Discuss a current issue on a pharmacological agent and your opinion. reviewed journals no older than 5 years.
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Use apa format
Discuss an advantage and one disadvantage of one non-narcotic drug used for chronic pain syndrome.
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1-Explain the importance of random sampling. What problems/limitations could prevent a truly random sampling and how can they be prevented?
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Reflect back over the past 8 weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #1, MSN Essential I, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies
Program Outcome #1: Provide high quality, safe, patient-centered care grounded in holistic health principles. (holistic health & patient-centered care)
MSN Essential I: Background for Practice from Sciences and Humanities:
Recognizes that the master’s prepared nurse integrates scientific findings from nursing, biopsychosocial fields, genetics, public health, quality improvement, and organizational sciences for the continual improvement of nursing care across diverse settings.
Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies
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Comment 1
P-values or significance level is commonly used (e.g. clinical trials) to determine whether hypothesis tested (comparison of groups’ characteristics) was significant or not. Often outcomes are labeled with “statistically significant” “non-statistically significant” “unlikely due to chance”, or “due to chance”, and so forth. Researchers make conclusions whether to reject the null hypothesis and accept the alternative hypothesis, vice versa, based on significant level.
Alpha levels are set depending on nature of experiments. Researchers set rate how much error is tolerable. For instance, 0.01 alpha level is more liberal than a conservative 0.001 alpha level. Many clinical trials choose alpha level of 0.05. Those drugs on clinical trial with higher alpha level of 0.05 rarely receive FDA approval. In a Phase II clinical trial, where effectiveness and safety is still being evaluated and there are fewer treatment options (for example for rare type diseases), scientist might set a liberal alpha level (Palesch, 2014). Many higher alpha levels are driven by studies’ cost and lower alpha levels by risks such as possible lifelong disability or death. For instance, in Phase III clinical trial such as testing efficacy of hyperbaric oxygen therapy (HBO) on post stroke patients require a conservative alpha level such as 0.02 (Rusyniak, et al. 2018,) or even more stringent level.
Comment 2
The Greek letter alpha is significant in hypothesis testing. There is not a universal value of alpha that should be used on all statistical tests. Choosing the alpha level is a judgement call of the researcher and it depends on the situation. Raising the alpha level poses more risk to type I and type II errors. Raising the alpha level is
usually related to having a small or limited sample size.
An experiment when the alpha level 0.01l might be used is in a study of a medical screen for a disease. An example, testing for cancer. All possibilities must be considered when the choosing the alpha level, The possibilities that he test may give a false positive report of cancer along with a report of egative when the disease was actually positive but the test did not catch the isease. A false positive will increase the patient’s anxiety leading to other ests and in the end the test was negative. This creates a type 1 error. The patient hat tested negative will not get the treatment that they needed for the isease which can lead to death and this is a type II error. Increasing the alpha level to 0.1 could result n a lower likelihood of a false negative
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week 4
Conduct an interview with someone in an informatics role in a clinical setting. Then, compose a 4-5 pages paper discussing the following components:
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UNIT 4
Topic: Strategies for Implementing Change
Benchmark – Change Initiative: Develop a Change Model
Details:
Research the various change models used by organizations today. After assessing these models, create a change model conducive to your field, and that will work within your organization’s culture. This model should serve to implement a strategic process that can help your organization integrate a change and respond to the internal or external driving forces that affect organizational success.
Create a visual representation of your model using a graphic organizer of your choice (flow chart, concept map, etc.). The design of your model will be unique and relevant to your organization, based on a critical analysis of its culture and behavior. However, your model must demonstrate the necessary steps for realistic implementation. Your model will be assessed on the quality of strategic implementation you design, the support you present for your model, and inclusion of the following concepts:
1. Methods to evaluate the need for change
2. Approach and criteria for choosing individuals or teams necessary for a change initiative
3. Communication strategies
4. Strategies to gather stakeholder support and overcome resistance
5. Implementation strategies
6. Sustainability strategies
Once you have created your model, prepare a 15-20 slide PowerPoint presentation to present your model and demonstrate how this model is relevant to your organization and why it will work well within your organization’s culture. In conclusion, discuss why this model will lead to sustainable change when most change initiatives fail. You will utilize this change model for your final paper.
Prepare this assignment according to the guidelines found in the APA Style Guide.
Plagiarism Free.
Textbook
1. The Heart of Change: Real-Life Stories of How People Change Their Organizations
Read the Introduction and Chapter/Step 5 in The Heart of Change: Real-Life Stories of How People Change Their Organizations.
e-Library Resource
1. Evaluating the Success of Strategic Change Against Kotter’s Eight Steps
Read “Evaluating the Success of Strategic Change Against Kotter’s Eight Steps,” by Spencer and Winn, from Planning for Higher Education (2004/2005).
2. Integrating Organizational Change Management and Customer Relationship Management in a Casino
Read “Integrating Organizational Change Management and Customer Relationship Management in a Casino,” by Chi Cong Mai, Perry, and Loh, from UNLV Gaming Research and Review Journal (2014).
3. Mastering the Art of Change
Read “Mastering the Art of Change,” by Blanchard, from Training Journal (2010).
4. Navigating Change
Read “Navigating Change,” by Bisoux, from BizEd (2015).
5. Team-Building and Change Management in Respiratory Care: Description of a Process and Outcomes
Read “Team-Building and Change Management in Respiratory Care: Description of a Process and Outcomes,” by Stoller et al., from Respiratory Care (2010).
6. The Meaning and Measurement of Implementation Climate
Read “The Meaning and Measurement of Implementation Climate,” by Weiner et al., from Implementation Science (2011).
7. Transformational Change
Read, “Transformational Change,” by Hannon, from Training Journal (2014).
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Define Evidence-based practice
According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interaction with clients. How do you see this being applied in your workplace?
350 WORDS, NO PLAGIARISM, MINIMUM OF 1 REFERENCE
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Location: XYZ Family Practice
You are an NP student in this practice. Your next patient is the following:
“I had to come in today because I have been coughing for a long time”
Amanda Smith (69 year old, black female) is a retired postal worker. During the visit, she is coughing continually. She states the cough started 5 days ago intermittently but 2 days ago it became constant. Her chart indicates that she has been a patient of the practice for 5 years, gets care regularly and her HTN has been controlled for 4 years.
Social History
Married – 2 adult children A & W
Non-Smoker now. Smoke 1 pack a day for 15 years. Quit x5 years ago
No alcohol or drug use
Baptist, attends church regularly and is a member of the choir
Family History
Mother – Deceased at age 27 from traumatic accident
Father – Deceased age 78 related to renal failure secondary to diabetes type II
Siblings – one brother age 61 A & W
Medical/Surgical/Health Maintenance Hx
Measles, mumps and chicken pox as a child.
Tetanus/Diptheria/Pertussis – Last dose 2 years ago
Influenza – Last dose 9 months ago
Pneumococcal vaccine at age 65
Zostivax at age 60
Chronic diagnoses – HTN x 5 years
Takes HCTZ 25 mg daily
ROS
General
Usual weight has been maintained
Fever for 5 days up to 101
Skin
Dry skin, uses emollient frequently
HEENT
Wears reading glasses
Dentition fair. Partial upper denture
Neck
No swelling or stiffness
Chest
Substernal pain on cough
Respiratory
Began coughing 4 days ago. Started mild, intermittent and non-productive. Two days ago became constant and productive of frothy sputum. Keeps her awake at night. No relief with OTC cough syrup. She states she is short of breath today.
CV
No CP at rest or when not coughing
PV
Some swelling of feet and ankles at end of day, relieved by elevating feet
GI
Decreased appetite for one week
No change in bowel habits
GU
No frequency, hesitancy, nocturia or change in bladder habits
Genitalia
No changes
MS
Stiffness in hands and legs on awakening. Relieved with activity
Psych
No depression, anxiety, or memory change
Neurologic
No numbness, weakness, headache, change in mentation, or paralysis
Hematologic
No past anemia
Endocrine
No change in weight, thirst, heat/cold intolerance.
Your physical exam reveals:
Temp 101.4, Resp 30 labored, no retractions, BP 135/92, HR 110, Pulse Ox 90 Wt 130 lbs
General appearance – Alert in all spheres, in mild respiratory distress, able to answer questions with short sentences, tripod breathing
HEENT –
Eyes ,ear, nose, head wnl
Mouth -mucosa dry
Pharynx – tonsils present not enlarged, normal pink color
Lymph – no enlargement
Skin – Dry and scaly legs and arms. Tenting of skin noted
Heart- regular rhythm at 110 bpm, no murmurs or extra sounds
Lungs – normal breath sound without crackles, bronchophony or egophony
Abdomen – no mass, tenderness, rigidity
Extremities – Hands – no swelling, Feet/legs – +1 edema feet to ankle level
Pedal pulses – wnl
Differential diagnoses:
Plan – transfer to acute care setting for further work-up
Assignment Details:
The “Elevator Consult”
In this activity, you will practice giving a synopsis of your patient to your preceptor. In practice, you may often give this type of report if you are sending a patient for a consultation and your phone the specialist to discuss the patient. This report should be concise and clear. The receiver should, within one minute (slightly less for simple cases, slightly more for complex cases) have a picture of the patient in his/her head. You will report on ONLY items pertaining to the acute problem in this case. Do not include extraneous material or material not directly impacting the decision-making regarding this problem. Remember, this is a FOCUSED visit and assessment to evaluate a focused concern. The history and physical exam applies techniques relevant to the specific complaint for the patient at that visit. Your report should be similarly focused, providing only information that relates specifically to the presenting problem.
Please review the grading rubric under Course Resources in the Grading Rubric section.
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1.Discuss the differences between a leader and a manager.
2. Which is more important, working for an effective leader or an effective manager? Explain your answer.
3. Observe the nurse manager in a unit to which students have been assigned. What management style is displayed? How does the staff respond to this style
4. What qualities do you think are most important to be a good nurse manager?
1. Interview the nurse manager on your assignment unit. What interpersonal, decisional, and informational activities does he or she complete on a daily basis?
2. You are the nurse manager on your unit. One of the most experienced staffers has been out on sick leave, and another just had a baby. The rest of the staff are working very hard to pick up the slack to avoid using agency personnel. What tangible and intangible rewards might you use to thank the staff?
3. PART 1: Begin by writing a 50-word description of the ideal nurse manger, someone you would like to work for. Describe a real-life nurse manager whom you have encountered in one of your clinical rotations. What qualities of this person meet your ideal? In what ways does this individual not meet your ideal? (Reminder: nobody’s perfect.)
PART 2: Think about becoming an ideal manager yourself. What qualities of an ideal manager do you already possess? What qualities do you still need to develop? How will you accomplish this?
1. Find your own state’s requirements for informed consent. Do elective procedures and emergency situations use the same standard?
2. Obtain a copy of your state’s Nurse Practice Act. Does the act give adequate guidance for nurses to know if an action is within the scope of nursing practice?
1. Explain how the Nurse Practice Act in your state provides for consumer protection and for professional nursing progress.
2. What are your thoughts on multistate licensure? How does it strengthen and weaken professional nursing?
3. As a new nurse, how can you ensure confidentiality in clinical settings?
4. How can nurses safeguard the confidentiality of medical information when sending it by fax or e-mail?
5. Explain the role of the nurse in obtaining informed consent. Do you believe that this is within the scope of nursing practice? Explain your answer.
6. Should nurses carry malpractice insurance? Explain your answer.
7. Should all patients have advance directives? Explain your answer.
8. Should employers be permitted to require nurses to work overtime if there is a shortage of registered nursing staff on a unit? Support your answer with evidence from the literature.
Essentials of Nursing Leadership & Management
6th Edition
Sally A. Weiss MSN, EdD, RN, CNE, ANEFRuth M. Tappen EdD, RN, FAAN
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