3 paragraph and less than 10 % similarity 

 You have been asked to be a peer reviewer for a team of nurse researchers who are conducting a phenomenological study of the experiences of physical abuse during pregnancy. What specific questions would you ask the team during debriefing and what documents would you want the researchers to share? 

Assignment:

Write a 750-word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least one (1) source in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Address the following questions:

• Describe the purpose of the Flannigan et al. (2014) study and why this study is important to advancing nursing knowledge.
• According to the study narrative and Figures 1, 2, & 3 in the Flannigan et al. (2014) study, describe the three formulas used in the prediction of mean weight for PICU patients. Which formula best estimates the weight for children under 1 year of age? Provide a rationale for your answer.
• Describe one potential clinical advantage and one potential clinical problem with using the three novel formulas presented in Exercise 14 see Figures 1, 2, & 3 in a PICU setting.

Assignment Expectations

Length: At least 750-words; answers must thoroughly address the questions in a clear, concise manner.

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment.

References: Use at least one APA style in-text citations and references for all resources utilized to answer the questions.

REPLY 1

It’s important for nurses to provide culturally competent care. It’s important to assess the importance of a client’s culture/ethnicity (and their accompanying beliefs and values) when planning, providing, and evaluating care. Nurses’ practice must incorporate cultural needs and beliefs into their nursing practice to provide care that is individualized for the client and appropriate to the client’s needs (Cultural Awareness and Influences on Health: NCLEX-RN, 2020).

In the Asian culture, there is often a belief that terminally ill patients should not be informed about their prognosis, and many believe that speaking of it may bring bad luck or a poor outcome (Ritter & Graham, 2017, P. 235). Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patient’s knowledge or consent is ethically unacceptable (AMA, 2020). After completing a cultural assessment, if the patient holds this belief, I would respect the cultural practice and withhold the information. 

The patient would be encouraged to specify preferences regarding the communication of medical information, preferably before the information becomes available (AMA, 2020); it’s important to honor a patient’s request not to receive certain medical information or to convey the information to a designated surrogate, provided these requests appear to represent the patient’s genuine wishes (AMA, 2020). For the family who believes this, “decisions and communication are often considered the responsibility of the oldest male in the family, and can be seen as a moral obligation for that person to act in that capacity” (Ritter & Graham, 2017, P. 235). 

For health care providers to balance the patient’s right to know with respect to the cultural practices and beliefs of the family, it’s important to: assess the amount of information the patient is capable of receiving at a given time, and tailor disclosure to meet the patient’s needs and expectations in keeping with the individual’s preferences; Monitor the patient carefully and offer full disclosure when the patient is able to decide whether to receive the information (AMA, 2020). 

In short, each year, the United States becomes more diverse, with people of different races and religions, and with differing beliefs about medicine and medical care. As nurses, we owe it to our patients to provide them with the best care possible in ways they find appropriate (Reed, 2017).

References

AMA. (2020). Withholding Information from Patients. Retrieved from https://www.ama-assn.org/delivering-care/ethics/withholding-information-patients

Cultural Awareness and Influences on Health: NCLEX-RN. (2020). Retrieved from https://www.registerednursing.org/nclex/cultural-awareness-influences-health/

Reed, C. (2017). Cultural Competence. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2017/07000/Cultural_Competence.5.aspx

Ritter, L.A., & Graham, D.H. (2017). Multicultural Health (2nd ed.). Burlington, MA: Jones and

Bartlett Learning. ISBN: 9781284021028

REPLY 2

        Health is viewed as a cultural concept, and culture determines how we perceive the world. Therefore, respect for cultural practice in Asia is predetermined because culture helps shape how both the patient and the healthcare provider perceive illness and what they believe to be its cause (Fowler et al., 2011). I will only respect the culture if I lack the knowledge and skills of delivering bad news, the appropriate provision of optimal care to a dying patient, and the compassion to ensure that the patient retains his or her self-worth even at the time of his or her death. 

      According to Rosenberg et al. (2017), negative information should be briefly relayed to patients. The author recommends that the information be rehearsed to communicate the bad news concisely and how the healthcare team is committed to the patient’s support and treatment at the terminally ill stage. A good example of a prognosis that should be delivered to the patient, especially by word of mouth, is as follows: ‘The tests done on your collected samples have confirmed that your condition arose from a malignant tumor (sad news). Therefore, I have informed a radiotherapist and the oncologist to speak with you about the condition and then advise you further. Once I receive the recommendations from their examinations on you, I will decide on what best treatment to give to you (doing something about it). As things unfold, I will always be around to discuss with you on how we will go on with the treatment.’ Maintaining a silent observation at this point will lead to the patient’s psychological condition’s best results (Sarafis et al., 2014). Therefore, I will respect the culture, but any information that must reach the patient will always be delivered just as the profession prescribes.

        Healthcare providers can balance the patient’s right to know their prognosis concerning their cultural practices and beliefs. To achieve such a balance, healthcare personnel should always try hard to become culturally sensitive (Chaet, 2016). Such sensitive care can be achieved through creating awareness, avoiding assumptions, and learning about other cultures. In any social issue, the first step is always to be aware. Any competent healthcare provider must always be endowed with culturally sensitive care. A good nurse or doctor will always strive to become culturally sensitive personnel while letting others understand their line of duty (Swihart & Martin, 2020). Secondly, a good healthcare provider should always avoid making assumptions because it is always important not to assume matters that you are not familiar with. Making such assumptions can cause a breakdown of trust and rapport between the healthcare provider and the patient. Lastly, a good doctor or nurse should always learn about other cultures. Learning a patient’s culture includes their medical history, medications, and current symptoms. Learning different cultures will involve immersing oneself in the culture of others. 

     In conclusion, it is always essential to have a truthful and open communication between the patient and the medic. Such open communication will enhance trust in the relationship and respect for autonomy. On the other hand, not fully disclosing information to the patient is an ethical breach because it brings the clash between the physician’s duty of promoting the patient’s health and the physician’s respect for the patient’s autonomy.

References:

Chaet, D. H. (2016). AMA Code of Medical Ethics’ Opinions Related to Discrimination and Disparities in Health Care. AMA Journal of Ethics, 18(11), 1095-1097.

Fowler, F. J., Levin, C. A., & Sepucha, K. R. (2011). Informing And Involving Patients To Improve The Quality Of Medical Decisions. Health Affairs, 30(4), 699–706. https://doi.org/10.1377/hlthaff.2011.0003

Rosenberg, A. R., Starks, H., Unguru, Y., Feudtner, C., & Diekema, D. (2017). Truth Telling in the Setting of Cultural Differences and Incurable Pediatric Illness. JAMA Pediatrics, 171(11), 1113–1119. https://doi.org/10.1001/jamapediatrics.2017.2568

Sarafis, P., Tsounis, A., Malliarou, M., & Lahana, E. (2014). Disclosing the Truth: A Dilemma between Instilling Hope and Respecting Patient Autonomy in Everyday Clinical Practice. Global Journal of Health Science, 6(2), 128. https://doi.org/10.5539/gjhs.v6n1p128

Swihart, D. L., & Martin, R. L. (2020). Cultural Religious Competence In Clinical Practice. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK493216/

All replies must be constructive and use literature where possible.

Your assignment will be graded according to the grading rubric.

Consider the topic you have selected to complete your evidence-based practice project. While we are not conducting research here, per se, we are considering implementing a new practice – and with any new practice comes the potential for both benefit and harm to clients. It’s important to think about how practice changes may affect clients – both positively and negatively. So as you get ready to conduct your EBP review, you’ll want to think about how you can make sure to keep your clients safe and your practice ethical.

In an APA format paper, approximately 3 pages in length, address the following questions. (Please note that you will continue to write in the same document you completed for part 1 of this assignment (completed in module 2) – you can keep the same cover page, correcting any errors noted on your feedback. Please correct your reference page as noted from your module 2 submission feedback and update it with your new material.) In addition, although you are submitting your entire project to date (with revisions), your actual grade will be based only on the current section, as addressed below:

• Discuss what the principle of “respect for persons” means to you.
• How will you ensure that it is carried out in the implementation of your EBP project? (Remember that you don’t need to know the exact outcome/findings of the project yet – you just need to consider how you will ensure autonomy for clients, and protection of those with diminished autonomy, if that is relevant to the practice setting.)
• Discuss what the principle of “beneficence” means to you. How will you ensure that it is carried out in the implementation of your EBP project?
• Discuss what the principle of “justice” means to you. How will you ensure that it is carried out in the implementation of your EBP project?

Consider this brief example as you begin the paper:

In previous modules, we gave this example of a PICO(T) question:

In clients over the age of 65 undergoing elective total hip arthroplasty, is chemical DVT prophylaxis more effective than mechanical DVT prophylaxis alone in preventing the development of DVT in the 30 days following surgery?

So for this assignment you might consider the following:

Respect for persons:
Do individuals have the right to refuse DVT prophylaxis if they choose (right to self-determination)?
What if they fall into the “diminished autonomy” category (i.e. have dementia, etc.)
How does this affect their right to autonomy?Beneficence:
How will this project maximize benefits and minimize harms?
What might be the benefits of changing practice or staying with the same practice?
What would be the risks?
How will you make sure that you reduce risks to clients as you consider practice changes?Justice:
How will you make sure that there is fairness in the distribution of burdens and benefits?
Will you make sure that the findings are distributed to all clients?
What about on other units? Remember, we should make sure that everyone has the opportunity to benefit from research findings, when applicable.