1. Focused Reflection (30 points)

Objective: To reflect on the interprofessional roles (MD, SW, OT, PT, RT, RD, PharmD) you saw on the unit and describe communication between them and the nurse.

· List all of the different providers that were involved in your patient’s care. What was the focus of each of these providers in the patient’s care? What was your nursing focus on the patient’s care? Be specific and give examples.

· How did you or the nurse communicate with each different provider? How did each provider communicate with the nurse? Be specific and give examples.

· What did you see done well and what would you improve? What would you specifically do to improve it?

The reflection should be 2-3 pages, but not longer than 3 pages. Use Times New Roman 12 point font, 1-inch margins, and double spacing to format your paper. The reflection does not need a title page or references. See syllabus for late assignment point deductions.

Focused Reflection rubric

0

3

Length and Mechanics

Does not meet page requirement.

One formatting error. Multiple spelling/grammar errors. Point is not understandable.

3 pages typed.

Double spaced.

TNR 12 pt font.

1 inch margins.

Minor spelling/ grammar   errors, but point is understandable

0

3

5

7

9

Listed providers and their focus vs. nursing focus. Was specific and gave examples.

Does not address.

Needs improvement.

Mostly complete.

Above average.

Completely addresses.

0

3

5

7

9

Described nurse to   provider and provider to nurse communication. Was specific and gave examples.

Does not address.

Needs improvement.

Mostly complete.

Above   average.

Completely   addresses.

Described what was done well and what to improve. Gave specific suggestions on their improvements.

Does not address.

Needs improvement.

Mostly complete.

Above average.

Completely addresses.

This paper will have an 8-page narrative (8 pages maximum – 5 point deduction for over page limit) plus a title page, abstract page, and reference list. 

You must use a minimum of four original research articles for your paper.

The purpose is to write a review of the literature on to answer your PICOT question using original research evidence. Discuss how this health problem is applicable in both the United States and a non-USA country, and appraise four original research studies on this topic.

This is a scholarly paper, written as if it was a “Review of the Literature” article published in a nursing journal. Select articles published within the past five years (2014 to present).
Do not use a non-peer review journal. Do not use a literature review article or systematic review article or clinical protocols as one of your articles. At least TWO of the four original research report articles MUST BE authored by nurses and published in a peer-reviewed nursing journal.  At least ONE of the two nursing research studies must address nursing practice in a non-USA country.

• Page 1: Title page Create a title for your paper. Refer to your APA Manual.
• Page 2: Abstract The abstract should open with a sentence that will serve as an introduction to and purpose of the paper. Then describe what is in each part of the paper. An abstract is usually a brief outline of the contents of the paper that typically does not exceed 250 words. At the end of the abstract place the phrase Key Words, and denote 3-4 keywords that would describe your paper (as for publication and indexing in CINAHL or PubMed).
• Pages 3-11: Narrative
  • Heading: Significance and Background: Start the paper with a short paragraph that introduces the health problem in your PICOT question. (Approximately ½-page).
  • Heading: Purpose: Clearly define the global health problem, and discuss why it is important for nursing (why you are discussing this topic).  Discuss what is known about this problem in the United States and in a non-USA country.  For example, if the focus is adult hypertension, discuss guidelines for defining hypertension in the US and in a non-USA country.  (Approximately 1 page).
  • Heading: Methods: Discuss the methods used to select the following research studies.
    Next use the subheading:
    • Sub-headings: Study #1: Nursing research Study in the USA (Approximately 1½ pages)
    • Sub-headings: Study #2: Nursing Research Study Non-USA (Approximately 1½ pages)
    • Sub-headings: Study #3: Nursing Research Study USA or Non-USA (Approximately 1½ pages)
    • Sub-headings: Study #4: Nursing Research Study USA or Non-USA (Approximately 1½ pages)
  • Heading: Conclusion.  Summarize the key points from your discussion. How would you translate (use) the new evidence found from your appraisals to change practice or answer your PICOT question? (Approximately 1 page).
• Page 12+: Reference page: Refer to your APA Manual.

PICOT QUESTION:

In hospitalized patients (P), what is the effect of hand washing (I) on infection control (O) compared to hand sanitizers (C), over a 3-month-period(T)?

This review is a scholarly paper in APA format and with at least three APA references (two articles and textbook), cited both in the text and the reference page.

CASE STUDY: Respiratory

#1 Patient Profile:

A 62-year-old female client with a history of COPD has been admitted to the hospital with acute exacerbation and left-sided pneumonia.

The nurse observes increased anterior-posterior diameter of the chest, reddish-blue skin tone, and prolonged expiratory phase when breathing.

Admission vital signs: temperature 101.5 F (oral), blood pressure 154/92, heart rate 110, and respiratory rate 26 breaths/minute.

Critical Thinking Questions:

Answer each question thoroughly and with details

1)    What nursing diagnosis is the priority for this patient and why?

2)    During the initial physical assessment of the patient, the patient exhibits a frequent cough with copious purulent secretions expectorated.

This assessment finding is compatible with which etiology of pneumonia?

What type of nursing care would you then provide?

3)    What should the nutritional plan for this patient include? Explain why?

Case Study: Burn/Trauma

You are caring for Mr. Stevenson a 26 year male patient who is an employee in a chemical plant on the assembly line. There was a unusual event and two explosive chemicals combined and caused a chemical explosion in the plant. Mr. Stevenson was near to the explosion and sustained severe burns from the accident.

He is now a patient in the Burn/Trauma ICU receiving life saving care. Mr. Stevenson received 3rd degree burns to his entire chest and back and his entire right leg front and back. He sustained second degree burns to his entire face. He is intubated, sedated and on a ventilator at the moment.

Please answer the following questions.

1) According to the Rule of Nines, what percentage of his body received burns? Please explain your answer in details.

2) Explain in details what is meant by treating the ABCDE’s of Burn Injuries?

3) What would be his fluid resuscitation goals for the first 24 hours? How about after that?

4) According to the American Burn Association, name at last 5 findings that would necessitate a referral to a burn center?

5) Explain the process of skin grafting for burn management.

GI CASE STUDY: 

#1 Patient Profile: A 56-year-ld male patient tells you that he has been having abdominal pain about 3 hours after he eats. It feels like burning and is mostly in the upper abdomen. He gets some relief with over-the-counter antacids. 

Critical Thinking Questions: Answer each question completely and thoroughly.

1) What is the differential diagnosis?

2) An endoscopy is ordered on this patient, and he is found to have multiple scattered duodenal ulcers. Now what do you think?

3) Suppose the serum gastrin is high. How can a diagnosis of Zollinger-Ellison syndrome be confirmed?

4) What are the signs and symptoms of Zollinger-Ellison and how would you educate your patient?

#2 Patient Profile:

 A 46-year-old patient tells you he’s been vomiting blood, but he does not bring any in for you to see. 

Critical Thinking Questions: Answer each question completely and thoroughly.

1) What is the differential diagnosis and what priority question should you ask?

2) What lab tests would you expect the physician to order?

3) What is an appropriate nursing diagnosis and what education would you provide?

Presentation:

Instruction:

Look up the disorder of , PAD (peripheral Artery Disease)

Its treatment, medication

Patients are taught

Side effect of the medication

Refusal of patient to take medication.