All posts by : chebby

 Using the attached worksheet (Study Identification worksheet), 

• Using  the knowledge gained during your preparation and the flowchart at the  bottom of the Worksheet, you will review the pdfs of the 10 studies  linked below.
• Identify each study as follows by highlighting your choice on the document: 
• Is it a primary study, a secondary study, or “other” (neither)?
• If a primary study, is it quantitative or qualitative? (If it is not a primary study, leave the last two columns blank.)

  Based on the readings, viewing the online materials & resources on the Module 4: Lecture Materials & Resources page, and your own experience, what strategies would you recommend encouraging culturally competent care of Native Americans? 

Read and watch the lecture resources & materials below early in the week to help you respond to the discussion questions and to complete your assignment(s).

(Note: The citations below are provided for your research convenience. Students should always cross reference the current APA guide for correct styling of citations and references in their academic work.)

Read

Ritter, L.A., Graham, D.H. (2017). Multicultural Health (2nd ed.). Burlington, MA: Jones and Bartlett Learning.
ISBN: 9781284021028
Chapter 8

 Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. 

Now that you have completed your paper, build and deliver a video presentation that details your solution to the healthcare issue that serves as your topic.
In your presentation, you should:

• Exhibit comprehensive research and understanding by referencing important points and insights from the perspectives of inquiry papers.
  • Present your issue and your argument for your solution

Make a PowerPoint presentation with at least 7-8 slides over the paper uploaded discussing the solution to declined patient satisfaction in the ED. With detailed important points and insights over the paper uploaded.

Choose one of the following options to respond to in your initial post for this week’s discussion:

• In your current role, describe your interactions with a KSA healthcare accreditation body. What was the accreditation agency? Did the accreditation body focus on large quality improvement items, or lower priority but easier to address items (i.e., cleanliness, organization of supplies, etc.)?
• If you have had no interaction with accreditation agencies and/or do not currently work in the field, based on the course readings, do you believe accrediting bodies are important to healthcare quality improvement? Why or why not?

Embed course material concepts, principles, and theories, which require supporting citations along with at least one scholarly, peer-reviewed reference in supporting your answer. These scholarly references can be found in the Saudi Digital Library by conducting an advanced search.

 Some guidelines address the researchers’ obligations not just to do the research but to do a follow up on providing medical care to the participants after the research is completed. There is no clear guide to have ethical answers to what happens to the participants when the research is complete? Or what are the researchers if any obligation toward the participants that were enrolled as untreated in the specific group? Provide examples of vulnerable populations.  Some of the low-income countries and low institutional capacity for data are usually vulnerable to compromising the confidentiality, there is still no consensus of who has the responsibility to report back to the participants and their well-being after the trials. Thoughts about ethics in research?  

Instructions:

Use an APA style and a minimum of 100 words. Provide support from scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 year), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply. 

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be used.

Attention Wizard Kim. 

Week 6 Discussion: Practicum professional Development Objectives/ Progress Appraisal  3 pages. 

Rubrics 

Open the attached…

HOMEWORK ASSIGNMENT

The WHO has published an important document titled, “Social Determinants of Health—The Solid Facts.” It states:

Even in the most affluent countries, people who are less well off have substantially shorter life expectancies and more illnesses than the rich. Not only are these differences in health an important social injustice, they have also drawn scientific attention to some of the most powerful determinants of health standards in modern societies. They have led in particular to a growing understanding of the remarkable sensitivity of health to the social environment and to what have become known as the social determinants of health.

http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf

1. In your opinion, are social determinants of health more important for a health educator to understand than the biological/genetic determinants of health? 

2. Additionally, if the social determinants of health are so critical to one’s health outcomes how can health education improve the social environment/condition of persons most affected by social determinants? Please post your response by the end of this module and critique the response of at least one other student. Please provide at least two paragraphs for your response.

PLEASE SEE ATTACHMENT FOR READING ATTACHMENT

Case Study: Mrs. J.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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. 

Theories and Conceptual Models in Nursing and Advanced Nursing Practice

Introduction

Theories in nursing provide an organized body of knowledge that defines the nursing practices, what the nurses are supposed to do in every situation, and why they need to do it.  The theories act as the framework of fundamental concepts and provide a purpose to guide the nursing practice at more concrete or specific stages. Butts (2013) and Fawcett et al. (2018) stated that the major categories of theories that guide the nursing and advanced nursing practices include grand theory, middle-range theory and practice level theory, need-based theories, interaction theories, outcome theories, descriptive theories, factor-isolating theory, explanatory theory, and prescriptive theories.  The nursing theorist explained that the theories describe the connection between the patient, environment, health and nursing goals, role, and functions.  Additionally, the conceptual model defines the nursing ideas, statement, and concepts; organize a framework for nursing practices, direct clinical practice, clinical and professional leadership, consultation, ethical decision making and collaboration, quality improvements especially DNP and APN programs and research.

Evaluation of theories and Conceptual Models

Nursing Theories

Grand nursing theory addresses and focuses on the nursing met paradigm components such as the patient (person), nursing, health, and environment (Smith & Parker, 2015). However, the theory does not guide specific nursing care interventions rather it focuses on providing a general framework and ideals in nursing. Butts (2013) mentioned that grand theories provide an abstract, wider scope and complex demand for more intense research for clarification in the nursing environment and advance nursing practices. Additionally, middle-range theories address a specific phenomenon in nursing (Brandão et al., 2017).  However, the middle range nursing theories have a limited scope compared to the grand theories while they present nursing and advance nursing concepts and propositions at lower levels.

Finally, the practice level nursing theories provide a narrow scope and focus on a specific patient population within a framed set time. Butts (2013) explained that the practice level nursing theories are effective in providing a framework of nursing interventions and practices as well as provide a suggestion of the outcomes or the effects of the nursing practices. Based on this perspective, the practice-level nursing theories have more direct effects on the nursing practices as well as in advanced nursing practices, shaping the nursing interventions, their impact, and potential outcomes.

Conceptual Nursing Models

The conceptual models in nursing identify various components, their interactions, and patterns in nursing and in advance nursing practices. The conceptual nursing models include Consensus Model for advanced Practices Registered nurse regulations, Hamric’s Integrative model, Calkin’s model, Brown’s Framework, and Shuler’s models of nurse practitioner practice among other models (Spross & Lawson, 2009; Fawcett, 2016; Fawcett et al., 2018). Each model focuses on a specific section and complements the focus of other models to contribute to nursing practices as well as advanced nursing practice. However, no model offers a comprehensive approach to nursing practices or advanced nursing practices. Nevertheless, an integrated approach and multi-application of various models contribute to an expected outcome.

 Regardless of the classification of the nursing theory and the conceptual models, each theory and model, compliment the other since no single theory or model can fit all the nursing care, intervention, and suggest outcomes. However, the combination of different theories from the abstraction (grand, middle-range, practice-led theories) to goal orientation (descriptive, factor-isolating, explanatory, prescriptive) to need-based, interaction theories complement each other to shape, define and direct the nursing practices as well as advanced nursing practices to achieve the patients’ outcome.

Conclusion

The nursing theories and conceptual models provide the foundation of nursing and advanced nursing today.  The nursing theories and models provide a guiding framework for the development of knowledge, direct education, research processes, and practices. Further, the conceptual models are an abstraction of reality, provide a visualization of the reality to simplify the thinking processes, give direction for search regarding various phenomena of central interest in nursing as well as suggest potential solutions. Thus, the nursing theories and models help in the recognition of what sets the foundation of the current nursing practices, providing a definition of purpose and role in the healthcare environment. Besides, the nursing and conceptual models provide a rationale for interventions and enhance the development of knowledge.  

References

Brandão, M. A. G., Martins, J. S. A., Peixoto, M. D. A. P., Lopes, R. O. P., & Primo, C. C.

       (2017). Theoretical and methodological reflections for the construction of middle-range nursing theories. Texto Contexto Enferm, 26(4), e1420017.

Butts, J. B. (2013). Philosophies and theories for advanced nursing practice. Jones & Bartlett

          Publishers.

Fawcett, J. (2016). Applying conceptual models of nursing: quality improvement, research, and

          practice. Springer Publishing Company.

Fawcett, J., Amweg, L. N., Legor, K., Kim, B. R., & Maghrabi, S. (2018). More thoughts about

           conceptual models and literature reviews: Focus on population health. Nursing science          quarterly, 31(4), 384-389.

Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice. FA Davis.

Spross, J. A., & Lawson, M. T. (2009). Conceptualizations of advanced practice nursing.

             Advanced practice nursing: An integrative approach, 33-74.