Nursing – Clinical Reasoning Cycle – Medical-Surgical Nursing – Case Study

Nursing – Clinical Reasoning Cycle – Medical-Surgical Nursing – Case Study Assignment Help

Case :

Melody King, 36, Peritonitis following ruptured appendix:

Ms. Melody King presented to the Emergency department with 2-3 days of severe Right Lower Quadrant abdominal pain, which required emergency laparoscopic surgery for removal of a ruptured appendix. She has a past medical history of asthma and depression, with her current prescribed and compliant medications list which includes Ventolin, Seretide, Sertraline.

Melody’s observations were as follows:

BP 95/45mmHg

HR 120

Temp 38.3°Celcius

RR 22/min and shallow

SpO2 95% on room air

She complained of increasing nausea and centralised abdominal pain 7-8 on a scale of 0 to10. Physical assessment showed a distended abdomen and generalised abdominal guarding. To investigate her condition further, pathology results reveal a raised white blood cell (WBC) count and CRP. You are the RN caring for Melody post-operatively on the surgical ward.

Task :

Task, will take the form of a case study, in the field of medical-surgical nursing, which discusses the provision of ethical, legal, evidence-based, holistic person-centred care including the establishment of realistic and relevant goals through the theoretical examination of a particular nursing specialty case study using the Clinical Reasoning Cycle (Levett-Jones, 2013).

Utilise the Clinical Reasoning Cycle (Levett-Jones, 2013) (a clinical decision making framework) to plan and evaluate person-centred care:

Considering the person’s situation, collect, process and present related health information;

Identify and prioritise at least three (3) nursing problems/issues based on the health assessment data that you have identified for the person at the centre of care;

Establish goals for priority of nursing care as related to the nursing problem/issues identified;

Discuss the nursing care of the person, link it to assessment data and history;

Evaluate your nursing care strategies to justify the nursing care provided;

Reflect on the person’s outcomes.

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Nursing Theories

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10-15 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:

  1. Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.
  2. Explain how the nursing theory incorporates the four metaparadigm concepts.
  3. Provide three evidence-based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

  • Rubric_Print_Format1.xlsx
  • APA6thEditionStyleGuide.docx
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Understanding Nursing Research: Building an Evidence-Based Practice

Question Description

Adittional information for the paper

This assignment will demonstrate your knowledge of the nursing research process by critiquing published research articles in a systematic manner. The assignment will show your understanding of the components of research and the procedures necessary to implement the research process.

The assignment does not have to be in a paper format. Using the posted criteria, write each question and respond to it based on the article you’re critiquing.

Find the assignment as an attachment below.

Question Description

Hello Students! I hope you will have a fabulous Sunday.

For the following two questions please write at least 3 paragraphs each. Be sure to explore and read more than one reference and include it in your references. Please only utilize word documents so that I can open the document.

Questions:

1. Do you view nursing as a career or a job? What are your professional goals related to nursing?

2. Describe the steps you would take to prepare yourself to interview for your ideal future Nursing role?Hello Students! I hope you will have a fabulous Sunday.

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Strategic human resources management aligns human resource practices with the strategic objectives of an organization. Successful health care managers need to understand how human resource functions can be utilized to fulfill their organization’s mission and goals,

Strategic human resources management aligns human resource practices with the strategic objectives of an organization. Successful health care managers need to understand how human resource functions can be utilized to fulfill their organization’s mission and goals, such as the promotion of high-quality care, a customer-service orientation, and financial viability. In addition, today’s health care environment requires that organizations demonstrate the value-added for the services they provide—and this includes those related to human resources management. The traditional approach to evaluating HR services has been based on productivity, volume, and efficiency measures. Such measures include the percentage of people who participated in a training program, time to fill a position, and cost per hire. These are valid measures but only capture part of the HR role. In current thinking, the HR department should not only work efficiently and productively, but also should add value to the organization. This means that the work of HR begins with the concerns of the business. And while HR groups typically see themselves as responsive to internal customers, a value-added approach means that HR needs to be aligned with internal and external stakeholders and be a source of competitive advantage for the organization. In preparation for this Discussion, review this week’s Learning Resources and consider the following: Based on your experiences and the information presented in the Learning Resources (particularly the article “Why We Hate HR”), how would you assess the HR function in most health care organizations? Is it closer to the negative or the positive view of HR? Why does HR often have a negative reputation? What have you learned in previous courses or through your professional experiences that informs your understanding of strategic human resources management? What do you see as your current or future responsibility for ensuring that an organization’s human resources practices align with its mission and objectives? How do you think the efficiency, productivity, and/or value added by HR services should be assessed? What types of metrics would you suggest be used? Why? Post by Day 4 a response to the following: Share key insights you have gained about the impression (positive, negative, or mixed) that you and others have of human resources management. Also, explain what factors might be contributing to this perception. Describe how you view your current or future responsibilities for promoting strategic human resources management within health care. Analyze two metrics and indicate how each could be used as an indicator of HR efficiency, productivity, and/or value added.

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IDENTIFY AND DISCUSS WHAT YOU BELIEVE IS THE MOST IMPORTANT FACTOR THAT INFLUENCES PATIENT/CUSTOMER SATISFACTION POSITIVELY AND NEGATIVELY IN HEALTH CARE.

For most health care organizations, the customer is the patient. Like other businesses, health care organizations are evaluated by many of the usual measures of customer satisfaction (e.g., convenience of location, ease of getting the appointment, waiting time, price, etc.). Unlike most businesses, health care organizations are also judged by patient outcomes. What the “customer” wants and what the “patient” needs may occasionally be in conflict, even though the “customer” and “patient” is the same person. This is one reason customer satisfaction for health care organizations can seem to be an elusive goal.

To prepare for this Discussion:

· Review this week’s Learning Resources.

· Locate and read a scholarly article that identifies factors that influence patient/customer satisfaction in a health care setting.

Post a brief description of and a link to the scholarly article. Then, identify and discuss what you believe is the most important factor that influences patient/customer satisfaction positively and negatively in health care. Finally, justify why those factors are important and address how the article you cited supports or refutes your opinion.

Support your work with specific citations from this week’s Learning Resources and/or additional sources as appropriate. Your citations must be in APA format.

Resources:

Article: Ford, R. C., Bach, S. A., & Fottler, M. D. (1997). Methods of measuring patient satisfaction in health care organizations. Health Care Management Review, 22(2), 74–89.

Article: Otani, K., Waterman, B., Faulkner, K. M., Boslaugh, S., Burroughs, T. E., & Dunagan, W. (2009). Patient satisfaction: Focusing on “excellent.” Journal of Healthcare Management, 54(2), 93–103.

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Risk Management

This assignment builds on the Risk Management Program Analysis Part One assignment you completed in Topic 1 of this course.

Assume that the example risk management program you analyzed in Topic 1 was developed by and is now currently implemented by your health care employer/organization. Further assume that your supervisor has asked you to present a high-level summary brief of this new risk management program to a group of administrative personnel from a newly created community health organization in your state who has enlisted your organization’s assistance in developing their own risk management policies and procedures.

Compose a 1,250-1,500 word summary brief that expands upon the elements you addressed in the Risk Management Program Analysis Part One assignment. In addition, analyze the following:

  1. Explain the Joint Commission’s role in the evaluation of an organization’s quality management processes.
  2. Describe the roles that different levels of administrative personnel play in establishing or sustaining operational policies that are focused on employer-employee organizational risk management policies.
  3. Explain the relationship of risk management programs and compliance with ethical standards.

In addition to your textbook, you are required to support your analysis with a minimum of three peer-reviewed references.

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

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

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Part one assignment is

For this assignment, you will research risk management programs for health care facilities or organizations. Review the criteria below in order to select an exemplar that applies to your current or anticipated professional arena. (Note: Select an example plan with sufficient data to be able to complete the assignment successfully.)

In a 1,000-1,250 word paper, provide an analysis that includes the following:

Brief summary description of the type of risk management plan you selected (new employee, specific audience, community-focused, etc.) and your rationale for selecting that example.

Description of the recommended administrative steps and processes in a typical health care organization risk management program contrasted with the administrative steps and processes you can identify in your selected example plan. (Note: Select an example plan with sufficient data to be able to complete the assignment successfully.)

Analyze the key agencies and organizations that regulate the administration of safe health care and the roles each play in the risk management oversight process.

Evaluation of the selected exemplar risk management plan regarding compliance with the American Society of Healthcare Risk Management (ASHRM) standards relevant to privacy, health care worker safety, and patient safety.

Proposed recommendations or changes you would make to your selected risk management program example to enhance, improve, or to secure compliance standards.

In addition to your textbook, you are required to support your analysis with a minimum of three peer-reviewed references.

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

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

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

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differences between research and evidence-based practice.



Question Description

Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

References:

Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

  • Response posts: Minimum 100 words excluding references.



Discussion 2

We are looking at the differences between research and evidence-based practice. According to (LoBiondo -Wood & Haber, 2014, p. 6), the term research involves systematic, scientific approaches whereas the goal is to answer specific questions about nursing developments. Research further breaks down into two major categories which are qualitative research and quantitative research. (LoBiondo -Wood & Haber, 2014, p. 8)

An example of a research study would be to sit down face to face and interview 20 adults who tested positive for Influenza A, 10 who took Tamiflu and 10 who did not. The research question would be, “What is the relationship between those adults who were diagnosed with pneumonia after testing positive for Influenza A, amongst those who took Tamiflu and those who did not?”

Evidence-based practice is best described by (Stevens, 2013, para. 3) as combining our current knowledge on a particular subject and adding that to our plan of care to improve the outcomes of our patients. In other words, the knowledge and research now exists, we just have to translate the information into our daily practice and possibly keep patients from going through something we can predict may happen, based on what we have already learned.

An example of evidence-based practice would be to find your source, and as (Hoyka & Heese, 2006, p. 348) states, it can be books and journals, among several other materials. As we have been told since day one of writing research papers, not all sources are correct and it is our job to know how to locate reputable ones. To implement evidence-based practice, for example, a patient’s mother may want to know the correlation between her 12 month old child receiving the Measles, Mumps, Rubella (MMR) vaccine. For the clinical question, I would ask, “In 12 month old children, does receiving the MMR vaccine increase the risk of developing autism?”

To summarize, there are differences between research in nursing and evidence-based practice in nursing. There are times throughout our career that we will use one or both practices to gain knowledge and apply that to our plans of care.

References

(2010). Publication Manual of the American Psychological Association (6th ed.). Washington, DC: American Psychological Association.

Hoyka, L., & Heese, D. (2006). Finding and evaluating sources. Upper Saddle River, NJ: Pearson Prentice Hall.

LoBiondo -Wood, G., & Haber, J. (2014). Nursing Research Methods and Critical Appraisal for Evidence-Based Practice (8th ed.). St. Louis, MO: Elsevier.

Stevens, K. R. (2013, May 31). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. OJIN, 18. https://doi.org/10.3912/OJIN.Vol18No02Man04

LoBiondo-Wood, G., & Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice. St. Louis, MO: Elsevier.

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CASE STUDY ON DISORDERS OF HEMOSTASIS

Disorders of Hemostasis

Leona is 52 years old and smokes. She is also overweight and has atherosclerosis. When she was given a two-week vacation from work, she packed up her bags and flew from Minnesota to Sydney, Australia, for the trip she always wanted to take. Unfortunately, just three days after she arrived, she was hospitalized when her left calf became inflamed, causing her considerable pain. The physician attending to her told her she developed a deep vein thrombosis. 

Explain, using your knowledge of hypercoagulability, why the trip to Australia contributed to Leona’s DVT? 

Why was Leona already at risk for thrombus development?How does Leona’s atherosclerosis affect platelet function? Conversely, what is the effect of increased platelet activity on the development of atherosclerosis?

How do atherosclerosis and immobility promote changes in blood coagulation?

When Leona was in hospital, she received heparin therapy. Explain why this course of action was taken to treat her DVT. Why was she not given heparin tablets to take back to the hotel with her?

No Plegarism please, assignemnt will be checked with Turnitin. 

Will need 4 full pages double spaced for the case study, APA Style, Times New Roman, font 12, Title Page and a Reference page. 

In your discussion be sure to include evidence of your knowledge of tissue and organ structure and function to physiologic alterations in systems and analyze the cause and effect relationship in response to disease.

Make sure all of the questions in the case study have been addressed and answered. 

Cite at least 3 References; journal articles, textbooks, or evidenced-based websites to support the content. 3.

All sources must be within five years (2012-2017).


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RESEARCH THE RELATIONSHIP BETWEEN HEALTH STATUS AND WEALTH.

Assignment 2: The Relationship Between Health and Wealth
There is an apparent relationship between longevity, morbidity, and wealth. Health outcomes improve according to one’s socioeconomic status. The purpose of this assignment is to understand how wealth can impact the health of populations.
Using the module readings, Argosy University online library resources, and the Internet, research the relationship between health status and wealth. Then, develop a presentation that includes the following:

Detailed information about what you have learned about the health-wealth gradient in your home state or region. Ensure that you provide relevant facts, figures, and references in support of your information.

Charts and/or graphs that display any relationship between a specific health disparity and income or poverty status.
 

Comparison of the relationship between income and poverty status with certain health indicators such as infant mortality, life expectancy, etc. In addition, you can compare the relationship between education status and mortality rates or income and mortality rates; breast cancer mortality and income; cervical cancer mortality and education; and between infant mortality and income, federal poverty level (FPL), or education status.

Develop an 8­–10-slide presentation in PowerPoint format

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Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team.

Purpose

To apply lessons in quality improvement in nursing to a real-world nursing issue. This Course Project will use the Six Sigma DMAIC process.

Course Outcomes

The Course Project enables the student to meet the following Course Outcomes (COs):

  • CO1: Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)
  • CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

Points

The entire Course Project is worth 600 points. Milestone 1 is worth 150 points of this total.

Due Date

Submit your completed NR392 Milestone 1 by Sunday, 11:59 p.m. MT, end of Week 1.

Requirements and Guidelines

  • Quality improvement is an important issue in professional nursing today. In Milestone 1, the student will define a nursing care issue (not a workforce issue such as staffing) from a current or former workplace or clinical setting that could be impacted by improved quality, and state the desired outcome of the improvement in quality. The student will then provide details about this issue, as well as explain the reason this issue was selected. Milestone 1 is due at the end of Week 1.
    • Save it to your computer in Microsoft Word 2013 (or later) as a .docx file with the file name: Your Last Name NR392 Milestone 1.docx.
    • After you have developed your responses, type your responses directly in your saved Milestone 1 Template.
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