Substance abuse programs

Substance abuse programs

Based on the strength of the evidence from the three articles reviewed in do introduce substance abuse programs compared to no substance abuse programs reduce substance abuse within a year., decide if a practice change or a recommendation for the implementation of a practice is indicated. You will make a recommendation to change or not change current practice (“C”) to the new practice that you reviewed (“I”) based on this evidence.

Prepare a voice-over PowerPoint presentation summarizing the PICO question, research findings, recommendations for change/no change to practice, and rationale for the recommendation.  Limit your presentation to no more than 10 minutes and 8-10 slides that are clear, succinct, and compelling enough to convince the audience of the soundness of your recommendation.

 Nursing Assessment

 Nursing Assessment

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

Temperature: 37.1 degrees C

BP 123/78 HR 93 RR 22 Pox 99%

Denies pain

Height: 69.5 inches; Weight 87 kg

Laboratory Results

WBC: 19.2 (1,000/uL)

Lymphocytes 6700 (cells/uL)

CT Head shows no changes since previous scan

Urinalysis positive for moderate amount of leukocytes and cloudy

Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

Describe the clinical manifestations present in Mr. M.

Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.

When performing your nursing assessment, discuss what abnormalities would you expect to find and why.

Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.

Discuss what interventions can be put into place to support Mr. M. and his family.

Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Nursing stereotypes

Nursing stereotypes

The media portray many images of nursing, some favorable and some unfavorable.

In order to receive full credit, you will need to clearly respond to both parts of the question using subtitles or bullets AND cite at least one scholarly reference in your response. 

Assessment of the  an assisted living facility

Assessment of the  an assisted living facility

1. Do an assessment of the  an assisted living facility , a continuing care retirement community or the Nursing facility in which you work.  Write a report on your opinion of the services offered and improvements that could be made.

2. Research and report the means for recording and reporting elder abuse in the community in which you work

Please answer each question using APA format . Each answer should be no less than 500 words and no more than 750 words.

Variety of models

Variety of models for making decisions

A variety of models for making decisions are available. Three of these models are paternalistic, informative, and shared decision making.

500 words, 2 academic resources 2017-2022, NO WEBSITE REFERENCE!!!!!!!!

Quality Improvement Project

Final Quality Improvement Project

  • To assess a clinical issue that is the focus of the Quality Improvement Project.
  • Evaluate the clinical project.
  • Putting it all together for the final Quality Improvement Project.

Content Requirements:

  1. A description of the clinical issue to be addressed in the project.
  2. A SWOT (strengths, weaknesses, opportunities, threats) analysis for the project. Analysis of the strengths, weaknesses, opportunities, and threats related to the quality improvement process.
  3. An outline of the action plan for the project.
  4. An assessment of clinical issues is the focus of the quality improvement project.
  5. Discuss stakeholders and decision-makers who need to be involved in the quality improvement project.
  6. Discuss resources including budget, personnel, and time needed for the quality improvement project.
  7. Discuss potential strategies for implementation and evaluation.
  8. 8 pages
  9. 9 current (published within the last five years 2017-2022) scholarly journal articles or primary legal sources (statutes, court opinions) within your work, NO WEBSITE REFERENCES

Quality In Health Care

Overview Of Quality In Health Care

The purpose of this assignment is to apply the concepts you have learned in this course to a situation you have encountered. Choose one quality or patient safety concern with which you are familiar and that you have not yet discussed in this course (Pressure Injuries). In a 1,250-1,500-word essay, reflect on what you have learned in this course by applying the concepts to the quality or patient safety concern you have selected. Include the following in your essay:

1. Briefly describe the issue and associated challenges.

2. Explain how EBP, research, and PI would be utilized to address the issue.

3. Explain the PI or QI process you would apply and discuss why you chose it.

4. Describe your data sources, including outcome and process data.

5. Explain how the data will be captured and disseminated.

6. Discuss which organizational culture considerations will be essential to the success of your work. This assignment uses a rubric.

Use a minimum of four peer-reviewed, scholarly sources as evidence.

APA Style Guidelines. This assignment uses a rubric.

 

Annotated Bibliography

Annotated Bibliography

Goal: Compile an annotated bibliography. Your bibliography should be based on the Weekly Article Summary related to clinical practice from week 1 through week 6 and should include the following:

1. a template to document useful data.
2. a brief overview of each article, including the research type, major findings, and conclusions.
3. a description of relevance of each article for clinical practice.

Submission Instructions:

  • The bibliography should be original and logically organized.
  • The bibliography should follow current APA format for citing and documenting references.
  • The bibliography should be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
  • Incorporate a minimum of 3 current (published within last five years) references from peer-reviewed journals.

Article summary1

The article focuses on the use of evidence-based practice service as a way of increasing patient satisfaction. The purpose of the research conducted was conducted to determine the impact of using evidence-based practice in emergency department and the resultant impact it has on patient satisfaction. In determining the link between evidence-based practice and patient satisfaction, a service nursing bundle as a quality improvement (QI) initiative was implemented. With the bundle, it was easier to determine the change in overall quality of care in terms of ratings and rankings (Skaggs et al, 2018).

The article is based on a quantitative study in that it focuses on the use of quantitative data and collection methods in collecting information used in making decisions. Quantitative research is distinguished by logic, data, and an objective viewpoint. The focus of quantitative research is on numerical and static data, as well as detailed, converging reasoning, as opposed to divergent thinking, which is the spontaneous, free-flowing generation of numerous ideas about a research issue (Guetterman & Fetters, 2018). In collecting data, random sampling was used in selecting samples from which data was collected. Observation audits were conducted on quality improvement initiative where all the nursing services were evaluated. Also, phone surveys were conducted to determine patients; feedbacks from the services offered.

The research question used in the study includes: Does implementation of quality improvement initiative yield to increased patient satisfaction? The quality improvement (QI) represented the evidence-based nursing practice while offering services within the emergency department. From the organization of the research study, a conclusion can be made that validity and reliability were attained. The principles of validity and reliability are often employed to gauge the effectiveness of a study. They give an indication of how accurate a method, approach, or test is. Reliability refers to the measure’s consistency, and validity refers to the measure’s correctness (Peeters & Harpe, 2020).

Reference Guetterman, T. C., & Fetters, M. D. (2018). Two methodological approaches to the integration of mixed methods and case study designs: A systematic review. American Behavioral Scientist, 62(7), 900-918. Peeters, M. J., & Harpe, S. E. (2020). Updating conceptions of validity and reliability. Research in Social and Administrative Pharmacy, 16(8), 1127-1130. Skaggs, M. K. D., Daniels, J. F., Hodge, A. J., & DeCamp, V. L. (2018). Using the evidence- based practice service nursing bundle to increase patient satisfaction. Journal of emergency nursing, 44(1), 37-45. https://www.sciencedirect.com/science/article/abs/pii/S0099176717305470

Weekly Article Summary 4

The article Barriers and facilitators of following perioperative internal medicine recommendations by surgical teams: a sequential, explanatory mixed-methods study is a write-up that examines the impact of patients undergoing perioperative consultation on treatment outcomes in patients preparing for surgical procedures. The study was a mixed-method study comprised of qualitative and quantitative research models. The purpose of the investigative study was to deduce the kinds of recommendations that healthcare providers usually fail to adhere to, to determine the intervention that will enhance the quality of care that patients receive postoperatively (Flemons et al., 2022). It aimed to answer an important research question: What types of recommendations are not followed during postoperative care, and what are the barriers and facilitators of this trend?

The method that the author used in the investigative study was a mixed model that examined the chart audits of over 250 patients and carried out semi-structured interviews on eighteen healthcare professionals. The authors incorporated an equal number of male and female participants and a substantially large number of participants. The purpose of encapsulating these measures was to ensure that the research was dependable (Damasceno, 2020). The result of the study showed that the healthcare providers fail to follow protocols recommended during the preoperative period, such as the prescribed anticoagulation management and cardiac biomarker surveillance process (Flemons et al., 2022). Further, the study results also indicated that failure to adhere to the recommended protocols was due to individual-level reasons such as the failure to examine notes made during preoperative consultations and system-level reasons such as failure to define the individuals tasked with implementing different roles in the clinical setting.

The study results caused the authors to conclude that only half of the recommendations made are usually followed, causing a significant gap in the quality of care that the patients received. Therefore, it is necessary to address the factors that contributed to the failure to follow the recommendation to increase healthcare providers’ adherence.

References

Damasceno, B. (2020). Research Methods and Designs. In Research on Cognition Disorders (pp. 123-137). Springer, Cham.

Flemons, K., Bosch, M., Coakeley, S., Muzammal, B., Kachra, R., & Ruzycki, S. M. (2022). Barriers and facilitators of following perioperative internal medicine recommendations by surgical teams: a sequential, explanatory mixed-methods study. Perioperative Medicine11(1), 1-12

Weekly Article Summary 5

The article named Patients’ and healthcare workers’ recommendations for a surgical patient safety checklist – a qualitative study articulates the essentiality of healthcare professionals using surgical checklists to ensure patients’ safety. It is a qualitative study aiming to pinpoint the views of ailing individuals and medical practitioners on the most significant components that should be encapsulated in the safety checklist (Harris et al., 2020). The primary research question that the study seeks to answer is: What risk factors and essential components should be included in a safety checklist designed for use before and after a surgical procedure?

The methodology that Harris et al. (2020) used in the study is a qualitative research design based on an exploratory model. Subsequently, it used a set of focus groups to compile the information needed to answer the research question. The use of focus groups in the study was significant because it ensured in-depth exploration of the issue to unearth meaningful content (O. Nyumba et al., 2018). The groups used informal interviews to compile the data, which was later documented and analyzed to find the critical elements identified in the study that answer the research question.

The themes that emerged from the study included the fact that the vital elements components that should be encapsulated in the checklist for use before surgical procedures should include availing the number of an individual who should be contacted in case an emergency arises and documenting the health status of the patients. On the other hand, the proposed information on postoperative checklists includes any complications that the surgical procedure may precipitate and any activities that the patient should avoid (Harris et al., 2020). Subsequently, it consists of the proposed strategy for ensuring medication safety and adequate pain relief. The patients and healthcare professionals also emphasized the need to make sufficient preparations before and after the surgery.

The information compiled from the study led the authors to conclude that creating a surgical checklist is a significant factor determining the outcomes of the surgical procedures. The list should incorporate all the vital components to help remember all the essential processes that should be performed to reduce cases of complication or unprecedented errors that undermine the quality of care that patients receive.

References

Harris, K., Søfteland, E., Moi, A. L., Harthug, S., Storesund, A., Jesuthasan, S., … & Haugen, A. S. (2020). Patients’ and healthcare workers’ recommendations for a surgical patient safety checklist–a qualitative study. BMC health services research20(1), 1-10.

O. Nyumba, T., Wilson, K., Derrick, C. J., & Mukherjee, N. (2018). The use of focus group discussion methodology: Insights from two decades of application in conservation. Methods in Ecology and evolution9(1), 20-32.

Weekly Article Summary 6

The article Environmental Needs, Barriers, and Facilitators for Optimal Healing in the Postoperative Process: A Qualitative Study of Patients’ Lived Experiences and Perceptions is investigative research whose purpose is to determine the needs of environmental needs of ailing individuals who have undergone surgical procedures, and the factors that bar or facilitate their chances of experiencing optimal healing (Hesselink et al., 2020). The query that the article aims to answer is: What are the environmental requirements of ailing individuals during post-operative care and what barriers and facilitators impact these needs?

Hesselink et al. (2020) use a qualitative research design to determine the impact of patients’ environment during the post-operative period on the speed with which they recuperate. They used the purposive sampling model to select a total of twenty-one patients. The purpose of using the sampling design was to ensure that the selected participants could provide the factual data needed to answer the research question. Subsequently, the diversity present in the population was also considered to ensure that the outcomes of the study did not have any biases that limit its credibility (Tracy, 2019). With adequate consent, the authors collected data by interviewing the patients to get their views on the aspects that impacted their healing process.

The outcomes compiled from the investigative research presented several noteworthy themes. Firstly, they perceived the ability to have adequate control over different aspects of the treatment process such as privacy as a significant aspect that determined the treatment outcomes (Hesselink et al., 2020). Subsequently, the presence of positive distracting features was identified as a significant aspect that hastened the healing process. A therapeutic healing environment further enhanced the healing process. On the other hand, barriers such as monotony and lack of control over the systems disrupted the healing process, while aspects such as involvement in the treatment process and adequate accommodations enhance the healing process.

The outcomes of the article lead the authors to conclude that the environment that patients stay in during the post-operative period has a significant impact on their healing. Therefore, healthcare providers should provide a positive environment to elicit positive outcomes in the treatment process.

References

Hesselink, G., Smits, M., Doedens, M., Nijenhuis, S. M., van Bavel, D., van Goor, H., & van de Belt, T. H. (2020). Environmental needs, barriers, and facilitators for optimal healing in the postoperative process: A qualitative study of patients’ lived experiences and perceptions. HERD: Health Environments Research & Design Journal13(3), 125-139.

Tracy, S. J. (2019). Qualitative research methods: Collecting evidence, crafting analysis, communicating impact. John Wiley & Sons.

Findings for a stroke

Findings for a stroke

Discuss characteristic findings for a stroke and how it affects the lives of patients and their families. Discuss the nurse’s role in supporting the patient’s psychological and emotional needs. Provide an example.