Category: Nursing

  • End of Life Essay

    The End of Life Essay paper must be written using the current APA Format and should include headings. References other than your textbook are required. Please be aware of the validity and reliability of the sources you utilize, especially sources from the internet – bias is not uncommon!

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    Please include the following information:

    1. Introduction of issue, relevant history/ landmark events/ rulings to provide a clear picture of how the issue is viewed in society.

    2. Discuss why this issue is an ethical dilemma for you, including:

    a. Ethical principles involved or conflicting

    b. Relevant values you hold End of Life Essay

    c. Ethical theory to which you ascribe

    d. Any fallacies of reasoning that might interfere in your ethical decision making process related to this issue

    3. Describe how this ethical issue affects patients, families, society, law, and economics.

    4. Describe the role of the nurse in the decision making process regarding the ethical issue. Describe any conflicts/ concerns, legal and ethical responsibilities (what standards apply).

    5. Discuss actual or potential resolution of the issue with attention to how it involves/ affects the nurse, patient, family, society, the law and economics. End of Life Essay

    6. Provide a strong conclusion.

    PLEASE NOTE THE 2ND PAGE IS FOR A VOICE ENHANCED POWERPOINT PRESENTATION THAT I HAVE TO DO, THE ACTUAL PAPER IS THE FIRST PORTION I’VE INCLUDED IT FOR RESEARCH AND INFORMATIONAL PURPOSES.

    Your presentation should focus on the following:

    – A brief description of the issue

    – Key information regarding application of an ethical theory

    – Relevant ethical and legal standards

    – Ethical principles End of Life Essay

    – Fallacies of reasoning

    – The role of the nurse in the decision-making process.

    – Discuss Actual or potential resolution of the ethical dilemma

    Include a slide of references utilized in your presentation.

    The presentation should be ~ 10 – 15 slides in length.

    The assignment is worth 20% of your grade for this course.

    The End of Life Essay assignment will be graded using the Presentation Grading Rubric.

  • Cardiovascular and respiratory systems Case Study Analysis

    Cardiovascular and respiratory systems Case Study Analysis

    Assignment: Case Study Analysis

    An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other.

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    Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact. Cardiovascular and respiratory systems Case Study Analysis

    An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

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

    To prepare:

    Assignment (2-page case study analysis)

    In your Case Study Analysis related to the scenario provided, explain the following

    • The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms. Cardiovascular and respiratory systems Case Study Analysis

    • Any racial/ethnic variables that may impact physiological functioning.

    • How these processes interact to affect the patient

    Scenario: 76-year-old female patient complains of weight gain, shortness of breath, peripheral edema, and abdominal swelling. She has a history of congestive heart failure and admits to not taking her diuretic, as it makes her “have to get up every couple hours to go to the bathroom.” She now has to sleep on two pillows in order to get enough air.

    READING/RESOURCES

    McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

    • Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review

    • Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review

    • Chapter 35: Structure and Function of the Pulmonary System; Summary Review

    • Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review

    Inamdar, A. A. & Inamdar, A. C. (2016). Heart failure: Diagnosis, management, and utilization, 5(7). doi:10.3390/jcm5070062 Cardiovascular and respiratory systems Case Study Analysis

  • Leadership Theories in Practice

    Leadership Theories in Practice

    A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

    However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations. Leadership Theories in Practice

    Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

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    To Prepare:

    • Review the Resources and examine the leadership theories and behaviors introduced.

    • Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

    • Reflect on the leadership behaviors presented in the three resources that you selected for review.

    Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace. Leadership Theories in Practice

    READING/RESOURCES

    Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

    • Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)

    • Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)

    • Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194)

    Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3 Leadership Theories in Practice

  • Nursing Leadership Strategy Discussion

    Nursing Leadership Strategy Discussion

    As a nurse, you serve an important role in identifying strategies to effectively manage health care resources and in leading health care quality improvement. You must be able to decide what leadership style or strategy to apply in a given situation to achieve an effective resolution of the issue. Read the following two scenarios and select one to focus on in this Discussion. Consider the leadership style or strategy that might be most effective in the scenario you selected.

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    Scenario 1

    You work in a for-profit nursing home, with about 100 beds, on a 20-bed unit that is largely patients with Alzheimer’s disease. Your patient mix is predominantly Medicare and Medicaid patients. Your nursing home is part of a larger system that includes a major medical center, as well as VNA, outpatient dialysis, and a fully integrated network. Your nurse manager is getting feedback from the hospital that your nursing home is sending too many patients to the ED who really don’t need to go Nursing Leadership Strategy Discussion. How would you go about figuring out what could be done at the nursing home to prevent avoidable ED visits?

    Scenario 2

    You’ve been associated with an outpatient cardiology clinic that is part of a large academic medical center. Your patients are mostly charity care and managed Medicaid. Most have a prescription plan, but none have a “family doctor” and use the clinic (and the ED) regularly. Most are unfamiliar with their medications and do not have the resources for care coordination in their family/social network Nursing Leadership Strategy Discussion. About 25 CHF patients have been “lovingly,” but inappropriately, called “frequent fliers” because of their inability to manage their own care, their frequent visits to the ED, and their “one night stays” paid at the observation rate. As a staff nurse in this clinic, describe the strategies you could devise for you and your fellow staff nurses targeting these 25 patients. Find at least one article from the professional literature to corroborate your recommendations.

    Select one of the scenarios, and post the following:

    Describe the most appropriate leadership style and/or strategy to apply in the scenario you chose in order to implement the recommendations successfully. Justify your selection. Nursing Leadership Strategy Discussion.

    Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.

    Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). Nursing Leadership Strategy Discussion

  • Policy Issue Presentation. NRP/508: Health Policy And Role Of The Advanced Practice Nurse

    Policy Issue Presentation. NRP/508: Health Policy And Role Of The Advanced Practice Nurse

    Week 5 Assignment Instructions

    Policy Issue Presentation.  NRP/508: Health Policy And Role Of The Advanced Practice Nurse

    Create a 8- to 10-slide Microsoft® PowerPoint® presentation, with speaker’s notes, communicating the change vision of the policy issue you selected.

    Locate a minimum of three academic articles to support your stance. Two of the three articles can be previous resources used in earlier weeks.

    Include the following in your presentation:

    Summarize the problem statement using relevant background information and supporting details from the articles you located. (15 pts)

    Identify the policy objectives, options, and alternatives. (10 pts)

    Who is directly impacted by the health policy issue? (10 pts)

    Identify the stakeholders who will assist you in implementing the change and define their roles. (10 pts)

    What are the outside influences on the policy issue? (10 pts)

    How has the media’s influence shaped the policy? (10 pts)

    How will the policy change improve health care? (10 pts)

    Are there any cultural or ethical implications to this policy? (10 pts)

    Cite and reference using APA guidelines. There must be at least 3 scholarly works that are peer-reviewed and within the last 5 years. References and in-text citations must be included in APA format. (5 pts) Policy Issue Presentation. NRP/508: Health Policy And Role Of The Advanced Practice Nurse

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    Assignment texts and readings.

    Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016). Policy & politics in nursing and health care, 7th ed. St. Louis, MO: Elsevier.

    Chapter 14.

    Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F. D., & East, L. (2014). Addressing issues impacting advanced nursing practice worldwide. Online Journal of Nursing Issues, 19(2), 1-12.

    Week 5 Assignment Instructions
    Policy Issue Presentation.  NRP/508: Health Policy And Role Of The Advanced Practice Nurse

    Create a 8- to 10-slide Microsoft® PowerPoint® presentation, with speaker’s notes, communicating the change vision of the policy issue you selected.

    Locate a minimum of three academic articles to support your stance. Two of the three articles can be previous resources used in earlier weeks.

    Include the following in your presentation:

    Summarize the problem statement using relevant background information and supporting details from the articles you located. (15 pts)

    Identify the policy objectives, options, and alternatives. (10 pts)

    Who is directly impacted by the health policy issue? (10 pts)

    Identify the stakeholders who will assist you in implementing the change and define their roles. (10 pts)

    What are the outside influences on the policy issue? (10 pts)

    How has the media’s influence shaped the policy? (10 pts)

    How will the policy change improve health care? (10 pts)

    Are there any cultural or ethical implications to this policy? (10 pts)

    Cite and reference using APA guidelines. There must be at least 3 scholarly works that are peer-reviewed and within the last 5 years. References and in-text citations must be included in APA format. (5 pts)

    Policy Issue Presentation. NRP/508: Health Policy And Role Of The Advanced Practice Nurse

     

    Assignment texts and readings.

    Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016). Policy & politics in nursing and health care, 7th ed. St. Louis, MO: Elsevier.

    Chapter 14.

    Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F. D., & East, L. (2014). Addressing issues impacting advanced nursing practice worldwide. Online Journal of Nursing Issues, 19(2), 1-12. Policy Issue Presentation. NRP/508: Health Policy And Role Of The Advanced Practice Nurse

  • Ethical Decision-Making, NRP/508: Health Policy And Role Of The Advanced Practice Nurse

    Week 4 Assignment Instructions

    Conduct an Internet search for the Core Concepts of Jean Watson’s Theory of Human Caring/Caring Science article.

    Read the article.

    Complete the questions from Box 15-1: Ethics Inventory located on p. 141 in Ch. 15 of Policy & Politics.

    Select an ethical dilemma you would face as an APRN.

    Write a 1,050-word paper addressing the following:

    Identify which provision of the nursing code of ethics would be violated in the ethical dilemma. How can you use the code of ethics to address the issue? (15 pts)

    How can you create an ethical environment in your workplace to bring about awareness for other nurses in this area? (15 pts)

    Explain how you can use Watson’s theory of human caring as a guide when encountering ethical decisions. (15 pts)

    Provide references for all sources cited and format according to APA guidelines. There must be at least one scholarly work that is peer-reviewed and within the last 5 years. References and in-text citations must be included in APA format. (5 pts)

     

    Reading for assignment.  Box 15-1 is included in the reading below.  Box 15-1, page 141, Chapter 15, Policy and Politics in Nursing and Health Care text.

    Hamric, A. B., Hanson, C. M., Tracy, M.F., & O’Grady, E.T (2019). Hamric and Hanson’s advanced practice nursing: an integrative approach (6th ed.). St. Louis, MO: Elsevier.

    Chapter 7 and 13.

     

    Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016). Policy & politics in nursing and health care, 7th ed. St. Louis, MO: Elsevier.

    Chapter 8 and 15.

     

    Weber, B. B. (2011). The role of professional nursing organizations in maintaining a healthy workplace. Plastic Surgical Nursing, 31(3), 92-94.

  • Benchmark – Electronic Health Record Implementation Paper

    Benchmark – Electronic Health Record Implementation Paper

    Electronic health records (EHR) is a tool that has received much attention in the health care industry, particularly because of its capacity to track the opportunities for improving health care through the database feature. To be more precise, the database contained in the EHR contains patient registries that indicate the status of the patient, measures taken and results of the care approaches, as well as any relevant warnings or advices. In fact, the registries contain information on all the patient interactions with the…

    This benchmark assignment assesses the following programmatic competencies:

    2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.

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    5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care.

    One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process. Benchmark – Electronic Health Record Implementation Paper

    In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse’s role during this type of scenario:

    What key information would be needed in the database that would allow you to track opportunities for care improvement?

    What role does informatics play in the ability to capture this data?

    Which systems and staff members would need to be involved in the design and implementation process and team?

    What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?

    How would the EHR team ensure that all order sets are part of the new record?

    How would you communicate the changes, including any kind of transition plan?

    What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?

    What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

    You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Benchmark – Electronic Health Record Implementation Paper.

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

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

    Benchmark – Electronic Health Record Implementation Paper – Rubric

    No of Criteria: 14 Achievement Levels: 5

    Criteria

    Achievement Levels

    DescriptionPercentage

    Unsatisfactory

    0.00 %

    Less than Satisfactory

    80.00 %

    Satisfactory

    88.00 %

    Good

    92.00 %

    Excellent

    100.00 %

    Content

    70.0

    Key Information Needed in the Database to Track Opportunities for Care Improvement

    10.0

    A discussion of key information needed in the database to track opportunities for care improvement is not included.

    A discussion of key information needed in the database to track opportunities for care improvement is present, but it lacks detail or is incomplete.

    A discussion of key information needed in the database to track opportunities for care improvement is present.

    A discussion of key information needed in the database to track opportunities for care improvement is clearly provided and well developed. Benchmark – Electronic Health Record Implementation Paper

    A comprehensive discussion of key information needed in the database to track opportunities for care improvement is thoroughly developed with supporting details.

    Role Informatics Plays in the Ability to Capture This Data

    10.0

    A discussion of the role informatics plays in the ability to capture this data is not included.

    A discussion of the role informatics plays in the ability to capture this data is present, but it lacks detail or is incomplete.

    A discussion of the role informatics plays in the ability to capture this data is present.

    A discussion of the role informatics plays in the ability to capture this data is clearly provided and well developed.

    A comprehensive discussion of the role informatics plays in the ability to capture this data is thoroughly developed with supporting details.

    The Systems and Staff Members that Would Need to Be Involved in the Design and Implementation Process and Team

    10.0

    A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is not included.

    A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is present, but it lacks detail or is incomplete.

    A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is present.

    A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is clearly provided and well developed.

    A comprehensive discussion of the systems and staff members that would need to be involved in the design and implementation process and team is thoroughly developed with supporting details.

    Professional, Ethical, and Regulatory Standards That Must Be Incorporated Into the Design and Implementation of the System (5.2) Benchmark – Electronic Health Record Implementation Paper

    10.0

    A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is not included.

    A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is present, but it lacks detail or is incomplete.

    A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is present.

    A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is clearly provided and well developed.

    A comprehensive discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is thoroughly developed with supporting details.

    How the EHR Team Would Ensure That All Order Sets Are Part of the New Record

    5.0

    A discussion of how the EHR team would ensure that all order sets are part of the new record is not included.

    A discussion of how the EHR team would ensure that all order sets are part of the new record is present, but it lacks detail or is incomplete.

    A discussion of how the EHR team would ensure that all order sets are part of the new record is present.

    A discussion of how the EHR team would ensure that all order sets are part of the new record is clearly provided and well developed.

    A comprehensive discussion of how the EHR team would ensure that all order sets are part of the new record is thoroughly developed with supporting details.

    Communication of the Changes, Including Any Kind of Transition Plan

    5.0

    A discussion of how to communicate the changes, including any kind of transition plan, is not included.

    A discussion of how to communicate the changes, including any kind of transition plan, is present, but it lacks detail or is incomplete. Benchmark – Electronic Health Record Implementation Paper

    A discussion of how to communicate the changes, including any kind of transition plan, is present.

    A discussion of how to communicate the changes, including any kind of transition plan, is clearly provided and well developed.

    A comprehensive discussion of how to communicate the changes, including any kind of transition plan, is thoroughly developed with supporting details.

    Measures and Steps to Evaluate the Success of the EHR Implementation

    5.0

    A discussion of measures and steps to evaluate the success of the EHR implementation is not included.

    A discussion of measures and steps to evaluate the success of the EHR implementation is present, but it lacks detail or is incomplete.

    A discussion of measures and steps to evaluate the success of the EHR implementation is present.

    A discussion of measures and steps to evaluate the success of the EHR implementation is clearly provided and well developed.

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    A comprehensive discussion of measures and steps to evaluate the success of the EHR implementation is thoroughly developed with supporting details.

    Leadership Skills, Theories, and Styles to Employ for Collaboration on Interprofessional Teams Participating in the Legislative Process and Providing Evidence-Based, Patient-Centered Care (2.3)

    10.0

    A discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is not included.

    A discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is present, but it lacks detail or is incomplete.

    A discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is present.

    A discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is clearly provided and well developed. Benchmark – Electronic Health Record Implementation Paper

    A comprehensive discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is thoroughly developed with supporting details.

    Required Sources

    5.0

    Sources are not included.

    Number of required sources is only partially met.

    Number of required sources is met, but sources are outdated or inappropriate.

    Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

    Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

    Organization and Effectiveness

    20.0

    Thesis Development and Purpose

    7.0

    Paper lacks any discernible overall purpose or organizing claim.

    Thesis is insufficiently developed or vague. Purpose is not clear.

    Thesis is apparent and appropriate to purpose.

    Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    Argument Logic and Construction

    8.0

    Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

    Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

    Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Benchmark – Electronic Health Record Implementation Paper

    Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

    Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    5.0

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

    Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

    Writer is clearly in command of standard, written, academic English.

    Format

    10.0

    Paper Format (Use of appropriate style for the major and assignment)

    5.0

    Template is not used appropriately or documentation format is rarely followed correctly.

    Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

    Template is used, and formatting is correct, although some minor errors may be present.

    Template is fully used; There are virtually no errors in formatting style.

    All format elements are correct.

    Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

    5.0

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    Total Percentage 100

     

    Electronic health record implementation

    What key information would be needed in the database that would allow you to track opportunities for care improvement?

    Electronic health records (EHR) is a tool that has received much attention in the health care industry, particularly because of its capacity to track the opportunities for improving health care through the database feature. To be more precise, the database contained in the EHR contains patient registries that indicate the status of the patient, measures taken and results of the care approaches, as well as any relevant warnings or advices. In fact, the registries contain information on all the patient interactions with the medical facility and personnel (HealthIT, 2019). To maximize its benefits in terms of tracking care improvement opportunities, there is a need for the database to have certain elements as routine features. Benchmark – Electronic Health Record Implementation Paper. The first element is records keepings that makes it possible to track trends across all demographics thus making it possible to monitor care improvement efforts applied as well as inform research into additional improvements. The records should also contain information on how the patients react to the different care approaches and whether the desired objectives were achieved in each care setting. The second element is a clear link between health care approach and outcomes, making use of informatics to support decision making through noting what works to achieve the desired objectives. The final element is the presence of comprehensive indices that collect all the information at a single point and ensure that they are access to the authorized persons thereby supporting inter-professional collaboration and care approaches for the best outcomes (HealthIT, 2019).

    What role does informatics play in the ability to capture this data?

    Informatics is concerned with organization and analyzing health care information with a focus on extracting the useful aspects and assigning logical meaning to the information. It acknowledges that all interactions between medical facilities and personnel produce cumbersome data, and that deliberate processes are needed to make sense of the data. As such, informatics makes sense of the collected data by assigning value and extracting insight to allow the health care systems to reduce the opportunities for errors while improving the odds of achieving the desired outcomes. In fact, it associates the data variables and develops logical correlations to show associations that can support deliberate care improvement and cost reduction efforts (Saba & McCormick, 2015). Given that informatics makes use of data, then it is not hard to imagine that informatics plays a role in the ability to capture data. In this case, informatics influences the data capture process by identifying the determinants and contextual factors that are relevant to the health care objectives, and considering them as variables (Estiri, Patel & Murphy, 2018). In this respect, informatics influences the ability to capture data by identifying the useful data Benchmark – Electronic Health Record Implementation Paper.

    Which systems and staff members would need to be involved in the design and implementation process and team?

    Designing and implementing informatics requires input from systems and staff members. In this case, the systems include the specific technologies that support staff members to perform logical functions. There are a range of systems that are required to complete these functions. Firstly, clinical decision support systems are necessary to support primary care provision through diagnosis, prevention and treatment efforts. They include prediction algorithms, reminders and
    e
    -tools. Secondly, personal health records that contain all the information collected during interactions between patients and medical personnel. Thirdly, telehealth and telemedicine systems that support self-care efforts without placing the patients in unnecessary risks. All the systems must support efforts to secure the information and ensure that only authorized persons can access the information. This is in line with confidentiality and autonomy expectations for patient information (Demiris & Kneale, 2015). Besides the mentioned systems, there are personnel who are needed to complete the logical health care functions. They are identified based on their interactions with informatics and knowledge levels. Firstly, creators who are proficient in programing and mathematics can address the technical needs, such as computer engineers, programmers and system analysts. They are engaged in informatics design and development. Secondly, administrators and operators who operate and manage the informatics systems on a daily basis, determine how they are used and access. They include trainers, help-desk/support analysts, database administrators, and operators. Thirdly, information managers and users who determine what the informatics results will be used for in terms of application. They include the information security officer, project manager, function manager and information officer (McGonigle & Mastrian, 2018).

    What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?

    Informatics systems have implications for professional, regulatory and ethical standards. That is because they make use of protected health information as inputs. To be more precise, there is an inherent expectation for patient information to be protected. However, informatics systems rely on this information thereby presenting concerns that can be potentially preempted through implementing the standards that act as guides to ensure that information security and confidentiality expectations are not violated. These standards have an overlap with the health care practice standards that are already in use in managing all health care information. In fact, regardless of context, there is an expectation of information integrity, non-maleficence, beneficence, justice, equality, confidentiality, and autonomy. In addition, these standards include an expectation of accountability, legitimate infringement, least intrusive alternative, openness, access, security and privacy for all informatics activities (Davis & LaCour, 2014). In addition, the regulatory standards must be observed, particularly the legislation intention to protect patient information. That is because they have legal implications with possibility of judicial intervention and penalties for violations. Examples of the relevant regulatory regulations include the 21
    st
    Century Cures Act of 2016, Medicare Access & CHIP (Children’s Health Insurance Program) Reauthorization Act of 2015, Food and Drug Administration Safety and Innovation Act (FDASIA) of 2012, Affordable Care Act of 2010, Health Insurance Portability and Accountability Act (HIPAA) of 1996, Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, and Privacy Act of 1974. Benchmark – Electronic Health Record Implementation Paper. In addition, there is a need to observe the regulations presented by the institutional review boards (IRB), Medicare laws, and patient records confidentiality rules (Hoffman 2017).

    How would the EHR team ensure that all order sets are part of the new record?

    The EHR team must ensure that all order sets are part of the new record. These occurs by undertaking deliberate steps. Firstly, the new record must be compatible with the old record. If not compatible, then the old record should be reviewed and integrated into the new record so that all the available information is assimilated into one information database. Secondly, the new record should be implemented in a progressive manner so that users familiarize themselves with its use even as data is transferred from the old record into the new record. This step ensures that the new record performs as intended even as kinks are eliminated with continued use (Davis & LaCour, 2014) Benchmark – Electronic Health Record Implementation Paper.

    How would you communicate the changes, including any kind of transition plan?

    Communicating the changes ensures that all stakeholders are aware of what is taking place, and are well prepared for the change. Successful, efficient and effective can only be achieved through the inclusion of three features. Firstly, ensuring that all the stakeholders are primed to have a shared vision of what the change seeks to address. They must recognize that change is necessary to address an existing problem Benchmark – Electronic Health Record Implementation Paper. Secondly, appointing or assigning effective leadership that has a good understanding of the change and can explain its intentions. This ensures that knowledgeable persons are assigned to lobby for the change and convince other stakeholders to support the change. Thirdly, disturbing the status-quo so that the stakeholders are dissatisfied with the state of affairs and look to the change as a way of achieving a new acceptable status quo (McGonigle & Mastrian, 2018).

    What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?

    The success of the EHR implementation can be evaluated using two approaches. The first approach is to check if the technical performance of the EHR matches the expectations. In addition, this approach looks at the cost of the implementation and confirms how the actual cost matches to the budgeted costs and whether the implementation wend under or over the budget. The second approach is to engage the stakeholders and collect their perspective on the EHR system. This approach identifies the affected stakeholders, how they were affected, performance evaluation, and whether there is a need for changes (McGonigle & Mastrian, 2018).

    What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

    There is a need for leadership between stakeholders to ensure that the best possible care is provided. There are two leadership skills that should be applied. The first skill is supporting co-governance and self-governance so that the stakeholders are encouraged to express their opinions with regards to their expectations. This allows them to point out areas that need improvement, particularly the features that relate to specific disciplines and stakeholder groups. The second skill is applying hierarchical governance that assigns clear authority and responsibility to individuals. In addition to the two skills, leaders should be effective change agents, self-aware, vision, innovation, self-regulation, team building, motivation, strategic planning, decisive, and have integrity. Besides that, they should apply situational leadership theory that requires the leader to always correspond the leadership style to the respective situation through evacuating the relevant variables such as the number of team members, nature of professionals and type of task (Arnold & Boggs, 2019). Benchmark – Electronic Health Record Implementation Paper.

    References

    Arnold, E. & Boggs, K. (2019).
    Interpersonal relationships e-book: professional communication skills for nurses
    (8
    th
    ed.). St. Louis, MO: Elsevier.

    Davis, N. & LaCour, M. (2014).
    Health information technology
    (3
    rd
    ed.). Amsterdam: Elsevier.

    Demiris, G. & Kneale, L. (2015). Informatics systems and tools to facilitate patient-centered care coordination.
    Yearbook of Medical Informatics
    , 10(1), 15-21. DOI: 10.15265/IY-2015-003

    Estiri, H., Patel, C. & Murphy, S. (2018). Informatics can help providers incorporate context into care.
    JAMIA Open
    , 1(1), 3–6. DOI: 10.1093/jamiaopen/ooy025

    HealthIT (2019).
    What information does an electronic health record (EHR) contain?
    https://www.healthit.gov/faq/what-information-does-electronic-health-record-ehr-contain

    Hoffman, S. (2017).
    Electronic health records and medical big data: law and policy
    . New York, NY: Cambridge University Press.

    McGonigle, D., & Mastrian, K. G. (2018).
    Nursing informatics and the foundation of knowledge
    (4
    th
    ed.). Burlington, MA: Jones and Bartlett Learning.

    Saba, V. & McCormick, K. (2015).
    Essentials of nursing informatics
    (6
    th
    ed.). New York, NY: McGraw-Hill. Benchmark – Electronic Health Record Implementation Paper.

  • Practicum Journal: Safe Prescribing

    Week 2 Practicum Journal: Safe Prescribing

    There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications.

    In this Practicum Journal Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state.

    Learning Objectives

    Students will:

    • Analyze roles of the Drug Enforcement Administration

    • Analyze PMHNP responsibilities when issued a DEA number

    • Analyze DEA number application procedures

    • Analyze state requirements for safe prescribing and prescription monitoring

    • Analyze PMHNP responsibilities for safe prescribing and prescription monitoring

    • Analyze Schedule II-V drug levels

    ** Assigned in Week 2 and submitted in Week 4.

    To prepare for this Practicum Journal:

    • Review the Learning Resources.

    In 2-3 pages:

    • Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.

    • Explain your responsibilities when having a DEA number.

    • Explain how you apply for a DEA number.

    • Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements.

    • Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

     

    Every patient has a right to be prescribed the right medication upon visiting a healthcare facility. Getting the correct medication not only ensures that a patient’s chances of better outcomes are increased but it also minimizes the chances of medication errors and adverse effects (Gorgich, Barfrohan, Ghoreshi, et al., 2016). It is, therefore, important that a PMHNP is well versed with the state and federal legislation that guides the use and prescription of controlled drugs. This paper will discuss the role that DEA plays, responsibilities of a person in possession of a DEA number, application of DEA, requirements for the safe prescription of controlled drugs and the role of PMHNP, and lastly some examples of schedule II-Vdrugs will be discussed.

    The Role of DEA

    Kanouse & Compton (2015) point out that the main responsibility of the DEA is to ensure that the circulation of illegal narcotics is controlled. The Department of Justice oversees the activities of the DEA. The DoJ makes sure the federal laws that touch on the manufacturing, sale, use as well as the distribution of controlled drugs adherence. As regards the PMHNP, the role of the DEA is in ensuring that drugs are controlled and that the prescription and supply are done by licensed persons who possess a DEA number (Kanouse & Compton, 2015). This prevents the misuse and abuse of controlled drugs.

    Responsibilities of Possessing a DEA Number

    When a professional possess a DEA number it shows one’s competency in the controlled drugs prescription. A DEA provisional number ought to be given to a person that is licensed prior to attaining the number. Hence, a person is tasked by federal legislation adherence as pertaining to the drug prescription, manufacturing and distribution (Caulkins &Reuter, 2017)

    Application of DEA Number

    The acquisition of a DEA number is necessary for the legalization of controlled drugs prescribed to patients. One has to visit the DEA website to create an order form. Alternatively, a person can visit a DEA field where one gets a form that will fill to acquire the number. After filling out the form and submitting it, one should note the ID number with which a person can check the progress status. After a three day waiting period, a person can contact the DEA to find out if the registration is approved or is yet pending. Additionally, one can make any necessary changes, on the application form. A person needs to first hold a license for practice as well as a permit for controlled substance distribution prior to being issued with a DEA number.

    Requirements for Safe Prescription, PMHNP Responsibility, and Cleveland’s Program on Prescription Monitoring

    The process of manufacturing, distribution, and prescription of controlled substances in Cleveland is governed by several guidance rules. These guidelines aim at eradicating or at least minimizing incidences of drug abuse. A practitioner first has to register with the regional DEA office that heads the drug monitoring program. Once successfully registered, a physician is licensed to prescribe controlled drugs to a patient in need of the same in their treatment process. However, Bao, Pan, Taylor et al., (2016) point out that a physician is required to first consult with the PDMP of a patient before prescribing a controlled drug. Further, upon dispensing a controlled drug, a report should be filed on the same for accountability purposes.

    As a PMHNP, I am expected to prescribed controlled drugs to patients residing in the area in which I practice my profession. I should not for any reason, self-prescribe. Regarding schedule narcotics, I should first check the ILPMP before initial first time prescription of the said drugs. This action ensures that controlled substances are not misused or abused and also medical errors are averted.

    Schedule II-V Drug Examples

    Controlled drugs are classified into schedules in order of their severity in the possibility of abuse and causing harm. They are also categorized based on their usefulness and possibility of dependence. The top of this list is the schedule II drugs. These drugs are likely to cause severe dependence both psychologically and physically with equally high abuse potential. Fentanyl is a schedule II drug that can be prescribed for patients with chronic pain and who have already developed a tolerance for other opioids (Ramos & Lope, 2019). Schedule III drugs have physical reliance that is low while psychological reliance is high. Pentobarbital is an example of a schedule III drug that can be prescribed for treating insomnia (Johnson & Sadiq, 2019). The schedule IV drugs have a lesser chance of abuse compared to the previous two schedules. Benzphetamine is one such drug in the schedule IV list. This drug is an appetite suppressant used in the treatment of obesity and overweight patients (Plodkowski, McGaeve, Reisinger et al., 2016). Schedule V drugs are moderately mild and Lomotil is one such example. Lomotil is used in the treatment of diarrhea (Khan, Asghar, Kanwal, et al, 2019).

    Conclusion

    Controlled drugs need to be administered by licensed professionals. Abuse and misuse of these drugs can cause a lifetime of dependence and in some cases, death. Physicians and NPs that are licensed to prescribe controlled drugs need to be vigilant and perform their due diligence before prescribing the drugs to a first-time patient. Additionally, a PHMNP should be knowledgeable on the correct dosage and prescription and always stay informed on any changes affecting the drugs the one prescribes.

     

    References

    Bao, Y., Pan, Y., Taylor, A., Radakrishnan, S., Luo, F., Pincus, H. A., & Schackman, B. R. (2016). Prescription drug monitoring programs are associated with sustained reductions in opioid prescribing by physicians.
    Health Affairs
    ,
    35
    (6), 1045-1051.

    Caulkins, J. P., & Reuter, P. (2017). Dealing more effectively and humanely with illegal drugs. 
    Crime and justice
    , 
    46
    (1), 95-158.

    Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. 
    Global journal of health science
    , 
    8
    (8), 220.

    Johnson, A. B., & Sadiq, N. M. (2019). Pentobarbital. In 
    StatPearls [Internet]
    . StatPearls Publishing.

    Kanouse, A. B., & Compton, P. (2015). The epidemic of prescription opioid abuse, the subsequent rising prevalence of heroin use, and the federal response. 
    Journal of pain & palliative care pharmacotherapy
    , 
    29
    (2), 102-114.

    Khan, H. R., Asghar, S. A., Kanwal, S., Qadar, L. T., & Qadri, K. H. (2019). Diphenoxylate-atropine (Lomotil) Toxicity in Infantile Diarrhea: A Case Report of Therapeutic Failure. 
    Cureus
    , 
    11
    (10).

    Plodkowski, R. A., McGarvey, M. E., Reisinger-Kindle, K., Kramer, B., Nelson, E., Lee, J., & Nguyen, Q. T. (2016). Obesity Management: Clinical Review and Update of the Pharmacologic Treatment Options. 
    Federal Practitioner
    , 
    33
    (1), 6.

    Ramos-Matos, C. F., & Lopez-Ojeda, W. (2019). Fentanyl. In 
    StatPearls [Internet]
    . StatPearls Publishing.

  • NUR-550 – Benchmark – Population Health Policy Analysis

    NUR-550 – Benchmark – Population Health Policy Analysis

    Course Code

    Class Code

    Assignment Title

    Total Points

    NUR-550

    NUR-550-XO0905XB

    Benchmark – Population Health Policy Analysis

    160.0

    Criteria

    Percentage

    Unsatisfactory (0.00%)

    Less than Satisfactory (80.00%)

    Satisfactory (88.00%)

    Good (92.00%)

    Excellent (100.00%)

    Content

    70.0%

    Financially Sound Health Care Policy That Incorporates the Nursing Perspective and Relevant Ethical, Legal, and Political Factors (2.1)

    20.0%

    A discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is not included.

    A discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is present, but it lacks detail or is incomplete.

    A discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is present.

    A discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is clearly provided and well developed.

    A comprehensive discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is thoroughly developed with supporting details.

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    Integration of Appropriate State, Federal, and Global Health Policies and Goals Related to Equitable Health Care for Populations (4.2)

    20.0%

    A discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is not included. NUR-550 – Benchmark – Population Health Policy Analysis

    A discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is present, but it lacks detail or is incomplete.

    A discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is present.

    A discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is clearly provided and well developed.

    A comprehensive discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is thoroughly developed with supporting details.

    Advocacy Strategies for Improving Access, Quality, and Cost-Effective Health Care for Diverse Populations (2.2)

    10.0%

    A discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is not included.

    A discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is present, but it lacks detail or is incomplete.

    A discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is present.

    A discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is clearly provided and well developed.

    A comprehensive discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is thoroughly developed with supporting details.

    The Professional and Moral Obligation of Advanced Registered Nurses to Respect Human Dignity and Advance the Common Good Through Working to Promote Health and Prevent Disease Among Diverse Populations from a Christian Perspective (4.3)

    15.0%

    A discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is not included.

    A discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is present, but it lacks detail or is incomplete.

    A discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is present.

    A discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is clearly provided and well developed.

    A comprehensive discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is thoroughly developed with supporting details.

    Required Sources

    5.0%

    Sources are not included. NUR-550 – Benchmark – Population Health Policy Analysis

    Number of required sources is only partially met.

    Number of required sources is met, but sources are outdated or inappropriate.

    Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

    Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

    Organization and Effectiveness

    20.0%

    Thesis Development and Purpose

    7.0%

    Paper lacks any discernible overall purpose or organizing claim.

    Thesis is insufficiently developed or vague. Purpose is not clear.

    Thesis is apparent and appropriate to purpose.

    Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    Argument Logic and Construction

    8.0%

    Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

    Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

    Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

    Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

    Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    5.0%

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

    Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

    Writer is clearly in command of standard, written, academic English.

    Format

    10.0%

    Paper Format (Use of appropriate style for the major and assignment)

    5.0%

    Template is not used appropriately or documentation format is rarely followed correctly. NUR-550 – Benchmark – Population Health Policy Analysis

    Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

    Template is used, and formatting is correct, although some minor errors may be present.

    Template is fully used; There are virtually no errors in formatting style.

    All format elements are correct.

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    Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) NUR-550 – Benchmark – Population Health Policy Analysis

    5.0%

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    Total Weightage

    100%