Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

Objectives

• Identify types of research questions to be studied with qualitative methods
• Describe the steps in making a clinical decision based on evidence

References:

• Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

• Response posts: Minimum 100 words excluding references.

Discussion 1

Evidence-based practice is an essential part of providing safe, quality patient care in nursing. It involves the collection, evaluation, and integration of valid research evidence, combined with clinical expertise and an understanding of patient and family values and preferences, to inform clinical decision making (LoBiondo-Wood & Haber, 2006). The purpose of this post is to discuss a situation in my current practice as a staff RN where evidence-based practice has been applied.

I currently work on a step-down neurosurgical unit that is comprised of 18 patient beds. Throughout my 2 years as a nurse, I have seen many different changes and new evidence-based practices implemented. One major new practice was that of bedside shift report. This practice calls for nurses to give their change of shift report to the on-coming RN at the patient’s bedside, rather than outside the room at the nurse’s server, at the nurse’s station, or in a conference room.

Nurse hand-off report is crucial in providing safe and quality patient care. Nurses often feel rushed and are distracted during traditional report. This can cause the outgoing RN to potentially leave out crucial information, cause the oncoming RN to get started on their shift late, and lengthens the time that patients are left unseen. Research has shown that sentinel events, call bell usage, and patient falls are all more frequent during this period of patient “alone” time (Labriole, MacAulay, Williams, Bunting, & Pettorini-D’Amico, 2018). The newly implemented bedside shift report is to not only preventing any of the previous incidences from occurring, but also allows for patient’s to be more involved in their care. This inclusion of the patient and family enhances communication between the patient and nurses as part of patient- and family-centered care (Labriole et al., 2018). By having a real-time conversation with the patient and family, the nurses can establish a trusting relationship that encourages the patient and family to feel more comfortable voicing their questions and concerns. This promotes a sense of security and empowerment among patients when they feel that they play an active role in maintaining the accuracy of the patient handoff.

There are countless evidence-based research studies that have been conducted to support bedside shift report. One such study conducted on a ten-bed rehabilitation unit over a 60-day period, showed significant improvement in not only patient satisfaction, but nurse satisfaction as well (Labriole et al., 2018). Nurse accountability, patient condition, communication with patient and family, nursing communication, and overall satisfaction all increased dramatically (Labriole et al., 2018). Shift report, as well as patient falls and call light usage all decreased over this period as well (Labriole et al., 2018).

The new implementation of the bedside shift report has been difficult for some nurses to get use to. There are some drawbacks that I have personally experience. It is hard to do bedside report when you have a difficult patient or family. Patients often times like to interrupt with side notes or requests to use the bathroom during report. These inconveniences are small however, compared to the improved outcomes that bedside report has brought. Bedside report allows for the outgoing nurse to be accountable, lets the two nurses assess the patient together, and communicate with the patient about what is going on in their care. I think that the new report provides for better patient care and safety and allows me to get a better start to my day.

In conclusion, evidence-based practice allows for nursing care to be the most safe, quality care that it can be. Practices, such as bedside shift report, are constantly being evaluated and implemented to improve patient care.

References

Labriole, J., MacAulay, C., Williams, K., Bunting, D. R., & Pettorini-D’Amico, S. (2018). Implementing bedside shift report: Walking the walk and talking the talk. Nursing 2018, 1-4. doi:DOI-10.1097/01.NURSE.0000529809.90912.30

LoBiondo-Wood, G., & Haber, J. (2006). Nursing research: Methods, critical appraisal, and utilization. St. Louis, MO: Elsevier Mosby.

Discussion 2

Evidence based practice is a very important practice that can provide safe and comfortable care to our patients. Our discussion board for this week is to work on a project related to patient care, that can be a study research in evidence-based practice.

The evidence-based project I would like to work on is, the management of gestational diabetes on laboring patients. Is fingerstick or capillary blood glucose checks, everyone hour, is a necessary during all phases of labor? Gestational diabetes is very frequent in our labor patients. At my work place, we are checking the blood sugar every 1 hour, when the patient is in, for delivery, even if the patient is not in active labor. It is very painful to patients with diabetes, all their fingers are sore. Beside having labor pain, patients are having fingers pain. Spacing out the fingerstick checks should be more comfortable to our laboring patient.

According to the National institutes of health, (2013), study shows that continuous monitoring of the capillary blood sugar, (fingerstick), during labor may improve the outcome of mother and baby; It can help prevent maternal hyperglycemia and neonatal hypoglycemia or fetal acidemia. But the National institutes of health, (2013), added that, monitoring blood sugar every two to four hours, during the latent phase, and one to two hours during the active phase should be done to maintain or correct any hyperglycemia during labor. They added, if the capillary blood sugar is controlled, checking it every four to six hours should be better. My workplace is doing the blood sugar checks everyone hour. Changes need to be done.

In conclusion, further research on the evidence-based practice on the diabetes management should be done in our workplace, to help improve our safe and comfortable patient care. Physiological measurement, self-reporting data, existing data, even observational data, will be very helpful on this research project. Because evidence-based practice involves, a series of action steps and a complex nonlinear process, according to LoBiondo and Haber, (2010), implementing a change will take a long time to be establish. Management and physician should be aboard with this research for a change of practice to take place.

References:

LoBiondo, G. W., Haber, J., (2010). Nursing research: methods and critical appraisal for evidence-based practice. 7^th ed. Mosby Elsevier. St Louis, Missouri.

US national library of medicine, (NLM). National institute of health, (2013). Peripartum management of diabetes. Retrieved from https://www.ncbi.nlm.nih.gov

youll have to read since its based on a book no online resource I believe it is 3/4 chapters

ESSAY

The assigned readings in Weeks 10 from the New Latino Studies Reader critically explore issues of gender and sexuality among Latino populations.They do so both historically (Ramon Gutierrez’s “The History of Latino Sexuality”) and contemporarily (Robert Smith’s “Gender Strategies, Settlement, and Transnational Life in the First Generation” and Lorena Garcia’s “She’s Old School Like That: Mother and Daughter Sex Talks”).All three articles in this section offer a sophisticated analysis of the way that manhood and womanhood is given cultural meaning among different generations of Latinos and Latinas in the United States.

Drawing upon Ramon Gutierrez’s historical analysis of “male honor” and “female shame,” discuss how these gender ideals have contemporary meaning in the lives of the Mexican and Puerto Rican subjects that Robert Smith and Lorena Garcia interviewed in their essays.How do cultural constructions of “male honor” and “female shame” impact on the lives of the first-generation Mexican immigrant couples that Smith interviewed and the second-generation Mexican and Puerto Rican young women that Garcia interviewed?Your essay must make use of all three of these essays in addressing the essay question posed.Make sure you begin with the Gutierrez essay and then discuss the Smith and Garcia articles.

Your essay will be evaluated on how carefully and successfully you directly draw from these three course readings in crafting your essay.It is the quality of the engagement with and use of the assigned readings that is key to this assignment.Please make sure that you include concrete examples taken from them and correctly cite the readings in writing your essay.As always; no first-person voice, personal experiences, or personal points of view should be included in your essay. I am only interested in you telling me what the authors of these essay have to say.You may use any footnoting style that you prefer (MLA, APA, or Chicago Manual of Style) as long as you are consistent.Please make sure to include a word count and bibliography at the end of your essay.

There are four questions below. Each response should be highly detailed – think of a short essay-style format, rich with detail! MINIMUM one paragraph per question.

What are social NORMS that influence healthy decisions in your life from friends and family members? What are social norms that influence unhealthy decisions? Also, think about the cultural health habits that you grew up with from your own family. What are things that encourage healthy habits and things that discouraged healthy habits? Reflect on both.

Think about your current sleeping habits. Do you feel you get enough sleep at night? Why or why not? What are some things that get in the way of a full, solid night sleep (think of technology, things you do before bed, noise levels, etc.). How would getting a full night’s sleep at night make your daytime hours more productive? Also, share some tips that have helped you get a good night’s sleep!

Discuss your understanding of mental health disorders. What are some things you learned about the disorders that you didn’t know? What are some things you would suggest to a friend or family member who feels a bit off but believes that any issues mentally can be resolved with thinking “happy thoughts” or “giving it time”. Be clear in your recommendations and WHY you feel that way.

What are some issues you’ve had with stress in your own life? Clearly list and describe that challenges you’ve faced. What are some things that have helped in stress management? What are some things that haven’t helped, or even increased the stress? Finally, describe the ideas of optimism, autonomy, gratitude, and mindfulness (see text for description) – how could these FOUR ideas bring about stress reduction in your own life?

PART A: Having read the HBR Case Study, Big Shoes to Fill answer the following questions about the case.

1. What type of leader, discussed within the current course module, best characterizes former CEO Jack Donally. Be sure to provide rationale for your selection.
2. What situational variables contributed to the success and maintenance of this type of leader in this specific case?

PART B: Now imagine you are Stephanie Fortas, the new CEO of Innostat.

1. What leadership style/approach/theory would you embrace and implement, and why? Be sure to reference reasons for your decision (e.g., company history, current personnel, market trends, etc.).
2. How would you communicate your new strategy for the company to maximize buy-in and organizational success and why would you use this style and medium of communication? Draft detailed messages to each and every group of stakeholders you identify as necessary (e.g., board, senior management, all employees, etc.) to communicate your position(s) and rationale. These messages may take various forms depending upon the content and the audience so make sure and identify the specific medium you would use to communicate with each group (e.g., memo, presentation, etc.).

Reminders for Part B:

• Answer each of the questions above first on one page. Then draft the necessary message(s) to your organization on subsequent pages.
• If you choose to write memos, or emails please make sure your formatting is consistent throughout and the message length is appropriate for this type of message.
• If you choose to include a white paper or other report please follow APA guidelines for formatting (e.g., font, margins, page numbers, headings, etc.)
• If you choose to include a presentation make sure and write out the presentation content fully so that I can see exactly how the presentation would be delivered. Don’t assume I will fill in the blanks.
• The entire assignment for Part B should NOT exceed 5 typed pages.

This assignment has two parts.

Part I:

Compare traditional communication tools with social media communication tools in no more than 175 words. What are the pros and cons of each?

Part II:

Review the following scenario:

Your coworker’s office is situated next to yours. One day she comes into your office and informs you of a huge project that is in the process of being assigned from upper management to your department’s manager. Within forty eight hours, your department manager contacts you through a text message informing you of your inclusion in this project. Unfortunately, your manager included very minimal information about project specifics, so you do not know enough to get a solid start.

Your manager is highly political and does not pay much attention to detail. Also, he does not like his personnel reaching out to individuals outside of the department, especially his counterparts.

On the other hand, you do have good relationships with other departmental managers.

Discuss in 525 to 700 words the following:

• Explain how you would go about gathering the information needed to start your project, while navigating the tough political map.
• Select one of the communication tools from Part I to deliver your message, and explain the rationale behind your selection.
• Describe how you would use the selected communication tool in the given scenario to deliver your message.