Nursing

Write an essay addressing each of the following points/questions. Be sure to completely answer all the questions for each number item. There should be three sections, one for each item number below, as well the introduction (heading is the title of the essay) and conclusion paragraphs. 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. Support your ideas with at least three (3) citations in your essay. Make sure to reference the citations using the APA writing style for the essay.  Identify one aspect of big data and data mining that is interesting to you. Explain the concept and how it might bring value to healthcare.  Describe the concept of continuity planning. If you were the director or manager for your current workplace, describe the preparedness program you would recommend. Locate an article discussing the use of informatics in healthcare education of the general public or of nursing students. Discuss the benefits and drawbacks to using technology in this situation and recommendations from the author. Do you feel this use of technology is a viable method of educating (the public or nursing students)? Why or why not?

scenario: The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines. Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient. Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

To prepare: ·        How has your understanding of the national health-promotion and disease-prevention issue and your selected problem and target population developed over the past several weeks? How has your perception changed, if at all? ·        Critically evaluate the pros and cons of the program you have designed. Based on what you have learned in this course, as well as your professional experiences, do you think your program would address the problem for the target population? Would the benefits outweigh the costs? ·        Examine the ethical implications of the program you have designed. What questions, concerns, and/or insights do you have? ·        As a nurse engaged in advance practice, which venues would be viable for disseminating the results of your program design and evaluation? What audience would be most interested in these findings? Identify at least one professional journal to which you could publish the results of your program design and evaluation, as well as at least one other venue for disseminating results.

You are responsible for minimally at least 3 posts for each question in your discussion boards; your initial post and reply to two of your classmates. Your initial post(s) should be your response to the questions posed in the discussion question. You should research your answer and cite at least one scholarly source when appropriate, and always use quality writing. The discussion board is never a place to use text language or emoticons. You will also be asked to respond to your classmates. This is designed to enhance the academic discussion around the topic. It is all right to disagree with something posted by another, however your responses should always be thoughtful and respectful and reflect your opinions professionally. Discussion Question: When discussing stress and burnout in nursing, the nursing shortage is a concern that comes to the top of the list (for legal and ethical reasons), both for working nurses and educational faculty. Find an article that explores this issue, summarize the article’s findings, and add a possible solution to the problem. Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length.

Peer response Length: A minimum of 150 words per post, not including references Citations: At least one high-level scholarly reference in APA per post from within the last 5 year Peer Post: A common cultural belief that we come across today is the rejection of blood transfusions by Jehovah’s witnesses. Although many people may not understand the rejection of blood transfusions it must be respected as a part of their religious and cultural beliefs. Therefore, it is vital to find other lifesaving measures that can be used for Jehovah’s witnesses. While many Jehovah’s witnesses reject whole blood and packed red blood cells some do accept components of blood such as albumin, clotting factors, and immunoglobulins (Norfolk, 2013; Tachi, Yoneda, N., Yoneda, S., & Saito. 2018). Jehovah’s witnesses also do not normally object to hemodialysis, normovolaemic haemodilution, and intraoperative cell salvage (Norfolk, 2013). Furthermore, if a Jehovah’s witness is going into a known procedure iron infusions should also be considered to raise hemoglobin levels if the patient is anemic prior to the procedure (Tachi, Yoneda, N., Yoneda, S., & Saito. 2018). Lastly, it is important to respect the patient’s wishes if they do not wish to receive blood transfusions whether or not they are conscious. To administer a blood transfusion to a patient who has refused it would be considered assault and is unethical; even if it would save the patient’s life.  (Finfer, Howell, Miller, Willett, & Wilson-MacDonald. 1994) As future nurse practitioners (NPs) it is vital that we listen to our patient’s wishes and ensure we educate them on the risks and benefits of refusing treatment. It is also important to look for different avenues of treatment to respect their culture and beliefs such as looking for different treatments outside of blood transfusions for Jehovah’s witnesses. Therefore, NPs should be well versed in the cultural and religious beliefs of their patients to develop effective treatment plans while respecting their beliefs. By researching different avenues of evidence based treatment for patients who refuse blood transfusion or other therapy NPs can ensure they are delivering exceptional care for their patients while doing no harm to their mental or physical being.    References Finfer, S., Howell, S., Miller, J., Willett, K., & Wilson-MacDonald, J. (1994). Managing patients  who refuse blood transfusions: An ethical dilemma: Major trauma in two patients refusing blood transfusion. BMJ : British Medical Journal, 308(6941), 1423.  doi:http://dx.doi.org/10.1136/bmj.308.6941.1423 Norfolk, D. (2013). Handbook of Transfusion Medicine. Retrieved August 06, 2020, from  https://www.transfusionguidelines.org/transfusion-handbook/12-management-of-patients-who-do-not-accept-transfusion/12-2-jehovah-s-witnesses-and-blood-transfusion Tachi, S., Yoneda, N., Yoneda, S., & Saito, S. (2018). Successful treatment of total placenta previa by multidisciplinary therapy in a  Jehovah’s witness patient who refused blood transfusions. BMJ Case Reports, 2018 doi:http://dx.doi.org/10.1136/bcr-2018-226486

Peer Response Length: A minimum of 150 words per post, not including references Citations: At least one high-level scholarly reference in APA per post from within the last 5 years Peer Post: Working in the operating room of a level two trauma center, you encounter conflicts of all kinds. Emphasizing the importance of being a patient advocate during surgery is imperative. Surgery patients cannot hear, nor are they aware of what happens under anesthesia. The Operating Room (OR) team is the only voice in that room for the patient. Many times, this voice lands on the circulating nurse in the operating room. The medical team consists of surgeons, anesthesiologists, nurses, and surgical technologist at minimum. It is not unusual to have conflict in the OR suite, and with that conflict, the nurse has the responsibility to advocate for their patient. OR nurses need the skills and ability to resolve an issue in a positive way that does not cause patient harm. Thomas-Kilmann Index (TKI) describes five specific responses around conflict, avoiding, accommodating, compromising, collaborating, and competing (Price and Murphy, 2018). Of these types of conflict, nurses tend to use avoiding and compromising the most (2018). Avoidance is one I often see in the OR environment, which can be detrimental to patients. As a charge nurse of the OR, I am often called upon to help resolve conflict.              Recently a trauma patient was rushed to our OR bleeding from a wound to his abdomen. He was emergently opened and packed with sponges to help absorb the blood so the surgeon could locate the source and stop the bleeding. Standard policy and procedure are to perform an instrument and sponge count at the beginning and end of every surgery where there is the possibility of a retained item. The final surgical sponge count was incorrect; the surgeon was told, he ignored the nurse and continued his closure of the abdominal cavity. The nurse is ultimately responsible for making sure all instruments, sponges, and small items are visually accounted for. She voiced the incorrect count to the surgeon, who refused to acknowledge her concern and continued to close. No one else in the OR suite spoke up, told the surgeon to stop, and that an x-ray was needed. Collectively they were avoiding a hard conversation with a very prestigious surgeon. Eventually, the nurse called out to the charge desk and asked for support; she needed help advocating for her patient’s safety. The nurse explained the situation, what they had done to find the missing sponge already, and the implications for the patient if not found. This patient safety issue needed immediate attention before the patient was awakened from surgery and taken to recovery. I very quickly went to the room; I asked the surgeon to pause for a patient care concern. I advocated for not only the patient but the nurse simultaneously. I had to do this in a way that showed the facts, followed policy, and had the patient’s best interests in mind.  I stated to the surgeon all actions taken up to this point to find the missing sponge; the room was searched, sponges in counter recounted twice, and the room garbage searched. I stated that not only am I concerned about the sponge being in the abdomen, but my nurse and surgical technologist are as well. I supported the facts with hospital policy stating that any incorrect count warrants an x-ray to make sure nothing is left behind at minimum. I validated back the surgeon’s feelings while still supporting the need for the x-ray.  He stated that he did not think the sponge could be in the patient, for he checked the abdomen thoroughly before closing.  I reminded him we have a responsibility to the patient when they are under our care to take every safety measure possible to make sure there is nothing left behind. After our discusosion, the surgeon agreed to the intraoperative x-ray. The nurse called radiology a machine was brought to the OR, and an x-ray taken. The patient remained on the table until the findings were confirmed and reported to the OR. Indeed, there was a sponge seen on the imaging left in the patient’s abdomen tucked way up under his rib cage. The surgeon had to reopen the patient and retrieve the missing sponge.  Avoidance on the nurse’s part or myself would have caused significant harm to the patient, a lawsuit for the surgeon and the hospital. Providing the surgeon with facts around the conflict, taking the blame out of the discussion, using hospital policy, and ultimately making it know to the team that we have an obligation and responsibility to do what’s right for the patient lead to the surgeon calming down and ordering the x-ray. According to McKibben, if conflict is not addressed adequately, it can have direct repercussions on patients (2017). With poor patient care delivery, personal integrity, professional, and the hospital itself is at risk (2017). This will not be the last, nor was it the first conflict to arise in our department. Having skills and knowledge around conflict resolution will continue to be a crucial skill for all nurses. As a profession, we need to uphold our integrity and be prepared to handle conflicts of all kinds; patients’ lives are at risk. References McKibben, L. (2017). Conflict management: Importance and implications. British Journal of Nursing, 26(2), 100-103. doi:10.12968/bjon.2017.26.2.100 Price, D. M, & Murphy, P.A. (2018). Conflict Resolution in Advanced Practice Nursing. In L.A. Joel Editor (Ed.), Advanced practice nursing: Essentials for role development (pp. 336-348). Philadelphia, PA, PA: F.A. Davis Company.

“The Final Word” Give a brief summary evaluation of your community’s health, the major strengths of your community, and the hopes for your community in the future.  Also discuss what has resonated with you in this course. FYI: I live in Hallandale Florida

Discussion Prompt Select a care environment where advanced practice registered nurses (APRNs) may practice. Some examples to choose from may include: Rural health clinic Emergency department Urgency care Community health center Family practice Pediatric Clinic Using the conditions listed in Box 11.1 in the Joel textbook, identify and discuss two different conditions that may have a significant impact on revenue in the care setting. Describe how these conditions might affect how APNs provide care in these settings? Length: A minimum of 250 words, not including references Citations: At least one high-level scholarly reference in APA from within the last 5 years

In the research paper include: The issues surrounding covid 19 and it is effects on nurses in The Bahamas. State how these issues can impact patient care. Identify and describe self-care activities that can assist nurses in managing the stress of covid 19

What is your research trajectory? (briefly explain your research hypothesis and plans of how you can apply this into practice settings as well as how you will incorporate this into your future work as an advanced practice nurse?) MY HYPOTHESIS IS  “How to Lower Blood Pressure in Women with Preeclampsia.” Forum Discussion