the first step of the EBP process is to develop a question from the nursing practice problem of interest.

Select a practice problem of interest to use as the focus of your research.

Start with the patient and identify the clinical problems or issues that arise from clinical care.

Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.

Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts.

Suggestions for locating qualitative and quantitative research articles from credible sources:

1. Use a library database such as CINAHL Complete for your search.
2. Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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 not required to submit this assignment to Turnitin.

the first step of the EBP process is to develop a question from the nursing practice problem of interest.

Select a practice problem of interest to use as the focus of your research.

Start with the patient and identify the clinical problems or issues that arise from clinical care.

Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.

Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts.

Suggestions for locating qualitative and quantitative research articles from credible sources:

1. Use a library database such as CINAHL Complete for your search.
2. Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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 not required to submit this assignment to Turnitin.

No plagiarism please.

Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations. 

Discuss the most common screening test and diagnostics used throughout pregnancy and the purpose of the tests. When during pregnancy are tests performed and what is the protocol when an abnormal test or diagnostic is found? 

Peer Resp#1

Health care provider may recommend a variety of screenings, tests and imaging techniques during a pregnancy. These tests are designed to provide information about the health of your baby and may help you optimize your child’s prenatal care and development (American Pregnancy Association, 2018). Genetic screening can help diagnose the potential for certain genetic disorders before birth. First-trimester screening is a combination of fetal ultrasound and maternal blood testing. This screening process can help determine the risk of the fetus having certain birth defects. Second trimester prenatal screening may include several blood tests called multiple markers. These markers provide information about the risk of having a baby with certain genetic conditions or birth defects. The ultrasounds can be performed at different times during the pregnancy to check for fetal growth, estimate the due date and look for any structural abnormalities in the baby. Additional testing during pregnancy may include amniocentesis, chronic villus, sample (CVS) and fetal monitoring glucose testing and Group B strep culture. Many genetic abnormalities can be diagnosed before birth (American Pregnancy Association, 2018) . Therefore, the PCP or midwife may recommend genetic testing during pregnancy in case there is a family history of genetic disorders. other reason may also be to have genetic screening when the fetus or baby has a genetic abnormality.

Depending on the situation if an abnormal screening test comes the patient should be aware of and counsel the risk of having the baby and the percentage of survival of the fetus. It will be up to the parents of the unborn child to decide whether they should continue with the pregnancy. I have seen a patient who was advised to end the pregnancy because of the high risk of the death of the mother. depending on the situation, some parents may choose to abort the baby.  for example, this who recently found that she was 8—9 weeks pregnant via ultrasound for the fifth time, the patient who had 3 c sections 4 living children and was pregnant for the fifth her last baby was 10 months old. The physician had to explain the high risk of having a hysterectomy right after given birth and risk of bleeding to death.

Peer Resp#2

Pregnancy is a cascade of miracles occurring one after another.  The development of a growing embryo to a fetus to a full-term infant involves constant replication of cells and therefore any delivery of a healthy baby is truly a miracle.  Gestation typically last 40 weeks and is broken down into trimesters (i.e. 1st – 0-12 weeks, 2nd – 13-28 weeks, 3rd – 29 weeks to delivery).  Women typically request pregnancy testing, either at home or at their primary care provider’s office, when they have either missed a menstrual cycle or are having symptoms of pregnancy (i.e. nausea, breast tenderness, etc.).  These tests are designed to measure human chorionic gonadotropin (HCG), which is a hormone secreted by the placenta once a fertilized egg implants within the uterine lining (Mayo Clinic, 2018).

 Because pregnancy is not a benign condition, many screening tests can be completed in order to identify any potential issues with the growing fetus (i.e. birth defects, low weight, etc.) at the earliest possible stage. 

During the first trimester, the following tests can be ordered:

1. Maternal blood screen to test for HCG and pregnancy associated plasma protein A (PAPP-A).  If either of these results are elevated, there can be an increased probability for chromosomal disorders. Blood typing also occurs at this time and if the mother is RH negative will need a Rhogam injection at 28 weeks and immediately after childbirth.
2. Ultrasound in the first trimester can be used to look for anomalies such as fluid behind the fetus’ neck or presence of a nasal bone and is considered the most accurate method to determine estimated delivery date (EDD).  These two screening methods can accurately provide evidence of Trisomy 18 or 21 (Down Syndrome) (John Hopkins Medicine, 2016).

During the second trimester the following tests can be ordered:

1. Between 15-20 weeks, a Quad screen tests for the presence of 4 proteins (alpha-fetoprotein (AFP), HCG, Estriol and Inhibin-A.  
2. Between 18-20 weeks, an anomaly ultrasound can be completed to determine size of the fetus and identification of any birth defects (Centers for Disease Control and Prevention, 2017).

During the third trimester, the following tests can be ordered:

1. Oral glucose tolerance test (OGGT) to determine whether the patient has developed gestational diabetes (GDM) can be completed during the 24-28 weeks.  If found to have GDM, patient will need to be educated on diet changes and potentially get started on metformin.
2. Group beta strep (GBS) can be tested for during the 35-37 weeks.  If positive, IV antibiotics will need to be administered prior to delivery of the child.
3. Tdap for anyone who will be in contact with the infant to protect against pertussis and the influenza vaccine to protect against influenza.

If any of the genetic testing results in an anomaly, further diagnostic testing can take place.  These types of additional testing include amniocentesis and chorionic villus sampling (CVS) and can help differentiate between the exact genetic anomaly exists (Centers for Disease Control and Prevention, 2017).

 I need to respond to this peer’s discussion post

 The peer response has to be from a peer-reviewed NURSING journal less than 5 y/o. 

New technologies have significantly changed the way nurses practice, conduct research, manage and administrate, and advance their education (Blais & Hayes, 2016). In today’s health environment technology and education are the most essential parts in innovate nursing practice within the healthcare system. Nursing Informatics has become the cornerstone in nursing, in which it has influences the day-to-day operations in the practice of nursing in several areas such as data recovery, patient care, electronic patient records and imaging informatics. The competency of nursing informatics can simply be determined through computer skills, informatics knowledge and informatics skills. Informatics has the potential to assist in identifying the key competency of a beginning nurse, experienced nurse, informatics specialist, and informatics innovator.  According to Blais and Hayes (2016) informatics nurses are challenged to continue to research and apply the appropriate codes and laws to protect patients and to use information tools to improve the quality of patient care. 

However, the success of students’ learning and their perception of a ‘good’ placement however are influenced by a number of factors extending beyond the current standards of competency (Barry & Martin, 2018). Ultimately, it’s the resposibitly of the nurse educator to ensure that student’s are begin properly assess for competency and supporting the students technical and clinical learning abilities. Nursing education made the transition from hospital-based training to the tertiary sector over 20 years ago (Algoso, 2015). However, grave concerns about the quality and quantity of undergraduate nurses‘ clinical experiences prior to graduation remains (Algoso, 2015). According to Lyons, Brunero and Lamont (2015) nursing today involves critical thinking, reflection and problem solving; partnering with patients to promote shared decision- making. Moreover, evidence base suggest that nursing practice changes patient care improvements relying on multifaceted, innovation and patient centered focus. Education has revolutionized nursing by improving the future of nursing through communication and forming partnerships between education, regulation, as well as in nursing practice in order to prevent any and all adverse outcome in the healthcare industry. 

Reference

Algoso, M. (2015, August). Undergraduate Assistant in Nursing (AIN) employment in aged care: does this 

prepare new graduates for the clinical work environment? Australian Nursing & Midwifery Journal, 23(2), 35. Retrieved from http://edb.pbclibrary.org:2084/apps/doc/A426902407/ITOF?u=d0_mlpbcls&sid=ITOF&xid=021292ae

Barry, S., & Martin, C. (2018, June). FACTORS IMPACTING ON THE SUCCESS OF CLINICAL

LEARNING–A STUDENT AND NURSE EDUCATOR PERSPECTIVE: Clinical placement provides an opportunity for student nurses to consolidate their clinical skills and apply their theoretical knowledge into practice (Siggins Miller Consultants 2012). Australian Nursing & Midwifery Journal, 25(11), 42. Retrieved from http://edb.pbclibrary.org:2084/apps/doc/A545479292/ITOF?u=d0_mlpbcls&sid=ITOF&xid=a63d1d0a

Blais K. K., & Hayes, J. (2016). Professional Nursing Practice; Concepts and Perspective (7thed).  Upper 

Saddle River, NJ: Pearson.

Lyons, S., Brunero, S., & Lamont, S. (2015, April). A return to nursing rounds–person centered or a task too far?

Australian Nursing & Midwifery Journal, 22(9), 30+. Retrieved from http://edb.pbclibrary.org:2084/apps/doc/A410141003/ITOF?u=d0_mlpbcls&sid=ITOF&xid=57c6244c