01/13W1H1

 

Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low birth weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community, or a population in your community. Provide the link to the resource in your post.

PICOT STATEMENT

Review the Topic Materials and the work completed in NRS-433V to formulate a PICOT statement for your capstone project.

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement: Evidence-Based Solution Nursing Intervention Patient Care Health Care Agency Nursing Practice

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.

MY PICOT STATEMENT IS DOWNLOADED IN FILES

Health Promotion Planning Project

Health Promotion Planning Project: Students will use a planning model to plan a health promotion program to reduce or improve on school bus safety, fire safety, oral hygiene, vegetables intake, playground safety, pedestrian safety among children or youth (elementary/middle/high school). (Planning models PRECEDE-PROCEED, MATCH, Intervention Mapping, CDCynergy, SMART, MAPP, Generalized Model for Program Planning). Topics will be assigned to students. No more than 5 students will be assigned the same topic. A 6-8 page paper, typed and double spaced will be required.Include all sources used (APA format). Project is due on November 15th. Project will be turned in under assignments titled: Health Promotion Planning Project. Assess objectives 5, 11. 

Health Promotion Planning Project Resource.doc

Evidence-based Research and Practice

Write a 500-word paper using APA Format Assignment:

A decision-making investigation often requires the investigator to do the following. List these FOUR investigations from your textbook and explain each one.

Discussion replay each, similarities less 5%, APA 6th, 2 references,

A minimum of 2 paragraphs 

Discussion

Advanced registered nurse practitioners (ARNPs) have to consider a broad range of factors when prescribing medicines. For instance, professionals in this area have to consider federal and state laws that regulate their practices. The focus on controlled substances is particularly important because registered nurses have a responsibility to prevent fraud and diversion (Klein, 2016). ARNPs have the authority to prescribe Schedule II, Schedule III, and Schedule IV drugs if they pass certification (Florida Board of Nursing, 2016). It is imperative to prevent tampering to prevent abuse and negative health effects when prescribing such substances. Similarly, nurses have to identify behavioral red flags and demonstrate outstanding communication skills when dealing with scammers (Klein, 2016).

Advanced practice nurses have to deal with a set of barriers that limit their ability to prescribe medicines. First of all, ARNPs have to consider such factors as state licensure and regulations. The situation has improved over the years, and such organizations as the American Association of Nurse Practitioners (AANP) seek to improve the prescriptive authority of nurse practitioners. Nevertheless, nurse practitioners have to deal with such issues as supervision and delegation. It is also noted that physician professional organizations believe that it is necessary to limit the scope of nursing practice because of such factors as the overall quality and safety of care (Hain & Fleck, 2014). Available research indicates that most of the concerns voiced by the opponents of unrestricted prescriptive authority are unreasonable. It is also suggested that payer policies affect the ability of registered nurses to prescribe medicines because of low reimbursement rates (Hain & Fleck, 2014). The situation is challenging because both public and private payers often prevent nurse practitioners from practicing independently. It may be beneficial to cooperate with policymakers to address the problem and eliminate the barriers that have an adverse effect on advanced practice nurse prescribers.

References

Florida Board of Nursing. (2016). Important legislative update regarding HB 423. Retrieved from https://floridasnursing.gov/new-legislation-impacting-your-profession/

Hain, D., & Fleck, L. M. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). DOI: 10.3912/OJIN.Vol19No02Man02

Klein, T. (2016). Legal and professional issues in prescribing. In T. M. Woo, & M. Robinson (Eds.), Pharmacotherapeutics for advanced practice nurse prescribers (4th ed.) (37-50). Philadelphia, PA: F. A. Davis Company.

Advanced Practice Nurses (APRNs) as health professionals, are tasked with the responsibility to care for and safeguard the health and safety of patients. One duty of care owed by APRNs is on ethical and legal prescribing of medication. APRNs are expected to adhere to strict standards of prescribing, which serve the needs of the patient, minimize medical errors as well as maintain high levels of professionalism and accountability (Mitchell & Oliphant, 2016). In 2007, the World health Organization (WHO), outlined 7 guidelines which were meant to serve as a universal regulatory framework for ethical prescribing for all health practitioners, including APRNs. They are as follows: (1)Evaluate and define the patient’s problem; (2) Determine the therapeutic objective of the drug therapy; (3) Select an appropriate medication; (4) Provide patients with information, warnings and instructions; (5) Monitor the patient regularly; (6) Consider drug costs when prescribing and (7) Use appropriate tools, such as prescribing software and electronic drug references, to reduce prescription errors.

While the role of APRNs has been extended to include drug prescription, the independence to do so is not absolute. The primary barrier to APRN prescribing involves state practice and licensure (Hain & Fleck, 2014). Only 22 states so far have given full independence to APRNS to prescribe to patients. In the majority of states, including Florida, APRNs can only prescribe with the supervision or collaboration of a qualified physician. Another major barrier lies in the lack of physician cooperation and goodwill. The American Medical Association for instance, is yet to accept and support APRNs as capable of handling independent practice (Hain & Fleck, 2014). Thirdly, APRNs grapple with a physician-biased insurance system that discriminates against nurse practice. Several payer policies and reimbursement models in various states fail to recognize nurse practitioners as primary care providers, thereby affecting the extent of APRN practice including prescription (Altman et al.,2016).

References

Altman, S. H., Butler, A. S., Shern, L., & National Academies of Sciences, Engineering, and Medicine. (2016). Removing Barriers to Practice and Care. In Assessing Progress on the Institute of Medicine Report the Future of Nursing. National Academies Press (US).

Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2).

Mitchell, A., & Oliphant, C. M. (2016). Responsibility for Ethical Prescribing. The Journal for Nurse Practitioners, 12(3), A20.

See the instructions in this website.

 

  Biblical Landscape Helps

Health Promotion Program, Part B2

Hi, i need the table i uploaded to be filled

Health Promotion Program, Part B2: Evidence-based Literature SearchYou will be expected to search for the highest level of evidence for your health promotion project. Please listen to the lecture on searching the evidence, use the services of the research librarian, and pull from the knowledge gained in NUR 39000 Nursing Research to complete this assignment. The Purdue Owl website is a great resource for you when citing your references in APA style.  

Self- Assessment of Learning Styles.pdf          .
JBI-Levels-of-Evidence(1).pdf

Library Resources: The reference librarian for the School of Nursing has created a very helpful website of library resources for this course. Click on the link below to accept this website:NUR 39400 Library Resource Guide

 https://mycourses.purdue.edu/bbcswebdav/pid-12421733-dt-content-rid-93949047_1/courses/pnw_45033.201920/JBI-Levels-of-Evidence%281%29.pdf

New JBI Levels of Evidence

Developed by the Joanna Briggs Institute Levels of Evidence and Grades of Recommendation Working Party October 2013

PLEASE NOTE: These levels are intended to be used alongside the supporting document outlining their use. Using Levels of Evidence does not preclude the need for careful reading, critical appraisal and clinical reasoning when applying evidence.

LEVELS OF EVIDENCE FOR EFFECTIVENESS

Level 1 – Experimental Designs

Level 1.a – Systematic review of Randomized Controlled Trials (RCTs)

Level 1.b – Systematic review of RCTs and other study designs

Level 1.c – RCT

Level 1.d – Pseudo-RCTs

Level 2 – Quasi-experimental Designs

Level 2.a – Systematic review of quasi-experimental studies

Level 2.b – Systematic review of quasi-experimental and other lower study designs

Level 2.c – Quasi-experimental prospectively controlled study

Level 2.d – Pre-test – post-test or historic/retrospective control group study

Level 3 – Observational – Analytic Designs

Level 3.a – Systematic review of comparable cohort studies

Level 3.b – Systematic review of comparable cohort and other lower study designs

Level 3.c – Cohort study with control group

Level 3.d – Case – controlled study

Level 3.e – Observational study without a control group

Page | 2

Level 4 – Observational –Descriptive Studies

Level 4.a – Systematic review of descriptive studies

Level 4.b – Cross-sectional study

Level 4.c – Case series

Level 4.d – Case study

Level 5 – Expert Opinion and Bench Research

Level 5.a – Systematic review of expert opinion

Level 5.b – Expert consensus

Level 5.c – Bench research/ single expert opinion

Page | 3

LEVELS OF EVIDENCE FOR DIAGNOSIS

Level 1 – Studies of Test Accuracy among consecutive patients

Level 1.a – Systematic review of studies of test accuracy among consecutive patients

Level 1.b – Study of test accuracy among consecutive patients

Level 2 – Studies of Test Accuracy among non-consecutive patients

Level 2.a – Systematic review of studies of test accuracy among non-consecutive patients

Level 2.b – Study of test accuracy among non-consecutive patients

Level 3 – Diagnostic Case control studies

Level 3.a – Systematic review of diagnostic case control studies

Level 3.b – Diagnostic case-control study

Level 4 – Diagnostic yield studies

Level 4.a – Systematic review of diagnostic yield studies

Level 4.b – Individual diagnostic yield study

Level 5 – Expert Opinion and Bench Research

Level 5.a – Systematic review of expert opinion

Level 5.b – Expert consensus

Level 5.c – Bench research/ single expert opinion

Page | 4

LEVELS OF EVIDENCE FOR PROGNOSIS

Level 1 – Inception Cohort Studies

Level 1.a – Systematic review of inception cohort studies

Level 1.b – Inception cohort study

Level 2 – Studies of All or none

Level 2.a – Systematic review of all or none studies

Level 2.b – All or none studies

Level 3 – Cohort studies

Level 3.a – Systematic review of cohort studies (or control arm of RCT)

Level 3.b – Cohort study (or control arm of RCT)

Level 4 – Case series/Case Controlled/ Historically Controlled studies

Level 4.a – Systematic review of Case series/Case Controlled/ Historically Controlled studies

Level 4.b – Individual Case series/Case Controlled/ Historically Controlled study

Level 5 – Expert Opinion and Bench Research

Level 5.a – Systematic review of expert opinion

Level 5.b – Expert consensus

Level 5.c – Bench research/ single expert opinion

Page | 5

LEVELS OF EVIDENCE FOR ECONOMIC EVALUATIONS

Levels

1. Decision model with assumptions and variables informed by systematic review and tailored to fit the decision making context.

2. Systematic review of economic evaluations conducted in a setting similar to the decision makers.

3. Synthesis/review of economic evaluations undertaken in a setting similar to that in which the decision is to be made and which are of high quality (comprehensive and credible measurement of costs and health outcomes, sufficient time period covered, discounting, and sensitivity testing).

4. Economic evaluation of high quality (comprehensive and credible measurement of costs and health outcomes, sufficient time period covered, discounting and sensitivity testing) and conducted in setting similar to the decision making context.

5. Synthesis / review of economic evaluations of moderate and/or poor quality (insufficient coverage of costs and health effects, no discounting, no sensitivity testing, time period covered insufficient).

6. Single economic evaluation of moderate or poor quality (see directly above level 5 description of studies). 7. Expert opinion on incremental cost effectives of intervention and comparator.

Page | 6

LEVELS OF EVIDENCE FOR MEANINGFULNESS

1. Qualitative or mixed-methods systematic review

2. Qualitative or mixed-methods synthesis

3. Single qualitative study

4. Systematic review of expert opinion

5. Expert opinion

NUR-631-D4Q2 redo

 Minimum of 300 words with at least 2 peer review reference in 6th edition APA style. 

  Discuss the epidemiology of thalassemia and share evidence-based practice guidelines necessary for chronic management. Sickle-cell anemia has treatment parameters in the chronic state and acute exacerbation. The acute phase requires aggressive hydration and pain medication. What is the physiologic pattern for this problem?

Article essay

3 page typed paper using APA format on an article from a recent journal of nursing( article provided)

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Persuasive Esay Topic: Physician Assisted-Suicide

After you find a credible source that can be used for your persuasive essay, identify it. Then, explain how the source fared with the C.R.A.A.P test by answering the following questions in one fully developed paragraph: What were the total points the source earned on the test? Where did it earn the most points? How did it earn these points? Where did it earn the least points? Why did it lose points here? How will this source help support the main argument (or counterargument) of your essay?