Becoming a Leader in the Translation of Evidence to Practice

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Application 3: Becoming a Leader in the Translation of Evidence to Practice

Reflect on your growth, professionally and personally, since you embarked on your DNP journey. The AACN believes that one of the benefits of a practice doctorate is that it enhances your leadership skills to “strengthen practice and health care delivery” (2006, p. 5). As you continue to engage in your practicum experience, be cognizant of your growth in these areas.

In Week 6, you were asked to reflect on your leadership skills for this Assignment. This week, you continue your reflection on leadership and how you can lead the translation of evidence to practice through contribution to policy development.

Prepare for this week’s section of Application 3 as follows: Building      on the work you began in Week 6 for this Application, review this week’s      Discussion posting, and consider how you can lead policy development to      address your EBP Project issue.

To complete:

Due tomorrow 10/11/18 before midnight

Write a 2- to 3-page paper in APA format with a minimum of 5 scholarly references less than 5 years old that synthesizes (DO NOT GO OVER THREE PAGES): Your      vision of yourself as a leader—specifically:

1) How you would continue to increase your knowledge and awareness of financial, economic, and other concerns related to new practice approaches (see week 6 discussion attached you did for me, except focus on the critics the professor added for me [see bold and underlined professor critique below] which you failed to include in this discussion 

2) How translating evidence would enable you to affect or strengthen health care delivery and nursing practice

3) How you would advocate for the use of new evidence-based practice approaches through the policy arena (see week 7 discussion attached you did for me)

Professor Critics in week 6 on the cost and financial impact of the implementation of the project 

Dear student: Thank you for your contribution to this week’s discussion.  You brought forward potential costs associated with increased mobilization of ICU patients….namely the need for more nurse time.  Do you have some hard numbers you can provide on the potential cost of this? Do you have any local or national information on the cost of not mobilizing the patients (longer stays, increased infection, readmission)? Calculating approximate cost associated with the practice change versus the cost of not changing is important. This will help stakeholders see the value in the investment.

Required Readings

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). Translation of evidence into nursing and health care practice (2nd ed.). New York, NY: Springer. Chapter      6, “Translation of Evidence for Leadership”

Balakas, K., Sparks, L., Steurer, L., & Bryant, T. (2013). An outcome of evidence-based practiced education: Sustained clinical decision-making among bedside nurses. Journal of Pediatric Nursing, 28, 479-485.

 

Brown, D.S. (2012). Interview with quality leaders: Dr. Donna E. Shalala and Dr. Linda Burnes Bolton on the committee on the Robert Wood Johnson Foundation initiative on the future of nursing at the Institute of Medicine. Journal for Healthcare Quality, 24(4), 40-44.

Brandt, B., Lutfiyya, M.N., King, J.A., & Chioresco, C. ( 2014). A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim. Journal of Interprofessional Care, 28(5), 393-399.

Grindel, C.G. (2016). Clinical leadership: A call to action. Med-Surg Nursing, 25(1), 9-16.

Mannix, J., Wilkes, L, & Daly, J. (2015). Grace under fire: Aesthetic leadership in clinical nursing, Journal of Clinical Nursing, 24, 2649-2658.

Stetler, C.B., Ritchie, J.A., Rycroft-Malone, J., & Charns, M.P. (2014). Leadership for evidence-based practice: Strategic and functional behaviors for institutionalizing EBP. Worldviews on Evidence-Based Nursing, 11(4), 219-226. 

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). Translation of evidence into nursing and health care practice (2nd ed.). New York, NY: Springer. Chapter      4, “Translation of Evidence to Improve Clinical Outcomes” Chapter      5, “Translation of Evidence for Improving Safety and Quality” Chapter      7, “Translation of Evidence for Health Policy” (See attached file)

Andermann, A., Pang, T., Newton, J.T., Davis, A., & Panisset, U. (2016). Evidence for health II: Overcoming barriers to using evidence in policy and practice. Health Research Policy and Systems, 14 (17) doi 10.1186/s12961-016-0086-3

Catallo, C. & Sidani, S. The self-assessment for organizational capacity instrument for evidence-informed health policy: Preliminary reliability and validity of an instrument (2014). Worldviews on Evidence-Based Nursing, 11(1), 35–45.

Malterud, K., Bjelland, K., & Elvbakken, K.T. (Evidence-based medicine – an appropriate tool for evidence-based health policy? A case study from Norway. Health Research Policy and Systems, 14 (15) doi 10.1186/s12961-016-0088-1

Rehfuess, E.A., Durao, S., Kyamanywa, P., Meerpohl, J. J., Young, T., & Rohwer, A. (2016). An approach for setting evidence-based and stakeholder-informed research priorities in low- and middle-income countries, Policy & Practice, 94, 297–305 doi: http://dx.doi.org/10.2471/BLT.15.162966

Schaffer, M.A., Sandau, K.E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing, 69(5), 1197-1209 (see attached file).

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients 

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients 

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months

FOLLOW THE INSTRUCTIONS EXACTLY AS IN THE GRADING RUBRIC ATTACHED IN THE FILE AREA (see attached file) APA format and minimum of 5 scholarly references less than 5 years old.

Nursing developing personal nursing philosophy

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3 pages

APA format

2central concepts

description of a theory and how it supports my personal theory 

2 peer reviewed journal sources

Interprofessional Practice and Collaboration

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Assignment Details

Interprofessional Practice and Collaboration:

The future of health care delivery will require multidisciplinary teams of health care professionals that collaborate to provide patient-centered care. The key to high performance in multidisciplinary teams is an understanding of the distinctive roles, skills, and values and ethics of all team members. What will be your role as an NP and how do you see yourself collaborating with other health care professionals? Why is this important to know and understand? Who benefits? Who are the stakeholders.Support your work with examples and evidence-based research.

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements:

Before finalizing your work, you should: be sure to read the Assignment description carefully(as displayed above); consult the Grading Rubric(under the Course Resources) to make sure you have included everything necessary; and Utilize spellingand grammar check to minimize errors.

Your writingAssignment should: follow the conventions of Standard English(correct grammar, punctuation, etc.); be well ordered,logical,and unified,as well as original and insightful; display superior content, organization, style, andmechanics; and use APA 6th Editionformat as outlined in the APA Progression Ladder.

Cultural Competence in the Health History and Physical Examination

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 1) **********3 full pages**************************** (cover or reference page not included)
2)¨**********APA norms
3)********** It will be verified by Turnitin and SafeAssign
4) **********References from the last 5 years  

_______________________________________________________

Present an discussing the importance of “Cultural Competence in the Health History and Physical Examination” .

Check the power point attached

physical therapy test

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1- A swimmer is having difficulty with her right arm. She reports that it is always cold, at times somewhat weak, and she is unable to detect sharp and dull sensations. What possible condition might she have, and how would you evaluate this injury

 

 

 

 

 

2.A baseball pitcher is experiencing anterior shoulder pain, especially in the middle of his throwing motion. How would you evaluate this condition, and what possible injuries might he have?

 

 

 

 

South University NSG5003 Midterm Exam 2019

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 What causes the rapid change in the resting membrane potential to initiate an action potential?
Question 1 options:
               Potassium gates open and potassium rushes into the cell, changing the membrane potential from negative to positive
               Sodium gates open and sodium rushes into the cell, changing the membrane potential from negative to positive.
               Sodium gates close, allowing potassium into the cell to change the membrane potential from positive to negative.
               Potassium gates close, allowing sodium into the cell to change the membrane potential from positive to negative.
 

Question 2
 

What is a consequence of leakage of lysosomal enzymes during chemical injury?
Question 2 options:
               Enzymatic digestion of the nucleus and nucleolus occurs, halting deoxyribonucleic acid (DNA) synthesis.
               Influx of potassium ions into the mitochondria occurs, halting the adenosine triphosphate (ATP) production.
               Edema of the Golgi body occurs, preventing the transport of proteins out of the cell.
               Shift of calcium out of the plasma membrane occurs, destroying the cytoskeleton.
 

Question 3
 

In hypoxic injury, sodium enters the cell and causes swelling because:
Question 3 options:
               The cell membrane permeability increases for sodium during periods of hypoxia.
               Adenosine triphosphate (ATP) is insufficient to maintain the pump that keeps sodium out of the cell.
               The lactic acid produced by the hypoxia binds with sodium in the cell.
               Sodium cannot be transported to the cell membrane during hypoxia.
 

Question 4
 

What mechanisms occur in the liver cells as a result of lipid accumulation?
Question 4 options:
               Obstruction of the common bile duct, preventing the flow of bile from the liver to the gallbladder
               Increased synthesis of triglycerides from fatty acids and decreased synthesis of apoproteins
               Increased binding of lipids with apoproteins to form lipoproteins
               Increased conversion of fatty acids to phospholipids
 

Question 5
 

Which solution is best to use when cleaning a wound that is healing by 101. During an Immunoglobulin E (IgE)-mediated hypersensitivity reaction, the degranulation of mast cells is a result of which receptor action?
Question 5 options:
               Histamine bound to H2
               Chemotactic factor binding to the receptor
               Epinephrine bound to mast cells
               Acetylcholine bound to mast cells
 

Question 6
 

What is the mechanism that results in type II hypersensitivity reactions?
Question 6 options:
               Antibodies coat mast cells by binding to receptors that signal its degranulation, followed by a discharge of preformed mediators.
               Antibodies bind to soluble antigens that were released into body fluids, and the immune complexes are then deposited in the tissues.
               Cytotoxic T (Tc) lymphocytes or lymphokine-producing helper T 1 (Th1) cells directly attack and destroy cellular targets.
               Antibodies bind to the antigens on the cell surface.
 

Question 7
 

Type III hypersensitivity reactions are a result of which of the following?
Question 7 options:
               Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators
               Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
               Cytotoxic T (Tc) cells or lymphokine-producing helper T 1 (Th1) cells directly attacking and destroying cellular targets
               Antibodies binding to the antigen on the cell surface
 

Question 8
 

Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host deoxyribonucleic acid (DNA) is the cause of which disease?
Question 8 options:
               Hemolytic anemia
               Pernicious anemia
               Systemic lupus erythematosus
               Myasthenia gravis
 

Question 9
 

Why does tissue damage occur in acute rejection after organ transplantation?
Question 9 options:
               Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T (Tc) cells directly attack the endothelial cells of the transplanted tissue.
               Circulating immune complexes are deposited in the endothelial cells of transplanted tissue, where the complement cascade lyses tissue.
               Receptors on natural killer (NK) cells recognize antigens on the cell surface of the transplanted tissue, which releases lysosomal enzymes that destroy tissue.
               Antibodies coat the surface of the transplanted tissue to which mast cells bind and liberate preformed chemical mediators that destroy tissue.
 

Question 10
 

Oncogenes are genes that are capable of:
Question 10 options:
               Undergoing mutation that directs the synthesis of proteins to accelerate the rate of tissue proliferation
               Directing synthesis of proteins to regulate growth and to provide necessary replacement of tissue
               Encoding proteins that negatively regulate the synthesis of proteins to slow or halt the replacement of tissue
               Undergoing mutation that directs malignant tissue toward blood vessels and lymph nodes for metastasis
 

Question 11
 

After the baroreceptor reflex is stimulated, the resulting impulse is transmitted from the carotid artery by which sequence of events?
Question 11 options:
               From the vagus nerve to the medulla to increase parasympathetic activity and to decrease sympathetic activity
               From the glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase sympathetic activity and to decrease parasympathetic activity
               From the glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase parasympathetic activity and to decrease sympathetic activity
               From the glossopharyngeal cranial nerve through the vagus nerve to the hypothalamus to increase parasympathetic activity and to decrease sympathetic activity
 

Question 12
 

Regarding the endothelium, what is the difference between healthy vessel walls and those that promote clot formation?
Question 12 options:
               Inflammation and roughening of the endothelium of the artery
               Hypertrophy and vasoconstriction of the endothelium of the artery
               Excessive clot formation and lipid accumulation in the endothelium of the artery
               Evidence of age-related changes that weaken the endothelium of the artery
 

Question 13
 

What is the expected electrocardiogram (ECG) pattern when a thrombus in a coronary artery permanently lodges in the vessel and the infarction extends through the myocardium from the endocardium to the epicardium?
Question 13 options:
               Prolonged QT interval
               ST elevation myocardial infarction (STEMI)
               ST depression myocardial infarction (STDMI)
               Non-ST elevation myocardial infarction (non-STEMI)
 

Question 14
 

A patient reports sudden onset of severe chest pain that radiates to the back and worsens with respiratory movement and when the patient is lying down. These clinical manifestations describe:
Question 14 options:
               Myocardial infarction (MI)
               Pericardial effusion
               Restrictive pericarditis
               Acute pericarditis
 

Question 15
 

Respirations that are characterized by alternating periods of deep and shallow breathing are a result of which respiratory mechanism?
Question 15 options:
               Decreased blood flow to the medulla oblongata
               Increased partial pressure of arterial carbon dioxide (PaCO2), decreased acid-base balance (pH), and decreased partial pressure of arterial oxygen (PaO2)
               Stimulation of stretch or J-receptors
               Fatigue of the intercostal muscles and diaphragm
 

Question 16
 

Which cytokines activated in childhood asthma produce an allergic response?
Question 16 options:
               IL-1, IL-2, and interferon-alpha (IFN-α)
               L-8, IL-12, and tumor necrosis factor–alpha (TNF-α)
               IL-4, IL-10, and colony-stimulating factor (CSF)
               IL-4, IL-5, and IL-13
 

Question 17
 

Which statement accurately describes childhood asthma?
Question 17 options:
               An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
               A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest X-ray imaging
               A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, the pancreas, the sweat ducts, and the vas deferens
               An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency
               Improvement on a trial of asthma medication
 

Question 18
 

Which statement best describes cystic fibrosis?
Question 18 options:
               Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
               Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest X-ray imaging
               A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that obstructs the airways, the pancreas, the sweat ducts, and the vas deferens
               A pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency
 

Question 19
 

What are the abnormalities in cytokines found in children with cystic fibrosis?
Question 19 options:
               A deficit of IL-1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α)
               A deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)
               A deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α
               A deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)
 

Question 20
 

Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?
Question 20 options:
               Retropharyngeal abscess
               Laryngospasms
               Rupturing of the tonsils
               Gagging induced aspiration
 

Question 21
 

Free radicals play a major role in the initiation and progression of which diseases?
Question 21 options:
               Cardiovascular diseases, such as hypertension and ischemic heart disease
               Renal diseases, such as acute tubular necrosis and glomerulonephritis
               Gastrointestinal diseases, such as peptic ulcer disease and Crohn disease
               Muscular diseases, such as muscular dystrophy and fibromyalgia
 

Question 22
 

What is a consequence of plasma membrane damage to the mitochondria?
Question 22 options:
                Enzymatic digestion halts deoxyribonucleic acid (DNA) synthesis.
               Influx of calcium ions halts adenosine triphosphate (ATP) production.
               Edema from an influx in sodium causes a reduction in ATP production.
               Potassium shifts out of the mitochondria, which destroys the infrastructure.
 

Question 23
 

In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces?
Question 23 options:
               Oncotic pressure
               Buffering
               Net filtration
               Hydrostatic pressure
 

Question 24
 

Venous obstruction is a cause of edema because of an increase in which pressure?
Question 24 options:
               Capillary hydrostatic
               Interstitial hydrostatic
               Capillary oncotic
               Interstitial oncotic
 

Question 25
 

At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because:
Question 25 options:
               The interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure.
               The capillary hydrostatic pressure is higher than the capillary oncotic pressure.
               The interstitial oncotic pressure is higher than the interstitial hydrostatic pressure.
               The capillary oncotic pressure is lower than the interstitial hydrostatic pressure.
 

Question 26
 

Secretion of antidiuretic hormone (ADH) and the perception of thirst are stimulated by:
Question 26 options:
               A decrease in serum sodium
               An increase in plasma osmolality
               An increase in the glomerular filtration rate
               A decrease in osmoreceptor stimulation
 

Question 27
 

Some older adults have impaired inflammation and wound healing because of which problem?
Question 27 options:
               The circulatory system cannot adequately perfuse tissues.
               Complement and chemotaxis are deficient.
               Underlying chronic illnesses exist.
               The number of mast cells is insufficient.
 

Question 28
 

Lead poisoning affects the nervous system by:
Question 28 options:
               Interfering with the function of neurotransmitters
               Inhibiting the production of myelin around the nerves
               Increasing the resting membrane potential
               Altering the transport of potassium into the nerves
 

Question 29
 

Carbon monoxide causes tissue damage by:
Question 29 options:
               Competing with carbon dioxide so that it cannot be excreted
               Binding to hemoglobin so that it cannot carry oxygen
               Destroying the chemical bonds of hemoglobin so it cannot carry oxygen
               Removing iron from hemoglobin so it cannot carry oxygen
 

Question 30
 

Which statement is true regarding the difference between subdural hematoma and epidural hematoma?
Question 30 options:
               No difference exists, and these terms may be correctly used interchangeably.
               A subdural hematoma occurs above the dura, whereas an epidural hematoma occurs under the dura.
               A subdural hematoma is often the result of shaken baby syndrome, whereas an epidural hematoma rapidly forms as a result of a skull fracture.
               A subdural hematoma usually forms from bleeding within the skull, such as an aneurysm eruption, whereas an epidural hematoma occurs from trauma outside the skull, such as a blunt force trauma.
 

Question 31
 

What physiologic change occurs during heat exhaustion?
Question 31 options:
               Hemoconcentration occurs because of the loss of salt and water.
               Cramping of voluntary muscles occurs as a result of salt loss.
               Thermoregulation fails because of high core temperatures.
               Subcutaneous layers are damaged because of high core temperatures.
 

Question 32
 

Hemoprotein accumulations are a result of the excessive storage of:
Question 32 options:
               Iron, which is transferred from the cells to the bloodstream
               Hemoglobin, which is transferred from the bloodstream to the cells
               Albumin, which is transferred from the cells to the bloodstream
               Amino acids, which are transferred from the cells to the bloodstream
 

Question 33
 

Hemosiderosis results in what substance being stored in excess as hemosiderin in cells of many organs and tissues?
Question 33 options:
               Hemoglobin
               Ferritin
               Iron
               Transferrin
 

Question 34
 

What two types of hearing loss are associated with noise?
Question 34 options:
               Acoustic trauma and noise induced
               High frequency and low frequency
               High frequency and acoustic trauma
               Noise induced and low frequency
 

Question 35
 

What type of necrosis results from ischemia of neurons and glial cells?
Question 35 options:
               Coagulative
               Liquefactive
               Caseous
               Gangrene
 

Question 36
 

During cell injury caused by hypoxia, sodium and water move into the cell because:
Question 36 options:
               Potassium moves out of the cell, and potassium and sodium are inversely related.
               The pump that transports sodium out of the cell cannot function because of a decrease in adenosine triphosphate (ATP) levels.
               The osmotic pressure is increased, which pulls additional sodium across the cell membrane.
               Oxygen is not available to bind with sodium to maintain it outside of the cell.
 

Question 37
 

In decompression sickness, emboli are formed by bubbles of:
Question 37 options:
               Oxygen
               Nitrogen
               Carbon monoxide
               Hydrogen
 

Question 38
 

What is an example of compensatory hyperplasia?
Question 38 options:
               Hepatic cells increase cell division after part of the liver is excised.
               Skeletal muscle cells atrophy as a result of paralysis.
               The heart muscle enlarges as a result of hypertension.
               The size of the uterus increases during pregnancy.
 

Question 39
 

Current research has determined that chemical-induced cellular injury:
Question 39 options:
               Affects the permeability of the plasma membrane
               Is often the result of the damage caused by reactive free radicals
               Is rarely influenced by lipid peroxidation
               Seldom involves the cell’s organelles
 

Question 40
 

What is the inflammatory effect of nitric oxide?
Question 40 options:
               It increases capillary permeability and causes pain.
               It increases neutrophil chemotaxis and platelet aggregation.
               It causes smooth muscle contraction and fever.
               It decreases mast cell function and decreases platelet aggregation. 

DQ91 RESPONSE

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Dorothy Troutman    4 posts   Re: Topic 9 DQ 1  One of my personal strengths regarding professional presentations is my ability to explain things. I enjoy teaching and helping people understand information. One way that I can improve this is to make sure that I use simple language so that everyone in my audience is able to understand the material.  One of my personal weaknesses is keeping my presentation short. I feel like completing my BSN has helped me with this. The limited word count on our assignments has helped me to be more concise. Practicing my presentation will help me stay within my allotted time.  It is important for me to improve these skills if I plan to present in a more formal setting so I may provide my audience with clear communication and demonstrate respect for their time by staying within the allotted time.  To be a successful speaker, one must know their audience, adjust the presentation as needed, and have planned outcomes both for the speaker and audience (Zamfir, 2019).     Refernce  Zamfir, C., M. (2019). Effective strategies for successful presentations: An NLP analysis.  Ovidius University Annals: Economic Sciences Series,(1), 333. Retrieved from https://search-ebscohost-  com.lopes.idm.oclc.org/login.aspxdirect=true&db=edsdoj&AN=edsdoj.9c771af8424a4dbf80fed977d3de4  e07&site=eds-live&scope=site

Healthy People 2020 – Falls (State of Florida)

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Please read rubric. 3 pages of work and must include all the requirements. APA format and excellent grammar. I’ve seen a lot here trust me. 

Due date also very important! Observe all the highlighted words, frases, etc as it’s important points. 

Module 05 Written Assignment – Normal Changes in Pregnancy

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Create a paper, power point, or Prezi presentation to demonstrate your knowledge of this week’s learning objectives. Your presentation should cover the following topic fully, and be correctly cited in APA format. Minimum 1 – 2 page paper or 10 slide presentation, not including your cover sheet/ slide and reference page/ slide.

You are approached by a neighbor and her 16 year old daughter who just found out she is pregnant. The neighbor and her daughter want to know what to expect during the pregnancy. Outline for this mother and daughter what to expect during each of the trimesters.

literature

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This is the third and final week allocated to the development of your literature review section of your Capstone. Each subsection of your literature review should be 3–5 pages, totaling a completed literature review of 9–15 pages. By the end of this week, you will also have a reference list with at least 25 scholarly resources which are present throughout you literature review section.