HIT 1450 MOD 3 DB

Home>Homework Answsers>Nursing homework helpInstructions:This discussion will be completed in two parts and will give you an opportunity to reflect upon this week’s content and to interact with your classmates.Part 1 – Post your initial response to the discussion questions by Thursday at 11:59 pmPart 2 – Post substantive feedback to a classmate by Sunday at 11:59 pmReview Section I.C of the OGCR and find the chapters for your systems this week.  Review each chapter and note any information that will impact coding.Choose two types of anemia and discuss the characteristics of each of those types of anemia?What errors could a coder make when searching the Index for anemia?Locate the coding guidelines related to coding anemia due to neoplasms and anemia due to chemotherapy. Provide an example of how to code one scenario that would fall under this guideline. Describe the scenario and give the codes you think should be used.7 months ago09.12.20243Report issueBids(50)PROF_ALISTERDr. Sarah Blakefirstclass tutorMUSYOKIONES A+Dr CloverDiscount AssigngrA+de plusSheryl HoganProf Double RProWritingGuruIsabella HarvardBrilliant GeekTutor Cyrus KenAshley Elliepacesetters2121Coleen AndersonAmerican TutorDr. Emma OliviaAmanda SmithQuality AssignmentsShow All Bidsother Questions(10)CH 17 B-17 – ASHLEY CORPORATION – SCHEDULE OF COST OF GOODS MANUFACTUREDUnit VIII Case Study (For hifsa shaukat Only) Project Management Strategy and TacticsI need this assignment by 1:00pm 02/22/2016Managerial Economics is applied microeconomics FOR GUARDIANTUTOR ONLYdesign a (fictional) scientific study to answer a specific question based upon an observation.FIN 571 Week 6 – Individual Assignment – Wiley Plus – (10.14,11.20,11.24,12.24,13.11)The Morning Brew Coffee shop sells regular, Cappuccino, and Vienna blends of coffee. The shop’s current daily labor cost is…QNT 351 JULY VERSION FINAL EXAM (100% ANSWER)Biologyoutpatient

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Home>Homework Answsers>Nursing homework helpWORKstudyTotal of 2 replies APA format due in 6 hours7 months ago09.12.202415Report issuefiles (1)week6discussion.docxweek6discussion.docxDaynaKelly is a 19-year-old female who comes to your clinic complaining of severe menstrual pain that is usually worse just prior to and during the first two days of her menses. The pain is sometimes so severe that she has fainted. She states that defecation can cause severe pain and she therefore frequently becomes constipated. She often must miss work when experiencing the severe pain. Her periods are heavy and last seven days with a tapering of the bleeding from days 3 to 7. Her BMI is 23.9 and her VS are all WNL. She is G0 P0.SubjectiveCC: severe dysmenorrhea, heavy periods, painful defecation, symptoms interfere with life styleHPI: 19 y/o F, G0P0 presents to clinic today with complains of menstrual pain and heavy menstrual bleeding. Patient states that pain is usually worse just prior to and during the first two days of her menses. Patient describes pain as severe, causing patient to faint and often causing her to miss work. Patient reports periods lasting seven days with a tapering of the bleeding from days 3 to 7.  Patient also mentions that defecation can cause severe pain and she therefore frequently becomes constipated.What other relevant questions should you ask regarding the HPI?When did you start experiencing pain? Was onset sudden or gradual?Where does pain occur? Is it localized or diffused? Lower abdomen, lower back, inner thighs?What does the pain feel like? Is it sharp, dull, burning, aching, cramping etc.,?Is there anything which makes this pain better or worse (compress, hot shower, physical exercise)?Does this pain in your breast radiate anywhere in your body?Would you say that your pain is getting progressively worse over time?Do you experience pain between menstrual periods?How severe is the pain on the scale from 0 to 10?Did you attempt to take any medications  to help relieve pain? Was it successful?Did you always heavy periods from onset of menses?Do you have an bleeding between periods?Are you sexually active? Is your intercourse painful?How frequent are your BM?Did you notice any blood in your stool?When did you start experiencing painful defecation and constipation?Gyn/OB history:G0P0Any chance you can be pregnant?How old were you when you started your period?Heavy menses that last seven days with a tapering of the bleeding from days 3 to 7Have you noticed any changes in your menstrual cycle, such as irregular periods or changes in flow?Do you experience blood clots during menstruation?What method of contraception do you use? Do you have IUD? Any hx of STIs?Have you been tried to conceive without success?Any history of pelvic inflammatory disease, endometriosis, or other gynecological conditions?What other medical history questions should you ask?Do you take any new medications, including OTC or supplements?Do you take oral birth control pills? If so, does it provide any pain control/relief?Do you have allergies?Any chronic medical conditions, such as diabetes or thyroid disorders?Have you been treated for dysmenorrhea in the past?Do you have any other medical issues?Any past surgeries, including surgeries to the reproductive system?What other family history questions should you ask?Are there any family members with a history of gynecological disorders, like endometriosis, PID, infertility?Any family history of dysmenorrhea or heavy prolonged menses?Any history of cancer in the family, including cancer of reproductive organs?Anu hx of autoimmune disorders in your family?Any history of early menses onset in your family?What other social history questions should you ask?Social Hx:Do you drink, smoke, use drugs?How much of a physical activity you get daily?What do you do for work?What does your diet look like?ROSGeneral:: Any fever fever, chills, malaise? Reports fatigue right before and during menses.HEENT:Denies changes in vision and hearing, sore throat, and dysphagiaCardiovascular:Denies chest pain and palpitationsRespiratory:Denies shortness of breath or coughGastrointestinal:Reports pain with defecation and constipation. Any nausea, vomiting, diarrhea, associated with menstrual pain?Genitourinary:Any frequency or urgency or pain with urination? Reports lower abdomen/lower back intense cramping, heavy menstrual bleedingIntegumentary:Denies rash, pruritus, erythemaBreast:Do you notice any breast changes right before and during menstruation. Denies breast pain, skin changes, nipple discharge.Musculoskeletal:Denies myalgia, joint painNeurological:Denies headache, dizziness, weakness. Reports syncope s/t painPsychological:Denies depression, anxiety, or suicidal thoughts. Reports insomnia s/t pain and acute distress around periods due to interruption of daily routine and responsibilitiesObjective DataWrite a detailed focused physical assessment on this patient.VS: WNLBMI – 23.9POCT:Pregnancy test – negativeGeneral:A&O x 4, normal weight, no signs of acute distress, cooperative and answering questions appropriatelyRespiratory:Clear breath sounds to auscultation bilaterally, no use of accessory muscles, respirations within normal rangeCardiovascular:Regular rate and rhythm, SI and S2 auscultated, no murmur, no JVD.Integumentary:Skin warm and dry with no rashes, no lesions, or erythemaGastrointestinal:BS present x4 quadrant, no abdominal guarding with palpationGenitourinary:Palpating abdomen to assess for tenderness or massesPelvic exam:· External genitalia: Normally developed genitalia· Vagina: Visually inspecting for discharge or bleeding, lesions· Adnexa: palpating for tenderness or masses, ovaries· Uterus and cervix : bimanual exam for size to r/u enlargement, shape, position to r/u irregular-shaped mobile uterus, bogginess and restricted motion of the uterus, nodules in the posterior fornix· Rectum: visualizing and digital exam for hemorrhoids or any other abnormalitiesPsychological:Cooperative, appropriate mood and affectAssessment/ DiagnosisWhat is your presumptive diagnosis? Why?Secondary dysmenorrhea possibly due to endometriosisN94.5, N80.0Any other diagnosis or differential diagnosis you would like to add?Differential Diagnosis:Primary dysmenorrheaN94.4Begins early in the reproductive years, starts before or at the beginning of menstruation. The pain typically lasts 8 to 72 hours and is most severe on the first day of menstruation. Can be accompanied by nausea, vomiting, diarrhea, and fatigue. Nulliparity and high BMI are major risk factors (Alexander et al., 2023). This pattern describes Kelly’s menstruation, but the severity of pain accompanied by heavy HMB and pain with defecation makes me consider secondary nature of it and look into other possible causes. Additionally, Kelly’s BMI in a healthy range.Other possible causes include:Pelvic inflammatory disease (PID)N73.9,AdenomyosisN80.03,Ovarian cystN83.2,Uterine fibroids (leiomyoma)D25Secondary dysmenorrhea is often caused by endometriosis, but other causes include adenomyosis, leiomyomas, ovarian cysts, and PID, and is often accompanied by AUB/HMB (Alexander et al., 2023). Kelly’s symptoms of severe menstrual pain accompanied by heavy periods, are consistent with description of secondary dysmenorrhea. The possibility of endometriosis should be considered due to the severity of symptoms and the presence of pain with defecation and constipation.PlanHow will you manage this patient? What treatment or medication would you prescribe and why?DiagnosticsTransvaginal ultrasoundTypically the initial imaging study. Allows for routine pelvic imaging and evaluation of the posterior compartment, observation of the relative positioning of the uterus and ovaries. Expected findings consistent with pelvic endometriosis include  ovarian cysts, nodules of the rectovaginal septum, and bladder nodules (Schenken, 2024).CBC – to evaluate for anemia due to hx of HMBExplain treatment guidelines and side effects including any possible side effects of the medication and treatment(s)The surgical diagnosis of endometriosis has been the gold standard, particularly before initiating treatments with significant negative side effects such as gonadotropin-releasing hormone agonists or antagonists. However, presumptive clinical diagnosis based on symptoms, physical examination, and imaging is beneficial especially for starting low-risk  interventions such as hormonal contraceptives, as presumptive diagnosis is less invasive, and reduces treatment delay (Schenken, 2024).Start Acetaminophen or NSAIDs, such as ibuprofen, naproxen, or celecoxib, 1 to 2 days before the anticipation of the onset of menses. Stomach ulcers or gastrointestinal bleeding are serious side effects if taken for a long timeStart combined estrogen-progestin hormonal contraceptives for 6-12 months. Side effects include HTN, bloating, breakthrough bleeding, nausea, breast tenderness, blood clots.If Kelly does not respond adequately to NSAID/COCs therapy, surgical diagnosis with histologic evaluation of a biopsied tissue via laparoscopy is indicated,  which will allow for definitive diagnosis and treatment (growth, scar tissue, or adhesions removal) at the same time (Schenken, 2024).Referrals: none at this timeWhat patient education is important to include for this patient? (Consider including pharmacological, supplements, and nonpharmacological recommendations and education)Education:· Heating pads and warm baths can help relieve pain· An anti-inflammatory diet consisting of mainly fruits, vegetables, whole grains, and foods rich in omega-3 fatty acids may be beneficial· Limit caffeine and alcohol intake· Walking, swimming, and biking can help reduce estrogen levels as well as inflammation.· Endometriosis can make it more difficult to become pregnant due to development of scar tissue in the ovaries or fallopian tubesExplain complications that can occur if patient does not comply with treatment regimen?Endometriosis can cause infertility(30-50%).  If endometrial  tissue grows outside the uterus it can affect other organs, including bowel and bladder.Health Maintenance· Pap smear (every three years starting at age 23)· STI screening every time a sexual history reveals new or persistent risk factors· Annual physical with comprehensive blood work (yearly)· Screening mammogram starting at age 45 (yearly)What is the follow-up plan of care?Follow up: in 6-8 weeks to assess treatment effectivenessSamanthaSubjective·Chief Complaint:pelvic pain and irregular bleeding·History of Present Illness:Donnais 35-year-old African American female who comes to the clinic complaining of pelvic pain that started as intermittent, but now is almost constant. She also complains of irregular vaginal bleeding/spotting that has occurred in between her monthly menses for the last six months. She has no family history of breast or ovarian cancer.What other relevant questions should you ask regarding the HPI?· Do you experience pain during or after intercourse?· Are you currently trying to conceive or having difficulty becoming pregnant?· Have you had any pregnancy complications or uterine surgeries?· When did the pain start, and how has it changed over time?· Was there a triggering event (trauma, sexual activity, recent infections)?· Is the pain localized or generalized? Does it radiate to the back, thighs, or elsewhere?· How would you describe the pain (cramping, sharp, dull, burning)?· On a scale of 0 to 10, how severe is the pain?· Does the pain occur at specific times (during menstruation, ovulation, or intercourse)?· Does anything make it better or worse (heat, rest, exercise, bowel movements, urination)?· Are your menstrual cycles regular? How many days between periods?· How long does your period last, and is it heavier than usual?· How much bleeding occurs between periods (e.g., spotting or full flow)?· Have you noticed clots?· Is the pelvic pain worse during your period?·Medications:What medications are you taking? Are you taking any medications or supplements, including over-the-counter or herbal remedies?·Allergies/Immunizations:Any allergies? reports up to date with immunizations. Have you been vaccinated by HPV?·LMP:LMP date?·GYN/OB History:She is G2 P2 with both normal spontaneous vaginal deliveries (NSVD) 10 and 8 years ago.· Have you been pregnant? If so, at what age was your first full-term pregnancy?· Last PAP?,· Last Mammogram? normal/abnormal result?· Menarche: At what age?· Are you on hormone replacement therapy, oral contraceptives, or other medications?2. What other medical history questions should you ask?· Have you experienced pelvic pain or irregular bleeding before this six-month period?· Was the pain or bleeding similar or different to now?· How are these symptoms affecting your daily activities, work, or quality of life?· Have you ever been diagnosed with fibroids, ovarian cysts, endometriosis, or other uterine/ovarian conditions· Have you ever had an abnormal Pap smear? If so, what follow-up was performed (colposcopy, biopsy)?· Have you ever been diagnosed or treated for STIs such as chlamydia, gonorrhea, or HPV?· Are your periods usually regular?·Past Med. Hx (PMH): Tell me about your medical history. Have you had breast lumps, biopsies, or previous breast cancer?·Surgical History:Tell me about your surgical history3. What other social history questions should you ask?·Social Hx:· Do you smoke, drink alcohol, or use recreational Drugs?· Are you in a relationship? Do you feel safe?· Are you sleeping well? Have you been feeling stressed or overwhelmed recently?· How much do you exercise a week?· Who lives with you at home?· Are you currently sexually active?· What is your occupation?· Are you up to date with other screenings, such as Pap smears or colonoscopies?· Do you experience high levels of stress or anxiety?· Do you have a support system to rely on?What other family history questions should you ask?·Family Hx:What is your family history? Does anyone in your family (maternal or paternal) have a history of breast, ovarian, or other cancers? Is there a history of heavy menstrual bleeding, easy bruising, or diagnosed bleeding disorders?· Have any female relatives been diagnosed with uterine fibroids, endometriosis, or adenomyosis?· Tell me about any other family hx·Review of Systems(ROS):· Constitutional: denies fever, night sweats, chills, fatigue, cold intolerance, weight gain, weight loss.· Respiratory: denies dyspnea, cough· Cardiovascular: denies chest pain or palpitations· Gastrointestinal: denies abdominal pain, nausea, vomiting· SKIN:Any changes in the skin of the breast, such as redness, dimpling, or thickening?· GYN: reports pelvic pain that started as intermittent, but now is almost constant. Reports irregular vaginal bleeding/spotting that has occurred in between her monthly menses for the last six months· Lymphatic: Any swelling or lumps in the armpit or neck?· Psychiatric: denies anxiety,  increased stress, depression, and suicidal ideation.ObjectiveWrite a detailed focused physical assessment on this patient· Vital signs: BP, HR, Temp, Ht, Wt,  BMI, SpO2, RR Her vital signs (VS) and BMI are all within normal limits· GEN: Vital signs stable, in no acute distress. Alert, well developed, well nourished.· RESP: Lungs clear to auscultation bilaterally, no abnormal sounds bilaterally, no use of accessory of muscles of respiration, nonlabored breathing, normal rate and rhythm, no shortness of breath, chest rise is equal and symmetric· CV: S1, S2 without murmurs, rubs, or gallops appreciated.· Abodmen/Pelvis: palpate a firm, raised area on her uterus. no cervical motion tenderness (CMT), no adnexal tenderness (AT), and no other abnormalities.· INTEGUMENTARY: Skin was warm and intact. No rashes, masses or discoloration. No trauma.· PSYCH: A&O x3 judgment/insight intact, NL mood/affect. Judgment and insight were within normal limits at the time of the visit.Explain what test(s) you will order and perform, and discuss your rationale for ordering and performing each test.· POCT:· UA: Identifies signs of urinary tract infection (UTI) or hematuria. UTIs, bladder infections, or other urinary tract issues causing pelvic discomfort.Assessment (Diagnosis/ICD10 Code)What is your diagnosis?·Working Diagnosis:· Leiomyomas(D25.9): Donna reports pelvic pain that started intermittently but is now constant. This is a common symptom of uterine fibroids as they can cause pressure or inflammation within the uterus. Donna’s complaint of irregular vaginal bleeding and spotting between her menses over the past 6 months is a typical symptom of uterine fibroids, especially if they are submucosal or intramural. Fibroids can cause menorrhagia (heavy menstrual bleeding) or bleeding outside of the regular cycle. The physical exam finding of a firm, raised area on the uterus is highly suggestive of fibroids. Larger fibroids are often palpable on bimanual examination. The absence of CMT may help differentiate fibroids from conditions like pelvic inflammatory disease (PID) or endometriosis, which would often present with tenderness or pain on cervical motion. Donna does not report symptoms such as fatigue, dizziness, or weakness, which would suggest anemia related to heavy menstrual bleeding. This is a pertinent negative, as anemia is a common complication of fibroids due to heavy menstrual bleeding.· Adenomyosis (N80.0): Pertinent Positives: Dysmenorrhea, heavy menstrual bleeding (menorrhagia), chronic pelvic pain, enlarged and tender uterus, menstrual irregularities, infertility, pain with intercourse, and a history of uterine surgery.Pertinent Negatives: No menstrual pain, no heavy bleeding, normal-sized uterus, absence of chronic pelvic pain or dyspareunia, no history of uterine surgery, no infertility issues, and no evidence of ovarian cysts or back pain.week6discussion.docxDaynaKelly is a 19-year-old female who comes to your clinic complaining of severe menstrual pain that is usually worse just prior to and during the first two days of her menses. The pain is sometimes so severe that she has fainted. She states that defecation can cause severe pain and she therefore frequently becomes constipated. She often must miss work when experiencing the severe pain. Her periods are heavy and last seven days with a tapering of the bleeding from days 3 to 7. Her BMI is 23.9 and her VS are all WNL. She is G0 P0.SubjectiveCC: severe dysmenorrhea, heavy periods, painful defecation, symptoms interfere with life styleHPI: 19 y/o F, G0P0 presents to clinic today with complains of menstrual pain and heavy menstrual bleeding. Patient states that pain is usually worse just prior to and during the first two days of her menses. Patient describes pain as severe, causing patient to faint and often causing her to miss work. Patient reports periods lasting seven days with a tapering of the bleeding from days 3 to 7.  Patient also mentions that defecation can cause severe pain and she therefore frequently becomes constipated.What other relevant questions should you ask regarding the HPI?When did you start experiencing pain? Was onset sudden or gradual?Where does pain occur? Is it localized or diffused? Lower abdomen, lower back, inner thighs?What does the pain feel like? Is it sharp, dull, burning, aching, cramping etc.,?Is there anything which makes this pain better or worse (compress, hot shower, physical exercise)?Does this pain in your breast radiate anywhere in your body?Would you say that your pain is getting progressively worse over time?Do you experience pain between menstrual periods?How severe is the pain on the scale from 0 to 10?Did you attempt to take any medications  to help relieve pain? Was it successful?Did you always heavy periods from onset of menses?Do you have an bleeding between periods?Are you sexually active? Is your intercourse painful?How frequent are your BM?Did you notice any blood in your stool?When did you start experiencing painful defecation and constipation?Gyn/OB history:G0P0Any chance you can be pregnant?How old were you when you started your period?Heavy menses that last seven days with a tapering of the bleeding from days 3 to 7Have you noticed any changes in your menstrual cycle, such as irregular periods or changes in flow?Do you experience blood clots during menstruation?What method of contraception do you use? Do you have IUD? Any hx of STIs?Have you been tried to conceive without success?Any history of pelvic inflammatory disease, endometriosis, or other gynecological conditions?What other medical history questions should you ask?Do you take any new medications, including OTC or supplements?Do you take oral birth control pills? If so, does it provide any pain control/relief?Do you have allergies?Any chronic medical conditions, such as diabetes or thyroid disorders?Have you been treated for dysmenorrhea in the past?Do you have any other medical issues?Any past surgeries, including surgeries to the reproductive system?What other family history questions should you ask?Are there any family members with a history of gynecological disorders, like endometriosis, PID, infertility?Any family history of dysmenorrhea or heavy prolonged menses?Any history of cancer in the family, including cancer of reproductive organs?Anu hx of autoimmune disorders in your family?Any history of early menses onset in your family?What other social history questions should you ask?Social Hx:Do you drink, smoke, use drugs?How much of a physical activity you get daily?What do you do for work?What does your diet look like?ROSGeneral:: Any fever fever, chills, malaise? Reports fatigue right before and during menses.HEENT:Denies changes in vision and hearing, sore throat, and dysphagiaCardiovascular:Denies chest pain and palpitationsRespiratory:Denies shortness of breath or coughGastrointestinal:Reports pain with defecation and constipation. Any nausea, vomiting, diarrhea, associated with menstrual pain?Genitourinary:Any frequency or urgency or pain with urination? Reports lower abdomen/lower back intense cramping, heavy menstrual bleedingIntegumentary:Denies rash, pruritus, erythemaBreast:Do you notice any breast changes right before and during menstruation. Denies breast pain, skin changes, nipple discharge.Musculoskeletal:Denies myalgia, joint painNeurological:Denies headache, dizziness, weakness. Reports syncope s/t painPsychological:Denies depression, anxiety, or suicidal thoughts. Reports insomnia s/t pain and acute distress around periods due to interruption of daily routine and responsibilitiesObjective DataWrite a detailed focused physical assessment on this patient.VS: WNLBMI – 23.9POCT:Pregnancy test – negativeGeneral:A&O x 4, normal weight, no signs of acute distress, cooperative and answering questions appropriatelyRespiratory:Clear breath sounds to auscultation bilaterally, no use of accessory muscles, respirations within normal rangeCardiovascular:Regular rate and rhythm, SI and S2 auscultated, no murmur, no JVD.Integumentary:Skin warm and dry with no rashes, no lesions, or erythemaGastrointestinal:BS present x4 quadrant, no abdominal guarding with palpationGenitourinary:Palpating abdomen to assess for tenderness or massesPelvic exam:· External genitalia: Normally developed genitalia· Vagina: Visually inspecting for discharge or bleeding, lesions· Adnexa: palpating for tenderness or masses, ovaries· Uterus and cervix : bimanual exam for size to r/u enlargement, shape, position to r/u irregular-shaped mobile uterus, bogginess and restricted motion of the uterus, nodules in the posterior fornix· Rectum: visualizing and digital exam for hemorrhoids or any other abnormalitiesPsychological:Cooperative, appropriate mood and affectAssessment/ DiagnosisWhat is your presumptive diagnosis? Why?Secondary dysmenorrhea possibly due to endometriosisN94.5, N80.0Any other diagnosis or differential diagnosis you would like to add?Differential Diagnosis:Primary dysmenorrheaN94.4Begins early in the reproductive years, starts before or at the beginning of menstruation. The pain typically lasts 8 to 72 hours and is most severe on the first day of menstruation. Can be accompanied by nausea, vomiting, diarrhea, and fatigue. Nulliparity and high BMI are major risk factors (Alexander et al., 2023). This pattern describes Kelly’s menstruation, but the severity of pain accompanied by heavy HMB and pain with defecation makes me consider secondary nature of it and look into other possible causes. Additionally, Kelly’s BMI in a healthy range.Other possible causes include:Pelvic inflammatory disease (PID)N73.9,AdenomyosisN80.03,Ovarian cystN83.2,Uterine fibroids (leiomyoma)D25Secondary dysmenorrhea is often caused by endometriosis, but other causes include adenomyosis, leiomyomas, ovarian cysts, and PID, and is often accompanied by AUB/HMB (Alexander et al., 2023). Kelly’s symptoms of severe menstrual pain accompanied by heavy periods, are consistent with description of secondary dysmenorrhea. The possibility of endometriosis should be considered due to the severity of symptoms and the presence of pain with defecation and constipation.PlanHow will you manage this patient? What treatment or medication would you prescribe and why?DiagnosticsTransvaginal ultrasoundTypically the initial imaging study. Allows for routine pelvic imaging and evaluation of the posterior compartment, observation of the relative positioning of the uterus and ovaries. Expected findings consistent with pelvic endometriosis include  ovarian cysts, nodules of the rectovaginal septum, and bladder nodules (Schenken, 2024).CBC – to evaluate for anemia due to hx of HMBExplain treatment guidelines and side effects including any possible side effects of the medication and treatment(s)The surgical diagnosis of endometriosis has been the gold standard, particularly before initiating treatments with significant negative side effects such as gonadotropin-releasing hormone agonists or antagonists. However, presumptive clinical diagnosis based on symptoms, physical examination, and imaging is beneficial especially for starting low-risk  interventions such as hormonal contraceptives, as presumptive diagnosis is less invasive, and reduces treatment delay (Schenken, 2024).Start Acetaminophen or NSAIDs, such as ibuprofen, naproxen, or celecoxib, 1 to 2 days before the anticipation of the onset of menses. Stomach ulcers or gastrointestinal bleeding are serious side effects if taken for a long timeStart combined estrogen-progestin hormonal contraceptives for 6-12 months. Side effects include HTN, bloating, breakthrough bleeding, nausea, breast tenderness, blood clots.If Kelly does not respond adequately to NSAID/COCs therapy, surgical diagnosis with histologic evaluation of a biopsied tissue via laparoscopy is indicated,  which will allow for definitive diagnosis and treatment (growth, scar tissue, or adhesions removal) at the same time (Schenken, 2024).Referrals: none at this timeWhat patient education is important to include for this patient? (Consider including pharmacological, supplements, and nonpharmacological recommendations and education)Education:· Heating pads and warm baths can help relieve pain· An anti-inflammatory diet consisting of mainly fruits, vegetables, whole grains, and foods rich in omega-3 fatty acids may be beneficial· Limit caffeine and alcohol intake· Walking, swimming, and biking can help reduce estrogen levels as well as inflammation.· Endometriosis can make it more difficult to become pregnant due to development of scar tissue in the ovaries or fallopian tubesExplain complications that can occur if patient does not comply with treatment regimen?Endometriosis can cause infertility(30-50%).  If endometrial  tissue grows outside the uterus it can affect other organs, including bowel and bladder.Health Maintenance· Pap smear (every three years starting at age 23)· STI screening every time a sexual history reveals new or persistent risk factors· Annual physical with comprehensive blood work (yearly)· Screening mammogram starting at age 45 (yearly)What is the follow-up plan of care?Follow up: in 6-8 weeks to assess treatment effectivenessSamanthaSubjective·Chief Complaint:pelvic pain and irregular bleeding·History of Present Illness:Donnais 35-year-old African American female who comes to the clinic complaining of pelvic pain that started as intermittent, but now is almost constant. She also complains of irregular vaginal bleeding/spotting that has occurred in between her monthly menses for the last six months. She has no family history of breast or ovarian cancer.What other relevant questions should you ask regarding the HPI?· Do you experience pain during or after intercourse?· Are you currently trying to conceive or having difficulty becoming pregnant?· Have you had any pregnancy complications or uterine surgeries?· When did the pain start, and how has it changed over time?· Was there a triggering event (trauma, sexual activity, recent infections)?· Is the pain localized or generalized? Does it radiate to the back, thighs, or elsewhere?· How would you describe the pain (cramping, sharp, dull, burning)?· On a scale of 0 to 10, how severe is the pain?· Does the pain occur at specific times (during menstruation, ovulation, or intercourse)?· Does anything make it better or worse (heat, rest, exercise, bowel movements, urination)?· Are your menstrual cycles regular? How many days between periods?· How long does your period last, and is it heavier than usual?· How much bleeding occurs between periods (e.g., spotting or full flow)?· Have you noticed clots?· Is the pelvic pain worse during your period?·Medications:What medications are you taking? Are you taking any medications or supplements, including over-the-counter or herbal remedies?·Allergies/Immunizations:Any allergies? reports up to date with immunizations. Have you been vaccinated by HPV?·LMP:LMP date?·GYN/OB History:She is G2 P2 with both normal spontaneous vaginal deliveries (NSVD) 10 and 8 years ago.· Have you been pregnant? If so, at what age was your first full-term pregnancy?· Last PAP?,· Last Mammogram? normal/abnormal result?· Menarche: At what age?· Are you on hormone replacement therapy, oral contraceptives, or other medications?2. What other medical history questions should you ask?· Have you experienced pelvic pain or irregular bleeding before this six-month period?· Was the pain or bleeding similar or different to now?· How are these symptoms affecting your daily activities, work, or quality of life?· Have you ever been diagnosed with fibroids, ovarian cysts, endometriosis, or other uterine/ovarian conditions· Have you ever had an abnormal Pap smear? If so, what follow-up was performed (colposcopy, biopsy)?· Have you ever been diagnosed or treated for STIs such as chlamydia, gonorrhea, or HPV?· Are your periods usually regular?·Past Med. Hx (PMH): Tell me about your medical history. Have you had breast lumps, biopsies, or previous breast cancer?·Surgical History:Tell me about your surgical history3. What other social history questions should you ask?·Social Hx:· Do you smoke, drink alcohol, or use recreational Drugs?· Are you in a relationship? Do you feel safe?· Are you sleeping well? Have you been feeling stressed or overwhelmed recently?· How much do you exercise a week?· Who lives with you at home?· Are you currently sexually active?· What is your occupation?· Are you up to date with other screenings, such as Pap smears or colonoscopies?· Do you experience high levels of stress or anxiety?· Do you have a support system to rely on?What other family history questions should you ask?·Family Hx:What is your family history? Does anyone in your family (maternal or paternal) have a history of breast, ovarian, or other cancers? Is there a history of heavy menstrual bleeding, easy bruising, or diagnosed bleeding disorders?· Have any female relatives been diagnosed with uterine fibroids, endometriosis, or adenomyosis?· Tell me about any other family hx·Review of Systems(ROS):· Constitutional: denies fever, night sweats, chills, fatigue, cold intolerance, weight gain, weight loss.· Respiratory: denies dyspnea, cough· Cardiovascular: denies chest pain or palpitations· Gastrointestinal: denies abdominal pain, nausea, vomiting· SKIN:Any changes in the skin of the breast, such as redness, dimpling, or thickening?· GYN: reports pelvic pain that started as intermittent, but now is almost constant. Reports irregular vaginal bleeding/spotting that has occurred in between her monthly menses for the last six months· Lymphatic: Any swelling or lumps in the armpit or neck?· Psychiatric: denies anxiety,  increased stress, depression, and suicidal ideation.ObjectiveWrite a detailed focused physical assessment on this patient· Vital signs: BP, HR, Temp, Ht, Wt,  BMI, SpO2, RR Her vital signs (VS) and BMI are all within normal limits· GEN: Vital signs stable, in no acute distress. Alert, well developed, well nourished.· RESP: Lungs clear to auscultation bilaterally, no abnormal sounds bilaterally, no use of accessory of muscles of respiration, nonlabored breathing, normal rate and rhythm, no shortness of breath, chest rise is equal and symmetric· CV: S1, S2 without murmurs, rubs, or gallops appreciated.· Abodmen/Pelvis: palpate a firm, raised area on her uterus. no cervical motion tenderness (CMT), no adnexal tenderness (AT), and no other abnormalities.· INTEGUMENTARY: Skin was warm and intact. No rashes, masses or discoloration. No trauma.· PSYCH: A&O x3 judgment/insight intact, NL mood/affect. Judgment and insight were within normal limits at the time of the visit.Explain what test(s) you will order and perform, and discuss your rationale for ordering and performing each test.· POCT:· UA: Identifies signs of urinary tract infection (UTI) or hematuria. UTIs, bladder infections, or other urinary tract issues causing pelvic discomfort.Assessment (Diagnosis/ICD10 Code)What is your diagnosis?·Working Diagnosis:· Leiomyomas(D25.9): Donna reports pelvic pain that started intermittently but is now constant. This is a common symptom of uterine fibroids as they can cause pressure or inflammation within the uterus. Donna’s complaint of irregular vaginal bleeding and spotting between her menses over the past 6 months is a typical symptom of uterine fibroids, especially if they are submucosal or intramural. Fibroids can cause menorrhagia (heavy menstrual bleeding) or bleeding outside of the regular cycle. The physical exam finding of a firm, raised area on the uterus is highly suggestive of fibroids. Larger fibroids are often palpable on bimanual examination. The absence of CMT may help differentiate fibroids from conditions like pelvic inflammatory disease (PID) or endometriosis, which would often present with tenderness or pain on cervical motion. Donna does not report symptoms such as fatigue, dizziness, or weakness, which would suggest anemia related to heavy menstrual bleeding. This is a pertinent negative, as anemia is a common complication of fibroids due to heavy menstrual bleeding.· Adenomyosis (N80.0): Pertinent Positives: Dysmenorrhea, heavy menstrual bleeding (menorrhagia), chronic pelvic pain, enlarged and tender uterus, menstrual irregularities, infertility, pain with intercourse, and a history of uterine surgery.Pertinent Negatives: No menstrual pain, no heavy bleeding, normal-sized uterus, absence of chronic pelvic pain or dyspareunia, no history of uterine surgery, no infertility issues, and no evidence of ovarian cysts or back pain.Bids(54)Dr. Ellen RMMISS HILLARY A+Dr. Aylin JMProf Double REmily ClareDr. Sarah Blakefirstclass tutorMUSYOKIONES A+Dr ClovergrA+de plusSheryl Hoganpacesetters2121ProWritingGuruDr. Everleigh_JKColeen AndersonIsabella HarvardBrilliant GeekWIZARD_KIMPROF_ALISTERAshley EllieShow All Bidsother Questions(10)human service admini. #4 dissPowerpointNursingStatistical Methods for Engineering and ScienceassignmentFor Sysco_systemsFor MADAM PROFESSOREssay on macro- and micro-level factors ni quality of life casesmall budgetAssignment 1: Discussion—Television Character

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Nursing

Home>Homework Answsers>Nursing homework helpHow will you as a nurse make judgments in practice, supported by evidence, that integrate nursing science in the provision of safe, quality care? (300 word minimum)Discuss why the nurse uses the nursing process as a method to organize, analyze, and respond to a variety of patient needs. (300 word minimum)Why is it important for the nurse to be able to identify critical principles in the maintenance of infection control and safety? (300 word minimum)Why is it important for the nurse to be able to discuss concepts of physical assessment of key body systems (integumentary, respiratory, cardiovascular, abdominal, and neurological) across the lifespan? (300 word minimum)Complete your reflection in APA format, Size 12 Times New Roman font, with a cover page and reference page. A minimum of one reference is required.  Please submit 1200-1500 words on what it means to you to use nursing judgment as a nursing student.7 months ago08.12.20246Report issueBids(51)MISS HILLARY A+Prof Double RProf. TOPGRADEDr. Sarah Blakefirstclass tutorMUSYOKIONES A+Dr ClovergrA+de plusSheryl HoganProWritingGuruDr. Everleigh_JKColeen AndersonIsabella HarvardBrilliant GeekPROF_ALISTERAshley EllieMadam MichelleAmerican TutorPremiumAbdullah AnwarShow All Bidsother Questions(10)world religion paperIP3MADAMPROFESSORCJA 474 Week 4 Individual Assignment Case Study Officer Robert Barton PaperIP2BSHS 485 Week 1 What is Advocacy?ACCT 551 Final ExamAll My Sons , Arthur Miller Essay.Strategic Choice and EvaluationCapstone Research Project

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leadership dis

Home>Homework Answsers>Nursing homework helpMSNNurs7 months ago08.12.202410Report issuefiles (1)leadershipdisc.docxleadershipdisc.docxOrganizational Policies and Practices to Support Healthcare IssuesQuite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.ResourcesBe sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.WEEKLY RESOURCESTo Prepare:· Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.· Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.leadershipdisc.docxOrganizational Policies and Practices to Support Healthcare IssuesQuite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.ResourcesBe sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.WEEKLY RESOURCESTo Prepare:· Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.· Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.Bids(54)Dr. Ellen RMMISS HILLARY A+Dr. Aylin JMnicohwilliamProf Double REmily ClareDr. Sarah Blakefirstclass tutorMUSYOKIONES A+Dr ClovergrA+de plusSheryl HoganProWritingGuruDr. Everleigh_JKColeen AndersonIsabella HarvardBrilliant GeekWIZARD_KIMPROF_ALISTERAshley EllieShow All Bidsother Questions(10)BUS 309 Week 5 Quiz 4 Chapter 4BA 405 Multinational Management600 + wordsEffects of risk-discussion postFor NJosh ONLYFOR PHYLLIS YOUNG MGMT 436- Last• The following link will take you to a one page article on 7 methods to address health care costs for a medical provider. Please consider reviewing the article and share your thoughts on two of the suggested approaches. 7 ways lean healthcare managemenLiberalism and the American RevolutionCauses of Lymphedema and its Probable EffectsGBIO 225 WEEK 5 In the news

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Compare and examine the consequences of an unethical behaviors in a nursing Master’s program and in the nursing practice by providing one example for each.

Home>Homework Answsers>Nursing homework helptheorynursingReply to at least two other student posts about   “Compare and examine the consequences of an unethical behaviors in a nursing Master’s program and in the nursing practice by providing one example for each “.you should use a reflection of their response. 2 references for each Reply.   Please include scholarly reference.Word limit 200 words .Post # 1 :Ethics are integral to nursing education programs and nursing practice. All nurses and prospective nurses should adhere to the highest ethical behavior standards. Ethical practices in nursing education ensure that students acquire quality education that equips them with the necessary skills for competent nursing practice by adhering to the set rules and regulations and accreditation standards (Taghadosi, Valiee & Aghajani, 2021). Ethical behavior in nursing practice ensures that nurses navigate complex moral dilemmas, provide safe and effective care, and uphold patients’ interests. Ethical practice also maintains the nursing profession’s integrity, promoting trust between practitioners and patients. Therefore, nursing Master’s program students and nurses should uphold ethical behavior and practices.Unethical behaviors in nursing Master’s programs and nursing practice take different forms. However, they are similar because they undermine patient care. An example of unethical behavior in a nursing Master’s program includes fabricating research data where students make up or falsify research project data (Kang & Hwang, 2020). Students create fake research data, alter existing data, or modify results. Fabricating research data is an unethical practice that undermines the nursing program’s credibility and the research process’s integrity. The practice has dire consequences on the students because it makes them fail the research project and leads to expulsion. It also dents the nursing profession’s reputation and integrity. Fabricated data and subsequent recommendations also undermine the provision of safe care when published or used in evidence-based practice that relies on research evidence to advance patient care.An example of unethical behavior in nursing practice includes discriminating against patients based on protected characteristics like race, ethnicity, religion, and cultural beliefs, among others. Nurses demonstrate discriminative behavior by denying such people healthcare services, being disrespectful towards them, providing poor services, or making negative and derogatory remarks about the affected patients (Rafii, Ghezeljeh & Nasrollah, 2019). Discrimination has adverse consequences on nurse practitioners because it exposes them to disciplinary actions, loss of practice license, penalties, and lawsuits. It also undermines the provision of safe patient care. In addition, it exposes patients to physical and psychological torture and hinders access to care. Patients also lose trust in the healthcare system, further hindering access to quality care.The discussion shows that unethical behavior adversely affects nurses and students and undermines the provision of safe patient care. Therefore, nursing Master’s program students and nurse practitioners should uphold ethical conduct to uphold the profession’s integrity and reputation and advance patient care.ReferencesKang, E., & Hwang, H. J. (2020). The consequences of data fabrication and falsification among researchers.Journal of Research and Publication Ethics,1(2), 7-10.Rafii, F., Ghezeljeh, T. N., & Nasrollah, S. (2019). Discriminative nursing care: A grounded theory study.Journal of Family Medicine and Primary Care, 8(7), 2289.Taghadosi, M., Valiee, S., & Aghajani, M. (2021). Nursing faculty’s point of view regarding noncompliance with ethics in academic environments: a qualitative study.BMC nursing,20, 1-10.Post # 2 :Unethical behaviors in a nursing Master’s program and in nursing practice can have severe consequences for individuals and the healthcare system. It is important to understand and examine these consequences to prevent them from occurring and promote ethical behavior in the nursing profession.In a Master’s program for nursing, there are several types of unethical behavior, including cheating on tests or copying assignments. An instance of unethical behavior in a nursing Master’s program is falsifying clinical hours. Nursing students should fulfill specific clinical hours as part of their learning and development. Falsifying clinical hours is an unethical behavior that involves lying about the number of hours completed, which can have serious consequences (Pittman & Barker, 2020). Nursing students who falsify their clinical hours may lack the skills and knowledge to provide safe and competent care to patients. This can lead to patient harm, lawsuits, and the nursing student’s licensure loss. Additionally, falsifying clinical hours undermines the integrity of the nursing profession and can erode trust between healthcare providers and patients (Pittman & Barker, 2020).Unethical behavior in nursing practice can have significant implications as well. Discrimination is one instance of unethical behavior in nursing practice that can be detrimental. Discrimination refers to providing patients with unequal or biased treatment based on race, ethnicity, gender, sexual orientation, or other factors (Narayan, 2019). Discrimination disregards the ethical standards for nursing and can lead to harm, erosion of trust, and legal ramifications for the nurse. Discrimination can take many forms, such as denying certain treatments or procedures to patients based on their identity, making derogatory comments or jokes about patients, or refusing to work with colleagues based on their identity. Discrimination is unethical and undermines nurses’ duty to provide safe and compassionate patient care (Blanchet Garneau et al., 2018). Discrimination can lead to patient harm, lawsuits, and nurse licensure loss. Additionally, discrimination can create a toxic work environment and damage the reputation of the nursing profession.Both nursing Master’s programs and nursing practice can encounter severe consequences from unethical behaviors that may impact both the person and the healthcare profession in general. Nursing students and nurses need to understand the essentials of ethical behavior and the outcomes of unethical behavior. Ethics education and training should be incorporated into nursing education and ongoing professional development. Healthcare organizations should also have policies and procedures to address unethical behavior and promote ethical behavior in the workplace (Choe et al., 2020). By promoting ethical behavior, the nursing profession can maintain its integrity and provide safe and competent care to patients.ReferencesBlanchet Garneau, A., Browne, A. J., & Varcoe, C. (2018). Drawing on antiracist approaches toward a critical antidiscriminatory pedagogy for nursing.Nursing Inquiry,25(1), e12211.https://doi.org/10.1111/nin.12211Choe, K., Kim, S., Lee, C., & Kim, S. (2020). Effect of ethics seminar on moral sensitivity and ethical behavior of clinical nurses.International Journal of Environmental Research and Public Health,18(1), 241.https://doi.org/10.3390/ijerph18010241Narayan, M. C. (2019). CE: Addressing implicit bias in nursing: A review.AJN The American Journal of Nursing,119(7), 36-43.DOI:10.1097/01.NAJ.0000569340.27659.5aPittman, O. A., & Barker, E. (2020). Academic dishonesty: What impact does it have and what can faculty do?.Journal of the American Association of Nurse Practitioners,32(9), 598-601.DOI:10.1097/JXX.00000000000004772 years ago13.05.202320Report issueBids(76)Dr. Ellen RMMISS HILLARY A+abdul_rehman_Prof Double RSTELLAR GEEK A+Sheryl HoganBRIGHT MIND PROFDr. Adeline ZoeDr M. MichelleAshley EllieDr. Sophie MilesWIZARD_KIMnicohwilliamColeen AndersonIsabella HarvardElprofessoriPremiumPROF_ALISTERNightingaleDr. Freya WalkerShow All Bidsother Questions(10)BPA406 THE PUBLIC LEADER INTEGRATION AND APPLICATION Week 1_Public Leadership_AnswerChez Henri is a restaurant chain that operates in 40 different cities.Each month the National Association of Purchasing Managers publishes the NAPM indexManagement14 Point DemingCMGT 410 Week 2 Learning Team: Project CharterSuppose that the fisher hypothesis holds for an economy that has an expected real interest rate of 2 percentindividual Week 3-NTCI am currently starting a business and developing my business plan. I’m in need of some advice on how to start forming my business. I am not sure exactly how it will be financed and whether or not I want to take on partners. I am interested and willing toWeek 6 Test

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Nursing WEEK 6 RN CAPSTONE ASSIGNMENT

Home>Homework Answsers>Nursing homework help2 years ago10.08.202316Report issuefiles (2)WEEK6RNCAPSTONEASSIGNMENT.docxEBP_process_form_9_19ac.docxWEEK6RNCAPSTONEASSIGNMENT.docxEvidence-Based Practice Change ProcessAssignmentPurposeThe purpose of this assignment is:· To apply the PICOT elements identified in the Week 2 Check-In as the foundation for a nursing change process using the ACE Star Model and a systematic review as evidence.· The information from the ‘Illustration’ part of our lessons in Weeks 1-6 will mentor you through this process. Your change process is to be set up as a pilot project.1. Download theEBP Change Process formLinks to an external site.during Week 1. The use of this specific form is REQUIRED2. Use the instructor feedback from the Week 2 Check-In (clinical topic and PICOT) as the foundation for developing your change process.3.Locate a systematic review on your topic from the Chamberlain Library.Be sure this involves nursing actions.4. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.5. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).6. Work on a portion of the process each week, as the illustration unfolds.Best Practices· Please reach out to your instructor for feedback or assistance with your PICOT question as needed.· Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.· Please see the grading criteria and rubrics on this page.· Please use your browser’s File setting to save or print this page.Scholarly Sources and Citations· Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed.· Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!APPROVED PICOT QUESTIONIn the long-term care residents (P), does the implementation of hourly rounding to prevent falls (I) compared to the current standard fall prevention measures (C) decrease the current resident fall rates by 50% over a 6-month period ?EBP_process_form_9_19ac.docx1Week 6 Assignment: EBP Change Process formACE Star Model of Knowledge TransformationFollow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.Name: _____________________Star Point 1: Discovery (Identify topic and practice issue)Identify thetopicand thenursing practice issuerelated to this topic. (This MUST involve a nursing practice issue.)Briefly describe yourrationalefor your topic selection. Include thescopeof the issue/problem.Star Point 2: Summary (Evidence to support need for a change)Describe thepractice problem in your own wordsand formulate your PICOT question.List the systematic review chosen from the CCN Library databases. Type the completeAPA referencefor the systematic review selected.List and briefly describeother sourcesused for data and information. List any otheroptional scholarly sourceused as a supplement to the systematic review inAPA format.Brieflysummarizethe main findings (in your own words) from the systematic review and thestrengthof the evidence.Outline one or twoevidence-based solutionsyou will consider for the trial project.Star Point 3: Translation (Action Plan)Identifycare standards, practice guidelines, or protocolsthat may be in placeto support your interventionplanning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).List yourstakeholders(by title and not names; include yourself) and describe theirroles and responsibilitiesin the change process (no more than 5).What specifically isyour nursing role in the change process? Other nursing roles?List your stakeholders byposition titles(charge nurse, pharmacist, etc.).Why are the members chosen(stakeholders) important to your project?What type ofcost analysiswill be needed prior to a trial? Who needs to be involved with this?Star Point 4: (Implementation)Describe theprocess for gaining permissionto plan and begin a trial. Is there a specific group, committee, or nurse leader involved?Describe theplan for educating the staffabout the change process trial and how they will be impacted or asked to participate.Outline theimplementation timelinefor the change process (start time/end time, what steps are to occur along the timeline).List themeasurable outcomesbased on the PICOT. How will these be measured?Whatforms, if any, might be used for recording purposes during the pilot change process. Describe.What resources are available to staff (include yourself) during the change pilot?Will there bemeetingsof certain stakeholders throughout the trial? If so, who and when will they meet?Star Point 5: (Evaluation)How will youreport the outcomesof the trial?What would be thenext stepsfor the use of the change process information?9.2019 Update. DLP1EBP_process_form_9_19ac.docx1Week 6 Assignment: EBP Change Process formACE Star Model of Knowledge TransformationFollow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.Name: _____________________Star Point 1: Discovery (Identify topic and practice issue)Identify thetopicand thenursing practice issuerelated to this topic. (This MUST involve a nursing practice issue.)Briefly describe yourrationalefor your topic selection. Include thescopeof the issue/problem.Star Point 2: Summary (Evidence to support need for a change)Describe thepractice problem in your own wordsand formulate your PICOT question.List the systematic review chosen from the CCN Library databases. Type the completeAPA referencefor the systematic review selected.List and briefly describeother sourcesused for data and information. List any otheroptional scholarly sourceused as a supplement to the systematic review inAPA format.Brieflysummarizethe main findings (in your own words) from the systematic review and thestrengthof the evidence.Outline one or twoevidence-based solutionsyou will consider for the trial project.Star Point 3: Translation (Action Plan)Identifycare standards, practice guidelines, or protocolsthat may be in placeto support your interventionplanning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).List yourstakeholders(by title and not names; include yourself) and describe theirroles and responsibilitiesin the change process (no more than 5).What specifically isyour nursing role in the change process? Other nursing roles?List your stakeholders byposition titles(charge nurse, pharmacist, etc.).Why are the members chosen(stakeholders) important to your project?What type ofcost analysiswill be needed prior to a trial? Who needs to be involved with this?Star Point 4: (Implementation)Describe theprocess for gaining permissionto plan and begin a trial. Is there a specific group, committee, or nurse leader involved?Describe theplan for educating the staffabout the change process trial and how they will be impacted or asked to participate.Outline theimplementation timelinefor the change process (start time/end time, what steps are to occur along the timeline).List themeasurable outcomesbased on the PICOT. How will these be measured?Whatforms, if any, might be used for recording purposes during the pilot change process. Describe.What resources are available to staff (include yourself) during the change pilot?Will there bemeetingsof certain stakeholders throughout the trial? If so, who and when will they meet?Star Point 5: (Evaluation)How will youreport the outcomesof the trial?What would be thenext stepsfor the use of the change process information?9.2019 Update. DLP1WEEK6RNCAPSTONEASSIGNMENT.docxEvidence-Based Practice Change ProcessAssignmentPurposeThe purpose of this assignment is:· To apply the PICOT elements identified in the Week 2 Check-In as the foundation for a nursing change process using the ACE Star Model and a systematic review as evidence.· The information from the ‘Illustration’ part of our lessons in Weeks 1-6 will mentor you through this process. Your change process is to be set up as a pilot project.1. Download theEBP Change Process formLinks to an external site.during Week 1. The use of this specific form is REQUIRED2. Use the instructor feedback from the Week 2 Check-In (clinical topic and PICOT) as the foundation for developing your change process.3.Locate a systematic review on your topic from the Chamberlain Library.Be sure this involves nursing actions.4. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.5. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).6. Work on a portion of the process each week, as the illustration unfolds.Best Practices· Please reach out to your instructor for feedback or assistance with your PICOT question as needed.· Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.· Please see the grading criteria and rubrics on this page.· Please use your browser’s File setting to save or print this page.Scholarly Sources and Citations· Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed.· Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!APPROVED PICOT QUESTIONIn the long-term care residents (P), does the implementation of hourly rounding to prevent falls (I) compared to the current standard fall prevention measures (C) decrease the current resident fall rates by 50% over a 6-month period ?EBP_process_form_9_19ac.docx1Week 6 Assignment: EBP Change Process formACE Star Model of Knowledge TransformationFollow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.Name: _____________________Star Point 1: Discovery (Identify topic and practice issue)Identify thetopicand thenursing practice issuerelated to this topic. (This MUST involve a nursing practice issue.)Briefly describe yourrationalefor your topic selection. Include thescopeof the issue/problem.Star Point 2: Summary (Evidence to support need for a change)Describe thepractice problem in your own wordsand formulate your PICOT question.List the systematic review chosen from the CCN Library databases. Type the completeAPA referencefor the systematic review selected.List and briefly describeother sourcesused for data and information. List any otheroptional scholarly sourceused as a supplement to the systematic review inAPA format.Brieflysummarizethe main findings (in your own words) from the systematic review and thestrengthof the evidence.Outline one or twoevidence-based solutionsyou will consider for the trial project.Star Point 3: Translation (Action Plan)Identifycare standards, practice guidelines, or protocolsthat may be in placeto support your interventionplanning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).List yourstakeholders(by title and not names; include yourself) and describe theirroles and responsibilitiesin the change process (no more than 5).What specifically isyour nursing role in the change process? Other nursing roles?List your stakeholders byposition titles(charge nurse, pharmacist, etc.).Why are the members chosen(stakeholders) important to your project?What type ofcost analysiswill be needed prior to a trial? Who needs to be involved with this?Star Point 4: (Implementation)Describe theprocess for gaining permissionto plan and begin a trial. Is there a specific group, committee, or nurse leader involved?Describe theplan for educating the staffabout the change process trial and how they will be impacted or asked to participate.Outline theimplementation timelinefor the change process (start time/end time, what steps are to occur along the timeline).List themeasurable outcomesbased on the PICOT. How will these be measured?Whatforms, if any, might be used for recording purposes during the pilot change process. Describe.What resources are available to staff (include yourself) during the change pilot?Will there bemeetingsof certain stakeholders throughout the trial? If so, who and when will they meet?Star Point 5: (Evaluation)How will youreport the outcomesof the trial?What would be thenext stepsfor the use of the change process information?9.2019 Update. DLP1WEEK6RNCAPSTONEASSIGNMENT.docxEvidence-Based Practice Change ProcessAssignmentPurposeThe purpose of this assignment is:· To apply the PICOT elements identified in the Week 2 Check-In as the foundation for a nursing change process using the ACE Star Model and a systematic review as evidence.· The information from the ‘Illustration’ part of our lessons in Weeks 1-6 will mentor you through this process. Your change process is to be set up as a pilot project.1. Download theEBP Change Process formLinks to an external site.during Week 1. The use of this specific form is REQUIRED2. Use the instructor feedback from the Week 2 Check-In (clinical topic and PICOT) as the foundation for developing your change process.3.Locate a systematic review on your topic from the Chamberlain Library.Be sure this involves nursing actions.4. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.5. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).6. Work on a portion of the process each week, as the illustration unfolds.Best Practices· Please reach out to your instructor for feedback or assistance with your PICOT question as needed.· Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.· Please see the grading criteria and rubrics on this page.· Please use your browser’s File setting to save or print this page.Scholarly Sources and Citations· Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed.· Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!APPROVED PICOT QUESTIONIn the long-term care residents (P), does the implementation of hourly rounding to prevent falls (I) compared to the current standard fall prevention measures (C) decrease the current resident fall rates by 50% over a 6-month period ?EBP_process_form_9_19ac.docx1Week 6 Assignment: EBP Change Process formACE Star Model of Knowledge TransformationFollow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.Name: _____________________Star Point 1: Discovery (Identify topic and practice issue)Identify thetopicand thenursing practice issuerelated to this topic. (This MUST involve a nursing practice issue.)Briefly describe yourrationalefor your topic selection. Include thescopeof the issue/problem.Star Point 2: Summary (Evidence to support need for a change)Describe thepractice problem in your own wordsand formulate your PICOT question.List the systematic review chosen from the CCN Library databases. Type the completeAPA referencefor the systematic review selected.List and briefly describeother sourcesused for data and information. List any otheroptional scholarly sourceused as a supplement to the systematic review inAPA format.Brieflysummarizethe main findings (in your own words) from the systematic review and thestrengthof the evidence.Outline one or twoevidence-based solutionsyou will consider for the trial project.Star Point 3: Translation (Action Plan)Identifycare standards, practice guidelines, or protocolsthat may be in placeto support your interventionplanning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).List yourstakeholders(by title and not names; include yourself) and describe theirroles and responsibilitiesin the change process (no more than 5).What specifically isyour nursing role in the change process? Other nursing roles?List your stakeholders byposition titles(charge nurse, pharmacist, etc.).Why are the members chosen(stakeholders) important to your project?What type ofcost analysiswill be needed prior to a trial? Who needs to be involved with this?Star Point 4: (Implementation)Describe theprocess for gaining permissionto plan and begin a trial. Is there a specific group, committee, or nurse leader involved?Describe theplan for educating the staffabout the change process trial and how they will be impacted or asked to participate.Outline theimplementation timelinefor the change process (start time/end time, what steps are to occur along the timeline).List themeasurable outcomesbased on the PICOT. How will these be measured?Whatforms, if any, might be used for recording purposes during the pilot change process. Describe.What resources are available to staff (include yourself) during the change pilot?Will there bemeetingsof certain stakeholders throughout the trial? If so, who and when will they meet?Star Point 5: (Evaluation)How will youreport the outcomesof the trial?What would be thenext stepsfor the use of the change process information?9.2019 Update. DLP112Bids(75)Dr. Ellen RMPROF_ALISTERDr. Sarah BlakeEmily ClareSheryl Hoganfirstclass tutorMiss DeannaProf Double RFiona DavaMUSYOKIONES A+Dr CloverMISS HILLARY A+Discount AssignJudithTutorIsabella Harvardpacesetters2121STELLAR GEEK A+Jahky BBrilliant GeekWIZARD_KIMShow All Bidsother Questions(10)read response”Healthcare Factors Behind Cost Curve and Supply Curve Shifts”  Please respond to the following:
From the e-Activity, compare the healthcare-based factors in…FIN 200 Week 7 CheckPoint Short-Term FinancingI need help with 2 paperswork solution onlyfin540from alpia websiteHuman resource developmentAshford BUS 401 Principles of Finance Complete CourseTypes of Misconduct

In a 2-3 page, APA style paper, describe the types of misconduct by community corrections professionals and provide…

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Community health (Nursing)

Home>Homework Answsers>Nursing homework helpAPAimportantThe purpose of this assignment is to conduct a community assessment in a form of an interview and physical appraisal of the community.Part I: AssessmentBased on the demographic and community selected in the Topic 3 assignment, perform a physical assessment of the community site using the “Functional Health Patterns Community Assessment Guide,” located in the topic Resources. This document does not need to be filled out, but rather serves as a guide for what to look for in the physical assessment of the community site.Part II: InterviewConduct an interview with the appropriate representative selected in Topic 3 regarding that person’s role and experiences within the community. Interviews can take place in person, by phone, or via Zoom.Develop 5-10 interview questions to gather information about the representative’s role and the health issues faced within the selected community, the role of public health in addressing environmental issues, and the health issues faced within the selected community.Part III: PowerPoint PresentationBased on your interview/community assessment, create a PowerPoint presentation of 15-20 slides (slide count does not include title and references slide) describing the chosen community interest.Include the following in your presentation:Summary of how the interview went, including responses to the questions.Description of the community and community boundaries including the people and the geographic, geopolitical, financial, educational level; ethnic and phenomenological features of the community, as well as types of social interactions; common goals and interests; and barriers and challenges, including any identified social determinants of health.Summary of community assessment, including funding sources and partnerships.Based on your findings from the interview/community assessment, discuss any issues that are lacking or can be improved upon for health promotion, modifying your teaching plan as needed to address these findings.A conclusion summarizing your key findings and a discussion of your impressions of the general health of the community.While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA format ting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.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. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance.question2.docx2 years ago08.08.202340Report issueBids(79)PROVEN STERLINGDr. Ellen RMEmily ClareDr. Sarah BlakeMISS HILLARY A+abdul_rehman_STELLAR GEEK A+Prof Double RMiss DeannaYoung NyanyaJane the tutorProWritingGuruJahky BProf. TOPGRADEDr. Adeline ZoeSheryl HoganDr M. MichelleAshley Elliesherry proffProf SapolskyShow All Bidsother Questions(10)BENCHMARK ASSIGMENTWeekly Math Quizterrorism DB 2Book Review- Only for Wendy Lewis!!Leadership vs. Management”A” WORK DISCUSSION BOARDEconomics of Health CareA. Do a python code project be sure to read and understand the assignment. I will do the report part i just need working codehomeland security forum post (215)English

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Acne soap note in teenager

Home>Homework Answsers>Nursing homework helpPlease see the attachment for the instructions2 years ago13.08.202314Report issuefiles (1)SOAPnoteoutlinePED.docxSOAPnoteoutlinePED.docx1Delete all text in red – these are instructions and not part of the SOAP document.Well child SOAP note- Infant and Child examplesRequirement:· APA format· Intext citation· References at least 4 high-level scholarly reference per post within the last 5 years in APA format.· EACH differential diagnostic gets 1 reference· Include Immunization chart (age and gender appropriate)· Include Growth Chart (age and gender appropriate)· Plagiarism free.· Turnitin receipt.ID:Patients name: ____, Age: __16____, Race: _____, Gender: __male____ Date of Birth: _______Reliable Historian: _______*Include brief statement on whether the patient came to the clinic alone or accompanied, and if so by whom, and whether they are a reliable historian.SUBJECTIVE:CC:“I have a lot of pimples in my face”History of Present Illness (HPI)In paragraph format, including at the minimum OLDCARTS. Please start with demographics: V.L. is a 12-month-old Hispanic male comes to the clinic today with his mother with complaint of ______Onset, Location, Duration, Characteristics/context, Aggravating factors or Associated symptoms, Relieving Factors, Treatment, and Timing, Severity. Include any pertinent positives or negatives.Past Medical History (PMH):IfNo prior medical history (first time patient- mention it; typically, with infants)Surgeries:Hospitalizations:Medical problem list:Medications:Allergies:Immunizations: All immunizations are up to date. Immunizations due today include Hepatitis A, MMR and Varicella vaccineImmunizationTotal DosesUp to DateHepB3YesRotavirus2YesDTaP5YesHib3YesPCV133YesIPV4YesMMRDueVaricellaDueHepatitis A2YesPfizer COVID-192YesInfluenza2YesDevelopmental Milestones EXAMPLE-Social: EX: V.L. is very friendly and get along well with other kids of his age.Language: EX: V.L. can says words like mama, papa and waves bye-bye.Speech: EX: His speech is clear and appropriate for his age.Cognitive: EX: He can recognize some colors and shapes. He picks up toys and puts them in the box.Motor:EX: he interacts and plays with other children; imaginative play; draws recognizable pictures; Walking and climbing, skips on 1 foot, climbs stairs alternating feet without support (Bright Futures, 2017)Self help: EX: Potty trained at 2 ½ years old, regular bowel movements; brushes his teeth; dresses and undresses without helpDevelopmental Milestones FOR INFANTS ONLY: EXAMPLE-Social: EX: V.L. is very friendly and get along well with other kids of his age.Language: EX: V.L. can says words like mama, papa and waves bye-bye.Speech: EX: His speech is clear and appropriate for his age.Cognitive: EX: He can recognize some colors and shapes. He picks up toys and puts them in the box.Gross motor: EX: V.L. can walk few steps without support. He picks up toys and puts them in the box.Fine motor: EX: Can hold pencil with his fist and scribbles in the paper (Misirliyan et al., 2023).Family HistoryMother:Father:Siblings:Maternal grandmother:Maternal grandfather:Paternal grandmother:Paternal grandfather:Social HistoryLiving condition: V.L. lives in a single-family home with his parents and brother. He stays home with his mother. He doesn’t go to any day care or play school.Financial resources: Fathers works as engineer, mother works part-time as a teacher; They have health insuranceSchool performance: has peer interactionsSafety: When riding in a motor vehicle, V.L. is always buckled up and is seated in a car seat rear facing. There is no pool or gun at home. Medication cabinets are always locked. Has a pet cat.Diet: drinks Enfamil baby formula and water. He also eats rice cereal and pureed fruits and vegetables.Exercise: He is very active. Likes to plays with his brother at home. He plays with kids of his age when he goes to the playground.Sleep: sleeps through the night. He sleeps 10-12 hours at night and 2-3 hours in the afternoon when he naps.Behavior: Normal age-appropriate behavior.Exposure: No exposure to second hand smoking, alcohol or any other drug use in the family.Screen time: 45 minutes dailySpiritual Affiliation: Christian. Goes to church on Sundays.Other:-Other social historyas applicable to each case(diet/exercise, spirituality, school/work, living arrangements, developmental history, birth history, breastfeeding, ADLs, advanced directives, etc. Exercise your critical thinking here – what is pertinent and necessary for safe and holistic care)Birth History: (ONLY FOR INFANT) EXAMPLE-Gestation: Ex: Full term at 39 weeksDelivery Method: Ex: Spontaneous vaginal deliveryBirth Complications: Ex: NoneBirth weight: Ex: 7 pounds, 7 ouncesBirth Length: Ex: 21.5 inchesBreastfed: Ex: Yes. Until 8 monthsReview of Systems (ROS):(write out by system):Comprehensive (>10) ROS systems for wellness exams or complex cases only. Do not include all 14 systems for every SOAP unless needed – review and document thepertinent systems.Do not include diagnoses – those belong in PMH. The below categories are per CMS guidelinesConstitutional: obese child.Eyes:Ears/Nose/Mouth/Throat:Cardiovascular:Pulmonary:Gastrointestinal:Genitourinary:Musculoskeletal:Integumentary & breast:Neurological:Psychiatric:Endocrine:Hematologic/Lymphatic:Allergic/Immunologic:OBJECTIVEVital Signs:(be sure to include percentiles for peds)Temperature:HR:BPRR:SpO2:Pain:Height: 31.5 inches (98th percentile- See the plotted growth chart below)Weight: 10.5 kg (75th Percentile- See the plotted growth chart below)Head Circumference: 18.5 inches (75th Percentile-See the plotted growth chart below)BMI: 16.14- NormalPhysical Exam(write out by system):General Survey:Head:Eyes:Ears:Nose:ThroatNeck:Cardiovascular:Respiratory:Gastrointestinal:Genitourinary: EX: No diaper rash was observed, and the female genitalia were normal. Tanner first stage.Musculoskeletal: EX: Able to move all extremities freely. Has begun to walk normally for his age. Pink, warm, dry, and flawless skin. Ecchymosis, rashes, moles, or lesions were not present.Neuro: EX: conscious and aware. Smiles and acknowledges his name. Meeting developmental goals.Psych: EX: Pleasant personality, bit timid with healthcare provider, but age appropriate. Age-appropriate interaction with mother.ASSESSMENT(you will often have more than one diagnosis/problem, but do the differential on the main problem)Differential Diagnosis(with a brief rationale, and references for each one:1. Acne vulgaris:2. Sebaceous hyperplasia3. FolliculitisFinal Diagnosis Acne vulgarisPLAN(4 pronged-plan for each problem on the problem list) use clinical guidelines to develop treatment plans for your patientsDiagnostics:Treatment: (please use Guidelines reference) use clinical guidelines to develop treatment plans for your patientsEducation/Anticipatory Guidance:EX:1. Health/Developmental – Encourage parents to keep developing nap and bedtime routines creating a tooth-brushing regimen, and scheduling dental appointments. Remind parents to employ constructive punishment and to avoid watching TV or other media.2. Safety – Inform parents on how to use a car seat correctly, how to remove or lock up poisonous items to prevent accidental poisonings, where to find the poison control number, how to stay safe around water, how to use sunscreen and other protective equipment, how to avoid choking hazards with pets, how to install gates near stairs, and other ways to make the home a safer place.3. Diet – Promote the benefits of following a balanced diet, which should include three meals and two to three snacks per day, as well as the promotion of self-feeding and the avoidance of tiny, hard foods (Philips et al., 2019).EX: Education to the parents should be the safety and milestones he will continue to have. Some new motor milestones may include balancing on foot, hops (Bright Futures). Some language milestones may include counting up to 10, naming 4 or more colors (Bright Futures). He may also draw a person with at least 6 body parts and copy squares and triangles (Bright Futures).Follow Up: EX: Follow up with immunization, hearing, oral health, and vision. Order for bloodwork. Maintain appropriate diet, and exercise for his age group. Such as implementing vegetables and fruits into diet. As for exercise if he plays a sport it should be at most four hours per week/EX: Administer scheduled vaccinations: Hepatitis A, MMR, Varicella according to CDC vaccine schedule for infants.Referral to dentist- If not established with one already. This is for dental checkups and routine clean ups.Return in three months for a 15-month well-child exam and vaccines.Follow up as necessary if sick or any other issues.Prescriptions two refills on epi pen autoinjector; Dose 0.15mg (0.3 ml)Side effects: weakness, shaking, fear, dizziness headache, anxiety, paleness, throbbing, and tenseness (How EpiPen works)List plan under each Diagnosis.Example1: Morbid Obesity BMI XX.X (E66.01)A: Goal of 5% weight reduction in 3 monthsB: Increase exercise by walking 30 minutes each dayC: Portion Size Education2: T2 Diabetes with diabetic neuropathy (E11.21)A: Repeat A1C in 3 monthsB. Increase Metformin to 1000mg BID #180, refills: 3C: Annual referral to diabetic educator, ophthalmology, and podiatry (placed X/X)D: Daily blood glucose check in the am and when sickE. Return to clinic in 3-4 months to reassessEXAMPLE CHART: for (2-20 years) (MALE)EXAMPLE: for BABIES/INFANTS (birth-24 months)ReferencesCDC Growth Charts – Centers for Disease Control and Prevention. Center for Disease Control.(2022). https://www.cdc.gov/growthcharts/data/set1clinical/set1color.pdfCenters for Disease Control and Prevention. (2022).Birth-18 years immunizationschedule. Centers for Disease Control and Prevention.https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.htmlCenters for Disease Control and Prevention. (2022).Developmental monitoring andscreening. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/childdevelopment/screening.htmlPhillips, S. P., Jiang, M., Lakkadghatwala, R., & Wang, S. (2019).Assessing wellness in the well-child check: What about social and emotional development.Canadian family physician Medecin de famille canadien,65(3), e113–e120.Misirliyan, S. S., Boehning, A. P., & Shah, M. (2023).Development Milestones. InStatPearls. StatPearls Publishing.image1.pngimage2.emfimage3.emfSOAPnoteoutlinePED.docx1Delete all text in red – these are instructions and not part of the SOAP document.Well child SOAP note- Infant and Child examplesRequirement:· APA format· Intext citation· References at least 4 high-level scholarly reference per post within the last 5 years in APA format.· EACH differential diagnostic gets 1 reference· Include Immunization chart (age and gender appropriate)· Include Growth Chart (age and gender appropriate)· Plagiarism free.· Turnitin receipt.ID:Patients name: ____, Age: __16____, Race: _____, Gender: __male____ Date of Birth: _______Reliable Historian: _______*Include brief statement on whether the patient came to the clinic alone or accompanied, and if so by whom, and whether they are a reliable historian.SUBJECTIVE:CC:“I have a lot of pimples in my face”History of Present Illness (HPI)In paragraph format, including at the minimum OLDCARTS. Please start with demographics: V.L. is a 12-month-old Hispanic male comes to the clinic today with his mother with complaint of ______Onset, Location, Duration, Characteristics/context, Aggravating factors or Associated symptoms, Relieving Factors, Treatment, and Timing, Severity. Include any pertinent positives or negatives.Past Medical History (PMH):IfNo prior medical history (first time patient- mention it; typically, with infants)Surgeries:Hospitalizations:Medical problem list:Medications:Allergies:Immunizations: All immunizations are up to date. Immunizations due today include Hepatitis A, MMR and Varicella vaccineImmunizationTotal DosesUp to DateHepB3YesRotavirus2YesDTaP5YesHib3YesPCV133YesIPV4YesMMRDueVaricellaDueHepatitis A2YesPfizer COVID-192YesInfluenza2YesDevelopmental Milestones EXAMPLE-Social: EX: V.L. is very friendly and get along well with other kids of his age.Language: EX: V.L. can says words like mama, papa and waves bye-bye.Speech: EX: His speech is clear and appropriate for his age.Cognitive: EX: He can recognize some colors and shapes. He picks up toys and puts them in the box.Motor:EX: he interacts and plays with other children; imaginative play; draws recognizable pictures; Walking and climbing, skips on 1 foot, climbs stairs alternating feet without support (Bright Futures, 2017)Self help: EX: Potty trained at 2 ½ years old, regular bowel movements; brushes his teeth; dresses and undresses without helpDevelopmental Milestones FOR INFANTS ONLY: EXAMPLE-Social: EX: V.L. is very friendly and get along well with other kids of his age.Language: EX: V.L. can says words like mama, papa and waves bye-bye.Speech: EX: His speech is clear and appropriate for his age.Cognitive: EX: He can recognize some colors and shapes. He picks up toys and puts them in the box.Gross motor: EX: V.L. can walk few steps without support. He picks up toys and puts them in the box.Fine motor: EX: Can hold pencil with his fist and scribbles in the paper (Misirliyan et al., 2023).Family HistoryMother:Father:Siblings:Maternal grandmother:Maternal grandfather:Paternal grandmother:Paternal grandfather:Social HistoryLiving condition: V.L. lives in a single-family home with his parents and brother. He stays home with his mother. He doesn’t go to any day care or play school.Financial resources: Fathers works as engineer, mother works part-time as a teacher; They have health insuranceSchool performance: has peer interactionsSafety: When riding in a motor vehicle, V.L. is always buckled up and is seated in a car seat rear facing. There is no pool or gun at home. Medication cabinets are always locked. Has a pet cat.Diet: drinks Enfamil baby formula and water. He also eats rice cereal and pureed fruits and vegetables.Exercise: He is very active. Likes to plays with his brother at home. He plays with kids of his age when he goes to the playground.Sleep: sleeps through the night. He sleeps 10-12 hours at night and 2-3 hours in the afternoon when he naps.Behavior: Normal age-appropriate behavior.Exposure: No exposure to second hand smoking, alcohol or any other drug use in the family.Screen time: 45 minutes dailySpiritual Affiliation: Christian. Goes to church on Sundays.Other:-Other social historyas applicable to each case(diet/exercise, spirituality, school/work, living arrangements, developmental history, birth history, breastfeeding, ADLs, advanced directives, etc. Exercise your critical thinking here – what is pertinent and necessary for safe and holistic care)Birth History: (ONLY FOR INFANT) EXAMPLE-Gestation: Ex: Full term at 39 weeksDelivery Method: Ex: Spontaneous vaginal deliveryBirth Complications: Ex: NoneBirth weight: Ex: 7 pounds, 7 ouncesBirth Length: Ex: 21.5 inchesBreastfed: Ex: Yes. Until 8 monthsReview of Systems (ROS):(write out by system):Comprehensive (>10) ROS systems for wellness exams or complex cases only. Do not include all 14 systems for every SOAP unless needed – review and document thepertinent systems.Do not include diagnoses – those belong in PMH. The below categories are per CMS guidelinesConstitutional: obese child.Eyes:Ears/Nose/Mouth/Throat:Cardiovascular:Pulmonary:Gastrointestinal:Genitourinary:Musculoskeletal:Integumentary & breast:Neurological:Psychiatric:Endocrine:Hematologic/Lymphatic:Allergic/Immunologic:OBJECTIVEVital Signs:(be sure to include percentiles for peds)Temperature:HR:BPRR:SpO2:Pain:Height: 31.5 inches (98th percentile- See the plotted growth chart below)Weight: 10.5 kg (75th Percentile- See the plotted growth chart below)Head Circumference: 18.5 inches (75th Percentile-See the plotted growth chart below)BMI: 16.14- NormalPhysical Exam(write out by system):General Survey:Head:Eyes:Ears:Nose:ThroatNeck:Cardiovascular:Respiratory:Gastrointestinal:Genitourinary: EX: No diaper rash was observed, and the female genitalia were normal. Tanner first stage.Musculoskeletal: EX: Able to move all extremities freely. Has begun to walk normally for his age. Pink, warm, dry, and flawless skin. Ecchymosis, rashes, moles, or lesions were not present.Neuro: EX: conscious and aware. Smiles and acknowledges his name. Meeting developmental goals.Psych: EX: Pleasant personality, bit timid with healthcare provider, but age appropriate. Age-appropriate interaction with mother.ASSESSMENT(you will often have more than one diagnosis/problem, but do the differential on the main problem)Differential Diagnosis(with a brief rationale, and references for each one:1. Acne vulgaris:2. Sebaceous hyperplasia3. FolliculitisFinal Diagnosis Acne vulgarisPLAN(4 pronged-plan for each problem on the problem list) use clinical guidelines to develop treatment plans for your patientsDiagnostics:Treatment: (please use Guidelines reference) use clinical guidelines to develop treatment plans for your patientsEducation/Anticipatory Guidance:EX:1. Health/Developmental – Encourage parents to keep developing nap and bedtime routines creating a tooth-brushing regimen, and scheduling dental appointments. Remind parents to employ constructive punishment and to avoid watching TV or other media.2. Safety – Inform parents on how to use a car seat correctly, how to remove or lock up poisonous items to prevent accidental poisonings, where to find the poison control number, how to stay safe around water, how to use sunscreen and other protective equipment, how to avoid choking hazards with pets, how to install gates near stairs, and other ways to make the home a safer place.3. Diet – Promote the benefits of following a balanced diet, which should include three meals and two to three snacks per day, as well as the promotion of self-feeding and the avoidance of tiny, hard foods (Philips et al., 2019).EX: Education to the parents should be the safety and milestones he will continue to have. Some new motor milestones may include balancing on foot, hops (Bright Futures). Some language milestones may include counting up to 10, naming 4 or more colors (Bright Futures). He may also draw a person with at least 6 body parts and copy squares and triangles (Bright Futures).Follow Up: EX: Follow up with immunization, hearing, oral health, and vision. Order for bloodwork. Maintain appropriate diet, and exercise for his age group. Such as implementing vegetables and fruits into diet. As for exercise if he plays a sport it should be at most four hours per week/EX: Administer scheduled vaccinations: Hepatitis A, MMR, Varicella according to CDC vaccine schedule for infants.Referral to dentist- If not established with one already. This is for dental checkups and routine clean ups.Return in three months for a 15-month well-child exam and vaccines.Follow up as necessary if sick or any other issues.Prescriptions two refills on epi pen autoinjector; Dose 0.15mg (0.3 ml)Side effects: weakness, shaking, fear, dizziness headache, anxiety, paleness, throbbing, and tenseness (How EpiPen works)List plan under each Diagnosis.Example1: Morbid Obesity BMI XX.X (E66.01)A: Goal of 5% weight reduction in 3 monthsB: Increase exercise by walking 30 minutes each dayC: Portion Size Education2: T2 Diabetes with diabetic neuropathy (E11.21)A: Repeat A1C in 3 monthsB. Increase Metformin to 1000mg BID #180, refills: 3C: Annual referral to diabetic educator, ophthalmology, and podiatry (placed X/X)D: Daily blood glucose check in the am and when sickE. Return to clinic in 3-4 months to reassessEXAMPLE CHART: for (2-20 years) (MALE)EXAMPLE: for BABIES/INFANTS (birth-24 months)ReferencesCDC Growth Charts – Centers for Disease Control and Prevention. Center for Disease Control.(2022). https://www.cdc.gov/growthcharts/data/set1clinical/set1color.pdfCenters for Disease Control and Prevention. (2022).Birth-18 years immunizationschedule. Centers for Disease Control and Prevention.https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.htmlCenters for Disease Control and Prevention. (2022).Developmental monitoring andscreening. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/childdevelopment/screening.htmlPhillips, S. P., Jiang, M., Lakkadghatwala, R., & Wang, S. (2019).Assessing wellness in the well-child check: What about social and emotional development.Canadian family physician Medecin de famille canadien,65(3), e113–e120.Misirliyan, S. S., Boehning, A. P., & Shah, M. (2023).Development Milestones. InStatPearls. StatPearls Publishing.image1.pngimage2.emfimage3.emfBids(68)Dr. Ellen RMEmily ClareProf. TOPGRADESheryl HoganDr. Freya Walkerfirstclass tutorProf Double RFiona DavaDemi_RoseProWritingGuruMUSYOKIONES A+Dr CloverMISS HILLARY A+Discount AssignJudithTutorIsabella HarvardSTELLAR GEEK A+Jahky BColeen AndersonBrilliant GeekShow All Bidsother Questions(10)HCS 440 Economics Terms and Health Care HistoryECO-365,ECO365,ECO/365,ECO 65 Week 5 Learning Team Reflection Global Competion Version 4Principles of Microeconomics Economics (8th ed.). New York, NY: McGraw-Hill.XBCOM 275 Week 1 CheckPoint Communication Process ModelPSY 400 Week 4 Individual Assignment Culture and Group Influence PaperPSY 285 Week 1 CheckPoint Causation and CorrelationECO-365,ECO365,ECO/365,ECO 365 Week 3 DQ 2 Version 4Principles of Microeconomics Economics (8th ed.). New York, NY: McGraw-Hill.BUS 515 Chapter 06 Statistical Quality Control Homework SolutionsaccountingPhysics hw questionCJS 230 Week 9 Final Project Community Corrections

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Foundations and Essentials for the Doctor of Nursing Practice

Home>Homework Answsers>Nursing homework helpLINKING AREAS OF FOCUS INTO FUTURE PLANS FOR THE DNP2 years ago15.09.202320Report issuefiles (10)LINKINGAREASOFFOCUSINTOFUTUREPLANSFORTHEDNP.docxTheImpactoftheDoctorateofNursingPractice.pdfRubric1.docxAnsweringthequestion.pdfResearchtranslation.pdfApplicationofprojectmanagementtools.pdfTheroleofDoctorofNursingPractice.pdfDNPEssentials1.pdfDoctorofnursingpracticestudents.pdfDevelopingguideline.pdfLINKINGAREASOFFOCUSINTOFUTUREPLANSFORTHEDNP.docxLINKING AREAS OF FOCUS INTO FUTURE PLANS FOR THE DNP·Points100In obtaining your DNP degree at Walden, you will complete a practicum/field experience and Doctoral Project. Both of these program-of-study milestones are directly aligned to the achievement of the AACN DNP Essentials.The focus of your Doctoral Project will be on a quality improvement project that you would advocate for to address a nursing practice gap or organizational need.In this first course, you will begin to consider the type of Doctoral Projects you might be interested in pursuing for completion of your DNP degree. Similarly, the clinical hours you will complete in your practicum/field experience will also align to the achievement of certain competencies as defined in the AACNDNP Essentials. Consider how alignment between your future plans in completing your practicum/field experience and your Doctoral Project will represent alignment to the DNP Essentials.For this Assignment, reflect on the Discussion Forum from Week 4 and think about how the completion of your Doctoral Project and practicum/field experience demonstrates alignment to the AACN DNP Essentials.TO PREPARE:· Review the Discussion.· Review the AACNDNP Essentialsdocument in the Learning Resources and reflect on how the completion of your Doctoral Project and the completion of a practicum/field experience may align to these Essentials.· Select at least 3 AACN DNP Essentials to focus on for this Assignment.THE ASSIGNMENT: (2–3 PAGES)· Describe the 3 AACN DNP Essentials that most align to the completion of a Doctoral Project. Be specific. Note: This is in general terms, not in relation to a particular quality improvement or organizational goal.· Explain how the AACN DNP Essentials will relate to the completion of a practicum/field experience. Be specific.Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.TheImpactoftheDoctorateofNursingPractice.pdfJONA
Volume 48, Number 12, pp 600-602
Copyright B 2018 Wolters Kluwer Health, Inc.
All rights reserved.The Impact of the Doctorate of
Nursing Practice Nurse in a
Hospital SettingTodd E. Tussing, DNP, RN, CENP, NEA-BC
Bevra Brinkman, DNP, RN, APRN, ACNS-BC
Deborah Francis, DNP, RN, ACNS-BC
Brenda Hixon, DNP, RN, ACNS-BC, ANP-BC
Ruth Labardee, DNP, RNC, CNL
Esther Chipps, PhD, RN, NEA-BCThis article describes the initiatives
of doctorate of nursing practice
(DNP)Yprepared nurses in a large
healthcare system supporting the
DNP competencies as outlined by
the American Association of Colleges
of Nursing. The goal of this group
was to demonstrate the impact of
DNP education on the roles for nurseadministrators, advanced practice
nurses, and educators in a large health
system. Exemplars profile nurse
administrators, clinical nurse spe-
cialists, and a nurse educator.Despite the growing numbers of
nurses prepared with a doctorate
of nursing practice (DNP), the im-
pact of the DNP in the acute care
hospital setting has not been well
described. At our institution, a work-
group of DNP-prepared adminis-
trators, clinicians, and educators
formed to examine the current
practices and complete a gap anal-
ysis comparing their current DNP
practices with the American Asso-
ciation of Colleges of Nursing DNP
competencies.1 The goal of this group
was to demonstrate the impact of
the DNP education on the enhance-
ment of roles for nurse administra-
tors, advanced practice nurses, and
educators in our setting.Clinical Nurse Specialist
Exemplars
A major challenge faced in medical-
surgical inpatient units is the balancingof the continuous need to increase
quality of care and patient outcomes
while simultaneously decreasing
length of stay (LOS), and overall
costs of care. To enhance patient
care and meet these challenges, a
DNP-prepared clinical nurse spe-
cialist (CNS) developed the role of
clinical coordinator (CC) for each
medical-surgical unit. The role of
the CC (see Supplemental Digital
Content 1, http://links.lww.com/
JONA/A653) is to facilitate com-
prehensive care planning, ensure
patient progress toward discharge
goals, and eliminate barriers to plan
of care and to be the consistent point
of contact with the patient and
family. The DNP-prepared CNS
used the principles of Essential:
Organizational and Systems Lead-
ership for Quality Improvement
and Systems Thinking1 during the
design of the CC role, emphasiz-
ing the importance of focusing on
panels of patients and the need to
reexamine care delivery models.
To establish and communicate the
vision of the project and to work
with stakeholders to obtain approval600 JONA � Vol. 48, No. 12 � December 2018Spotlight on LeadershipAuthor Affiliations: Administrative Director
of Nursing/Patient Care Services (Dr Tussing);
Patient Care CoordinatorYClinical Nurse Spe-
cialist (Dr Brinkman); Clinical Nurse Specialist
(Dr Francis), The Ohio State University, Wexner
Medical Center, University Hospital, Columbus;
Director of Health System Nursing Education
(Dr Hixon); Associate Director of Nursing
Evidence-Based Practice and Standards (Dr
Labardee), The Ohio State University, Wexner
Medical Center, Columbus; Associate Professor
of Clinical Nursing (Dr Chipps), The Ohio State
University College of Nursing Clinical Nurse
Scientist, Wexner Medical Center, The Ohio
State University, Columbus.The authors declare no conflict of interest.
Correspondence: Dr Tussing, WexnerMedical Center, University Hospital East,
181 Taylor Ave, Columbus, OH 43203
([email protected]).Supplemental digital content is available
for this article. Direct URL citations appear in
the printed text andareprovided in theHTML
and PDF versions of this article on the journal’s
web site (www.jonajournal.com).DOI: 10.1097/NNA.0000000000000688Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A653http://links.lww.com/JONA/A653http://www.jonajournal.comand resources, the DNP-prepared
CNS drew upon knowledge from
the Essential: Inter-professional
Collaboration for Improving Patient
and Population Health Outcomes.1The effectiveness of the CC role
was supported by multidisciplinary
involvement, rounding and com-
munication, and the development
of a patient-specific plan of care,
goal setting, and family involvement.
The Essential: Advanced Nursing
Practice1 provided the framework
for role development for top of
licensure practice for the CC. The
CCs are members of the patient
care team, and outcomes mea-
sured include patient satisfaction,
LOS, and all-cause readmission
rate and have revealed to be prom-
ising (see Supplemental Digital
Content 2, http://links.lww.com/
JONA/A654).A 2nd DNP-prepared CNS
was interested in facilitating and
helping staff prioritize unit-level
quality improvement (QI) processes.
A total of 22 registered nurses (RNs)
representing 10 units were selected
to form a QI workgroup. These
RNs were provided 6 hours of course
work that included QI and an
8-hour immersion course on
evidence-based practice (EBP) (see
Supplemental Digital Content 3,
http://links.lww.com/JONA/A655).
The DNP-prepared CNS who or-
ganized and led this effort was
guided by Essential: Organizational
and System Leadership for Quality
Improvement and Systems Think-
ing,1 which emphasizes the impor-
tance of advanced communication
skills to lead practice change initia-
tives. Framing the development
and organization of this new work
group was the understanding that
sustainability of practice improve-
ments requires mentoring and edu-
cation of frontline staff. Rolemodeling and teaching the impor-
tance of QI and bedside scholar-
ship to the selected nursing staff
were guided by Essential: Clinical
Scholarship and Analytical Methods
for Evidence-based Practice.1 To
date, 2 staff nurseYled QI projects
have had positive outcomes. An out-
patient wound care center changed
their nursing care delivery model
to enhance staff efficiency and im-
prove discharge teaching resulting
in improved patient satisfaction
scores (from 75% to 99%). The
2nd project on an inpatient cardi-
ology unit resulted in improvement
of patient intake/output documen-
tation over a 3-month period (from
45% to 69%) (see Supplemental
Digital Content 4, http://links.lww.
com/JONA/A656).Administrator Exemplars
Our academic community hospital
serves a low socioeconomic minor-
ity population. As part of a long-
range strategic plan, the university
entered into partnership with the
city and local metropolitan hous-
ing authority to transform the
neighborhood into spaces for
health living and growth. A com-
ponent of the community transfor-
mation plan was to develop the 7
local schools into magnet schools
for health careers (Health Sciences
Academy). The partnership with
this community school system was
a new opportunity to form a bridge
between the academic medical
center’s health system and the local
community. To move this effort
forward, a DNP-prepared nurse
administrator served as an advo-
cate for promoting equitable health-
care (Essential: Health Care Policy
for Advocacy in Health Care1) and
exploring new avenues for health
education/promotion to improve
gaps in care for an underservedcommunity (Essential: Clinical
Prevention and Population Health
for Improving the Nation’s Health1).
This project required skills related
to Essential: Clinical prevention and
Population Health for Improving
the Nation’s Health1 as the project
required exploring avenues for health
education/health promotion to
improve care gaps for vulnerable
populations. The outcome from the
project was a curricular plan for
grade levels prekindergarten thru
12th grade that included medical
experiential content involving the
medical center and its professionals.The 2nd administrator serves
as the associate director of EBP and
Standards and led an interdisci-
plinary team. This group reviewed
internal quality data, identified stake-
holders, completed a literature re-
view, and critically appraised the
evidence to develop the STAND
skin bundle (a practice bundle used
to prevent hospital-acquired pres-
sure injury [HAPI] for patients at
risk). This leader’s expertise led the
interdisciplinary team through the
7-step EBP process2 using Essen-
tial: Clinical Scholarship and Ana-
lytical Methods for Evidence-Based
Practice.1 Essential: Interprofes-
sional Collaboration for Improv-
ing Patient and Population Health
Outcomes1 provided the frame-
work as the team consisted of
nurses, would ostomy continence
team members, and a registered
dietician. Reduction of HAPIs has
broad implications for improving
the health of patients and reducing
healthcare costs using the knowl-
edge from Essential: Clinical Pre-
vention and Population Health for
Improving the Nation’s Health.1Although data on the impact of the
STAND Skin Bundle is not avail-
able yet, the educational prepara-
tion as a DNP nurse positivelyJONA � Vol. 48, No. 12 � December 2018 601Spotlight on LeadershipCopyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A654http://links.lww.com/JONA/A654http://links.lww.com/JONA/A655http://links.lww.com/JONA/A656http://links.lww.com/JONA/A656impacted the structure and process
of this workgroup.Educator
The DNP-prepared Director of
Education lead a multidisciplinary
team in the development of educa-
tional resources and a staff training
plan for the care for patients ex-
periencing infection and emerging
pathogens such as Ebola Virus
disease. This project required fact-
based, goal-directed health system-
wide collaboration to prepare for
an unexpected health crisis. The
Essential: Clinical Prevention and
Population Health for Improving
the Nation’s Health1 provided the
framework for understanding the
impact of emerging infectious dis-
ease and preparation for unexpected
disasters. The interdisciplinary team
reacted efficiently and quickly todevelop the care protocol and begin
training (see Supplemental Digital
Content 5, http://links.lww.com/
JONA/A657). The outcome from
the project was the development
of an institutional guideline for the
care of patients experiencing a new
emerging pathogen and education
of the care team members. More
than 100 staff members were trained
(see Supplemental Digital Content 6,
http://links.lww.com/JONA/A658;
Supplemental Digital Content 7,
http://links.lww.com/JONA/A659).Conclusion
The growing number of DNP
graduates presents a great poten-
tial for innovation around new care
delivery models, interdisciplinary
projects, and community involve-
ment for a healthier society. Hos-
pital and health system leaders mustbe open to the contribution of these
advanced practice nurses in new
and redesigned roles. The time has
come to integrate the essential com-
petencies of the DNP graduate into
healthcare system roles and com-
petencies. Nurses prepared at the
DNP level must demonstrate their
value to healthcare administrators and
nurse executives by sharing their out-
comes and engaging in empirically
based work to substantiate their value.REFERENCES1. American Associations of College ofNursing. AACN Position Statement on
the Practice Doctorate. Washington, DC:
American Association of Colleges ofNursing; 2004.2. Melnyk B, Fineout-Overholt E. Evidence-
Based Practice in Nursing & Healthcare.
Philadelphia, PA: Lippincott Williams &Wilkins; 2015.602 JONA � Vol. 48, No. 12 � December 2018Spotlight on LeadershipCopyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A657http://links.lww.com/JONA/A657http://links.lww.com/JONA/A658http://links.lww.com/JONA/A659Rubric1.docxThis file is too large to display.View in new windowAnsweringthequestion.pdfThis file is too large to display.View in new windowResearchtranslation.pdfThis file is too large to display.View in new windowApplicationofprojectmanagementtools.pdfThis file is too large to display.View in new windowTheroleofDoctorofNursingPractice.pdfThis file is too large to display.View in new windowDNPEssentials1.pdfThis file is too large to display.View in new windowDoctorofnursingpracticestudents.pdfThis file is too large to display.View in new windowDevelopingguideline.pdfThis file is too large to display.View in new windowDevelopingguideline.pdfThis file is too large to display.View in new windowLINKINGAREASOFFOCUSINTOFUTUREPLANSFORTHEDNP.docxLINKING AREAS OF FOCUS INTO FUTURE PLANS FOR THE DNP·Points100In obtaining your DNP degree at Walden, you will complete a practicum/field experience and Doctoral Project. Both of these program-of-study milestones are directly aligned to the achievement of the AACN DNP Essentials.The focus of your Doctoral Project will be on a quality improvement project that you would advocate for to address a nursing practice gap or organizational need.In this first course, you will begin to consider the type of Doctoral Projects you might be interested in pursuing for completion of your DNP degree. Similarly, the clinical hours you will complete in your practicum/field experience will also align to the achievement of certain competencies as defined in the AACNDNP Essentials. Consider how alignment between your future plans in completing your practicum/field experience and your Doctoral Project will represent alignment to the DNP Essentials.For this Assignment, reflect on the Discussion Forum from Week 4 and think about how the completion of your Doctoral Project and practicum/field experience demonstrates alignment to the AACN DNP Essentials.TO PREPARE:· Review the Discussion.· Review the AACNDNP Essentialsdocument in the Learning Resources and reflect on how the completion of your Doctoral Project and the completion of a practicum/field experience may align to these Essentials.· Select at least 3 AACN DNP Essentials to focus on for this Assignment.THE ASSIGNMENT: (2–3 PAGES)· Describe the 3 AACN DNP Essentials that most align to the completion of a Doctoral Project. Be specific. Note: This is in general terms, not in relation to a particular quality improvement or organizational goal.· Explain how the AACN DNP Essentials will relate to the completion of a practicum/field experience. Be specific.Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.TheImpactoftheDoctorateofNursingPractice.pdfJONA
Volume 48, Number 12, pp 600-602
Copyright B 2018 Wolters Kluwer Health, Inc.
All rights reserved.The Impact of the Doctorate of
Nursing Practice Nurse in a
Hospital SettingTodd E. Tussing, DNP, RN, CENP, NEA-BC
Bevra Brinkman, DNP, RN, APRN, ACNS-BC
Deborah Francis, DNP, RN, ACNS-BC
Brenda Hixon, DNP, RN, ACNS-BC, ANP-BC
Ruth Labardee, DNP, RNC, CNL
Esther Chipps, PhD, RN, NEA-BCThis article describes the initiatives
of doctorate of nursing practice
(DNP)Yprepared nurses in a large
healthcare system supporting the
DNP competencies as outlined by
the American Association of Colleges
of Nursing. The goal of this group
was to demonstrate the impact of
DNP education on the roles for nurseadministrators, advanced practice
nurses, and educators in a large health
system. Exemplars profile nurse
administrators, clinical nurse spe-
cialists, and a nurse educator.Despite the growing numbers of
nurses prepared with a doctorate
of nursing practice (DNP), the im-
pact of the DNP in the acute care
hospital setting has not been well
described. At our institution, a work-
group of DNP-prepared adminis-
trators, clinicians, and educators
formed to examine the current
practices and complete a gap anal-
ysis comparing their current DNP
practices with the American Asso-
ciation of Colleges of Nursing DNP
competencies.1 The goal of this group
was to demonstrate the impact of
the DNP education on the enhance-
ment of roles for nurse administra-
tors, advanced practice nurses, and
educators in our setting.Clinical Nurse Specialist
Exemplars
A major challenge faced in medical-
surgical inpatient units is the balancingof the continuous need to increase
quality of care and patient outcomes
while simultaneously decreasing
length of stay (LOS), and overall
costs of care. To enhance patient
care and meet these challenges, a
DNP-prepared clinical nurse spe-
cialist (CNS) developed the role of
clinical coordinator (CC) for each
medical-surgical unit. The role of
the CC (see Supplemental Digital
Content 1, http://links.lww.com/
JONA/A653) is to facilitate com-
prehensive care planning, ensure
patient progress toward discharge
goals, and eliminate barriers to plan
of care and to be the consistent point
of contact with the patient and
family. The DNP-prepared CNS
used the principles of Essential:
Organizational and Systems Lead-
ership for Quality Improvement
and Systems Thinking1 during the
design of the CC role, emphasiz-
ing the importance of focusing on
panels of patients and the need to
reexamine care delivery models.
To establish and communicate the
vision of the project and to work
with stakeholders to obtain approval600 JONA � Vol. 48, No. 12 � December 2018Spotlight on LeadershipAuthor Affiliations: Administrative Director
of Nursing/Patient Care Services (Dr Tussing);
Patient Care CoordinatorYClinical Nurse Spe-
cialist (Dr Brinkman); Clinical Nurse Specialist
(Dr Francis), The Ohio State University, Wexner
Medical Center, University Hospital, Columbus;
Director of Health System Nursing Education
(Dr Hixon); Associate Director of Nursing
Evidence-Based Practice and Standards (Dr
Labardee), The Ohio State University, Wexner
Medical Center, Columbus; Associate Professor
of Clinical Nursing (Dr Chipps), The Ohio State
University College of Nursing Clinical Nurse
Scientist, Wexner Medical Center, The Ohio
State University, Columbus.The authors declare no conflict of interest.
Correspondence: Dr Tussing, WexnerMedical Center, University Hospital East,
181 Taylor Ave, Columbus, OH 43203
([email protected]).Supplemental digital content is available
for this article. Direct URL citations appear in
the printed text andareprovided in theHTML
and PDF versions of this article on the journal’s
web site (www.jonajournal.com).DOI: 10.1097/NNA.0000000000000688Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A653http://links.lww.com/JONA/A653http://www.jonajournal.comand resources, the DNP-prepared
CNS drew upon knowledge from
the Essential: Inter-professional
Collaboration for Improving Patient
and Population Health Outcomes.1The effectiveness of the CC role
was supported by multidisciplinary
involvement, rounding and com-
munication, and the development
of a patient-specific plan of care,
goal setting, and family involvement.
The Essential: Advanced Nursing
Practice1 provided the framework
for role development for top of
licensure practice for the CC. The
CCs are members of the patient
care team, and outcomes mea-
sured include patient satisfaction,
LOS, and all-cause readmission
rate and have revealed to be prom-
ising (see Supplemental Digital
Content 2, http://links.lww.com/
JONA/A654).A 2nd DNP-prepared CNS
was interested in facilitating and
helping staff prioritize unit-level
quality improvement (QI) processes.
A total of 22 registered nurses (RNs)
representing 10 units were selected
to form a QI workgroup. These
RNs were provided 6 hours of course
work that included QI and an
8-hour immersion course on
evidence-based practice (EBP) (see
Supplemental Digital Content 3,
http://links.lww.com/JONA/A655).
The DNP-prepared CNS who or-
ganized and led this effort was
guided by Essential: Organizational
and System Leadership for Quality
Improvement and Systems Think-
ing,1 which emphasizes the impor-
tance of advanced communication
skills to lead practice change initia-
tives. Framing the development
and organization of this new work
group was the understanding that
sustainability of practice improve-
ments requires mentoring and edu-
cation of frontline staff. Rolemodeling and teaching the impor-
tance of QI and bedside scholar-
ship to the selected nursing staff
were guided by Essential: Clinical
Scholarship and Analytical Methods
for Evidence-based Practice.1 To
date, 2 staff nurseYled QI projects
have had positive outcomes. An out-
patient wound care center changed
their nursing care delivery model
to enhance staff efficiency and im-
prove discharge teaching resulting
in improved patient satisfaction
scores (from 75% to 99%). The
2nd project on an inpatient cardi-
ology unit resulted in improvement
of patient intake/output documen-
tation over a 3-month period (from
45% to 69%) (see Supplemental
Digital Content 4, http://links.lww.
com/JONA/A656).Administrator Exemplars
Our academic community hospital
serves a low socioeconomic minor-
ity population. As part of a long-
range strategic plan, the university
entered into partnership with the
city and local metropolitan hous-
ing authority to transform the
neighborhood into spaces for
health living and growth. A com-
ponent of the community transfor-
mation plan was to develop the 7
local schools into magnet schools
for health careers (Health Sciences
Academy). The partnership with
this community school system was
a new opportunity to form a bridge
between the academic medical
center’s health system and the local
community. To move this effort
forward, a DNP-prepared nurse
administrator served as an advo-
cate for promoting equitable health-
care (Essential: Health Care Policy
for Advocacy in Health Care1) and
exploring new avenues for health
education/promotion to improve
gaps in care for an underservedcommunity (Essential: Clinical
Prevention and Population Health
for Improving the Nation’s Health1).
This project required skills related
to Essential: Clinical prevention and
Population Health for Improving
the Nation’s Health1 as the project
required exploring avenues for health
education/health promotion to
improve care gaps for vulnerable
populations. The outcome from the
project was a curricular plan for
grade levels prekindergarten thru
12th grade that included medical
experiential content involving the
medical center and its professionals.The 2nd administrator serves
as the associate director of EBP and
Standards and led an interdisci-
plinary team. This group reviewed
internal quality data, identified stake-
holders, completed a literature re-
view, and critically appraised the
evidence to develop the STAND
skin bundle (a practice bundle used
to prevent hospital-acquired pres-
sure injury [HAPI] for patients at
risk). This leader’s expertise led the
interdisciplinary team through the
7-step EBP process2 using Essen-
tial: Clinical Scholarship and Ana-
lytical Methods for Evidence-Based
Practice.1 Essential: Interprofes-
sional Collaboration for Improv-
ing Patient and Population Health
Outcomes1 provided the frame-
work as the team consisted of
nurses, would ostomy continence
team members, and a registered
dietician. Reduction of HAPIs has
broad implications for improving
the health of patients and reducing
healthcare costs using the knowl-
edge from Essential: Clinical Pre-
vention and Population Health for
Improving the Nation’s Health.1Although data on the impact of the
STAND Skin Bundle is not avail-
able yet, the educational prepara-
tion as a DNP nurse positivelyJONA � Vol. 48, No. 12 � December 2018 601Spotlight on LeadershipCopyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A654http://links.lww.com/JONA/A654http://links.lww.com/JONA/A655http://links.lww.com/JONA/A656http://links.lww.com/JONA/A656impacted the structure and process
of this workgroup.Educator
The DNP-prepared Director of
Education lead a multidisciplinary
team in the development of educa-
tional resources and a staff training
plan for the care for patients ex-
periencing infection and emerging
pathogens such as Ebola Virus
disease. This project required fact-
based, goal-directed health system-
wide collaboration to prepare for
an unexpected health crisis. The
Essential: Clinical Prevention and
Population Health for Improving
the Nation’s Health1 provided the
framework for understanding the
impact of emerging infectious dis-
ease and preparation for unexpected
disasters. The interdisciplinary team
reacted efficiently and quickly todevelop the care protocol and begin
training (see Supplemental Digital
Content 5, http://links.lww.com/
JONA/A657). The outcome from
the project was the development
of an institutional guideline for the
care of patients experiencing a new
emerging pathogen and education
of the care team members. More
than 100 staff members were trained
(see Supplemental Digital Content 6,
http://links.lww.com/JONA/A658;
Supplemental Digital Content 7,
http://links.lww.com/JONA/A659).Conclusion
The growing number of DNP
graduates presents a great poten-
tial for innovation around new care
delivery models, interdisciplinary
projects, and community involve-
ment for a healthier society. Hos-
pital and health system leaders mustbe open to the contribution of these
advanced practice nurses in new
and redesigned roles. The time has
come to integrate the essential com-
petencies of the DNP graduate into
healthcare system roles and com-
petencies. Nurses prepared at the
DNP level must demonstrate their
value to healthcare administrators and
nurse executives by sharing their out-
comes and engaging in empirically
based work to substantiate their value.REFERENCES1. American Associations of College ofNursing. AACN Position Statement on
the Practice Doctorate. Washington, DC:
American Association of Colleges ofNursing; 2004.2. Melnyk B, Fineout-Overholt E. Evidence-
Based Practice in Nursing & Healthcare.
Philadelphia, PA: Lippincott Williams &Wilkins; 2015.602 JONA � Vol. 48, No. 12 � December 2018Spotlight on LeadershipCopyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A657http://links.lww.com/JONA/A657http://links.lww.com/JONA/A658http://links.lww.com/JONA/A659Rubric1.docxThis file is too large to display.View in new windowAnsweringthequestion.pdfThis file is too large to display.View in new windowResearchtranslation.pdfThis file is too large to display.View in new windowApplicationofprojectmanagementtools.pdfThis file is too large to display.View in new windowTheroleofDoctorofNursingPractice.pdfThis file is too large to display.View in new windowDNPEssentials1.pdfThis file is too large to display.View in new windowDoctorofnursingpracticestudents.pdfThis file is too large to display.View in new windowDevelopingguideline.pdfThis file is too large to display.View in new windowLINKINGAREASOFFOCUSINTOFUTUREPLANSFORTHEDNP.docxLINKING AREAS OF FOCUS INTO FUTURE PLANS FOR THE DNP·Points100In obtaining your DNP degree at Walden, you will complete a practicum/field experience and Doctoral Project. Both of these program-of-study milestones are directly aligned to the achievement of the AACN DNP Essentials.The focus of your Doctoral Project will be on a quality improvement project that you would advocate for to address a nursing practice gap or organizational need.In this first course, you will begin to consider the type of Doctoral Projects you might be interested in pursuing for completion of your DNP degree. Similarly, the clinical hours you will complete in your practicum/field experience will also align to the achievement of certain competencies as defined in the AACNDNP Essentials. Consider how alignment between your future plans in completing your practicum/field experience and your Doctoral Project will represent alignment to the DNP Essentials.For this Assignment, reflect on the Discussion Forum from Week 4 and think about how the completion of your Doctoral Project and practicum/field experience demonstrates alignment to the AACN DNP Essentials.TO PREPARE:· Review the Discussion.· Review the AACNDNP Essentialsdocument in the Learning Resources and reflect on how the completion of your Doctoral Project and the completion of a practicum/field experience may align to these Essentials.· Select at least 3 AACN DNP Essentials to focus on for this Assignment.THE ASSIGNMENT: (2–3 PAGES)· Describe the 3 AACN DNP Essentials that most align to the completion of a Doctoral Project. Be specific. Note: This is in general terms, not in relation to a particular quality improvement or organizational goal.· Explain how the AACN DNP Essentials will relate to the completion of a practicum/field experience. Be specific.Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.TheImpactoftheDoctorateofNursingPractice.pdfJONA
Volume 48, Number 12, pp 600-602
Copyright B 2018 Wolters Kluwer Health, Inc.
All rights reserved.The Impact of the Doctorate of
Nursing Practice Nurse in a
Hospital SettingTodd E. Tussing, DNP, RN, CENP, NEA-BC
Bevra Brinkman, DNP, RN, APRN, ACNS-BC
Deborah Francis, DNP, RN, ACNS-BC
Brenda Hixon, DNP, RN, ACNS-BC, ANP-BC
Ruth Labardee, DNP, RNC, CNL
Esther Chipps, PhD, RN, NEA-BCThis article describes the initiatives
of doctorate of nursing practice
(DNP)Yprepared nurses in a large
healthcare system supporting the
DNP competencies as outlined by
the American Association of Colleges
of Nursing. The goal of this group
was to demonstrate the impact of
DNP education on the roles for nurseadministrators, advanced practice
nurses, and educators in a large health
system. Exemplars profile nurse
administrators, clinical nurse spe-
cialists, and a nurse educator.Despite the growing numbers of
nurses prepared with a doctorate
of nursing practice (DNP), the im-
pact of the DNP in the acute care
hospital setting has not been well
described. At our institution, a work-
group of DNP-prepared adminis-
trators, clinicians, and educators
formed to examine the current
practices and complete a gap anal-
ysis comparing their current DNP
practices with the American Asso-
ciation of Colleges of Nursing DNP
competencies.1 The goal of this group
was to demonstrate the impact of
the DNP education on the enhance-
ment of roles for nurse administra-
tors, advanced practice nurses, and
educators in our setting.Clinical Nurse Specialist
Exemplars
A major challenge faced in medical-
surgical inpatient units is the balancingof the continuous need to increase
quality of care and patient outcomes
while simultaneously decreasing
length of stay (LOS), and overall
costs of care. To enhance patient
care and meet these challenges, a
DNP-prepared clinical nurse spe-
cialist (CNS) developed the role of
clinical coordinator (CC) for each
medical-surgical unit. The role of
the CC (see Supplemental Digital
Content 1, http://links.lww.com/
JONA/A653) is to facilitate com-
prehensive care planning, ensure
patient progress toward discharge
goals, and eliminate barriers to plan
of care and to be the consistent point
of contact with the patient and
family. The DNP-prepared CNS
used the principles of Essential:
Organizational and Systems Lead-
ership for Quality Improvement
and Systems Thinking1 during the
design of the CC role, emphasiz-
ing the importance of focusing on
panels of patients and the need to
reexamine care delivery models.
To establish and communicate the
vision of the project and to work
with stakeholders to obtain approval600 JONA � Vol. 48, No. 12 � December 2018Spotlight on LeadershipAuthor Affiliations: Administrative Director
of Nursing/Patient Care Services (Dr Tussing);
Patient Care CoordinatorYClinical Nurse Spe-
cialist (Dr Brinkman); Clinical Nurse Specialist
(Dr Francis), The Ohio State University, Wexner
Medical Center, University Hospital, Columbus;
Director of Health System Nursing Education
(Dr Hixon); Associate Director of Nursing
Evidence-Based Practice and Standards (Dr
Labardee), The Ohio State University, Wexner
Medical Center, Columbus; Associate Professor
of Clinical Nursing (Dr Chipps), The Ohio State
University College of Nursing Clinical Nurse
Scientist, Wexner Medical Center, The Ohio
State University, Columbus.The authors declare no conflict of interest.
Correspondence: Dr Tussing, WexnerMedical Center, University Hospital East,
181 Taylor Ave, Columbus, OH 43203
([email protected]).Supplemental digital content is available
for this article. Direct URL citations appear in
the printed text andareprovided in theHTML
and PDF versions of this article on the journal’s
web site (www.jonajournal.com).DOI: 10.1097/NNA.0000000000000688Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A653http://links.lww.com/JONA/A653http://www.jonajournal.comand resources, the DNP-prepared
CNS drew upon knowledge from
the Essential: Inter-professional
Collaboration for Improving Patient
and Population Health Outcomes.1The effectiveness of the CC role
was supported by multidisciplinary
involvement, rounding and com-
munication, and the development
of a patient-specific plan of care,
goal setting, and family involvement.
The Essential: Advanced Nursing
Practice1 provided the framework
for role development for top of
licensure practice for the CC. The
CCs are members of the patient
care team, and outcomes mea-
sured include patient satisfaction,
LOS, and all-cause readmission
rate and have revealed to be prom-
ising (see Supplemental Digital
Content 2, http://links.lww.com/
JONA/A654).A 2nd DNP-prepared CNS
was interested in facilitating and
helping staff prioritize unit-level
quality improvement (QI) processes.
A total of 22 registered nurses (RNs)
representing 10 units were selected
to form a QI workgroup. These
RNs were provided 6 hours of course
work that included QI and an
8-hour immersion course on
evidence-based practice (EBP) (see
Supplemental Digital Content 3,
http://links.lww.com/JONA/A655).
The DNP-prepared CNS who or-
ganized and led this effort was
guided by Essential: Organizational
and System Leadership for Quality
Improvement and Systems Think-
ing,1 which emphasizes the impor-
tance of advanced communication
skills to lead practice change initia-
tives. Framing the development
and organization of this new work
group was the understanding that
sustainability of practice improve-
ments requires mentoring and edu-
cation of frontline staff. Rolemodeling and teaching the impor-
tance of QI and bedside scholar-
ship to the selected nursing staff
were guided by Essential: Clinical
Scholarship and Analytical Methods
for Evidence-based Practice.1 To
date, 2 staff nurseYled QI projects
have had positive outcomes. An out-
patient wound care center changed
their nursing care delivery model
to enhance staff efficiency and im-
prove discharge teaching resulting
in improved patient satisfaction
scores (from 75% to 99%). The
2nd project on an inpatient cardi-
ology unit resulted in improvement
of patient intake/output documen-
tation over a 3-month period (from
45% to 69%) (see Supplemental
Digital Content 4, http://links.lww.
com/JONA/A656).Administrator Exemplars
Our academic community hospital
serves a low socioeconomic minor-
ity population. As part of a long-
range strategic plan, the university
entered into partnership with the
city and local metropolitan hous-
ing authority to transform the
neighborhood into spaces for
health living and growth. A com-
ponent of the community transfor-
mation plan was to develop the 7
local schools into magnet schools
for health careers (Health Sciences
Academy). The partnership with
this community school system was
a new opportunity to form a bridge
between the academic medical
center’s health system and the local
community. To move this effort
forward, a DNP-prepared nurse
administrator served as an advo-
cate for promoting equitable health-
care (Essential: Health Care Policy
for Advocacy in Health Care1) and
exploring new avenues for health
education/promotion to improve
gaps in care for an underservedcommunity (Essential: Clinical
Prevention and Population Health
for Improving the Nation’s Health1).
This project required skills related
to Essential: Clinical prevention and
Population Health for Improving
the Nation’s Health1 as the project
required exploring avenues for health
education/health promotion to
improve care gaps for vulnerable
populations. The outcome from the
project was a curricular plan for
grade levels prekindergarten thru
12th grade that included medical
experiential content involving the
medical center and its professionals.The 2nd administrator serves
as the associate director of EBP and
Standards and led an interdisci-
plinary team. This group reviewed
internal quality data, identified stake-
holders, completed a literature re-
view, and critically appraised the
evidence to develop the STAND
skin bundle (a practice bundle used
to prevent hospital-acquired pres-
sure injury [HAPI] for patients at
risk). This leader’s expertise led the
interdisciplinary team through the
7-step EBP process2 using Essen-
tial: Clinical Scholarship and Ana-
lytical Methods for Evidence-Based
Practice.1 Essential: Interprofes-
sional Collaboration for Improv-
ing Patient and Population Health
Outcomes1 provided the frame-
work as the team consisted of
nurses, would ostomy continence
team members, and a registered
dietician. Reduction of HAPIs has
broad implications for improving
the health of patients and reducing
healthcare costs using the knowl-
edge from Essential: Clinical Pre-
vention and Population Health for
Improving the Nation’s Health.1Although data on the impact of the
STAND Skin Bundle is not avail-
able yet, the educational prepara-
tion as a DNP nurse positivelyJONA � Vol. 48, No. 12 � December 2018 601Spotlight on LeadershipCopyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A654http://links.lww.com/JONA/A654http://links.lww.com/JONA/A655http://links.lww.com/JONA/A656http://links.lww.com/JONA/A656impacted the structure and process
of this workgroup.Educator
The DNP-prepared Director of
Education lead a multidisciplinary
team in the development of educa-
tional resources and a staff training
plan for the care for patients ex-
periencing infection and emerging
pathogens such as Ebola Virus
disease. This project required fact-
based, goal-directed health system-
wide collaboration to prepare for
an unexpected health crisis. The
Essential: Clinical Prevention and
Population Health for Improving
the Nation’s Health1 provided the
framework for understanding the
impact of emerging infectious dis-
ease and preparation for unexpected
disasters. The interdisciplinary team
reacted efficiently and quickly todevelop the care protocol and begin
training (see Supplemental Digital
Content 5, http://links.lww.com/
JONA/A657). The outcome from
the project was the development
of an institutional guideline for the
care of patients experiencing a new
emerging pathogen and education
of the care team members. More
than 100 staff members were trained
(see Supplemental Digital Content 6,
http://links.lww.com/JONA/A658;
Supplemental Digital Content 7,
http://links.lww.com/JONA/A659).Conclusion
The growing number of DNP
graduates presents a great poten-
tial for innovation around new care
delivery models, interdisciplinary
projects, and community involve-
ment for a healthier society. Hos-
pital and health system leaders mustbe open to the contribution of these
advanced practice nurses in new
and redesigned roles. The time has
come to integrate the essential com-
petencies of the DNP graduate into
healthcare system roles and com-
petencies. Nurses prepared at the
DNP level must demonstrate their
value to healthcare administrators and
nurse executives by sharing their out-
comes and engaging in empirically
based work to substantiate their value.REFERENCES1. American Associations of College ofNursing. AACN Position Statement on
the Practice Doctorate. Washington, DC:
American Association of Colleges ofNursing; 2004.2. Melnyk B, Fineout-Overholt E. Evidence-
Based Practice in Nursing & Healthcare.
Philadelphia, PA: Lippincott Williams &Wilkins; 2015.602 JONA � Vol. 48, No. 12 � December 2018Spotlight on LeadershipCopyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.http://links.lww.com/JONA/A657http://links.lww.com/JONA/A657http://links.lww.com/JONA/A658http://links.lww.com/JONA/A659Rubric1.docxThis file is too large to display.View in new windowAnsweringthequestion.pdfThis file is too large to display.View in new windowResearchtranslation.pdfThis file is too large to display.View in new windowApplicationofprojectmanagementtools.pdfThis file is too large to display.View in new windowTheroleofDoctorofNursingPractice.pdfThis file is too large to display.View in new windowDNPEssentials1.pdfThis file is too large to display.View in new windowDoctorofnursingpracticestudents.pdfThis file is too large to display.View in new windowDevelopingguideline.pdfThis file is too large to display.View in new window12345678910Bids(80)Dr. Ellen RMabdul_rehman_Emily ClareProf Double RYoung NyanyaProWritingGuruJahky BDr. Adeline ZoeSheryl HoganDr M. MichelleAshley Elliesherry proffDr. Sophie MilesWIZARD_KIMIsabella HarvardColeen AndersonPROF_ALISTERQuality AssignmentsPremiumNightingaleShow All Bidsother Questions(10)RewriteYoung NyanyaModule_8Edit my personal financesHuman Resource Business Partner (HRBP) Developmentn/aDescriptive Epidemiology Reportbusiness statisticsI need this ASAP….please no plagiarismBible

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ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT

Home>Homework Answsers>Nursing homework helpAmy, a 3 year old girl is brought to your office by her mother because she has a fever and complains that her ear hurts. She has no significant medical history. The child is not pleased to be in the provider’s office and has been crying. Her mother explains that she developed a “cold” about 3 days ago with sniffles. As she cries she continues to cough and has yellowish nasal discharge.Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. Listfivedifferent possible conditions for the patient’s differential diagnosis and justify why you selected each.Amy_Case_Studysample.pdfAmycasestudy.docxFocusedNoteTemplate.doc2 years ago27.09.202315Report issueBids(85)Dr. Ellen RMnicohwilliamPROF_ALISTEREmily ClareProf. TOPGRADESheryl HoganDr. Freya Walkerfirstclass tutorProf Double RFiona DavaDemi_RoseMUSYOKIONES A+Dr CloverIsabella HarvardDiscount AssignJudithTutorSTELLAR GEEK A+Jahky BProWritingGuruColeen AndersonShow All Bidsother Questions(10)NUR 405 Week 6 Individual Assignment Persuasive LetterMGT 437 Week 5 Individual Assignment Performance Measurement PaperHCS 490 Week 4 Individual Assignment Communication PaperHCS 465 Week 2 Individual Assignment Applying the Background and Methodology of the ResearchAccounting paper need helpBusiness lawACCT 505 Week 2 Quiz Job Order and Process Costing Systems (Devry)Discuss the differences between horizontal, vertical and conglomerate mergers and how those differ from a joint venture. Prepare a 350- to 1,050- word paper detailing the findings of your discussion.The Defense of PoesyMultiple Questions Answers

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