Discussion board Reply

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Attention Deficit Hyperactivity Disorder

  • What sort of problems would you expect Scott to have at school? 

ADHD is one of the most common neurodevelopmental disorder in children and can affect their social interaction, well-being and academics. Its symptoms are hyperactivity, lack of attention, and impulsivity. The cause for ADHD is not known but genetics plays a huge role. Some problems that I would expect Scott to have in school would be forgetfulness, inability to sit through class, poor focus, and a disruptive behavior. A task might be given to him and in a few moments, he acts like he doesn’t remember what task it was or do not even pay attention to what the person might be saying. He could also be experiencing an outburst of energy and finds it hard to stay still, interrupting his classmate, teacher or class activities.

  1. What are some teachings you might provide for this parent?

Some teaching that might help would be creating a schedule that the child has to follow every day, with time it would become a routine; and implement transition into things that needs to be done like giving a reminder few minutes prior to when a task is to be done. Since ADHD could have an overstimulating effect, it would help to limit choice. For example, choosing between two things rather than three things. Breaking down complicated task into simpler ones would help a lot as well as taking little breaks between them. Create goal and reward them as they complete each task. Take away privileges and use time outs to discipline inappropriate behaviors.

  1. What interventions would give Scott the best chance of having positive outcomes? 

A combination of medication and therapy would help Scott a lot and result in a positive outcome. Medication like Ritalin will help normalize the brain’s activity associated with ADHD and its daily symptoms when given at schedule times throughout the day. This medication must be prescribed by a physician. The medications used to treat ADHD are known as Psycho-stimulants and are shown to be very effective. Psycho-stimulant drugs could be a stimulant or a non-stimulant medication depending on the need of the child. The family therapy would help with his behavior and thoughts. The therapy would help to develop coping mechanism as well as incorporate a structure in the family for managing his behavior. Both behavior therapy and FDA-approved medications have been demonstrated to reduce behaviors associated with ADHD and improve function (Wolraich et al., 2011).

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HQ3

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Before submitting your Assessment, carefully review the rubric. This is the same rubric the assessor will use to evaluate your submission, and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.

All submissions must follow the conventions of scholarly writing. Properly formatted APA citations and references must be provided, where appropriate. Submissions that do not meet these expectations will be returned without scoring.

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Health Policy

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Determine what policy you may want to be involved in changing by creating an objective policy brief. A policy brief is a concise summary of a particular issue, the policy options to deal with it, and some recommendations on the best option. This assignment will be two parts.

 

Part One:

Write a policy brief regarding an issue relevant to health policy of 700-900 words. Include the following:

  1. Executive summary
  2. Introduction
  3. Approaches and results
  4. Conclusion
  5. Implications and recommendations
  6. Graphics and tables may be included as appropriate

Part Two: 

  1. Locate the contact information for a state, local, or federal official for your area.
  2. Locate information regarding the official’s stance on the issue you discuss in your policy brief.
  3. Send the official a letter or e-mail that explains your position and offers suggestions on how the official should move forward with the agenda from your policy brief. Include the brief as an attachment.

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Budgeting and Timeline Tools

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· Describe the budgeting tool(s) you will use and the steps you plan to take in order to identify the financial resources necessary for your Strategic Plan issue. Explain your rationale for your selected tool(s) and plans.

· Explain your plans for outlining the timeline for implementation of your proposed change. Explain which timeline tool(s) you will use and how they will represent the activities needed to successfully plan and implement your project.

· Explain how your timeline can allow leeway for variance.

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521 Boar discussion Correction

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Class Nursing 521 week 1 discussion board Moral Survey: Base on this question that I answer (Ethic in Healthcare )you need to response the following questions:Discussion Prompt #1· Reflect upon the survey you took. In your initial response, address some of the following questions. Explain your answers.· Did you find it easy to make confident and decisive decisions with several strongly agree or strongly disagree answers, or did you select mostly moderate responses?· Did any subject areas trigger personal emotions or issues?  If so, do you feel you were able to remain objective? · Were any of the decisions especially difficult to make?· Did you employ any critical thinking or resolution strategies to determine a response?· Did you rely on policy or legal parameters to make your decisions? · Would you be comfortable making your answers to the survey public, or do you prefer anonymity?· Have you dealt with similar situations and could you perceive similar situations occurring in your clinical practice?· How might a moral inventory such as this survey impact your clinical practice? APA and References. Survey Questions· Question 1· Question 2· Question 3· Question 4· Question 5· Question 6· Question 7· Question 8· Question 9· Question 10

   
  Physician assisted suicide (PAS) remains a controversial practice in terminal illness cases, and has been railroaded in most states. Only three states allow PAS at this time. Consider your role in counseling a patient seeking PAS services. Your patient is under 30 years old and believes that quality of life comes first over compromising medical treatments. The patient has therefore made a clear decision to forgo traditional medical treatment due to poor prognosis and the likelihood that medical treatment will only give an additional three to six months to live. Do you remain supportive of the patient’s decision to pursue PAS?

 

      
 
Selected Answer: Completely Disagree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree

 

      
   
  Although cases of eugenic sterilization are now relatively rare, sterilization without consent was performed with some regularity decades ago amongst state institutionalized patients with extreme cases of mental illness or retardation. Sterilizations were also performed on patients who were poor, of color, or who signed consents for sterilization procedures when they did not understand what they were signing. In unethical situations such as these, does the nurse have the responsibility to be the whistleblower, even if it means personal scrutiny or loss of livelihood?

 

      
 
Selected Answer: Completely Agree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree

 

      
   
  A police officer brings an intoxicated patient to your addiction recovery center. As a nurse at the detox unit, you are used to dealing with belligerent and intoxicated patients. In this case you are concerned because of the length of time it took for the police officer to bring the patient into detox relative to the time the person was picked up, per the police report. In examining the patient, you see a number of bruises and lacerations over the person’s arms, neck, and trunk, but when you question the patient about how the injuries occurred, the patient says he doesn’t remember. You suspect that the police officer may have assaulted and abused the person. You are unsure how to pursue your suspicions, and you regularly interface with this particular officer. You decide that you don’t have enough evidence to make a report and say nothing about your suspicions to your supervisor or coworkers. Have you violated the ANA Code of Ethics by remaining silent?

 

      
 
Selected Answer: Completely Agree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree

 

      
   
  You are a nurse in an OR and have noticed that patients are not achieving adequate pain relief intraoperatively and postoperatively. You are very concerned. Procedurally, you can see nothing different in how the anesthesia or narcotics are being administered. However, time and again, patients are complaining of inadequate pain relief. You know the certified nurse anesthetist (CRNA) almost lost his license last year when it was suspected that he was abusing fentanyl, and you worry that he may be stealing fentanyl and covering it up, but you cannot be sure since the ampules of fentanyl that are pulled from the Pyxis appear to be intact. You speak with your supervisor and it comes to light that the employee under investigation is someone other than the CRNA. Are you obligated to share your concerns about the CRNA with the state board of nursing?

 

      
 
Selected Answer: Somewhat Agree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree

 

      
   
  The payroll director of your hospital was recently sued for embezzlement. He was caught when a fired employee called the hospital to say that her W-2 tax form showed more payment than she had actually received. An investigation determined that the director had deposited the employee’s additional pay into his bank account and had done this multiple times with other employees. You discover that one of the directors of nursing who you work closely with, and who is a friend of the payroll director, is also under investigation for aiding and abetting the embezzlement scheme. The circumstances have generated a lot of fear and distrust amongst hospital staff and it has fallen to you to provide support to your nursing staff. Are you legally obligated to discuss specifics regarding the case with those staff directly affected by the embezzlement?

 

      
 
Selected Answer: Completely Disagree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree

 

      
   
  The mother of your pediatric patient in the emergency room is a Jehovah’s Witness and she has informed you that her daughter cannot get the blood transfusion needed to save her life. The matter is taken before the ethics committee of the hospital in an attempt to negotiate with the child’s mother for the life-saving transfusion that her child needs. In the end, the physician’s right to administer emergency medical treatment over the parent’s objections was allowed, but the physician was also protected from liability in the event he had chosen to honor the parent’s refusal of treatment. In general, the law does not dictate the physician’s action, and the physician’s decision is ultimately a moral one.

 

      
 
Selected Answer: Completely Agree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree

 

      
   
  You are a pediatric nurse and you have noticed a growing trend in the last five years of children who are identifying as transgender. The physician you work with has begun offering administration of cross-sex hormones to children identifying as transgender who wish to transition. You feel some internal conflict in certain cases about the decision to offer puberty-blocking cross-sex hormones to children who are not of legal age to make the decision, but who have lived with the stigma of expressing in the opposite sex their whole lives. In spite of your internal conflict, you have a moral obligation to remain supportive to these patients.

 

      
 
Selected Answer: Somewhat Agree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completly Disagree

 

      
   
  You are working in an infertility clinic as a nurse and are aware that the physician you work with chose to transfer more than five embryos into your patient when normally the physician transfers only two. When you read the patient’s chart, you discover that part of the justification is that the embryos were not all of the best quality when graded; there was a quality issue amongst the embryos in general, but the patient insisted they be transferred regardless of their quality. The woman ends up with a quintuplet pregnancy and sues the physician. Was the patient within her rights to sue the physician when she had expressly requested the embryo transfer even though their quality contradicted the usual transfer criteria and protocol?

 

      
 
Selected Answer: Completely Agree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree

 

      
   
  A nurse that was working as a health care worker in a camp for Ebola victims developed a low-grade fever the day of her flight but did not develop other Ebola symptoms, such as nausea and vomiting, until she had landed in the United States. Was she negligent to other passengers and airline personnel for flying with a low-grade fever?

 

      
 
Selected Answer: Completely Agree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree

 

      
   
  You are a nurse practitioner providing prenatal care in a community health center. A patient who regularly receives medication for chronic pain and who is a known opioid addict presents as a prenatal patient on your schedule. It is early in her pregnancy and you decide that weaning her from the pain medication now would be the best option. The patient herself is in agreement and goes home with your plan of tapering the dose over the next month, but instead abruptly stops all pain medication without your knowledge. You receive a hospital report three weeks later that the patient was admitted to the hospital for opioid withdrawal and miscarriage. The patient states you told her to stop the pain medications and you are now under investigation for medical malpractice. When patients do not follow medical advice and end up with a poor outcome, providers are always protected as long as their plan is well documented in the patient’s chart.

 

      
 
Selected Answer: Completely Agree
Answers: Completely Agree
  Somewhat Agree
  Somewhat Disagree
  Completely Disagree
 

 

Discussion Prompt# 2

 

Identify examples of active and latent errors. Provide examples from your clinical experience, if possible. How can such errors be avoided to support better patient care?

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Evidence-Based Population Health Improvement Plan

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Write a 4-5 page population health improvement plan, based on your evaluation of the best available evidence from a minimum of 3-5 current scholarly or professional sources of demographic, environmental, and epidemiological data that focuses on your diagnosis of a widespread population health issue.

Part of effectively engaging in evidence-based practice is the ability to synthesize raw health data with research studies and other relevant information in the literature. This will enable you to develop sound interventions, initiatives, and outcomes to address health concerns that you find in data during the course of your practice.

In this assessment, you have an opportunity to evaluate community demographic, environmental, and epidemiological data to diagnose a widespread population health issue, which will be the focus of a health improvement plan that you develop.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 2: Apply evidence-based practice to design interventions to improve population health.
    • Evaluate community demographic, epidemiological, and environmental data to diagnose widespread population health issues.
    • Develop an ethical health improvement plan to address a population health issue within a community.
  • Competency 3: Evaluate outcomes of evidence-based interventions.
    • Propose criteria for evaluating population health improvement plan outcomes.
  • Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.
    • Justify the value and relevance of evidence used as the basis of a population health improvement plan.
  • Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.
    • Develop a strategy for communicating with colleagues and members of the community in an ethical, culturally sensitive, and inclusive way.
    • Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

Scenario

Your organization is undertaking a population health improvement initiative focused on one of the pervasive and chronic health concerns in the local community. Examples of health improvement initiatives include nationwide concerns, such as type 2 diabetes, HIV, obesity, insect bites, and Zika. However, your organization has asked you to determine which widespread health concern should be addressed in a population health improvement plan for your community and has entrusted you with gathering and evaluating the relevant data.

Your Role

You are a nurse in a community clinic or hospital and you have a good idea about the most common chronic health issues among its patients. You have been asked to prepare a presentation for the next staff meeting about the issue and the plan that you are proposing to help improve the community’s health.

Instructions

The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may want to review the performance-level descriptions for each criterion to see how your work will be assessed.

Part 1: Data Evaluation

Evaluate the outcomes of a population health improvement initiative from community demographic, epidemiological, and environmental data.

  • Identify the relevant data.
  • Identify the level of evidence, validity, and reliability for each source.
  • Describe the major community health concerns suggested by the data.
  • Explain how environmental factors affect the health of community residents.
Part 2: Health Improvement Plan

Develop a health improvement plan that ethically and effectively addresses the population health concern that you identified in your evaluation of the relevant data.

  • Base your plan on the best available evidence from a minimum of 3–5 current scholarly or professional sources.
    • Apply correct APA formatting to all in-text citations and references.
    • Attach a reference list to your plan.
  • Ensure that your plan meets the cultural and environmental needs of your community and will likely lead to some improvement in the community’s health related to this concern.
    • Consider the environmental realities and challenges existing in the community.
    • Address potential barriers or misunderstandings related to the various cultures prevalent in the community.
  • Justify the value and relevance of the evidence you used as the basis of your plan.
    • Explain why the evidence is valuable and relevant to the community health concern you are addressing.
    • Explain why each piece of evidence is appropriate and informs the goal of improving the health of the community.
  • Propose relevant and measurable criteria for evaluating the outcomes of your plan.
    • Explain why your proposed criteria are appropriate and useful measures of success.
  • Explain how you will communicate with colleagues and members of the community, in an ethical, culturally sensitive, and inclusive way, with regard to the development and implementation of your plan.
    • Develop a clear communications strategy mindful of the cultural and ethical expectations of colleagues and community members regarding data privacy.
    • Ensure that your strategy enables you to make complex medical terms and concepts understandable to members of the community, regardless of language, disabilities, or level of education.
  • The headings for your Evidence-Based Population Health Improvement Plan should be the following:
    • Data Evaluation.
    • Meeting Community Needs.
    • Evidence.
    • Measuring Outcomes.
    • Communication Plan.

Additional Requirements

  • Length: Your recommendation will be 4–5 double-spaced pages, not including title and reference pages.
  • Font: Times New Roman, 12 points.
  • APA Format: Your title and reference pages need to conform to APA format and style guidelines. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.
  • Scoring Guide: Please review this assessment’s scoring guide to ensure you understand how your faculty member will evaluate your work.

Grading Rubric:

1.  Evaluate community demographic, epidemiological, and environmental data to diagnose widespread population health issues.

Passing Grade:  Evaluates community demographic, epidemiological, and environmental data to diagnose widespread population health issues. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the evaluation).

2.  Develop an ethical health improvement plan to address a population health issue within a community.

Passing Grade:   Develops an ethical health improvement plan to address a population health issue within a community, identifying multiple complementary elements that will sensitively meet a wide variety of community members’ needs.

3.  Justify the value and relevance of evidence used as the basis of a population health improvement plan.

Passing Grade:  Justifies the value and relevance of evidence used as the basis of a population health improvement plan, and impartially considers conflicting data and other perspectives.

4.  Propose criteria for evaluating population health improvement plan outcomes.

Passing Grade:  Proposes criteria for evaluating population health improvement plan outcomes, and explains why other possible criteria were considered and rejected.

5.  Develop a strategy for communicating with colleagues and community members in an ethical, culturally sensitive, and inclusive way.

Passing Grade:   Develops a strategy for communicating with colleagues and community members in an ethical, culturally sensitive, and inclusive way; acknowledges potential difficulties and how those challenges will be met.

6.  Write clearly and logically, with correct grammar and mechanics.

Passing Grade:   Writes clearly, logically, and persuasively; grammar and mechanics are error-free.

7.   Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

Passing Grade:   Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Citations are error-free.

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nur521p1reply

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Reply1

Ethical dilemma is a decision-making problem between two possible moral imperatives,neither of which is unambiguously acceptable or preferable .One action must be chosen, thereby generating a quandary for the person or group who is burdened with the choice. Example,the ethical dilemma which was encountered is in line of patient autonomy.The patient relatives were refusing to have blood transfusion for their child post operatively, despite the possible consequences ,but blood transfusion was necessary for saving the life of the child.With their refusal almost they created the end of life issue situation.

In the above scenario the other nurse was trying to leave the case by mentioning that patient and relatives are not willing  and are not consenting for blood transfusion.

I was not against the patient autonomy,but  my intention was to save the life of the child by explaining the consequences of refusal of blood transfusion.At last, they understood the importance of it ,they have been convinced for the blood transfusion and the child was out of danger.

Reply2

Nurses face variety of ethical issues while dealing with patients, colleagues, or other health care personnel. Nurses, as a human being, differ from one another and possess their own intellectual and moral values. The ethical dilemmas vary in different situations depending upon the way we address it. Some nurses deal with the situation easily while it would create a dilemma for others. One of the examples of an ethical dilemma that can occur in our nursing practice is when nurses themselves are not properly equipped to complete their duties like nurses who notice their coworker’s lack of knowledge face an ethical dilemma of whether they should bring the issue to their nurse manager (Duquesne University, n.d.).

For some nurses, it would not be a problem and whistle blow right away, whereas, for other, it would be dilemma between patient care and the loyalty to colleagues and employer. One of my colleagues had a patient who had Ventricular Tachycardia then CODED at the beginning of the shift soon after taking the report. It was found that patient’s potassium and magnesium level been low for the last 12hrs and EKG showing frequent PVCs which was not addressed. The patient was on Lasix injection and the potassium level was not monitored. In my opinion, it happened because of a delay in patent management due to incompetency. My colleague had a dilemma about whether to report it or not because the nurse who gave a report to her was her best friend.

Personally, when I notice the incompetency among peers, I critically analyze the situation and if it is a threat to patient safety, I would report because as per the code of ethics as a patient advocator we are obliged to take action when a patient’s right or safety is endangered (Mansbach.,Kushnir., Ziedenberg., & Bachner, 2014). If it is something, we can help our colleague improve incompetency, I privately talk and advice the best way so that the nurse’s license as well as patient’s safety would not be affected.  In that case, I talked to and assessed the knowledge of the nurse who gave the report. She said that she was not so confident to analyze the EKG rhythms and not aware of the protocols of managing patients on Lasix. So, I brought this issue and requested the management for the Inservice education which keeps us up to date in knowledge and skill helping to manage promptly and prevent from reoccurrence of the situation.

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mental illness

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According the National Alliance on Mental Illness (2016), 1 in 5 adults will experience mental illness each year–that’s 20% of the American population. Examples of mental illness include anxiety, depression, post-traumatic stress disorder, and schizophrenia. Like other chronic conditions, mental illnesses are marked by behavioral and biological components.

  • Pick a mental illness and briefly describe it.
  • Describe both the behavioral and biological components of the disease. What treatment options exist for each component of the disease?

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521 Week 2 Ethical Frameworks Essay

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Week 2 Ethical Frameworks Essay

 

Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below).  Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way?  Does this seem like a valid process for you to apply in your practice?

Your paper should be 1-2 pages. Adhere to APA formatting throughout and cite any outside sources you may use.

All the question should be answer in an essay format (no bullet)

 

Medical Indications: The Principles of Beneficence and Nonmaleficence
1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?

2.  What are the goals of treatment?

3.  In what circumstances are medical treatments not indicated?

4.  What are the probabilities of success of various treatment options?

5.  In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
 

 

 

Notes for this paperwork:

Base on the work that I do, (Care management) I need to apply a situation where I had faced the principles of Beneficence and Nonmaleficence.

As a care management I take care of:

· wound care (patient without treatment can develop an Osteomyelitis, severe infection (sepsis)

· IV for dehydration, (patient without treatment can develop arrhythmias, electrolytes imbalance, hypotension.

 

· high level of glucose in blood, (patient without treatment can develop Ketoacidosis that can lead to a shortness of breast and death.

 

· Medication Issues (patient without medication can end in an ER department with other complication, if patient felt due to an arrhythmia, low blood pressure, infection, severe pain.

 

· Emergencies and Urgencies (patient without treatment can develop Myocardial Infarction, Strokes, Respiratory syndrome, anaphylactic shock, asthma attack.

 

I give you some examples that can used to apply for a situation.

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Science and Policy Alignment

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As a healthcare professional, effective communication is an essential skill for you to have. For this assignment, you will synthesize scientific research with relevant health policy, and write a professional editorial piece for public consumption.

Your role: Content contributor for The American Journal of Nursing

Audience: Healthcare professionals, nursing and administrative.

Format: 3-page paper, editorial style. Plus, a cover and reference page. A minimum of three scholarly sources should be included. In-text citations are required. APA style should be followed throughout.

  • Refer to the article Engaging policy in science writing: Patterns and strategies within Unit 3 Topic 2 for additional guidance on using the “push” style of writing.

Structure:

  • Choose any scientific research topic, with relevant and reliable scholarly sources available for you to review. If your background is clinical, your focus may be heavy on the science or clinical elements. If your background is more administrative, you may choose research which is more closely related to a social issue (such as emergency contraceptives, vaping use, etc.)
  • Choose a policy or proposed policy that directly relates to your area of scientific research.
  • Write an editorial article, approximately 3 pages in length, summarizing the scientific research on your chosen topic, and aligning it with relevant health policy. Explain the need for increased awareness around the topic:
    • Who needs to do something about it,
    • When action is needed,
    • What that action could look like, and
    • Why such action will positively influence the future of healthcare.

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