Category: Nursing

NHS-FPX4000 Developing a Health Care Perspective Assessment 2 Instructions: Applying Research Skills – Annotated Bibliography

Annotated Bibliography

Fernando, S. M., Tran, A., Cheng, W., Klompas, M., Kyeremanteng, K., Mehta, S., … & Rochwerg, B. (2020). Diagnosis of ventilator-associated Pneumonia in critically ill adult patients—a systematic review and meta-analysis. 
Intensive care medicine
, 
46
(6), 1170-1179.

Fernando et al. state that physical examination findings, chest radiography, and endotracheal; aspirate cultures are very essential when caring for a patient with ventilator-associated Pneumonia (VAP). This article’s authors aim to compare the efficacy of various diagnostic tests, for instance, endotracheal aspirate, when caring for a patient with ventilator-associated Pneumonia. Some of the research designs that were used in the article include meta-analysis and systematic review. The study’s findings suggest that individual signs and the clinicians’ tests are neither sensitive nor specific when caring for that particular patient. The most reliable reference standard for VAP diagnosis is histopathology from a lung biopsy. The findings also state that healthcare workers should be mindful even when caring for patients who do not have signs of VAP. The results indicate that the clinicians should not only initiate antibiotics when they identify these signs but rather conduct a comprehensive assessment.

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.

The authors of the article, Luyt et al., conducted a retrospective cohort study to assess the frequency, clinical characteristics, and pathogenesis of the individuals with ventilator-associated Pneumonia requiring mechanical ventilation. Many individuals with the severe form of Covid 19 need venovenous extracorporeal membrane oxygenation (ECMO). Besides the ECMO management, drug monitoring was part of the routine care of these lot of individuals. Among the 60 controls with influenza-associated Acute respiratory failure, only 51 patients had received mechanical ventilation, while 45 of them required VV-ECMO. The findings confirmed that the patients who had received mechanical ventilation at long last needed VV-ECMO for their deteriorating condition. The rationale for including this article in the study is simply because, the authors were more interested in informing individuals about the effectiveness of the VV- ECMO intervention in patients with VAP.In conclusion, patients with severe Covid 19 associated Acute respiratory disease who require ECMO are particularly prone to develop the late onset of VAP and thus may need VV-ECMO NHS-FPX4000 Developing a Health Care Perspective Assessment 2 Instructions: Applying Research Skills – Annotated Bibliography.

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

The article’s authors, Papazian and Luyt, determine the effectiveness of microbial treatment in managing Ventilator-associated Pneumonia in patients admitted to the Intensive Care Unit. They define Ventilator-associated Pneumonia is an infection of the pulmonary parenchyma in patients exposed to invasive mechanical ventilation for more than 48 hours. In the article, the severity of the case has been stated to affect about 5-40 % of the patients under Intensive care monitoring. The primary causative agents that have been believed to cause ventilator-associated Pneumonia include Pseudomonas aeruginosa, Klebsiella pneumonia, and Acinetobacter species. The article’s findings by the author state that the administration of antimicrobials should be withheld in cases where the patient’s health is stable. Additionally, administering full course antibiotics may result in antimicrobial resistance; hence procalcitonin should be administered to stop increased resistance. The authors concluded that there is a great need to conduct various studies to confirm that the bundles may improve health outcomes.

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Wu, D., Wu, C., Zhang, S., & Zhong, Y. (2019). Risk factors of ventilator-associated Pneumonia in critically III patients. 
Frontiers in pharmacology
, 
10
, 482.

Wu et al. state that some of the current challenges of managing VAP are the lack of a gold standard for diagnosing, the absence of effective preventive strategies, and the rise of antibiotic resistance. This article reviews the infection’s international risk factors, including the patient’s characteristics and the corresponding treatment measures. The elderly are more prone to contracting the infection as they are more susceptible than the young population. Some of the preventive measures highlighted by the article include head elevation to 30-45 degrees, reducing unnecessary sputum suction, and selective decontamination of the digestive tract. Besides that, oral disinfection of the individual with 2% chlorhexidine is also considered effective in reducing the oral colonization of VAP. This article was included in the study since the authors were more interested in determining the infection’s various treatment and prevention interventions. To conclude, a unified diagnostic criterion and VAP treatment measures make the results look accurate.

Summary of what I have learned from the Annotated Bibliography

I have learned that an annotated bibliography provides an overview of the available Research on a given concept. It is basically a list of research sources that assumes the form of a citation of each selected source. It should be brief and not lengthy; some essential information about the article that should be included in the writing consists of a short summary of the research findings, the rationale for including the article in the study, and the conclusion. Besides that, the sources should be carefully selected to ensure that they meet the criteria needed.

Summary of what I have learned in the Research

Ventilator-associated Pneumonia primarily affects patients with acute respiratory distress syndrome, especially those who have been admitted to the Intensive Care units. The effective diagnostic criteria of the infection include Microbial sampling, lung biopsy, and also chest x-rays. Antimicrobial resistance is more likely to occur and will affect those individuals who have been on an entire course of antibiotics without adhering to the medications. The healthcare workers also need to be watchful when caring for the patients, as most infections are nosocomial. Lastly, collaborating with the healthcare workers will help prevent the occurrence of severe VAP infection NHS-FPX4000 Developing a Health Care Perspective Assessment 2 Instructions: Applying Research Skills – Annotated Bibliography.

Main points I have learned from the Research

Ventilator-associated Pneumonia is a type of a hospital-acquired Pneumonia that develops after 48 hours of mechanical ventilation.

The Head of the bed should be elevated between 30-45 degrees

Oral care with chlorhexidine 2% can help prevent ventilator-associated Pneumonia.

A unified diagnostic criterion and VAP treatment measures make the results look accurate.

Severe forms of VAP may need VV-ECMO intervention.

The primary causative agents for VAP include Pseudomonas Aeruginosa and Klebsiella Pneumonia.

 

NHS-FPX4000 Developing a Health Care Perspective Assessment 2 Instructions: Applying Research Skills – Annotated Bibliography

Assessment 2 Instructions: Applying Research Skills

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.

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 NHS-FPX4000 Developing a Health Care Perspective Assessment 2 Instructions: Applying Research Skills – Annotated Bibliography.

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:

 

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

 

Rubric

Applies academic peer reviewed journal articles relevant to the health care problem or issue being researched, including why the chosen articles are relevant to the topic. 

Assesses the credibility of information, explaining the process used for determining the sources’ credibility, and explains the relevance of the information sources, providing the reasons for considering the sources relevant to the topic.

 
Analyzes academic peer-reviewed journal articles using the annotated bibliography organizational format, and provides rationale for inclusion of each selected article.

 
Summarizes what was learned from developing the annotated bibliography, including examples.

 
Produces text free of grammatical, usage, spelling, and mechanical errors

 
Integrates into text appropriate use of scholarly sources, evidence, and citation style without errors and uses current reference sources.

NHS-FPX4000 Developing a Health Care Perspective Assessment 2 Instructions: Applying Research Skills – Annotated Bibliography

NHS-FPX4000 DHCP Assessment 3 : Applying Ethical Principles

Evidence-Based Practice Proposal – Section D: Change Model

Roger’s diffusion of innovation theory is a particularly good theoretical framework to apply to an EBP project. However, students may also choose to use change models, such as Duck’s change curve model or the transtheoretical model of behavioral change. Other conceptual models, such as a utilization model (Stetler’s model) and EBP models (the Iowa model and ARCC model) can also be used as a framework for applying your evidence-based proposal in clinical practice. Apply one of the above models and carry your implementation through each of the stages, phases, or steps identified in the chosen model.

In 500-750 words (not including the title page and references page), discuss applying one of the change models to the implementation plan:

1. Identify the selected model or theoretical framework and discuss its relevance to your project.

2. Discuss each of the stages in the change model/framework.

3. Describe how you would apply each stage in your proposed implementation.

–In addition, create a conceptual model of the project. Although you will not be submitting the conceptual model you design in Topic 4 with the narrative, you will include the conceptual model in the appendices for the final paper.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Please, Please look at the papers uploaded to continue with Section D.

This is a continuous proposal

I live in el Paso, Texas

I work in a Managed Care organization. I look at Hierarchical Condition Category coding (HCC codes) and proper documentation for accurately diagnosing and reimbursement. More specific, I work for WellMed Medical Management. I am a clinical nurse coding consultant.

I have been working my papers around diabetes, elderly with Type 1 diabetes and continuous glucose monitor

PICOT question

In elderly patients with type 1 diabetes mellitus (T1DM), how does continuous glucose monitoring (CGM), when compared to the traditional self-monitoring of blood glucose (SMBG) levels decrease hypoglycemic events, improve glycemic control, and reduce hospital readmissions or admissions in the long-term.

 

Evidence-Based Practice Proposal – Section D: Change Model

The Selected Theoretical Framework: Roger’s Diffusion of Innovation Theory

The proposed EBP aims to introduce continuous glucose monitoring (CGM) strategy to decrease hypoglycemic events, improve glycemic control, and reduce hospital readmissions in the long-term among elderly patients with type 1 diabetes mellitus (T1DM). Roger’s Diffusion of Innovation Theory will be utilized to guide the implementation of the proposed change.

E.M. Rogers developed the Diffusion of Innovation (DOI) Theory in 1962 (Aizstrauta et al., 2015). It is ranked among the oldest theories in the social science field. This theory was based on communication regarding how a particularly new idea, behavior, or product diffuses or gains momentum after a certain period. Therefore, the idea spreads out over a particular social system or population. Consequently, part of a social system adopts the new idea, behavior, or product. Individuals tend to abandon their old behavior and practices and implement what is proposed by the new idea. However, people must consider the idea as new before adopting it. Diffusion is only possible if the new idea is considered as innovative.

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The DOI theory is relevant to the selected project. The idea of using continuous glucose monitoring (CGM) strategy to manage diabetes among elderly patients with type 1 diabetes mellitus (T1DM) will diffuse through the healthcare facility. Care providers will consider the new idea as innovative, thus embracing it. Consequently, they will stop using the old strategies of managing diabetes among this patient population but instead adopt the new approach. This move will, in turn, decrease hypoglycemic events, improve glycemic control, and reduce hospital readmissions in the long-term among elderly patients with type 1 diabetes mellitus (T1DM).

Stages of the Diffusion of Innovation (DOI) Theory and their Implementation to the Proposed Project

The model constitutes of five major stages. These stages play a significant role in determining the new model’s impact on nurse practitioners in the healthcare facility. The first stage is innovators, which entails the practitioners willing to take risks and implement a new idea that they consider as innovative in their practices (Dang & Dearholt, 2018). The level of convincing required in this stage is not much. These nurses only need to understand the logic behind the new concept. Early adopters are the second stage of this change model. It involves practitioners involved in convincing and influencing other healthcare staff, including the management and opinion-makers about the new idea. They are willing to support the new concept since they know its effectiveness in managing diabetes among elderly patients with type 1 diabetes mellitus (T1DM) in the long-term.

The third stage of this model is the early majority, which involves subordinate nurses. This group of practitioners requires evidence for them to adopt the new idea in their practices. The new idea’s previous success stories determine their willingness to embrace it Grinspun & Bajnok, 2018). They are convinced by success stories and evidence of the concept being effective before they adopt it. Therefore, statistical data about the effectiveness of continuous glucose monitoring (CGM) strategy in managing diabetes among elderly patients with type 1 diabetes mellitus (T1DM) would be required to influence them to adopt the new approach.

The fourth stage of this model is known as the late majority, which involves skeptical nurses. This group of practitioners is only willing to adopt the new idea once it has gained popularity in the nursing practice, and many other nurses having already implemented it (Dibra, 2015). Therefore, success stories of the nurses who have used continuous glucose monitoring (CGM) strategy in managing diabetes among elderly patients with type 1 diabetes mellitus (T1DM) are required to convince these nurses to adopt the new approach in their practices. The final stage is known as laggards. This stage involves a group of conservative nurses who are reluctant to adopt the new idea (Dearing & Cox, 2018). This group of practitioners is only willing to implement the new idea if no other option is available. In other words, they require pressure from workflow and procedures changes for them to embrace any new idea or behavior. Thus, influencing these nurses to adopt the continuous glucose monitoring (CGM) strategy in managing diabetes among elderly patients with type 1 diabetes mellitus (T1DM) would require workflow pressure.

Therefore, each stage of the Diffusion of Innovation (DOI) theory can be implemented in the proposed project. However, the results vary significantly depending on the implemented stage. More positive results would be obtained if stage one was implemented since the nurse would be willing to adopt the new idea without much convincing. The possibility of getting positive results declines once other stages of this change model are implemented. Consequently, very minimal positive results can be obtained once stage five is implemented. In this stage, nurses are unwilling to adopt the new idea unless they are pressurized to do so either by the management or by the workflow.

References

Aizstrauta, D., Ginters, E., & Eroles, M. A. P. (2015). Applying the theory of diffusion of innovations to evaluate technology acceptance and sustainability.
Procedia Computer Science
, 
43
, 69-77.

Dang, D., & Dearholt, S. (2018).
Johns Hopkins Nursing
Evidence-Based Practice
: Model and Guidelines (3
rd
ed.).
Sigma Theta Tau International.

Dearing, J, W & Cox, J, G. (2018). Diffusion Of Innovations Theory, Principles, And Practice.
Health Affairs
, 37(2):183-190

Dibra, M. (2015). Rogers’s theory on the diffusion of innovation-the most appropriate theoretical model in the study of factors influencing the integration of sustainability in tourism businesses.
Procedia-Social and Behavioral Sciences
, 
195
, 1453-1462.

Grinspun, D., & Bajnok, I. (2018).
Transforming Nursing Through Knowledge: Best Practices for Guideline Development, Implementation Science, and Evaluation
. Sigma Theta Tau International.

NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

NR520 Applied Theoretical Foundations, Scientific Inquiry, and Decision-Making

Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

There are two parts to this assessment. In the first (Part I), students will consider a professional practice issue or problem, and develop a clinical/practice question to guide an evidence-based practice process improvement project. Second (Part II), students will select a qualitative and quantitative article related to the professional practice issue. Students will answer the questions related to quantitative and qualitative research within the Professional Practice Issue form. Consider different professional practice issues related to future professional practice in the master’s-

prepared advanced practice role. Think about your practicum project and where this will take place. What issues or problems, have you identified in the practicum practice setting? (Other suggested issues or problems might include unit nurse staffing, supply access, patient falls, or staff to patient/family communication.) How might you resolve the issues or problems with an evidence-based practice quality improvement project?

1. Complete the Project Professional Practice Issue form.

2. Choose one quantitative and one qualitative scholarly source which will help you identify why this issue or problem is important to nursing and healthcare. Answer the questions related to

quantitative and qualitative research within the Professional Practice Issue form.

NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

Consider your practicum work setting and environment. Complete the following:  

(1)

What issues or problems are you working on or want to work on for your MSN evidence-based practice quality improvement project?
How would the Johns Hopkins model be used to support this project process?
(This is brainstorming.)

Answer

The professional practice issue in my practicum setting is patient falls among adults older than 65 years on a medical-surgical unit. Falls increase injuries, length of stay, and healthcare costs. For my MSN evidence-based practice quality improvement project, I plan to implement structured hourly rounding and improved patient fall education. The Johns Hopkins Nursing Evidence-Based Practice Model will guide this project using the PET process. First, I will define the practice question about fall prevention. Second, I will review current research evidence. Third, I will translate the evidence into practice by implementing the intervention and evaluating results.

 

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(2)

Thinking about these issues or problems, what internal organization data is currently available, tracked, or reviewed? (What is it that indicated to you that this was an issue or problem? Do not drill down to the details; keep it broad. Do you see patterns developing? Such as between 2-4 am most patients between the ages of 65-85 fall.)

Answer

The organization tracks fall rates per 1,000 patient days, falls with injury, patient age, time of fall, and unit location. Incident reports show that most falls happen at night and involve older adults trying to go to the bathroom without help. There is also data on staffing levels and call light response times. The pattern shows that lower staffing and delayed response times may increase fall risk.

 

(3)

Based on the data that is available, what is done with it? (Are process improvement plans generated? Are there groups of people that work on this? Such as a Root Cause Analysis group? Clinical nurse specialists?  Nurse managers?)

Answer

The Quality Improvement Committee and nurse managers review fall data monthly. Root Cause Analysis is completed for serious falls. Education sessions are sometimes provided, and reminders are posted. However, fall rates remain a concern, and current strategies are not always consistent.

 

(4)

When this issue or problem is improved / positive change occurs, how will you know you have been successful? (What measures? Can be patient-centered, financial, clinical-based?)

Answer

Success will be measured by a reduction in total fall rates and falls with injury within six months. Data will be compared before and after the intervention. Other measures include improved staff compliance with hourly rounding and improved patient satisfaction scores related to safety.

 

(5)

Identify why this issue or problem is important to nursing and healthcare. (You should include at least 2 scholarly sources here which include 1 quantitative and 1 qualitative design)

Answer

Patient falls are important to nursing and healthcare because they affect patient safety and quality of care. A recent quantitative study by Morris et al. (2024) examined a hospital fall prevention education program and measured falls per 1,000 bed days. The study showed that structured education programs can reduce falls in acute care hospitals. A qualitative study by McLennan et al. (2024) explored views of nurses, patients, and families about fall prevention. The study found that teamwork, communication, and leadership support are key factors in successful fall prevention programs. Together, these studies show that both measurable outcomes and staff experiences are important in improving safety.

 

(6)

What are the real or potential barriers to you implementing your intervention to the problem? (Identify at least (4) potential barriers.)

Answer

Potential barriers include staff resistance to change, limited staffing, time constraints, and inconsistent documentation. Other barriers may include poor communication between shifts and lack of leadership support.

NR520 Applied Theoretical Foundations, Scientific Inquiry, and Decision-Making

(7)

Who (inside and outside) can you connect with to refine & develop this work? NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

Answer

I can collaborate with nurse managers, bedside nurses, clinical nurse specialists, and the quality improvement team.

I can consult faculty mentors and patient safety experts outside the organization.

 

(8)

State your PICO(T) Elements

Answer

P
– Hospitalized adults over 65 years on a medical-surgical unit

I –
Structured hourly rounding and enhanced fall education

C –
Usual care without structured rounding

O –
Reduced fall rates and fall-related injuries

T –
Six months

 

(9)

From you PICOT elements, state your clinical practice or EBP question.

Answers

 

In hospitalized adults over 65 years on a medical-surgical unit (P), how does structured hourly rounding and enhanced fall education (I), compared to usual care (C), affect fall rates and fall-related injuries (O) over six months (T)?

 

 

(10)

Quantitative Research

 

Reflect upon the nursing professional practice issue of interest that you identified. In addition, consider the intervention that you proposed to improve the issue. Be sure to reference and cite the quantitative scholarly source you identified in item 5 from above. Include the full reference for article (APA Format) and hyperlink to article.

 

With both the issue and the intervention in mind, respond to the following:

 

·        What type of evidence produced through quantitative research would be helpful to better understand the selected practice issue?

·        How might quantitative research findings shape your efforts to improve the issue?

·        Describe an example (real or hypothetical) of a quantitative research design that would provide valuable evidence regarding this issue (may refer to source above related to question 5).

Answers

 

 Quantitative research provides numerical data such as fall rates and injury rates. This type of evidence helps determine if the intervention works. The study by Morris et al. (2024) used measurable outcomes to compare fall rates before and after an intervention. These findings support the use of structured education and rounding to reduce falls. A randomized controlled trial or quasi-experimental design would provide strong evidence by comparing two groups and measuring statistical differences. NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

Reference:

Morris, M. E., Thwaites, C., Lui, R., McPhail, S. M., Haines, T., Kiegaldie, D., Heng, H., Shaw, L., Hammond, S., McKercher, J. P., Knight, M., Carey, L. M., Gray, R., Shorr, R., & Hill, A. (2024). Preventing hospital falls: Feasibility of care workforce redesign to optimise patient falls education. 
Age and Ageing
, 
53
(1). 
https://doi.org/10.1093/ageing/afad250

 

(11)

Qualitative Research

 

Reflect upon the nursing professional practice issue of interest that you identified. In addition, consider the intervention that you proposed to improve the issue. Be sure to reference and cite the qualitative scholarly source you identified in item 5 from above. Include the full reference for article (APA Format) and hyperlink to article.

 

With both the issue and the proposed practice change in mind, respond to the following:

 

·        What type of evidence produced through qualitative research would be helpful to better understand the selected practice issue?

·        How might qualitative research findings shape your efforts to improve the issue?

·        Describe an example (real or hypothetical) of a qualitative research design that would provide valuable evidence regarding this issue (may refer to source above related to question 5).

Answers

 

Qualitative research provides information about experiences and perceptions. The study by McLennan et al. (2024) used interviews to explore barriers and facilitators of fall prevention. This type of evidence helps understand staff attitudes and patient concerns. A phenomenological or interview-based study would help identify challenges in workflow and communication. These insights can guide better implementation of the fall prevention program and improve long-term success.

Reference:

McLennan, C., Sherrington, C., Tilden, W., Jennings, M., Richards, B., Hill, A. M., … & Haynes, A. (2024). Considerations across multiple stakeholder groups when implementing fall prevention programs in the acute hospital setting: a qualitative study. 
Age and Ageing
, 
53
(10), afae208.
https://doi.org/10.1093/ageing/afae208

NR520 Module 3 Assessment: Project Area of Interest Form Professional Practice Issue

KTIP lesson plan

Please create a KTIP lesson plan in PE on the game Ultimate Frisbee for a seventh grade PE class

Lesson Plan Rubric

ARTIFACT

Exemplary

4

Accomplished

3

Developing

2

 Ineffective

1

SCORE

Lesson Plans (4)

 

CAEP:
1.1, 1.3, 1.4, 1.5

InTASC:
1,2,4, 5, 7, 8

 

 

 

 

Includes a comprehensive plan with:

§  learning targets clearly aligned to Kentucky Academic Standards

§  lesson procedures clearly defined

§  a variety of appropriate  instructional strategies

§  multiple examples of differentiation within the lesson

§  effective formative and summative assessments

Includes an adequate plan with:

 

§  learning targets aligned to Kentucky Academic Standards

§  lesson procedures defined

§  appropriate instructional strategies

§  sufficient evidence of differentiation within the lesson

§  effective formative or summative assessments

 

Includes a limited plan with:

 

§  learning targets

§  lesson procedures somewhat defined

§  instructional strategies

§  some evidence of differentiation within the lesson

§  formative and / or summative assessments KTIP lesson plan

Includes a plan with:

 

§  unrelated learning targets

§  partial / incomplete lesson procedures

§  ineffective instructional strategies

§  ineffective differentiation within the lesson

§  ineffective formative and / or summative assessments

 

 

KTIP lesson plan

Source of Evidence:  Lesson

Plan

 

 

Name:

Date of Observation:

Cycle:
Spring 26

Grades/Ages of Students:
7th Grade / Ages 12-14

Number of Students:
12

Number of Students with IEP/504:

Number of Gifted Students
: 0

Number of Students with LEP
: 0

Lesson Title:
Introduction to Ultimate Frisbee: Passing, Movement, and Team Play

 

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1. Context: Description of Students (IB)

This is a seventh-grade physical education class with 12 students who have different levels of athletic skills and experience with team sports. There are two students with IEPs for attention deficit and motor coordination. These two students require clear instructions, visual modeling, and more practice. The students are very engaged with cooperative learning and games. The students respond well to routines and positive reinforcement. The students require small group instruction, feedback, and physical learning. All the students are English fluent. There are no gifted or LEP students.

2.  
Lesson Learning Targets/Objectives
(lA) (lC)

Learning Targets:

• Students will demonstrate correct forehand and backhand Frisbee passing techniques.

• Students will apply basic Ultimate Frisbee rules where no running with the disc, self-officiating and inclusion of fair play during modified gameplay.

•Students will work cooperatively with teammates to maintain possession and score points.

Connection to Standards:

• SHAPE America Standard 1: Demonstrates competency in motor skills and movement patterns.

• SHAPE America Standard 4: Exhibits responsible personal and social behavior that respects self and others.

3. Students’ Baseline Knowledge
and Skills (lB) (lF)

The students’ knowledge was determined by observing the students and asking them questions during the warm-up activities at the beginning of the unit. Half of the students had some knowledge of throwing a Frisbee, however, the students were having difficulties with gripping and throwing the Frisbee. The students were not familiar with the rules of Ultimate Frisbee, such as not running with the disc; this is a big part of the game. (Appendix A) KTIP lesson plan.

4. 
Formative Assessment (lF)

Formative Assessment Methods:

·        Teacher observation during partner passing drills to assess grip, stance, and accuracy

·        Questioning during instruction to check understanding of rules and strategies

·        Observation of student engagement, teamwork, and rule adherence during small-sided games

Use of Data:

·        Immediate feedback and corrective cues provided during drills

·        Students demonstrating proficiency are encouraged to model skills

·        Students needing support receive additional practice and simplified tasks (Appendix B)

 

5.  Resources (lD)

 

6-8 Ultimate Frisbees.

Cones to mark boundaries and end zones.

Whistle.

Visual cue cards showing throwing techniques.

Outdoor field or gym space.

6.Lesson Procedures (lE)

Opening / Warm-Up (5 minutes)

·        Light jog and dynamic stretching

·        Review of safety expectations and lesson objectives

Activity #1: Frisbee Passing Skills (10 minutes)

·        Teacher models forehand and backhand throws

·        Students practice passing with partners at short distances

Differentiation:

·       
Extension:
Increase distance or add moving targets

·       
Remediation:
Shorter distance, slower pace, additional modeling

Assessment:

·        Teacher observation using a skills checklist

Activity #2: Movement and Catching Drill (10 minutes)

·        Students practice cutting and changing direction and catching while stationary throwers pass

·        Emphasis on communication and spacing

Differentiation:

·       
Extension:
Add defenders

·       
Remediation:
Walk-through pace with fewer players

Assessment:

·        Observation of movement patterns and teamwork

Activity #3: Modified Ultimate Frisbee Game (10 minutes)

·        4v4 or 5v5 small-sided games

·        Focus on passing, teamwork, and rule application

Differentiation:

·       
Extension:
Limit number of passes before scoring

·       
Remediation:
Allow additional time or modified rules

Assessment:

·        Teacher notes on skill application, cooperation, and rule adherence.

 

 

Closing of the Lesson

Cool-down stretches

Group discussion:

“What skill helped your team the most today?”

“How did teamwork affect your success?”

Preview of next lesson: offensive and defensive strategies

KTIP lesson plan

 

 

 

 

 

 

Appendices

Appendix A: Pre-Assessment Data Summary Table

Skill/Knowledge Area Assessed

Assessment Method

Number of Students Demonstrating Proficiency (out of 12)

Percentage

What the Data Indicates

Basic Frisbee Throwing (grip & release)

Teacher observation during warm-up toss

6

50%

Half of the class can throw with basic accuracy;

Others need explicit modeling and practice.

Catching Skills

Observation during partner toss

7

58%

Most students can catch stationary throws but struggle with movement and timing.

Knowledge of Ultimate Frisbee Rules

Oral questioning

4

33%

Majority of students are unfamiliar with rules such as no running with the disc and self-officiating KTIP lesson plan.

Teamwork and Communication

Observation during small-group activity

8

67%

Students are generally cooperative but need guidance on strategic movement and spacing.

Overall Readiness for Gameplay

Teacher judgment based on all indicators

5

42%

Class requires skill instruction and modified games before full gameplay.

 

 

 

Appendix B: Ultimate Frisbee Performance Rubric

Student Name: ________________________ Date: ____________ Class: ____________

Lesson Focus:
Passing, movement, teamwork, and rule application in Ultimate Frisbee

Performance Levels

4 – Exceeds Expectations

3 – Meets Expectations

2 – Approaching Expectations

1 – Needs Improvement

Criteria

4- Exceeds Expectations

3 – Meets Expectations

2 – Approaching Expectations

1-Needs Improvement

Throwing Skills (Forehand/Backhand)

Consistently throws with correct grip, form, and accuracy to moving teammates

Usually throws with correct form and accuracy

-Inconsistent form or accuracy;

– Needs reminders

Unable to demonstrate correct throwing technique

Catching Skills

Consistently catches passes while moving and under light pressure

Catches most passes when stationary or lightly moving

Catches some passes but struggles with timing

Rarely catches passes

Movement & Positioning

Moves effectively to create space; demonstrates strong cutting and awareness

Moves appropriately to support teammates

Limited movement; often stands still

Does not move to support play

Knowledge & Application of Rules

Consistently follows all rules and self-officiates respectfully

Follows most rules with minimal reminders

Needs frequent reminders about rules

Does not follow rules

Teamwork & Sportsmanship

Demonstrates excellent cooperation, communication, and fair play

Works well with teammates and shows respect

Limited communication or cooperation

Poor teamwork or unsportsmanlike behavior

Effort & Participation

Fully engaged and gives best effort throughout lesson

Participates actively most of the time

Inconsistent effort or engagement

Minimal participation

Throwing Skills (Forehand/Backhand)

Consistently throws with correct grip, form, and accuracy to moving teammates

Usually throws with correct form and accuracy KTIP lesson plan

Inconsistent form or accuracy; needs reminders

Unable to demonstrate correct throwing technique

 

Scoring Guide

21-24 points:
Advanced

15-20 points:
Proficient

9-14 points:
Developing

6-8 points:
Beginning

KTIP lesson plan

Confidentiality vs. Duty to Warn Scenario Essay

Discussion: Confidentiality vs. Duty to Warn

Balancing Confidentiality and the Duty to Warn

The aspect of confidentiality is a foundation of psychiatric-mental health nursing and is important in creating therapeutic trust. However, this duty is not absolute in some specific circumstances (Ismayilova, 2024). In the case under consideration, a patient poses a realistic risk of inflicting harm on a specific colleague upon discharge and demands confidentiality. The nurse in this case will need to balance confidentiality with ethical and legal duty to avoid preventable harm to others. In a scenario where there is a clear and recognizable danger to an individual, then confidentiality would put other individuals at a significant risk and would be morally unjustifiable.

Ethical Principles Guiding the Decision

A number of ethical principles guide the response of the nurse. In the instances of plausible threat, strict confidentiality is secondary to nonmaleficence (the obligation to do no harm) and beneficence (the obligation to promote safety and well-being). Justice would assist in protecting the potential victims against unnecessary harm, and fidelity would require the nurse to be honest with the patient about the limits of confidentiality. Ethical behavior of nurses, as defined in the American Nurses Association (ANA) Code of Ethics, presupposes that the nurse in question should act accordingly in case a patient endangers other individuals in a significant way, whether this means breaking the principle of confidentiality or not (American Nurses Association [ANA], 2025).

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Legal Considerations and Duty to Warn

Legally, this scenario is guided by the Tarasoff v. Regents of the University of California ruling, which established the clinician’s duty to warn or protect identifiable victims when a patient makes a credible threat (Gorshkalova & Munakomi, 2025). Most of the states in the United States support this duty through statutes or case laws. In addition, the Health Insurance Portability and Accountability Act (HIPAA) permits the release of the protected health data to prevent or reduce a critical and imminent risk to wellbeing or security (Edemekong et al., 2024). The nurse should report the threat and direct the treatment team to ensure the protection measures required, such as informing supervisors, the police, or the potential victims, are established Confidentiality vs. Duty to Warn Scenario Essay.

Application to Psychiatric Nursing Practice

In practice, the nurse must initially determine the urgency and reliability of the threat, note down the disclosure in an objective manner, and educate the patient about the lawful boundaries of confidentiality. It is important to collaborate with interdisciplinary team members to make ethical decisions, ensure patient safety, and adhere to the law Confidentiality vs. Duty to Warn Scenario Essay. This is a viable alternative to maintain professionalism and ensure the safety of the patient and the community .

References

American Nurses Association (ANA). (2025). Code of ethics for nurses.
American Nurses Association
.
https://codeofethics.ana.org/home

Edemekong, P., Haydel, M., & Annamaraju, P. (2024).
Health Insurance Portability and Accountability Act (HIPAA)
. National Library of Medicine.
https://www.ncbi.nlm.nih.gov/books/NBK500019/

Gorshkalova, O., & Munakomi, S. (2025, February 15).
Duty to warn
. PubMed; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK542236/

Ismayilova, P. F. (2024). Key characteristics of autonomy, confidentiality, beneficence, non-maleficence, justice, and privacy principles in medical law within the context of human rights.
Analytical and Comparative Jurisprudence
,
3
(3), 663–674.
https://doi.org/10.24144/2788-6018.2024.03.112 
 Confidentiality vs. Duty to Warn Scenario Essay

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

 

References

Forkus, S. R., Raudales, A. M., Rafiuddin, H. S., Weiss, N. H., Messman, B. A., & Contractor, A. A. (2022). The posttraumatic stress disorder (PTSD) checklist for DSM–5: A systematic review of existing psychometric evidence.
Clinical Psychology: Science and Practice
,
30
(1), 110–121.
https://doi.org/10.1037/cps0000111

Hoskins, M. D., Bridges, J., Sinnerton, R., Nakamura, A., Underwood, J. F. G., Slater, A., Lee, M. R. D., Clarke, L., Lewis, C., Roberts, N. P., & Bisson, J. I. (2021). Pharmacological therapy for post-traumatic stress disorder: A systematic review and meta-analysis of monotherapy, augmentation and head-to-head approaches.
European Journal of Psychotraumatology
,
12
(1), 1802920.
https://doi.org/10.1080/20008198.2020.1802920

Jones, K., Boschen, M., Devilly, G., Vogler, J., Flowers, H., Winkleman, C., & Wullschleger, M. (2024). Risk and protective factors that predict posttraumatic stress disorder after traumatic injury: A systematic review.
Health Sciences Review
,
10
, 100147.
https://doi.org/10.1016/j.hsr.2023.100147

Mann, S. K., Marwaha, R., & Torrico, T. J. (2024, February 25).
Posttraumatic stress disorder (PTSD)
. PubMed; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK559129/

 

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Pathophysiology and Etiology

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis

Increased sympathetic nervous system activity

Altered neurotransmitters (↓ serotonin, ↑ norepinephrine, altered dopamine)

Hyperactivity of the amygdala with reduced prefrontal cortex inhibition (Mann et al., 2024)

Impaired hippocampal function affecting memory processing and fear extinction.

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Pharmacology

SSRIs
(e.g., citalopram, sertraline, paroxetine): first-line for mood, anxiety, and intrusive symptoms

SNRIs
(e.g., venlafaxine): alternative first-line agents

Prazosin
: alpha-1 blocker used off-label to reduce nightmares and sleep disturbances

Adjuncts (if needed)
: mood stabilizers or atypical antipsychotics for severe symptoms

Avoid benzodiazepines
due to dependency risk and limited PTSD benefit (Hoskins et al., 2021)

Physical Assessment Signs and Symptoms

Recurrent nightmares and intrusive flashbacks

Sleep disturbance and insomnia

Hypervigilance and exaggerated startle response

Anxiety, irritability, restlessness

Avoidance of trauma-related stimuli

Emotional numbness or guilt

Difficulty concentrating (Mann et al., 2024).

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Risk Factors

Exposure to severe or repeated trauma (combat, war journalism, violence)

Chronic occupational trauma exposure

Personal history of depression or anxiety

Family history of anxiety disorders

Poor coping mechanisms, or limited social support.

Diagnostic Procedures

Clinical assessment using DSM-5-TR criteria, PTSD screening tools (e.g., PCL-5, CAPS-5), Suicide risk assessment (Forkus et al., 2022)

CBC and CMP to rule out medical contributors and establish medication baselines

Blood pressure monitoring (especially with prazosin and antihypertensives)

Complications

Major depressive disorder, Suicidal ideation or behavior

Substance use disorders, Chronic insomnia

Impaired occupational and interpersonal functioning

Cardiovascular complications related to chronic stress

Nursing Diagnoses

Disturbed Sleep Pattern related to recurrent nightmares and hyperarousal as evidenced by difficulty falling and staying asleep and reports of frequent trauma-related nightmares.

Anxiety related to traumatic experiences and dysregulation of stress response as evidenced by hypervigilance, restlessness, intrusive thoughts, and reported fear when exposed to triggers.

Ineffective Coping related to persistent trauma exposure and maladaptive stress responses as evidenced by avoidance behaviors, social withdrawal, and difficulty managing emotional responses Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD).

Risk for Self-Directed Violence related to history of trauma, depression, and escalating PTSD symptoms as evidenced by sleep disturbance, guilt, and emotional distress.

Impaired Social Interaction related to emotional numbing and avoidance of reminders as evidenced by isolation, decreased participation in activities, and preference to be alone.

Chronic Low Self-Esteem related to trauma-related guilt and negative self-perception as evidenced by self-blame and feelings of responsibility for traumatic events.

Nursing Interventions

Establish a therapeutic, trauma-informed relationship

Assess sleep patterns, anxiety levels, and suicide risk regularly

Administer and monitor medications (SSRIs, prazosin) and observe for side effects

Educate on PTSD, medication adherence, and orthostatic precautions

Teach relaxation and grounding techniques

Encourage engagement in psychotherapy (CPT, PE, EMDR)

Promote sleep hygiene and stress-reduction strategies

Coordinate interdisciplinary mental health care

 

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Create a concept map of a mental health diagnosis using one of the mental health scenario case studies presented in this section of the course.

Introduction

Concept maps are useful tools to help care providers and patients visualize the big picture of a condition. By being able to present a snapshot of symptoms, impacts, treatments, as well as contributing and risk factors, concept maps can improve communication, treatment planning, and health outcomes. Understanding how to create accurate, well-organized, and easy to understand concept maps will help you improve your efficacy as a healthcare practitioner and the outcomes of the patients you work with.

Instructions

Before beginning this assessment, make sure that you have completed the three Sentinel U case study activities included in the assessment. These will form the basis of your assessment.

For this assessment you will select one of the mental health Sentinel U case study activities and create a concept map that outlines the pathophysiology, pharmacology, and physical assessment of the mental health diagnosis from your chosen case study.

The key components of a mental health diagnosis concept map include the pathophysiology, pharmacology, and physical assessment of the diagnosis. The concept map should outline the key concepts related to the diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions. The map should be organized using a nursing concept map template, such as spider maps, hierarchical maps, or flow charts, to organize the information. The concept map should be accurate, complete, well-organized, and use appropriate nursing concepts and terminology.

To complete your concept map, you may wish to follow these steps:

Select one of the mental health Sentinel U scenarios:

Ivy Jackson, 61 YO, Female, African American.

Marco Mancini, 43 YO, Male, Mediterranean.

Wesley Blanco, 13 YO, Non-Binary, Filipino, White.

Research the pathophysiology, pharmacology, and physical assessment of the chosen mental health diagnosis within the Sentinel-U case study.

Complete the case study simulation and download the simulation report showing the patient you selected and showing 100% complete.

Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

You may wish to use the 
Concept Map Template [DOCX]
, but are also free to create your own.

Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).

Your assessment submission will be assessed on the following criteria.

Diagnosis:
Describe a mental health diagnosis. The diagnosis should be accurate and supported by relevant and evidence-based sources.

Make sure that the diagnosis is accurate and includes specific symptoms or criteria that support the diagnosis.

Ensure you have downloaded the completed Sentinel-U simulation report showing the patient you selected.

Concept Map:
Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

Make sure that your use of evidence to support the concept map is explicit and relevant, and that the relationships between the concepts are clearly defined.

Organization:
The concept map should be well-organized and easy to follow. The content should be presented in a logical and clear manner, with a clear purpose and goals.

Also, you should make sure that your map is visually appealing and easy to read, incorporating appropriate use of colors, shapes, and symbols.

Professional Communication:
The concept map should demonstrate professionalism and effective communication. The map should be free of errors and typos and should use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis to a professional audience.

APA format and style:
The reference list should be formatted in APA style. All sources used should be relevant to the topic and evidence-based, published within the last 5 years.

Additional Requirements

Concept Map:
1-page concept map that clearly organizes the 3Ps related to a mental health diagnosis, risk factors, diagnostics, complications, nursing diagnosis, and nursing interventions.

SIM Report: 
Ensure you download the completed SIM report showing the patient selected.

Reference List: 
Create an APA style reference list for all sources that you used to help build and support the information in your concept map. Include this in the same document as your concept map, but on its own page.

APA Style: 
Use current APA style for all in-text citations and any current APA-approved font.

Competencies Measured

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

Competency 2: Create evidence based interventions to address the health needs, risks, and resources of individuals from diverse backgrounds and cultures.

Describe a mental health diagnosis that is supported by relevant and evidence-based sources.

Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

The concept map is well-organized and easy to follow, with a clear purpose and goals.

Competency 4: Perform comprehensive and focused physical assessments using appropriate techniques and tools.

Upload the Sentinel-U case study showing the Simulation name OR showing 100% complete.

Competency 5: Apply scholarly writing standards to communicate evidence based strategies that support safe and effective patient care.

The concept map should demonstrate professionalism and effective communication, use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis.

The reference list is formatted in APA style. All sources used should be relevant to the topic, evidence-based, and published within the last 5 years.

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

 

Criterion 1

Describe a mental health diagnosis that is supported by relevant and evidence-based sources.

Distinguished

Describes a mental health diagnosis that is supported by relevant and evidence-based sources. The diagnosis is accurate and includes specific symptoms or criteria that support the diagnosis.

 

Criterion 2

Create a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions.

Distinguished

Creates a concept map that outlines the key concepts related to the chosen diagnosis, including risk factors, signs and symptoms, diagnostic procedures, medications, complications, nursing diagnoses, and nursing interventions. The use of evidence to support the concept map is explicit and relevant. The relationships between the concepts are clearly defined.

 

Criterion 3

Upload the Sentinel-U case study showing the Simulation name OR showing 100% complete.

Distinguished

Uploads the Sentinel-U case study showing the Simulation name AND showing 100% complete.

 

Criterion 4

The concept map is well-organized and easy to follow, with a clear purpose and goals.

Distinguished

The concept map is well-organized and easy to follow, with a clear purpose and goals. It is visually appealing and easy to read, incorporating appropriate use of colors, shapes, and symbols.

 

 

 

Criterion 5

The concept map should demonstrate professionalism and effective communication, use appropriate terminology and language. The map should effectively communicate the key concepts related to the diagnosis.

Distinguished

The concept map showcases excellent professionalism and effective communication, is free of errors and typos, utilizes appropriate terminology and language, and effectively communicates the key concepts related to the diagnosis Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD).

 

Criterion 6

The reference list is formatted in APA style. All sources used should be relevant to the topic, evidence-based, and published within the last 5 years.

Distinguished

The reference list is in APA format, exceptionally well-organized and provides comprehensive evidence-based support for the topic, utilizing highly relevant and credible sources.

Concept Map: The 3 P’s and Mental Health Care – Mind Map Concept: Post-Traumatic Stress Disorder (PTSD)

Ethics, Cyber Ethics, and Security

Assignment instructions:

Read
 a selection of your colleagues’ blog posts and 
respond
 to colleagues by expanding upon their responses or sharing additional or alternative perspectives.

Post to write a response to:

Healthcare practitioners face significant challenges when balancing high-quality patient care with the growing demand for stringent data protection. One key challenge is workflow disruption caused by security measures such as complex authentication processes, role-based access controls, and documentation requirements, which can slow clinical decision-making in time-sensitive environments. Clinicians may also experience “security fatigue,” where repeated alerts or cumbersome systems increase the risk of workarounds that unintentionally compromise patient confidentiality. Additionally, the expansion of digital tools—including electronic health records (EHRs), telehealth platforms, and artificial intelligence—has increased the volume of sensitive patient data, heightening vulnerability to cyberattacks and data breaches.

Healthcare organizations can address these challenges by integrating cybersecurity and ethical principles into system design rather than treating them as add-ons. Implementing user-centered EHR interfaces, single sign-on authentication, and tiered access based on clinical roles can protect patient data while maintaining efficient workflows. Ongoing education is also critical; regular training helps clinicians understand ethical responsibilities related to data privacy and reinforces compliance with regulations such as HIPAA. Leadership support and organizational culture play a pivotal role in ensuring that data protection is viewed as an essential component of patient safety rather than a barrier to care Ethics, Cyber Ethics, and Security.

Furthermore, interprofessional collaboration supported by secure digital systems can enhance care delivery when privacy safeguards are embedded into communication tools. Ethical governance frameworks, combined with continuous system evaluation and audit trails, allow organizations to responsibly leverage digital innovations while maintaining patient trust. Ultimately, protecting patient confidentiality and advancing digital care delivery are not competing goals but complementary responsibilities essential to ethical clinical practice.

References

American Nurses Association. (2022). Nursing informatics: Scope and standards of practice (3rd ed.). ANA Publishing.

Beckmann, M., Dittmer, K., Jaschke, J., Karbach, U., Köberlein-Neu, J., Nocon, M., Rusniok, C., Wurster, F., & Pfaff, H. (2021). Electronic patient record and its effects on social aspects of interprofessional collaboration and clinical workflows in hospitals (eCoCo): A mixed-methods study protocol. BMC Health Services Research, 21(377). 
https://doi.org/10.1186/s12913-021-06377-5Links to an external site.

Goodman, K. W. (2020). Ethics in health informatics. Yearbook of Medical Informatics, 29(1), 26–31. 
https://doi.org/10.1055/s-0040-1701966Links to an external site.

 

 Instructions –
Ethics, Cyber Ethics, and Security

In recent years, hackers have targeted medical records, from hospitals and other healthcare institutions, across the country. These records contain personal information, contact information, and most importantly, for the hackers, information that may prove useful in stealing an identity. Thus, healthcare organizations have made it a priority to protect patient records and privacy. However, with the influx of technological advancements and hacker determination, there is no perfect way to ensure that all records are secure and safe.

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In addition to medical records, privacy concerns are relevant with any patient chart in any setting. For example, a chart left open on a computer monitor in a patient room, employee passwords and log-in information, and new employee access and screening all represent other ways in which ethics and security merge in healthcare and nursing practice.

For this Discussion, you will consider the importance of ethics as it relates to security. You will also reflect on how these topics might affect clinical practice and the connection to nursing informatics.

To Prepare

Review the Learning Resources associated with the topics of ethics, cyber ethics, and security.

Consider the role of each of these topics for clinical practice, as well as the importance of understanding each of these topics.

Post a cohesive response to the following:

What are the key challenges that healthcare practitioners encounter when balancing patient care with the requirement for stringent data protection? How can healthcare organizations ensure patient confidentiality while effectively leveraging digital tools to enhance care delivery? Ethics, Cyber Ethics, and Security

 

Post Response – Ethics, Cyber Ethics, and Security

Hello, your discussion is well-argued with your claims based on credible evidence. Indeed, balancing high-quality patient care with the growing demand for stringent data protection is a significant challenge facing healthcare practitioners. Data protection acts, particularly the HIPAA requires healthcare practitioners to comply with established to enhance safety and security of patients’ medical data documented in digital tools (Di Fede et al., 2023). To meet this requirement, healthcare organizations have adopted multiple security measures such as complex authentication processes, role-based access controls, and documentation requirements. These security measures contribute to workflow disruption. Additionally, compliance with these new data protection policies hinders collaboration among team members, which slows down decision-making within clinical settings. Therefore, compliance with data protection regulations increases risk of heath complications or deaths especially in emergency care units.

Additionally, I support your proposed measures that healthcare organizations should adopt to address the above challenges. Indeed, these organizations should consider strategies for enhancing cybersecurity while developing system design. For instance, the new design of clinical health systems should integrate user-centered EHR interfaces. In this case, the clinical system would protect patient data by only allowing authorized professionals to access electronic medical data (Bayor et al., 2025). This new design would also support workflow efficiency, which would result in prompt clinical decisions, preventing health complications that would result from delayed care. Furthermore, integrating single sign-on authentication into clinical system would enhance data security, while eliminating potential workflow disruption. Thus, this measure is recommendable since would support timely delivery of quality patient care without compromising safety of patient data Ethics, Cyber Ethics, and Security.

References

Bayor, A. A., Li, J., Yang, I. A., & Varnfield, M. (2025). Designing Clinical Decision Support Systems (CDSS)—A User-Centered Lens of the Design Characteristics, Challenges, and Implications: Systematic Review. 
Journal of Medical Internet Research
, 
27
, e63733.
https://www.jmir.org/2025/1/e63733/

Di Fede, O., La Mantia, G., Cimino, M. G., & Campisi, G. (2023) Ethics, Cyber Ethics, and Security. Protection of patient data in digital Oral and general health care: A scoping review with respect to the current regulations.
Oral
, 
3
(2), 155-165.

https://doi.org/10.3390/oral3020014

Gellert, G. A., Johnston, D., Wilcox, A., Starmer, Z., Gopi, M., Nicol, M. F., … & Kelly, S. P. (2025). Clinician Time Savings and Financial Value of Workstation Single Sign-On and Access Management in the United Kingdom and Ireland. 
Advances in Health Information Science and Practice
, 
1
(2).
https://ahisp.kglmeridian.com/view/journals/3995/1/2/article-IPGV6692.xml
 Ethics, Cyber Ethics, and Security

Ethics, Cyber Ethics, and Security – What are the key challenges that healthcare practitioners encounter when balancing patient care with the requirement for stringent data protection? How can healthcare organizations ensure patient confidentiality while effectively leveraging digital tools to enhance care delivery?

NU675: Unit 3: Assignment Clinical SOAP Note

 
Clinical SOAP Note

Initial Psychiatric Interview/SOAP Note Template 

Criteria

Clinical Notes

 

Informed Consent

Informed consent was obtained prior to the psychiatric interview. The patient was informed of the nature and purpose of the psychiatric assessment, medication management, and psychotherapy, including risks, benefits, and alternatives to treatment. Verbal and written consent were obtained. The patient demonstrated adequate decisional capacity, was able to respond appropriately to questions, and verbalized understanding of the treatment process. Additional informed consent will be reviewed as part of the ongoing treatment plan.

Subjective

Verify Patient

Name: S.G.

DOB: 10/12/1983

 

Minor: No

Accompanied by: Self

 

Demographic: 42-year-old African American female

 

Gender Identifier Note: Identifies as female

 

CC: “My anxiety is better, but I’m still having trouble sleeping and I have very low motivation.”

 

HPI: S.G. is a 42-year-old female with a history of generalized anxiety disorder (GAD) and major depressive disorder (MDD), recurrent, moderate, who presents for a scheduled 4-week follow-up. She reports significant improvement in anxiety symptoms since her last visit and the initiation of escitalopram 10 mg daily, noting a marked reduction in daily worry and panic attacks. However, she endorses persistent insomnia, characterized by prolonged sleep latency and frequent nocturnal awakenings, which she rates as 6/10 in severity. Concurrently, she reports persistent depressive symptoms including low energy, anhedonia, poor concentration, and low motivation, which have impaired her work performance as a graphic designer. She denies active suicidal or homicidal ideation, intent, or plan. She has been fully adherent to her medication regimen and denies adverse effects. She continues biweekly cognitive behavioral therapy (CBT) sessions, which she finds beneficial yet emotionally taxing.

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SI/ HI/ AV: Patient currently denies suicidal ideation, denies self-injurious behaviors, denies homicidal ideation, denies violent behavior, and denies inappropriate or illegal behaviors.

 

Allergies: NKA.

(medication & food)

 

Past Medical Hx:

Medical history: Reports hypothyroidism, stable on levothyroxine, and episodic migraine without aura.

Patient denies history of chronic infection, including MRSA, TB, HIV and Hep C.

Surgical history no surgical history reported

 

Past Psychiatric Hx:

Previous psychiatric diagnoses: major depressive disorder and generalized anxiety disorder.

Describes stable but fluctuating course of illness.

Previous medication trials
: sertraline (discontinued due to gastrointestinal intolerance) and venlafaxine (partial response).

 

Safety concerns:

History of Violence
to Self:
  none reported

History of Violence t
o Others
: none reported

Auditory Hallucinations: Denied

Visual Hallucinations: Denied

 

Mental health treatment history
discussed:

History of outpatient treatment: Ongoing CBT since 2020

Previous psychiatric hospitalizations: not reported

Prior substance abuse treatment: not reported

 

Trauma history:
Client does not report history of trauma including abuse, domestic violence, witnessing disturbing events NU675: Unit 3: Assignment Clinical SOAP Note.

 

Substance Use:
Client denies use or dependence on nicotine/tobacco products.

Client does not report abuse of or dependence on ETOH, and other illicit drugs.

 

Current Medications: Escitalopram 10 mg PO daily, Levothyroxine 75 mcg PO daily, Ibuprofen 400 mg PO PRN headache.

(Contraceptives): None reported

Supplements: None reported

 

Past Psych Med Trials: Sertraline; Venlafaxine

 

Family Medical Hx:

·        Mother: Major Depressive Disorder

·        Father: Hypertension

·        Paternal brother: Alcohol Use Disorder

 

Family Psychiatric Hx:

·        Substance use: paternal brother

·        Suicides: none reported

·        Psychiatric diagnoses/hospitalization: mother MDD

·        Developmental diagnoses: none

 

 

Social History:

Occupational history: Employed full-time as a graphic designer.

Military service history: Denies prior military service.

Education history: Completed high school and vocational training.

Developmental history: No significant developmental concerns reported.

Legal history: No known legal issues NU675: Unit 3: Assignment Clinical SOAP Note.

Spiritual/Cultural considerations: None reported.

 

ROS:

Constitutional: Denies fevers, chills, or unintentional weight changes.

Eyes: Reports no vision changes or eye pain.

ENT: No hearing difficulties, sore throat, or swallowing problems.

Cardiovascular: Denies chest discomfort, palpitations, or swelling in extremities.

Respiratory: No shortness of breath, cough, or wheezing.

Gastrointestinal: Denies abdominal pain, nausea, vomiting, or changes in bowel habits.

Genitourinary: No dysuria, hematuria, or urinary frequency reported.

Musculoskeletal: No joint pain, stiffness, or muscle weakness.

Skin: Denies rashes, lesions, or other skin changes.

Neurological: No headaches, dizziness, seizures, or numbness/tingling.

Endocrine: No polyuria, polydipsia, or heat/cold intolerance.

Hematologic: Denies easy bruising, bleeding, or clotting problems.

Allergic/Immunologic: No allergic reactions, hives, or immune concerns.

Reproductive: Denies gynecologic issues such as abnormal menses, pregnancies, or miscarriages.

Verify Patient:
Name, Assigned 
identification
 number (e.g., medical record number), Date of birth, Phone number, Social security number, Address, Photo.

 

Include demographics, chief complaint, subjective information from the patient, names and relations of others present in the interview.

 

HPI:

 

 

 

 

 

, Past Medical and Psychiatric History,

Current Medications, Previous Psych Med trials,

Allergies.

 Social History, Family History.

Review of Systems (ROS) – if ROS is negative, “ROS noncontributory,” or “ROS negative with the exception of…”

Objective                

Vital Signs:
Stable

Temp: 98.4°F

BP: 122/78 mmHg

HR: 72 bpm

R: 14/min

O2: 99% RA

Pain: 0/10

Ht: 5’5”

Wt: 154 lbs

BMI: 25.6

BMI Range: Overweight:

 

LABS:

Lab findings WNL

Thyroid Function (6 mo ago): TSH 2.1 mIU/L WNL

Tox Screen: Negative

Alcohol: Negative

HCG: N/A

 

Physical Exam:

General: Alert, cooperative, no distress

HEENT: Normocephalic, atraumatic; PERRLA; moist mucous membranes

Cardiovascular: RRR, no murmurs/rubs/gallops

Respiratory: Clear bilaterally

Abdomen: Soft, non-tender, non-distended

Neurologic: CN II-XII intact; motor 5/5; sensation intact; gait steady

MSE:

Patient is cooperative and communicative, appears without acute distress, and fully oriented to person, place, time, and situation. Patient is dressed neatly and appropriately for age and season. Psychomotor activity is within normal limits.

Presents with appropriate eye contact, affect is restricted but congruent with her reported mood of “tired and flat.” Speech is spontaneous, of normal rate, rhythm, and volume, with no difficulty expressing herself. Thought content is appropriate, with no delusions, obsessions, or perceptual disturbances. Denies suicidal or homicidal ideation. Thought process is linear, coherent, and goal-directed NU675: Unit 3: Assignment Clinical SOAP Note.

Cognition appears grossly intact, with alertness, intact memory, and mild impairment in concentration noted on serial sevens. Attention span is appropriate, and fund of knowledge is average. Judgment and insight are good.

The patient is able to articulate her needs, demonstrates motivation for adherence to her medication regimen, and is willing and able to participate actively in her treatment plan, including follow-up and self-monitoring of symptoms.

Diagnostic Data/Assessment Tools:

PHQ-9: 14 (moderate depressive severity)

GAD-7: 8 (mild anxiety severity)

 

 

This is where the “facts” are located.

Vitals,

**Physical Exam (if performed, will not be performed every visit in every setting)

Include relevant labs, test results, and Include MSE, risk assessment here, and psychiatric screening measure results.

Assessment

DSM5 Diagnosis: with ICD-10 codes

 

Dx: –    F32.1 Major Depressive Disorder, recurrent episode, moderate severity

S.G. meets DSM-5-TR criteria for a recurrent major depressive episode, characterized by persistent insomnia, anhedonia, low energy, and impaired concentration for over two months, causing significant social and occupational impairment (APA, 2022).

Dx: –   F41.1 Generalized Anxiety Disorder, well-controlled

S.G.’s reduction in her GAD-7 score from a previously documented 15 to the current 8, along with her subjective report of decreased worry and absence of panic attacks, meets the clinical threshold for a “treatment response” (Szuhany & Simon, 2022).

Dx: –    G47.00 Insomnia Disorder:

Highly likely as a comorbid condition, though it is currently conceptualized as a core symptom of her active MDD.

Dx: –    E03.9 Hypothyroidism, stable

Stable under levothyroxine, TSH WNL

Patient demonstrates the capacity to understand and respond to information regarding psychiatric medications and psychotherapy. She appears to comprehend the purpose, potential benefits, risks, and alternatives, including the option to decline treatment, and expresses willingness to adhere to the agreed treatment plan.

Include your findings, diagnosis and differentials (DSM-5 and any other medical diagnosis) along
with ICD-10 codes
, treatment options, and patient input regarding treatment options (if possible), including obstacles to treatment.

 

Informed Consent Ability

Plan

 

(Note some items may only be applicable in the inpatient environment)

 

 

Inpatient: N/A

 

Safety Risk/Plan:  Patient stable, minimal risk to self/others, no abnormal perceptions.

 

Pharmacologic interventions:

·        Escitalopram increased to 15 mg PO daily ×4 weeks; monitor side effects (Simon et al., 2024)

·        Trazodone 50 mg PO at bedtime PRN insomnia

Non-Pharmacologic Interventions:

·        CBT continuation

·        Sleep hygiene education

·        Encourage re-engagement in hobbies

·        Consider MBSR workshop referral if anxiety worsens

Education, including health promotion, maintenance, and psychosocial needs

·        Medication adherence

·        Sleep hygiene techniques

·        Psychosocial support, local depression groups

·        Safety planning and symptom monitoring

 

Referrals: Continue CBT therapist

Follow-up:

·        RTC in 4 weeks; complete PHQ-9/GAD-7 and sleep log

·        Call clinic for worsening symptoms, SI, or side effects

 

☒ > 50% time spent counseling/coordination of care: 35

 

Time spent in Psychotherapy 
20  
minutes

 

Visit lasted
70
minutes

 

Billing Codes for visit:   99214

F32.1 Major depressive disorder, recurrent, moderate

F41.1 Generalized Anxiety Disorder

G47.00 Insomnia, unspecified

E03.9 Hypothyroidism, unspecified

 

 

____________________________________________

NAME, TITLE

 

 

 

Date: Click here to enter a date.    Time: X

 

 

References

American Psychiatric Association. (2022).
Diagnostic and statistical manual of mental disorders
(5th ed., text rev.).
https://doi.org/10.1176/appi.books.9780890425787

Simon, G. E., Moise, N., & Mohr, D. C. (2024). Management of depression in adults.
JAMA, 332
(2), 141.
https://doi.org/10.1001/jama.2024.5756

Szuhany, K. L., & Simon, N. M. (2022). Anxiety disorders.
JAMA, 328
(24), 2431.
https://doi.org/10.1001/jama.2022.22744 
NU675: Unit 3: Assignment Clinical SOAP Note

 

NU675: Unit 3: Assignment Clinical SOAP Note

Clinical SOAP Note

Unit 3: Introduction (1 of 6)

Unit 3: Reading and Activities (2 of 6)

Unit 3: Discussion Complementary and Alternative Therapy (3 of 6)

Unit 3: Assignment Weekly Clinical Communication (4 of 6)

Current Assignment: Unit 3: Assignment Clinical SOAP Note (5 of 6)

Unit 3: Unit 3 Clinical Journal Reflection, Assignment (6 of 6)

Instructions

Each week students will choose one patient encounter to submit a Follow-up SOAP note for review.

Follow the rubric to develop your SOAP notes for this term.

The focus is on your ability to integrate your subjective and objective information gathering into the formulation of diagnoses and development of patient-centered, evidence-based plans of care for patients of all ages with multiple, complex mental health conditions. At the end of this term, your SOAP notes will have demonstrated your knowledge of evidence-based practice, clinical expertise, and patient/family preferences as expected for an independent nurse practitioner incorporating psychotherapy into practice.

Note: Grades of Incomplete on this NU675: Unit 3: Assignment Clinical SOAP Note assignment will result in a clinical failure.

All work should be original and submitted as a Word document unless otherwise indicated in the assignment instructions. ALL assignments need to be APA 7 format and accompanied title page in APA 7th edition format in order that the work would be properly identified for the student, the course, and the assignment. Work submitted without a title page will receive a grade of 0.

NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters

My name is. I am a Pulmonary Nurse on a Telemetry Step-Down Unit at a local Acute Care Hospital in Upstate South Carolina. I worked as a Nursing Assistant before going back to school and all through nursing school on the unit, and stayed on as an RN after graduation 4 ½ years ago. I graduated from Greenville Technical College in July of 2021 .

Climate change has significantly contributed to air pollution, accelerating atmospheric conditions, which are conducive for the formation of harmful pollutants. As a result, climate change has affected peoples’ lives negatively, especially through respiratory illnesses. Climate change is also associated with rapid rise in temperature (Ren et al., 2022). Chemical reactions in the atmosphere are associated with rapid rise in temperatures. This condition further triggers ground-level ozone, leading to the formation of smog, which exposes individuals to respiratory diseases, including asthma. Moreover, the severity and frequency of wildfires are on the rise due to climate-driven heat waves. Ecosystems are highly interconnected with change in one element affecting another. For instance, air population caused by atmospheric conditions accelerated by rapid rise in temperature exposes humans to respiratory disorders NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters.

Climate change is a significant contributing factor for the high rates of infectious diseases. It creates a conducive environment that facilitate growth of different pathogens and their vectors. Additionally, climate change accelerates transmission of infectious diseases. For instance, the incubation duration of viruses within mosquitoes is relatively shorter in places with warmer temperatures than those with cool temperatures. As a result, people living in warmer areas are at a relatively high risk of contracting Dengue fever, Malaria, or Zika. Furthermore, floods attributed to climate change expose people living in affected areas to diarrhea and other water-borne diseases. Nurses implement infection control measures to curb the spread of infectious diseases. For example, nurses educate persons at a high risk of contracting the coronavirus about the benefits of using protective masks to lower risk of contracting this virus.

PLACE YOUR ORDER HERE

Climate-related disasters have a significant impact on vulnerable groups, particularly pediatric and elderly Populations: Children’s immune systems are still developing. As a result, they are more prone to climate-related disasters. For instance, diarrhea outbreak following floods affects disproportionately high number of children since floodwaters usually channel pathogens to sources of drinking water (Yazdi et al., 2024). Children are at high risk due to their developing immune systems and are more likely to come into contact with these pathogens as they play. Moreover, the relatively high risk of dehydration makes children more vulnerable.

The community’s system-level disaster response plan is effective. First, the plan consists of early warning systems targeting community members with sensory impairments. Additionally, the plan prioritizes reducing risk of climate change potential adverse outcomes. For instance, persons living in flood-prone areas are relocated from this region ahead of anticipated floods, reducing risk on contractive water-borne diseases. The plan is also designed to offer mobile medical care services following outbreak of climate change-related crises, thereby preventing potential adverse health outcomes.

Nurses’ role in bridging the gap in the healthcare system extends to addressing issues related to climate change. For instance, nurses understand how climate change-related health issue increase community’s disease burden and mortality rates. As a nurse, I am committed to improve health outcomes and quality of life in the local community. Thus, I can advocate for the implementation of effective measures that would curb spread of health issues associated with climate change, thereby lowering the disease burden and death rates in the local community.

References

Ren, Z., Fu, Y., Dong, Y., Zhang, P., & He, X. (2022). Rapid urbanization and climate change significantly contribute to worsening urban human thermal comfort: A national 183-city, 26-year study in China. 
Urban Climate
, 
43
, 101154.
https://www.sciencedirect.com/science/article/abs/pii/S2212095522000724

Yazdi, M. S., Ardalan, M. A., Hosseini, M., Zoshk, M. Y., Hami, Z., Heidari, R., … & Chamanara, M. (2024). Infectious diarrhea risks as a public health emergency in floods; a systematic review and meta-analysis. 
Archives of Academic Emergency Medicine
, 
12
(1), e46.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11221827/

 

NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters

Op-Ed Commentary: Nurses’ Vital Role in Climate Change Related Disasters

Nurses are leaders in communicating public health information in communities. Natural disasters due to climate change have increased fivefold in the past 50 years. Storms, fires, floods, tornados, earthquakes, and hurricanes severely impact the health of populations.

In this Assignment, you will compose an op-ed for your local newspaper about the impact of climate change in your community. You will discuss how nurses such as yourself can protect and improve the lives of populations—especially vulnerable populations—from the impacts of climate change.

To prepare:

Review the Learning Resources for this module, focusing specifically on The 
Washington Post
 resource.

Download the 
Op-Ed Commentary Writing Template
 Download Op-Ed Commentary Writing Template
.

The Assignment (2 pages)

Op-ed commentaries are written by external contributors (“experts”) who present a well-defined point of view on new, current, or controversial topics. In this instance, you are the nurse expert and are tasked with highlighting the impact of climate change in your local community newspaper.

In your 2-page article, using at least one current scholarly reference, include the following:

Introduce yourself and your excellent nursing education and experience.

Describe the impact of climate change on the environment, i.e., air pollution, temperature, and precipitation extremes, etc. How are ecosystems interdependent?

Discuss the impact of climate change on populations, i.e., increased communicable and infectious diseases and water/vector-borne pathogens.

Provide an example of how nurses implement infection control measures, including the use of personal protective equipment (PPE).

How is the impact of climate-related disasters relevant to your local community and its vulnerable populations, such as elderly, pregnant, and pediatric populations, for example?

Is your community’s system-level disaster response plan effective? Why or why not? (You can find information about your community’s disaster plans on city and government websites for your specific community.)

Conclude by expressing the value of nurses in addressing climate change and your personal commitment to your local community (called a “kicker” in op-eds).

 

NURS_4212_Week4_Assignment_Rubric – NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters

NURS_4212_Week4_Assignment_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome Introduces self and nursing experience

20 to >16.0 ptsMastered Expectations
The response comprehensively and clearly introduces the author and experience. The response includes relevant, specific, and appropriate examples that fully support the identification and introduction NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters.

16 to >14.5 ptsAchieved Expectations 
The response introduces the author and experience. The response includes relevant, specific, and appropriate examples that support the identification and introduction NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters.

14.5 to >0 ptsDoes Not Meet Expectations 
The response inaccurately and vaguely introduces the author and experience, or it is missing. The response includes inaccurate and vague examples that do not support the identification and introduction, or it is missing.

20 pts

This criterion is linked to a Learning Outcome Describes the impact of climate change, specifically how ecosystems are interdependent

20 to >16.0 ptsMastered Expectations
The response comprehensively and clearly describes the impact of climate change. The response includes relevant, specific, and appropriate examples that fully support the description.

16 to >14.5 ptsAchieved Expectations 
The response describes the impact of climate change. The response includes relevant, specific, and appropriate examples that support the description.

14.5 to >0 ptsDoes Not Meet Expectations 
The response inaccurately and vaguely describes the impact of climate change, or it is missing. The response includes inaccurate and vague examples that do not support the description, or it is missing.

20 pts

This criterion is linked to a Learning Outcome Discusses the impact of climate change on populations, with an example of how nurses implement infection control measures, such as PPE

20 to >16.0 ptsMastered Expectations
The response comprehensively and clearly discusses the impact of climate change on populations. The response includes a relevant, specific, and appropriate example of how nurses implement infection control measures, such as PPE, that fully supports the discussion.

16 to >14.5 ptsAchieved Expectations
The response discusses the impact of climate change on populations. The response includes a relevant, specific, and appropriate example of how nurses implement infection control measures, such as PPE, that supports the discussion.

14.5 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely discusses the impact of climate change on populations, or it is missing. The response includes an inaccurate and vague example of how nurses implement infection control measures, such as PPE, that does not support the discussion, or it is missing NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters.

20 pts

This criterion is linked to a Learning Outcome Analyzes the impact of climate change on communities and vulnerable populations

20 to >16.0 ptsMastered Expectations
The response comprehensively and clearly analyzes the impact of climate change on communities and vulnerable populations. The response includes relevant, specific, and appropriate examples that fully support the analysis.

16 to >14.5 ptsAchieved Expectations
The response analyzes the impact of climate change on communities and vulnerable populations. The response includes relevant, specific, and appropriate examples that support the analysis.

14.5 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely analyzes the impact of climate change on communities and vulnerable populations, or it is missing. The response includes inaccurate and vague examples that do not support the analysis, or it is missing.

20 pts

This criterion is linked to a Learning Outcome Analyzes the effectiveness of a specific community’s system-level response plan.

20 to >16.0 ptsMastered Expectations
The response comprehensively and clearly analyzes the effectiveness of a community’s system-level response plan. The response includes relevant, specific, and appropriate examples that fully support the analysis.

16 to >14.5 ptsAchieved Expectations 
The response analyzes the effectiveness of a community’s system-level response plan. The response includes relevant, specific, and appropriate examples that support the analysis.

14.5 to >0 ptsDoes Not Meet Expectations 
The response inaccurately and vaguely analyzes the effectiveness of a community’s system-level response plan, or it is missing. The response includes inaccurate and vague examples that do not support the discussion, or it is missing.

20 pts

This criterion is linked to a Learning OutcomeExpresses the value of nurses in addressing climate change and personal commitment to local community

20 to >16.0 ptsMastered Expectations 
The response comprehensively and clearly analyzes the value of nurses in addressing climate change. The response includes relevant, specific, and appropriate examples that fully support the analysis.

16 to >14.5 ptsAchieved Expectations 
The response analyzes the value of nurses in addressing climate change. The response includes relevant, specific, and appropriate examples that support the analysis.

14.5 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely analyzes the value of nurses in addressing climate change, or it is missing. The response includes inaccurate and vague examples that do not support the analysis, or it is missing.

20 pts

This criterion is linked to a Learning OutcomeProfessional writing: Context, organization, audience, purpose, tone, style, clarity, flow

10 to >7.33 ptsMastered Expectations
Demonstrates full awareness of writing context, audience, and purpose Content is generally clear, logical, and well organized, with appropriate sentence and paragraph structure. Tone is highly professional, scholarly, and free of bias. Style is consistently appropriate for a professional setting/workplace context. Mostly free of spelling, punctuation, and grammar/syntax errors

7.33 to >6.0 ptsAchieved Expectations
Demonstrates some awareness of writing context, audience, and purpose Content is mostly clear, logical, and well organized, with adequate sentence and paragraph structure. Tone is adequately professional, scholarly, and/or free of bias. Style is mostly appropriate for a professional setting/workplace context. Contains a few spelling, punctuation, and/or grammar/syntax errors NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters

6 to >0 ptsDoes Not Meet Expectations 
Demonstrates minimal awareness of writing context, audience, and purpose Content lacks clarity, logic, and/or discernible organization; the content does not use proper sentence and paragraph structure. Tone is not professional/scholarly and/or contains bias. Style is inconsistent with a professional setting/workplace context. Contains significant spelling, punctuation, and/or grammar/syntax errors

10 pts

This criterion is linked to a Learning OutcomeProfessional writing: Originality, source credibility, and attribution of ideas

10 to >7.33 ptsMastered Expectations
Content fully reflects original writing and proper paraphrasing. Writing demonstrates full adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate citations and references in APA format.

7.33 to >6.0 ptsAchieved Expectations
Content adequately reflects original writing and paraphrasing. Writing demonstrates adequate adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate citations and references in APA format. There are a few minor APA formatting errors.

6 to >0 ptsDoes Not Meet Expectations 
Content does not reflect original writing and/or paraphrasing. Writing demonstrates minimal or no adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate citations and references in APA format. There are numerous APA formatting errors.

10 pts

Total Points: 140 NURS 4212: Population Health Nursing Assignment: Op-Ed Commentary: Nurses Vital Role in Climate Change Related Disasters

Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment

INTRODUCTION

High-acuity respiratory patient population.

Complex interdisciplinary care coordination.

Telemetry-related alarm fatigue risks.

Need for nurse-led quality change.

Lewin’s structured change framework.

There are unique challenges in delivering quality care in a pulmonary step-down unit within an acute care facility. That is because of the high acuity of patients with complex respiratory diagnoses. The patients receiving care in the unit typically require advanced respiratory support, continuous monitoring, and coordinated interdisciplinary interventions that involve nursing, occupational therapy, physical therapy, speech therapy, and respiratory therapy. As a telemetry unit, the pulmonary step-down unit faces additional risks such as alarm fatigue that further complicates staff workflow and patient safety. There is a need for effective nurse-driven change initiatives in the unit to address the persistent safety and quality concerns. Lewin’s Theory of Planned Change offers a structured framework for implementing sustainable improvements by guiding organizations through unfreezing the existing practices, changing by moving towards new deliberate behaviors, and refreezing the change into standard practice. Applying this theory enables nurses to lead evidence-based change while fostering staff engagement and long-term adherence (Gielen et al., 2022) Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment.

1: ALARM FATIGUE

Excessive nonactionable telemetry alarms.

Delayed response to emergencies.

Increased patient safety risks.

Pulmonary alarms occur frequently.

Priority nurse-led safety improvement.

A significant quality care problem in the unit is alarm fatigue linked with continuous telemetry and respiratory monitoring. There are excessive non-actionable alarms that desensitize the staff, thereby increasing their risk of delaying response to critical events. Albanowski et al. (2023) note that alarm fatigue contributes to missed alarms and adverse patient outcomes, particularly in telemetry-intensive environments. The Joint Commission (2024) identifies alarm management as a national patient safety goal, emphasizing that it impacts care quality. Among patients with pulmonary issues, frequent oxygen desaturation and ventilator alarms heighten the risk of alarm fatigue. Without staff education and a systematic alarm customization, alarm fatigue would continue to undermine situational awareness, patient safety, and staff morale. As such, alarm fatigue is a priority area for nurse-led quality improvement.

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2: INTERDISCIPLINARY COMMUNICATION

Interdisciplinary communication frequently breaks down.

Handoff errors delay patient care.

Miscommunication increases adverse outcomes.

Pulmonary care requires unified planning.

Nurses lead structured communication tools.

Breakdown in interdisciplinary communication, especially during care coordination and handoffs among nursing, rehabilitation, and respiratory therapy services is a significant quality care problem. Ineffective communication is linked to patient dissatisfaction, care delays, and medical errors. Shrivastava et al. (2025) explains that inadequate interdisciplinary communication significantly compromises continuity in step-down and acute units. In pulmonary care settings, miscommunication regarding mobility status, swallowing precautions, or oxygen delivery methods can result in prolonged hospitalization, hypoxia, or aspiration. Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment The complexity of respiratory care necessitates structured, timely communication strategies to ensure all disciplines share a unified care plan. Nurses are well positioned to identify communication gaps and champion standardized tools to enhance interdisciplinary collaboration.

3: PATIENT-TO-NURSE RATIOS

Unsafe patient-to-nurse staffing ratios.

High workloads increase nurse burnout.

Delayed interventions worsen outcomes.

Limited interdisciplinary care coordination.

Need data-driven staffing advocacy.

Unsafe patient-to-nurse ratios is a significant quality care problems that directly affects patient outcomes and nurse well-being. Patients in the pulmonary step-down unit often require frequent assessments, titration of oxygen therapy, and rapid intervention for respiratory deterioration. Griffiths et al. (2024) explains that high patient-to-nurse ratios cause nurses to have high workloads that are linked to increased mortality, higher rates of failure-to-rescue, and burnout. In addition, inadequate nurse staffing limits the ability of nurses to coordinate interdisciplinary care and promptly respond to alarms. It is essential to address staffing concerns as a measure for maintaining quality, safety, and workforce sustainability. Data-informed staffing models and nurse-driven advocacy are critical to migrating risks linked to high-acuity respiratory care environments.

CHANGE
THEORY

Lewin’s Theory of Planned Change provides a practical framework for implementing nurse-driven improvements that target there three quality care problems. During the unfreezing stage, nurse can be involved in presenting data from the unit on incidences of alarm fatigue, communication errors, and adverse outcomes related to staffing. Their involvement in presenting the data can help to build awareness and urgency. The change stage involves implementing targeted interventions, such as standardizing alarm parameters to address alarm fatigue, implementing SBAR-based interdisciplinary handoff protocols to address communication concerns, and adopting acuity-adjusted staffing assignments to addressing staffing concerns. Interdisciplinary engagement, pilot testing, and education are essential in the change stage Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment. Finally, the refreezing stage solidifies the change through performance metrics, ongoing education, and integrating new practices into policies. Through the change model, nurses can lead sustainable change that enhances safety, interdisciplinary collaboration, and quality outcomes in pulmonary step-down unit (Gielen et al., 2022).

REFERENCES

Albanowski, K., Burdick, K. J., Bonafide, C. P., Kleinpell, R., & Schlesinger, J. J. (2023). Ten Years Later, Alarm Fatigue Is Still a Safety Concern.
AACN advanced critical care, 34
(3), 189–197.
https://doi.org/10.4037/aacnacc2023662

Gielen, A. C., Peterson, D. V., Ottoson, J. M., Green, L. W., & Kreuter, M. W. (2022).
Health Program Planning, Implementation, and Evaluation: Creating Behavioral, Environmental, and Policy Change
. Johns Hopkins University Press.

Griffiths, P., Saville, C., Ball, J., Culliford, D., Jones, J., Lambert, F., Meredith, P., Rubbo, B., Turner, L., Dall’ora, C., & Workforce Health Outcomes Study Group (2024). Nursing Team Composition and Mortality Following Acute Hospital Admission.
JAMA network open, 7
(8), e2428769.
https://doi.org/10.1001/jamanetworkopen.2024.28769

Joint Commission. (2025).
National Patient Safety Goals® Effective 2025 for the Hospital Program
.
https://digitalassets.jointcommission.org/api/public/content/9be383450fc941df806b76c5fbdd9ae6?v=3c600c3a

Shrivastava, S. R., Chong, S. V., & Bobhate, P. S. (2025). Facilitating effective communication through the adoption of SBAR tool in medical training.
Journal of education and health promotion, 14
, 249.
https://
doi.org/10.4103/jehp.jehp_1213_24

 

Instructions – Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment

Presentation

What are best ways to implement and maintain change over time? One way is through the use of Lewin’s Theory of Planned Change. It involves three stages:

Unfreezing (understanding change is needed)

Moving (process of initiating change)

Refreezing (establishing a new status quo)

Now, it is time for you to think about quality care problems that exist in your area. What are the top three problems that you see? When considering these problems, what evidence supports why these are problems? Using Lewin’s Theory of Planned Change, how can this theory be used to implement change surrounding these problems.

In this Assignment, you will explore quality care problems in your area. While providing evidence to support each of them, you will also apply Lewin’s theory to your nurse driven change. This information will be analyzed through a slide presentation.

Resources

To prepare:

Review the Required Learning Resources, specifically resources related to Lewins’ Change Theory

Consider your clinical practice area and potential quality care problems

Research evidence for potential practice problems

The Assignment

Construct a 5–7 slide presentation, with notes, in which you complete the following:

Identify three different quality care problems within your area.

Present one piece of evidence for each of the potential practice problems (3 total)

Apply Lewin’s change theory to a nurse driven change to a quality care or safety problem

Important Reminder: 
Be sure to include speaker’s notes for every slide in your presentation. You may either embed the notes directly in the “Notes” section beneath each PowerPoint slide or provide them as a separate Word document.

 

Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment Readings

Spath, P., & Devane, A. (2023). 
Introduction to healthcare quality management
Links to an external site.
 (4
th
 ed). Health Administration Press.

Chapter 10, “Managing the Use of Healthcare Resources” (pp. 315–319)

Burnes, B. (2020). 
The origins of Lewin’s three-step model of change.Links to an external site.
 
The Journal of Applied Behavioral Science, 56
(1), 32–59. https://journals.sagepub.com/doi/full/10.1177/0021886319892685

Kotter. (n.d.). 
The 8 steps for leading change.
Links to an external site.
 https://www.kotterinc.com/methodology/8-steps

Prosci. (n.d.). 
The prosci ADKAR model.
Links to an external site.
 https://www.prosci.com/methodology/adkar

Sutherland, K. (n.d.). 
Applying Lewin’s change management theory to the implementation of bar-coded medication administration.
Links to an external site.
 
https://www.printfriendly.com/p/g/xVnXSE

Media

Forde-Johnston, C. (2023). 
Lewin’s change management model explained using two example nursing projects
Links to an external site.
 [Video]. YouTube. https://youtu.be/GZKzUKp_KFMhttps://youtu.be/GZKzUKp_KFM

 

 

NURS_4106_Week6_Assignment3_Rubric – Lewin’s Theory of Planned Change in Nursing 

NURS_4106_Week6_Assignment3_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeIdentified three different quality care problems within the area.

30 to >22.5 ptsMasters Expectations
The response comprehensively and clearly identified three different quality care problems… The response includes relevant, specific, and appropriate examples that fully support the identification.

22.5 to >18.0 ptsAchieves Expectations
The response identified three different quality care problems… The response includes relevant, specific, and appropriate examples that support the identification.

18 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely identified three different quality care problems, or it is missing… The response includes inaccurate and vague examples that do not support the identification, or it is missing.

30 pts

This criterion is linked to a Learning OutcomePresented one piece of information for each of the potential practice problems (3 total).

60 to >45.0 ptsMasters Expectations
The response comprehensively and clearly presented one piece of information for each of the three practice problems… The response includes relevant, specific, and appropriate examples that fully support the presentation.

45 to >36.0 ptsAchieves Expectations
The response presented one piece of information for each of the three practice problems… The response includes relevant, specific, and appropriate examples that support the presentation.

36 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely presented one piece of information for each of the three practice problems, or some or all are missing… The response includes inaccurate and vague examples that do not support presentation, or it is missing.

60 pts

This criterion is linked to a Learning OutcomeApplied Lewin’s Change Theory to a quality care or safety problem.

40 to >30.0 ptsMasters Expectations
The response comprehensively and clearly applied Lewin’s change theory to a quality care or safety problem… The response includes relevant, specific, and appropriate examples that fully support the application.

30 to >24.0 ptsAchieves Expectations
The response applied Lewin’s change theory to a quality care or safety problem… The response includes relevant, specific, and appropriate examples that support the application.

24 to >0 ptsDoes Not Meet Expectations
The response inaccurately and vaguely applied Lewin’s change theory to a quality care or safety problem, or it is missing… The response includes inaccurate and vague examples that do not support the application, or it is missing.

40 pts

This criterion is linked to a Learning OutcomeProfessional writing: Context, organization, audience, purpose, tone, style, clarity, flow

10 to >7.33 ptsMasters Expectations
Demonstrates full awareness of writing context, audience, and purpose… Content is generally clear, logical, and well organized with appropriate sentence and paragraph structure… Tone is highly professional, scholarly, and free of bias… Style is consistently appropriate for a professional setting/workplace context… Mostly free of spelling, punctuation, and grammar/syntax errors Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment.

7.33 to >6.0 ptsAchieves Expectations
Demonstrates some awareness of writing context, audience, and purpose… Content is mostly clear, logical, and well organized with adequate sentence and paragraph structure… Tone is adequately professional, scholarly, and/or free of bias… Style is mostly appropriate for a professional setting/workplace context… Contains few spelling, punctuation, and/or grammar/syntax errors.

6 to >0 ptsDoes Not Meet Expectations
Demonstrates minimal awareness of writing context, audience, and purpose… Content lacks clarity, logic, and/or discernible organization; does not use proper sentence and paragraph structure… Tone is not professional/scholarly and/or contains bias… Style is inconsistent with a professional setting/workplace context… Contains significant spelling, punctuation, and/or grammar/syntax errors.

10 pts

This criterion is linked to a Learning OutcomeProfessional writing: Originality, source credibility, and attribution of ideas

10 to >7.33 ptsMasters Expectations
Writing fully reflects original thought and paraphrasing and adheres to reference requirements, including the use of credible evidence to support a claim while incorporating appropriate citations and references in APA format.

7.33 to >6.0 ptsAchieves Expectations
Writing adequately reflects original thought and paraphrasing and adheres to reference requirements, including the use of credible evidence to support a claim while incorporating appropriate citations and references in APA format.

6 to >0 ptsDoes Not Meet Expectations
Writing does not reflect original thought and paraphrasing and does not adhere to reference requirements, including the use of credible evidence to support a claim while incorporating appropriate citations and references in APA format.

10 pts

Total Points: 150 Lewin’s Theory of Planned Change in Nursing – NURS 4106 Week 6 Assignment