In a perfect world, research studies would be flawless however, that is not typically the case.  Inherently, flaws exist related to study design, how the study is conducted, and also the manner in which research is reported.  “Given that research is not perfect, users of research must learn to carefully evaluate research reports to determine their worth to practice through critical appraisal” (Melnyk & Fineout-Overholt, 2015, p. 92-93).  Factors that need to be assessed when critically appraising quantitative studies include validity, reliability and applicability (Melnyk & Fineout-Overholt, 2015).  

      The validity of a study relates to obtaining results from utilizing sound methods which are scientific.  Bias and confounding variables can compromise validity of a study.  Bias can occur at any stage of the process but while assessing the reliability of the results one must look at if the study was systematic, grounded in theory, and criteria was followed for all of the processes.  If so, then the study, more than likely, is valid and reliable.  Clinicians need the ability to interpret the results so they can implement EBP into their practice (LoBiondo-Wood & Haber, 2014).  “Whether we are interpreting the research studies of others, or designing our own, we need a good understanding of research design and an ability to recognize weaknesses in intervention studies which may reduce the reliability of study findings” (Ebbels, 2017, p. 229).      Although each factor is important to quality research, I feel the most important factor is the applicability to practice.  Having the ability to appraise research, which is evidence-based, and implement EBP interventions with our patients is essential in promoting optimal patient outcomes.   
 

References

Ebbels, S. H. (2017). Intervention research:  Appraising study designs, interpreting findings and creating research in clinical practice. International Journal of Speech-Language Pathology, 19(3), 218-231. https://doi.org/https://doi-org.arbor.idm.oclc.org/10.1080/17549507.2016.1276215

LoBiondo-Wood, G., & Haber, J. (2014). Nursing research:  Methods and critical appraisal for evidence-based practice (8th ed.). St. Louis, MO: Mosby Elsevier.

Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare:  A guide to best practice (3rd ed.). Retrieved from Amazon Kindle App

1-, remarkable presentation, just to add on I would recommend the physician if he/she can consider treating the patient with hyper baric oxygen in order to increases oxygenation to the tissue, improves circulation and blood flow, to increase the ability of neutrophils to kill the Mucar and to decreases the pain and swelling.

Thank you

2-There really isn’t enough information to determine if this patient really warrants an ICU admission. Where I work, our Progressive Care Unit could most likely manage this patient. Depending on the presentation, such things to consider are vitals, face to face assessment data, respiratory efforts, heart rate and rhythm. The chest xray does show white out of the mid to lower left fields but is clear at the left apex and to the right. Hard to determine the appropriate level of care based on the limited data provided.

3-Hyperbaric oxygen would help this patient because hyperbaric therapy increases oxygenation to the tissue, improves circulation and blood flow, boosts white blood cells especially neutrophils, enhances effectiveness of antibiotics, and decreases pain and swelling

(Latham E., 2018). However, there is some precaution while taking this treatment “the fire hazard” because the use of oxygen is always high risk to fire explosion. so, any material that can explode fire is prohibited in the treatment room, for instance nurses must make sure that the patient is not using a hair spray, deodorant, electric devices or cigarette lighter and proper education should be given to the patient (Latham E., 2018).

Reference

Latham E. (2018) Hyperbaric Oxygen Therapy retrieved [online] from: https://emedicine.medscape.com/article/1464149-overview

4-I enjoyed reading your post. Over the years, I have had many diabetic patients that are diagnosed with pneumonia, but never with Mucor. You stated, “Mucor is most commonly found in uncontrolled diabetics, transplant patients, cancer patients, and others who are immunocompromised (Centers for Disease Control and Prevention, 2015).” It is interesting to know that Mucor is commonly found in uncontrolled diabetics. However, I found that there have also been cases found in well controlled diabetics. According to Panigrahi,M., Manju,R., Kumar, S.V. & Toi, P.C. (2014) “Uncontrolled diabetes, particularly diabetic ketoacidosis, predisposes patients to the development of mucormycosis; however, cases have been described even in patients with well controlled diabetes mellitus.”

Panigrahi,M., Manju,R., Kumar, S.V. & Toi, P.C. (2014). Pulmonary Mucormycosis Presenting as Nonresolving Pneumonia in a Patient With Diabetes Mellitus. Retrieved  from http://rc.rcjournal.com/content/59/12/e201

5-I agree, a sputum or tissue sample like biopsy is needed to identify the fungal infection. However, amphotericin B, posaconazole or isavuconazole iv  are very effective treatments if started early and aggressively. In addition to this and an excision of the infected tissue or organ is also needed to save the rest of the tissue or organ and life as well. Nice post.

6- Nice post, I agree, once patient is on bed rest and NPO,  pantop and low molecular weight heparin needed to be started as gastric and  DVT prophylaxis. And this patient is going to be very unstable so needed to be admitted in ICU for monitoring and further management.

Assignment 2: Middleville Regional Healthcare

Due Week 9 and worth 130 points

Middleville Regional Health Care is one (1) of three (3) hospitals serving a community of 350,000 people. Summary statistics on Middleville and its competitors, from the AHA Guide, are shown below in Table 1. All three organizations are not-for-profit.

Table 1: Middleville, Brierfield, and Greystone Health Care Systems

Name

Beds

Admissions

Census

OP Visits

Births

Expenses (000)

Personnel

Middleville

575

13,000

350

221,000

2,300

$125,000

2,000

Brierfield

380

17,000

260

175,000

1,200

$130,000

1,875

Greystone

350

10,000

180

40,000

900

$80,000

1,200

The governing board of Middleville hired a consulting company to evaluate its strategic performance, specifically in the areas of Human Resources, Information Technology, Financing, and Marketing. As part of the consultant’s evaluation, several leaders of Middleville’s units were asked their perspective of the organization’s performance.

You are working for the consultant. Your job is to identify the issues from the response that should be considered further by the consultant team and possibly discussed with the governing board and the CEO. The firm has a rule, “Never offer a criticism or negative finding without suggesting how the client organization can correct it,” so you must indicate what sort of correction you would recommend as part of your list. Because you know there were about two (2) dozen other interviews, you decide you should rank your issues in importance, to make sure the most critical are discussed.

Write a six to eight (6-8) page paper in which you:

1. Explain the governing board’s role in these strategic initiatives, determining its responsibility and involvement.
2. Evidence-based management means that operational and strategic decisions are made based upon the evidence that goals and objectives are actually being met. Quantitative measurements must be identified and measured. This data is then used to evaluate the HCO’s performance. Name three (3) performances Middleville can use to measure its success in providing quality healthcare to the community, and identify quantifiable, measureable indicators that can be used to do so. Explain the importance of each performance measurement.
3. Given the statistics of Middleville and its two (2) competitors provided in Table 1, recommend to the HCO what areas it should focus on to maintain its competitive market share as well as continue to provide healthcare to the community in the 21stcentury.
4. Some of Middleville’s Board members are very interested in pursuing advanced technology systems over the next five (5) years, while others are concerned about the enormous expense and need assurance that the investment in technology will be worthwhile. In both monetary and process terms, describe the costs and benefits associated with implementing EMR and associated health data systems. Lay out a plan for how various systems can be implemented.
5. Middleville has faced many challenges in recruiting and retaining nurses and other clinical employees. The economy has hit the area very hard and budgetary limitations have reduced the amount of money available for salary increases. The Board knows it needs to provide other benefits to their valued employees. Provide at least two (2) suggestions to Human Resources to promote employee satisfaction and, therefore, retain experienced personnel.
6. Use at least three (3) quality resources in this assignment. Note:Wikipedia and similar Websites do not qualify as quality resources.
7. Format your assignment according to the following formatting requirements:

 Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page is not included in the required page length.

  Include a source list. Citations and sources must follow SWS format. The source list is not included in the required page length.

The specific course learning outcomes associated with this assignment are:

• Examine how healthcare management concepts and theories are applied to critical issues in healthcare organizations.
• Analyze the critical management issues, purpose, functions, and performance measures of different departments within healthcare organizations.
• Explain how public policy has shaped the development of the U.S. healthcare system.
• Use technology and information resources to research issues in health services organization management.
• Write clearly and concisely about health services organization management using proper writing mechanics.

36342 Topic: Identifying a Researchable Problem

Number of Pages: 4 (Double Spaced)

Number of sources: 1

Writing Style: APA

Type of document: Essay

Academic Level:Undergraduate

Category:   Nursing

Language Style: English (U.S.)

Order Instructions: Attached