Follow up discussion please one paragraph using same resource 2 citation and reference add information or comment on the following post 

 A systemic review of literature is a structured and well-guided search for available literature that have been reviewed, free of bias, and can be recommended for practice. (Houser, 2016).  According to Houser (2016), conducting a systematic review that results in an evidence-based practice guideline requires the ability to develop research questions methodically, write inclusion criteria, conduct in-depth literature searches, and review the results of many studies critically (p.10). It is therefore important for a nurse to be well knowledgeable about ways to identify and review articles that are evidence-based and can be safely implemented during patient care. Below are some of the importance of systemic review literature stated by Boren and Moxley (2015)

1. It prevents personal options and bias that may result in patient harm
2. A reviewed literature provides the opportunity for continuous study and improvement.
3. A systematic review draws upon the best health services research principles and methods to address specific medical issues.
4. Gives researchers the opportunity to examine current practices
5. Helps with the development of guidelines for practice and work-related policies

                           References

Boren, S. A., & Moxley, D. (2015). Systematically Reviewing the Literature: Building the Evidence for Health Care Quality. Missouri Medicine, 112(1), 58–62.

 Houser, J. (2016). Nursing research: Reading, using and creating Evidence. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781284138887/

Select two grand nursing theories and discuss how each theorist addresses the metaparadigm for nursing. Discuss briefly the similarities and differences of the two. 

 Identify a quality improvement opportunity in your organization or practice. In a 1,000 to 1,250 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal.

Include the following:

1. Provide an overview of the problem and the setting in which the problem or issue occurs.
2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
5. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

Discussion: Workplace Environment Assessment

How healthy is your workplace?

You may think your current organization operates seamlessly, or you may feel it has many issues. You may experience or even observe things that give you pause. Yet, much as you wouldn’t try to determine the health of a patient through mere observation, you should not attempt to gauge the health of your work environment based on observation and opinion. Often, there are issues you perceive as problems that others do not; similarly, issues may run much deeper than leadership recognizes.

There are many factors and measures that may impact organizational health. Among these is civility. While an organization can institute policies designed to promote such things as civility, how can it be sure these are managed effectively? In this Discussion, you will examine the use of tools in measuring workplace civility.

To Prepare:

• Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
• Review and complete the Work Environment Assessment Template in the Resources.

By Day 3 of Week 7

Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples.

3 sources for this discussion

A 38-year old female arrives at the infusion clinic that you are working at. She states that she has already had a double mastectomy and is not sure why the oncologist is ordering chemotherapy since she has already had her breast removed.

1. Why would an oncologist order chemotherapy in addition to surgery?
2. What are the benefits of using a combination of chemotherapy to treat cancer?
3. What are some of the topics you should discuss with a patient that is here for her first chemotherapy treatment?