professional and personal growth through a spirit of inquiry

Purpose

Evidence-based practice is initiated by nurses and other healthcare professionals who identify questions about specific health-related interventions and the outcomes of those interventions on individuals and populations. The creation of a PICOT question helps guide evidence-based initiatives. The purpose of this worksheet is to provide an opportunity to explore the development of a PICOT question as a foundation for evidence-based practice.   CO1: Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. (PO 1, 4)

CO2: Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare outcomes.  (PO 1, 2)

CO3: Demonstrate professional and personal growth through a spirit of inquiry, scholarship, and service in diverse healthcare settings. (PO 3, 4)

CO4: Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies.  (PO 1, 2, 5)

Requirements:

  1. Review the elements included in PICOT questions to guide evidence-based nursing practice.
  2. Respond to the questions below using the PICOT Question Worksheet Template 
  3. Using a minimum of 3 scholarly nursing sources, current within 5 years:
    • Identify and describe one practice-related issue or concern.  You may choose to build on the practice issue you identified in NR500NP/NR501NP.
    • Explain why the issue/concern is important to nurse practitioner practice and its impact on health outcomes.
    • Describe each element of your PICOT question in one or two sentences, being sure to address all of the following:
      • P-Population and problem– What is the nursing practice concern or problem and whom does it affect?
      • I–Intervention– What evidence-based solution for the problem would you like to apply?
      • C–Comparison– What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or alternative solutions.
      • O–Outcome– Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome.
      • T–Time frame– What is the Timeframe involved for the EBP initiative or the target date of completion?
    • Construct your PICOT question in the standard PICOT question format (narrative) and define each letter separately, such as:
      • P =
      • I =
      • C =
      • O =
      • T =
      • PICOT question written in full =
  4. At the graduate level, we like to see you synthesizing your ideas into your own words. No direct quotes may be used in this worksheet.
  5. Use APA formatting guidelines for references and citations.

types of studies

types of studies

1. Critique the quality of the literature reviews conducted for two different types of studiesquantitative and qualitative research.

2. Identify and discuss the “research questions”, “sampling and sampling sizes“, “research designs” (qualitative vs. quantitative), “hypothesis”, data collection “methods”, and research “findings”.

3. Discuss the credibility of the sources and the research/researchers’ findings.

4.  400-word minimum

5 Minimum of 3 references must have been published within the last 3-5 years.

6 Based on the Literature review-what did you learn, and what will you change in your practice?

Technological Or Human Induced Disaster

Technological Or Human Induced Disaster

We have already discussed weather related natural disasters. And bioterrorism, and now we will focus on other types of disasters. For this week’s discussion, you are asked to research a technological or human induced disaster.

(This not the same as in Weeks 3 and 4 where you might have discussed hostage situations. Mass shootings, multiple-vehicle or mass transit accidents with multiple critical injuries, bioterrorism, and disease outbreaks.) Here you want to look at situations such as radiological, nuclear accidents. Technological disasters (electromagnetic pulse), and hazardous material spills.

In your post, provide the name of the incident you have chosen, and support your answers with evidence/examples. Please provide a working link and a citation for your source(s).

Select 2 of the items below to discuss:

  1. At what point does a technological or man made event become labeled a disaster?
  2. Name and explain the impact categories associated with your disaster.
  3. How well do you think the United States is prepared for a disaster like the one you selected?
  4. Discuss the factors that can influence the effects a disaster may have on a community or region.
  5. What nursing interventions would be a priority for these victims?
  6. What community resources should be provided to the victims for follow up needs?

Support your answer with evidence from scholarly sources.

Abortion

Abortion is one of the most difficult and controversial moral issues we will consider. Listen to both sides, even if it is difficult to do. Both sides have important moral insights, even if ultimately these insights are outweighed by the insights of the other side. The goal of this discussion is not to convince you to accept one position over the other, but to help you to understand both sides. As you consider this difficult issue, it is important to distinguish two questions:

  • Is abortion morally wrong?
  • Should abortion be illegal?

Choose one of the questions above and argue both sides with supporting evidence

Assessing And Treating Patients With Sleep/Wake Disorders

The Assignment: 5 pages

Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult (https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/DT/week_11/index.html). You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

References

Fernandez-Mendoza, J., & Vgontzas, A. N. (2013). Insomnia and its impact on physical and mental health. Current Psychiatry Reports, 15(12), 418. https://doi.org/10.1007/s11920-012-0418-8

Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. Chest, 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/

Morgenthaler, T. I., Kapur, V. K., Brown, T. M., Swick, T. J., Alessi, C., Aurora, R. N., Boehlecke, B., Chesson, A. L., Friedman, L., Maganti, R., Owens, J., Pancer, J., & Zak, R. (2007). Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. SLEEP, 30(12), 1705–1711. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_Narcolepsy.pdf

Morgenthaler, T. I., Owens, J., Alessi, C., Boehlecke, B, Brown, T. M., Coleman, J., Friedman, L., Kapur, V. K., Lee-Chiong, T., Pancer, J., & Swick, T. J. (2006). Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children. SLEEP29(1), 1277–1281. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_NightWakingsChildren.pdf

Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13(2), 307–349. https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6470

Winkleman, J. W. (2015). Insomnia disorder. The New England Journal of Medicine, 373(15), 1437–1444. https://doi.org/10.1056/NEJMcp1412740

Improving Population Health

Policy And Advocacy For Improving Population Health

In this Discussion, you will identify a recently proposed health policy. And share your analysis of the evidence in support of this policy.

To Prepare:

  • Review the Congress website provided in the Resources. And identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

The Difference Between A Nursing Practice Problem And A Medical Practice Problem

Although nursing practice problems and medical practice problems are related in that they are used for medicine. There are differences between the two. A nursing practice problem is an issue encountered during nursing practice. Such as during a patient assessment, related to the patient’s response to a health problem they are experiencing. There are numerous considerations to the nursing practice problems (Fuller, 1982). This ranges from the patient’s signs and symptoms to an illness to their difficulties in completing the activities of daily living due to a fractured extremity. This is due to nursing care involves the entire individual, family or community. Fuller, (1982) states that nursing practice problems, “…deal with modalities of patient care such as support, comfort, prevention of trauma, promotion of recovery. Health screening, appraisal and/or assessment, health education, and coordination of health care.”

medical practice problem

A medical practice problem is concerned with a medical condition or disease. It identifies a condition, searches for causes, establishes a prognosis, and prescribes a treatment for the condition (Chiffi & Zanotti, 2015).

Chiffi and Zanotti (2015) state, “In conclusion, medical and nursing diagnoses have different goals: a medical diagnosis identifies a variation from a norm, while a nursing diagnosis should judge the existence of a potential for enhancing self-care.”

Consider a patient with a fractured wrist. The physician will set the fracture and prescribe pain medication. These are examples of medical practice problems. The nurse will review the aftercare and medication instructions with the patient. The nurse will also review care of the splint and possibly arrange a visiting RN to help with activities of daily living.

The PICOT question is the first step in establishing or improving evidence-based practice with the goal of solving problems with patients. “Nurses use EBP to provide patients with safe, quality care and to improve outcomes” (Helbig, 2018). The PICOT is based on a nursing practice problem because it is designed to improve patient care. An example of using PICOT for evidence-based practice would be studying the frequency of oral care with the goal of reducing the incidence of ventilator associated pneumonias. It is not designed for disease research.

Using 200-300 words APA format with references to support discussion

Cultural Competency And Pharmecology

Pharmacology And Cultural Competency

Week 3: Discussion Question – Healthy People 2020

How does Healthy People 2020 address culture and spirituality considerations?

Select at least one topic or objective from Healthy People 2020 that is of interest to you.  Summarize key points of the topic or objective and discuss how this topic will affect patient care and its significance to the advanced nursing role and/or practice.

Expectations

Initial Post:

Week 3: Discussion Question – Case Study

Previous  Next 

Discussion Prompt

Mr. Smith is a 64 year old African American male. He was diagnosed with hypertension and hyperlipidemia 5 years ago and has not taken meds regularly for the last year, states he has been experiencing chest pain when working around the house and sometimes while on his evening walk. And also complains that his feet are swelling in the evening. His vitals today: P-105, B/P-165/100, R-20. Wt-260 Ht-5’9”  Labs: TC- 240, LDL- 145, HDL- 30, Trig-250. Sulfa allergy. You are assigned as his new PCP.

  1. What medication recommendations will you make? Include the drug class, generic and trade name and starting dose range. Provide rationale for your choices.
  2. Discuss any potential side effects and drug interactions for this patient.
  3. What non-pharmacological interventions would you suggest?
  4. What patient education would you provide?

Expectations

Initial Post:

Ethical dilemmas in healthcare

200-250 words APA 6 format, in-text citation, Please provide a copy of all references used.

**The links to the mentioned video are provided below. **

Assignment Details:

For this Discussion Board, please complete the following:

Ethical dilemmas in healthcare are not always about life and death, but these are faced by healthcare professionals every day in their interactions with patients. Consider the scenario in this video about a patient’s request for painkillers to relieve his dental pain:

After viewing the video and considering the possible decisions that the dentist can make, answer the following questions:

  • What ethical principles are involved in this case and what are the steps in the ethical decision-making process that the dentist should use to come to an ethical decision?
  • If you were the dentist, what do you think is the best ethical decision and why?

**Reference and link to video**

American College of Dentists. (2018, May 10). ACD ethical dilemma–patient in pain [Video]. YouTube. https://www.youtube.com/watch?v=_NlBhxLLBRw