Category: Nursing

  • NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis

    NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis

    Introduction

    This essay describes the disease that is highlighted in the scenario of the 11-year old boy. In the scenario, the boy complains of wheezing and difficulty “getting enough air.” These symptoms especially increase when the boy is exercising, and there is an improvement when the activity stops. The mother suggests that the boy is allergic to cat dander, and since the next-door neighbor started sheltering cats, the symptoms have worsened even when the boy is at rest. Auscultation showed wheezes on forced expiration throughout all lung fields. This study will analyze the cardiovascular and cardiopulmonary pathophysiologic processes of the diseases that are presented in the case study NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis.

    The disease is likely a result of the blocking of the airways in the lungs. The blockage may be a result of narrowing, swelling, or production of extra mucus in the lungs. When this happens, the space for passing air is constricted, making a person force the passage of air, struggle to breathe, and this ends up producing the wheezing sound. The problem may be aggravated by the cat dander, a situation the mother says that the boy is allergic to. In this case, the inner walls of the lungs’ airways contain mucosal cells that produce mucus to act as a protective system against the foreign matters in the lungs. In the case there is dander from the cats in the air, these are tiny pieces of dead skin, the boy may inhale them and invoke a reaction that makes antigen-presenting cells in the airways to make extra mucus (McCance & Huether, 2019). As a result, the mucus further blocks the airways leading the boy to struggle to breathe and thus wheezing sound.

    In genetics, children who have been born in families with cases of allergic asthma have had a high likelihood of developing the same conditions. According to research, certain gene variations that change the encoding of epithelial cell-derived cytokines like interleukin-33 and thymic stromal lymphopoietin are involved in the pathogenesis of allergies (Min, 2010). These gene variations are inherited from parent to child, and thus the family history of the condition increases the risk of developing this condition. Other gene variations in the ORMDL3 and GSDML genes that are also hereditary are associated with early-onset of the condition NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis.

    The other factor that may affect the propensity to develop the condition is race and ethnicity. According to studies, some races are less exposed to allergies and asthma more than others. The chance of developing such conditions varies dramatically based on the ethnicity and race of an individual. For example, Caucasians are found to have the highest rate of allergies that are about three times more than the Asians from presented with the lowest rate (Ortiz & Barnes , 2015).

    In this case, the stimulus could include exercise activities and exposure to cat dander. In exercise activities, the body requires more oxygen than when the person is stationary. Therefore, the heightened oxygen requirement is faced with narrowed or swollen airways making the boy breathe hard to supply more oxygen. In the case of cat dander, they stimulate a reaction that produces more mucus that ends up blocking the airways NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis.

    Conclusion

    From the analysis, the boy is suffering from asthma that is worsened by the allergy to cat dander. The physiology of the problem involved narrowed or swollen airways in the lungs. The extra mucus may also block the airways causing heavy breathing and wheezing sound. Genetic factors could have played a role in predisposing the child to a hereditary condition NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis.

    References

    McCance, K. L., & Huether, S. E. (2019).
    Pathophysiology: The Biologic Basis for Disease in Adults and Children.
    New York: Elsevier.

    Min, Y.-G. (2010). The Pathophysiology, Diagnosis and Treatment of Allergic Rhinitis.
    Allergy Asthma Immunol Res.
    , 65-76.

    Ortiz, R. A., & Barnes , K. C. (2015). Genetics of Allergic Diseases.
    Immunol Allergy Clin North Am
    , 19-44.

    Module 1 Assignment: Case Study Analysis

    An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

    Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

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    Photo Credit: Getty Images/Hero Images

    An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis.

    In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

    To prepare:

    By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

    The Assignment (1- to 2-page case study analysis)

    Develop a 1- to 2-page case study analysis in which you:

    Explain why you think the patient presented the symptoms described.

    Identify the genes that may be associated with the development of the disease.

    Explain the process of immunosuppression and the effect it has on body systems.

    By Day 7 of Week 2

    Submit
     your Case Study Analysis Assignment 
    by Day 7 of Week 2
    .

    Reminder: 
    The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at 
    https://academicguides.waldenu.edu/writingcenter/templates
    ). All papers submitted must use this formatting.

     

    NURS_6501_Module1_Case Study_Assignment_Rubric

    Grid View

    List View

    Excellent

    Good

    Fair

    Poor

    Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:

    Explain why you think the patient presented the symptoms described.

    28 
    (28%)
     – 30 
    (30%)

    The response accurately and thoroughly describes the patient symptoms.

    The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

    25 
    (25%)
     – 27 
    (27%)

    The response describes the patient symptoms.

    The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

    23 
    (23%)
     – 24 
    (24%)

    The response describes the patient symptoms in a manner that is vague or inaccurate.

    The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research.

    0 
    (0%)
     – 22 
    (22%)

    The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.

    The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research.

    Identify the genes that may be associated with the development of the disease.

    23 
    (23%)
     – 25 
    (25%)

    The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis.

    20 
    (20%)
     – 22 
    (22%)

    The response includes an accurate analysis of the genes that may be associated with the development of the disease.

    18 
    (18%)
     – 19 
    (19%)

    The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.

    0 
    (0%)
     – 17 
    (17%)

    The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.

    Explain the process of immunosuppression and the effect it has on body systems.

    28 
    (28%)
     – 30 
    (30%)

    The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.

    25 
    (25%)
     – 27 
    (27%)

    The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.

    23 
    (23%)
     – 24 
    (24%)

    The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

    0 
    (0%)
     – 17 
    (17%)

    The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

    Written Expression and Formatting – Paragraph Development and Organization:

    Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

    5 
    (5%)
     – 5 
    (5%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

    A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

    4 
    (4%)
     – 4 
    (4%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

    Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

    3 
    (3%)
     – 3 
    (3%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

    Purpose, introduction, and conclusion of the assignment are vague or off topic.

    0 
    (0%)
     – 2 
    (2%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) APA format errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6501_Module1_Case Study_Assignment_Rubric NURS 6501: Advanced Pathophysiology Module 1 Assignment: Case Study Analysis

  • Discussion: Alterations in Cellular Processes

    Discussion: Alterations in Cellular Processes

    Pathophysiology case study discussion

    Pathology is the study of disease diagnosis through the investigation of indicators for a given disease in samples of surgically removed tissues, organs, body fluids, and even the whole body. Proper understanding of disease symptoms and underlying pathophysiology is imperative in the mastery of pathology. Furthermore, competency in pathology is essential in advanced Practice Nursing since it ensures effective patient management through the employment of rational treatment plans. This discussion highlights the role of genetics, underlying reasons for symptom manifestation, and physiologic response to the stimulus presented in a case scenario Discussion: Alterations in Cellular Processes.

    The case scenario involves a 16-year –old boy that presents with a sore throat that had persisted for three days with a negative past medical history of ear infections, nor treatment of colds and influenza. His posterior pharynx is reddened and produces a white exudate from the 3+ enlarged tonsils. The patient has no known food and drug allergies but later presents with anaphylaxis upon taking the first dose of amoxicillin.

    Role of genetics.

    Sore throat infections are commonly due to infection by streptococcus group A bacterium. Recurrent infection by the bacteria is linked to an underlying genetic predisposition that makes the body’s immune system unable to fight off the infection (Crotty, 2020). The large scale genome-wide association studies suggest shared genetics between autoimmunity, related phenotypes, and allergy. This finding is based on the identification of GWAS of monogenic diseases. Furthermore, these findings support the concept of an allergic response to particular triggers being affected by genetic factors (Klaus Bønnelykke, 2015).

    Presentation of symptoms.

                
    Signs and symptoms are indicative features of an underlying disease. Therefore, investigating and understanding the presenting signs and symptoms is imperative in establishing a rational diagnosis in pathology. For example, infection by the streptococcus bacteria caused an inflammatory response of the throat which presents as pain, reddening and swelling of the tonsils. Production of exudate is also a result of immune response to the bacterial invasion, which results in the production of pus. Anaphylactic response is a condition characterized by excessive release of chemical mediators upon exposure to specific allergens. This production of chemical triggers results in symptoms such as dyspnea, swelling of the tongue and lips, and wheezing. The patient having presented the anaphylactic response upon taking amoxicillin may be allergic to penicillin, which is commonly associated with such reactions Discussion: Alterations in Cellular Processes.

    Physiologic response to the stimulus and involved cells.

    Infection by streptococcus group A bacterium, as confirmed by a rapid strep test, presents as enlarged tonsils that produce an exudate and positive cervical adenopathy. This presentation is due to an underlying immune response in an attempt to fight off the infection through the release of mediators such as chemokines, PGE2, leukotriene B4, eicosanoids, proinflammatory cytokines, and antimicrobial peptides.

    Anaphylactic presentation is due to the release of chemical mediators due to exposure to triggers. Chemical mediators that play a significant role include histamine that leads to increased vasodilation and permeability and changes in cardiac contractility and heart rate. Prostaglandin D is also a chemical mediator that functions as pulmonary and cardiac vasoconstrictor that also causes peripheral vasodilation and vital organs hypoperfusion. Leukotrienes also play a significant role in bronchoconstriction and airway remodeling, which causes difficulty in breathing. Other significant chemical mediators include platelet activation factor and TNF alpha (McLendon & Sternard., 2021).

    Consideration of the patient’s age is essential in the management of group A streptococci infection. This consideration is especially significant in elderly populations, whereby it is considered a life-threatening condition, especially in individuals who reside in long term care facilities. Management of the disease in such population thereby requires a different response approach that involves large scale efforts which includes infectious disease practitioners, the staff, and public health officials in an attempt of preventing and managing GAS outbreak (Kevin P. High, 2007)

                                                                                                  References

    Crotty, S. (2020). 
    Strep Throat
    . Retrieved from La Jolla Institute For Immunology: https://www.lji.org/diseases/strep-throat/

    Kevin P. High, H. T. (2007). Group A Streptococcal Disease in Long-Term Care Facilities: Descriptive Epidemiology and Potential Control Measures. 
    Oxford ACADEMIC
    .

    Klaus Bønnelykke, R. S. (2015). Genetics of allergy and allergic sensitization: common variants, rare mutations. 
    National Center for Biotechnology Information
    .

    McLendon, K., & Standard., B. T. (2021). Anaphylaxis. 
    National Center for Biotechnology Information Discussion: Alterations in Cellular Processes
    .

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    Discussion: Alterations in Cellular Processes

    At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

    Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

    For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

    To prepare:

    By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

    By Day 3 of Week 1

    Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

    The role genetics plays in the disease.

    Why the patient is presenting with the specific symptoms described.

    The physiologic response to the stimulus presented in the scenario and why you think this response occurred.

    The cells that are involved in this process.

    How another characteristic (e.g., gender, genetics) would change your response.

    Read
     a selection of your colleagues’ responses.

    Genetic factors play two roles in this case first, as you have mentioned, genetics play a role in the recurrent  infection, especially in cases where genetics contributes to reduced immunity or allergies (Loh et al., 2017). It is also important to appreciate the role of genetics when it comes to triggering the hypersensitivity to amoxicillin.  It is likely that a mutation  in the patient’s HLA-B*55:01 has contributed to the development of mild forms of penicillin allergies in the patient (Krebs et al., 2020). This calls for extricate investigation in order to find an antibiotic that will not trigger anaphylaxis in the patient and thus guarantees positive outcomes in the patient Discussion: Alterations in Cellular Processes.

    References

    Krebs, K., Bovijn, J., Zheng, N., Lepamets, M., Censin, J. C., Jürgenson, T., … & Fadista, J. (2020). Genome-wide study identifies association between HLA-B∗ 55: 01 and self-reported penicillin allergy. The American Journal of Human Genetics, 107(4), 612-621.

    Loh, J. M., Lorenz, N., Tsai, C. J. Y., Khemlani, A. H. J., & Proft, T. (2017). Mucosal vaccination with pili from Group A Streptococcus expressed on Lactococcus lactis generates protective immune responses. Scientific reports, 7(1), 1-9 Discussion: Alterations in Cellular Processes.

  • NUR 681 Integration of Evidence for Advanced Practice

    NUR 681 Integration of Evidence for Advanced Practice

    NUR 681

    Integration of Evidence for Advanced Practice

    3 credit hours

    Verse of the Year

    “If we walk in the light as he is in the light, we have fellowship with one another.”

    –

    I John 1:7 (NIV)

    Spring Arbor University Concept

    “Spring Arbor University is a community of learners distinguished by our lifelong involvement in the study and application of the liberal arts, total commitment to Jesus Christ as the perspective for learning, and critical participation in the contemporary world.” NUR 681 Integration of Evidence for Advanced Practice

    Table of Contents

    NUR 681: Integration of Evidence for Advanced Practice   3

    Course Description                                                                                          3

    Course Overview                                                                                              3

    Learning Outcomes                                                                                         3

    Professional Skills                                                                                        4

    Critical Reasoning                                                                                        4

    Theory Application                                                                                      4

    Evidence-Based Practice                                                                           4

    Resources                                                                                                            5

    Required Texts                                                                                              5

    Repeating Textbooks                                                                                  5

    Supplemental Resources on Blackboard                                              5

    Grading Guidelines                                                                                          6

    Course Schedule                                                                                               7

    Week 1                                                                                                            8

    Week 2                                                                                                          12

    Week 3                                                                                                          15

    Week 4                                                                                                          18

    Week 5                                                                                                          20

    Week 6                                                                                                          23

    Week 7                                                                                                          26

    Course Expectations                                                                                     29

    Academic Integrity                                                                                    30

    SAU-MSN Academic Integrity (SafeAssign)                                       30

    Accommodation for Students with Disabilities                               31

    Attendance and Financial Aid
                                                                    32

    Attendance and Participation Policy                                                   32

    Blackboard Netiquette                                                                            32

    Course Evaluation                                                                                     34

    Discussion Boards (DB)                                                                            34

    Faculty Interaction                                                                                    35

    Faith and Learning                                                                                    35

    Inclusivity Statement                                                                               35

    Late Submission of Assignments                                                          36

    Late Point Deductions by Calendar Day                                             36

    Naming Convention                                                                                  36

    Prayer Requests, Chapel, and Break Room                                       37

    Quiz/Examination Settings                                                                     37

    Rounding Policy                                                                                         37

    Technical Support                                                                                     38

    Writing Standard                                                                                       38

    Right to Modify                                                                                          38

    Rubrics                                                                                                               39

    Discussion Board Assignments Rubric                                                40

    Section A: (Week 1) Organizational Culture and Readiness Assessment Rubric                                                                                    41

    Section B: (Week 2) Problem Description Rubric                            43

    Section C: (Week 3) Literature Support Rubric                                45

    Section D: (Week 4) Solution Description Rubric                            47

    Section E: (Week 5) Change Model                                                     50

    Section F: (Week 6) Implementation Plan Rubric                           52

    (Week 7) EBP Proposal Final Paper Rubric                                        54

    (Week 7) Presentation Discussion Board Rubric                             56

     

    Revised October 2020

    Syllabus Disclaimer:
    This syllabus is intended as a set of guidelines for NUR 681. Spring Arbor University and your instructor reserve the right to make modifications in content, schedule, and requirements as necessary to promote the best education possible within prevailing conditions affecting this course NUR 681 Integration of Evidence for Advanced Practice.

    NUR 681: Integration of Evidence for Advanced Practice

    Course Description

    Students will examine the evidence base for resolving a current health problem, design and evaluate a project specific to their practice setting. Students will utilize evidence-based practice skills learned earlier in the program.

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    Course Overview

    This course provides an opportunity for students to develop an evidence-based practice project proposal that addresses a problem, issue, or concern in professional practice. Students identify a problem amenable to research-based intervention; search literature; propose a solution; and develop a plan to implement the solution, evaluate its outcome(s), and disseminate the findings. Problems identified are those that are appropriate to students’ specialty tracks: adult – gerontology primary care nurse practitioner, and family nurse practitioner.

    Learning Outcomes

    Each course in the MSN curriculum follows the Christ-centered mission of the SAU Nursing Department, which is to develop and empower advanced practice professional nurses. For SAU, the mission of graduate nursing education is devoted to integrating our faith and learning exemplified by the SAU Concept. This integration starts with the conviction that God is already in us and in the classroom, and we are engaged in blending or uniting our Christian beliefs with our intellectual pursuits of knowledge to interpret and inform our nursing practice NUR 681 Integration of Evidence for Advanced Practice.

    The SAU Model of Graduate Nursing Education incorporates Professional Skills, Critical Reasoning, Theory Application, and Evidence-Based Practice through application of the American Association of Colleges of Nursing (AACN) Essentials of Master’s Education in Nursing. The Essentials include: I. Background for Practice from Sciences and Humanities, II. Organizational and Systems Leadership, III. Quality Improvement and Safety, IV. Translating and Integrating Scholarship into Practice, V. Informatics and Healthcare Technologies, VI. Health Policy and Advocacy, VII. Interprofessional Collaboration for Improving Patient and Population Health Outcomes, VIII. Clinical Prevention and Population Health for Improving Health, and IX. Master’s-Level Nursing Practice.

    At the completion of NUR 681, the student will be able to meet the following learning objectives and AACN Essentials of Master’s Education in Nursing that align with the SAU Model of Graduate Nursing Education.

    Professional Skills

    Critically analyzes data and evidence for improving advanced nursing practice.
    Scientific Foundation – 1

    Uses best available evidence to continuously improve quality of clinical practice.
    Quality – 1

    Critical Reasoning

    Develops new practice approaches based on the integration of research, theory, and practice knowledge.
    Scientific Foundation – 1

    Advances practice through the development and implementation of innovations incorporating principles of change.
    Leadership – 5

    Theory Application

    Applies clinical investigative skills to improve health outcomes.
    Practice Inquiry – 1

    Integrates knowledge from the humanities and sciences within the context of nursing science.
    Scientific Foundation – 2

    Evidence-Based Practice

    Translates research and other forms of knowledge to improve practice processes and outcomes.
    Scientific Foundation – 3

    Disseminates evidence from inquiry to diverse audiences using multiple modalities x.
    Practice Inquiry – 5

    NUR 681 Integration of Evidence for Advanced Practice
     

    Resources

    Required Texts

    Melnyk, B. M., & Fineout-Overholt, E. (2019).
    Evidence-based practice in nursing and healthcare: A guide to best practice
    (4th ed.). Wolters Kluwer Health. ISBN-13: 978-1-4963-8453-9

    Repeating Textbooks

    American Psychological Association. (2020).
    Publication manual of the American Psychological Association
    (7th ed.). 
    https://doi.org/10.1037/0000165-000

    Supplemental Resources on Blackboard

    American Journal of Nursing. (2020, February 4).
    Evidence-based practice, step by step.

    This web page is a collection of articles.

     

    Bettany-Saltikov, J. (2012).
    How to do a systematic literature review in nursing: A step-by-step guide
    . Open University Press, McGraw-Hill Education.

     

    Melnyk
    ,
    B. M., Gallagher-Ford, L., & Fineout-Overholt, E. (2017).
    Implementing the evidence- based practice (EBP) competencies in healthcare: A practical guide for improving quality, safety, and outcomes
    . Sigma Theta Tau International.
     

    Grading Guidelines

    Assignment

    Points Possible

    Points Earned

    Due

    Discussion Boards (16 points x 7 discussions)

    112 points

    Weekly

    Section A

    28 points

    Week 1

    Section B

    36 points

    Week 2

    Section C

    36 points

    Week 3

    Section D

    60 points

    Week 4

    Section E

    32 points

    Week 5

    Section F

    36 points

    Week 6

    EBP Proposal Final Paper

    36 points

    Week 7

    Total NUR 681 Integration of Evidence for Advanced Practice

    376 points

     

    A            95-100%

    A-          90-94%

    B+         87-89%

    B            83-86%

    B-          80-82%

    C+         77-79%

    C            73-76%

    C-          70-72%

    D+         67-69%

    D           66%

    U           lower than 65%

    I             Incomplete

     

    Overall Directions

    Prepare all assignments according to APA (American Psychological Association) Style (2010). An abstract and Table of Contents are not required.

    All assignments have a rubric. Please, review the rubric before beginning the assignment to become familiar with the expectations for successful completion.

    You are required to submit each paper assignment to SafeAssign and include the resulting report with the uploaded assignment. Refer to the directions in Blackboard.

    Course Schedule

    Week

    Readings

    Assignments

    1

    ●        Articles and Links (6)

    ●        Section A: Organizational Culture and Readiness Assessment

    ●        Discussion Board

    2

    ●        Melnyk & Fineout-Overholt (2019), Chapter 3

    ●        Articles and Links (2)

    ●        Section B: Problem Description

    ●        Discussion Board

    3

    ●        Articles and Links (3)

    ●        Section C: Literature Support

    ●        Discussion Board

    4

    ●        Melnyk & Fineout-Overholt (2019), Chapters 7, 8

    ●        Section D: Solution Description

    ●        Discussion Board

    5

    ●        Melnyk & Fineout-Overholt (2019), Chapter 14

    ●        Articles and Links (2)

    ●        Section E: Change Model

    ●        Discussion Board

    6

    ●        Melnyk & Fineout-Overholt (2019), Chapters 9, 10

    ●        Section F: Implementation Plan

    ●        Discussion Board

    7

    ●        Melnyk & Fineout-Overholt (2019), Chapter 20

    ●        Article (1)

    ●        EBP Proposal Final Paper

    ●        Discussion Board

    NUR 681 Integration of Evidence for Advanced Practice

    Week 1

    Topics

    Evidence-Based Practice

    Learning Objectives

    Identify problems, issues, or concerns in the professional work setting that are amenable to a research-based intervention using the PICOT format (population, intervention, comparison, outcomes, and timeframe).

    Understand how to determine organizational readiness for change.

    Determine feasibility of specific change projects.

    Reading Due

    Read

    (n.d.).
    Evidence based practice toolkit for nursing
    .

    Eberhart, A. E. (2014).
    Quality improvement needs assessment for evidence-based practice readiness in primary care
    [Unpublished doctoral dissertation]. Graduate School of The Ohio State University.

    Example of a finished project.

    Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture.
    PloS one
    ,
    14
    (12), e0226742.
    https://doi.org/10.1371/journal.pone.0226742

    Duke University. (n.d.).
    Model one: Intro to EBP
    .

    This website is a good review of EBP that you had in NUR551. It may be helpful as a guide for this course.

    S. Department of Health and Human Services. (n.d.).
    Readiness assessment & developing project aims
    .

    Agency for Healthcare Research and Quality. (2015, August).
    Readiness Assessment
    .

    Review

    Organizational culture and system wide interrogation of EBP survey, EBP beliefs, and EBP implementation scale in Appendix K of Melnyk & Fineout-Overholt (2019).

     

    Examples of EBP Topics for Project

    AAFP

    North Dakota center for Nursing
    : Please choose from Family Practice or Geriatric/Long-Term care topics.

    Assignments Due

    Acknowledgment Quiz

    Points Possible:
    Ungraded

    Due:
    Wednesday, 11:59 p.m. EST/EDT

     

    After reviewing the Textbooks & Information area, the student will complete a short quiz to acknowledge that he or she reviewed the syllabus, grading rubrics, and SAU’s Policy on Academic Integrity. Completion of the quiz counts for attendance in Week 1 of the course. By clicking Yes, you acknowledge that you completed and understood the required tasks NUR 681 Integration of Evidence for Advanced Practice.

    ORDER A CUSTOM-WRITTEN PAPER OR EXAM NOW

    2.    Evidence-Based Proposal – Introduction

    This is the beginning of the Evidence-Based Practice Proposal, which will be completed by writing a section each week and editing the document with feedback from the professor each week. The final product is due in Week 7 and is the culmination of the course. Each week the section due will be graded and returned with suggestions for improvement. Students need to make the suggested changes and/or add to the document for the final grading process.

    3.    Section A: Organizational Culture and Readiness Assessment

    Points Possible:
    28 points

    Due:
    Sunday, 11:59 p.m. EST/EDT

     

    Before making a case for an evidence-based project, it is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation.

    Complete an assessment of your clinical practice site using questions from the samples in the Week 1 Bb folder, “Organizational Culture and Readiness for System-Wide Integration of EBP Survey,” “EBP Beliefs,” and “EBP Implementation Scale.” Use as many questions from these samples to accurately assess readiness for change in your organization. You will use personal reflection of your experience in the clinical setting. The setting may be your job site or a student clinical placement.

     

    Develop an analysis summary of at least 250 words from the results of your questions addressing your organization’s readiness level, possible project barriers and facilitators, as well as how to integrate clinical inquiry. Make sure to include the rationale for your answers on the questionnaire, incorporating details and examples. Also, explain how to integrate more clinical inquiry into the organization, providing strategies that strengthen the organization’s weaker areas. The actual questionnaire results do not need to be included.

     

    The grading guidelines for this assignment are in the rubric section of this syllabus. Upon receiving feedback from the instructor, revise Section A: Organizational Culture and Readiness Assessment for your final paper submission. This will be a continuous process throughout the course for each section.

     

    Submit work to the assignment link in Blackboard. Use the naming convention:

    NUR681_LastName_FirstInitial_EBPSectionA1.docx

    4.    Discussion Board

    Points Possible:
    16 points

    Due:
    Initial post by Thursday, 11:59 p.m. EST. Two responses by Sunday, 11:59 p.m. EST.

    Review the
    “Rapid Critical Appraisal Checklists” Appendix B
    in your course text. You should save this tool and use it throughout the development of the PICOT question, problem description, and literature review. Begin the development of your PICOT question using the following resource: Melnyk & Fineout-Overholt,
    Appendix A: Template for Asking Clinical Questions.

     

    Formulate your PICOT question and post it to the Week 1 Discussion Board. Respond to at least two other statements, providing feedback on their clinical questions regarding relevance to primary care practice. Review the statements to see if the clinical issue is clearly defined and that all aspects are identified. Also, refer to the “PICOT: Components of an Answerable, Searchable Question” Table 2.2 in your text, p. 40. If one PICOT statement has at least three feedback posts, move to another statement. You will be using the feedback to make revisions to your PICOT question before using it in your
    Section B of Final Proposal: Problem Description
    assignment.

     

    Respond to at least 2 other statements, providing feedback on their clinical questions regarding relevance to primary care practice. Review the statements to see if the clinical issue is clearly defined and that all aspects are identified NUR 681 Integration of Evidence for Advanced Practice.

    See the Discussion Boards and Blackboard Netiquette policies in the Course Expectations of this syllabus. Include required readings and outside references for your Discussion Board post. Respond to at least two of your peers’ posts. Your responses should be substantive and supported by cited sources
    .

    Week 2

    Topics

    Making the Case for Evidence-Based Practice

    Learning Objectives

    Analyze practice versus research to recognize a change.

    Assess stakeholders, team roles, and leadership skills needed to bring about change.

    Create EBP objectives that are aligned to measurable outcomes.

    Reading Due

    Melnyk & Fineout-Overholt (2019):

    Chapter 3: Finding relevant evidence to answer clinical questions: Tools for Finding the Needle in the Haystack, pp. 55-92.

    (n.d.).
    Topics
    .

    This resource has topics that may give you specific information on change projects. It also has research reports, sources of data and tools useful to translating evidence into practice.

    Stevens, K., Marcley, S., DeGrazia, M., & Schuler, E. (2019, July 12).
    The Stevens Star Model of Knowledge Transformation to improve care and outcomes
    [Video]. OPENPediatrics.

    Assignments Due

    1.    Section B: Problem Description

    Points Possible:
    36 points

    Due:
    Sunday, 11:59 p.m. EST/EDT

     

    Write a paper of 500-750 words (not including the title page and reference page) on your proposed problem description for your EBP project. The paper should address the following:

    Describe the background of the problem. Tell the story of the issue and why it deserves attention. Identify the stakeholders/change agents and who or what organizations are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc. Use the feedback from this week’s (Week 2) Discussion Board post, and refine your PICOT question for the final proposal. Make sure that the question fits with your graduate degree specialization.

    State the purpose or goal and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus on how to answer the question.

    Provide supportive rationale that the problem or issue is an important one for nursing to resolve; use relevant professional literature sources.

    Develop an initial reference list to assure that there is adequate literature to support your evidence-based practice project. The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ), and others may be used when you are gathering statistics to provide the rationale for the problem.

    Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence-based project, you must have enough evidence to introduce this as a desired practice change. If you find that you do not have enough supporting evidence to change a practice, further research would need to be conducted NUR 681 Integration of Evidence for Advanced Practice.

    The grading guidelines for this assignment are in the rubric section of this syllabus. Upon receiving feedback from the instructor, refine Section B: Problem Description for your final submission. This is a continuous process throughout the course for each section.

     

    Submit work to the assignment link in Blackboard. Use the naming convention:

    NUR681_LastName_FirstInitial_EBPSectionB2.docx

    2.    Discussion Board

    Points Possible:
    16 points

    Due:
    Initial post by Thursday, 11:59 p.m. EST. Two responses by Sunday, 11:59 p.m. EST.

    Answer this question in a minimum 250-word post in the Week 2 Discussion Board: What strategies will you use in your new practice as an APN to review and critique literature pertinent to your practice? Respond to at least two others.

    See the Discussion Boards and Blackboard Netiquette policies in the Course Expectations of this syllabus. Include required readings and outside references for your Discussion Board post. Respond to at least two of your peers’ posts. Your responses should be substantive and supported by cited sources.

    Week 3

    Topics

    Critical Appraisal of the Evidence

    Learning Objectives

    Formulate research support.

    Critically appraise the best available evidence for the proposed solution.

    Recognize the validity and reliability of clinical recommendations for practice.

    Reading Due

    Bramer et al.
    Systematic Reviews
    (2016) 5:39.

    Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010).
    Evidence-based practice step by step: Critical appraisal of the evidence: Part I.

    AJN The American Journal of Nursing, 110
    (7), 47-52.

    Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010).
    Evidence-Based Practice, Step by Step: Critical Appraisal of the Evidence: Part II: Digging deeper—examining the “keeper” studies.

    AJN The American Journal of Nursing, 110
    (9), 41-48.

    Assignments Due

    1.    Section C: Literature Support

    Points Possible:
    36 pints

    Due:
    Sunday, 11:59 p.m. EST/EDT

     

    To begin, work through the reference list you created in Section B: Problem Description. Appraise each resource using the one of the “Rapid Critical Appraisal Checklists” located in
    Appendix B, pp. 708-722
    of the Melnyk & Fineout-Overholt text in the course materials or other literature review tools such as the ones used in NUR 551 in the Johns Hopkins Model. The specific checklist you use will be determined by the type of evidence within the resource (i.e., case-control studies, or cohort studies, etc.).

     

    Develop an “Evidence Synthesis” table to organize and summarize the research studies. Using a summary table allows you to be more concise in your narrative description. Only research studies used to support your intervention are summarized in this table. Refer to the “Evaluation and Synthesis Tables” templates in
    Appendix C, pp. 723-727
    of the Melnyk & Fineout-Overholt text, or you may use this table that uses the PICO to summarize the research studies:

     

    Author, title,

    journal

    P
    opulation

    I
    ntervention

    C
    omparison

    O
    utcome

    V
    alidity

     

    Write a narrative of 750-1,000 words (not including the title page and reference list) that presents the research support for the project’s problem and proposed solution. Make sure to do the following:

    Include a description of the search method (e.g., databases, keywords, criteria for inclusion and exclusion, and number of studies that fit your criteria).

    Summarize all of the research studies used as evidence. The essential components of each study need to be described so that readers can evaluate its scientific merit, including study strengths and limitations.

    Incorporate a description of the validity of the internal and external research.

     

    It is essential to make sure that the research support for the proposed solution is sufficient, compelling, relevant, and from peer-reviewed professional journal articles. Please, submit the checklist information and the evaluation table you design for the instructor as well as the narrative that summarizes the information.

     

    The grading guidelines for this assignment are in the rubric section of this syllabus. Upon receiving feedback from the instructor, refine Section C: Literature Support for your final submission. This will be a continuous process throughout the course for each section.

     

    Submit work to the assignment link in Blackboard. Use the naming convention:

    NUR681_LastName_FirstInitial_EBPSectionC3.docx

    2.    Discussion Board

    Points Possible:
    16 points

    Due:
    Initial post by Thursday, 11:59 p.m. EST. Two responses by Sunday, 11:59 p.m. EST.

    What factors must be assessed when critically appraising quantitative studies? Which is the most important? Why? Submit answers in a 250-word post and respond to two peers.

    See the Discussion Boards and Blackboard Netiquette policies in the Course Expectations of this syllabus. Include required readings and outside references for your Discussion Board post. Respond to at least two of your peers’ posts. Your responses should be substantive and supported by cited sources NUR 681 Integration of Evidence for Advanced Practice.

    Week 4

    Topics

    Analyzing Evidence-Based Practice Outcomes

    Learning Objectives

    Critique measurements for expected outcomes (validity and reliability).

    Describe the obstacles or barriers to implementing evidence-based practice.

    Explain why patient values and clinical judgment must be considered before applying the evidence in clinical decision making for an individual patient.

    Reading Due

    Melnyk & Fineout-Overholt (2019):

    Chapter 7: Integration of Patient Preferences and Values and Clinician Expertise into Evidence-Based Decision-Making, pp. 219-232.

    Chapter 8: Advancing Optimal Care with Clinical Practice Guidelines and Evidence based Recommendations, pp. 233-256.

    Assignments Due

    1.    Section D: Solution Description

    Points Possible:
    60 points

    Due:
    Sunday, 11:59 p.m. EST/EDT

     

    Write a paper of 500-750 words (not including the title page and reference list) for your proposed evidence-based practice project solution. Address the following criteria:

    Proposed Solution:

    Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention.

    Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing.

    Organization Culture:
    Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.

    Expected Outcomes:
    Explain the expected outcomes of the project. The outcomes should flow from the PICOT.

    Method/s to Achieve Outcomes:
    Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations that may need to be addressed.

    Outcome Impact:
    Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, and/or professional expertise.

    The grading guidelines for this assignment are in the rubric section of this syllabus. Upon receiving feedback from the instructor, refine Section D: Solution Description for your final submission. This will be a continuous process throughout the course for each section.

     

    Submit work to the assignment link in Blackboard. Use the naming convention:

    NUR681_LastName_FirstInitial_EBPSectionD4.docx

    2.    Discussion Board

    Points Possible:
    16 points

    Due:
    Initial post by Thursday, 11:59 p.m. EST. Two responses by Sunday, 11:59 p.m. EST.

     

    Conducting research projects while ensuring the protection of human subjects is necessary. What are some methods to protect personal rights of someone in one of the groups that is labeled as vulnerable? Justify your rationale. Post your 250-word initial post and respond to two classmates.

     

    See the Discussion Boards and Blackboard Netiquette policies in the Course Expectations of this syllabus. Include required readings and outside references for your Discussion Board post. Respond to at least two of your peers’ posts. Your responses should be substantive and supported by cited sources.

     

     

    Week 5

    Topics

    Evidence-Based Practice Implementation Model

    Learning Objectives

    Analyze the components associated with implementing evidence-based practice.

    Differentiate between the following models for applying evidence-based practice: Stetler model, Iowa model, and the ARCC model NUR 681 Integration of Evidence for Advanced Practice.

    Reading Due

    Melnyk & Fineout-Overholt (2019):

    Chapter 14: Models to guide implementation and sustainability of evidence-based practice, pp. 378-427.

    Nilsen, P. (2015).
    Making sense of implementation theories, models and frameworks
    .
    Implementation Science, 10
    (53), 1-13.

    Open Access

    Sigma Global Nursing Excellence. (2017, September 17). Iowa model of evidence-

    based practice: Revisions and validation Worldviews on Evidence-Based Nursing.

    https://sigmapubs.onlinelibrary.wiley.com/doi/abs/10.1111/wvn.12223

    Assignments Due

    1.    Section E: Change Model

    Points Possible:
    32 points

    Due:
    Sunday, 11:59 p.m. EST/EDT

     

    In 500-750 words (not including the title page and reference page), critique change models for feasibility for your practice problem.

     

    Review the resources that describe the following change implementation models:

    Stetler model of evidence-based practice

    Advancing Research and Clinical Practice through Close Collaboration model (ARCC)

    Iowa model of evidence-based practice to promote quality care

     

    You will use one of these models in the actual implementation plan for Week 6. For this Week 5 assignment, analyze the above models for suitability to use in your proposed practice change described in the previous sections of your proposal.

     

    Include the following:

    Assumptions of the model – “assumptions, aims and other characteristics, which have implications for their use” (Nilsen, 2015) must be recognized in order to determine the best model to follow.

    Evidence that the model can be used for your type of project (i.e., primary care versus acute care).

    Able to guide the process of implementation for your project. In other words, you can use the model to create objectives for the process of implementation, and it will describe what you want to do in your project very well.

    In addition, create a conceptual model of your project. This model may be a combination of elements from the three models above or a self-determined diagram that allows the reader to see your whole project pictorially. Submit a draft of the conceptual model you design in this week as an appendix on a separate page, so it can be reviewed by your instructor. The final version of the conceptual model will be due in the appendices of the final paper.

     

    The grading guidelines for this assignment are in the rubric section of this syllabus. Upon receiving feedback from the instructor, refine Section E: Change Model for your final submission. This will be a continuous process throughout the course for each section.

     

    Submit work to the assignment link in Blackboard. Use the naming convention:

    NUR681_LastName_FirstInitial_EBPSectionE5.docx

    ORDER A CUSTOM-WRITTEN PAPER OR EXAM HERE

    2.    Discussion Board

    Points Possible:
    16 points

    Due:
    Initial post by Thursday, 11:59 p.m. EST. Two responses by Sunday, 11:59 p.m. EST.

    Why is it important to incorporate a theory or model related to change when implementing practice changes? Does the benefit of incorporating a change model outweigh the time and effort it took to include it? Post your answer to these questions in a 250-word post and respond to two other classmates.

    See the Discussion Boards and Blackboard Netiquette policies in the Course Expectations of this syllabus. Include required readings and outside references for your Discussion Board post. Respond to at least two of your peers’ posts. Your responses should be substantive and supported by cited sources NUR 681 Integration of Evidence for Advanced Practice.

    Week 6

    Topics

    Evidence-Based Practice Implementation Model

    Learning Objectives

    Using an EBP model describe a plan for implementing a change project.

    Develop strategies to counter opposition and facilitate change.

    Design processes to evaluate outcomes

    Reading Due

    Melnyk & Fineout-Overholt (2019):

    Chapter 9: Implementing Evidence in Clinical Settings, pp. 269-292.

    Chapter 10: The Role of Outcomes in Evaluating Practice Change, pp. 293-312

    Assignments Due

    1.    Section F: Implementation Plan

    Points Possible:
    36 points

    Due:
    Sunday, 11:59 p.m. EST/EDT

     

    In 500-750 words (not including the title page and reference page), provide a description of the methods to be used to implement the proposed solution. Carry your implementation through each of the stages, phases, or steps identified in the chosen model. Include the following:

     

    Describe the
    setting and access to potential subjects
    . If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval form(s) in this week with the narrative, the consent or approval form(s) should be placed in the appendices for the final paper.

     

    Describe the
    amount of time needed to complete this project
    . Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in this week with the narrative, the timeline should be placed in the appendices for the final paper.

     

    Describe the
    resources (human, fiscal, and other) or changes
    needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Place this list in the appendices for the final paper.

     

    Describe the
    methods and instruments
    , such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments and place in the appendices for the final paper. Describe the rationale for the methods used in collecting the outcome data. Describe the ways in which the outcome measures evaluate the extent to which the project objectives are achieved. Describe how the outcomes will be measured and evaluated based on the evidence. Address validity, reliability, and applicability. Describe strategies to take if outcomes do not provide positive results. Describe implications for practice and future research.

     

    Explain the
    process for delivering the (intervention) solution
    and indicate if any training will be needed. Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Place all tools in the appendices for the final paper.

     

    Describe the
    strategies
    to deal with the management of any barriers, facilitators, and challenges. Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment, computer related costs, and other costs (travel, presentation, database access, consultation). Make sure to provide a brief rationale for each. Develop a budget plan. Place the budget plan in the appendices for the final paper.

     

    The grading guidelines for this assignment are in the rubric section of this syllabus. Upon receiving feedback from the instructor, refine Section F: Implementation Plan for your final submission. This will be a continuous process throughout the course for each section.

     

    Submit work to the assignment link in Blackboard. Use the naming convention:

    NUR681_LastName_FirstInitial_EBPSectionF6.docx

    2.    Discussion Board

    Points Possible:
    16 points

    Due:
    Initial post by Thursday, 11:59 p.m. EST. Two responses by Sunday, 11:59 p.m. EST.

    In a 250-word post, describe an evaluation plan that includes how the expected change outcomes will be measured and how the implementation process outcomes will be measured. Review page 285, Table 9.4. Please, use this table to show your plan and describe the plan in the 250-word narrative: NUR 681 Integration of Evidence for Advanced Practice

     

    Element

    Expected Change

    Outcomes

    Implementation

    Process Outcomes

     

    Respond to two classmates.

     

    See the Discussion Boards and Blackboard Netiquette policies in the Course Expectations of this syllabus. Include required readings and outside references for your Discussion Board post. Respond to at least two of your peers’ posts. Your responses should be substantive and supported by cited sources.

    Week 7

    Topics

    Disseminating Evidence

    Learning Objectives

    Compile the seven sections of the proposal into a final formal paper.

    Create an evaluation plan based on the project objectives developed during Week 4 assignment.

    Develop an evidence-based presentation to present the major sections of the proposal to an audience of nursing professionals.

    Reading Due

    Melnyk & Fineout-Overholt (2019):

    Chapter 20: Disseminating Evidence through Publications, Presentations, Health Policy Briefs, and the Media, pp. 547-597.

    Elsberry, L., & Mirambeau, A. (n.d.).
    Creating an effective dissemination plan
    . Center for Disease Control and Prevention.

    Assignments Due

    1.    EBP Proposal Final Paper

    Points Possible:
    36 points

    Due:
    Sunday, 11:59 p.m. EST/EDT

     

    Throughout this course you have been developing a formal, evidence-based practice proposal to improve quality of care or improve healthcare outcomes. The proposal is the plan for an EBP project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence.

     

    Proposals are submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed, they can be between 3,500 and 5,000 words, approximately 11-16 pages. The cover sheet, abstract, references page, and appendices are not included in the word limit. A proposal with less than 11 pages or more than 16 will be charged a penalty in grading.

     

    Section headings are required for each section exactly as outlined below.
    Evaluation of the proposal in all sections is based upon the extent to which the depth of content reflects graduate-level, critical-thinking skills.

     

    This project contains seven formal sections:

    Section A: Organizational Culture and Readiness Assessment

    Section B: Problem Description

    Section C: Literature Support

    Section D: Solution Description

    Section E: Change Model

    Section F: Implementation Plan

    Section G: Dissemination of Evidence

     

    The first six sections were submitted as separate assignments, so your instructor could provide feedback as noted above. Section G: Dissemination of Evidence is a new section to be included in the final paper/proposal but will not have feedback from the instructor. The final paper consists of the completed project (with revisions), title page, abstract, reference list, and appendices. Appendices will include a conceptual model for the project (figure, picture, or line drawing showing connection of key concepts), handouts, data and evaluation collection tools, a budget, a timeline, and resource lists.

     

    The grading guidelines for this assignment are in the rubric section of this syllabus.

     

    Submit work to the assignment link in Blackboard. Use the naming convention:

    NUR681_LastName_FirstInitial_FinalEBP7.docx

    2.    Discussion Board

    Points Possible:
    16 points

    Due:
    Initial post by Thursday, 11:59 p.m. EST. Two responses by Sunday, 11:59 p.m. EST.

    Develop a PowerPoint presentation no longer than 10 slides with comprehensive speaker’s notes that cover all of the major sections of your proposal. The major objective of this presentation is to make the case for the project you want to do. You will need to post your presentation to the Discussion Board as directed by the instructor for class discussion and peer feedback.

    While APA Style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA Style documentation guidelines. You are NOT required to submit this assignment to SafeAssign.

     

    This discussion board is worth 16 points. However, the grading rubric is different than the other discussion board rubrics. See the grading guidelines for the Week 7 presentation discussion board in the rubric section of this syllabus.

     

    See the Discussion Boards and Blackboard Netiquette policies in the Course Expectations of this syllabus. Include required readings and outside references for your Discussion Board post. Respond to at least two of your peers’ posts. Your responses should be substantive and supported by cited sources NUR 681 Integration of Evidence for Advanced Practice.

    Course Expectations

    The MSN program writes all courses at the graduate level and reflects learner outcomes espoused by the Essentials of Master’s Education for Advanced Practice Nursing, National League for Nursing: Core Competencies of Nurse Educators, National Organization of Nurse Practitioner Faculties: Domains and Core Competencies of Nurse Practitioner Practice, Nurse Executive (KSA), and the Spring Arbor University graduate requirements. Online learning requires participatory, collaborative interactions between students and students-to-faculty. Seminar and discussion format promote metacognitive reasoning by requiring students to utilize reflective thought to synthesize and apply information within the context of advanced professional practice and expound on the ideas of others.

     

    Spring Arbor University is a community of learners distinguished by our lifelong involvement in the study and application of the liberal arts, total commitment to Jesus Christ as the perspective for learning, and critical participation in the contemporary world. As an SAU student, you are expected to support the Spring Arbor University Concept. All students will work together in the Blackboard online environment with opportunities for group and face-to-face sessions. Online learning requires participatory, collaborative interactions between students and students-to-faculty. Seminar and discussion format promote metacognitive reasoning by requiring students to utilize reflective thought to synthesize and apply information within the context of advanced professional practice and expand on the ideas of others.

     

    The MSN online graduate program design assumes that each student is a self-directed adult learner. Each student is responsible for completing all course requirements including but not limited to readings, postings, and written assignments on time and in a manner that reflects graduate level work. As adult learners, students bring life experiences and knowledge from a variety of venues into the learning environment. Building on this premise requires respect from fellow students as colleagues and faculty as facilitators. Students should actively participate in learning activities as individuals and collaborative team members. The goal is to facilitate learning for all within the community of learners.

     

    As graduate nursing students, you are expected to have professional behaviors and actions grounded in the
    American Nurses Association (ANA) Scope and Standards of Practice
    ,
    ANA Code of Ethics
    , and guidelines from state boards of nursing, which comprise the National Council of State Boards of Nurses (NCSBN) and the nurse practice act within the licensee’s state of practice. Licensure must be kept up-to-date and on file in the Graduate Office throughout the program. Any violation of professional nursing practice guidelines may result in disciplinary action at the academic and/or professional level as deemed by the university and nursing faculty.

    Academic Integrity

    Students will adhere to the policy of the university found in the
    MSN Graduate Handbook
    . The MSN program will approach problems from a Christian perspective that reflects both justice and compassion. Interactions should first take place between the faculty and student. The instructor, in accordance with policy, will determine sanctions.

     

    Spring Arbor University expects that students and faculty will follow the principles of truth and honesty in all academic endeavors, including the preparation and presentation of lectures, preparation of class reports and papers, giving and taking of examinations, and in protecting the validity of assigned grades. This assumes that all work will be done by the person who purports to do the work, without unauthorized aids or assistance. Instructors will exercise due diligence in planning and supervising the academic program to uphold the principles of truth and honesty.

    SAU-MSN Academic Integrity (SafeAssign)

    SafeAssign is a plagiarism prevention software tool embedded into Blackboard. This tool encourages students to submit original work that reflects the highest levels of scholarly integrity and to prevent instances of plagiarism. Students and faculty are to utilize SafeAssign for all written assignments submitted in this course NUR 681 Integration of Evidence for Advanced Practice.

    According to Merriam-Webster’s (n.d.) online dictionary,
    plagiarism
    is “an act or instance of plagiarizing, something plagiarized, the act of using another person’s words or ideas without giving credit to that person: the act of plagiarizing something.” It is also defined as using another individual’s product without proper citation. In other words, plagiarism occurs when you either intentionally or unintentionally present the words, thoughts, and ideas of another person as your own original work. Some examples include the following:

    Copying and pasting,

    Failing to cite sources,

    Purchasing papers online,

    Proofing and editing by another person that results in substantial edits, and

    Using a paper from another course without citing self or others.

      ORDER A PLAGIARISM FREE PAPER NOW

    When a student submits an assignment to SafeAssign, the program generates an originality report. The originality report provides a percentage that indicates how much of the paper is attributed to other sources. The report also highlights the potential infractions and provides a link that allows one to compare the student’s work with other sources. Typically, a score of 15% or less most likely reflects original work; scores of 40% or higher are generally reflective of excessive reliance on outside sources.

     

    Students have two ways to drop a paper into SafeAssign. A student may submit a draft paper (prior to the due date) to SafeAssign, review the originality report, and make corrections before submitting the final assignment.
    Faculty will not review the draft paper or make any suggestions for corrections.
    This optional step is an opportunity for students to improve their use of APA Style and grammar to build on scholarly writing skills. Once the student submits the final assignment, he or she will NOT be able to make edits or changes; the final assessment and the calculation of the assignment’s grade will use this final SafeAssign originality score. While instructors will interpret each report cautiously, typically a paper that receives a SafeAssign score of 21% or higher likely reflects over reliance on outside sources and could receive a zero. Therefore, students SHOULD SUBMIT DRAFTS of their papers and make the needed corrections PRIOR to submitting their papers for a grade.

     

    When a faculty member has determined that plagiarism has occurred, he or she will follow the Academic Integrity policies. See the SAU Academic Integrity Policy, found electronically on the SAU Portal, for further information. The program may dismiss students with a pattern of plagiarism, whether intentional or unintentional.

    Accommodation for Students with Disabilities

    Spring Arbor University, in compliance with Federal regulations and in support of our efforts to enable students to maximize their God-given talents and abilities, provides the Academic Student Connections (ASC) office to direct academic services for students with disabilities.

     

    Students with disabilities may request accommodations as provided within federal law. Documentation and requests should be made to the Disability Services Coordinator as early in the semester as possible to prevent delays in accommodation. Students must fill out a
    Student Support Plan Request
    to start the accommodations process. Students may contact the ASC office (517-750-6481 or 517-750-6479). Further information regarding policies and guidelines can be found on the
    Students with Disabilities website
    .

     

    Please watch the
    Academic Student Connections
    video to learn more about the accommodations process and the resources Academic Student Connections provides.

    Attendance and Financial Aid

    If the student drops the course or if the student is dropped from the course by the institution, recalculation of financial aid eligibility may be necessary. Students have until no later than the 7th calendar day of an online session to voluntarily drop from a course without financial penalty. A course dropped before the 7th calendar day also will not appear on a student’s transcript. After that date, students have until the midpoint in the course to voluntarily withdraw. A withdrawal results in a “W” in the academic record and may result in a partial refund on tuition. Withdrawing from a course after the designated withdrawal period deadline will result in a “U” on the academic record and no tuition refund. Upon discretion of an SAU online administer or the instructor of record, the program may withdraw a student in attendance of an online course if he or she does not log in or attend the course by the 8th day of the course and/or ceases to actively participate throughout the course. Any potential tuition refund will be based on the date of the withdrawal. An administrative withdrawal from a course, after the halfway point, will result in a “U” on the student’s academic record and no tuition refund. Academic programs may have requirements beyond those outlined in this policy for which a student will be accountable. Please review the
    Student Handbook
    for additional information NUR 681 Integration of Evidence for Advanced Practice.

    Attendance and Participation Policy

    In an online course, Blackboard records attendance when students log in and make a posting (i.e., discussion board, journal, wiki, blog) or interact within group interactions or submit written assignments and/or tests. This participation, as required by the syllabus guidelines, constitutes attendance. Failure to make the required postings, group interactions, or written assignments within the specified timeframe constitutes absence or tardiness. Blackboard records attendance when a student logs in and participates as outlined above and is automatically evaluated each week. Students must interact with Blackboard in order to qualify for financial aid.

    Blackboard Netiquette

    Professional role development includes learning and mastering the use of professional demeanor and communication patterns. Netiquette describes how to clearly and respectfully communicate in the online environment to direct professional communication. Words can convey many messages; when communicating online, body language, tone, and other non-verbal cues are not available to the recipient which may result in confusion or a misinterpretation of the sender’s intent. Therefore, students should apply netiquette guidelines to all online discussions and communication, including email, to avoid perceived disrespect, anger, rudeness, or yelling. Following are some basic netiquette guidelines:

    Avoid the use of “ALL CAPS,” which could imply that you are shouting or yelling.

    Reserve the use of italics, bolding, underlining, non-black, or non-standard fonts for specially warranted situations, if used at all. Employ SAU standardized font and type preset in email and Blackboard in all communications. Avoid changing fonts or type settings within single communications.

    Include a subject, appropriate salutations, and a respectful closing in all emails. Provide a signature line that includes your name and title, when appropriate.

    Use your assigned SAU academic email address for all course communications.

    Avoid lengthy dialogs in emails; include pertinent ordered content pointed at addressing the subject of the email.

    Avoid the use of emojis and images that may be misinterpreted.

    Respond to emails in a timely fashion; the normal expected response time is within 24-48 hours of receipt, or sooner when possible.

    Use positive tone. Tone reflects the attitude and intention of communication based on the way a message is written. Careful attention to tone by always using courteous words and expression can assure that the message is perceived as intended by the recipient.

    Proof read all initial messages or responses carefully before posting or sending them to assure that what you said is what you mean.

    Avoid the use of sarcasm or jokes that can be misinterpreted as hurtful or rude. The online community of learners includes a diverse population of students and faculty; such diversity can alter expected interpretation of such comments. Therefore, use language and terminology free of double meanings, slang, abbreviations, and sensitive or emotional connotations.

    Honor the opinions and work of others. Respect the rights of others to disagree with your viewpoint.

    Avoid replies to any message if angry. Anger inspires anger, so take time to calm down before responding.

    Avoid intentional attacks (flaming) on individuals or groups within the learning community environment. Such behavior can include bullying, insults, or use of other disrespectful words. Flaming is a means to force one’s viewpoint on another person in a destructive way. The wholesome netiquette environment avoids flaming activities.

    Write to the best of your ability for all communication. Always check grammar, spelling, sentence structure, punctuation, and clarity of expression NUR 681 Integration of Evidence for Advanced Practice.

    Course Evaluation

    Students may provide feedback, comments, and suggestions to the instructor and program director throughout the course. Students will complete a formal online course evaluation as soon as possible at the end of every course. The instructor will not see the results until after he or she posts the final grades. Evaluations are utilized to provide evidence of course effectiveness and promote ongoing program improvement.

    Discussion Boards (DB)

    The course material or directions for the initial discussion board posting will make clear the expectations for discussions. The instructor will provide feedback for discussion threads to enhance learning. All postings should be meaningful, constructive, relevant, substantive, and follow online netiquette rules. In-text citations and references should follow guidelines provided by the
    Publication Manual of the American Psychological Association
    (APA)
    .

     

    Discussion board assignments are important learning activities for MSN students. Students use the online discussion board to interact with other students and faculty according to the assignment. Additionally, in regard to the discussion board assignments and responses, students will meet the following expectations:

    Follow the appropriate syllabus and Blackboard course guidelines.

    Utilize correct grammar, spelling, punctuation and style, which includes APA format. In addition to course textbook(s) and resources provided, you are required to cite a minimum of two additional outside scholarly sources to support your discussion. A typical, well-written initial post will consist of approximately 250 words or more (not counting the reference list) and will effectively utilize content from required readings as well as other professional literature sources. You will use integration and critical thinking by applying content from your resources into a well-written document.

    Use concise language that reflects graduate-level interactions for all posts and responses. Include a greeting and your name at the end of each post. Composing a post as a Word document first may help avoid negative or inflammatory language, encourage use of the spelling and grammar tool, and saves work should there be an interruption prior to or during posting. Be encouraging but not superfluous in your responses. Well-written peer responses should be approximately 100-150 words each and include a minimum of one in-text citation and corresponding reference from the required readings and/or professional literature inquiry.

    Postings are private and for class use only; they are not to be shared or posted to YouTube, Twitter, or personal Blogs. They are not to be distributed to anyone outside of the

    Faculty Interaction

    Students may contact the instructor through direct email via the arbor.edu address. The instructor will ordinarily respond within 24 hours, but no later than 48 hours. If the instructor must be absent, students will be notified of the absence and the instructor’s expected date of return. If necessary, the class will have an alternate substitute instructor.

    Faith and Learning

    The culture of advancing professional skills and evidence-based practice (EBP) demands integrity in doing assignments, practicing new skills and sharing concerns with each other. Each course seeks to promote a Christian perspective and worldview that recognizes the dignity and worth of each individual. Inherent in this belief is honor towards God and His creation. Faculty and students will speak the truth in love and in a manner that edifies one another. Compassion and encouragement are means of conveying a Christ-like attitude and promotes the tenets of the nursing profession. The nursing program at Spring Arbor University recognizes nursing as both a calling and a profession NUR 681 Integration of Evidence for Advanced Practice.

    Inclusivity Statement

    SAU students and faculty represent a rich variety of backgrounds and perspectives. The MSN program is committed to providing an atmosphere for learning that respects diversity. While working together to build this community we ask all members to:

    share their unique experiences, values, and beliefs;

    be open to the views of others;

    honor the uniqueness of their colleagues;

    appreciate the opportunity that we have to learn from each other in this community;

    value each other’s opinions and communicate in a respectful manner;

    keep confidential discussions that the community has of a personal (or professional) nature; and

    use this opportunity together to discuss ways in which we can create an inclusive environment in this course and across the SAU MSN community.

    Late Submission of Assignments

    Note that all due date times are EST/EDT. Students residing in other time zones should make a note of this. Assignments, projects, and group work turned in after the due date will receive a penalty based on the number of calendar days late. Assignments more than five days late will receive 0 points.

    Late Point Deductions by Calendar Day

    Calendar Days Late

    Penalty

    One

    -10%

    Two

    -20%

    Three

    -30%

    Four

    -40%

    Five

    -50%

     

    Assignments turned in more than five days past the due date will not be accepted. Assignments will not be accepted after the final date of the course. Students with extenuating circumstances (hospitalization, death in the family, etc.) should contact their instructors in writing prior to the assignment due date or as soon as possible following the emergency.
    Please, note that technical difficulties are not defined as extenuating circumstances.
    The instructor will exercise his or her professional discernment in deciding to accept the late work and what, if any, penalty will be assessed NUR 681 Integration of Evidence for Advanced Practice.

    Naming Convention

    Standardization of naming convention for assignment labeling is Course ID _ last name _ first initial _ assignment title and week that the assignment is to be submitted.

    Style:
    NUR###_LastName_FirstInitial_AssignmentWk#

    Example:
    NUR601_Doe_J_HealthInterview1

     

    Note that the 1 designates the Week the Assignment is due in (i.e., Week 1).

    Prayer Requests, Chapel, and Break Room

    Participation in the online Chapel area is voluntary. Everyone is invited and welcome to enter at any time. Another area is the Break Room. As professional nurses, present problems in these areas to the faculty. Participants will use confidence, dignity, and respect for all individuals.

    ORDER A CUSTOM-WRITTEN PAPER OR EXAM HERE

    Quiz/Examination Settings

    To better prepare students for taking national board examinations, the following guidelines are for quizzes and examinations accessed in Blackboard. Unless otherwise noted, each Blackboard quiz or test will follow the protocols listed below:

    Students will access quizzes and examinations between Wednesdays at midnight to Sundays, 11:59 p.m. EST/EDT.

    Students will see one question at a time.

    Students are not permitted to backtrack to previous questions.

    Students must complete each question before the next question will display.

    Students’ answers will be auto-submitted.

    Students’ questions will be presented in random order.

    Students will see only the final test scores; item feedback and rationale will not be available.

     

    NOTE:
    Students should be aware that there are some exceptions to these afore mentioned quiz/examination guidelines. Some courses allow for multiple attempts; other courses might use a publisher website with different guidelines. Always note designated time allotments for taking examinations. The course will address any deviation from the prior mentioned protocols, so always be sure to carefully review the quiz instructions in the assignment forum. A demonstration video on how to take quizzes or examinations is in Blackboard located under the Start Here tab from your course’s home page.

    Rounding Policy

    B- is the lowest passing grade for each assignment and for the final composite score in this course. The only time a score will be rounded up will be for the final grade. At that time, if the tenths place digit is greater than or equal to 5, the grade will be rounded up to the next whole number. Grades are reported on the final grade roster as a letter grade based on the earned whole number grade range, as indicated above.

     

    Examples: A composite score or final grade for the course is 86.5. The student’s whole number grade will be rounded up to 87 = B+. A final grade average of 94.4 = 94 or A-. Please note, that final grades will be rounded using the first decimal place ONLY. The one-hundredth place will not factor into the final rounding of the grade. For example, a final grade of 86.58 will be rounded based on 86.5, which is rounded up to 87.

    Technical Support

    Students experiencing technical difficulties should contact the SAU
    Help Desk
    at 877-728-9880. The
    Help Desk
    is open Monday-Thursday from 7:30 a.m.-10:00 p.m., Fridays 7:30 a.m.-5:00 p.m., Saturdays from 1:00-4:00 p.m., and Sundays from 1:00-10:00 p.m. (NOTE: All times are EST/EDT.)

    Writing Standard

    Students should use the textbook,
    Publication Manual of the American Psychological Association
    for all formal written papers and discussion board communications. Students should also use correct grammar, spelling, punctuation, APA Style, and adherence to netiquette guidelines are expected for all discussion board (DB) postings and assignments. Faculty may deduct up to 5 points for APA Style or grammatical errors if not addressed in the corresponding DB or assignment rubric. If APA Style or writing style is a part of the DB or assignment rubric, that rubric will be followed for point application and/or deductions NUR 681 Integration of Evidence for Advanced Practice.

    Right to Modify

    The Nursing program and faculty reserve the right to modify or alter course materials or curriculum according to the guidelines set forth in the Graduate Catalog. Students will be notified in writing of any changes and are responsible for adherence to subsequent changes.

     

     

    Rubrics

    The following rubric provides descriptions of each letter grade.

     

    Score

    Indicators

    4.0/A

    Assignment completed with exceptional effort and/or quality. Work shows that the student did over and above the expected. Student demonstrates desire to use the information to enhance their own learning or to apply the knowledge in advanced ways.

    3.67/A-

    Assignment meets desired outcomes with some areas exceeding expectations.

    3.33/B+

    3.0/B

    Assignment completed with very few errors or very minimal deficiencies. Work shows that the student did exactly what was expected with little or no additional assistance from the professor or only moderate amount of insight, or understanding.

    2.67/B-

    Assignment completed with errors and did not meet some expectations.

    2.33/C+

    2.0/C

    The assignment was completed but there are either errors or some missing or deficient parts. Ideas are incompletely explained and student does not effectively use supporting evidence. It took extended intervention with the professor to complete the assignment.

    1.67/C-

    1.33/D+

    1.0/D

    Assignment completed with significant errors or noticeable deficiencies. The work provides no understanding or reflective thought about the topic. Ideas not explained clearly and no supporting evidence provided. Information presented in a disjointed, unpolished style, not at graduate level.

    0.0/U

    The work was so substandard as to not be accepted by the professor.

     

    Discussion Board Assignments Rubric

    Criteria

    4

    3

    2

    1

    Score

    Initial Post/ Response posts

    Includes all the elements of the assignment in a graduate level, academic format.

    Includes most of the elements with very few errors or very minimal deficiencies

    Includes errors or some missing or deficient parts

    Has significant errors or noticeable deficiencies.

    /4

    Integration

    Incorporates significant discussion of how this assignment integrates with nursing practice.

    Includes most of the elements with very few errors or very minimal deficiencies;

    Includes errors or some missing or deficient parts about how to integrate new information with nursing practice.

    The work provides no understanding or reflective thought about the topic.

    /4

    Critical Thinking

    Includes all the elements of the assignment demonstrating a desire to use the information to enhance their own learning or to apply the knowledge in advanced ways.

    Includes most of the elements with very few errors or very minimal deficiencies but lacks information about application to knowledge development.

    Includes errors or some missing or deficient parts especially about advancing knowledge of nursing role.

    Information presented in a disjointed, unpolished style, not at graduate level.

    /4

    Style

    Includes all the APA style elements with accuracy.

    Includes most of the elements with very few errors or very minimal deficiencies;

    Includes errors or some missing or deficient parts.

    The work has significant errors in APA formatting and writing style.

    /4

    Total

    /16

     

     

    Section A: (Week 1) Organizational Culture and Readiness Assessment Rubric

    Element

    4 points

    3 points

    2 points

    1 point

    Readiness level

    Provides excellent discussion of organizational readiness, staff readiness, and resource readiness NUR 681 Integration of Evidence for Advanced Practice.

    Provides good discussion of organizational readiness, staff readiness, and resource readiness with only minor missing elements.

    Provides discussion of organizational readiness, staff readiness, and resource readiness with some missing elements.

    Provides poor discussion of organizational readiness, staff readiness, and resource readiness with several missing elements.

    Project barriers

    Provides excellent information on barriers such as leadership, team members, ability to collect and analyze data.

    Provides good information on barriers such as leadership, team members, ability to collect and analyze data with only minor missing elements.

    Provides information on barriers such as leadership, team members, ability to collect and analyze data with some missing elements.

    Provides poor information on barriers such as leadership, team members, ability to collect and analyze data with several missing elements.

    Project facilitators

    Provides excellent information on facilitators such as leadership, team members, ability to collect and analyze data and organizational culture.

    Provides good information on facilitators such as leadership, team members, ability to collect and analyze data and organizational culture with only minor missing elements.

    Provides information on facilitators such as leadership, team members, ability to collect and analyze data and organizational culture with some missing elements.

    Provides poor information on facilitators such as leadership, team members, ability to collect and analyze data and organizational culture with several missing elements.

    Details/ examples

    Details and/or examples of organizational or project readiness are specific to the type of project planned and demonstrate understanding of organizational culture and readiness assessment.

    Details and/or examples of organizational or project readiness lack some specificity to the type of project planned and demonstrate minor flaws in understanding of organizational culture and readiness assessment.

    Details and/or examples of organizational or project readiness are not specific to the type of project planned and demonstrate some misunderstanding of organizational culture and readiness assessment.

    Details and/or examples of organizational or project readiness are not specific to the type of project planned and do not demonstrate understanding of organizational culture and readiness assessment.

    Strategies for integrating clinical

    inquiry

    Provides excellent discussion of organizational ability to utilize internal and external clinical evidence.

    Provides good discussion of organizational ability to utilize internal and external clinical evidence with only minor missing elements.

    Provides discussion of organizational ability to utilize internal and external clinical evidence with some missing elements.

    Provides poor discussion of organizational ability to utilize internal and external clinical evidence with several missing elements.

    APA Style (citations and format)

    Excellent use of all elements of APA Style format, including font, spacing, headings, citations, references.

    Good use of all elements of APA Style format, including font, spacing, headings, citations, references with only minor errors.

    Good use of some elements of APA Style format, including font, spacing, headings, citations, references with some errors.

    Poor use of some elements of APA Style format, including font, spacing, headings, citations, references with several errors.

    APA Style (writing, punctuation, grammar)

    Excellent use of sentence structure, paragraph structure, logical progress of ideas, concluding statements.

    Good use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors.

    Good use of some elements of sentence structure, paragraph structure, logical progress of ideas, concluding statements with some errors.

    Poor use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with several errors.

    Total

    28

    21

    14

    7

     

     

    Section B: (Week 2) Problem Description Rubric

    Element

    4 points

    3 points

    2 points

    1 point

    Background of problem: story of the problem

    Provides excellent discussion of the reason for a needed change including a recognized standard/guideline or a quality of care issue or new evidence regarding a process or procedure.

    Provides good discussion of the reason for a needed change including a recognized standard/guideline or a quality of care issue or new evidence regarding a process or procedure with only minor missing elements

    Provides discussion of the reason for a needed change including a recognized standard/guideline or a quality of care issue or new evidence regarding a process or procedure with some missing elements.

    Provides poor discussion of the reason for a needed change including a recognized standard/guideline or a quality of care issue or new evidence regarding a process or procedure with several missing elements.

    Background of problem: stakeholders

    Provides excellent discussion of the stakeholder perspective of a needed change including clinical evidence, patient concern, organizational goals.

    Provides good discussion of the stakeholder perspective of a needed change including clinical evidence, patient concern, organizational goals with only minor missing elements.

    Provides discussion of the stakeholder perspective of a needed change including clinical evidence, patient concern, organizational goals with some missing elements.

    Provides poor discussion of the stakeholder perspective of a needed change including clinical evidence, patient concern, organizational goals. with several missing elements.

    Problem fits specialty

    Provides excellent discussion of the relevance of the proposed change to nursing advanced practice.

    Provides good discussion of the relevance of the proposed change to nursing advanced practice with only minor missing elements.

    Provides discussion of the relevance of the proposed change to nursing advanced practice with some missing elements.

    Provides poor discussion of the relevance of the proposed change to nursing advanced practice with several missing elements.

    Goal statement

    The goal statement is specific to the PICO or the researchable problem, is understood by the stakeholders and can be measured by individual objectives.

    The goal statement lacks some specificity to the PICO or the researchable

    problem and is understood by the stakeholders and can be generally measured by individual objectives.

    The goal statement is only specific to some of the PICO or the Researchable problem, is not well understood by the stakeholders and can only be partially measured by individual objectives.

    The goal statement is not specific to the PICO or the researchable problem, is not understood by the stakeholders and cannot be measured by individual objectives.

    Objectives

    Objectives are Specific, Measurable, Acceptable, Realistic and Time bound.

    Objectives are mostly Specific, Measurable, Acceptable, Realistic or Time bound.

    Objectives are only partially Specific, Measurable, Acceptable, Realistic or Time bound.

    Objectives are not Specific, or are not Measurable, or are not Acceptable, or are not Realistic or are not Time bound.

    Support for problem

    Excellent discussion of support for the problem and support for the problem solution from evidence.

    Good discussion of support for the problem and support for the problem solution from evidence with only minor missing elements.

    Some discussion of support for the problem and support for the problem solution from evidence with some missing elements.

    Poor discussion of support for the problem and support for the problem solution from evidence with several missing elements.

    Reference list

    Sources are all pertinent and have obvious purpose useful to the topic; authors have appropriate credentials.

    Most of the Sources are pertinent and have obvious purpose useful to the topic; authors have appropriate credentials.

    Some of the Sources are pertinent and have obvious purpose useful to the topic or some authors have questionable credentials.

    Some of the sources seem not to be pertinent and have no obvious purpose useful to the topic or authors have inappropriate credentials.

    APA Style (citations and format)

    Excellent use of all elements of APA Style format, including font, spacing, headings, citations, references.

    Good use of all elements of APA Style format, including font, spacing, headings, citations, references with only minor errors.

    Good use of some elements of APA Style format, including font, spacing, headings, citations, references with some errors.

    Poor use of some elements of APA Style format, including font, spacing, headings, citations, references with several errors.

    APA Style (writing, punctuation, grammar)

    Excellent use of sentence structure, paragraph structure, logical progress of ideas, concluding statements.

    Good use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors.

    Good use of some elements of sentence structure, paragraph structure, logical progress of ideas, concluding statements with some errors.

    Poor use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with several errors.

    Total

    36

    27

    18

    9

     

    ORDER A CUSTOM-WRITTEN PAPER OR EXAM HERE

    Section C: (Week 3) Literature Support Rubric

    Element

    4 points

    3 points

    2 points

    1 point

    Search method/s

    Description of search strategy includes databases, keywords, criteria for inclusion and exclusion, number of studies that fit your criteria and correct broad to specific process.

    Description of search strategy is missing a few elements of the search that may make it hard to be unbiased.

    Description of search strategy is missing some elements of the search that may make it hard to be unbiased.

    Description of search strategy is missing several elements of the search that make it hard to be unbiased.

    Research evidence summary: P

    Provides compelling and accurate evidence clearly linked to the topic and participants. The importance/ relevance of all pieces of evidence is clearly stated.

    Provides good evidence clearly linked to the topic and participants. The importance/ relevance of some pieces of evidence is stated but some clarity is missing.

    Provides some evidence linked to the topic and participants. The importance/ relevance of all pieces of evidence is not clearly stated.

    Provides very little evidence linked to the topic and participants. The importance/ relevance of all pieces of evidence is not stated.

    Research evidence summary: I

    Provides compelling and accurate evidence clearly linked to the topic and intervention. The importance/ relevance of all pieces of evidence is clearly stated.

    Provides good evidence clearly linked to the topic and intervention. The importance/ relevance of some pieces of evidence is stated but some clarity is missing

    Provides some evidence linked to the topic and intervention. The importance/ relevance of all pieces of evidence is not clearly stated

    Provides very little evidence linked to the topic and intervention. The importance/ relevance of all pieces of evidence is not stated.

    Research evidence summary: C

    Provides compelling and accurate evidence clearly linked to the topic and comparisons. The importance / relevance of all pieces of evidence is clearly stated NUR 681 Integration of Evidence for Advanced Practice.

    Provides good evidence clearly linked to the topic and comparison. The importance / relevance of some pieces of evidence is stated but some clarity is missing

    Provides some evidence linked to the topic and comparison. The importance / relevance of all pieces of evidence is not clearly stated

    Provides very little evidence linked to the topic and comparison. The importance / relevance of all pieces of evidence is not stated.

    Research evidence summary: O

    Provides compelling and accurate evidence clearly linked to the topic and outcomes. The importance / relevance of all pieces of evidence is clearly stated.

    Provides good evidence clearly linked to the topic and outcomes. The importance / relevance of some pieces of evidence is stated but some clarity is missing

    Provides some evidence linked to the topic and outcomes. The importance / relevance of all pieces or evidence is not clearly stated

    Provides very little evidence linked to the topic and outcomes. The importance / relevance of all pieces of evidence is not stated.

    Research evidence summary: scientific merit related to problem

    Excellent summary of evidence from sources that have the best scientific merit and clearly make the case for the propose problem solution.

    Good summary of evidence from sources that have good scientific merit and make the case for the proposed problem solution with only minor missing elements.

    Good summary of evidence from scientific sources related to the proposed solution, but clearly missing some elements.

    Poor summary of evidence from sources that do not make the case for the proposed problem solution.

    Validity description

    Excellent discussion of how the validity of the resources was verified.

    Good discussion of how the validity of the resources was verified with only minor missing elements.

    Discussion of how the validity of the resources was verified with some missing elements.

    Poor discussion of how the validity of the resources was verified with several missing elements.

    Evidence Synthesis table

    Completes all the columns with comprehensive information required to summarize evidence. Utilizes the rapid critical appraisal tool effectively

    Completes the all the columns with basic information required to summarize evidence

    The table is incomplete with several missing elements. Does not address all the elements of the rapid critical appraisal tool

    The table is incomplete with several missing and incorrect information

    APA Style &

    writing

    Excellent use of sentence structure, paragraph structure, logical progress of ideas, concluding statements. Excellent use of all elements of APA Style format, including font, spacing, headings, citations, references.

    Good use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors. Good use of all elements of APA Style format, including font, spacing, headings, citations, references with only minor errors NUR 681 Integration of Evidence for Advanced Practice.

    Good use of some elements of sentence structure, paragraph structure, logical progress of ideas, concluding statements with some errors. Good use of some elements of APA Style format, including font, spacing, headings, citations, references with some errors.

    Poor use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with several errors. Poor use of some elements of APA Style format, including font, spacing, headings, citations, references with several errors.

    Total

    36

    27

    18

    9

    Section D: (Week 4) Solution Description Rubric

    Element

    4 points

    3 points

    2 points

    1 point

    Solution description

    Excellent description of the problem solution consistent with current evidence and with appropriate references.

    Good description of the problem solution consistent with current evidence and with appropriate references but with minor missing elements.

    Description of the problem solution is not well referenced so hard to determine consistence with current evidence.

    Poor description of the problem solution and not well referenced.

    Feasibility of intervention

    Excellent description of feasibility of implementation in practice setting including cost and training justification.

    Good description of feasibility of implementation in practice setting with some review of cost and training.

    Description of feasibility is lacking some key elements to determine how well it could be implemented.

    Poor description of feasibility of implementation, lacking specific budget or training details.

    Consistency with culture

    Excellent description of how project fits the organizational culture or minor issues that need to be addressed.

    Good description of how project fits the organizational culture but no consideration for issues that need to be addressed.

    Description of how project fits the organizational culture is lacking specificity.

    Poor description of how project fits the organizational culture and no consideration for any issues that need to be addressed.

    Expected outcomes: P

    Excellent explanation of expected outcomes with specific objectives regarding the participants / population.

    Good explanation of expected outcomes but the objectives lack some specifics regarding the participants / population.

    Explanation of expected outcomes is lacking proper format and/or clarity of purpose regarding participants / population.

    Poor explanation of expected outcomes and is lacking proper format and / or clarity of purpose regarding participants / population.

    Expected outcomes: I

    Excellent explanation of expected outcomes with specific objectives regarding the intervention.

    Good explanation of expected outcomes but the objectives lack some specifics regarding the intervention.

    Explanation of expected outcomes is lacking proper format and/or clarity of purpose regarding the intervention.

    Poor explanation of expected outcomes and is lacking proper format and/or clarity of purpose regarding the intervention.

    Expected outcomes: C

    Excellent explanation of expected outcomes with specific objectives regarding the comparison intervention.

    Good explanation of expected outcomes but the objectives lack some specifics regarding the comparison intervention.

    Explanation of expected outcomes is lacking proper format and/or clarity of purpose regarding the comparison intervention.

    Poor explanation of expected outcomes and is lacking proper format and/or clarity of purpose regarding the comparison intervention.

    Expected outcomes: O

    Excellent explanation of expected outcomes with specific objectives for the process of the project.

    Good explanation of expected outcomes but the objectives lack some specifics regarding the process of the project.

    Explanation of expected outcomes is lacking proper format and/or clarity of purpose regarding the process of the project.

    Poor explanation of expected outcomes and is lacking proper format and/or clarity of purpose regarding the process of the project.

    Methods: Quality care

    The outline of how to translate evidence to practice includes excellent measures to assure quality of care.

    The outline of how to translate evidence to practice includes measures to assure quality of care with minor missing elements.

    The outline of how to translate evidence to practice includes measures to assure quality of care but with some missing or faulty elements.

    The outline of how to translate evidence to practice does not include specific measures to assure quality of care.

    Methods: Processes

    The outline of how to translate evidence to practice includes excellent measures to assure a logical process of implementation.

    The outline of how to translate evidence to practice includes measures to assure a logical process with minor missing elements.

    The outline of how to translate evidence to practice includes measures to assure a logical process but with some missing or faulty elements.

    The outline of how to translate evidence to practice does not include specific measures to assure a logical process.

    Methods: Professional expertise

    The outline of how to translate evidence to practice includes excellent measures to assure professional expertise is followed.

    The outline of how to translate evidence to practice includes measures to assure professional expertise with minor missing elements.

    The outline of how to translate evidence to practice includes measures to assure professional expertise but with some missing or faulty elements.

    The outline of how to translate evidence to practice does not include specific measures to assure professional expertise.

    Outcome impact description: Quality care

    Outcome measures will evaluate the impact of the proposed solution on quality care very well.

    Outcome measures may evaluate the impact of the proposed solution on quality care but have a few missing elements

    Outcome measures may evaluate the impact of the proposed solution on quality care but have some missing elements.

    Outcome measures may not evaluate the impact of the proposed solution on quality care because of major flaws in describing the evaluation

    Outcome impact description: Processes

    Outcome measures will evaluate the impact of the proposed solution on work processes very well NUR 681 Integration of Evidence for Advanced Practice.

    Outcome measures may evaluate the impact of the proposed solution on work processes but have a few missing elements.

    Outcome measures may evaluate the impact of the proposed solution on work processes but have some missing elements.

    Outcome measures may not evaluate the impact of the proposed solution on work processes because of major flaws in describing the evaluation.

    Outcome impact description: Professional expertise

    Outcome measures will evaluate the impact of the proposed solution on professional expertise very well.

    Outcome measures may evaluate the impact of the proposed solution on professional expertise but have a few missing elements.

    Outcome measures may evaluate the impact of the proposed solution on professional expertise but have some missing elements.

    Outcome measures may not evaluate the impact of the proposed solution on professional expertise because of major flaws in describing the evaluation.

    APA Style (citations and format)

    Excellent use of all elements of APA Style format, including font, spacing, headings, citations, references.

    Good use of all elements of APA Style format, including font, spacing, headings, citations, references with only minor errors.

    Good use of some elements of APA Style format, including font, spacing, headings, citations, references with some errors.

    Poor use of some elements of APA Style format, including font, spacing, headings, citations, references with several errors.

    APA Style (writing, punctuation, grammar)

    Excellent use of sentence structure, paragraph structure, logical progress of ideas, concluding statements.

    Good use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors.

    Good use of some elements of sentence structure, paragraph structure, logical progress of ideas, concluding statements with some errors.

    Poor use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with several errors.

    Total

    60

    45

    30

    15

     

     

     

    Section E: (Week 5) Change Model

    Element

    4 points

    3 points

    2 points

    1 point

    Model assumptions

    Excellent discussion of all elements related to assumptions of the implementation model.

    Good discussion of elements related to assumptions of the implementation model with only minor missing elements.

    Discussion of elements related to assumptions of the implementation model with some missing elements.

    Poor discussion of elements related to assumptions of the implementation model with several missing elements.

    Evidence of suitability for project: Explains why the proposed intervention will work

    Excellent discussion of evidence for the suitability of the project related to why the intervention will work.

    Good discussion of the evidence for the suitability of the project related to why the intervention will work with only minor missing elements.

    Discussion of the evidence for the suitability of the project related to why the intervention will work with some missing elements.

    Poor discussion of the evidence for the suitability of the project related to why the intervention will work with several missing elements.

    Evidence of suitability for project: Scope of project fits clinical setting

    Excellent discussion of evidence for the suitability of the project related to the scope of the project and fit with the setting.

    Good discussion of evidence for the suitability of the project related to the scope of the project and fit with the setting with only minor missing elements.

    Discussion of evidence for the suitability of the project related to the scope of the project and fit with the setting with some missing elements.

    Poor discussion of evidence for the suitability of the project related to the scope of the project and fit with the setting with several missing elements.

    Able to guide implementation

    Excellent discussion of how the model will guide implementation.

    Good discussion of how the model will guide implementation with only minor missing elements.

    Discussion of how the model will guide implementation with some missing elements.

    Poor discussion of how the model will guide implementation with several missing elements.

    Conceptual model: Concepts relate to problem solution

    Excellent discussion of the conceptual model related to the problem solution.

    Good discussion of the conceptual model related to the problem solution with only minor missing elements.

    Discussion of the conceptual model related to the problem solution with some missing elements.

    Poor discussion of the conceptual model related to the problem solution with several missing elements.

    Conceptual model: Process and/or interactions make sense

    Excellent discussion of the conceptual model related to the process and interactions.

    Good discussion of the conceptual model related to the process and interactions with only minor missing elements.

    Discussion of the conceptual model related to the process and interactions with some missing elements.

    Poor discussion of the conceptual model related to the process and interactions with several missing elements.

    APA Style (citations and format)

    Excellent use of all elements of APA Style format, including font, spacing, headings, citations, references.

    Good use of all elements of APA Style format, including font, spacing, headings, citations, references with only minor errors.

    Good use of some elements of APA Style format, including font, spacing, headings, citations, references with some errors.

    Poor use of some elements of APA Style format, including font, spacing, headings, citations, references with several errors.

    APA Style (writing, punctuation, grammar)

    Excellent use of sentence structure, paragraph structure, logical progress of ideas, concluding statements.

    Good use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors.

    Good use of some elements of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors.

    Poor use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors.

    Total

    32

    24

    16

    8

     

     

     

    Section F: (Week 6) Implementation Plan Rubric

    Element

    4 points

    3 points

    2 points

    1 point

    Setting & Access to Participants

    Excellent coverage of all elements related to participants NUR 681 Integration of Evidence for Advanced Practice.

    Good coverage of elements related to participants with only minor missing information.

    Coverage of elements related to participants with some missing information.

    Poor coverage of elements related to participants with several missing pieces of information

    Timeline

    Excellent coverage of elements related to the timeline.

    Good coverage of elements related to the timeline with only minor missing information.

    Coverage of elements related to the timeline with some missing information.

    Poor coverage of elements related to the timeline with several missing pieces of information.

    Resources

    Excellent discussion of resources required for this project.

    Good discussion of resources required for this project with only minor missing information.

    Discussion of resources required for this project with some missing information.

    Poor discussion of resources required for this project with several missing pieces of information.

    Methods & Tools

    Excellent discussion of methods and tools for this project.

    Good discussion of methods and tools for this project with only minor missing information.

    Discussion of methods and tools for this project with some missing information.

    Poor discussion of methods and tools for this project with several missing pieces of information.

    Intervention

    Excellent coverage of all elements related to the intervention.

    Good coverage of elements related to the intervention. with only minor missing information.

    Coverage of elements related to the intervention with some missing information.

    Poor coverage of elements related to the intervention with several missing pieces of information.

    Management of Barriers

    Excellent discussion of barriers to implementation.

    Good discussion of barriers to implementation with only minor missing information

    Discussion of barriers to implementation with some missing information.

    Poor discussion of barriers to implementation with several missing pieces of information.

    Budget

    Excellent coverage of all elements of the budget for this project.

    Good coverage of all elements of the budget for this project with only minor missing information

    Coverage of all elements of the budget for this project with some missing information.

    Poor coverage of all elements of the budget for this project with several missing pieces of information.

    APA Style (citations and format)

    Excellent use of all elements of APA Style format, including font, spacing, headings, citations, references.

    Good use of all elements of APA Style format, including font, spacing, headings, citations, references with only minor errors.

    Good use of some elements of APA Style format, including font, spacing, headings, citations, references with some errors.

    Poor use of some elements of APA Style format, including font, spacing, headings, citations, references with several errors.

    APA Style (writing, punctuation, grammar)

    Excellent use of sentence structure, paragraph structure, logical progress of ideas, concluding statements.

    Good use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors.

    Good use of some elements of sentence structure, paragraph structure, logical progress of ideas, concluding statements with some errors.

    Poor use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with several errors.

    Total

    36

    27

    18

    9

     

     

     

    (Week 7) EBP Proposal Final Paper Rubric

    Element

    4 points

    3 points

    2 points

    1 point

    Section A

    Excellent coverage of all content and attention to recommended changes.

    Good coverage of all content and some attention to recommended changes.

    Some content is covered, or some changes have been made but some elements are still missing.

    Poor coverage of content and recommended changes have not been made.

    Section B

    Excellent coverage of all content and attention to recommended changes.

    Good coverage of all content and some attention to recommended changes NUR 681 Integration of Evidence for Advanced Practice.

    Some content is covered, or some changes have been made but some elements are still missing.

    Poor coverage of content and recommended changes have not been made.

    Section C

    Excellent coverage of all content and attention to recommended changes.

    Good coverage of all content and some attention to recommended changes.

    Some content is covered, or some changes have been made but some elements are still missing.

    Poor coverage of content and recommended changes have not been made.

    Section D

    Excellent coverage of all content and attention to recommended changes.

    Good coverage of all content and some attention to recommended changes.

    Some content is covered, or some changes have been made but some elements are still missing.

    Poor coverage of content and recommended changes have not been made.

    Section E

    Excellent coverage of all content and attention to recommended changes.

    Good coverage of all content and some attention to recommended changes.

    Some content is covered, or some changes have been made but some elements are still missing.

    Poor coverage of content and recommended changes have not been made.

    Section F

    Excellent coverage of all content and attention to recommended changes.

    Good coverage of all content and some attention to recommended changes.

    Some content is covered, or some changes have been made but some elements are still missing.

    Poor coverage of content and recommended changes have not been made.

    Section G

    Excellent coverage of all content and attention to recommended changes.

    Good coverage of all content and some attention to recommended changes.

    Some content is covered, or some changes have been made but some elements are still missing.

    Poor coverage of content and recommended changes have not been made.

    APA Style (citations and format)

    Excellent use of all elements of APA Style, including font, spacing, headings, citations, references.

    Good use of all elements of APA Style, including font, spacing, headings, citations, references with only minor errors.

    Good use of some elements of APA Style, including font, spacing, headings, citations, references with some errors.

    Poor use of some elements of APA Style, including font, spacing, headings, citations, references with several errors.

    APA Style (writing, punctuation, grammar)

    Excellent use of sentence structure, paragraph structure, logical progress of ideas, concluding statements.

    Good use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with only minor errors.

    Good use of some elements of sentence structure, paragraph structure, logical progress of ideas, concluding statements with some errors.

    Poor use of sentence structure, paragraph structure, logical progress of ideas, concluding statements with several errors.

    Total

    36

    27

    18

    9

     

     

     

    (Week 7) Presentation Discussion Board Rubric

    Criteria

    4

    3

    2

    1

    Initial Post/ PowerPoint

    Includes all the elements of the assignment in a graduate level, academic format; thoroughly but concisely presents main points of each Section of the project proposal in a well-organized manner.

    Includes most of the elements with very few errors or very minimal deficiencies; adequately presents main points of each Section of the project proposal in a fairly well-organized manner.

    Includes errors or some missing or deficient parts; presents main points of the project proposal but not as sufficiently and not as well- organized.

    Has significant errors or noticeable deficiencies; does not sufficiently present main points of the project proposal or is not well- organized.

    Integration

    Incorporates significant discussion of how this assignment integrates with nursing practice.

    Includes most of the elements with very few errors or very minimal deficiencies.

    Includes errors or some missing or deficient parts about how to integrate new information with nursing practice.

    The work provides no understanding or reflective thought about the topic.

    Critical Thinking

    Includes all the elements of the assignment demonstrating a desire to use the information to enhance their own learning or to apply the knowledge in advanced ways.

    Includes most of the elements with very few errors or very minimal deficiencies but lacks information about application to knowledge development.

    Includes errors or some missing or deficient parts especially about advancing knowledge of nursing role.

    Information presented in a disjointed, unpolished style, not at graduate level.

    Professional Communication

    Includes all the APA Style elements with accuracy.

    Includes most of the elements with very few errors or very minimal deficiencies.

    Includes errors or some missing or deficient parts.

    The work has significant errors in APA Style formatting and writing style.

    Totals

    16

    12

    8

    4

    NUR 681 Integration of Evidence for Advanced Practice

  • Adolescent Hispanic/Latino boy living in a middle-class suburb

    Adolescent Hispanic/Latino boy living in a middle-class suburb

    Main post

    Adolescent Hispanic/Latino boy living in a middle-class suburb 

    An accurate health history is vital when creating a care plan that is inclusive of the patient’s needs. According to Ball et al. (2018), it is a key component when diagnosing and treating any patient. Gaining trust and allowing for autonomy is crucial with this particular age group. According to Erickson’s stages of development, “finding themselves” is a key area of growth for adolescents (Orenstein, 2020). By creating a relationship in which the adolescent can participate in providing a health history, they will be more inclined to also participate in activities that improve their health Adolescent Hispanic/Latino boy living in a middle-class suburb.

    Communication/Interview Techniques and Targeted Questions

    Communication and interview techniques must be tailored based on with whom the provider is working. For example, when interviewing a 75 year old, male Hispanic, I would utilize formal greetings, shake hands and make eye contact. I would use proper terms for anatomical parts, but not necessarily formal medical terminology. For an adolescent, I would utilize techniques that generate involvement from both the patient as well as their parent. For example, I would ask leading questions like “when was the last time you played on your Xbox and when was the last time you played outside. These types of questions acknowledge that mental play and physical play time are equally important. It is important they both feel like they play a role in the health and wellness of the adolescent.

    Social Determinants of Health

    Asking targeted questions that are appropriate for the social determinants is important in gaining a trusting relationship. For example, it would not make sense for an adolescent of this socioeconomic standing to be asked if they know where or when their next meal might be. However, asking how many fruits or vegetables they eat per day, would be a more appropriate question. Likewise, obesity is not uncommon in this culture so framing questions that are non-judgmental is important as well. An example might be, “do you know why your body needs healthy foods?” This not only engages them in understanding their own body but allows for education where gaps might be highlighted Adolescent Hispanic/Latino boy living in a middle-class suburb.

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    Risk Assessment Tools

    According to Ball (2019), understanding the growth and development of adolescents is important when taking a health history. For example, ensuring the individual met all of their development milestones, regardless of their current reason for visiting will help in understanding where the issues might originate. Next, depression and anxiety are becoming more prevalent in this age group, so utilizing a screening tool that is age appropriate would be important. An example of an age appropriate tool would be the Center for Epidemiologic Studies Depression Scale for Children (CES-DE), which is utilized to assess as well as monitor ongoing treatment plans in children and young adults aged 6-23 (Zsamboky et al., 2021). The benefit of this tool is the length of time in which it is appropriate to use. As a result, this is the risk assessment tool I would utilize, primarily because having years of growth and development to review can make creating individualized treatment plans that much easier Adolescent Hispanic/Latino boy living in a middle-class suburb.

    Other Health Related Risks

    Obesity and mental health are noted as chronic health related problems afflicting this population (Isasi et al., 2016). It has been well-documented that chronic obesity has psychological consequences. Rankin et al. (2016), finds that obese children are significantly more likely to struggle with psychiatric and psychological disorders than children who are not obese. Additionally, Tamayo et al., (2020) argues that ¼ of Hispanic youths in the U.S. are obese. This is clearly an important health related issue that must be addressed for this population.

    Five (+) Targeted Questions

    How many fruits and vegetables do you eat every day?

    How often do you eat breakfast?

    How many cups of water do you drink at school? How big are those cups?

    Do you have a best friend at school?

    How many days in a week do you feel sad or lonely?

    Who do you talk to about feeling sad or lonely?

     

    References

    Ball, J., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). 
    Seidel’s guide to physical examination: An Interprofessional approach
    . Mosby.

    Isasi, C. R., Rastogi, D., & Molina, K. (2016). Health issues IN Hispanic/latino youth. 
    Journal of Latina/o Psychology
    , 
    4
    (2), 67–82. https://doi.org/10.1037/lat0000054

    Orenstein, G. A. (2020, November 22). 
    Eriksons stages of psychosocial development
    . StatPearls [Internet]. 
    https://www.ncbi.nlm.nih.gov/books/NBK556096/
    .

    Rankin, J., Matthews, L., Cobley, S., Han, A., Sanders, R., Wiltshire, H. D., & Baker, J. S. (2016). Psychological consequences of childhood obesity: Psychiatric comorbidity and prevention. 
    Adolescent Health, Medicine and Therapeutics
    , 
    Volume 7
    , 125–146. https://doi.org/10.2147/ahmt.s101631

    Tamayo, M. C., Dobbs, P. D., & Pincu, Y. (2020). Family-centered interventions for treatment and prevention of childhood obesity in hispanic families: A systematic review. 
    Journal of Community Health
    , 
    46
    (3), 635–643. 
    https://doi.org/10.1007/s10900-020-00897-7

    Zsamboky, M., Haskell, B., Vick, R., & Schroer, M. (2021). Treating child and adolescent depression and anxiety in primary care. 
    The Journal for Nurse Practitioners
    , 
    17
    (1), 54–59. https://doi.org/10.1016/j.nurpra.2020.08.019 Adolescent Hispanic/Latino boy living in a middle-class suburb

    response

    Thanks for your post.  In addition to increased risk for obesity and mental health issues, a middle-class adolescent is at higher risk for teen substance abuse.  In a study conducted by Patrick et al. (2012), it was noted that there is a higher incidence of substance use among youth from families with higher socioeconomic status.  Substances more likely to be abused are alcohol and marijuana (Patrick et al., 2012).  In a study by Martin (2019), it was noted that adolescents living in suburban neighborhoods were more likely to abuse drugs or alcohol.  This may be due in part to the fact that people in higher socioeconomic groups are more likely to engage in deviant behaviors (Martin, 2019).  I would employ the PACES risk assessment tool when interviewing this patient.  PACES stands for parents/peers, accidents/alcohol or drugs, cigarettes, emotional issues, and school/sexuality (Ball et al., 2019) Adolescent Hispanic/Latino boy living in a middle-class suburb.

    References

    Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). 
    Seidel’s guide to physical examination: An interprofessional approach
     (9th ed.). Mosby.

    Patrick, M. E., Wightman, P., Schoeni, R. F., & Schulenberg, J. E. (2012). Socioeconomic status and substance use among young adults: A comparison across constructs and drugs. 
    Journal of Studies on Alcohol and Drugs
    , 
    73
    (5), 772–782. 
    https://doi.org/10.15288/jsad.2012.73.772

     

    Sample response 2

    I enjoyed reading your reply, it was interesting and contained many valid points. It is crucial to understand how to conduct a proper assessment geared towards gathering as much patient history as possible. I agree gaining trust and allowing for autonomy is crucial with this particular age group. It’s important to remember that this age group and ethical background are at risk for having an unhealthy diet. When assessing what the patients diet is its important to ask questions with a non judge mental attitude. “Erikson’s Stages of Psychosocial Development can be utilized by mental health providers when treating patients who are facing periods of adjustment or turning points in life”(Orenstein, G. A. 2020). These stages are also important for nurses to use when conducting an assessment and gaining back ground information. Evaluation for drug use should also be conducted. These turning points in life often cause adolescents to explore and experiment.
     

    References
     

    Orenstein, G. A. (2020, November 22). Eriksons stages of psychosocial development. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK556096/Adolescent Hispanic/Latino boy living in a middle-class suburb.

  • 16-year-old white pregnant teenager living in an inner-city neighborhood

    16-year-old white pregnant teenager living in an inner-city neighborhood

    Initial Post

    My specific patient is a 16-year-old white pregnant female living in an inner-city neighborhood. This specific patient is a pregnant female. I would focus my assessment on women’s health and examining the fetus. First, before I begin collecting information, I would introduce myself. The introduction is essential; it establishes your professional role. I would also ask the patient for permission to be involved in her care. Often patients do not want the opposite sex providing care. Respect for the patient’s beliefs, attitudes, and rights enhances patient rapport. It is crucial to communicate empathy because this encourages patients to express their concerns. I would focus my questions on an open-ended format; this way, I can understand what kind of care the patient has received previously. Open-ended questions also allow for the patient to speak freely 16-year-old white pregnant teenager living in an inner-city neighborhood.

    Several important points need to be addressed to assess health risks for a pregnant woman properly. I would focus on what kind of prenatal care has been completed. What are the plans this patient has as far as breastfeeding? I would also inquire about any cigarette smoking and alcohol use. “Entry into prenatal care represents the beginning of her new life. The adolescent should be praised for beginning prenatal care, particularly if it is in the 1st trimester” (Montgomery, K. S. 2003). Another critical factor that needs to be addressed is the mothers feeling and attitude towards her pregnancy. A potential health-related risk that should be taken into consideration is possible postpartum depression. This is a 16-year-old girl who hasn’t experienced much in life. Poverty and a high-risk pregnancy due to her age are important factors that need to be monitored. I would complete a functional assessment for this patient. “Quite simply, functional assessment is an attempt to understand a patient’s ability to achieve the basic activities of daily living” (Ball, J 2019). It is important to understand how this young woman plans to raise her child.

    Questions-

    Have you been pregnant before?

    What do your peers say about your pregnancy?

    Have you set up the baby room?

    Is your partner excited?

    What hospital have you chosen?

    References

    Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.) 16-year-old white pregnant teenager living in an inner-city neighborhood

    Montgomery, K. S. (2003). Nursing care for pregnant adolescents. Journal of Obstetric, Gynecologic & Neonatal Nursing, 32(2), 249–257. https://doi.org/10.1177/0884217503252191

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    Response

    We get a lot of women under the age of
     
    18
     
    and pregnant, admitted to our floor.
     
      The main issue we deal with most of the time is these women are addicted to
     
    opioids. Opioid dependence in pregnancy carries clear identifiable maternal and fetal risk (Shainkar et al., 2012). Most are admitted for issues ranging from cellulites to endocarditis. Many of them don’t know they are pregnant or they do,
     
    and they don’t care.  It can be very challenging as a nurse to separate your emotions from these particular cases.
     
    A significant barrier to treatment for pregnant women is
     
    caregiver
     
    attitudes. Pregnant women who abuse substances are the mostly likely group to be stigmatized and
     
    treated punitively for their addiction-related behavior (Crawford et
     
    al., 2015).  Some of the questions we need to ask them are “if they have a desire to have the baby” and if so, “are they willing to get help to stop doing drugs”.  Unfortunately, a large majority of them have no plans to stop their drug use.  The questions would appear as if they could be answered very cut and dry, although many if not all of the patient population we receive have very complicated pasts that range from histories of sexual abuse, homelessness, mental health issues, and little to no family support.  In these particular circumstances it can be very frustrating to know all the right questions to ask, but subsequently end up feeling defeated and helpless when a patient refuses help and elopes during treatment 16-year-old white pregnant teenager living in an inner-city neighborhood.

    References

    Crawford, C., Sias, S., & Goodwin, L. (2015).
     
    Treating Pregnant Women With Substance Abuse Issues in an OBGYN Clinic: Barriers to Treatment
    . https://www.counseling.org/docs/default-source/vistas/treating-pregnant-women-with-substance-abuse-issues-in-an-obgyn-clinic-barriers-to-treatment.pdf?sfvrsn=6

    Shainker, S. A., Saia, K., & Lee-Parritz, A. (2012). Opioid Addiction in Pregnancy.
     
    Obstetrical & Gynecological Survey
    ,
     
    67
    (12), 816–824. https://doi.org/10.1097/ogx.0b013e3182788e8c

    Response 2

    Women ages from 15-19 who are pregnant are at a risk for maternal death related to maternal complications (Amjad, et. al., 2019). With this risk of complication for this patient it is important that she continues with prenatal care for herself and the baby. This will assist in any early detection of complications from the pregnancy. Another risk area that needs to be considered and reviewed postpartum is depression. Within this age range these individuals are finishing high school and have many other stressors in their life. Now they will be having an addition of a baby. Depression occurs two times the rate for adolescents who are raising children as opposed to those who are not raising children (Russotti, et. al., 2020) 16-year-old white pregnant teenager living in an inner-city neighborhood.

    Continued effective communication for this individual is needed so that they will sustain prenatal and postpartum care. They will need assistance with knowledge regarding community resources. One question that should be asked is what support do you have at home to assist with the baby?  Another would be what resources are you aware of within the community for assistance?

    References

    Amjad, S., Macdonald, I., Chambers, T., Osornio-Vargas, A., Chandra, S., Voaklander, D., & Ospina, M. B. (2019). Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies. A systematic review and meta-analysis. 
    Paediatric and Perinatal Epidemiology, 33
    (1), 88-99. 
    https://doi-ord.ezp.waldenulibrary.org/10.1111/ppe.12529

    Russotti, J., Handley, E. D., Rogosch, F. A., Toth, S. L., & Cicchetti, D. (2020). The interactive effects of child maltreatment and adolescent pregnancy on late-adolescent depressive symptoms. 
    Journal of Abnormal Child Psychology, 48(
    9), 1223-1237. https://doi-org.ezp.waldenulibrary.org/10.1007/s10802-020-00669-w 16-year-old white pregnant teenager living in an inner-city neighborhood

  • 55-year-old Asian female living in a high-density public housing complex

    55-year-old Asian female living in a high-density public housing complex

    Summary of interview

    Patient Scenario:

    55-year-old Asian female living in a high-density public housing complex

     

    As noted in Seidels Physical Examination book, to prevent misinterpretations and misrepresentations, practitioners must make every effort to see the world of the individual patient as the patient sees it (Ball et al., 2019). Each patient is unique, with unique circumstances and our first meeting with a patient helps to set the tone for the relationship (Ball et al., 2019). Both physical and emotional comfort is needed for effective communication, as well as carefully crafting your patient questions to ensure your patient responds effectively to you (Ball et al., 2019). Our communication with each patient differs based on their present needs, and comfort. As illustrated by Ball, establishing a positive patient relationship depends on communication built on courtesy, comfort, connection, and confirmation (Ball et al., 2019) 55-year-old Asian female living in a high-density public housing complex.

    My patient is a 55-year-old Asian woman living in a high-density population complex. Using the courtesy, comfort, connection, and confirmation framework for our interview, I addressed my patient formally, learned her name and respected her need for modesty including if she wanted others, such as another family member, friend, or woman in the room as well (Ball et al., 2019). Additionally, since my patient would be identified as an older adult with possible change in cognitive abilities, memory, and personality I wanted her to feel as comfortable as possible and ensure the settings in the room would not magnify any possible issues (Ball et al., 2019). I used this technique to ensure she felt comfortable with me. I allowed the patient to speak freely, giving her time to absorb the situation and decide how much she wanted to divulge. Since I was not clear on how comfortable she would feel with a lot of eye contact, I asked her what would make her feel more comfortable and allowed her to guide us down this discussion.

    As noted above, my patient is an older woman living in high density public housing complex and because of that my first questions were focused on her home or living conditions, which included number of people she was living with, types of furnishing, and any pets (Ball et al., 2019). Additionally, I asked her about family, her occupation to determine if there were any additional risks identified, travel, and access to care including transportation and health insurance coverage (Ball et al., 2019). Through this interview, I was able to get a glimpse into her day-to-day life and emotional health.

     

    The Risk Assessment Tool

    Each patient is assessed based on information gathered during the interview process by using open ended question. My patient lives in a high-density complex and could be at risk of falling and not getting the proper care that she needs, in a reasonable time (Adly et al., 2019). As a practitioner, one would evaluate how she is getting around and access to health care. An understanding of this would lead to developing a plan of care that can help meet the need of the patient 55-year-old Asian female living in a high-density public housing complex.

     

    Targeted Questions

    It is important to ask the right questions and utilize open ended question to further insight to patient for various risk factors such as fall, abuse, and malnutrition. To develop a tailored care plan for my patient based on her age, socioeconomic status, I would ask the following questions:

    1. What is your current employment status?

    2. What is your day to day like?

    3. What time do you wake up and what type of meals do you normally like to eat?

    4. Do you live with family? If not, how often do you visit family or does family visit you?

    5. How do you feel?

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    6. Are you currently taking any medication?

    7. Do you have access to transportation?

    8. Do you like to participate in any physical activities?

    10. What’s your insurance status?

    11. When was the last time you had a doctor visit? 55-year-old Asian female living in a high-density public housing complex

    Reference

    Adly, N. N., Abd-El-Gawad, W. M., &Abou-Hashem, R. M. (2019). Relationship between malnutrition and different fall risk assessment tools in a geriatric in-patient unit. Aging Clinical and experimental Research, 32 (7), 1279- 1287.

    https://doi.org/10.1007/s40520-019-01309-0

    Ball, J.W., Dains, J.E., Flynn, J. A, Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9
    th
     ed.). St. Louis, MO: Elsevier Mosby

    response

    Thank you for your discussion, it was very informative and descriptive. I agree, it is important to be non-judgmental and use open ended questions to communicate with a teenager.  Communication, giving and receiving information, in general can be challenging. Some techniques to improve communication are increasing cultural awareness and understanding of various life experiences and cultures, developing empathy and compassion for people, being aware of one’s own body language and paying attention to the patient’s/other’s body language (Raypole, 2020) 55-year-old Asian female living in a high-density public housing complex.

    The female in your case study is a 16-year-old female, which makes her at a higher risks of contracting a sexually transmitted infection. According to the CDC, youth between the ages of 15 and 24 make up half of the 26 million new sexually transmitted infections that occurred in United States. Furthermore, in the United States, 12.7% of sexually active adolescents and young adults who are on their parent’s health insurance won’t seek sexual and reproductive healthcare for fear that their parents would find out (Centers for Disease Control and Prevention, 2021).

    References

    Centers for Disease Control and Prevention. (2021, April 8). 
    Adolescents and young adults
    . Centers for Disease Control and Prevention. https://www.cdc.gov/std/life-stages-populations/adolescents-youngadults.htm.

    Raypole, C. (2020, January 16). 
    19 communication techniques to add to your arsenal
    . Healthline. https://www.healthline.com/health/communication-techniques#body-language 55-year-old Asian female living in a high-density public housing complex.

    response 2

    Thank you for your discussion, I found it very informative. I agree using the courtesy, comfort, connection, and confirmation approach would be beneficial in commutating and building a rapport with your patient. Communication, giving and receiving information, in general can be challenging. Some techniques to improve communication are increasing cultural awareness and understanding of various life experiences and cultures, developing empathy and compassion for people, being aware of one’s own body language and paying attention to the patient’s/other’s body language (Raypole, 2020).

    There are health risks associated with high density housing such as infectious diseases like STDs, tuberculosis, pneumonia, and diarrhea and noncommunicable diseases like heart disease, stroke, asthma and other respiratory illnesses, cancers, diabetes and depression (World Health Organization, 2021). Also, studies reveal that high density housing environments has an impact on respiratory health, because of poor air quality, and physical activity (Chen et al., 2019).

    References

    Chen, R., Li, X., Sun, W., Wang, L., & Yang, X. (2019, December 30). 
    Impact of high-density urban built environment on chronic obstructive pulmonary disease: A case study of Jing’an district, shanghai
    . International journal of environmental research and public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982330/ 55-year-old Asian female living in a high-density public housing complex.

    Raypole, C. (2020, January 16). 
    19 communication techniques to add to your arsenal
    . Healthline. https://www.healthline.com/health/communication-techniques#body-language.

    World Health Organization. (2021). 
    Urban health
    . World Health Organization. https://www.who.int/health-topics/urban-health 55-year-old Asian female living in a high-density public housing complex.

  • Week 1 Knowledge Check – NRNP 6568 Synthesis in Advanced Nursing Practice of Patients in Family Care Settings

    Week 1 Knowledge Check – NRNP 6568 Synthesis in Advanced Nursing Practice of Patients in Family Care Settings

    NRNP-6568-6-Syn Adv Nurs Pr Patient Family

    Quiz – Week 1 Knowledge Check

     

    QUESTION 1

    Health insurers can use genetic information to make enrollment or coverage decisions

    True

    False

    1 points   

    QUESTION 2

    DNP stands for Doctor of Nursing Profession

    True

    False

    1 points   

    QUESTION 3

    What are the main benefits to the NP of NP practice ownership?

    Decides on the length of patient visits and how the practice is the run

    Chooses employees and controls qualities

    May titrate workload to income

    A and B only

    All of the above

    1 points   

    QUESTION 4

    At what level of government is the role of the nurse practitioner defined?

    By the county in which the NP practices

    By the state in which the NP practices

    By the federal government
    Week 1 Knowledge Check – NRNP 6568 Synthesis in Advanced Nursing Practice of Patients in Family Care Settings

    1 points   

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    QUESTION 5

    When using a device other than a landline telephone to participate in telemedicine, the device must comply with ________________ and ____________ requirements.

    HIPAA; HITECH

    HIPAA; OSHA

    HIPAA; DEA

    HITECH; DEA

    1 points   

    QUESTION 6

    When speaking to a patient who is not a native English speaker, which of the following is the preferred interpreter to be used?

    Family members

    Friends of the patient

    Professional interpreters experienced in healthcare interpretation

    All of the above

    1 points   

    QUESTION 7

    It is vital for an NP to obtain a family history because

    Teaches you to have biases about your care

    Indicate need for Genetic testing

    Guide the decision for Diagnostic testing

    B and C correct 

    All of the above
    Week 1 Knowledge Check – NRNP 6568 Synthesis in Advanced Nursing Practice of Patients in Family Care Settings

    1 points   

    QUESTION 8

    There are several titles for NPs, and some are based on the state requirement. What does ARNP stand for?

    Adult Registered Nurse Practitioner

    Advanced Registered Nurse Practitioner

    Acute Registered Nurse Practitioner

    Advanced Registered Nurse Provider

    1 points   

    QUESTION 9

    When giving patients written information, what is the suggested reading level for that health information?

    10
    th
     grade

    7
    th
     grade

    1
    st
     grade

    5
    th
     grade

    1 points   

    QUESTION 10

    Which of the following are obstacles to improved patient health and safety?

    Missed appointments

    Failure to follow up with a referral or a diagnostic test

    Failure to comply with dietary, medication, or exercise recommendations
    Week 1 Knowledge Check – NRNP 6568 Synthesis in Advanced Nursing Practice of Patients in Family Care Settings

    All of the above

    None of the above

    Bottom of Form
    Week 1 Knowledge Check – NRNP 6568 Synthesis in Advanced Nursing Practice of Patients in Family Care Settings

  • 76-year-old black male with disabilities living in an urban setting

    B76-year-old black male with disabilities living in an urban setting

    y Day 3 of Week 1

    Post 
    a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

    76-year-old black male with disabilities living in an urban setting

    Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient 76-year-old black male with disabilities living in an urban setting.

     A strong patient-provider relationship facilitates cooperation and provides greater opportunities to learn about a patient’s unique health needs. This enables providers to better connect patients with the treatments and resources to improve overall health.

    How would your communication and interview techniques for building a health history differ with each patient? Before entering the room I would knock and wait for a response The first thing I would do upon entering the room would be a smile and introduction myself.  I would address the patient by his name and ask permission to sit in front of the patient, so I will have eye contact.  I would identify those problems that matters to the patient.  Questions should be tailored base on patient’s age, culture, and cognition (Ball el. al, 2019). Seeking clarity when needed to understand what the patient  is saying 76-year-old black male with disabilities living in an urban setting.

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    How might you target your questions for building a health history based on the patient’s social determinants of health? Social determinants of health are the conditions in which people are born, grow, live, work and age that shape health. It’s important to understand that  reviewing the patient social determinants The spiritual, psychosocial, and cultural contexts of the patient’s life are essential to an understanding.  Asking the patients if he has any habits: like nutritional and diet; regularity and patterns of eating and sleeping; quantity of coffee, tea, tobacco, alcohol; Home conditions: housing, economic condition, types of furnishings, pets and their health.eligious and cultural preferences: any religious proscriptions concerning food, medical care; spiritual needs. Access to care: transportation and other resources available to patient, type of health insurance coverage (if any), worries in this regard, primary care provider, customary pattern of seeking care. Social needs: insurance/medication coverage, food insecurity, housing instability, employment assistance need. It is important to have the conversation. Addressing social determinants of health is important for improving health and reducing longstanding disparities in health and health care (Ball el. al, 2019).

    What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?  The Functional. The risk assessment tool that  I would  use  the Home Safety Self-Assessment Tool (HSSAT), this tool was developed to evaluate the living conditions of older adults and whether the home was a safe environment to prevent falls and also provide a space that older adults can stay in their home longer. (Horowitz, Nochajski, & Schweitzer, 2013, p.218). I would also do a functional assessment to prevent further loss of function and to maintain the self-care status of many elders. Performing an office-based functional assessment measures the elder’s ability to perform self-care 76-year-old black male with disabilities living in an urban setting.

    Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration. Health risk assessment is an important in identifying risks with  chronic diseases, preventing  complications, and as well as to allowing  providers managed interventions that helps preventive care such as screening for potential health risks (Wu and Orlando, 2015). Obtaining the health history iis the baseline  for assessing the present concern. Major adult illnesses or chronic diseases: tuberculosis, hepatitis, diabetes, hypertension, myocardial infarction, heart disease, stroke, respiratory disease, tropical or parasitic diseases, other infections; any nonsurgical hospital admissions (Lushniak, 2015). Getting the health history is important to help improve health care .

    Understanding an older patient’s usual level of functioning and knowing about any recent significant changes are fundamental to providing appropriate health care. The Functional Assessment tool would assist and leeting to provide know what the patient can do for example can the patient completed his ADL. Knowing the limitation of the disability will assist the provider and family to better care for the patient. A functional assessment is a multidimensional and often interdisciplinary diagnostic process, which assesses and quantifies an older adult’s medical, the patient, and family to develop a comprehensive plan for therapy and future care decisions and can also help in the process of long-term care decision-making (Ball el. al, 2019) 76-year-old black male with disabilities living in an urban setting.

    Targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.  I would try to gather data before meeting with the patient. Request previous medical records or, if there is time, mail forms that the patient or a family member can complete at home (Ball el. al, 2019).

     1. What are areas do you think you need help in?

    2. Do you live alone?

    3. Do you feel safe in your home?

    4. Have you fallen recently?

    5. What medications are you currently taking and what method do you use to organize your medications?

    6. Do you have family that visit?

    References

    Horowitz, B., Almonte, T., Kaur, S., & Vasil, A. (2016). Use of the home safety self assessment tool (hssat) within community health education to improve home safety. 
    American Journal of Occupational Therapy
    , 
    70
    (4_Supplement_1), 7011510221p1. Retrieved September 1, 2021, from 
    https://doi.org/10.5014/ajot.2016.70s1-po5081

    Lushniak, B. D. (2015). Family health history: Using the past to improve future health. 
    Public Health Reports
    , 
    130
    (1), 3–5. Retrieved September 12, 2021, from 
    https://doi.org/10.1177/003335491513000102

    Wu,, R. A., & Orlando,, L. A. (2015). 
    Implementation of health risk assessments with family health history: Barriers and benefits | postgraduate medical journal
     [91 (1079), p 508-513.]. Retrieved September 1, 2021, from 
    https://pmj.bmj.com/content/91/1079/508

    Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). 
    Seidel’s guide to       physical examination: An interprofessional approach 
    (9th ed.). Elsevier Mosby.

    By Day 6 of Week 1

    Respond 
    to 
    at least two
     of your colleagues 
    on 2 different days
     who selected a different patient than you, using one or more of the following approaches:

    response

    It is crucial for Nurse Practitioners to develop and build a relationship with their patients as you indicated. Making patients feel comfortable physically and emotionally without being judgmental especially when interviewing an elderly patient is highly significant (Ball et al., 2019). Considering factors such as age, gender, functional abilities, culture, and environment that may have a significant impact on a patient’s wellbeing is crucial as well (Ball et al., 2019) 76-year-old black male with disabilities living in an urban setting.

    Fall is a leading cause of death among the elderly and performing a comprehensive assessment will guide the practitioner in individualizing a plan of care for the patient. An assessment tool that can be utilized is the Berge Balance Scale; the screening tool used to measure patients’ mobility, balance, transfer, and gait (Landers et al., 2016). As people advance in age, various factors that can impact their health includes; a decline in cognition, life stress, illness, and physical limitations (Ball et al., 2019). It is therefore significant that clinicians have a sound knowledge of health assessment and be able to use different screening tools that would guide diagnosis, treatment, and plan of care (Wu & Orlando, 2015).

     

    References

    Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., Stewart, R. W. (2019).
     Seidel’s guide to physical examination: An interprofessional approach (9th ed).
     St. Louis, MO: Elsevier Mosby

    Landers, M. R., Oscar, S., Sasaoka, J., Vaughn, K. (2016, April). Balance confidence and fear of falling. Avoidance behavior is most predictive of falling in older adults: Prospective Analysis. 
    Academic Journal,
     433-442.

    Wu, R., & Orlando, L. A. (2015). Implementation of health risk assessments with family health history: barriers and benefits. 
    Postgraduate Medical Journal, 91
    (1079), 508-513. http://pmj.bmj.com/content/91/1079/508 76-year-old black male with disabilities living in an urban setting

  • NRNP 6568 Week 7 Knowledge Check

    NRNP 6568 Week 7 Knowledge Check

    Quiz – Week 7 Knowledge Check

    QUESTION 1

    In an ambulatory patient, the most common cause of hypercalcemia is ____________.

    Hypoparthyroidism

    Hypothyroid

    Hyperparathyroidism

    Hyperthyroid

    C

    QUESTION 2

    Several organizations have come together to define the diagnostic criteria for metabolic syndrome.    One of these criteria is:

    Elevated fasting plasma glucose: 100  mg/dL or higher, or drug treatment for elevated glucose

    True

    False

    A

    QUESTION 3

    Acromegaly is a disease resulting from excessive secretion of growth hormone.

    True

    False

    A

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    QUESTION 4

    What HgA1C level indicates a diagnosis of diabetes?

    5.7

    6.0

    6.5

    7.0

    C

    QUESTION 5

    Several organizations have come together to define the diagnostic criteria for metabolic syndrome.    One of these criteria is:

    Reduced HDL cholesterol: below 50 mg/dL in males and below 60 in females, or specific treatment for this lipid abnormality

     

    True

    False

     

    B

    QUESTION 6

    The only cure for primary hyperparathyroidism is ________________.

    Medication

    Surgery

    Rest

    Calcium supplements

    B

    QUESTION 7

    In a patient with hyperglycemia, the intracellular fluid may shift into the extracellular compartment, leading to decreased sodium levels.

    True

    False

    A

    QUESTION 8

    What are cardinal signs of Type 1 Diabetes Mellitus?

    Weight gain, blurred vision, and increased energy

    Weight gain, blurred vision, insomnia

    Decreased urination, decreased thirst, and decreased appetite

    Increased urination, increased thirst, increased appetite

    D

    QUESTION 9

    The NP suspects a patient has hypothyroidism.  The NP would expect TSH and T4 level to be:

    Low TSH with High T4 levels

    Low TSH and low T4

    High TSH and high T4

    High TSH and low T4

    D

    QUESTION 10

    In Type 2 Diabetes Mellitus, vascular and neuropathic complications may begin to develop and progress before the diagnosis is made. True or False?

    True

    False

    A NRNP 6568 Week 7 Knowledge Check

  • 38-year-old native American pregnant female living on a reservation

    38-year-old native American pregnant female living on a reservation

    38 Year-old Native American Pregnant Female

                The patient I will interview is a 38-year-old Native American pregnant female living on a reservation. One very important part of building a good relationship with the patient is to build trust and help the patient feel comfortable to discuss anything she may need. It is important for me as the provider to have courtesy and build a connection with the patient (Ball, et al., 2019). Having kindness and building rapport with a patient is a great way for the patient to open up and for me to truly let the patient know they are valued and cared for 38-year-old native American pregnant female living on a reservation.

                The approach I like best is the patient-centered approach. When this approach is used, patients are fully involved in their health care decisions. This is part of rapport building but also helps give the patient a feeling of autonomy, engagement, and control of their health (Bridges, et al., 2018). Health care is better when a patient feels respected and part of the decision process. Especially in this case of the pregnant Native American patient because when it comes to different cultures and when a patient is put first, their culture is not only acknowledged but included with sensitivity in their health care. The patient may have holistic care she would like to use or other cultural factors that I may not be fully aware of.

    As this patient’s provider, I would first meet the patient and ask her to tell me about herself. I would ask questions about her family and her support group. I would see what support and resources she has. I would see if she had health insurance through the government and see if she was aware of the resources available to her. According to Kramer et al. (2009) many Native American women have health disparities and do not access all the benefits they could receive through Indian Health care Services. I would make sure she had information given to her in order to speak to someone to utilize the services she could receive 38-year-old native American pregnant female living on a reservation.

    I would ask her about her familial history. Finding out about the patient’s risk is very important when assessing a pregnant female. When a provider can truly know the risks the patient may have and can talk about the perceived risks the patient may think they may have, then come to an agreeable level of risk, the baby’s health is positively associated with the congruence of knowledge (Cannella et al., 2013). It is important to truly know all the risk factors and perceived risk factors the patient may have. When the patient is given the time to talk and is not rushed, she may open up a bit more to me as her provider as well. It is important to be patient and to give the patient time to open up.

    I would also feel it is part of my duty as a provider to ensure the patient has a safe place to live to ensure the baby gets good prenatal and postnatal care. The patient may not know the importance of eating healthy, taking prenatal vitamins, or about certain foods or drinks in a diet that are good or bad for her. It is important for the provider to make sure the patient knows their social determinants of health. Depending on the patient’s knowledge, she may not know about all the certain risks her culture, age, or health history may have in her pregnancy. According to Tesfalul et al. (2021) some providers do not tell the patients all their potential risks or determinants for health due to anxiety or knowing how to properly tell them 38-year-old native American pregnant female living on a reservation. I would find it my duty to learn about and help my patients know about their social determinants of health. Some things would be about diabetes, living conditions, or even age, as over 35 years is considered a geriatric pregnancy. It is my job to recognize the potential risks and let the patient know of them and assess and manage her healthcare according to her social determinants of health.

    I would ask my patient is she felt at risk for her or her child’s wellbeing or safety. I would want to make sure she felt safe and free from violence, poverty, or even mental health. I also definitely would make sure my patient felt she had good support during her pregnancy. I would ask the following questions:

    Whom do you live with?

    Do you feel safe in your home?

    Was your pregnancy planned?

    Do you have a partner that supports you?

    Do you feel depressed or sad in any way?

    What more could I do for you regarding your pregnancy so you feel supported so you can have a safe and successful pregnancy?

    In conclusion, I would want to make sure that my patient leaves the first appointment feeling safe, knowledgeable, and supported. I want her to know I care about her and want the best care for her. I also want her to know I will respect any cultural decisions she makes in her health care. It is also important she knows of potential risks if she does not have good health care while pregnant. I would want to make sure she takes her vitamins, has a healthy diet, feels safe in her environment, and takes the necessary tests since she is considered a geriatric pregnancy. I would make sure she leaves my office feeling aware and empowered in her health care supported during her pregnancy. It is important to know the patient’s history and also future plan and ensure she is making the best decisions possible for her to have a successful and healthy pregnancy 38-year-old native American pregnant female living on a reservation.

    References

    Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). Elsevier Mosby.

    Bridges, J. F., Crossnohere, N. L., Schuster, A. L., Miller, J. A., Pastorini, C., & Aslakson, R. A. (2018). A patient and community-centered approach selecting endpoints for a randomized trial of a novel advance care planning tool. 
    Patient Preference & Adherence
    , 
    12
    , 241–249. 
    https://doi-org.ezp.waldenulibrary.org/10.2147/PPA.S150663

    Cannella, D., Auerbach, M., & Lobel, M. (2013). Predicting birth outcomes: Together, mother and health care provider know best. 
    Journal of Psychosomatic Research, 75
    (4), 299–304. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jpsychores.2013.08.004

    Kramer, B. J., Jouldjian, S., Washington, D. L., Harker, J. O., Saliba, D., & Yano, E. M. (2009). Health care for American Indian and Alaska Native women. 
    Women’s Health Issues, 19
    (2), 135–143. https://doi-org.ezp.waldenulibrary.org/10.1016/j.whi.2008.11.002

    Tesfalul, M. A., Feuer, S. K., Castillo, E., Coleman-Phox, K., O’Leary, A., & Kuppermann, M. (2021). Patient and provider perspectives on preterm birth risk assessment and communication. 
    Patient Education and Counseling
    . https://doi-org.ezp.waldenulibrary.org/10.1016/j.pec.2021.03.038 38-year-old native American pregnant female living on a reservation

    Discussion: Building a Health History

    Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

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    For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

    Photo Credit: Sam Edwards / Caiaimage / Getty Images

    To prepare:

    With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

    By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. 
    Note
    : Please see the “Course Announcements” section of the classroom for your new patient profile assignment.

    How would your communication and interview techniques for building a health history differ with each patient?

    How might you target your questions for building a health history based on the patient’s social determinants of health?

    What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?

    Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration 38-year-old native American pregnant female living on a reservation.

    Select 
    one
     of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the 
    Seidel’s Guide to Physical Examination
     text, or another tool with which you are familiar, related to your selected patient.

    Develop 
    at least five
     targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

    By Day 3 of Week 1

    Post 
    a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Read a selection of your colleagues’ responses.

    By Day 6 of Week 1

    Respond 
    to 
    at least two
     of your colleagues 
    on 2 different days
     who selected a different patient than you, using one or more of the following approaches:

    Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

    Suggest additional health-related risks that might be considered 38-year-old native American pregnant female living on a reservation.

    Validate an idea with your own experience and additional research.

     

    Sample response

    Thank you for your insightful post. It was very inclusive regarding the care you would provide to your 38-year-old pregnant native American. Women who experience gestational diabetes (GD) are at greater risk for later developing type two diabetes and increases the risk of hypertension during the pregnancy (Center for Disease Control, 2021). Education regarding prevention and monitoring for symptoms of these two diseases will be optimal for early detection and care during their pregnancy. One way for prevention in gestational diabetes would be education. According to Stotz (2019), many native American women do not know what gestational diabetes is until they are diagnosed with it. Education may be provided on what gestational diabetes is and how it can be prevented to this individual 38-year-old native American pregnant female living on a reservation.

    Another area to look at within your interview would be to be culturally sensitive. Some Native American cultures incorporate different beliefs. One question that may be asked during the interview would be: are there any belief practices that you would affect care for yourself of infant? This is an open-ended question for the individual to incorporate any beliefs that they would like for the care of themselves during the pregnancy, delivery, and postpartum care. In previous experiences I have worked on reservations in Minnesota. I have not specifically cared for women during pregnancy however, I have for geriatric patients. When they are in the dying process one ritual that comes to mind would be the burning of sage after death. At the facility I was working at we were able to accommodate this request for the family.

     

    Center for Disease Control and Prevention.  (2021, August 10). Gestational diabetes. 
    https://cdc.gov/diabetes/basics/gestational.html

    Stotz, S., Charron-Prochownik, D., Terry, M.A., Gonzales, K., & Moore, K. (2019). Reducing risk for gestational diabetes mellitus (GDM) through a preconception counseling program for American indian/Alaska native girls: Perceptions from women with type 2 diabetes of a history of GDM. Diabetes Educator, 45(2), 137-145. https//doi-org.ezp.waldenulibrary.org/10.1177/0145721718821663 38-year-old native American pregnant female living on a reservation