QUESTION

Nursing

Scenario:

Mark, a 35-year-old, was brought via ambulance to the emergency department after collapsing on the street. He was diagnosed with appendicitis and the surgical team was alerted to the potential surgery. The physician prepared to obtain informed consent and began discussing the simple effective surgery and the treatment with the patient. The RN was present at the bedside. The patient stated he did not want surgery. Based upon his beliefs as a Christian Scientist, it is against his practices. He requested a Christian Science practitioner. The patient rated his pain as 9 on 0-10 verbal pain scale so the RN prepared the narcotic analgesic to relieve the patient’s pain. The patient declined the medication. The RN believes the patient should accept the pain medication and have the surgery thinking “If it were me I would proceed with the surgery and treatments proposed by the surgeon.” The surgeon can be heard speaking to a fellow surgeon about how to go about changing the patient’s decision.

Initial Discussion Post:

Address the following:

1. State and discuss the legal and ethical considerations occurring in this scenario. Include supporting citations.
2. How can RNs support the patient’s decision when the beliefs of the patient are contrary to their own? List three (3) interventions, with supporting rationales, the RN would perform to ensure the delivery of culturally sensitive care.
3. Identify one (1) additional major religion, in which the same circumstances might also require the RN to advocate for the patient’s refusal of surgery. Describe the beliefs behind why the identified religion could pose a moral conflict for a similar patient.

Base your initial post on your readings and research of this topic. Your initial post must contain a minimum of 250 words. References, citations, and repeating the question do not count towards the 250 word minimum.

Examine the burden of disease in the United States to provide important information on which parameter is to base decisions on public health priorities.

To do this, we will utilize mortality data for the United States. In the first part of this assignment, you will download and examine mortality data for your home state.

Go to USA Causes of Death by Age and Gender

• Choose your home state under the Choose State option (panel on left hand side)
• Select BOTH under the Choose gender option in the middle panel.
• Scroll down to the bottom of the page, and read the fine print to learn for which year the mortality data have been tabulated.
• Copy and paste the relevant mortality data into Excel.
  • Drag your mouse over all of the Cause of Death rows, (50 rows), right click, and select Copy,
  • Open Excel and paste your selection into Excel. You should have a spreadsheet with 50 row and 19 columns (Columns A-S).

For the first part of the assignment, you will prepare a histogram of the leading causes of death (regardless of age) in your state. Follow the steps below in order to prepare your histogram:

• Sort the Data
  • The numbers of deaths, all ages, are given in Column C.
  • Select all the columns.
  • Then, select Data>Sort>Sort by Column C, Values, largest to smallest. (Make sure that my data has headers is not selected.
  • You now have the leading causes of death in your state in Column A (cause) and Column C (frequency).
• If you already know how to draw a histogram in Excel, proceed to do so with Columns A and C, making sure to truncate the data to the 30 leading causes.
• If you do not know how to draw a histogram in Excel, here’s one method:
  • Choose the Chart Wizard, chart type column, chart sub-type clustered column (Step 1).
  • Click Next for Step 2.
  • At Step 2, Click the Series button, which will open a new box.
  • Click Add under Series,
    • Enter Causes of Death in the Name box;
    • Clear the Values box, then
    • Drag your mouse over the 30 largest frequencies for the Values; and,
    • Drag your mouse over the first 30 causes of death (Column A) for the Category (X) axis labels box.
• Click Next, and you’ll be brought to the Chart Options box.
• Add a suitable title (e.g., Leading Causes of Death, 2010, your state)
• Label the Y axis Frequency.
• Click Next, and place the histogram in a new worksheet.

You now have a histogram with the leading causes of death for your state. This presents one picture of the burden of disease in your state, but it isn’t the only picture. We shall now look at a different metric: years of life lost due to each cause.

Assignment:

• Explore the National Institute of Nursing Research (NINR) website: http://www.ninr.nih.gov/ Review their publication Bringing science to life: NINR strategic plan (2011, p. 7) to identify the current priorities for nursing research. Do you agree with the priorities or would you recommend addition or elimination of some of the priorities? What effect do the nursing research priorities have on nursing researchers?
• What criteria must be met in order to consider a practice, evidence-based? Provide examples. Explain the role quality plays in evidence-based practice? 
• Based on the information you’ve learned to this point, write a research proposal that relates to the topics you chose for a previous assignment. Be sure to include the following information in your proposal:
  • Hypothesis
  • Theory
  • Design model
  • Method
  • Anticipated results
  • Potential Dissemination Avenues 

The assignment should be between 1500 and 2000 words in length and contain at least two scholarly sources, in addition to the textbook and provided material. Please submit your assignment in one APA formatted document.