Nursing 2

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Vila Health: Remote Collaboration and Evidence-Based Care Question: How was remote collaboration used to improve the quality and safety of the care being provided in the scenario? Answer: the patient’s nurse physician and respiratory therapist collaborated with the patient’s pediatrician and patient’s mother to plan the patient’s post discharge care. the social workers were also included. family teaching was included and the parent was provided education on how to monitor the patient for signs of respiratory distress.

Question: In what ways was evidence-based practice being effectively applied to help the patient in the scenario? Were there opportunities for improvement? If so, what were they? Answer: EBP was being used in that interdisciplinary collaboration was used. Also patient centered decisions were made. The patient’s parent was kept informed and made a part of the decision making. also, the use of telecommunication was used. What could have been done better would be using video/telehealth during the initial conversation between the provider and nurse for the provider to do a visual virtual assessment of the patient.

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Nursing 2

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Create a 5-10 minute video of yourself, as a presenter, in which you will propose an evidence-based plan to improve the outcomes for the Vila Health patient and examine how remote collaboration provided benefits or challenges to designing and delivering the care.

Introduction

As technologies and the health care industry continue to evolve, remote care, diagnosis, and collaboration are becoming increasingly more regular methods by which nurses are expected to work. Learning the ways in which evidence-based models and care can help remote work produce better outcomes will become critical for success. Additionally, understanding how to leverage EBP principles in collaboration will be important in the success of institutions delivering quality, safe, and cost-effective care. It could also lead to better job satisfaction for those engaging in remote collaboration.

Professional Context

Remote care and diagnosis is a continuing and increasingly important method for nurses to help deliver care to patients to promote safety and enhance health outcomes. Understanding best EBPs and building competence in delivering nursing care to remote patients is a key competency for all nurses. Additionally, in some scenarios, while you may be delivering care in person you may be collaborating with a physician or other team members who are remote. Understanding the benefits and challenges of interdisciplinary collaboration is vital to developing effective communication strategies when coordinating care. So, being proficient at communicating and working with remote health care team members is also critical to delivering quality, evidence-base care.

Scenario

The Vila Health: Remote Collaboration on Evidence-Based Care simulation provide the context for this assessment.

Instructions

Before beginning this assessment, make sure you have worked through the following media:

· Vila Health: Remote Collaboration on Evidence-Based Care .

You may wish to review Selecting a model for evidence-based practice changes. [PDF] and Evidence-Based Practice Model s, which help explain the various evidence-based nursing models.

For this assessment, you are a presenter! You will create a 5–10-minute video using Kaltura or similar software. In the video:

· Propose your evidence-based care plan that you believe will improve the safety and outcomes of the patient in the Vila Health Remote Collaboration on Evidence-Based Care media scenario. Add your thoughts on what more could be done for the client and what more information may have been needed.

· Discuss the ways in which an EBP model and relevant evidence helped you to develop and make decision about the plan you proposed

· Wrap up your video by identifying the benefits of the remote collaboration in the scenario, as well as discuss strategies you found in the literature or best practices that could help mitigate or overcome one or more of the collaboration challenges you observed in the scenario.

Be sure you mention any articles, authors, and other relevant sources of evidence that helped inform your video. Discuss why these sources of evidence are credible and relevant. Important: You are required to submit an APA-formatted reference list of the sources you cited specifically in your video or used to inform your presentation. You are required to submit a narrative of all your video content to this assessment and to SafeAssign.

The following media is an example learner submission in which the speaker successfully addresses all competencies in the assessment.

· Exemplar Kaltura Reflection .

. Please note that the scenario that the speaker discusses in the exemplar is different from the Vila Health scenario you should be addressing in your video. So, the type of communication expected is being model, but the details related to the scenario in your submission will be different.

Make sure that your video addresses the following grading criteria:

· Propose your own evidence-based care plan to improve the safety and outcomes for a patient based on the Vila Health Remote Collaboration on Evidence-Care media scenario.

· Explain the ways in which you used an EBP model to help develop your plan of care for the client.

· Reflect on which evidence you found in your search that was most relevant and useful when making decisions regarding your care plan.

· Identify benefits and strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.

· Communicate in a professional manner that is easily audible and uses proper grammar, including a reference list formatted in current APA style.

Refer to Using Kaltura as needed to record and upload your video.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@Capella.edu to request accommodations. If, for some reason, you are unable to record a video, please contact your faculty member as soon as possible to explore options for completing the assessment.

Additional Requirements

Your assessment should meet the following requirements:

· Length of video: 5–10 minutes.

· References: Cite at least three professional or scholarly sources of evidence to support the assertions you make in your video. Include additional properly cited references as necessary to support your statements.

· APA reference page: Submit a correctly formatted APA reference page that shows all the sources you used to create and deliver your video. Be sure to format the reference page according to current APA style. Submit a narrative of all of your video content.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

· Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.

. Reflect on which evidence you collected that was most relevant and useful when making decisions regarding the care plan.

· Competency 3: Apply an evidence-based practice model to address a practice issue.

. Explain the ways in which you used an evidence-based practice model to help develop the care plan identifying what interventions would be necessary. This requires a particular evidence-based model, such as the Johns Hopkins, Iowa, Stetler, or other.

· Competency 4: Plan care based on the best available evidence.

. Propose your own evidence-based care plan to improve the safety and outcomes for the Vila Health patient with a discussion of new content for the care plan.

· Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

. Identify benefits and propose strategies to mitigate the challenges of interdisciplinary collaboration to plan care within the context of a remote team.

. Communicate via video with clear sound and light, and include a narrative of video content.

. Provide a full reference list that is relevant and evidence-based (published within five years), exhibiting nearly flawless adherence to APA format.

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Powerpoint

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Required Resources
Read/review the following resources for this activity:

Textbook: Chapters 7, 8
Lesson
Minimum of 2 scholarly source (in addition to the textbook)
Narrated PowerPoint Tutorial (Make sure to review this tutorial before you begin recording.)
Instructions
For this week’s assignment respond to one of the following options, and include Option 1, 2, or 3 as part of your heading.

Option 1: The first option is to name and describe in detail a key specific and recent healthcare technology. What are at least two key moral problems this technology creates? What are the proper moral guidelines for dealing with it in your view? Compare your approach to what a utilitarian and ethical egoist would say (each independently). Consider whether differing ethical beliefs globally might or not agree with what you say.

Option 2: In the second option, name and describe in detail a key specific and recent social technology. What are at least two key moral problems this technology creates? What are the proper moral guidelines for dealing with it in your view? Compare your moral approach to what a utilitarian and social contract ethicist would say (each independently). Consider whether differing ethical beliefs globally might or not agree with what you say.

Option 3: John Doe, Patient One, is in late stage of kidney disease. If he does not receive a new kidney, then he is predicted to die within a week. Doe is 45, single, and has no children. Doctors theorize that Doe damaged his kidney by not following a low-salt diet. Doe inherited one million dollars and is known for giving money to charity. Without a transplant, he will probably be forced to spend all his money searching for a kidney outside of the usual legal channels. Patient Two is Jane Doe (no relation to John). Patient Two is a mother of two children (ages 21 and 24). She is divorced and 55 years old. She developed kidney problems due to eating a high-fat and high-sugar diet. If she does not receive a kidney within one month, doctors believe she will die. Patient Three is an orphan. This orphan lives in a state facility. She was born with a genetic condition that constantly damages her kidney. The only known approach to her condition is to provide her with a kidney transplant every so often. She is 11 and has already undergone two kidney transplants. She will perish in two months if she does not receive another transplant.

All three patients are at the same hospital. The hospital only has one kidney to give out. The orphan’s birth parents were known to be of a religion that is opposed to organ donation. The other patients come from religions that do not oppose organ donation. Who should get the kidney? Why should that candidate receive it over the others? Devise a course of social action and a solution for this case by using the ethics of egoism and then utilitarianism to a key moral conflict involving health care in this case. Appraise the interests of diverse populations (in terms of ethnicity, race, religion, sexual orientation, etc.) and how they relate to the case. Consider whether differing ethical beliefs globally might or not agree with what you say.

For all the options:

Cite the textbook and incorporate outside sources, including citations.

You should not be using any text you used in a discussion board or assignment for this class or any previous class.

Consider whether differing ethical beliefs globally might or not agree with what you say.

You will submit the following:

An audiovisual presentation that presents one of the options above. Be sure to give equal time to each element. Doing a PowerPoint presentation with audio recorded on the slides is preferred. Please refer to the Narrated PowerPoint Tutorial located in the Required Resources in this assignment.
Please provide a transcript of anything said in the recording aloud that does not appear as text on a slide. This transcript can be provided as a Word document or placed in the Notes section on the PowerPoint slides.
The link or a scan of the article mentioning any health technology, social technology, or case you are reporting on. If you made up the case, please indicate that in your report. If you choose to do option #3 (the case about a shortage of transplant kidneys), your article would likely be an article about the shortage of transplant organs, or a shortage of people signing up to be transplant donors, or the status of educating people about being donors, etc.

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Week 5 Discussion: Kant’s Ethics And Our Duty

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Required Resources
Read/review the following resources for this activity:

Textbook: Chapters 9, 10
Lesson
Minimum of 1 scholarly source (in addition to the textbook)
Introduction
Kant’s famous First Formulation of the Categorical Imperative reads, “Act only according to that maxim whereby you can at the same time will that it should become a universal law.” Kant taught morality as a matter of following maxims of living that reflect absolute laws. “Universal” is a term that allows for no exceptions, and what is universal applies always and everywhere. Don’t forget about the second formulation of the categorical imperative which states, “Act in such a way that you treat humanity, whether in your own person or in the person of another, always at the same time as an end and never simply as a means.” It is just as important.

Initial Post Instructions
For the initial post, address one of the following sets of questions:

What are the personal and/or communal ethical factors that may be involved in determining the moral position of either side given a contemporary debate, such as those concerning animal rights, stem cell research, abortion, the death penalty, and so forth?
Elaborate in detail the ethical positions arrived at by using the Kantian categorical imperative relative to the long standing debate surrounding the death penalty or abortion. Argue the ethics from the point of view of the prisoner or from the fetus
Evaluate the ethical positions in part two. You will want to detail whether they are convincing, logical, correct, consistent, etc.
Follow-Up Post Instructions
Respond to at least one peer. Further the dialogue by providing more information and clarification.

Writing Requirements

Minimum of 2 posts (1 initial & 1 follow-up)
Minimum of 2 sources cited (assigned readings/online lessons and an outside scholarly source)
APA format for in-text citations and list of references

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Emergency Nursing

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1. A patient approximately 20 years of age without identification presents to the trauma unit on a backboard with cervical collar in place. The patient was ejected from the driver’s side of the car. The patient was oriented ×3 at the scene and able to move all four extremities. The patient stated he passed out and regained consciousness quickly. Within 5 minutes, the patient became lethargic, had slurred speech, and the right pupil was unequal and sluggish. Before becoming comatose, the patient had complained of chest pain when he breathed, and there was an imprint of the steering wheel on his chest in the form of a bruise. As he breathed, paradoxical chest movements were noted on the right side of the chest. The trachea is deviated to the right side. The trauma team, consisting of the trauma surgeon directing the team, two nurses and a resident, provided care. The initial vital signs were as follows: temperature, 100°F; blood pressure, 78/42 mm HG; heart rate, 70 bpm; respiratory rate, 28 breaths/min, uneven rapid breathing with periods of apnea. The pulse oximetry reading is 85% on room air. Two large IVs are established, and labs, including arterial blood gases, are obtained and sent to the lab for immediate processing. An indwelling urinary catheter is inserted, and 300 mL of amber-colored urine without sediments is noted. An initial survey is completed to assess for obvious problems, and steps are taken to prioritize the needs of the patient and provide emergent treatment. (Learning Objective 2)

What are the possible injuries to the patient according to the information presented in the initial presentation, and what medical–surgical management is anticipated?
What are the priorities for care for this individual based on the information presented?
2. Joe Barker, a 65-year-old patient, presents from doing work roofing on a 100°F day with 100% humidity to the emergency department with the diagnosis of heat stroke. The patient has the following vital signs: temperature, 104°F, blood pressure, 84/42 mm HG; heart rate, 110 bpm; respiratory rate, 20 breaths/min. The patient is hot, anhidrosis, confused to place and time, and drowsy. (Learning Objective 4)

What emergent management should the nurse anticipate for the patient?
What patient education should the nurse provide once the patient is stable?

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Assignment 1

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Scenario

Your hospital received $4,000,000 in revenue this past year. Medicare withholds 2.6% of this amount ($) until the value-based purchasing scores are in. If the scores are good this year, the hospital will earn back this money. If scores are below the national average, the hospital can lose this money. Twenty five percent (25%) of this score is based upon the Community Engagement patient satisfaction score (HCAHPS). Last year’s patient satisfaction scores (HCAHPS) in the following areas were below the national average, which cost your hospital $398,000 in revenue.

The hospital director of Quality Improvement has asked you to participate in developing a nursing action plan for your facility.

Instructions

Prepare a nursing action plan in poster format for improving one of the following key areas that:

· Selects one key area of focus:

· Communication with nurses

· Communication with physicians

· Responsiveness of hospital staff

· Communication about medications

· Cleanliness and quietness

· Discharge information

· Care transition

· Examines nursing actions to achieve optimal scores to contribute to the hospital’s financial success.

· Provides a list of recommended nursing actions to improve the selected key area.

· Appraises references/resources for best practices to increase score and enhance reimbursement.

· Communicates the rationale for the nursing actions listed in the action plan.

· Provides stated ideas with professional language and attribution for credible sources with correct APA citation, spelling, and grammar in the action plan poster.

Resources to use

Websites and Resources

· Centers for Medicaid and Medicare Service

· How to Read Your Fiscal Year (FY) 2019, Hospital Value-Based Purchasing (VBP), Program Percentage Payment Summary Report (PPSR)

· Quality Net

· The Institute for Healthcare Improvement

· The Agency for Healthcare Research and Quality

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Biological Basis And Ethical/Legal Considerations Of Psychotherapy

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Many studies have found that psychotherapy is as effective as psychopharmacology in terms of influencing changes in behaviors, symptoms of anxiety, and changes in mental state. Changes influenced by psychopharmacology can be explained by the biological basis of treatments. But how does psychotherapy achieve these changes? Does psychotherapy share common neuronal pathways with psychopharmacology?

Psychotherapy is used with individuals as well as in groups or families. The idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric-mental health nurse practitioner does. In your role, learning how to provide this type of therapy within the limits of confidentiality is essential.

For this Discussion, you will consider whether psychotherapy also has a biological basis and analyze the ways in which legal and ethical considerations differ in the individual, family, and group therapy settings.

To prepare:

Review this week’s Learning Resources, reflecting on foundational concepts of psychotherapy, biological and social impacts on psychotherapy, and legal and ethical issues across the modalities (individual, family, and group).
Search the Walden Library databases for scholarly, peer-reviewed articles that inform and support your academic perspective on these topics.

Post an explanation of whether psychotherapy has a biological basis. Explain how culture, religion, and socioeconomics might influence one’s perspective on the value of psychotherapy treatments. Describe how legal and ethical considerations for group and family therapy differ from those for individual therapy, and explain how these differences might impact your therapeutic approaches for clients in group, individual, and family therapy. Support your rationale with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

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Discussion Wk1

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Discussion: Alterations in Cellular Processes

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion,

you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

Scenario 1: A 16-year-old boy comes to clinic with chief complaint of sore throat for 3 days. Denies fever or chills. PMH negative for recurrent colds, influenza, ear infections or pneumonias. NKDA or food allergies. Physical reveals temp of 99.6 F, pulse 78 and regular with respirations of 18. HEENT normal with exception of reddened posterior pharynx with white exudate on tonsils that are enlarged to 3+. Positive anterior and posterior cervical adenopathy. Rapid strep performed in office was positive. His HCP wrote a prescription for amoxicillin 500 mg po q 12 hours x 10 days disp #20. He took the first capsule when he got home and immediately complained of swelling of his tongue and lips, difficulty breathing with audible wheezing. 911 was called and he was taken to the hospital, where he received emergency treatment for his allergic reaction.

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

The role genetics plays in the disease.
Why the patient is presenting with the specific symptoms described.
The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
The cells that are involved in this process.
How another characteristic (e.g., gender, genetics) would change your response.

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Nursing homework help

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Instructions: Response must be at least 510 words per case study written in current APA format with at least two academic references cited. Total amount of words needs to be 1,020. References must be within the last five years.
Integumentary Function:
K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.

Case Study Questions

Name the most common triggers for psoriasis and explain the different clinical types.
There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.
Included in question 2
A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking?
What others manifestation could present a patient with Psoriasis?
Sensory Function:
C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.

Case Study Questions

Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.
With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.
Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.

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ECQM Library

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Assignment:

A group of family practice physicians are having issues meeting stage 2 of meaningful use because the staff forget to provide patients with information on accessing the portal. The staff complain that they don’t have enough time to go over the process with the patients and the printed information is stacked in the utility room. Which quality improvement process should the nurse leader use to analyze this issue?

Access the CMS.gov web site: https://www.cms.gov/ and https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/MU_Stage1_ReqOverview.pdf
Read about the Quality Payment Programs and EHR Incentives.

Then select up-to-date information available for CQM Reporting options and answer the following questions:

What information is the eCQM Library?
Using the educational resources available, how can the nurse leader use these resources when participating in the design of the eCQM program?

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