptoms and stomach pain because of the history of gastric cancer in his immediate family. For that reason, she has referred him to a gastroenterologist for a more focused work-up. (a) Describe the location and subdivisions of the ventral cavity and (b) the dorsal cavity. (c) Describe which cavity or cavities the endoscopic device, which looks like a long hose, must travel through to get from the mouth to the stomach.

Assignment Expectations

Length: 750 – 1250 words

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment.  Be sure to include an introduction and conclusion paragraph for the assignment.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

Preview the document

Computer

This is the last Capstone and I want you to sell yourself. Take your Resume you created to make a presentation on why you are the best candidate for the JOB  we FAKE applied for in week two. 

Here is an example of the assignment:  How to Do A PowerPoint.pptx

Requirements:

10 slides

1 Picture of Yourself

4 Animations

4 Transition effects

1 image from online each slide

1 creative design

* Suggestion: Do this assignment in the PowerPoint Office 365 app as it is up to date and has the best side- suggestions to make your presentation beautiful* 

6612 Assessment 2

Assessment 2

  • Quality Improvement Proposal
    • Overview: 
    • Write a quality improvement proposal, 5–7 pages in length, that provides your recommendations for expanding a hospital’s HIT to include quality metrics that will help the organization qualify as an accountable care organization.
      Health care has undergone a transformation since the release of the Institute of Medicine’s 2000 report To Err Is Human: Building a Safer Health System. The report highlighted medical errors as a contributing factor leading to poor patient outcomes. The Institute of Medicine challenged organizations to implement evidence-based performance improvement strategies in order to improve patient quality and safety. Multiple governmental and regulatory agencies, such as the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Quality and Research (AHRQ), vowed to strengthen and improve incentives for participation, safety, quality, and efficiency in accountable care organizations (ACOs).
      Health  information technology (HIT) performs an essential role in improving health outcomes of individuals, the community, and populations. Health organizations, consumer advocacy groups, and regulatory committees have made a commitment to explore current and future opportunities that HIT offers to continue momentum to meet the Institute of Medicine’s goal of improving safety and quality.
      Understanding HIT is important to improving individual, community, and population access to health care and health information. HIT enables quick and easy access to information for both patients and providers. Accessible information has been shown to improve the patient care experience and reduce redundancies, thereby reducing health care costs.
      This assessment provides an opportunity for you to make recommendations for expanding a hospital’s HIT in ways that will help the hospital qualify as an ACO.
      By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
    • Competency 2: Explain the relationship between care coordination and evidence-based data. 
      • Recommend ways to expand an organization’s HIT to include quality metrics.
      • Identify potential problems that can arise with data gathering systems and outputs.
    • Competency 3: Use health information technology to guide care coordination and organizational practice. 
      • Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
    • Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards. 
      • Write clearly and concisely, using correct grammar and mechanics.
      • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
    • Reference
      Institute of Medicine. (2000). To err is human: Building a safer health system. Washington, DC: National Academies Press.
      Competency Map
      CHECK YOUR PROGRESSUse this online tool to track your performance and progress through your course.
  • Toggle DrawerResourcesHealth Informatics
  • Asssessment InstructionsPreparation
    In this assessment, you will again assume the role of case manager at Sacred Heart Hospital. This time, you are asked to develop a strategy for tracking quality metrics to help facilitate the hospital’s qualification for ACO status.
    Before drafting your proposal, complete the following simulation exercise:

    • Vila Health: Quality Metrics Tracking.
    • Note:Remember that you can submit all or a portion of your draft to Smarthinking for feedback before you submit the final version of this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
      Requirements
      Develop a proposal to expand Sacred Heart Hospital’s HIT to better include quality metrics—with the ultimate goal of qualifying for ACO status. Use the following template for your proposal:
    • APA Style Paper Template [DOCX].
    • Writing the Proposal
      The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your proposal addresses each point, at a minimum. You may also want to read the Quality Improvement Proposal Scoring Guide to better understand how each criterion will be assessed.
    • Recommend ways to expand the hospital’s HIT to include quality metrics.
      • How will you collect information and solve the problem of coordinating care for patients who are not getting diagnostic tests, such as mammograms or colonoscopies?
      • What can you do to track health information from the community or the target population to make necessary improvements?
      • How can you most effectively and efficiently show the role of informatics in nursing care coordination?
      • What evidence supports your recommendations?
    • Describe the main focus of information gathering in health care and how it contributes to guiding the development of organizational practice.
      • Provide examples to support your description.
    • Identify potential problems that can arise with data gathering systems and output. 
      • What suggestions can you make for avoiding those problems?
    • Write clearly and concisely, using correct grammar and mechanics.
      • Express your main points and conclusions coherently.
      • Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal.
    • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
      • Is your supporting evidence clear and explicit?
      • How or why does particular evidence support a claim?
      • Will your audience see the connection?
    • Additional Requirements
      Proposal Format and Length
      Format your proposal using APA style:
    • Use theAPA Style Paper Template [DOCX]provided. Be sure to include:
      • A title page and references page. An abstract is not required.
      • A running head on all pages.
      • Appropriate section headings.
    • See also theAPA Style Paper Tutorial [DOCX]to help you in writing and formatting your proposal.
    • Your proposal should be 5–7 pages in length,not includingthe title page and references page.
    • Supporting Evidence
    • Cite at least six sources of credible scholarly or professional evidence to support your proposal.
    • Apply APA formatting to all in-text citations and references.
    • Portfolio Prompt: You may choose to save your proposal to your ePortfolio.

Global Diseases Presentation

Summarize, for a country of your choice: (India)

  • group of non-communicable diseases: Cardiovascular Disease (Ischemic heart, stroke) 

Include in your presentation:

  • the people most affected by this disease or diseases
  • key risk factors
  • the economic and social costs of the disease(s)
  • what might be done to address the disease(s) in cost-effective ways.
  • key organizations and institutions, their roles, and the manner in which they can cooperate to address these key global health issues

Direction:

  1. 4 pages
  2. Use a minimum of three scholarly sources and cite your sources.
  3. Write in a professional manner with a logical sequence.
  4. No plagiarism 
  5. APA format  

Textbook : Global Health 101

4th Edition

Author: Richard Skolnik

Publisher: Jones and Bartlett Learning

Year: 2019

Nursing and the aging Family DQ week 7 part one student replay Joel Sanchez

 The following post is from another student that i have to reply adding some extra information.

Short answer

APA

less than 10 % similarity.  

 Hypochondriasis can be a problem for older adults. What situations contribute to hypochondriasis and what interventions can nurses provide that will address this problem in older adults? 

Hypochondriasis

Hypochondriasis refers to persistent anxiety with the likelihood of having one or more severe and progressive physical disorders. There is a wide range of differences between regular health anxiety and persistent incapacitating hypochondriasis (Bailer et al., 2016). The primary cause of hypochondriasis is unknown, but some factors increase the risk of developing the condition. Hypochondriasis is prevalent in older adults due to the aging changes and the fear of losing their memory. Memory issues and a time of high stress in life are some of the situations that contribute to the condition. Other situations include the history of abuses when one was a child, threats of severe illness that turn out to be less severe, and some personality traits, including having a worrier. Sometimes when an older adult had a severe childhood illness or had a parent with a severe illness, they are likely to develop health-related anxiety. Older adults experience a lot of changes in their bodies as a result of aging, which makes them feel more anxious.

           Nurses can provide cognitive behavioral therapy to older adults by using mindfulness techniques. Health anxiety can cause potential real distress to older adults, which can also make them uncomfortable in life. Through this therapy, they can be taught how to think positively and how to handle stress. Cognitive behavior therapy is essential since it involves challenging unnecessary fears and beliefs about health anxieties and monitoring your self-talk. The adults can be guided on managing their thoughts and viewing some of those physical symptoms they experience as less serious illnesses, and the past experiences may never reoccur. Nurses can also administer antidepressant drugs such as fluoxetine, which is also considered an effective treatment for hypochondriasis (Fallon et al., 2017). Antidepressants will help manage their anxieties and make them less depressed. Meanwhile, their families and close relatives can be informed to keep talking to them and reassure them, although it only has a temporary impact on the patients.

References

Bailer, J., Kerstner, T., Witthöft, M., Diener, C., Mier, D., & Rist, F. (2016). Health anxiety and hypochondriasis in the light of DSM-5. Anxiety, Stress, & Coping, 29(2), 219-239 https://doi.org/10.1080/10615806.2015.1036243

Fallon, B. A., Ahern, D. K., Pavlicova, M., Slavov, I., Skritskya, N., & Barsky, A. J. (2017). A randomized controlled trial of medication and cognitive-behavioral therapy for hypochondriasis. American Journal of Psychiatry, 174(8), 756-764 https://doi.org/10.1176/appi.ajp.2017.16020189

Nursing & Psychology

  I need these assignments in about 150 words

1. Would you provide different information and use different strategies to communicate with leadership vs bedside RNs? Please describe.

2. In humanistic psychology, my question for you to consider, “is psychology a science?”  If yes, what makes it a science? If no (and my friends from the Engineering, Chemistry and Physics departments certianly had an opinon), why not?

Case Study gastrointestinal

Case Study #1

Gastrointestinal Disorders

T.H., a 57-year-old stockbroker, has come to the gastroenterologist for treatment of recurrent mild to severe cramping in his abdomen and blood-streaked stool. You are the registered nurse doing his initial workup. Your findings include a mildly obese man who demonstrates moderate guarding of his abdomen with both direct and rebound tenderness, especially in the left lower quadrant (LLQ). His vital signs are 168/98, 110, 24, 100.4° F (38° C); he is slightly diaphoretic. T.H. reports that he has periodic constipation. He has had previous episodes of abdominal cramping, but this time the pain is getting worse. Past medical history reveals that T.H. has a “sedentary job with lots of emotional moments,” he has smoked a pack of cigarettes a day for 30 years, and he had “two or three mixed drinks in the evening” until 2 months ago. He states, “I haven’t had anything to drink in 2 months.” He denies having regular exercise: “just no time.” His diet consists mostly of “white bread, meat, potatoes, and ice cream with fruit and nuts over it.” He denies having a history of cardiac or pulmonary problems and has no personal history of cancer, although his father and older brother died of colon cancer. He takes no medications and denies the use of any other drugs or herbal products.

 

. 1. Identify four general health risk problems that T.H. exhibits.

 

  1. Identify a key factor in his family history that might have profound implications for his health and present state of mind.

 

3.The physician ordered a KUB (x-ray study of the kidneys, ureters, and bladder), complete blood count (CBC), and complete metabolic profile. Based on x-ray and laboratory findings, physical examination findings, and history, the physician diagnoses T.H. as having acute diverticulitis and discusses an outpatient treatment plan with him.What is diverticulitis? What are the consequences of untreated diverticulitis?

 

4.While the patient is experiencing the severe crampy pain of acute diverticulitis, what interventions would you perform to help him feel more comfortable?

 

5. What is the rationale for ordering bed rest?

 

T.H. is being sent home with prescriptions for metronidazole (Flagyl) 500mg PO q6h, ciprofloxacin (Cipro) 500mg PO q12h, and dicyclomine (Bentyl) 20mg  4 tomes per day for 5 days.

6.For each medication, state the drug class and the purpose for T.H.

 7.Given his history, what questions must you ask T.H. before he takes the initial dose of metronidazole? State your rationale

 

8.What is a disulfiram reaction?

 

9. What are the signs and symptoms of an allergic reaction

Family Interview – Compare and Contrast Cultures Paper

It is important to identify and understand your own family culture in order to be able to understand and respect other cultures. Interview a family member, and an individual from another culture with which you are unfamiliar. Some examples of an individual from another culture to consider for the assignment include a neighbor, coworker, patient, or friend. Please inform the individuals of the purpose of this assignment and make sure you receive their consent.

Interviews:

Review the “Family Interview ” template prior to the interview. Additional space is designated on the template for you to create three additional questions to ask both interviewees (family member and person from another culture). Additional questions should be relevant to the readings or discussion and should provide value to the interview by helping to understand culture.

Some of the questions may include:

  1. Family beliefs: Have they changed over generations?
  2. Educational and occupational status in the culture and in the family
  3. Communication methods: verbal and nonverbal
  4. Current family goals/priorities
  5. Family member roles and organizational systems
  6. Spiritual beliefs: current practice and death and dying
  7. Alternative lifestyles
  8. Work attitudes and structure

Written Paper:

Using the “Family Interview ” template, interview your designated family member and the person from another culture. Be sure to write your responses in a way that will assist you in writing your paper. After the interview is completed, write a paper of 750-1,000 words that includes the following:

  1. An introductory paragraph with the reasons for selecting the interviewees
  2. A summary of the responses from the interview template gathered from the interviewees
  3. A comparison and contrast of your findings between the two interviewees
  4. A reflective concluding paragraph on how family roles affect the cultural domains and relationships for each individual

General Requirements:

Submit both the completed “Family Interview” template and the written paper” to the instructor.

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.