Ethical Decision Making

Choose a case of a real patient with a potential ethical dilemma in end of life care pertaining to withholding or withdrawing life support; or euthanasia or assisted suicide in the United States (except Nancy Cruzan, Charlie Gard or Dax Cowart). There are numerous examples in the text and on the internet.

Using the Worksheet for Ethical Decision-Making Framework to guide you, complete the introduction and all 6 steps.There is a blank word document for you to use in the Supporting Documents. You do not need to use complete sentences and it does not need to be double spaced.  Also, Step 6 asks you to assess the outcomes, but you will only be able to indicate how you would assess the outcomes.

Please Note: You are viewing this end of life dilemma as if you were the Ethics Committee and you will use ethical reasoning to achieve a recommendation.  Discussions with family and patients and doctor would have already occurred. You will thoroughly examine the situation and will follow each step in the Framework for Ethical Decision Making, using the WorksheetYour recommendation may be different than what actually occurred (for example. You may recommend keeping a patient on life support when in reality, the “real” patient was taken off life support). The purpose of the assignment is to apply ethical reasoning to a real patient dilemma at end of life.

Completed worksheet should be at least 2-3 typed, single spaced pages. College level writing is expected but complete sentences are not required; in-text citations are also not required for this assignment.  A cover page and reference page, with at least 3 scholarly references, is required. Title page and reference page do not count for the 2-3 pages of content.

Big Data Risks And Rewards

When you wake in the morning, you may reach for your cell phone to reply to a few text or email messages that you missed overnight. On your drive to work, you may stop to refuel your car. Upon your arrival, you might swipe a key card at the door to gain entrance to the facility. And before finally reaching your workstation, you may stop by the cafeteria to purchase a coffee.

From the moment you wake, you are in fact a data-generation machine. Each use of your phone, every transaction you make using a debit or credit card, even your entrance to your place of work, creates data. It begs the question: How much data do you generate each day? Many studies have been conducted on this, and the numbers are staggering: Estimates suggest that nearly 1 million bytes of data are generated every second for every person on earth.

As the volume of data increases, information professionals have looked for ways to use big data—large, complex sets of data that require specialized approaches to use effectively. Big data has the potential for significant rewards—and significant risks—to healthcare. In this Discussion, you will consider these risks and rewards.

To Prepare:

  • Review the Resources and reflect on the web article Big Data Means Big Potential, Challenges for Nurse Execs.
  • Reflect on your own experience with complex health information access and management and consider potential challenges and risks you may have experienced or observed.

ASSIGNMENT:

I. Describe at least one potential benefit of using big data as part of a clinical system and explain why.

II. Then, describe at least one potential challenge. Or risk of using big data as part of a clinical system and explain why.

III. Propose at least one strategy you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using big data you described. Be specific and provide examples.

Ethical and Legal Issues in Nursing Practice

NURS 270 Authentic Assessment

 

EOPSLO #5 Practice within the ethical, legal and regulatory frameworks of professional standards for nursing, including employing agencies’ standards of care, assuming students had no past conduct or convictions, which prevent such practice.

 

 

Ethical and Legal Issues in Nursing Practice

The purpose of this assignment is to reflect on an actual or potential ethical dilemma or legal situation with one of your assigned patients during NURS 270 Nursing Internship clinical learning experience.

Directions:

Write a two-page paper that addresses the following components:

1. Describe the patient scenario, with background information, which is leading to an ethical dilemma or legal situation

2. Describe the actual or potential ethical dilemma or legal situation

3. If you have chosen to write about an ethical situation, cite and describe the related portion of the Code of Ethics for Nurses, available to view at https://www.nursingworld.org/coe-view-only If you have chosen to write about a legal situation, cite and describe the related law from your state board of nursing.

4. Explain the potential solutions for the ethical dilemma or legal situation, with potential consequences for each solution

5. Describe the actions you would take as the nurse, the rationale, and the potential consequences of these actions

Follow APA format in writing your paper.

The paper is worth 15 points and meets the following end-of-program student learning outcome:

SLO #5: Practice within the ethical, legal and regulatory frameworks of professional standards for nursing, including employing agencies’ standards of care

Scoring rubric: NURS 270 Ethical and Legal Issues in Nursing Practice

Component Meets Expectation Partially Meets Expectation Does not Meet Expectation
Description of patient scenario

2 points possible

Description is thorough so reader understands the situation

 

2 points

Description lacks background data and leaves the reader unsure of the situation

1 point

No description provided

 

 

0 points

Description of actual or potential ethical dilemma or legal situation

2 points possible

Description is thorough and addresses ethical principles or legal situation with proper terminology

 

2 points

Description lacks thoroughness and is missing two or more ethical principles or legal situations

 

1 point

No description provided

 

 

 

 

0 points

Explanation of ethical code or statute

2 points possible

Provides appropriate citation and relevant ethical or legal regulatory framework

 

 

2 points

Does not provide appropriate citation but does include ethical or legal regulatory framework

 

1 point

Does not include code of ethics or legal statutory description

 

 

 

0 points

Explain the potential solutions and potential consequences

4 points possible

Explains at least three potential solutions and a consequence for each

 

 

 

4 points

Explains at least two potential solutions and a consequence of each

 

 

 

3 points

Explains only one potential solution or does not identify potential consequences

 

1 point

Describes the actions the student would take as a nurse including the rationale and anticipated consequences

4 points possible

Description is thorough and includes rationale and consequences

 

 

4 points

Description of action is unclear or lacks rationale or consequences

 

3 points

Description of action is unclear and lacks rationale or consequences

 

1 point

Follows APA format

1 point possible

Follows APA format

 

 

1 point

Does not follow APA format

 

0 points

15 Points Possible

Fostering Learning

Fostering a Culture of Learning for a Lifetime

 

CO #6: Examine contributions nursing research has made to nursing practice, patient education, and to health care.

Information: Nurses must understand research in order to effectively participate in the provision of evidence-based nursing care. As a student nurse, learning to be a lifelong learner and integrating evidence based research into your daily routine is important. A provider who incorporates evidence based approaches to practice seeks the best, most current evidence available to make judgments, apply clinical expertise while integrating the client’s values and beliefs into decisions about their care. The purpose of this assignment is to investigate the research process while completing a critical examination of qualitative or quantitative research relative to a current nursing issue or practice. The goal is for student to further investigate the research process, improve knowledge of evidence based practice, refine information literacy skills, understand research and engage in activities to become a lifelong learner.

This assignment encourages students to investigate each step of the research process and complete a critical examination of quantitative and/or qualitative research relevant to their nursing practice. Nurses must understand research in order to effectively participate in the provision of evidence-based nursing care.

Objectives of this assignments are to:

· Value the concept of EBP as integral to determining best clinical practice

· Develop & Demonstrate scholarly writing skills

 

 

Outcome: Students will integrate best current evidence with clinical expertise, patient/family preferences and values for delivery of optimal nursing care while incorporating strategies of lifelong learning.

 

 

 

 

 

Assignment

1. Formulate a research question from a recent clinical experience (PICO or PICOT structure)

2. Search for Evidence-Identify 5 or more peer reviewed research articles (within 5 years) pertaining to your research question. At least 2 most be original research

Lifelong learning opportunities

· Locate available resources

· Search databases (i.e. CINAHL, PubMed, Ebsco, etc.)

· Journal articles

 

3. Review and assess the evidence learned

 

4. Identify what type of research would be most appropriate for studying this issue and why (i.e. Qualitative or quantitative). Also include, if similar research was completed what method/techniques would you use to gather data (i.e.- experiments, focus groups, case studies etc.). Please include a rationale

Reflection- Write a 2-3 page reflection in APA on the following:

· How you would integrate the results of the of literature assessment into practice, taking into consideration the patient’s preference, evidence learned from peer reviewed articles, and your clinical experience. Specifically address how you would incorporate what you learned in practice (i.e. patient education, change in practice etc.). Include any anticipated challenges with implementation or how barriers can be overcome to improve practice.

· Please include information in the reflection on how you will utilize this dynamic process of questioning, learning and obtaining knowledge in the future as a lifelong learner.

 

Teaching Plan

Teaching Plan

1. Purpose: To document and evaluate teaching skills necessary to provide teaching to an individual client with a demonstrated need. With the completion of this assignment the student will be able to achieve the following objectives.

a. Demonstrate ability to thoroughly assess the learning styles of an individual or family using given developmental or cultural models.

b. Demonstrate ability to anticipate learning needs based on developmental or cultural assessments.

c. Identify and utilize teaching/learning principles to facilitate achievement of learning goals and outcomes.

d. Select and prioritize learning strategies based on the developmental or cultural assessment to achieve learning goals and outcomes.

e. Support rationales for teaching plan using teaching and learning theories from required readings with references.

2. Nursing Competencies:

a. Assessing and identifying developmental, cultural, and socioeconomic factors affecting a client.

b. Providing evidence-based health information and teaching based on developmental, cultural, and socioeconomic factors affecting a client or family

c. Integrating teaching/learning activities into client interactions based on developmental, cultural, and socioeconomic factors affecting a client or family.

d. Incorporating health promotion and teaching into the plan of care based on developmental, cultural, and socioeconomic factors affecting a family or client.

3. Plan: submitted to the clinical instructor during the teaching experience. Your clinical instructor must approve the topic.

a. Develop nursing diagnosis (NANDA)

b. Develop two (2) learning objectives

c. State methodology (teaching methods)

d. Provide and utilize teaching aids

e. State needed resources

4. Implementation: Outline (step by step)

5. Evaluation: Evaluate your project describing the effectiveness of teaching methods and aids, learner’s response, ability to meet objectives, and self-evaluation including what the student learned and what the student would do differently in the future. A copy of the entire teaching plan with the evaluation of patient learning is to be submitted to your clinical instructor during the teaching presentation. This write-up should be 2-3 pages.

impact on the finances of stakeholders and the healthcare organization

Reply 1

The financial aspect of the change project will have little to no impact on the finances of stakeholders and the healthcare organization. With the availability of internet service, many older adults have phones with internet access. With this internet, health-related applications can be downloaded on the phones, and reminders can be set up on these phone apps that will remind the patient to take their medications. Another financial aspect of the change project will focus on the Healthcare organization; this may cost the organization some financial implications as the organization develops and sends out short messaging services (SMS) to patients to remind them about taking their prescribed medications.

health education

Quality aspects promote health education on setting reminders for medications to improve medication adherence and prevent the exacerbation of chronic illnesses commonly seen among older patients. Improving quality encompasses quality of nursing care and quality of patient life. Quality improvements involve a continuous process of collecting and analyzing data to improve nursing care delivery (Risch, n.d).

The clinical aspect is assessing the patients’ reasons for medication nonadherence and monitoring patients’ medication intake. The steps of evidence-based practice involve multiple processes; this requires nurses to have sufficient time to identify clinical problems that evidence-based practice can be implemented. Also, nurses need to research relevant literature, perform a necessary appraisal of the retrieved information, frame and utilize an intervention and evaluate the efficacy of the applied intervention (Majid, Foo, & Mokhtar, 2011).

References

Risch, S. (n.d). Evidence-based practice in a clinical setting. https://resources.nurse.com/evidence-based-practice-clinical-setting-nnw

Majid, S., Foo, S., Mokhtar, I.A. (2011). Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barriers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133901/#:~:text=As%20EBP%20is%20a%20multistep,the%20retrieved%20evidence%2C%20formulate%20and

Reply  |  Quote & Reply
Reply 2

Delivering high-quality patient care involves the implementation of evidence-based practice (EBP). (Kueny, et al., 2015). When speaking with my preceptor, we discussed the financial, quality, and clinical aspects of developing the change proposal. When implementing my project, one important financial aspect is budgeting for more staff and interventions to help support nurses. One of the biggest causes of nurses’ mental health issues is burnout caused by inadequate staffing ratios. To show the value of the importance of providing appropriate interventions to aid nurses is to show the savings the facility will generate, having decreased staff turnover and increased patient and staff satisfaction and safety.

healthier work environment

One quality aspect is to provide interventions that promote a healthier work environment. These interventions need to show nurses they are supported by the facility and to improve their mental health. Improving nurses’ mental health should increase staff morale, retention, give them the tools to improve their mental health, and decrease the long-term effects of depression, anxiety, and insomnia on nurses.

The clinical aspect is the time and resources available to help support the EBP project. Gaining managerial support to implement the project is extremely important in its success. Nurse burnout can lead to poor mental health amongst nurses causing emotional exhaustion and apathy, which can cause long-term effects. Amongst the nursing shortage, facilities need to work on supporting and retaining nurses. According to the AACN, nurses who left the profession were 40,000 in 2010 to nearly 80,000 by 2020, and most nurses have left due to inadequate staffing and a stressful work environment. Two states that have shown the lowest nurse burnout rates were California and Massachusetts, which have legislation regulating nurse staffing ratios. So facilities need to work on preventing burnout and using resources within their health care systems to help their patients and nurses, i.e., mental health counselors, spiritual health, etc.

Reference:

Kueny, A., Shever, L., Lehan Mackin, M., & Titler, M. (2015). Facilitating the implementation of evidence-based practice through contextual support and nursing leadership. Journal of healthcare leadership7, 29–39. https://doi.org/10.2147/JHL.S45077

AACN. (2020). Nursing shortage. https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage

Hallucinogen related Disorders.

 

2 REFERENCES

ZERO PLAGIARISM

Hallucinogen related Disorders.

According to DSM-5, hallucinogens are psychoactive drugs either synthetic or plant-based products. They cause auditory and or visual hallucinations, as well as changes in mood and perceptions (American Psychiatric Association, 2013).  Some common hallucinogens are LSD, magic mushrooms, DMT, N-bomb, Molly, ecstasy, and MDMA (Close and Thomas, 2021).

The diagnostic criteria for hallucinogen disorders according to DSM 5 Are :

  • Recent use of hallucinogen
  • Dilated pupils
  • Tachycardia
  • Diaphoresis
  • Palpitations
  • Tremors
  • Incoordination
  • Enzyme linked immunosorbent assay in urine.

Therapeutic approaches.

There are no medical treatments currents approved by FDA, but there are some management approaches to help those in this situation which are acute adverse reaction and chronic adverse reaction. In such cases intoxication dissolves with time, supportive talk down therapy helps the individual not to harm themselves. Other interventions are

-Individual therapy,

– Group therapy

-Relapse prevention

-Cognitive Behavioral therapy (CBT)

-Dialectal Behavioral Therapy (DBT)

-Anger management

-Interpersonal Therapy (IPT)

Under chronic adverse reaction intensive outpatient programs (IOP), support groups like Alcoholics Anonymous (AA).

Recommendations for clients to help determine they are not progressing.

According to Prochaska and Diclemente model, there are 6 stages to recovery which are Precontemplation, contemplation, preparation, action, maintenance, relapse or termination ( Castillo et al, 2020). Clients need to know the cycle so they can keep track and understand what stage they are in, so they know if there is progress or not. They should also be educated that each individual is different, and they should focus on their healing process rather than competing with any other individual especially during group therapy sessions.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author

Castillo, G. J. A., Montes, V. A., Perales, E. A., Sánchez, V. A., & Medina, C. S. (2020). Stages of change and engagement in a family intervention. Child & Family Social Work25(1), 45–52. https://doi-org.ezp.waldenulibrary.org/10.1111/cfs.12651

Close, L. and Thomas, S. (2021) Common hallucinogen. Retrieved from https://recoveryfirst.org/hallucinogens/.

current healthcare issue

current healthcare issue

Article must be peer reviewed, research study and related to the current healthcare issue/trend.

·       Article must have been published within last 3-5 years.

·       Identify and discuss the research question, hypothesis, sampling size, and research finding.

100 to 150 word maximum synopsis for the article, identifying the points stated above; as well as the APA formatted reference

Compare ‘Change Theories’ to ‘Change Strategies’

150 word per question and a total of 750. Use the book attached. 

Part 1:

Question A: Chapter 5: Compare ‘Change Theories’ to ‘Change Strategies’. B) Explain your understanding of the nurse’s role in change. Provide example of what a nurse leader can do to be a change agent.

Question B: Chapter 3 —A) Name 3 different models of care discussed in the chapter. Discuss advantages and disadvantages of the 3 difference models of care discussed in the chapter.  B) If you were in a manager position, which one would you prefer and why?

Question C: Chapter 13 – A) Discuss how different types of conflict can be positive or negative, provide example or hypothetical situation for each.  B) What do you feel is the most difficult part of handling conflict? What points from this chapter will you plan to try the next time you are involved in a conflict?

Question D: Chapter 24 – A) Summarize your understanding of the components of workplace violence.  B) Elaborate on an experience or observation that you experience bullying or a violent event? How did you respond, what is your perception of the event? Was it reported? What was the response of authorities or leaders in the situation? What do you feel should have been done differently?

Part 2:  Address your ‘a-ha moment’ for this week: Something that was a realization for the week, that really opened your eyes, changed your perceptions and/or something that you now know that you will remember forever. It may be from another class or clinical, but the topic must have a direct connection to something in this course.

Issues And Trends In Nursing

Issues And Trends In Nursing

Instructions: Reflect on any ONE of the following issues and post your answer on the discussion forum. Student must respond to at least two other students:

1. How do you think nursing education has changed in the past 100 years?

2. What are the pertinent societal trends and issues that affect nursing education?

3. How has the information explosion  affected nursing education?

4. What ethical concerns have emerged that require changes in nursing education?

5. How will you cope with high stress levels of increasing professional and personal responsibilities?

Posts should be no less than 250 words and each student is to respond to at least two other students in the class. Responses should be no less than 100 words in length