Discussion 1: Evidence Base in Design

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

• Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
• Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

Discussion 2: The Role of the RN/APRN in Policy-Making

Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to input words they feel best describe their team or their role. A “word cloud” is generated by the application that makes prominent the most-used terms, offering an image of the common thinking among participants of that role.

What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?

Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policy-making has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare legislation.

To Prepare:

• Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
• Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.

Vital Signs
1. You are a nurse caring for a 58-year-old ironworker who has been admitted to your unit with acute hypertension. He became extremely symptomatic at work and was brought to your emergency department (ED) via ambulance. After receiving a report from the ED nurse, he is brought to your unit asymptomatic (other than his BP of 178/106) and seems in good spirits. After completing his admission paperwork, he settles in and awaits his health care provider. Four hours later, you answer his call light and he reports headache (rated 6 on a 0-to-10 scale) and dizziness. 
a. Outline the pertinent information within this case study.
b. How often would you expect to measure the patient’s vital signs based on his history?
c. What would be your first intervention upon his reporting increased symptoms? Include rationale.
d. What is the patient’s pulse pressure?
e. Describe risk factors that could be contributing to your patient’s hypertension.
2. As a nurse in a critical care unit, your newest admission is a 24-year-old victim of a motor vehicle accident (MVA). Report from the OR nurse indicates that the patient has several surgically repaired fractures, a closed head injury, and elevated temperature. Additionally, he has IV fluid running postoperatively and dressing changes scheduled every shift. The patient is intermittently alert and disoriented, with his pain adequately controlled by IV analgesics. 
a. Outline the pertinent information within this case study.
b. What factors could be causing the patient’s elevated body temperature?
c. Why is determining the fever’s cause important?
d. Indicate areas that are important to monitor in a patient with elevated body temperature.
e. Describe cause-specific interventions useful in treating the patient’s elevated body temperature.

PLEASE, answer each question in order and separately. PLEASE,  this is the bibliography( Chapter 29-30).
1.Potter, P.A., &Perry, A. G. (2017). Fundamentals of Nursing: Concepts, Process, and Practice (9th ed.). St. Louis: MO:  Mosby. ISBN: 9780323327404

Read Chapter 6 & 7. Answer each question one by one.

1. Discuss the importance of effective communication in the personal relationship, the therapeutic relationship, and the relationship within the interprofessional health-care team.

2. What similarities and differences can you identify among the above interactions? 

3. Explain the concept of congruence between verbal and nonverbal communication.

4. There are many pitfalls to electronic communication. Identify a situation in which an electronic form of communication may result in miscommunication. What other methods of communication would have been more effective? 

5. How have you seen ISBAR used during your clinical experiences? 

6- Develop a hand-off report for yourself. Include items that you believe are pertinent for safe and effective nursing care. Refer to the information in the chapter for creating this report form. Using the information from the chapter, determine the effectiveness of the system currently in use on your unit for communicating shift-to-shift reports. 

7-Dr. Roberts comes into the nurses’ station demanding, “Where are Mr. Adams’s lab reports? I ordered these stat, and they’re not here! Who’s responsible for this patient?” How would you, as the nurse, respond? 

8-Explain the concept of accountability in the delegation. What are the legal ramifications of accountability in the delegation?

9. Dennie and Elias arrive in the unit for the 7:00 p.m. to 7:00 a.m. shift. Both nurses completed orientation 4 weeks ago. They find that they will be the only two RNs on the floor that night. There is a census of 48 clients. The remaining staff consists of two NAPs/UAPs and one LPN. What are the responsibilities of the RN, NAP/UAP, and LPN? Can Dennie and Elias effectively delegate client care tasks and care safely for all 48 clients? Use the Delegation Tree to make your decisions.

10. Discuss the differences between direct delegation and indirect delegation. 

1. You have to observe delegation procedures in your assigned unit:

A-What considerations does the RN take into account when delegating patient care? 

2-You have to look at the unit census and prioritize patient care:

A- Give the rationale for your choices.

3.Answer the following questions during your clinical experiences:

a. What specific tasks did your patients require that you might have been able to delegate?

b. How effective was your nurse/preceptor in delegating tasks to others? 

c. How did your nurse/preceptor ensure that the tasks were completed safely and appropriately? 

You will write a case study review which includes your critique. This will be worth 30 points total. Create a detailed case study review in an essay APA format and include as your final page a reference list in APA format. Your review should be double-spaced, 2 pages minimum (not including reference list), with correct grammar and spelling. 

The purpose of this summative assignment is to reflect upon the new knowledge you have obtained from this course and apply it to your chosen case study while developing your critical thinking and critique skills. Be sure to consider all information from the course content – discussion board exercises, videos and any additional readings. Revisit readings from your Gilmore text. Put thought into how well you think the case study conducted their assessment, and how you would augment or improve it. Utilizing your knowledge from our course around assessing community needs, provide a detailed description and critique of your case study. Be sure to review your case study carefully to look for any gaps or areas with which improvements could be made, and justify your thinking. Reference additional scholarly resources to reinforce your justification. Be sure to cite your work appropriately.

Provide a brief (1 – 2 paragraph) description of the population and the health concern or issue being addressed. Explain how your chosen case study did, or did not, do in the area of describing the community, justifying the need for conducting the assessment, etc. Describe how your case study did with (or if they omitted) considering learning styles and theories as well as models to promote health education. Describe how your case study assessed groups and/or individuals (if applicable) and if they considered any factors that impact health education. Using your knowledge around each weekly module, discuss three suggestions for improving your case study. You may present an alternative approach or additional steps that you believe would improve the quality of your case study. Consider these prompts as you complete your critique:

• How did the case study identify the issue and explain the importance of the specific topic within the community?
• Did the case study paint a detailed picture of the population?
• Does it include a detailed description including information on demographics, barriers and challenges?
• Does it justify the need to conduct a needs assessment?
• Does it identify and describe community resources and explain why the resources are or are not effective?
• Does it explain any process for collecting data?

Remember to discuss recommendations. As you have done previously in our discussion boards and weekly modules, apply your critical critiquing skills to suggest what improvements are needed. Finish your essay with a summative paragraph which includes your final thoughts around how your suggested improvements would enhance this case study to meet the needs, or “fill in the gaps” and provide assistance to the community or population represented. 

Finally, include in APA format, a list of references. This should include a minimum of 2 references which are scholarly sources of information no previously referenced in the course. You may use any of the resources that were referred to throughout our weekly modules. You may also include your text as a resource in addition to your 2 references.