Tag: Clinical-Nursing

Social Phobia Inventory (SPIN)

Student Example Anxiety and Related Disorders
Week 7

Instrument:
Social Phobia Inventory (SPIN)

 
Article:
Psychometric properties of the Social Phobia Inventory

 
Appropriateness for Dx:
This tool is meant for
screening
of individuals with social phobia and assignment of a severity score (Connor et al., 2000). The tool was created in congruence with DSM-4 but is consistent with the DSM-5 diagnosis of social anxiety disorder, minus some minor changes (Substance Abuse and Mental Health Service Administration [SAMHSA], 2016). Although the study is outdated, Duke University School of Medicine (2020) acknowledges that the tool is still relevant and utilized by their Anxiety and Traumatic Stress Program.

 

Response to Therapy/Treatment:
The SPIN is appropriate for testing treatment response and through studies has proven sensitive to symptom changes over time. Changes in scores are able to determine treatment efficiency (Connor et al., 2000).

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Psychometrics:
The tool is self-administered and consists of 17 separate statements regarding problems a patient may exhibit if they have social phobia. The statement is then rated on how much it has bothered the individual in the last week, from ‘not at all’ (0) to ‘extremely’ (4). Any score over 21 is considered clinically significant. In the study, the assessment tool was able to effectively separate individuals with and without social phobia. Validity is strong in regard to detecting the severity of illness and is sensitive to symptom reductions during treatment. The scale shows significant correlation with the Liebowitz Social Anxiety Scale Test, The Brief Social Phobia Scale and The Fear Questionnaire social phobia subscale (Connor et al., 2000).

 

Limitations:
Limitations exist in the tool’s alignment with DSM-4 instead of the more recent edition, although differences are very minor (SAMHSA, 2016). With a cutoff score of 19, sensitivity and specificity were good, but some individuals consider the cutoff score to be 15, in which these measures are weaker (Connor et al., 2000).

 
References

 
Connor, K., Davidson, J., Churchill, E., Sherwood, A., Foa, E., & Wisler, R. (2000).

Psychometric properties of the Social Phobia Inventory.
British Journal of Psychiatry, 176
, 379-386. Social Phobia Inventory (SPIN)

NURS-6053 Module 1: Discussion – Rising Healthcare Costs

By Day 3 of Week 1

Post
 a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Which social determinant(s) most affects this health issue? Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues 
on two different days
 who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

Rising Healthcare Costs

Rising healthcare costs in the United States represent a significant national issue, impacting healthcare delivery, access, and financial sustainability. In 2023, national health expenditures reached $4.9 trillion, reflecting a 7.5% increase from the previous year and accounting for 17.6% of the U.S. gross domestic product (Centers for Medicare & Medicaid Services [CMS], 2023). Several factors contribute to this escalation, including increased utilization of medical services, higher prescription drug prices, advanced medical technologies, and administrative costs. These rising expenses place financial strain on healthcare systems, patients, and providers, leading to disparities in access and quality of care (Martin et al., 2025). Healthcare organizations face growing pressure to balance cost containment with the delivery of high-quality, patient-centered services.

                                                                                    How It May Impact My Workplace Setting

Rising healthcare costs directly affect my workplace setting by increasing operational expenses, creating resource limitations, and intensifying staff workload. According to Kiss et al. (2023), budget constraints can lead to staff reductions, limited access to advanced medical technologies, and the postponement of non-urgent services. I have observed increased patient-to-nurse ratios, which compromise the quality of care and elevate the risk of errors. For example, nurses in my unit are often assigned more patients than the recommended ratio, reducing the time available for individualized care. Additionally, financial pressures have resulted in the postponement of equipment upgrades, forcing staff to rely on outdated technology that may hinder efficiency. Rising costs also impact patient access, as many individuals delay care due to high out-of-pocket expenses, leading to worsened health outcomes and increased reliance on emergency services.

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                                                                              Social Determinant Most Affecting Healthcare Costs

Income and socioeconomic status are the social determinants most significantly affecting the impact of rising healthcare costs. Individuals with lower incomes often struggle to afford healthcare services, medications, and insurance premiums, leading to delayed or foregone care. According to the Kaiser Family Foundation (2023), nearly one in four adults in the U.S. reported skipping or delaying medical care in the past year due to cost concerns. This financial barrier disproportionately affects vulnerable populations, exacerbating health disparities and increasing the demand for safety-net services. Geographic location also influences healthcare access, particularly in rural areas where medical facilities may be scarce, and travel expenses further complicate access to care. These social determinants contribute to a cycle of poor health outcomes and increased healthcare utilization, placing additional strain on the healthcare system Rising Healthcare Costs.

                                                              How My Healthcare System Has Responded to the Healthcare Issue and Changes

My healthcare system has implemented several strategies to address rising healthcare costs while maintaining quality care. One significant initiative includes the adoption of value-based care models, which focus on improving patient outcomes while controlling costs (Leao et al., 2023). This approach incentivizes providers to deliver evidence-based, efficient care, reducing unnecessary procedures and hospital readmissions. In my workplace, multidisciplinary care teams have been established to coordinate treatment plans, improving communication and reducing duplication of services. Telehealth services have also been expanded, allowing patients to access care remotely, which reduces operational costs and improves patient convenience. For instance, the implementation of virtual follow-up appointments for chronic disease management has decreased hospital readmissions by 15% over the past year.

Additionally, my healthcare system has prioritized staff training on cost-effective care delivery, emphasizing evidence-based practices and resource optimization. Cost-saving measures, such as bulk purchasing of medical supplies and streamlining administrative processes, have been implemented to reduce overhead expenses (Hinrichs-Krapels et al., 2022). Despite these efforts, the facility still faces challenges in balancing cost containment with staff satisfaction and patient-centered care. Continued investment in technology, staff support, and community outreach programs are essential to address the long-term impact of rising healthcare costs on both patients and healthcare providers Rising Healthcare Costs.

 
                                                                                                                         
References

Centers for Medicare & Medicaid Services. (2023). 
National Health Expenditures 2023 Highlights.
 Health Affairs. 
https://www.cms.gov/files/document/highlights.pdf
Links to an external site.

Hinrichs-Krapels, S., Ditewig, B., Boulding, H., Chalkidou, A., Erskine, J., & Shokraneh, F. (2022). Purchasing high-cost medical devices and equipment in hospitals: a systematic review. 
BMJ open
, 
12
(9), e057516. 
https://doi.org/10.1136/bmjopen-2021-057516
Links to an external site.

Kaiser Family Foundation. (2024, May 28). 
Health care affordability: Key facts.
 
https://www.kff.org/health-costs/issue-brief/health-care-affordability-key-facts/
Links to an external site.

Kiss, A., Kiss, N., & Váradi, B. (2023). Do budget constraints limit access to health care? Evidence from PCI treatments in Hungary. 
International Journal of Health Economics and Management
, 
23
(2), 281-302.  
https://doi.org/10.1007/s10754-023-09349-w
Links to an external site.

Leao, D. L., Cremers, H. P., van Veghel, D., Pavlova, M., & Groot, W. (2023). The impact of value-based payment models for networks of care and transmural care: a systematic literature review. 
Applied Health Economics and Health Policy
, 
21
(3), 441-466. 
https://doi.org/10.1007/s40258-023-00790-z
Links to an external site.

Martin, A. B., Hartman, M., Washington, B., Catlin, A., & National Health Expenditure Accounts Team. (2025). National Health Expenditures In 2023: Faster Growth As Insurance Coverage And Utilization Increased: Article examines National Health Expenditures in 2023. 
Health Affairs
, 
44
(1), 12-22. 
https://doi.org/10.1377/hlthaff.2024.01375
  Rising Healthcare Costs

NU711 Unit 2: Practice Collaboration Culture

For this NU711 Unit 2: Practice Collaboration Culture assignment, you will create a presentation that provides an overview of the state of collaborative culture in your current practice setting. Utilize the Four-Dimensional Model of Collaboration presented in the D’Amour, et al., 2008 to frame an analysis of the state of collaboration in your practice setting. https://pmc.ncbi.nlm.nih.gov/articles/PMC2563002/ When constructing the slides for your presentation be sure to include the following: Open your presentation with a brief description of your current practice setting Ensure that you have a slide that represents each of the 4 domains of the model as noted in Figure 1 on the third page of the article. Provide enough information on the slide to correlate observations from your practice setting to the collaboration Indicators noted in each of the 4 domains of the model. Review the descriptors outlined in Table 2 on the fifth and sixth page of the article and use those to guide your construction of the individual slide for each Indictor. Review Table 3 located at the bottom of the sixth page of the article and assign a collaboration Typology level for each of the 10 Indicators noted in this table. Provide a summary slide that demonstrates your overall thought about the collaborative culture in your practice setting referencing the Typology levels you assigned on the previous slide. The practice setting is the behavioral health unit at Northwest Hospital, which is dedicated to ensuring the delivery of safe, patient-centered mental health care. The unit provides comprehensive psychiatric services, including crisis intervention, inpatient and outpatient care, medication management, and psychological consultations. The interdisciplinary team includes psychiatrists, psychiatric nurse practitioners, nurses, therapists, social workers, and mental health technicians who work collaboratively to support patients experiencing acute behavioral health challenges. The hospital is committed to addressing the complex emotional and psychological needs of individuals while promoting recovery, safety, and dignity in a secure therapeutic environment

 

NU711 Unit 2: Practice Collaboration Culture

Collaborative Culture in the Behavioral Unit at Northwest Hospital

Student Name

Program Name or Degree Name, XXX University

Course Number, Section, Title of Course

Instructor Name

Month, Day, Year

Introduction: Setting Overview

üThe behavioral health Unit at Northwest hospital

üOffers outpatient and inpatient psychiatric care

üIt entails a multidisciplinary team i.e. NPs, therapists, nurses, psychiatrists, social workers, mental health technicians among others

üThe Unit’s primary focus is delivery of safe, patient informed or centered mental heath

The focused healthcare organization and unit, the Behavioral Health Unit, provides its patients with comprehensive mental healthcare services through its multidisciplinary team, addressing diverse concerns, including holistic care and patient safety. This presentation provides a detailed analysis of the state of collaboration within the Behavioral Health Unit. The unit is designed to address diverse and complex mental health needs through its interdisciplinary team.

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Shared Goals and Vision

ü Teamwork or collaborative treatment planning with regular meetings held for the different professionals

üCommon objectives including dignity, safety and recovery support

üCommitment to patient centered mental healthcare

üHeightened emphasis on interdisciplinary input towards care plans.

The aspect of shared goals unifies the team around their focus and core patient-centered principles. Conducting regular meetings within the unit ensures that every stakeholder and discipline contributes to care planning. According to D’Amour et al. (2008), an organization’s goals and vision are key facets that define its objectives, as well as facilitate teamwork and collaboration.

 

Internalization: mutual Respect & Interpersonal Relationships

üPracticing open communication among the unit members

üTrust fostered among the players via consistent interactions

üMutual recognition of professional expertise and roles

üPracticing informal discussions to coordinate care beyond scheduled meetings

The practice of internationalization involves fostering respect, trust, and understanding among team members. Regarding the behavioral health unit, members usually consult with each other outside the unit’s formal meetings, which enables them to identify patient needs promptly. According to Kaiser et al. (2022), the collaborative spirit within the unit helps prevent cases of care silos while fostering a culture where every member’s input is valued NU711 Unit 2: Practice Collaboration Culture.

 

Formalization: Protocols & and Structures

üApplication of structured meetings within the interdisciplinary team

üPractice of clear role delineation both in protocols and policies

üUtilization of standardized screening tools for risk assessment

üDocumented care plans  in the HER, which is accessible to all players within the team

Governance encompasses the way leadership fosters teamwork and collaboration among workers. Within the behavioral unit, leadership is shared among the different professionals and care providers, with a clear definition of roles and mutual respect for roles and authority. I.e., the psychiatrist oversees medication management, while social workers and therapists lead psychosocial care deliberations. According to Kaiser et al. (2022), the adoption of this integrated leadership model fosters a collaborative culture within the unit and organization.

 

Governance: Leadership & Decision Making

üImplementation of collaborative leadership in the Unit’s daily operations

üRegular teamwork is conducted for updates and decision making (shared)

üThe overall organization management offers support to inter-professional collaboration through workforce training and conflict resolution.

üThe psychiatrists leads decision making while the nurses and social workers in the unit  contributes to care planning

Governance encompasses the way leadership fosters teamwork and collaboration among workers. Within the behavioral unit, leadership is shared among the different professionals and care providers, with a clear definition of roles and mutual respect for roles and authority. I.e., the psychiatrist oversees medication management, while social workers and therapists lead psychosocial care deliberations. According to Kaiser et al. (2022), the adoption of this integrated leadership model fosters a collaborative culture within the unit and organization.

 

Typology Assignment for Collaboration Indicators

Centrality: Developing Collaboration

Leadership: Active Collaboration

Support for Innovation: Developing Collaboration

Connectivity: Active Collaboration

Formalization Tools: Active Collaboration

Information Exchange: Active Collaboration

Shared Goals: Active Collaboration

Client-Centered Orientation: Active Collaboration

Mutual Acquaintanceship: Developing Collaboration

Trust: Developing Collaboration

Based on the Table 3 from D’Amour et al., the units collaboration reflects active in some areas such as information sharing, leadership and shared goals. However, there are some areas which remains at developing stage including centrality, support for innovation and mutual acquaintanceship. This attributed to occasional role overlaps and communications gaps NU711 Unit 2: Practice Collaboration Culture.

Summary

üThe organizations Overall collaboration level can be established as between Active and developing

üKey strengths includes leadership, structured communicated and shared goals

üMajor areas that needs improvement include teams role clarity, relationship building and support for innovation.

References

D’Amour, D., et al. (2008). A model and typology of collaboration between professionals in healthcare organizations. BMC Health Services Research, 8(1), 188.
https://
doi.org/10.1186/1472-6963-8-188

Kaiser, L., Conrad, S., Neugebauer, E. A. M., Pietsch, B., & Pieper, D. (2022). Interprofessional collaboration and patient-reported outcomes in inpatient care: A systematic review. Systematic Reviews, 11(169). https://doi.org/10.1186/s13643-022-02027-x NU711 Unit 2: Practice Collaboration Culture

NURS-6053 Module 1: Discussion – Nursing Staffing Shortage Healthcare Issue /stressor

Healthcare Issue: Nursing Staffing Shortage

The United States is facing a significant and growing shortage of nurses, which has become a major healthcare stressor. One of the main challenges faced today is the shortage of the nursing workforce, which causes severe compromise on the quality of healthcare services, improving the well-being of the global population, and achieving universal health coverage (Tamata, et al, 2023). The nursing shortage impacts healthcare organizations at all levels, from acute care settings to outpatient services, and is linked to lower quality of care, increased patient mortality, and higher healthcare costs.

Impact on Work Setting

In the healthcare setting, nursing shortages have a direct impact on both patient outcomes and staff well-being. With fewer nurses available, existing staff often work longer hours, leading to fatigue, burnout, and a higher risk of making errors. Occupational burnout syndrome is characterized by emotional exhaustion, depolarization, and a diminished sense of personal accomplishment and is prevalent among nurses (Li, et al, 2024). In my work setting, the shortage has led to increased stress among the nurses, with many reports of feeling stretched thin and unable to provide the level of attention and care that patients need.

Social determinants affecting the health issue

Access to healthcare has been seen as an answer to improving population health in the United States, but access cannot be untangled from the issue of social determinants of health (Broome and Marshall, 2021).

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Economic Stability
: In certain areas of the country, low wages are a major factor that discourages individuals from entering the nursing profession or remaining in it.

Healthcare Access and Quality
: The lack of sufficient nursing affects the quality of patient care, especially in underserved areas. When hospitals and clinics cannot hire enough nurses, patients in these areas often experience longer wait times, lower quality of care, and worse health outcomes.

Response from Health System

In response to the nurse staff shortage, healthcare systems have adopted several strategies to address the issue. The healthcare systems that I work for have implemented recruitment and retention programs. Ohio Health offers sign-on bonuses as well as retention bonuses for nurses to keep them from leaving. I work in the Cath lab and our area offers self-scheduling that allows nurses and staff to select shifts based on personal preference in hopes of increasing job satisfaction and reducing turnover. The department I work in understands the importance of work-life balance and offering flexible scheduling is a huge perk for nurses.

References

Broome, M., & Marshall, E. S., (2021). Transformational leadership in nursing: From expert clinician to influential leader (3
rd
 ed). New York, NY: Springer.

Li, L. Z., Yang, P., Singer, S.J., Mathur, M. B., & Shanafelt, T. (2024). Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systemic Review and Meta-Analysis. JAMA network open, 7 (11), e2443059. https://doi.org/10.1001/jamanetworkopen.2024.43059

Tamata, A. T., & Mohammadenzhad, M. (2023). A systematic review study on the factors affecting the shortage of nursing workforce in the hospitals. Nursing Open, 10 (3), 1247-1257. https://doi.org/10.1002/nop2.1434 Nursing Staffing Shortage Healthcare Issue /stressor

 

Nursing Staffing Shortage Healthcare Issue /stressor

National Healthcare Issue: Nursing Workforce Shortages

Have you ever wondered what would happen if there weren’t enough nurses to care for patients? The nursing workforce shortage is one of the most critical challenges facing healthcare today, affecting patient outcomes, nurse well-being, and the efficiency of the healthcare system. The increasing demand for healthcare services due to an aging population, the prevalence of chronic illnesses, and lingering workforce disruptions from the COVID-19 pandemic have exacerbated this issue (Slonim, 2023). However, the supply of trained nurses has not kept pace, resulting in high workloads, burnout, and lower retention rates among nursing staff (Broome & Marshall, 2021).

Complexity of the Nursing Shortage

The nursing shortage is not a new issue, but its severity has increased due to multiple factors. One of the primary concerns is the retirement of Baby Boomer nurses, which has widened the gap in experienced professionals (Richardson, 2011). Additionally, new graduate nurses struggle with the transition into practice, leading to high turnover rates in their first years (Amicucci et al., 2023). The COVID-19 pandemic further intensified the crisis, as many nurses left the profession due to stress and burnout (White & Godsey, 2024).

The shortage impacts healthcare safety and quality. Research has shown that inadequate nurse-to-patient ratios contribute to higher mortality rates, increased medication errors, and lower patient satisfaction (Imes et al., 2023). The stress of high workloads and demanding shift schedules has been directly linked to burnout and job dissatisfaction (Greco et al., 2022). Furthermore, digitalization and the integration of advanced technology in healthcare settings present both opportunities and challenges for managing workforce shortages, requiring strategic leadership to ensure effective adoption (Gjellebæk et al., 2020).

Impact on My Work Setting

As a nursing supervisor in a subacute and long-term care facility, I have witnessed the nursing shortage’s direct effects on staff and residents. Short-staffing leads to increased workloads, making it difficult to provide the level of care our elderly residents require. Nurses working overtime, and extra shifts often experience physical exhaustion and emotional distress, increasing the likelihood of burnout and turnover. This shortage also affects patient care outcomes, as delays in medication administration, assessments, and response times can lead to complications.

Social determinants of health, particularly access to quality healthcare and workforce stability, further exacerbate this issue. Underserved communities struggle to recruit and retain nurses, leading to disparities in care (Lee & Cook, 2024). Additionally, financial barriers, such as the rising cost of nursing education and insufficient incentives for nontraditional students, limit the pipeline of new nurses entering the field (Morgan & Somera, 2014).

Transformational Leadership Strategies in Addressing the Nursing Shortage

Transformational leadership plays a critical role in addressing the nursing workforce crisis. Broome and Marshall (2021) emphasize the need for strategic planning and adaptive leadership in navigating complex healthcare challenges. Effective leaders must foster resilience, innovation, and collaboration to sustain and strengthen the nursing workforce.

Organizational Responses and Strategies

Recognizing the severity of the nursing shortage, my healthcare facility has implemented several initiatives to improve retention and workforce sustainability:

Recruitment and Training Programs:
 Partnering with local nursing schools to create residency programs has proven effective in supporting new graduate nurses and reducing early-career turnover (Amicucci et al., 2023).

Flexible Scheduling and Wellness Support:
 Addressing burnout through flexible work arrangements and wellness initiatives can mitigate stress and improve retention rates (Imes et al., 2023).

Financial Incentives and Career Pathways:
 Tuition reimbursement programs and professional development opportunities encourage career advancement, attracting and retaining skilled nurses (Lee & Cook, 2024).

Technology Integration:
Implementing AI-assisted monitoring tools and automated charting systems can reduce administrative burdens, allowing nurses to focus on patient care (Navaz et al., 2021).

Nursing Staffing Shortage Healthcare Issue /stressor

Challenges in Implementing Solutions

While these interventions aim to alleviate the nursing shortage, challenges persist. Amalberti et al. (2019) highlight that increasing demands in healthcare require systemic changes, including workforce planning, improved efficiency, and policy adaptations. Additionally, operational research strategies can enhance resource allocation but require commitment from leadership and frontline staff for successful implementation (Carter & Busby, 2023).

Transformational leadership is essential in overcoming these challenges. By fostering innovation, collaboration, and proactive workforce planning, healthcare leaders can drive sustainable solutions to the nursing shortage (Broome & Marshall, 2021) Nursing Staffing Shortage Healthcare Issue /stressor.

Conclusion

The nursing workforce shortage is a multifaceted issue that demands immediate and strategic action. Addressing this crisis requires a combination of workforce development, improved working conditions, leadership support, and policy changes. By implementing evidence-based strategies and embracing transformational leadership, healthcare organizations can build a sustainable nursing workforce and enhance patient care outcomes.

References:

Amalberti, R., Vincent, C., Nicklin, W., & Braithwaite, J. (2019). Coping with more people with more illness, Part 1: The nature of the challenge and the implications for safety and quality. 
International Journal for Quality in Health Care, 31
(2), 154–158.

Amicucci, B., Titus, D., & Warren, M. (2023). Let’s hang on! Ramping up nurse resident retention strategies after the pandemic. 
Journal of Continuing Education in Nursing Nursing Staffing Shortage Healthcare Issue /stressor

Bangani, R. G., Menon, V., & Jovanov, E. (2021). Personalized stress monitoring AI system for healthcare workers. 
2021 IEEE International Conference on Bioinformatics and Biomedicine (BIBM), 2992–2997.

Broome, M., & Marshall, E. S. (2021). 
Transformational leadership in nursing: From expert clinician to influential leader
 (3rd ed.). Springer.

Carter, M. W., & Busby, C. R. (2023). How can operational research make a real difference in healthcare? Challenges of implementation. 
European Journal of Operational Research, 306
(3), 1059–1068.

Gjellebæk, C., Svensson, A., Bjørkquist, C., Fladeby, N., & Grundén, K. (2020). Management challenges for future digitalization of healthcare services. 
Futures, 124.

Greco, E., Graziano, E. A., Stella, G. P., Mastrodascio, M., & Cedrone, F. (2022). The impact of leadership on perceived work-related stress in healthcare facilities organizations. 
Journal of Organizational Change Management, 35
(4/5), 734-748.

Imes, C., Tucker, S., Trinkoff, A., Chasens, E., Weinstein, S., Dunbar-Jacob, J., Patrician, P., Redeker, N., & Baldwin, C. (2023). Wake-up call: Night shifts adversely affect nurse health and retention, patient and public safety, and costs. 
Nursing Administration Quarterly.

Lee, M., & Cook, K. (2024). Career pathway strategies that reduce barriers for nontraditional nursing students. 
Creative Nursing.

Morgan, D., & Somera, P. (2014). The future shortage of doctoral-prepared nurses and the impact on the nursing shortage. 
Nursing Administration Quarterly.

Navaz, A. N., Serhani, M. A., El Kassabi, H. T., Al-Qirim, N., & Ismail, H. (2021). Trends, technologies, and key challenges in smart and connected healthcare. 
IEEE Access, 9,
 74044–74067.

Richardson, K. (2011). The impact of retiring Baby Boomers on the nursing shortage. 
Journal of Global Health Care Systems.

Slonim, A. (2023). Top challenges facing healthcare: Back to basics. 
Physician Leadership Journal, 10
(2), 12–14.

White, D., & Godsey, J. (2024). Distressed but not deterred: Nurses reveal solutions to the nursing shortage in the aftermath of a pandemic. 
OJIN: The Online Journal of Issues in Nursing. Nursing Staffing Shortage Healthcare Issue /stressor

PICO question sample template

 

[Title Here, up to 12 Words, on One or Two Lines, Bold Font]

[Author Name(s), First M. Last, Omit Titles and Degrees]

Texas Woman’s University

NURS 5893 Chronic Disease and Restorative Health

[Instructor’s name]

[Date]

 

[Title Here, up to 12 Words, on One or Two Lines, Bold Font]

[The body of your paper uses a half-inch first line indent and is double-spaced.  APA style provides for up to five heading levels, shown in the paragraphs that follow.  Note that the word
Introduction
should not be used as an initial heading, as it’s assumed that your paper begins with an introduction.]

This paragraph should be your introduction. Your introduction follows the title of your paper. You should identify the purpose of your
paper
and provide a preview of what the paper will include. Remember that formal papers are written in third person.

Background and Clinical Significance of the Problem

Here is where you include background information in relation to your chosen problem. It may be beneficial to include incidence/prevalence or other appropriate data in order to establish relevance and urgency. Be sure to add any supportive clinical guidelines or references as appropriate.

This section should explain why this topic is a problem for clinicians. This section should answer the questions “what is the problem and why is this important?” This section should convey a clear understanding to the reader of why this topic is important and relevant to current nurse practitioner practice.

Clinical Question Identified

This is where you will identify your PICO question. You should state your question and define each of the PICO elements (Population, Intervention, Comparison, Outcome).

Theoretical Model/Conceptual Framework

Here you will describe a chosen model for your project. We prefer this model to be on the Chronic Care Model or Evidence Based Practice model such as IOWA or Stetler, but you may use any model that is approved by your faculty. This model must be directly relatable to your project. You will first describe the model in detail and then you will describe how the model was used to guide the application of your project.

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Review of Literature

Search Strategy and Method

You should start off with a description of the search strategy. You should include your search words and terms, the databases used along with the results in those databases for each word or term, and inclusion and exclusion criteria. The reason for exclusion of a study that meets your inclusion criteria needs to be explained either by your exclusion criteria (e.g., English, adults, humans) or your inability to obtain the article despite your best efforts. You should summarize the final result by identifying the number of studies in each category (e.g., # of RCTs, # of qualitative studies, # of cohort studies, # of systematic reviews, etc.). This can be achieved through the use of a figure so you can provide a brief summary and then refer the reader to the figure.

Literature Review

After describing your search strategy then you will evaluate the chosen literature as a whole in relation to your stated problem, grouping the articles into similar categories and examining the strengths and weaknesses of the literature review and how it either supports or does not support your stated problem.  Keep in mind that the articles in this section should be research studies, systematic reviews, or summary articles. Do not use secondary sources; you need to get the article, read it, and make your own decision about quality and applicability to your question even if you did find out about the study in a systematic review. You will need to define what evidence rating scale you are using (SORT, Johns Hopkins Nursing Evidence-Based Practice Rating Scale, American Medical Association (AMA), etc.)

You should include at least
5 references
in this review that are relevant to your chosen problem. When writing about a study you should include at minimum the study design, setting, sample, and evidence rating.  You should address all of your main relevant studies in the review but do not have to give a full detailed description of all studies. Your summary table of evidence will do that.  Discuss the “high points” in this review.  Call out the most significant data that helped or that you think will help you decide whether or not to change a practice PICO question sample template

[Heading level 3, flush left, bold italic]

[Note that you can include consecutive paragraphs with their own headings, where appropriate.]
If you divide your review articles into categories, you will use this
Heading 3
as shown to designate each section.

Finally, the studies in this section MUST relate directly to your PICOT question.  Conclude with a summary statement regarding the strength of your evidence.  So. . . what is the answer to your question?

Analysis of the Literature

Evaluate the chosen literature as a whole in relation to your stated problem.  DO NOT simply restate the information in your table or from the previous review.  You should group articles into similar categories examining overall strength and weakness.  This section should support your conclusion.  This is the “So what” part of the paper.  Is there enough information to suggest/enact a change?  If not, what can/should be done?

 
Conclusion (closing paragraph)

The
conclusion for this phase of the project
will simply be a short summarization of what has been done so far. You should start with a statement regarding the intention of the paper. Mention that a theoretical framework or model was identified to guide the research process and a search of the literature was conducted.  You can mention that you identified sources of evidence related to the research question and conducted a critical review of those sources. You
will not
discuss the analysis or conclusions from this review as that will be covered in Phase III.

 

References

The Reference list should start on a new page after the text and before any tables, figures, and/or appendices. Double space all reference list entries, including between and within references. Use a hanging indent for all references, meaning that the first line of each reference is flush left and subsequent lines are indented by 0.5 inches.

Present both DOIs and URLs as hyperlinks. Because a hyperlink leads directly to the content, it is not necessary to include the words “
Retrieved from”
or “
Accessed from”
before a DOI or URL.

Example format:

Last Name, F. M. (Year). Article Title.
Journal Title
, Pages From – To.

Last Name, F. M. (Year).
Book Title.
City Name: Publisher Name.

Appendix

Review of Literature Table

Summary of Primary Sources of Evidence

Citation of Evidence

Study Question or Hypothesis

Study Design

Sample/Setting

Independent and Dependent Variables & Tools Used

Data Collection & Analysis

Findings

Recommendation/

Implications

Level of

Evidence

[Example]

Arora, T., Chen, M. Z.,

Omar, O. M.,

Cooper, A. R.,

Andrews, R. C., &

Taheri, S. (2015).

An investigation of the

associations among

sleep duration and

quality, body mass

index and insulin

resistance in newly

diagnosed type 2

diabetes mellitus

patients.

Therapeutic Advances

 in Endocrinology and

Metabolism
,
7
(1), 3-11.

doi:10.1177/2042018

815616549

 

“Sleep duration, frequency of night awakenings and nap duration would be directly associated with BMI and indirectly related to insulin resistance through the effects of BMI” (Arora et al., 2014, p. 4). PICO question sample template

Cross-Sectional

study

A. Sample: 522 newly diagnosed type 2 diabetes mellitus patients, 65.9% male, mean age 63.4 +/- 10.1 years

B. Setting: not provided

A. Independent variables: sleep duration, night awakenings, and nap duration

B. Dependent variables: BMI and insulin resistance

C. Tools: (a) 7- day sleep duration, sleep questionnaire, Epworth Sleepiness Scale

(b) measurements of height and weight,

(c) homeostatic model assessment of insulin resistance,

(d) self-reported demographics, smoking, average alcohol consumption per week and any history of sleeping problems,

(e) accelerometer to measure physical activity

A. Data collection: sleep diary, sleep questionnaire, objective height and weight, homeostatic model assessment of insulin resistance, and accelerometer for physical activity

B. Analysis: (a) IBM statistical package for the social sciences and SPSS AMOS.

(b) Independent t-tests, Mann-Whitney U tests and chi-square analysis “to examine differences between study characteristics according to BMI” (p. 5).

(c) “Bivariate correlations to examine the relationships between sleep duration and number of night awakenings, BMI and logged HOMA2-IR” (p. 5).

(d) Path analysis analyzed with chi-square, Comparative Fit Index, and mean square error of approximation with a p value

a)Average number night awakenings positively correlated with BMI (r=0.22, p<0.001) and negatively associated with insulin resistance (r=-0.16, p=0.04) (b)According to path analysis, night awakenings were directly associated with BMI and indirectly associated with insulin resistance with CMI as potential mediator (p<0.05) (c) Sleep duration was not associated with either BMI or insulin resistance (p>0.05)

(a)Sleep quality plays a role in insulin resistance with BMI as a mediator

(b)Recommend further studies to examine “impact of improving sleep quality on obesity and insulin resistance” (p. 1)

Level II

 

Figures title (if included):

Figure 1
. [Include all figures in their own section, following references (and footnotes and tables, if applicable).  Include a numbered caption for each figure.  Use the Table/Figure style for easy spacing between figure and caption.]

For more information about all elements of APA formatting, please consult the
APA Style Manual, 7th Edition
. PICO question sample template

NURS-6521 Walden University Final exam 

Question 30                                                                                                   1 pts

What is true about ADHD treatment?

Group of answer choices

 

Antipsychotics are considered first-line treatment for ADHD.

 

Alpha-2 agonists can be used to treat ADHD.

 

Norepinephrine reuptake inhibitors are approved in treating ADHD in children under six only.

 

There is no medication that has proven effective at treating ADHD symptoms.

NURS-6521 Walden University Final exam  Question 16                                        1 pts

How does allopurinol contribute to the
management
of gout?

Group of answer choices

 

It decreases urate production.

 

It increases urate excretion.

 

It inhibits leukocyte migration.

 

It blocks the action of interleukin-1.

 

It inhibits urate absorption.

Question 14                                               1 pts

Why is oral vancomycin not used for systemic infections?

Group of answer choices

 

It is rapidly inactivated by gastric acid.

 

It is not absorbed from the gastrointestinal tract.

 

It has a high risk of causing systemic allergic reactions.

 

It is too potent for systemic use and can lead to toxicity.

 

It is rapidly metabolized by liver enzymes, reducing its efficacy.

NURS-6521 Walden University Final exam – Which statement is most accurate regarding the comparison between alteplase and streptokinase?

Question 7                                                                 1 pts

Which statement is most accurate regarding the comparison between alteplase and streptokinase?

Group of answer choices

 

Alteplase is contraindicated in myocardial infarction, while streptokinase is not.

 

Alteplase has a lower risk of intracerebral hemorrhage

 

Alteplase shows an affinity for fibrin-bound plasminogen, while streptokinase does not.

 

Alteplase is more widely used worldwide.

 

Alteplase has a lower cost.

Question 6                               1 pts

What is more likely a side effect of meperidine than other opiates?

Group of answer choices

 

Miosis

 

Respiratory depression

 

Less dopamine stimulation

 

Seizures

 

Sedation