Category: Nursing

Benchmark – Part B: Literature Review

Introduction

           
The selected clinical issue is the noticeable difference in the Human Immunodeficiency Virus (HIV) rates within minority groups, including Blacks/ African Americans and Latinos/ Hispanics. Ethnicity and race are linked to human ancestry. The race is defined as a group of people with specific distinctive common physical traits, such as hair texture and skin colour. Ethnicity involves categorizing various groups of people according to a common language, race, tribe, religion, background or cultural origin (Blakemore, 2020). Ethnic and racial minorities are one of the fastest-growing communities in the United States. Yet, figures on health status have revealed poorer health outcomes among racial and ethnic minorities regarding death and preventable diseases (National Curriculum of HIV, 2021) Benchmark – Part B: Literature Review.

Hispanics and Blacks noticeably outnumber all other racial and ethnic groups. In the year 2018, African American represented only 13% of the entire population, but they accounted for 41% of people living with HIV. Latinos represent 15% of the people, but they accounted for 23% of people living with HIV. Asians made up 6% of people and accounted for 1.5%.  This disparity also exists in the new HIV infection rates. Subpopulations within these ethnic groups are more adversely affected.  Men who have sex with men are affected the most. They represent 70% of all new HIV infections, even though they only make up 2% of the entire population (National Curriculum of HIV, 2021). Despite medical advances in the treatment of HIV, minority groups continue to be one of public health biggest concerns. The minority health is affected by several variables, thus causing the high rate of HIV infections among this ethnic group. Therefore, the proposed PICOT question focuses on addressing the high quality of HIV infection among minorities in the US.

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Methods

Various strategies were used to select articles for this study. First, major nursing databases and websites, including CINAHL, Cochrane, EMBASE, and PubMed, were searched for the required articles. Secondly, some keywords, including minorities, health disparity, the Human Immunodeficiency Virus (HIV), HIV prevalence among the minorities, Hispanics, Blacks, population demographics were used in the search process. A total of 100 studies, such as reviews, RCT, quasi-experimental, and meta-analysis, were reviewed for the study. Ten studies that met the selection criteria, including being conducted with the last five years, were selected for this study.

Synthesize the Literature

Part A: A Discussion of the Main Components of each Article

           
A study by Noonan et al. (2016) focuses on how social justice can improve African Americans’ health in the USA. The methodology of this study was a review of the national statistics and literature on African American health. The key findings indicate that the Blacks’ health can be improved through various factors, including social development programs, engaging African Americans in decision and policy-making, investing in their education, and enhancing their access to health care. This article supports the PICOT since it reveals that African Americans’ health can be improved by expanding access to quality care services in the US. Another study was conducted by Donna Hubbard McCree et al. (2016) focuses on strategies for attaining health equity goals among the racial/ethnic minority communities in the US. The authors reviewed previous articles, including RCT, quasi-experimental, and meta-analysis, in this study. The study findings indicate that the health equity goals among the racial/ethnic minority communities in the US can be attained through health equity efforts. This article supports the PICOT since it claims that health equity efforts can support achieving the health equity goals among the racial/ethnic minority communities in the US.

Furthermore, Lang and Bird (2015) conducted a study to examine the primary cause of racial health disparities concentration of the cases of HIV/AIDS and cardiovascular disease among African Americans. This study was based on reviews of previous literature. Study findings indicate that health disparities among socioeconomically disadvantaged individuals are attributed to some socioeconomic factors. Therefore, this article supports the PICOT since it reveals that health disparities among socioeconomically disadvantaged community members are attributed to socioeconomic factors such as lack of funds to cater to their out-off pocket and purchase health insurance covers. A study was conducted by Guilamo-Ramos et al. (2020) evaluated the HIV crisis among Hispanic/Latino in the US. The study involves reviewing statistics about HIV infections among Hispanics in the US. The study findings indicate that the US HIV epidemic can be addressed by reinforcing national efforts, particularly making HIV treatment available for HIV-positive Hispanics/Latinos. Therefore, this article supports the PICOT question since it points out that HIV treatment as the major strategy of improving HIV-positive Hispanics/Latinos’ health status.

Shrage (2016) also conducted a study to assess mass incarceration and HIV infections among African Americans. This study was based on the reviews of previous articles on this subject matter. The study findings indicate that HIV infection among African Americans is relatively high than that of other ethnic groups. Thus, this article supports the PICOT question since it reveals the high prevalence of HIV among African Americans. Moreover, Baciu (2017) conducted a study to evaluate the condition of health disparities in the US. Upon reviewing the previous studies on the subject matter, the author found that healthcare disparity among minorities is caused by provider-related discrimination. This article relates to the PICOT question since it indicates that health disparities among the minorities are caused by a lack of access to quality care due to provider-related discrimination. American Heart Association (2019) evaluated the dangers of health disparities in resolving them urgently in the US. The study was based on the available data about cardiovascular diseases among minorities. The study findings reveal that health disparities among minorities are associated with the high prevalence of cardiovascular diseases among these ethnicities. Therefore, this article supports the PICOT question since it attributes the high prevalence of cardiovascular diseases among minorities to health disparities.

Another study by Uluğ and Tropp (2020) focused on understanding how collective action could resolve racial discrimination by promoting racial justice in the US. They tested three studies to assess if Whites would be willing to participate in collective action to promote racial justice in the country. The study findings indicate Whites are willing to promote racial justice by engaging in collective action. This article supports the PICOT question since it reveals racial discrimination against minorities in the US. Causadias et al. (2019) in their studies assessed racial discrimination against minorities in the United States. The study findings indicate that racial discrimination in the US is relatively high, leading to poor health among these ethnic groups. It involved a review of previous studies on this subject. This article supports the PICOT question since it reveals the connection between racial discrimination against minorities and their poor health. Finally, Bleich et al. (2019) focused on discrimination experienced by black Americans in the United States. The study was based on the findings of previous randomized trials. The study findings indicate that black Americans experience racial discrimination in the United States Benchmark – Part B: Literature Review. Therefore, this article supports the PICOT question since it reveals racial discrimination against Blacks in the country.

Part B: Comparison of the Articles

These studies
are characterized by various aspects, including similarities, differences, limitations, and controversies. These ten articles are similar since they were based on racial discrimination experienced by minorities in the US. Additionally, their study findings support racial discrimination against minorities in the US, leading to health disparities. However, these articles differ in various aspects. First, some studies focus on the minority groups in general, such as Donna Hubbard McCree et al. (2016) and Uluğ and Tropp (2020). On the other hand, some studies focus on particular minority groups, such as Shrage (2016), Guilamo-Ramos ea al. (2020), and Lang and Bird (2015). On controversies, most articles indicate that whites cause discrimination against minorities in the US. On the contrary, some studies such as Uluğ and Tropp (2020) suggest that whites are against racial discrimination in the US and are willing to participate in collective action to promote racial justice in the country. Lastly, these studies have various limitations. The major limitation is the failure of the reviewed articles to provide the required data. Another critical limitation is basing the study on a particular minority group such as Bleich et al. (2020), Shrage (2016), and Guilamo-Ramos et al. (2020). In this case, it is relatively challenging to generalize study findings to account for other minority groups.

References

American Heart Association. (2019). The Dangers of Health Disparities and the Urgent Need to Address Them.
American Heart Association
.
https://www.hcplive.com/view/the-dangers-of-health-disparitiesand-the-urgent-need-to-address-them

Baciu, A. (2017).
The State of Health Disparities in the United States
.
https://www.ncbi.nlm.nih.gov/books/NBK425844/

Blakemore, E., (2019). Race and ethnicity explained.
National Geographic. https://
HIV in Racial and Ethnic Minority Populations – Core Concepts (uw.edu)

Bleich, S., Findling, M, G., Casey, L, S., & Blendon, R, J. (2019). Discrimination in the United States: Experiences of black Americans.
Health Services Research Suppl 2
(7)

Causadias, J, M., Korous, K, M., & Denny, T. (2019). Racial Discrimination in the United States: A National Health Crisis that Demands a National Health Solution.
Journal of Adolescent Health
; 64 (2019) 147e148.

Donna Hubbard McCree, P et al. (2016). An Approach to Achieving the Health Equity Goals of the National HIV/AIDS Strategy for the United States Among Racial/Ethnic Minority Communities.
Public Health Rep; 131
(4): 526–530. doi: 10.1177/0033354916662209

Guilamo-Ramos, V., Thimm-Kaiser, M., Benzekri, A., Chacón, G., López, O, R., Scaccabarrozzi, L., & Rios, E. (2020). The Invisible US Hispanic/Latino HIV Crisis: Addressing Gaps in the National Response.
American Journal of Public Health
.
https://ajph.aphapublications.org/doi/10.2105/AJPH.2019.305309

 

Lang, M, E & Bird, C, E. (2015). Understanding and Addressing the Common Roots of Racial Health Disparities: The Case of Cardiovascular Disease and HIV/AIDS in African Americans.
The Journal of Law-Medicine, 25 (1):
109-138.
https://scholarlycommons.law.case.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=1020&context=healthmatrix

National HIV Curriculum, (2021
). HIV in ethnic and racial minority populations.

https:// HIV in Racial and Ethnic Minority Populations – Core Concepts (uw.edu)

Noonan, A, S., Velasco-Mondragon, H, E & Wagner, F, A. (2016). Improving the health of African Americans in the USA: an overdue opportunity for social justice.
Public Health Reviews
, 37 (12): 1-20. DOI 10.1186/s40985-016-0025-4

Shrage, L. (2016). African Americans, HIV, and mass incarceration.
The Lancet;
388 (10049). DOI:
https://doi.org/10.1016/S0140-6736(16)30830-3
.

Uluğ, O, M & Tropp, L, R. (2020). Witnessing racial discrimination shapes collective action for racial justice: Enhancing awareness of privilege among advantaged groups. Journal of Applied Social Psychology Benchmark – Part B: Literature Review

 

Course Code

Class Code

Assignment Title

Total Points

NUR-550

NUR-550-O502

Benchmark – Part B: Literature Review

250.0

Criteria

Percentage

Unsatisfactory (0.00%)

Less than Satisfactory (80.00%)

Satisfactory (88.00%)

Good (92.00%)

Excellent (100.00%)

Content

70.0%

Introduction

5.0%

An introduction is not included.

An introduction is present, but it lacks detail or is incomplete.

An introduction is present.

An introduction is clearly provided and well developed.

A comprehensive introduction is thoroughly developed with supporting details.

Methods

15.0%

A discussion of methods, including criteria used to select the articles, is not included.

A discussion of methods, including criteria used to select the articles, is present, but it lacks detail or is incomplete.

A discussion of methods, including criteria used to select the articles, is present.

A discussion of methods, including criteria used to select the articles, is clearly provided and well developed.

A comprehensive discussion of methods, including criteria used to select the articles, is thoroughly developed with supporting details.

Literature Synthesis, Part A

15.0%

A discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is not included.

A discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is present, but it lacks detail or is incomplete.

A discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is present.

A discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is clearly provided and well developed.

A comprehensive discussion of the main components of each article, including subjects, methods, key findings, and rationale for how the article supports the PICOT statement, is thoroughly developed with supporting details.

Literature Synthesis, Part B

15.0%

A discussion of the limitations, controversies, similarities, and differences of the studies is not included.

A discussion of the limitations, controversies, similarities, and differences of the studies is present, but it lacks detail or is incomplete.

A discussion of the limitations, controversies, similarities, and differences of the studies is present.

A discussion of the limitations, controversies, similarities, and differences of the studies is clearly provided and well developed.

A comprehensive discussion of the limitations, controversies, similarities, and differences of the studies is thoroughly developed with supporting details.

Areas of Further Study (C3.2)

15.0%

An analysis of evidence in the articles to identify what is known, unknown, and needed for further study is not included.

An analysis of evidence in the articles to identify what is known, unknown, and needed for further study is present, but it lacks detail or is incomplete.

An analysis of evidence in the articles to identify what is known, unknown, and needed for further study is present.

An analysis of evidence in the articles to identify what is known, unknown, and needed for further study is clearly provided and well developed.

A comprehensive analysis of evidence in the articles to identify what is known, unknown, and needed for further study 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.

Benchmark – Part B: Literature Review

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 – Part B: Literature Review.

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.

Benchmark – Part B: Literature Review

Total Weightage

100%

NURS-6050 Week 4: Assignment  – Legislation Grid and Advocacy Statement

Introduction

Shortages of healthcare staff create significant barriers to mental health service delivery, and these shortages are most severe in rural and underserved communities. The More Behavioral Health Providers Act of 2025 addresses this gap by expanding Medicare incentive payments to behavioral health clinicians, including nurse practitioners, who practice in Mental Health Professional Shortage Areas (HPSAs). As Short (2022) discusses in the chapter on healthcare financing, Medicare reimbursement structures influence where providers choose to practice and what services are prioritized. This paper examines the stakeholders and policy implications of S. 683, and provides testimony in support of its passage.

Purpose Statement

The purpose of this paper is to analyze the More Behavioral Health Providers Act of 2025 and advocate for its passage by showing how Medicare HPSA incentive expansion can improve workforce retention, increase access to mental health services, and address health inequities in underserved populations.

 

 

Legislation Grid Template

Legislation Grid Template

 

Use this document to complete Part 1 of the Module 2 Assessment
Legislation Grid and Testimony/Advocacy Statement

 

Health-related Bill Name

More Behavioral Health Providers Act of 2025

Bill Number

                     
   S. 683 (119th Congress)

Description

This bill expands eligibility for Medicare Health Professional Shortage Area (HPSA) bonus payments to include behavioral health providers—including psychiatrists, clinical psychologists, clinical social workers, psychiatric nurse specialists, and nurse practitioners—who provide mental health and substance use disorder services in designated shortage areas. Currently, only physicians providing primary care services are eligible for these incentive payments.

Federal or State?

Federal

Legislative Intent

To expand eligibility for Medicare Health Professional Shortage Area (HPSA) incentive payments to include behavioral health providers, including nurse practitioners, who provide mental health and substance use disorder services in designated shortage areas.

Proponents/ Opponents

Primary sponsors include Senator Gary Peters (D-MI) and Senator Steve Daines (R-MT). Professional organizations supporting the bill include the American Association of Nurse Practitioners (AANP) and mental health workforce advocacy groups.

Opponents: The bill is bipartisan and no formal opposition has been recorded as of December 2025, but the bill may face scrutiny from the Senate Finance Committee leadership, as chairs of committees with Medicare jurisdiction typically scrutinize proposals that increase federal healthcare expenditures carefully. Fiscal conservative legislators may raise concerns about expanding Medicare bonus payments without corresponding reductions elsewhere.

Target Population

Medicare beneficiaries who live in Mental Health Professional Shortage Areas (HPSAs), particularly older adults and individuals in rural or underserved communities. Behavioral health providers, including nurse practitioners, are also affected NURS-6050 Week 4: Assignment .

Status of the bill (Is it in hearings or committees?)

Introduced in the Senate on February 24, 2025, and read twice before being referred to the Senate Committee on Finance. As of December 2025, the bill is in committee with no hearings scheduled NURS-6050 Week 4: Assignment

General Notes/Comments

 

 

This bill addresses the severe shortage of mental health care by providing financial incentives to more providers. Understanding the legislative process, as Short (2022) describes in the chapter on policy enactment, will help nurses to identify where advocacy efforts are most effective. In this case, they can support the bill through the committee process. The bipartisan sponsorship suggests that the bill may be advanced, but fiscal concerns may delay its passage. The bill aligns with existing Medicare HPSA bonus structures, which provide 10% payment increases for services rendered in shortage areas. Expanding this to behavioral health providers could improve retention and access in underserved communities.

Legislative Testimony / Advocacy Statement

Title: In Support of the More Behavioral Health Providers Act of 2025

Name: xx

Date: xx

Introduction

As a nurse, I have often thought that if I had a role in shaping health policy, access to mental health care would work differently for patients living in underserved communities. In clinical practice, shortages of behavioral health providers delay care, worsen symptoms, and increase reliance on emergency services. I support the More Behavioral Health Providers Act of 2025 because it directly addresses workforce shortages by expanding Medicare incentive payments to behavioral health clinicians practicing in Mental Health Professional Shortage Areas (HPSAs).

Purpose Statement

The purpose of this legislation is to expand eligibility for Medicare HPSA incentive payments to include behavioral health providers, including nurse practitioners, who furnish mental health and substance use disorder services in shortage areas. Staff shortages in these regions significantly limits access to care, and behavioral health clinicians working in HPSAs report lower anticipated retention when financial and professional supports are insufficient (Pathman et al., 2025). By strengthening financial incentives, this bill promotes workforce stability and improved access for underserved populations.

 

 

Position Statement

I support this bill because it addresses a structural policy barrier that patients deal with every day. Inadequate access to mental health services is not just a clinical issue, it is a workforce and reimbursement problem. Using Medicare incentives to promote behavioral health service delivery will improve practice and continuity of care in underserved areas.

Social Determinants of Health

Income, age, education, and location affect the impact of this legislation. Medicare beneficiaries with limited income often face transportation issues and reduced provider access. Older adults are especially vulnerable to untreated mental health conditions, which increase hospitalization risk and disease severity. Lower educational attainment can further reduce health literacy, making consistent access to providers very important. Gender also plays a role. Women, who represent the majority of Medicare beneficiaries over age 75, experience high rates of depression and anxiety, but have greater barriers to accessing specialized mental health care in rural areas where this workforce shortage is most acute. By incentivizing clinicians to practice in shortage areas, this bill addresses inequities tied to these social determinants.

Addressing Opposition

This legislation has bipartisan support, but opposition to this legislation is most likely to focus on concerns about increased Medicare spending. In response, I would emphasize that workforce incentives represent a targeted investment. Financial incentives are associated with improved provider retention in underserved areas, which supports earlier intervention and reduces reliance on much more expensive emergency and inpatient care (Russell et al., 2021). This bill builds on an existing Medicare incentive framework rather than creating a new entitlement, which will improve workforce stability while containing costs.

Conclusion

The More Behavioral Health Providers Act of 2025 aligns Medicare policy with evidence-based strategies and the realities of clinical practice. Expanding HPSA incentives to behavioral health providers strengthens the workforce, improves access to care, and supports equitable mental health services for underserved populations. Nurses play a critical role in advocating for policies that reflect patient needs and system sustainability.

References

Centers for Medicare & Medicaid Services. (2025).
Physician bonuses in health professional shortage areas (HPSAs)
.
https://www.cms.gov/medicare/payment/fee-for-service-providers/physician-bonuses-health-professional-shortage-areas-hpsas

Pathman, D., Zerden, L., Konrad, T., Shafer, A., Harrison, J., Fannell, J., & Lombardi, B. (2025). Job assessments and the anticipated retention of behavioral health clinicians working in U.S. Health Professional Shortage Areas.
BMC Health Services Research, 25
(1).
https://doi.org/10.1186/s12913-025-12698-6

Russell, D., Mathew, S., Fitts, M., Liddle, Z., Murakami-Gold, L., Campbell, N., & Wakerman, J. (2021). Interventions for health workforce retention in rural and remote areas: A systematic review.
Human Resources for Health, 19
(1).
https://doi.org/10.1186/s12960-021-00643-7

Short, N. M. (2022).
Milstead’s health policy and politics: A nurse’s guide
(7th ed.). Jones & Bartlett Learning. NURS-6050 Week 4: Assignment

U.S. Congress. (2025). S. 683 –
More Behavioral Health Providers Act of 2025
. Congress.gov. https://www.congress.gov/bill/119th-congress/senate-bill/683/all-info

NURS-FPX 4010 Assessment 4 Stakeholder Presentation

Introduction to VAP – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØVentilator-associated pneumonia is the most common lung infection when an individual is placed on a ventilator.

ØNormally the infection occurs when germs or other microbial enter through the ventilator machine.

ØThe CDC provides various guidelines that help in preventing its occurrence in practice.

The most common microbial agent for VAP is the staphylococcus aureus; here, the micro aspiration of the bacteria colonizes the oropharynx and the upper airways, which also seeds the lung due to the inhalation of the contaminated aerosols. Research by Luyt et al. (2020), states that the mortality that is associated with hospital-acquired Pneumonia is very high despite the availability of effective antibiotics. The adequacy of various antibiotics helps improves an individual’s state of health together with an improved prognosis. Other than microbial therapy, there exist other forms of treatment for VAP, for example, head elevation, oral hygiene with 2% chlorhexidine, and suctioning of secretions to be in a better position to curb its occurrence; there is a greater need to ensure that the healthcare workers work collaboratively.

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Relevance of the Interdisciplinary team – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØWhile the indiscriminate use of antibiotics is a major cause of antimicrobial resistance, adequate use of the empiric antibiotics is a major determinant of a favorable outcome.

ØSome of the relevant interdisciplinary members that should be included in the care course include the intensivist, physician, nurse, medical intensive care unit occupational therapist, and the nutritionist.

ØThe team always aims to attain improved health outcomes and enhanced satisfaction for the clients.

In my opinion, the interdisciplinary team is the most effective approach to incorporate into the study simply because it is through them that various specific patient symptoms are recognized more easily. The inclusion of these teams will help achieve improved outcomes by implementing specific interventions that meet the client’s needs. In order to ensure maximum functioning of the team, an effective patient outcomes and also the roles of the multidisciplinary team should be clearly negotiated and defined (Papazian  et al.,2020).For this to happen, the team members need to ensure that trust and respect is enhanced and also ensure that there is a use of the skill mix within the team. By doing so, the patients’ current issues will be managed effectively since they have the prerequisite skills needed to meet their various needs.

 

Interdisciplinary Plan Summary – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØThe main Goal of the interdisciplinary team is to ensure that the infections decrease.

ØThe objective is likely to be met following the implementation various evidence-based care strategies at the workplace.

ØEach team member will be involved in various strategies to decrease the rate of Ventilator-associated Pneumonia at the workplace.

Some of the activities that the interdisciplinary team will participate in include drug administration, oral hygiene for the patients, bed elevation, and monitoring of the patients on mechanical ventilation. The interventions are evidence-based and proven; hence, the likelihood of decreasing infection rates is very high. For instance, the occupational therapist will engage the patient in various functional independence activities of daily living and also decrease the time that the patient spends on the mechanical Ventilator. Besides that, the manager will also need to mobilize sufficient resources for the team and ensure that they are well utilized to meet the patient’s needs. This is likely to result in improved health outcomes and thus decrease the susceptibility to the infections.

Ways to Implement the Interdisciplinary plan in the team – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØSome of the features of an effective interdisciplinary team include positive leadership, training, development, and the distribution of sufficient resources.

ØThere exist various competency statements that an effective interdisciplinary team should always demonstrate.

ØThe Kurt Lewin’s model is the most effective approach to implementing the plan in the team.

The increasing complexity of the skills and knowledge needed to provide a comprehensive care for the patients on mechanical ventilators is so alarming; thus, a great need to allocate the medical team to the patients based on their expertise. The first thing that should always be done in any healthcare facility is the training of the employees regarding the various interventions that might positively impact the patients’ health. After they have been trained on how the machines work and how the care is supposed to be given, they will be allowed to practice it as they ensure that they utilize the resources efficiently (Papazian et al.,2020). Lastly, the adoption of a waste management plan will help minimize a lot of wastage that could be incurred unexpectedly. The outcome criteria will help evaluate the effectiveness of the project once it is implemented, and also, the preliminary use analysis of the project will provide an overview of how the resources were used and also spent.

 

Strategies for Managing Human and Financial Resources – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØStrategic human resource management at the workplace provides a framework linking people management and the development practices to ensure long-term organizational goals and outcomes.

ØSome of the strategies include,

Management of employee competency and development.

Ensuring that the employees’ workload is right.

Taking availability and accountability into account

Just in time model

At the workplace, skill management entails matching the organizational needs with the available ones. Employment of skilled employees helps ensure that the exact resources are used for the patient with those needs alone and not just wasting them anyhow. The Just in time model is one of the key measures that will help ensure that resources are not wasted. This model involves the production of only what is needed depending on the patient’s needs. The other intervention is the adoption of various Electronic Health Records that provides accountability about the resources that have been spent on any patient, depending on the needs. In the future, this will be very useful as the managers will use it as a baseline in determining the expected resources that need to be produced without a surplus.

 

Evaluation Methods – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØA project needs careful planning, effective communication, and attention to succeed.

ØA successful outcome of the project is that which,

There is an increased patient satisfaction

Timely delivery of patient services

Projects fall within the budget

ØIn healthcare, the success of the projects is determined using three criteria, the Goal-based, process-based, and outcome-based criteria.

In healthcare, the evaluation of projects is conducted either monthly or annually, depending on the organization’s protocols. One of the evaluation criteria of the projects that I would use is the Goal based evaluation criteria, it provides the information pertaining how the program is working or operating as it tries to attain its goals (Lennox et al.,2018). It helps ensure that the program works as expected and implements various interventions to magnify its operations. The information on either pathogenicity or infectivity of Ventilator-associated pneumonia can help determine the effectiveness of the Evidence-based prevention strategies. A high infection rate of the VAP in the ICU will mean that the prevention strategies are ineffective and need to be modified.

 

Communication Strategies – NURS-FPX 4010 Assessment 4 Stakeholder Presentation

ØCommunication strategies in healthcare help in the spreading of knowledge and also the associated evidence-based care strategies to the patients and also the interdisciplinary team.

ØSome of the effective communication strategies for both parties include,

Turn-taking

Topic shifting

Active listening

Patient teach-back techniques

Following the patient’s discharge, communication about drug adherence and continuous exercise is paramount. The interdisciplinary team should ensure that they communicate the relevant information following patients’ discharge; this would help prevent the occurrence of infection recurrence. To the healthcare team, effective communication strategies will ensure that the exact care is provided to the patient, depending on their individual needs.

 

NURS-FPX 4010 Assessment 4 Stakeholder Presentation CONCLUSION

ØHealth education is very critical for any patient.

ØProper management of the healthcare resources also ensures that the patient pays for only what they have utilized.

ØIntegration of the most top-notch evidenced strategies helps minimize reinfection at a higher rate.

Targeted strategies to prevent VAP should be implemented to improve the patient’s outcomes and decrease their length of stay at the healthcare facilities. The frontline critical care nurses thus need to understand the factors that predispose the patients at risk of developing the VAP and institute the evidence-based practices that will not compromise the patients’ health.

 

References

Lennox, L., Maher, L., & Reed, J. (2018). Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare. Implementation Science, 13(1), 1-17.

Luyt, C. E., Sahnoun, T., Gautier, M., Vidal, P., Burrel, S., Pineton de Chambrun, M., … & Chastre, J. (2020). Ventilator-associated Pneumonia in patients with SARS-CoV-2-associated acute respiratory distress syndrome requiring ECMO: a retrospective cohort study. Annals of Intensive Care, 10(1), 1-10.

Papazian, L., Klompas, M., & Luyt, C. E. (2020). Ventilator-associated Pneumonia in adults: a narrative review. Intensive care medicine, 46(5), 888-906.

 

NURS-FPX 4010 Assessment 4 Stakeholder Presentation

Assessment 4 Instructions: Stakeholder Presentation

For this assessment you will create an 8-12 slide PowerPoint presentation for one or more stakeholder or leadership groups to generate interest and buy-in for the plan proposal you developed for the third assessment.

As a current or future nurse leader, you may be called upon to present to stakeholders and leadership about projects that you have been involved in or wish to implement. The ability to communicate a plan—and potential implications of not pursuing such a plan—to stakeholders effectively can be critically important in creating awareness and buy-in, as well as building your personal and professional brand in your organization. It is equally important that you know how to create compelling presentations for others’ delivery and ensure that they convey the same content you would deliver if you were the presenter.

You are encouraged to complete the Evidence-Based Practice: Basics and Guidelines activity before you develop the presentation. This activity consists of six questions that will create the opportunity to check your understanding of the fundamentals of evidence-based practice as well as ways to identify EBP in practice. The information gained from completing this formative will help promote success in the Stakeholder Presentation and demonstrate courseroom engagement—it requires just a few minutes of your time and is not graded.

 

Demonstration of Proficiency

Competency 1: Explain strategies for managing human and financial resources to promote organizational health.

Explain how the interdisciplinary plan could be implemented and how the human and financial resources would be managed.

Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.

Explain an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal.

Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.

Summarize an evidence-based interdisciplinary plan to address an organizational or patient issue.

Propose evidence-based criteria that could be used to evaluate the degree to which the project was successful in achieving the improvement goal.

Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.

Slides are easy to read and error free. Detailed speaker notes are provided.

Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years) with an APA formatted reference list with few errors.

Professional Context

This assessment will provide you with an opportunity to sharpen your ability to create a professional presentation to stakeholders. In this presentation, you will explain the Plan-Do-Study-Act cycle and how it can be used to introduce the plan (P), implement the plan (D), study the effectiveness of the plan (S), and act on what is learned (A) to drive continuous improvement. By using this cycle, the stakeholders will have a tool and a proposal to expand on these ideas to drive workplace change and create improved processes to solve an interprofessional collaboration problem.

 

Scenario

In addition to summarizing the key points of Assessments 2 and 3, you will provide stakeholders and/or leadership with an overview of project specifics as well as how success would be evaluated—you will essentially be presenting a discussion of the Plan, Do, and Study parts of the PDSA cycle. Again, you will not be expected to execute the project, so you will not have any results to study. However, by carefully examining the ways in which your plan could be carried out and evaluated, you will get some of the experience of the thinking required for PDSA.

When creating your PowerPoint for this assessment, it is important to keep in mind the target audience: your interviewee’s organizational leadership. The overall goal of this assessment is to create a presentation that your interviewee could potentially give in his or her organization NURS-FPX 4010 Assessment 4 Stakeholder Presentation.

 

Instructions

Please follow the Capella Guidelines for Effective PowerPoint Presentations [PPTX]. If you need technical information on using PowerPoint, refer to Capella University Library: PowerPoint Presentations.

 

Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

 

Explain an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal.

Summarize an evidence-based interdisciplinary plan to address an organizational or patient issue NURS-FPX 4010 Assessment 4 Stakeholder Presentation.

Explain how the interdisciplinary plan could be implemented and how the human and financial resources would be managed.

Propose evidence-based criteria that could be used to evaluate the degree to which the project was successful in achieving the improvement goal.

Communicate the PowerPoint presentation of the interdisciplinary improvement plan to stakeholders in a professional manner, with writing that is clear, logically organized, and respectful with correct grammar and spelling using current APA style.

There are various ways to structure your presentation; following is one example:

 

Part 1: Organizational or Patient Issue.

What is the issue that you are trying to solve or improve?

Why should the audience care about solving it?

Part 2: Relevance of an Interdisciplinary Team Approach.

Why is using an interdisciplinary team relevant, or the best approach, to addressing the issue?

How will it help to achieve improved outcomes or reach a goal?

Part 3: Interdisciplinary Plan Summary.

What is the objective?

How likely is it to work?

What will the interdisciplinary team do?

Part 4: Implementation and Resource Management.

How could the plan be implemented to ensure effective use of resources?

How could the plan be managed to ensure that resources were not wasted?

How does the plan justify the resource expenditure?

Part 5: Evaluation.

What would a successful outcome of the project look like?

What are the criteria that could be used to measure that success?

How could this be used to show the degree of success?

Again, keep in mind that your audience for this presentation is a specific group (or groups) at your interviewee’s organization and tailor your language and messaging accordingly. Remember, also, that another person will ultimately be giving the presentation. Include thorough speaker’s notes that flesh out the bullet points on each slide.

 

Additional Requirements

Number of slides: Plan on using one or two slides for each part of your presentation as needed, so the content of your presentation will be 8–12 slides in length. Remember that slides should contain concise talking points, and you will use presenter’s notes to go into detail. Be sure to include a reference slide as the last slide of your presentation.

Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas NURS-FPX 4010 Assessment 4 Stakeholder Presentation. Resources should be no more than five years old.

APA formatting: Make sure that in-text citations on your slides and in your notes pages and reference slide reflect current APA Style and Format.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

 

SCORING GUIDE

Explains an organizational or patient issue for which a collaborative interdisciplinary team approach would help achieve a specific improvement goal, noting potential consequences of not addressing the issue.

Summarizes an evidence-based interdisciplinary plan to address an organizational or patient issue, noting specific sources of evidence used to develop the plan.

Explains how the interdisciplinary plan could be implemented and how the human and financial resources would be managed, providing real-world examples relevant to the context of the health care organization.

Proposes evidence-based criteria to evaluate the degree to which the project was successful in achieving the improvement goal, noting specific sources of evidence used to develop the criteria.

Slides are easy to read and clutter free. Slide background is “visually” pleasing with a contrasting color for the text and may utilize graphics. Detailed speaker notes are provided.

Organizes NURS-FPX 4010 Assessment 4 Stakeholder Presentation content with clear purpose/goals. Power point slides support main points, assertions, arguments, conclusions, or recommendations with relevant and evidence-based sources (published within 5 years) with a flawless APA formatted reference list.

Applying Library Research Skills – NHS4000: Developing a Health Care Perspective

The Application of Research Skills on the Problem of Medication Errors

The acknowledgement of human error as an important factor contributing to avoidable sickness and mortality by the healthcare sector paved the path for technology to become one of the most life-saving discoveries ever. The Institute of Medicine’s (IOM) role in this cannot be contested. The IOM report, To Err Is Human, caused the change of heart. It was discovered that close to one hundred thousand avoidable fatalities were happening in healthcare facilities as a result of human mistake (Bates & Singh, 2018). This annotated bibliography’s practice topic of concern, medication mishaps, falls squarely within this category. The purpose of this paper is to present an annotated bibliography of four current peer-reviewed articles on medication errors.

Problem Summary, Personal Interest, and Professional Experience with the Issue

Every healthcare facility is concerned about improving quality in relation to medication administration errors or MAEs. It has long been recognized that medication administration errors made by nurses have a major negative impact on morbidity and death. Research by the likes of Simiyu et al. (2018) has revealed that at about half of the time every day, wrong time administration of medications by nurses occurs. Then the second most common error is documentation of the medication given about a third of the time all day. Last is the error of wrong technique that happens about 28% of the time.

The fact that MAE repercussions are so severe is what piqued my curiosity in the aforementioned subject. Therefore, I am curious about practical ways to prevent MAEs. In my professional life, I have repeatedly encountered MAEs as a result of colleagues’ and even my own forgetting to give a patient their medication on time.

The Database Search Strategy Employed

To find data supporting preventive measures against MAEs, a search of the following databases was carried out: Scopus, PubMed, ScienceDirect, Cochrane, and CINAHL. Among the key words and phrases utilized in the search were “errors,” “medication administration,” “prevention,” and “nurses.” These were combined with the Boolean “AND” operator before being entered into the search engines of the pertinent databases. 951 items in all were discovered. There were 15 full-text articles left after abstracts and unclear articles were filtered out and removed. Below is a list of four of these with annotated bibliographies. Since they were all published in journals that underwent peer review, they are all reliable. Since they are all current and were all published within the last five years, they are also highly pertinent.

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The
Annotated Bibliography

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia.
BMC Nursing, 19
(4), 1-9. 
https://doi.org/10.1186/s12912-020-0397-0

In tertiary care institutions in Ethiopia’s capital, Addis Ababa, the aim of this study was to evaluate the severity and contributing variables of errors in medication administration among nurses. The article was chosen because it specifically tackles the practice issue of MAEs among nurses. In this cross-sectional study, 298 randomly chosen nurses worked as nurses. The survey received 298 responses from nurses, or 98.3%. Of these, 203 (68.1%) acknowledged making errors in medicine administration in the previous twelve-month period preceding the study Applying Library Research Skills – NHS4000: Developing a Health Care Perspective.

Poor instruction, a lack of the administration of medicines recommendations, a dearth of professional experience, disruptions during the administration of medications, and late-night hours were all significant predictors of medication administration errors in this study. It may be necessary to retain experienced nursing staff, offer ongoing training on how to safely administer medications, make a medication administration guideline available for nurses to use, and create an environment that supports safe medication administration in order to improve the standard and safety of medication administration.

Weingart, S.N., Zhang, L., Sweeney, M., & Hassett, M. (2018). Chemotherapy medication errors.
The Lancet Oncology, 19
(4), e191–e199. 
https://doi.org/10.1016/S1470-2045(18)30094-9

The article’s goal is to provide information on the prevalence of pharmaceutical errors related to chemotherapy and suggest ways to avoid them. This article was chosen because it clearly addresses the practice problem that was selected, which is the justification. Even though chemotherapy is a well-established treatment option, mistakes can result in a significant risk of patient harm. The scientists examined published studies from 1980 to 2017 in order to appreciate the extent and type of medication errors in cancer chemotherapy and to find effective solutions to help minimize mistakes.

Chemotherapy errors arise at all stages of the medication usage process, impacting at least one to three percent of adult and pediatric oncology patients, and occurring at a rate of one to four per one thousand orders. One area where risk is increasing is the use of oral chemotherapy. Despite the fact that several of them seem to lessen chemotherapeutic errors, the bulk of therapies have little empirical support. More study is needed to understand and lower the incidence of chemotherapy drug mistakes.

Simiyu, K.N., El-Banna, H.M., Fattah, M.A., & Omondi, L.A. (2018). Nurses’ medication administration errors at medical surgical units.
American Journal of Nursing Science, 7
(3), 88-99.
https://doi.org/10.11648/j.ajns.20180703.12

The goal of the study was to evaluate medication administration mistakes made by nurses in general medical and surgical units. The main reason the article was chosen is that it discusses research done on MAEs by nurses working in medical-surgical units. Using stratified random sampling with the medical and surgical units as the strata, 100 nurses were proportionately selected for the descriptive cross-sectional study. The study included a total of 200 observations by adding two more observations of each nurse while dispensing medication. Two different technologies were used to obtain the data for the current inquiry.

The interviewer provided a questionnaire about medicine delivery errors as well as a disguised drug administration observation checklist. Data was collected over a period of four months and subsequently analyzed using descriptive and inferential statistics to seek for correlations between variables. The study’s findings revealed that, respectively, 27%, 23%, and 15% of the nurses who took part in it admitted to giving medication at the wrong time, at the wrong rate, or after getting a written order to stop. Nurses must recognize the prevalence of MAEs as a patient safety indicator in order to comprehend and prevent MAEs through rationalized drug management policies and guidelines.

Koyama, A.K., Maddox, C-S.S., Li, L., Bucknall, T., & Westbrook, J.I. (2019). Effectiveness of double checking to reduce medication administration errors: A systematic review.
BMJ Quality & Safety, 29
(7), 1-9.
http://dx.doi.org/10.1136/bmjqs-2019-009552

The study’s goal was to perform a systematic assessment of research that evaluated the evidence for the value of double checking in lowering MAEs. Because the paper focuses specifically on MAEs and their prevention, it was picked. Five databases were searched for studies examining the use and effectiveness of double checking on reducing medication delivery errors in a hospital setting.

A collection of thirteen research investigations were looked at, and it was found that double-checking adherence rates varied from 52% to 97% of administrations. The claim that a lower incidence of MAEs or less harm results from double versus single medication administration checks is not sufficiently supported by the available data. More research is required to demonstrate whether double checking actually improves patient safety to the point where the large costs required are justified.

Conclusion

The aforementioned annotated bibliography amply demonstrates that MAEs currently pose a concern to patient protection. Since nurses are the ones who deliver pharmaceuticals, evidence-based quality improvement activities aimed at them are required. The numerous recommendations for prevention that are backed up by literary evidence are the four sources analyzed in this annotated bibliography’s main contribution.

References

Bates, D.W., & Singh, H. (2018). Two decades since
To Err Is Human
: An assessment of progress and emerging priorities in patient safety.
Health Affairs, 37
(11), 1736-1743.

https://doi.org/10.1377/hlthaff.2018.0738

Koyama, A.K., Maddox, C-S.S., Li, L., Bucknall, T., & Westbrook, J.I. (2019). Effectiveness of double checking to reduce medication administration errors: A systematic review.
BMJ Quality & Safety, 29
(7), 1-9.
http://dx.doi.org/10.1136/bmjqs-2019-009552

Simiyu, K.N., El-Banna, H.M., Fattah, M.A., & Omondi, L.A. (2018). Nurses’ medication administration errors at medical surgical units.
American Journal of Nursing Science, 7
(3), 88-99.
https://doi.org/10.11648/j.ajns.20180703.12

Weingart, S.N., Zhang, L., Sweeney, M., & Hassett, M. (2018). Chemotherapy medication errors.
The Lancet Oncology, 19
(4), e191–e199. 
https://doi.org/10.1016/S1470-2045(18)30094-9

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia.
BMC Nursing, 19
(4), 1-9. 
https://doi.org/10.1186/s12912-020-0397-0

 

Applying Library Research Skills – NHS4000: Developing a Health Care Perspective

Create a 2-4 page annotated bibliography and summary based on your research related to best practices addressing one of the health care problems or issues in the Assessment Topic Areas media piece faced by a health care organization that is of interest to you.

Introduction

In your professional life, you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment. Being adept at research will help you find the information you need. For this assessment, you will review the Assessment Topic Areas media piece and select one of the health care problems or issues to research, which will be a current health care problem or issue faced by a health care organization that is of interest to you.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 4. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.

View the Assessment Topic Areas media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

Summarize the health care problem or issue.

Describe your interest in the topic.

Describe any professional experience you have with this topic.

Identify peer-reviewed articles relevant to health care issue or problem.

Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.

Refer to the NHS-FPX4000: Developing a Health Care Perspective Library Guide to help you locate appropriate references.

Use keywords related to the health care problem or issue you are researching to select relevant articles.

Assess the credibility and explain relevance of the information sources you find.

Determine if the source is from an academic peer-reviewed journal.

Determine if the publication is current Applying Library Research Skills – NHS4000: Developing a Health Care Perspective.

Determine if information in the academic peer-reviewed journal article is still relevant.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:

Identify the purpose of the article.

Summarize the information.

Provide rationale for inclusion of each article.

Include the conclusions and findings of the article.

Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.

List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.

Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.

Summarize what you have learned from developing an annotated bibliography.

Summarize what you learned from your research in a separate paragraph or two at the end of the paper.

List the main points you learned from your research Applying Library Research Skills – NHS4000: Developing a Health Care Perspective.

Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 2 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

Length: 2–4 typed, double-spaced pages, not including the title page and reference page.

Font and font size: Times New Roman, 12 point.

APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.

Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Content: Provide a title page and reference page following APA style.

References: Use at least four scholarly or academic peer-reviewed journal articles.

APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

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

Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.

Assess the credibility and relevance of information sources.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format.

Summarize what was learned from developing an annotated bibliography.

Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

Apply academic peer reviewed journal articles relevant to the health care problem or issue being researched.

Produce text with minimal grammatical, usage, spelling, and mechanical errors.

Integrate into text appropriate use of scholarly sources, evidence, and citation style

Applying Library Research Skills – NHS4000: Developing a Health Care Perspective

Annotated Bibliography-Medication Error

Applying Library Research Skills

In healthcare, there exist various challenges that affect the healthcare providers as well as patients. One common challenge that affects patients and healthcare providers almost in equal measure is medication errors. Medication errors refer to adverse effects of care that can be preventable with or without the evidence of harm to the patients. There exist a wide variety of medical errors that can exist in healthcare and they include incomplete diagnosis or improper prescription of drugs.

With my education and knowledge, I will help the healthcare team identify ways and approached that they can implement in their daily activities to prevent medical errors because they pause a great risk to the health of patients. Besides, medication errors can increase the cost of medication and to the extreme; they can cause the death of patients.

Identifying Academic Peer-Reviewed Journal Articles

I used Summon, Capella University’s search engine to find my relevant search articles through the online library. To ensure that my articles were aligned to my field of interest, I used key words to filter my search content using the phrases, “Medication error and “Medication Error in the U.S.A.”. Besides, I limited my search to peer reviewed articles.

Assessing Credibility and Relevance of Information Sources

I selected peer reviewed articles published within five years to ensure that the articles were credible and relevant to my area of interest. Besides, all the articles that I selected reflected authors that have experience or that practice in various fields in healthcare with profound professional experience. Besides, I assessed each of the selected articles to confirm that they had the actual concepts of medication errors, causes and their effects in healthcare.

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Annotated Bibliography

Owens, K., Palmore, M., Penoyer, D., & Viers, P. (2020). The effect of implementing bar-code medication administration in an emergency department on medication administration errors and nursing satisfaction. Journal of Emergency Nursing, 46(6), 884-891.

This article emphasizes the need for implementing Bar-code medication administration as a means of reducing medical errors in healthcare. Bar-code medication administration is an inventory used in hospitals to help in the distribution and prescription of medicines to help reduce medical errors. According to the literature presented by the article, bar-code medication administration implementation within the emergency department will help in curbing some of the medication administration errors that may cause adverse effects to the patients.

Further, the article reveals that bar-code medication administration implementation was responsible in reducing medical errors by a margin of 74.2% which is essential in improving nursing satisfaction as the system helps nurses in administering medicines. The major outcome of bar-code medication administration implementation as noted in the article is the possibility of preventing medical errors as well as improving nursing satisfaction. The importance of nursing satisfaction in healthcare is diverse as it builds the nurse morale and helps them to cope with occupational stress.

This article is relevant to my area of interest given that it addresses an evidence-based strategy of preventing medical errors, one of the contributing factors to poor patient outcomes and increased patient morbidity and patient mortality.

Yousef, N., & Yousef, F. (2017). Using total quality management approach to improve patient safety by preventing medication error incidences. 
BMC health services research
, 
17
(1), 1-16.

According to the article, drug administration errors account for the majority of medical errors within healthcare. For instance, the article affirms that in a previous study, data revealed that medication errors accounted for 6.7 out of 100 administrated medication doses, a worrying trend. The article therefore aimed to propose measures that would help in reducing medication errors to at least 1 out 100 doses. According to the article, some of the proposed interventions to help curb medication errors are clear handwritten prescription and professional education.

Clear handwriting is essential in ensuring that the dispensing physician is able to clearly see the exact dose written by the prescribing healthcare provider hence prevent instances where poor handwriting accounts to medication errors. Besides, professional education is essential in that it helps in equipping healthcare providers with the required knowledge on medication prescription and dispensation. According to the article, administration fault accounted to 24.8% while 42.8% was related to the prescription phase. Also mistakes due to poor handwritten prescription were 17.6%. The authors therefore concluded that improving on handwriting is an effective way of reducing medication errors.

Kahn, S., & Abramson, E. L. (2019). What is new in pediatric medication safety? 
Archives of Disease in Childhood
, 
104
(6), 596-599.

According to Kahn & Abramson, (2019), medication errors account to a large portion of medical errors with the pediatric population remaining to be highly vulnerable. Besides, the article highlights that errors can occur at various places during care. The article is particularly interested in highlighting the various advancements in pediatric care that have been implemented to ensure medication safety among the most vulnerable patient population, pediatric patients.

The article highlights some of the technologies that have implemented to reduce medical errors such as the use of mobile application technologies and workflow management, barcoding technologies that enhance safe medication administration through the use of SMART pumps as well as computerized provider order entry and clinical support Annotated Bibliography-Medication Error.

Effective implementation of the approaches will help in significant reduction in the general medication errors that have adversely affected the health and wellbeing of sick children. This article is in line to my area of interest because it highlights medical errors in healthcare and precisely focuses on the pediatric population that is more vulnerable.

Alqenae, F. A., Steinke, D., & Keers, R. N. (2020). Prevalence and nature of medication errors and medication-related harm following discharge from hospital to community settings: a systematic review. Drug safety, 43(6), 517-537.

Medication safety during hospital admissions has been greatly highlighted but the same has not emphasized on medical errors after hospital discharge. The point of discharge my particularly pose significant challenges which may affect the adherence to prescribed medication after discharge which may lead to medical errors and associated effects. For instance, discharge may make some patients anxious and hence feel the freedom to abuse some of the prescribed drugs. Also, medication errors at home can happen intentionally or by mistake, either of which leads to adverse consequences. According to the article, the home environment increases the risk for poor drug adherence as well as adverse drug reactions. The risks of drug reactions may result due to the fact that at the point of discharge, some of the medications are stopped while other are initiated that may react to previously administered medications. According to the authors, some of the factors that enhance medication errors include poor communication at the point of discharge, poor or insufficient monitoring, lack of discharge summaries ad letters. Therefore, to prevent medical errors after discharge, the aforementioned factors must be rectified.

Learning from the Research

The research has enriched me with relevant information on medication errors by identifying some of the factors that contribute to medication errors as well as ways of preventing the occurrence of the errors. The peer reviewed articles were of great help to the study because they contain information that is credible and practices that are evidence based. For instance, the study has helped appreciate that medication errors can equally happen within the home setting after hospital discharge.

References

Alqenae, F. A., Steinke, D., & Keers, R. N. (2020). Prevalence and nature of medication errors and medication-related harm following discharge from hospital to community settings: a systematic review. Drug safety, 43(6), 517-537.

Kahn, S., & Abramson, E. L. (2019). What is new in pediatric medication safety? 
Archives of Disease in Childhood
, 
104
(6), 596-599 Annotated Bibliography-Medication Error

Owens, K., Palmore, M., Penoyer, D., & Viers, P. (2020). The effect of implementing bar-code medication administration in an emergency department on medication administration errors and nursing satisfaction. Journal of Emergency Nursing, 46(6), 884-891.

Yousef, N., & Yousef, F. (2017). Using total quality management approach to improve patient safety by preventing medication error incidences. 
BMC health services research
, 
17
(1), 1-16.

 

Annotated Bibliography-Medication Error

Create a 3-5 page annotated bibliography and summary based on your research related to best practices addressing one of the health care problems or issues in the Assessment Topic Areas media piece faced by a health care organization that is of interest to you.

Introduction

In your professional life, you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment. Being adept at research will help you find the information you need. For this assessment, you will review the Assessment Topic Areas media piece and select one of the health care problems or issues to research, which will be a current health care problem or issue faced by a health care organization that is of interest to you.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 3. To explore your chosen topic, you should use the first two steps of the
 Socratic Problem-Solving Approach 
to aid your critical thinking.

View the 
Assessment Topic Areas
media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

Summarize the health care problem or issue.

Describe your interest in the topic.

Describe any professional experience you have with this topic as a Health care provider who has administered numerous and various medication to patients in the past.

Identify peer-reviewed articles relevant to health care issue or problem.

Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.

I Used “Summon”  database the school’s online Library.  I used key phrases such as “Medication error and “Medication Error in the U.S.A.” and any other phrase along that line.  The articles are peer reviewed.  I Attached them.

Refer to the 
NHS-FPX4000: Developing a Health Care Perspective Library Guide
to help you locate appropriate references.

Use keywords related to the health care problem or issue you are researching to select relevant articles.

Assess the credibility and explain relevance of the information sources you find.

Determine if the source is from an academic peer-reviewed journal.

Determine if the publication is current.

Determine if information in the academic peer-reviewed journal article is still relevant.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:

Identify the purpose of the article.

Summarize the information.

Provide rationale for inclusion of each article.

Include the conclusions and findings of the article.

Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.

List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.

Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.

Summarize what you have learned from developing an annotated bibliography.

Summarize what you learned from your research in a separate paragraph or two at the end of the paper.

List the main points you learned from your research.

Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 2 Example [PDF]
.

Additional Requirements

Your Annotated Bibliography-Medication Error assessment should also meet the following requirements:

Length: 3–5 typed, double-spaced pages, not including the title page and reference page.

Font and font size: Times New Roman, 12 point.

APA tutorial: Use the 
APA Style Paper Tutorial [DOCX]
 for guidance.

Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Content: Provide a title page and reference page following APA style.

References: Use at least four scholarly or academic peer-reviewed journal articles.

APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

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

Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.

Identify academic peer-reviewed journal articles relevant to a health care problem or issue and describe the criteria used for the literature search.

Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.

Assess the credibility and relevance of information sources.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format.

Summarize what was learned from developing an annotated bibliography.

Annotated Bibliography-Medication Error

Competency 4: Write for a specific audience, in appropriate tone and style.

Summarize a health care problem or issue and describe a personal interest in it and experience with it.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Write following APA style for in-text citations, quotes, and references.

Socratic Problem-Solving Approach

The Socratic Method is a teaching style in which teachers ask students questions designed to stimulate more complete thinking and deeper insight. It also relates to the steps of performing scientific research. When the Socratic approach is applied, students are prompted to look more closely at your ideas, question your assumptions and accepted premises, and view your choices through a rigorous lens.

Apply the Socratic approach

Applying the Socratic approach to problem solving helps you identify gaps and improve your thinking when writing papers or completing projects. The questions may be used to spark new insights when responding to discussion topics and posts.

Identify the elements of the problem, issue, or question

Supporting actions:

Break the problem down into pieces, elements, or components.

Recognize how the pieces or components are related to each other.

Look for missing information or gaps in what you know.

Note the information that you do not have, cannot find, or is unavailable.

Separate symptoms from underlying causes.

Avoid judgments and premature solutions.

Gather information.

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Supporting questions:

What problem am I trying to solve?

What are the key issues in this problem?

What facts do I have? A fact is “something that actually exists; reality; truth; a truth known by actual experience or observation; something known to be true.”*

What evidence do I have? Evidence is “that which tends to prove or disprove something; grounds for belief; proof.”*

Which pieces of information are opinions? Opinion is “a belief or judgment that rests on grounds insufficient to produce complete certainty; a personal view, attitude, or appraisal.”*

Which pieces of information are inferences? To infer is “to derive by reasoning; conclude or judge from premises or evidence.”*

Are the inferences well or poorly reasoned? Can alternative inferences be drawn from the same facts or observations?

Which pieces of the information are theories? A theory is “a more or less verified or established explanation accounting for known facts or phenomena.”*

What do I not know?

What information is missing, and is it possible to get the information I do not have?

What are the possible sources of information?

What must remain unknown for now?

Analyze, define, and frame the problem, issue, or question

Supporting actions:

Gather information that you need to know more about the context surrounding this problem.

Decide which pieces of information are important.

Identify your point of view.

Consider how your cultural values shape your perception of the problem.

Evaluate conflicting evidence.

Separate symptoms from underlying causes.

Socratic Problem-Solving Approach

Avoid value judgments and premature solutions.

Analyze arguments.

Identify what you do not understand and the complexities of the problem.

Define a research problem.

Supporting questions:

What are my goals? What am I trying to accomplish?

Which pieces of information are the most important in relationship to this problem?

Is the information, or presented evidence, relevant to the problem? Are there other ways to interpret the information?

How does the information relate to:

What I already know?

My personal and professional experiences?

How does this information support or match my experiences?

How does it contradict or differ from my experiences?

What information opposes my position?

What theories in my discipline shed light on this problem?

What are the values, beliefs, and assumptions (i.e. or the things that are taken for granted and usually unstated) implied in the problem statement?

What are my values and beliefs in relationship to this problem?

Am I ignoring evidence that does not fit with my beliefs?

Am I failing to consider or investigate evidence that may contradict the theory I support?

What are my assumptions in relationship to this problem?

What support or evidence do I have to back up these assumptions?

What are the values, beliefs, and assumptions of my sources of information and references in relationship to this problem?

How does my culture or my world view shape my approach to this problem?

How would someone from another culture or world view approach this problem?

What are the possible causes of this problem?

What blind spots are keeping me from seeing additional causes?

What evidence supports my assertions? How reliable is this evidence?

What evidence supports others’ assertions?

How reliable is this evidence?

What other issues relate to this problem?

Am I considering the complexities of this problem?

How important is the problem relative to other problems?

Socratic Problem-Solving Approach

NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Case Study of the The Missing Needle Protector

L. Straight is director of clinical services at Hopewell Hospital. As in many hospitals, a few physicians provide care that is acceptable, but not of very high quality; they tend to make more mistakes than the others and have a higher incidence of patients going “sour.” Since Straight took the position 2 years ago, new programs have been developed and things seem to be getting better in terms of quality.

Dr. Cutrite has practiced at Hopewell for longer than anyone can remember. Although once a brilliant general surgeon, he has slipped physically and mentally over the years, and Straight is contemplating taking steps to recommend a reduction in his privileges. However, the process is not complete, and Cutrite continues to perform a full range of procedures.

The operating room supervisor appeared at Straight’s office one Monday afternoon. “We’ve got a problem,” she said, somewhat nonchalantly, but with a hint of disgust. “ I’m almost sure we left a plastic needle protector from a disposable syringe in a patient’s belly, a Mrs. Jameson. You know, the protectors with the red–pink color. They’d be almost impossible to see if they were in a wound.”

“Where did it come from?” asked Straight.

“I’m not absolutely sure,” answered the supervisor. “All I know is that the syringe was among items in a used surgical pack when we did the count.” She went on to describe the safeguards of counts and records. The discrepancy was noted when records were reconciled at the end of the week. A surgical pack was shown as having a syringe, that was not supposed to be there. When the scrub nurse working with Cutrite was questioned, she remembered that he had used a syringe, but, when it was included in the count at the conclusion of surgery, she didn’t think about the protective sheath, which must have been on it.

“Let’s get Mrs. Jameson back into surgery.” said Straight. “We’ll tell her it’s necessary to check her incision and deep sutures. She’ll never know we’re really looking for the needle cover.”

“Too late,” responded the supervisor, “she went home day before yesterday.”

Oh, oh, thought Straight. Now what to do? “Have you talked to Dr. Cutrite?”

The supervisor nodded affirmatively. “He won’t consider telling Mrs. Jameson there might be a problem and calling her back to the hospital,” she said. “And he warned us not to do anything either,” she added. “Dr. Cutrite claims it cannot possibly hurt her. Except for a little discomfort, she’ll never know it’s there.” NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Straight called the chief of surgery and asked s hypothetical question about the consequences of leaving a small plastic cap in a patient’s belly. The chief knew something was amiss but didn’t pursue it. He simply replied there would likely be occasional discomfort, but probably no life–threatening consequences from leaving it in. “Although,” he added, “one never knows.”

Straight liked working at Hopewell Hospital and didn’t relish crossing swords with Cutrite, who, although declining clinically, was politically very powerful. Straight had refrained from fingernail biting for years, but that old habit was suddenly overwhelming.

 

NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Summary of case study facts

The case involves a missing needle protector that was most likely left in the patient during surgery. The operating room supervisor argues that a check of the equipment after surgery revealed that a disposable needle used in the surgery lacked a protector during the check. The missing needle protector is pink in color and likely to have been left in the patient’s belly and closed up in the wound after surgery. Dr. Cutrite who was the attending surgeon is getting old and is reported to have been making many mistakes. He was informed of the likely surgery mistake and decided to ignore the issue, indicating that it would unlikely to develop into a complication. The operating room supervisor bring the case before the director of clinical services who decides not to confront Dr. Cutrite because he had significant support in the facility, not to inform the patient, and ignore the issue because the chief of surgery advice that it would unlikely to be an issue.

A review of the case details based on the three components of ethical-decision making model reveals significant ethical concerns. Firstly, there is an absence of moral awareness/sensitivity. Only the supervisor appears to be aware that the situation contains a moral issue and is keen on locating the missing needle protector. Both the director and Dr. Cutrite seem unaware that their actions have the potential to harm or benefit the patient as they are not keen on informing the patient about the missing needle protector or having it removed before it develops into a complication. Secondly, there is a lack of moral judgement in terms of using moral justification to formulate and evaluate possible solutions. In fact, the medical personnel appear more concerned with how the case affects them, than how the missing needle protector would harm the patient. Thirdly, there is a lack of moral intention/motivation in terms of choosing a decision over another with a different value. The parties involved did not commit to choosing the moral value, and were instead more concerned with maintaining personal power than doing what is morally right (Grace, 2018).

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Analysis of the case factors

There are five factors revealed in the case details. Firstly, a pink-colored need protector is missing and likely to have been left in the wound during surgery. Secondly, Dr. Cutrite has been slipping physically and mentally, and may be unable to continue with his full range of responsibilities. Thirdly, Dr. Cutrite is politically powerful. Fourthly, if left in the wound, the needle protector is unlikely to threaten the patient’s life, although there is a possibility that it could have negative effects. Finally, the patient has been discharged home and is no longer in the hospital.

Effectiveness of communication approaches

There were four significant communication failures in the case. Firstly, Dr. Cutrite whose clinical capabilities have been digressing was allowed to continue with the full responsibilities. This was a communication failure since he is allowed to continue with surgery responsibilities that he may be unable to competently complete. Secondly, the issue of the missing needle protector was brought to Dr. Cutrite’s attention and he chose to ignore it as a non-issue. Thirdly, the director decided not to follow up with Dr. Cutrite on the possible mistake made thus exposing other surgery patients to potential harm. Finally, the patient was not informed of the possibility that a needle protector was left in the wound during surgery. These are all cases of ineffective communication that place the surgery patient at risk and allow Dr. Cutrite to continue with his surgery responsibilities even when other patients are placed at risk (Butts & Rich, 2020) NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Effectiveness of approach used

Five key actions were undertaken in the case. Firstly, Dr. Cutrite was allow to continue with his surgery responsibilities even as the responsibilities should have been reduced because he was slipping physically and mentally. Secondly, the supervisor become aware that a pink-colored needle protector was missing and informed Dr. Cutrite that the protector may have been left in the wound during surgery. Thirdly, Dr. Cutrite decided not to have the wound opened up and needle protector removed since it was unlikely to cause life-threatening complications. Fourthly, the director decided not to inform the patient about the missing needle protector and not to have the surgery as she was advised that it was unlikely to cause life-threatening complications. Finally, the director did not confront Dr. Cutrite on the missing needle or discuss with him the possibility of reducing surgical responsibilities owing to declining clinical capabilities.

All the five key actions reveal that the decisions made were focused on maintaining and increasing personal power without regard for what was morally right. Another lesson learned is that the individuals involved lacked the moral courage to make the right ethical decision. As a result, the needle protector continues to present a threat to the patient. In addition, Dr. Cutrite continues with his surgery responsibilities and this places the patients at significant risk of harm (DeNisco, 2020). 

Apply ethical principles

This case was a medical error and it presents ethical issues related to four ethical principles. Firstly, principle of veracity requires that the medical personnel provide objective, accurate and comprehensive information to the patient, in a manner that helps the patient understand the information. Informing the patient that a surgery mistake occurred would help to establish trust (DeNisco, 2020). Secondly, principle of disclosure and right to knowledge. The medical personnel have an ethical obligation to disclose all the information that the patient would require to make an informed decision. The patient should be informed about the mistake to enable her make an informed decision on whether to have the needle protector removed through surgery. Thirdly, principles of beneficence and non-maleficence that directs medical personnel towards avoiding harm and doing the best for the patient. The medical personnel should take the necessary steps to minimize the harm. This includes balancing projected personal benefits against possible risk to the patients. This involves taking steps to reduce Dr. Cutrite’s surgery responsibilities so that he does not place other patients at risk (Zaccagnini & White, 2017). Finally, principles of autonomy and right to self-determination that involves allowing the patient to make her own choices and make decisions based on perceived benefits and personal views. The medical personnel have an ethical obligation to inform the patient that a medical error occurred (Connor, 2019). Based on the four discussed principles, the ethically right decision is to inform the patient about the medical error and reduce Dr. Cutrite’s surgery responsibilities so that he does not place other patients at risk (Finkelman, 2019).

References

Butts, J. B., & Rich, K. L. (2020).
Nursing Ethics: Across the Curriculum and into Practice
(5
th
ed.). Jones & Bartlett Learning, LLC.

Connor, J. (2019).
Professional Moral Courage in Nurse Executive Leadership: A Competency Framework
. Springer Publishing Company.

DeNisco, S. M. (2020).
Advanced Practice Nursing: Essential Knowledge for the Profession
(4
th
ed.). Jones & Bartlett Learning, LLC.

Finkelman, A. (2019).
Professional Nursing Concepts: Competencies for Quality Leadership
(4
th
ed.). Jones & Bartlett Learning, LLC.

Grace, P. J. (2018).
Nursing Ethics and Professional Responsibility in Advanced Practice
(3
rd
ed.). Jones & Bartlett Learning, LLC.

Zaccagnini, M., & White, K. (Eds.) (2017).
The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing
(3
rd
ed.). Jones & Bartlett Learning, LLC.

 

Instructions – NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

Access the 
Ethical Case Studies
media piece to review the case studies you will be using for this assessment.

Select the case most closely related to your area of interest and use it to complete the assessment.

Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Include the selected case study in your reference list, using proper APA style and format. Refer to the 
Evidence and APA
section of the Writing Center for guidance.

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.

Identify who is involved or affected by the ethical problem or issue.

Access the 
Ethical Decision-Making Model
media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.

Apply the three components outlined in the Ethical Decision-Making Model media.

Analyze the factors that contributed to the ethical problem or issue identified in the case study.

Describe the factors that contributed to the problem or issue and explain how they contributed.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The 
NHS-FPX4000: Developing a Health Care Perspective Library Guide
will help you locate appropriate references.

Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.

Review the 
Think Critically About Source Quality

Assess the credibility of the information source.

Assess the relevance of the information source.

Discuss the effectiveness of the communication approaches present in a case study.

Describe how the health care professional in the case study communicated with others.

Assess instances where the professional communicated effectively or ineffectively.

Explain which communication approaches should be used and which ones should be avoided.

Describe the consequences of using effective and non-effective communication approaches.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Describe the actions taken in response to the ethical dilemma or issue presented in the case study.

Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.

Discuss the key lessons this case provides for health care professionals.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Describe the proposed solution.

Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.

Discuss how likely it is the proposed solution will foster professional collaboration.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Apply the principles of effective composition.

NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

Determine the proper application of the rules of grammar and mechanics.

Write using APA style for in-text citations, quotes, and references.

Determine the proper application of APA formatting requirements and scholarly writing standards.

Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 1 Example [PDF]
.

Additional Requirements

Your assessment should also meet the following requirements:

Length: 3–5 typed, double-spaced pages, not including the title page and reference page.

Font and font size: Times New Roman, 12 point.

APA tutorial: Use the 
APA Style Paper Tutorial [DOCX]
 for guidance.

Written communication: Use correct spelling, grammar, and punctuation.

References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.

APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

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

Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

Competency 3: Apply ethical principles and academic standards to the study of health care.

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

Discuss the effectiveness of the communication approaches present in a case study NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Write following APA style for in-text citations, quotes, and references.

 

Applying Ethical Principles Scoring Guide – NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

CRITERIA

NON-PERFORMANCE

BASIC

PROFICIENT

DISTINGUISHED

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Does not summarize the facts in a case study or use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Inadequately summarizes the facts in a case study or incompletely uses the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Summarizes the facts in a case study and uses the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Summarizes the facts in a case study and uses the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it. Supports the reasoning with examples from scholarly readings.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

Does not apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Identifies academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence but does not apply them to support an analysis of the case.

Applies academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

Applies academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case, and explains how the chosen articles support the analysis.

Discuss the effectiveness of the communication approaches present in a case study.

Does not discuss the effectiveness of the communication approaches present in a case study.

Describes the communication approaches present in a case study but does not discuss their effectiveness.

Discusses the effectiveness of the communication approaches present in a case study NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study.

Discusses the effectiveness of the communication approaches present in a case study, explaining which approaches should be used more and which should be avoided.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Does not discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Describes the approach used by a professional to deal with problems or issues involving ethical practice in a case study but does not discuss its effectiveness.

Discusses the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Discusses the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study, and describes consequences of using effective and non-effective approaches.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Does not apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Identifies ethical principles involved in a possible solution to an ethical problem or issue described in a case study but does not apply them.

Applies ethical principles to a possible solution to an ethical problem or issue described in a case study.

Applies ethical principles to a possible solution to an ethical problem or issue described in a case study, and explains how the proposed solution is based in ethical principles.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Does not write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Writes clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics with some errors and lapses.

Writes clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Writes clearly and logically, using evidence to support a central idea, with correct use of spelling, grammar, punctuation, and mechanics and ensures the paper contains supporting examples for the main points.

Write following APA style for in-text citations, quotes, and references.

Does not write following APA style for in-text citations, quotes, and references.

Writes following APA style for in-text citations, quotes, and references with some errors and lapses.

Writes following APA style for in-text citations, quotes, and references.

Writes following APA style for in-text citations, quotes, and references without errors, and uses current reference sources.

NHS-FPX4000 The missing needle Protector Ethical dilemma Case Study

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Traumatic Brain Injury Case Report: Evidence-Based Practice for Patient-Centered Care and Population Health

Introduction

Personalized care entails taking into account a patient’s unique information as expressed in clinical history, individual complains, and risk factors to provide appropriate treatment. Advances in technology has increased understanding of diseases and improved diagnostic approaches. Some diseases affecting the population are costly to manage due to complexity and chronicity. One of the critical damages caused by trauma to the head is traumatic brain injury (TBI) and can occur to anyone regardless of age. According to Maas et al. (2017), TBI is major cause of mortality and disability in young adults. Patients with relatively mild brain injury may sustain long-term disability if adequate interventions are unavailable.  The management of TBI relies heavily on integrated health interventions including medications, rehabilitation, psychotherapeutic approaches or surgery depending on severity.

This paper contains a discussion on the intervention to include in a Population Health Improvement Initiative (PHII) for patients with traumatic brain injury and identifies potential gaps in care. The author describes how these gaps can in incorporated in plan of care using evidence-based practices present in literature. The case involves elderly patients with traumatic brain injury and PTSD who required primary patient care and follow-up care plan. Alicia Balewa, the Director of Safe Headspace reviewed and evaluated outcomes of the PHII. She compared the effectiveness of exercise, medication and therapy. The author describes a personalized health plan for the patients based on evidence-based research provided by a community TBI expert and literature search about the condition.

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Evaluation of Population Health Improvement Initiative (PHII) Outcomes

Population Health Improvement Initiative (PHII) guided care provided to patients with TBI and associated PTSD. Some of the evidence-based initiative implement include medication such as diuretics, rehabilitation, counselling psychology, cognitive behavioral therapy, exercise and training on coping mechanisms. In the Safe Headspace, the Director determined that moderate aerobic exercise caused improved mood by 22% among participants. Besides, memory improved by 61% and muscle control by 15%. Among the patients, the use of medication and therapy improved mood by 26% if used over six months. Medication and therapy also improved memory by 6%. Furthermore, daily medication at home provided mood improvement by over 70% and memory with 32% improvement in muscle control. According to the results, daily medication showed most improvement NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

 
The knowledge gap in this PHII entails the use of surgical measures for severe traumatic head injury. The effectiveness of the surgery in targeted population is unknown because no patient was eligible for the procedure. For a better evaluation, the health organization could consider injury or symptoms based evaluation of patients’ progress. The injury/symptoms approaches would identify unique patient’s needs and priority diagnosis. The approach can also help care providers identify barriers to patient’s self-management plan and facilitate prompt interventions.

Strategy for Improving PHII Outcomes

Long-term quality improvement goals help achieved better population health outcomes. In this strategy, initial steps include identification of most appropriate interventions, desired outcomes and areas of concern. The use of Plan-Do-Study-Act (PDSA) cycle is significant in implementing improvement strategies (Coury et al., 2017). Interventions in this cycle are goal development, identification of strategies to achieve desired goals, instituting implementation plans and action plans.

Personalized Evidence-Based Patient Care Plan

The Patient-Centered Medical Home (PCMH) model could be most suitable for formulating patients’ care plans, which should personalized. The PCMH meets goals of quadruple aim, promotes independence and patient’s autonomy. Besides, the model facilitates the continuity of care from healthcare facility to home. While using the model, healthcare providers establish a long-term therapeutic relation with the patient and family after leaving health facility setting.

The PCMH encourages care providers to formulate short and long-term goals in collaboration with patients and family. The goals are based on unique patient needs and should be congruent to patient’s socio-economic and cultural determinants of health. The care plan defines strategies executed at home and those execute in the healthcare setting. The targeted outcomes of these strategies are increased independence of the patient and better quality of life.

Interventions instituted in plan of care should be supported the best evidence form scientific studies. Care providers handling elderly patients with TBI and PTSD should learn about his condition, needs, and current management based on recent scientific evidence. Evidence from studies shows that educating patient’s family and caregivers on the required treatment modalities. Caregivers would also learn about the use of technology such as electronic programs and telecommunication modalities to facilitate communication with care providers. Using the aforementioned approaches to develop plan of care will promote independence, improve quality of life and prevent frequent hospital visits.

 
Analysis of Evidence

Healthcare organizations, which bear the vision of best quality of care for their clients, are keen to purse evidence-based practices. Evidence from recent studies help advice practice and address healthcare needs. For patients requiring continuity of care, proper interventions in transiting and managing them are critical for achievement of success. The study by Barman et al. (2016) reveled that management of patient suffering from TBI should involve a combination of rehabilitation techniques and pharmacotherapy. The authors expressed that the interventions help manage ill effects of TBI on patient’s emotions, self-confidence, physical well-being, and behavioral stability NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

The study by Maas et al. (2017) revealed that best practice for managing patients with TBI should encompass the processes between history taking, diagnostic examination until actual treatment modalities. The authors highlighted on the need for advanced radiological examination through MRI as indicated by patient’s presentation. Besides, the study emphasized on use of technology to deliver care even at home settings discharge from hospital. Maas et al. (2017) emphasize on the use of telecommunication advances to ensure continued communication between patients and healthcare providers. The article describes the significance of rehabilitative measures on the patients and follow-up plans assisted by technology.

Evaluation Strategy for Personalized Care Approach Outcomes

A shared-decision making framework is a significant process of working with a client to reach a decision regarding care (Etingen et al., 2020). This framework is applicable in evaluating outcomes of personalized care because it aligns with goals of the care, which include wellness, health promotion and prevention of suffering. In this strategy, care providers and family require training on how to communicate and prompt handling of emergent issues. A shared decision-making improves patient, staff and family satisfaction because all parties are involved in care. Upon implementation, the outcomes of care are compared with desired outcomes NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

Application for Other Cases

Good outcomes of personalized care approach encourage care providers to base interventions to patients’ needs and strengths. Similar situation of patients with trauma or post-traumatic stress can be managed by incorporating clients’ choices in care. When patients have control over their plan of care, they easily cooperate and subsequently facilitate healing (Etingen et al., 2020). Beside, allowing the client to make choices in shared decision-making enhances patient’s cooperation in delivery of care.

 
References

Barman, A., Chatterjee, A., & Bhide, R. (2016). Cognitive impairment and rehabilitation strategies after traumatic brain injury. 
Indian journal of psychological medicine
, 
38
(3), 172-181.

Coury, J., Schneider, J. L., Rivelli, J. S., Petrik, A. F., Seibel, E., D’Agostini, B., … & Coronado, G. D. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. 
BMC health services research
, 
17
(1), 1-10.
https://link.springer.com/article/10.1186/s12913-017-2364-3

Etingen, B., Hessinger, J. D., & Hunley, H. A. (2020). Training providers in shared decision making for trauma treatment planning. 
Psychological Services
.

Maas, A. I., Menon, D. K., Adelson, P. D., Andelic, N., Bell, M. J., Belli, A., … & Francony, G. (2017). Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. 
The Lancet Neurology
, 
16
(12), 987-1048 NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

 

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Write a 4-6 page evidence-based patient-centered care report on the patient scenario presented in the Evidence-Based Health Evaluation and Application media piece. Base your report on the information provided by the traumatic brain injury expert from the population health improvement initiative (PHII) described in the media activity and your own evidence-based research on this population health issue.

In this assessment, you will apply evidence-based practice in patient-centered care and population health improvement contexts. You will be challenged to think critically, evaluate what the evidence suggests is an appropriate approach for a personalized patient care plan, and determine which aspects of the approach could be applied to similar situations and patients.

Demonstration of Proficiency

By successfully completing this NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Apply evidence-based practice to plan patient-centered care.

Evaluate the outcomes of a population health improvement initiative.

Develop a personalized patient care plan that incorporates lessons learned from a population health improvement initiative.

Competency 2: Apply evidence-based practice to design interventions to improve population health.

Propose a strategy for improving the outcomes of a population health improvement initiative, or for ensuring that all outcomes are being addressed, based on the best available evidence.

Competency 3: Evaluate outcomes of evidence-based interventions.

Propose an evaluation strategy for the outcomes of personalized patient care plan and determine what aspects of the approach could be applied to similar situations and patients.

Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.

Identify the level of evidence and describe the value and relevance it brings to personalized care for your patient.

Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.

Write clearly and logically, with correct grammar and mechanics.

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

Scenario

The charge nurse in your clinic has contacted you to assume primary care for a patient and develop a plan for follow-up care. The plan should be personalized for him based on evidence-based research provided by a community expert as well as your own research on the condition. You will also be challenged to determine which aspects of the traumatic brain injury (TBI) approach could be applied to similar situations and patients.

Your Role

You are a nurse who has been requested to provide primary patient care, including a follow-up care plan. You will revisit the interview with the community TBI expert and prepare a personalized health plan for the patient.

Instructions

Review the Assessment Case Study: Traumatic Brain Injury Care Report media activity.

Review relevant evidence-based research from 3–5 additional scholarly or professional sources about traumatic head injuries to support your evaluation, recommendations, and plans.

The following requirements correspond to the grading criteria in the scoring guide, so be sure to address each point:

Evaluate the expected outcomes of the population health improvement initiative (PHII) that the community expert reported based on data.

Describe the outcomes that were achieved, their positive effects on the community’s health, and any variance across demographic groups.

Describe the outcomes that were not achieved, the extent to which they fell short of expectations and any variance across demographic groups.

Identify the factors (for example: institutional, community, environmental, resources, communication) that may have contributed to any achievement shortfalls.

Propose a strategy for improving the outcomes of the PHII for traumatic head injuries.

Describe the corrective measures you would take in the PHII to address the factors that may have contributed to achievement shortfalls.

Cite the evidence (from similar projects, research, or professional organization resources) that supports the corrective measures you are proposing.

Explain how the evidence illustrates the likelihood of improved outcomes if your proposed strategy is enacted.

Develop a personalized patient care plan for the patient from the scenario that incorporates lessons learned from the PHII outcomes.

Identify a personalized care approach that addresses the patient’s:

Individual health needs NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

Economic and environmental realities.

Culture and family.

Explain how the lessons learned from the PHII informed the decisions you made in your personalized care plan for the patient.

Incorporate references to the best available evidence from the population health improvement initiative and other relevant sources.

Identify the level of evidence and describe the value it brings to personalize care for your patient.

Identify the level of evidence for each resource you referenced.

Explain why each piece of evidence is valuable and appropriate for the community health issue you are trying to address and for the unique situation of your patient and his family.

Propose an evaluation strategy to assess the outcomes of your personalized care approach.

Identify measurable criteria that are relevant to your desired outcomes NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health.

Explain why the criteria are appropriate and useful measures of success.

Determine the specific aspects of your approach that are most likely to be transferable to other individual cases.

Additional Requirements

Organization: Use the following headings for your Traumatic Brain Injury Care Report:

Evaluation of Population Health Improvement Initiative (PHII) Outcomes.

Strategies for Improving PHII Outcomes.

Personalized Evidence-Based Patient Care Plan.

Analysis of Evidence.

Evaluation Strategy for Personalized Care Approach Outcomes.

Application for Other Cases.

Length: Your recommended plan will be 4–6 double-spaced pages, not including title and reference pages.

Font: Times New Roman, 12 points.

APA Format: Your title and reference pages must adhere to current APA format and style guidelines. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health sources according to APA guidelines.

Scoring Guide: Please review this assessment’s scoring guide. The requirements outlined above correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may want to review the performance-level descriptions for each criterion to see how your work will be assessed.

Scoring Guide info:

Evaluates the outcomes of a population health improvement initiative based on demographic, environmental, and epidemiological data. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the evaluation).

Proposes a strategy for improving the outcomes of a population health improvement initiative, or for ensuring that all outcomes are being addressed, based on the best available evidence. Acknowledges challenges in the proposed strategy.

Develops a personalized care plan that incorporates lessons learned from a population health improvement initiative, and identifies assumptions on which the approach is based.

Identifies the value and relevance of evidence used to support a personalized patient care plan. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve a personalized patient care plan).

Proposes an evaluation strategy to assess the outcomes of a personalized care approach. Identifies aspects of the approach that could be challenging, with solutions.

Determines aspects of the personalized approach that could be applied to similar situations and patients. Exhibits insight into the broader application of the approach for the community.

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

Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Citations are error-free NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

iHuman Reflection Questions

Patient Ray william 55yr old male with 1. The patient was newly diagnosed with type 2 diabetes. What social determinants of health (SDOH) should the nurse assess for that could impact the patient’s ability for diabetes self-management?

2. What are some environmental and/or individual factors that could impact the patient’s ability for diabetes self-management?

3. Draft one question you have regarding the topic/content of the simulation to have answered in class.

iHuman Reflection Questions

Summary References In reviewing the electronic health record and performing a history interview and physical exam, you identified pertinent information needed to care safely for your patient. Mr. Williams presents to the urgent care with increased fatigue, thirst, and urination for several weeks. He reports increased blood glucose levels and weight loss, and you recognize elevated blood pressure on the exam. In analyzing the cues, Mr. Williams’ symptoms are consistent with diabetes mellitus, fluid and electrolyte imbalance, diabetes mellitus, thyroid problems, or acute illness. The nurse hypothesizes that Mr. Williams is at greatest risk for diabetes mellitus, given the elevated blood glucose level and classic presentation. Patient Outcome Mr. Williams, a 55-year-old retired military male, presented with increased fatigue, thirst, urination, and appetite of indefinite duration. He was confirmed as having new-onset type 2 diabetes mellitus with probable early complications of peripheral neuropathy iHuman Reflection Questions. Outpatient management will include the following: • Comprehensive diabetic education and counseling. • Nutritional assessment and education; weight-reduction monitoring. • Baseline evaluations: vascular, ophthalmological, podiatric. • Urological consultation regarding sexual dysfunction.

 

iHuman Reflection Questions

Impact of Social Determinants of Health (SDOH)

The nurse should assess various social determinants of health (SODH) that is likely to impact the patient’s ability to engage in diabetes self-management. The patient’s socioeconomic status comprised of income level, employment status, and access to healthcare has significant impact on the patient’s ability to afford medications, healthy food options, and other essential medical equipment for diabetes management. In their study Hill-Briggs et al. (2021) identified noted that there is an association between diabetes prevalence and complications associated with various levels of social economic status, with the lower social economic status associated with higher likelihood of diabetes and more associated complications. Another social determinants of health that should be considered in this case is the patient’s education level. Patients with lower educational attainment tend to have more challenges understanding and adhering to the complex diabetes self-management regimens (Hill-Briggs et al., 2021) iHuman Reflection Questions. It is also important to consider the patient’s social support, since this is likely to influence his ability to cope with requirements of diabetes self-management. According to Young et al. (2020) higher levels of perceived social support is related to lower diabetes-associated distress. It is also important to consider access to healthcare, which takes into account how proximity to healthcare facilities and availability of diabetes education programs are likely to influence the patient’s willingness to adopt and adhere to self-management strategies.

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Environmental and Individual Factors

The environmental factors that are could influence the patient’s ability to engage in diabetes self-management include; his living conditions such as access to areas for physical activity and availability of healthy food options; work schedule and demands, and access to diabetes support groups or other relevant community resources. The individual factors that are likely to influence the patient ability to engage in diabetes self-management include his literacy skills, cognitive ability and mental health, physical limitations, lifestyle habits, and self-motivation for engaging in self-management behaviors iHuman Reflection Questions.

Question on the Topic

What educational strategies can nurses utilize to address possible barriers and challenges experienced by patients with diabetes, with consideration on how social determinants of health and individual factors may influence their ability of effective diabetes self-management?

References

Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., … & Haire-Joshu, D. (2021). Social determinants of health and diabetes: a scientific review. 
Diabetes care
, 
44
(1), 258. https://doi.org/10.2337/dci20-0053

Young, C. F., Shubrook, J. H., Valencerina, E., Wong, S., Henry Lo, S. N., & Dugan, J. A. (2020). Associations between social support and diabetes-related distress in people with type 2 diabetes mellitus. 
Journal of Osteopathic Medicine
, 
120
(11), 721-731. https://doi.org/10.7556/jaoa.2020.145 iHuman Reflection Questions

I-HUMAN PATIENTS CASE STUDY: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL ASSESSMENT

Throughout this course, you have reviewed Learning Resources on various body systems and completed i-Human Patients Assignments for particular systems. For this i-Human Patients Assignment, you connect the knowledge and skills you gained from each individual assessment to perform a comprehensive head-to-toe physical examination.

Resources

 

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To prepare:

By Day 1 of this week, your Instructor will assign an i-Human Patients case for this Assignment. 
Note:
 Please see the 
Course Announcements
 section of the classroom for your i-Human Patients Assignment.

Review this week’s Learning Resources. Also review Learning Resources from previous weeks as needed.

Access and review this week’s i-Human Patients Case Study Assignment.

I-HUMAN PATIENTS CASE STUDY: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL ASSESSMENT

Assignment

As you interact with this week’s i-Human Patients patient, complete the assigned case study. For guidance on using i-Human Patients, refer to the 
i-Human Graduate Programs Help link
 within the i-Human Patients platform.

By Day 7 of Week 9

Upload your PDF from i-Human Patients to submit this Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the 
Turnitin Drafts
 from the 
Start Here
 area.

To submit your completed assignment, save your Assignment as 
WK9Assgn_LastName_FirstInitial

Then, click on 
Start Assignment
 near the top of the page.

Next, click on 
Upload File
 and select 
Submit Assignment
 for review.

Rubric

NURS_6512_Week 9_Assignment_Rubric

NURS_6512_Week 9_Assignment_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome
History: Complete an appropriate health history. (Scores are automatically calculated in the i-Human platform.) I-HUMAN PATIENTS CASE STUDY: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL ASSESSMENT

20
 pts
Excellent
Achieves a score of 85–100%

15
 pts
Good
Achieves a score of 84–75%

10
 pts
Fair
Achieves a score of 74–65%

5
 pts
Poor
Achieves a score of 64–55%

0
 pts
Unsatisfactory
Achieves a score of 54% or below

20
 pts

This criterion is linked to a Learning Outcome
Physical Exam: Complete an appropriate physical exam. (Scores are automatically calculated in the i-Human platform.)

20
 pts
Excellent
Achieves a score of 85–100%

15
 pts
Good
Achieves a score of 84–75%

10
 pts
Fair
Achieves a score of 74–65%

5
 pts
Poor
Achieves a score of 64–55%

0
 pts
Unsatisfactory
Achieves a score of 54% or below

20
 pts

This criterion is linked to a Learning Outcome
EMR Documentation Chief Complaint and History of Present Illness 5 criteria using OLDCARTS: 1.) Complete; 2.) Accurate; 3.) Written in Professional Language; 4.) Pertinent to the Chief Complaint; 5.) Includes Subjective findings only (Evidence of Academic Integrity Issues will result in a grade of 0.)

10
 pts
Excellent
Complete HPI meeting all 5 criteria.

8
 pts
Good
4 requirements are met.

6
 pts
Fair
3 requirements are met.

4
 pts
Poor
1–2 requirements are met.

0
 pts
Unsatisfactory
No requirements are met.

10
 pts

This criterion is linked to a Learning Outcome
EMR Documentation Subjective Data Document Current Medications, PMH, Allergies, Family History, Social History, Preventive Health, Review of Systems 5 criteria: 1.) Complete; 2.) Accurate; 3.) Written in Professional Language; 4.) Pertinent to the Chief Complaint; 5.) Includes Subjective findings only (Evidence of Academic Integrity Issues will result in a grade of 0.)

10
 pts
Excellent
Complete HPI meeting all 5 criteria.

8
 pts
Good
4 requirements are met.

6
 pts
Fair
3 requirements are met.

4
 pts
Poor
1–2 requirements are met.

0
 pts
Unsatisfactory
No requirements are met.

10
 pts

This criterion is linked to a Learning Outcome
EMR Documentation Objective Data Document Physical Exam Findings: 5 criteria: 1.) Complete; 2.) Accurate; 3.) Written in Professional Language; 4.) Pertinent to the Chief Complaint; 5.) Includes Objective findings only (Evidence of Academic Integrity Issues will result in a grade of 0.)

10
 pts
Excellent
Complete HPI meeting all 5 criteria.

8
 pts
Good
4 requirements are met.

6
 pts
Fair
3 requirements are met.

4
 pts
Poor
1–2 requirements are met.

0
 pts
Unsatisfactory
No requirements are met.

10
 pts

This criterion is linked to a Learning Outcome
Key Findings: Organize the key findings with the most important first and least important last. (Evidence of Academic Integrity Issues will result in a grade of 0.) I-HUMAN PATIENTS CASE STUDY: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL ASSESSMENT

5
 pts
Excellent
The key findings are complete and appropriately organized.

4
 pts
Good
The key findings are complete but the organization is not correct.

3
 pts
Fair
There are 1–2 key findings missing or organized inappropriately.

2
 pts
Poor
There are 3 key findings missing and organization is incorrect.

0
 pts
Unsatisfactory
There are more than 3 key findings missing and organization is incorrect.

5
 pts

This criterion is linked to a Learning Outcome
Problem Statement: Document a brief and accurate problem statement using professional language that includes the following: 1.) Name or initials, age; 2.) Chief complaint; 3.) Positive and negative subjective findings; 4.) Positive and negative objective findings. (Evidence of Academic Integrity Issues will result in a grade of 0.)

5
 pts
Excellent
All requirements are met.

4
 pts
Good
3 requirements are met.

3
 pts
Fair
2 requirements are met.

2
 pts
Poor
1 requirement is met.

0
 pts
Unsatisfactory
No requirements are met.

5
 pts

This criterion is linked to a Learning Outcome
Management Plan: Use the expert diagnosis provided to create a pertinent, comprehensive, evidenced-based management plan. Address the following criteria in the plan: 1.) Diagnostic tests; 2.) Medications (write out a complete order, even for OTC meds); 3.) Suggested consults/referrals; 4.) Patient education; 5.) Follow-up, including time interval and specific symptoms to prompt a return visit sooner; 6.) Provide rationales for each intervention and include references to support your plan. Clinical practice guidelines should be utilized as applicable. (Evidence of Academic Integrity Issues will result in a grade of 0.)

15
 pts
Excellent
All requirements are met.

13
 pts
Good
5 requirements are met.

10
 pts
Fair
4 requirements are met.

7
 pts
Poor
1-3 requirements are met.

0
 pts
Unsatisfactory
No requirements are met.

15
 pts

This criterion is linked to a Learning Outcome
References and Format: Current APA citations for references in management plan. Use of clinical practice guidelines when applicable.

5
 pts
Excellent
0–1 errors Clinical practice guidelines used when applicable.

4
 pts
Good
2–3 errors Clinical practice guidelines used when applicable.

3
 pts
Fair
4–5 errors Clinical practice guidelines not used when applicable.

2
 pts
Poor
6–7 errors Clinical practice guidelines not used when applicable.

0
 pts
Unsatisfactory
More than 7 errors; clinical practice guidelines not used when applicable.

5
 pts

Total Points: 
100 I-HUMAN PATIENTS CASE STUDY: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL ASSESSMENT