Project Overview

In this project, you will reflect on your worldview and how it affects your understanding of the world around you. Then, you will research the culture of another country and share strategies for collaborating between and among cultures.

This work will help you practice cultural competency and awareness. These are important skills in the modern diverse workplace.

Competency

In this project, you will demonstrate your mastery of the following competency:

Describe perspectives of more than one worldview in real-world interactions
Scenario

You work for Agua Sin Fronteras (ASF, or “Water Without Borders”), an international nonprofit. ASF works to provide access to clean drinking water, improve sanitation, and deliver health education programs. Globally, children living in urban poverty have little control over their water sources. The United Nations Children’s Fund (UNICEF) awarded funding to ASF to work on solving this problem. ASF plans to use this money to expand its efforts into new countries.

Your supervisor, Sue Edge, asked you to be on a committee that recommends countries for ASF’s programs. These programs include the following:

Building wells
Installing water purification systems
Creating educational materials about water health
Directions

Committee Orientation ActivityThe committee leader, Ty Dalwave, wants the team to be aware of their biases when doing research. To build that awareness, he has asked everyone to reflect on their worldview by doing the following:
Describe your worldview, including how it changes and forms.
How do you view the world?
How do you understand how the world works? How do you understand your purpose in the world?
What assumptions, beliefs, and values affect how you explain the world, understand your circumstances, and live your life?
How did your worldview develop? How has it changed over time?
Explain how your worldview affects the way you interact and perceive others at work.
How could your worldview affect your interactions with and perceptions of your coworkers?
Committee BriefNow that you’ve reflected on your worldview and its effect on how you navigate the world, you are ready to start researching. As a committee member, you will investigate the social, political, and cultural situations of another country and report what you learn to the group.
Choose a country to research.Choose a country that you are not familiar with and would like to learn more about.Note: For this project, you should assume that ASF’s worldview is the same as your own. For this reason, you must investigate a country that’s different from your own.
Research your chosen country.Use the Country Analysis Questions document to help you research your chosen country’s social, political, and cultural situations.If you would like to, you can do some of your own research beyond the country profiles information provided in the Supporting Materials section. Remember to use authoritative sources and cite them in your work.
Explore how ASF could conduct operations in your selected country.The committee wants you to present your findings in a committee brief. Remember to assume that ASF’s worldview is the same as your own and base your responses on that. In your committee brief, include the following information:
The name of your selected country
A summary of the country’s geography, government, health, education, culture, economy, and history
A discussion of how you think various groups in your selected country would perceive ASF’s work:
What potential sources of conflict do you expect? Brainstorm and describe at least three.
How do people in your own country interact in groups and at work? How does this compare to your selected country?
Propose at least three actionable solutions to address potential conflict and foster collaboration. Consider the following question:
If ASF started working in the country that you chose, what recommendations would you make to support collaboration and avoid conflict between differing worldviews?
What to Submit

Every project has a deliverable or deliverables, which are the files that must be submitted before your project can be assessed. For this project, you must submit the following:

Committee Orientation ActivityReflect on your worldview and describe how it affects your interactions and feelings of others. This should be 250–500 words (about 1–2 pages).
Committee BriefResearch and write a summary of the social, political, and economic situations of the country you chose. Then, discuss how ASF would be perceived in that country. Identify potential conflicts, and propose ways to reduce conflict and increase collaboration. Your committee brief should be 750–1,200 words (about 3–5 pages). Note: Do not submit the Country Analysis Questions document.

Discussion Question:

Define patient-centeredness in the context of evidence-based practice. Describe barriers to the implementation of patient-centered evidence-based care in your practice environment and share actions that might be taken to alleviate these barriers.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook.

Assignment:

Evidence-Based Practice Guideline

Write a fully developed and detailed APA essay addressing each of the following points/questions. There is no required word count; be sure to completely answer all the questions for each question in detail. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Sources are not required; however, if sources are used make sure to cite using the APA writing style for the essay and complete a reference page. The cover page is required. Review the rubric criteria for this assignment.

Utilize the databases identified in the text to locate an Evidence-Based Practice Guideline, related to your topic identified in Module 1. Perform a rapid critical appraisal of the Evidence-Based Guideline by answering the following questions in APA format. All questions should be answered in detail and explanations offered according to guideline content when applicable.

Who were the guideline developers?
Were the developers of the guideline representative of key stakeholders in this specialty (inter-disciplinary)?
Who funded the guideline development?
Were any of the guideline developers funded researchers of the reviewed studies?
Did the team have a valid development strategy?
Was an explicit (how decisions were made), sensible, and impartial process used to identify, select, and combine evidence?
Did its developers carry out comprehensive, reproducible literature review within the past 12 months of its publication/revision?
Were all important options and outcomes considered?
Is each recommendation in the guideline tagged by the level/strength of evidence upon which it is based and linked to the scientific evidence?
Do the guidelines make explicit recommendations (reflecting value judgments about the outcomes)?
Has the guideline been subjected to peer review and testing?
Is the intent of use provided (i.e. national, regional, local)?
Are the recommendations clinically relevant?
Will the recommendations help me in caring for my patients?
Are the recommendations practical/feasible? Are resources (people and equipment) available?
Are the recommendations a major variation from current practice? Can the outcomes be measured through standard care?
Be sure to include the database from which the guideline was obtained and please submit a copy of the guideline with your paper.

Your APA formatted paper fully answer each question in complete sentences.

Assignment Expectations:

Length: Clearly and fully answer all questions; include database; attach a copy of the guidelineStructure: Include a title page and reference page (if sources were used) in APA format. Your essay must include an introduction and a conclusion.References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. No minimum sources are required for this assignment; if sources are used APA format is required.

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1. Complete the palliative nursing care plan for a person who requires the maintenance of oral health.

The maintenance of oral health is related to the changes in the hydration and nutritional requirements of a person during palliative care and at end-of-life.

Refer to specific instruction listed above to clarify what information is expected in each column

Nursing Assessment and Identification of Actual or Potential issue	Planning	Implementation	Evaluation – assessment of the desired outcome
Actual problem – oral health Nursing assessment: Patient can experience a dry mouth due to dehydration or side effects of medication.	Specific ☐ Measurable ☐ Achievable ☐ Realistic ☐ Time-bound ☐	Ensure the patient is having adequate amounts of water to stay hydrated and make sure to Maintain the use of lubricating ointment on the lips to prevent drying and cracking.	After these interventions have been put into place, the patient will be hydrated and the risk of developing infection will be reduced.

1. Complete the palliative nursing care plan for personal care who has the potential problem of cachexia in relation to changes to their hydration and nutrition requirement during palliative care and end of life

Refer to specific instruction to clarify what information is expected in each column

Nursing Assessment and Identification of Actual or Potential issue	Planning	Implementation	Evaluation – assessment of the desired outcome
Potential problem – Cachexia Nursing assessment: Patient experiencing extreme weight loss and muscle wasting.	Specific ☐ Measurable ☐ Achievable ☐ Realistic ☐ Time-bound ☐	Ensure the patient is having a high intake of food and fluids to be getting the adequate amount of nutrition. Refer the Pt to a dietician. Weigh the Pt daily to see if there’s a decrease or increase in weight.	After these interventions have been put into place, the patient will start to get the right amount of nutrition in the body to slowly start gaining weight.

1. Complete a palliative nursing care plan for pain management including common non-pharmaceutical and complementary care for a person requiring a palliative approach to care

Refer to specific instruction to clarify what information is expected in each column

Nursing Assessment and Identification of Actual or Potential issue	Planning	Implementation	Evaluation – assessment of the desired outcome
Pain Management – Non pharmaceutical and complementary care Nursing assessment: The patient may be experiencing pain due to developing pressure sores.	Specific ☐ Measurable ☐ Achievable ☐ Realistic ☐ Time-bound ☐	Ensure to reposition the patient every 2 hours and provide support such as a pillow. Also provide pressure area care and ensure the patient is maintaining good nutrition + keep the skin clean and dry.	After these interventions have been put into place, the patient will have a reduction in pain and pressure sores. Reduced risk of further impairment of skin integrity.

1. Complete a nursing care plan of pain management including medication administered using a syringe driver or intima sub cut lines for a person requiring a palliative approach to care
2. Refer to specific instruction to clarify what information is expected in each column
   

   Nursing Assessment and Identification of Actual or Potential issue	Planning	Implementation	Evaluation – assessment of the desired outcome
   Maintenance and usage of sub cut line pain relief, anti-nausea, and steroid injection	Specific ☐ Measurable ☐ Achievable ☐ Realistic ☐ Time-bound ☐	Name four indications for the use of sub cut lines: Severe nausea and/or vomiting. Dysphagia. Unconscious or sedated patient. Non-absorption of oral drugs.	With the implementation of a sub cut line, the patient will be able to receive adequate pain relief and the risk of infection will be decreased.

4. In reference to the relevant organisational procedure “Administration of subcutaneous medications in Palliative Care: a) Intermittent b) Via a syringe driver” https://www.seslhd.health.nsw.gov.au/sites/default/files/migration/Policies_Procedures_Guidelines/Clinical/Cancer_Services/documents/SESLHDPR175AdministrationofsubcutaneousmedicationsinPalliativeC.pdf
5. Complete a nursing care plan for the management of syringe drivers to administer pain relief, antinausea and steroid injections.
6. Refer to specific instruction to clarify what information is expected in each column
   

   Nursing Assessment and Identification of Actual or Potential issue	Planning	Implementation	Evaluation – assessment of the desired outcome
   Care and use of syringe driver	Keep the skin around the tube dry and ensure to check the site every 4 hours.	According to the above procedure document, what are the indication and contraindication for use of a syringe driver: Patient is NBM due to nausea/vomiting. Poor absorption of oral medicines. Patient is in and out of consciousness.	With the implementation of the syringe driver, the patient will be comfortable because plasma drug concentrations are maintained without peaks and troughs, giving constant therapeutic drug levels over a 24-hour period. (“Safe practice in syringe pump management”, 2015)

7. PLEASE READ THROUGH Part 2: Palliative Nursing Care Plans
8. Specific Instructions
9. Completing Palliative Nursing Care plans will assist you to identify the needs of the person, family, and carers during the palliative approach to health care. In this task you will need to complete the Nursing Care Plans based on the knowledge you have obtained during this unit of study and your own personal research

1. Nursing assessment and identification of actual or potential problems – In this column, you should document how you would gather the information needed to identify the features of the actual or potential issue. The information may be obtained: –

• directly from the client or from significant others
• by physical examination using the techniques of inspection, palpation, percussion or auscultation
• by assessment tools
• from information, assessment and collaborative care from another member of the palliative interdisciplinary healthcare team

1. Planning – In this column you start planning by documenting and identifying the patient’s goals and what nursing care needs to be implemented to achieve these goals. In order to ensure goals are practical and reasonable applying the acronym SMART is helpful:

• Specific. Be clear about what the goal is — include specifics such as ‘who, where, when, why and what’.
• Measurable. Set goals that are measurable. The goal should include a quantity of ‘how much’ or ‘how many’, ‘how long’
• Achievable. Set goals that are reasonable. Setting a harder goal might lead to a better outcome, but only as long as it achievable.
• Realistic. Set goals that are practical for the person requiring a palliative approach to care, the environment, and the healthcare team.
• Time-related. Set a timeframe and have an endpoint.

1. Implementation – in this column you are expected to outline the nursing actions and interventions needed to help the person achieve the goal that has been set. These interventions benefit patients in a predictable and expected way. These interventions may be independent nursing interventions or collaborative interventions with a member of the interdisciplinary palliative healthcare team; a nursing colleague; a carer; the person requiring a palliative approach to care or a family member
2. Evaluation is the final stage – in this stage, you need to determine if the intervention has been effective. As this is an assessment task only, you will need to identify and document the process or processes you would use to determine the extent to which the set goal has been achieved.

1. ******TEACHER FEEDBACK AND WHAT NEEDS TO BE FIXED/ADDED TO WHAT I’VE ALREADY WRITTEN ******

• Planning column to be completed- What are you planning to do documented in SMART format.

2. All sections – Require further research and detail in answer. Expand on how you communicate in implementation column. Include the patient and family observations in evaluation column
4. Q. 22. Oral care- Assessment- include assessment – what do you do to assess. Planning include the plan what strategies are you using Implementation expand how do you do oral care and explain. Evaluation what will you see if outcome satisfactory.  Include the patient and family observations in evaluation column, focus on care of mouth.
6. Q. 23. Cachexia Assessment- include assessment – what do you do to assess. Planning include the plan what strategies are you using
7. Implementation do you know what the patient likes, otherwise great . Evaluation what would the patient, family and yourself observe if a good outcome.
9. Q. 24. Pain management- Assessment- include assessment – Relate to pain not pressure sores. how do you assess pain. Planning relates to non-pharmaceutical and complementary care. Include the plan what strategies are you using Implementation relates to non-pharmacological and complementary therapies  not pressure area prevention. Give examples here.
10. Evaluation. How would the patient appear if pain minimised- could they do more,? quality of life  Include what pain score would you aim to keep pain under.
12. Q. 25. Include plan. Expand evaluation with key points
14. Q. 26. expand plan to include all key points in the plan. Expand evaluation

Peruse the following Web sites:

• County Health Rankings
• Community Commons
• HealthyPeople.gov
• San Diego County Health and Human Services Agency
• Data.gov Data Catalog

The concept behind the 3-4-50 model is that there are three unhealthy behaviors that influence four chronic diseases, which leads to 50% of all deaths. The percentage of deaths can vary by community or place. For example, in some communities, this can be 3-4-63 or 3-4-45.

As you peruse the Web sites above, respond to the following questions:

• How do the 3 behaviors in the 3-4-50 model impact the 4 diseases in your community?
• Can you find the mortality of these 4 diseases in your community?
  • If you can, what is the percentage of deaths caused by these 4 diseases for your community?
• What are the underlying social determinants of health that impact the 3 behaviors in the 3-4-50 model?
• What are the health disparities observed from the data in your community (city or county)?
• Physical activity, or lack thereof, is 1 of the 3 behaviors that impact the 4 diseases. What is the walkability index for your neighborhood (area)?
  • Does this support the data as they relate to health conditions that are impacted by physical activity?
• From the data and the information you gathered, what recommendations might you have for your community?

Topic 2

Communication with the elderly can be challenging.

• Identify at least two modes of communication you have used with the elderly in your clinical practice.
• State what modes of communication were effective and which modes were challenging. Explain why.

BOTH QUESTIONS MUST BE ANSWERED COMPLETELY!

MUST CIITE AND REFERENCE!!!!

From your textbook, Nursing for Wellness in Older Adults, read the following chapters:

• Assessment of Health and Function
• Psychosocial Wellness
• Psychosocial Assessment
• Hearing
• Vision

TEXTBOOK

Miller, C. A. (2018). Nursing for Wellness in Older Adults (8th ed.). Philadelphia: Wolters Kluwer/Lippincott, Williams & Wilkins