Nursing

NRP/543: Management Of Pediatric And Adolescent
Wk 5 Discussion Populations Response 1 & 2 – Cardiovascular Disorders & Infectious Diseases
See each DQ question and instructions below.
Compare and contrast your responses with 1 classmate or respond to your faculty member. Your responses have the same requirements as the initial post, they must be substantive, at least 175 words (not counting the question or the reference, include a question to continue the discussion and be supported by a current reference.
Post 1 reply to each of the following discussion responses from classmates or your faculty member. Be constructive and professional.
• Each reply must be a minimum of 175 words each.
•You MUST include a question with every post response to receiving full credit.
• Each response must have at least 1 scholarly peer-reviewed reference or textbook listed
below under references.
• Must cite and list references in APA 7th edition format.
A substantive post should follow these criteria:
· At least 175 words per response
· Integrate theory, research, and/or professional experience
· Include specific examples and/or substantiating evidence
· Include in-text citations and references in 7th edition APA format
· Stay on topic and address the course objectives
· Demonstrate proper spelling, grammar, and scholarly tone
· You MUST include a question with every post response to receiving full credit.
Textbook for NRP/543:
Burns, C. E., Dunn, A. M., Brady, M. A., Barber Starr, N., Blosser, C. G., & Garzon, D. L. (2017). Pediatric primary care (6th ed.). Elsevier.
Wk 5 DQ Response 1. Please reply as instructed above.
Children diagnosed with chronic cardiac disorder will need lifelong interventions to keep themselves healthy. Their condition may require the use of antibiotics before having certain procedures or receiving vaccines to reduce health risks. What is important is providing information on all aspects of the treatment plan. Everyone who provides care for the patient needs to understand the plan and the reasons for each portion of the plan. Families need to understand the reason for and the benefits and risks associated with the plan.
Class: Many children may start to rebel against certain aspects of their treatment. How would you convince the child and family about the importance of continuing to follow the treatment plan?
Wk 5 DQ Response 2. Please reply as instructed above.
Class: What are pediatric cardiac conditions that can be managed by the FNP (family nurse practitioner)?
Common Pediatric Heart condition examples:
Heart disease is a very broad term for many things that can go wrong with the heart—in both adults and children. Narrow the focus to children, and the term still encompasses many different types of problems that range from a condition that has no symptoms and is never diagnosed, to a problem that is severe and potentially life-threatening that is apparent at birth.
If you are looking for information about a specific disease and would like to know more about its symptoms, how the disease develops over time, and how it is treated, the list below is a good place to start. Some of the most common conditions are listed as either congenital (present from birth) or acquired (developed after birth).
Congenital Heart Conditions
Acquired Heart Disease
Anomalous Coronary Arteries/Fistulas
Anomalous Pulmonary Venous Return
Aortic Stenosis/Bicuspid Aortic Valve
Atrial Septal Defect (ASD)
Atrioventricular Septal Defect (AVSD)
Coarctation of the Aorta/Interrupted Aortic Arch
D-Transposition of the Great Arteries
Ebstein’s Anomaly
Hypoplastic Left Heart Syndrome
L-Transposition of the Great Arteries
Patent Ductus Arteriosus (PDA)
Pulmonary Atresia
Pulmonary Stenosis
Tetralogy of Fallot
Tricuspid Atresia
Truncus Arteriosus
Vascular Ring/Sling
Ventricular Septal Defect (VSD)
Acquired Heart Disease in Pediatrics:
Dilated Cardiomyopathy
Endocarditis
Hypertrophic Cardiomyopathy
Kawasaki Disease
Myocarditis
Pericarditis
Rheumatic Fever
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Solution
Chronic Pediatrics Cardiovascular Diseases
Many children may start to rebel against certain aspects of their treatment. How would you convince the child and family about the importance of continuing to follow the treatment plan?
More often than not, cardiovascular diseases require lifelong treatment since it is chronic. Failure to which their condition will worsen and can proceed to multi-system organ failure as the heart cannot meet the body requirements. As a health care provider, you need to educate the patient and parents/ care giver about their condition and avoid use of scientific terms. This is important to help them understand the disease process. Acute rheumatic fever is an autoimmune condition that often results from group A streptococcal infections.
Patients should also know about the complications related to failure or non-compliance of treatment. The most significant complication of rheumatic fever is rheumatic heart disease. More often than not, rheumatic heart disease progresses to heart failure if not managed appropriately due to narrowing of the heart valves. Prolonged untreated heart failure makes it impossible for the heart to pump effectively to meet the body requirements leading to further organ damage.
Give full information on the available treatment options, durations and what to expect whether positive or negative. Also the side effects of the treatment options should be provided. They are put on steroids or NSAIDs to reduce the inflammatory process that leads to further damage of the heart valves. If the child develops heart failure, diuretics such as furosemide and vasodilators such as hydralazine are the mainstay treatment to enable the heart to function efficiently (Wallace, 2021). Secondary preventive measures can also be taken up in patients with recurrent ARF. The principal antibiotic used is benzathine penicillin, and if the patient is allergic to penicillin, erythromycin or sulfadiazine is used to prevent further damage to the heart. For patients with severe valvular damage, surgical intervention is required to improve the condition of the patient.
Encourage patients to join support groups. According to different studies, people with chronic illnesses are often faced with psychological and emotional challenges. Joining a support group helps in providing emotional and psychological well-being which has a direct impact in improving compliance. Support groups offer a platform where patients are able to learn, interact with their kind therefore sharing experiences and providing encouragement to the members.
What are the pediatric conditions that can be managed by the FNP?
The management of the pediatric cardiac condition involves a multidisciplinary approach with a family nurse practitioner (FNP) being critical. Children with either a congenital or acquired heart disease are usually initially encountered by the FNP, who recognizes key signs and symptoms aiding in diagnosing the conditions. After the diagnosis, a family nurse practitioner often contributes significantly to the patients’ treatment, follow-up, and rehabilitation. In this discussion, the focus is mainly on how a family nurse practitioner manages congenital or acquired Paediatric heart conditions.
After the delivery, the FNP usually interacts with the new mothers while offering immediate comprehensive care to the neonates. During this role, the FNP recognizes signs like cyanosis, difficulty in breathing, difficulties in breastfeeding, and pitting edema, suggestive of congenital heart disease. Early recognition leads to timely diagnosis, and this improves the prognosis of patients with heart disease. In this regard, the FNP can provoke the need of doing an early echocardiogram in the babies helping in speedy detection of any congenital heart disease that the baby could have, for example, atrial septal defect (ASD). In addition, critical congenital heart diseases often need early, timely surgical management making the family nurse practitioner crucial in detection and even in post-operative care (Chamsi-Pasha & Chamsi-Pasha, 2016). Thus, in cases of congenital heart diseases, the FNP cannot be excluded in offering interdisciplinary management of the affected children in early recognition and early diagnosis. The same can apply to the acquired pediatric heart disease, with the FNP managing the cardiology clinics, offering the treatment, follow-up, and guiding the caregivers of the patients with heart diseases.
References
Chamsi-Pasha, M. A., & Chamsi-Pasha, H. (2016). Critical congenital heart disease screening. Avicenna Journal of Medicine, 06(03), 65–68. https://doi.org/10.4103/2231-0770.184062
Wallace, M. R. (2021, November 9). Rheumatic Fever Treatment & Management: Medical Care, Surgical Care, Consultations. Medscape.com; Medscape. https://emedicine.medscape.com/article/236582-treatment
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Based on the case study, identify 6–8 measures for inclusion in a dashboard for the Community General Hospital Board. What organizational, national, and regulatory factors contributed to your decision to focus on these areas? Describe what you would expect to learn from the measurement and evaluation of your identified priority areas. Be specific and provide examples.
case study file
Community General Hospital Case Study
Creating a Quality and Safety Dashboard
It’s your first week on the job—your dream job, actually. You are thrilled to be working as the Assistant Director of Clinical Quality Improvement at Community General Hospital (CGH). For your first project, Dr. Schenk, your boss, and mentor, asks you to create a quality and safety dashboard for her monthly report to the Board. You are eager to show off the skills you’ve gained from your master’s program. If this goes well, you might be the one presenting to the Board in a few months.
Dr. Schenk gives you tips on where to start. She shows you some previous dashboards and says that they were not particularly helpful to the Board members, who really want information that allows comparisons to other hospitals.
You wonder aloud whether there are national standards that would be useful because you have read in the literature that active hospital board reviews of quality and safety using dashboards are associated with better performance (Denham, 2006; Kroch et al., 2006; Jha & Epstein, 2010).
Dr. Schenk agrees, “Yes, you should search the relevant sites for current information. Look at the Joint Commission, CMS Hospital Compare, and the Institute for Healthcare Improvement.” She continues, “Of course, we should have measures that are relevant to our quality and safety issues here at CGH. We need to highlight our current QI projects to show that we are making improvements, but we also want to identify some of the gaps where we could do better. Right now, we are working on reducing surgical site infections, reducing readmissions, and reducing wait times in the Emergency Department.”
Dr. Schenk outlines a few additional instructions:
Try to kill two birds with one stone—start with measures that the hospital is required to report.
Present clear metrics that reflect the current status of the hospital.
Don’t get too bogged down in detail because it will only overwhelm the Board.
Dr. Schenk then leaves you to your research. You look at the websites she has recommended for current reporting requirements and measures.
Centers for Medicare and Medicaid Services. (n.d.). Hospital Compare. Retrieved December 5, 2019, from https://www.medicare.gov/hospitalcompare/search.html
Joint Commission. (2019). Performance measurement. Retrieved from https://www.jointcommission.org/performance_measurement.aspx
Institute for Healthcare Improvement. (n.d.). Measures. Retrieved from http://www.ihi.org/resources/Pages/Measures/default.aspx
The websites include so many measures, too many for one dashboard. Clearly, you will need to focus the CGH Quality and Safety Dashboard on a subset or aggregation of the many possible measures that you could include.
Next, you remember Dr. Schenk’s advice to keep it relevant. You think about what you know about the hospital. Not everything that you found in your research would be relevant. On the other hand, you didn’t find measures for some things that are relevant for CGH. This hospital is such a vital part of the community. How do you capture that on a dashboard? People love working here. The turnover rate for nurses is low. Physicians move here to practice medicine because this is such a great hospital, in a family-oriented community. And the best part, in your opinion, is that physicians and staff are truly engaged in making things better—probably because everyone from the cleaning staff to the CEO is required to take the CGH Performance Improvement course. It’s hard to put numbers on those indicators.
Some other facts are easier to put numbers on. CGH is a nonprofit, 200-bed, non-teaching hospital. In 2019, CGH recorded the following data:
Number of admissions: 11,986
Number of patients over the age of 65: 2,637
Percent of patients over the age of 65: 22%
Percent of patients who identify as a race other than White: 38%
Percent of patients who are female: 59%
Mean length of stay for all patients (days): 3
Percent of patients readmitted within 30 days: 1.4
After completing your research, you now have enough details to select measures and draft the CGH Quality and Safety Dashboard.
References
Denham, C. R. (2006). Leaders need dashboards, dashboards need leaders. Journal of Patient Safety, 2(1), 45–53.
Jha, A., & Epstein, A. (2010). Hospital governance and the quality of care. Health Affairs, 29(1), 182–187. doi:10.1377/hlthaff.2009.0297
Kroch, E., Vaughn, T., Koepke, M., Roman, S., Foster, D., Sinha, S., & Levey, S. (2006). Hospital boards and quality dashboards. Journal of Patient Safety, 2(1), 10–19.
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Solution
Discussion: Community Hospital Case Study
A medical director must prepare a quality and safety dashboard to enable the key stakeholders to assess the quality and safety of patient care. Additionally, the dashboard allows board members to identify an area in the clinical practice that requires improvement. This discussion presents measures for inclusion in a dashboard, associated organizational, national, and regulatory variables contributing to the decision, and what is expected to be learned.
The case study indicates various measures to be included in the dashboard presented to the Community General Hospital (CGH) board members. These measures include the hospital’s bed capacity, recent quality improvement (QI) projects, high rate of surgical site infections, high rate of readmissions, long wait times in the Emergency Department, and availability of CGH Performance Improvement course. The decision to focus on the selected areas was impacted by organizational, national, and regulatory variables. First, corporate culture and values to meet the healthcare needs of the community members informed the decision to include hospital’s bed capacity and recent quality improvement (QI) projects in the dashboard. A medical facility should aim at meeting the health care needs of its patients (WHO, 2018). Additionally, regulatory authorities that require healthcare organizations to provide quality and safe patient care led to the inclusion of high rate of surgical site infections, high rate of readmissions, and long wait times in the Emergency Department in the dashboard. These measures enable the regulatory authorities to determine the quality of patient care based on the outcomes. Finally, national factors, particularly the federal government, influenced the decision to include the CGH Performance Improvement course since it emphasizes continuous training for medical practitioners. According to Song and Tucker (2016), performance improvement enables healthcare professionals to provide quality and safe patient care. I anticipate learning about various factors that determine the quality and safety of patient care from measurement and evaluation of the prioritized healthcare organization’s areas. For instance, I will learn that QI projects play a significant role in addressing quality and safety issues in a healthcare organization (Cantiello et al., 2016).
Overall, various measures enable the board to assess the performance of a healthcare organization. Thus, a director should carefully select measures to include in the director’s dashboard. The chosen measures based on the case study include the hospital’s bed capacity, recent quality improvement (QI) projects, high rate of surgical site infections, high rate of readmissions, long wait times in the Emergency Department, and availability of CGH Performance Improvement course.
References
Cantiello, J., Kitsantas, P., Moncada, S., & Abdul, S. (2016). The evolution of quality improvement in healthcare: patient-centered care and health information technology applications. J Hosp Admin, 5(2), 62-8.
Song, H., & Tucker, A. (2016). Performance improvement in health care organizations. Foundations and Trends® in Technology, Information and Operations Management, 9(3–4), 153-309.
World Health Organization (WHO) (2018). Delivering quality health services. WHO. https://apps.who.int/iris/bitstream/handle/10665/272465/9789241513906-eng.pdf

Application and interpretation of Public Health data-TOPIC 3 DQ 1
Topic 3: Introduction to Inferential Statistics and SPSS
QUESTION-TOPIC 3 DQ 1
Summarize the six steps of hypothesis testing. Propose a scenario in which hypothesis testing is applied to public health data.
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Solution
Hypothesis Testing
Hypothesis testing is a scientific method used by researchers to investigate ideas and theories in a study. The testing helps in the development of approaches and methodologies considering both the independent and dependent variables. Hypothesis testing provides a baseline foundation for scientific researchers, engineers, and those in other technical professions to reach a desirable agreement regarding their diverse hypotheses in their work areas. The following study focuses on the steps of hypothesis testing and the application of hypothesis testing in public health data.
Summary of Steps of Hypothesis Testing
Hypothesis testing has six steps in verifying whether to accept or reject the hypothesis. The steps are as follows; determining the null hypothesis mainly involves observing the idea of no change (Phang, 2018). Finding the alternative hypothesis that can be unilateral or bilateral, depending on the setting of the problem under investigation, follows (Phang, 2018). Testing the test statistic entails calculating the alternative hypothesis from the sampled data (Ioannidou & Erduran, 2021).
The last three steps involve critical analysis to derive the final hypothesis for the study. In analyzing data, it is crucial to determine the significance level or critical P-value. All hypothesis testing is subject to errors, either Type I or II error. Based on the types of errors, it can be easier to determine whether to accept or reject the hypothesis. The final step is concluding based on the size of the P-value. For instance, if the test value is smaller than the critical P-value, the null hypothesis is rejected. If greater, the null hypothesis is accepted, and the significance level is stated (Phang, 2018).
Hypothesis Testing in Public Health Data
A microbiome study conducted hypothesis testing and statistical analysis to explore the systematic concepts and their relationship among hosts, microorganisms, and surroundings, if at all there exists any (Xia& Sun,2017). The hypothesis testing shows the need for more tests in developing methods and models suitable for analyzing microbiome structural data due to its complex data taking too long to be analyzed and understood (Xia& Sun,2017). It is vital to consider this to help statisticians manage their work and conclude several ideas and views.
References
Ioannidou, O., & Erduran, S. (2021). Beyond hypothesis testing. Science & Education, 30(2), 345-364. https://link.springer.com/article/10.1007/s11191-020-00185-9
Phang, R. L. (2018). Basic concepts in hypothesis testing. https://sms.math.nus.edu.sg/smsmedley/Vol-16-2/Basic%20concepts%20in%20hypothesis%20testing(Rosalind%20L%20P%20Phang).pdf
Xia, Y., & Sun, J. (2017). Hypothesis testing and statistical analysis of microbiome. Genes & diseases, 4(3), 138-148. https://www.sciencedirect.com/science/article/pii/S2352304217300351

NURS 6521 week 4 Assignment, Case study. Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Photo Credit: Getty Images/iStockphoto
Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.
Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.
To Prepare
Review the case study assigned by your Instructor for this Assignment
Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.
Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
By Day 7 of Week 4
Write a 1-page paper that addresses the following:
Explain your diagnosis for the patient, including your rationale for the diagnosis.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.
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NURS 6521 Advanced Pharmacology, medule 1, week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
Assignment: Pharmacotherapy for Cardiovascular Disorders
…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…
—Murphy et al., 2018
Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.
Photo Credit: Getty Images/Science Photo Library RF
As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm
To Prepare
Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
Review the case study assigned by your Instructor for this Assignment.
Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
By Day 7 of Week 2
Write a 2- to 3-page paper that addresses the following:
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.
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ORGANIZATIONAL ETHICS PRESENTATION
Choose a topic: ENGAGING IN BIGOTRY, SEXISM, RACISM, OR SHOWING FAVORITISM
Taken from the assigned reading in Butts chapter 12, page 401, “Ethical Reflection: Typical Unethical or Illegal Behaviors in Organizations”
Create a presentation of 10 slides or screens excluding the title and references ( WITH SPEAKER NOTES).
Your slides/screen should include titles, main ideas, bullet points, and relevant images, charts, graphs, etc.
In your presentation:
Describe an ethical situation, based on the chosen topic, that can get in the nurse’s way of practicing ethically. Describe the situation clearly and concisely.
Identify how this situation relates to one provision within the Code of Ethics for Nurses.
Identify two ethical principles that may arise when facing this situation.
Discuss how a nurse might lessen the impact of the situation on the nurse’s practice.
In addition to the course texts, cite and reference a minimum of two (2) additional scholarly sources to support your work.
Close with a summary of your topic, and APA formatted reference slide(s).
Review the rubric for further information on how your assignment will be graded.
Due: Sunday, 11:59 p.m. (Pacific time).
Points: 300
Rubric
NURS_521_DE – Presentation Rubric NURS 512
NURS_521_DE – Presentation Rubric NURS 512
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Content
105 to >91.35 pts
Meets Expectations
The introduction is attention getting and lays out the topic well. It establishes a strong framework for the rest of the presentation. The conclusion is comprehensive and compelling. Presentation contains accurate and complete information. Ideas, facts, and information provided demonstrate a strong, confident, understanding of the material.
91.35 to >78.75 pts
Approaches Expectations
The introduction lays out the topic. It establishes some framework for the rest of the presentation. The conclusion is clear. Presentation contains accurate and complete information. Ideas, facts, and information provided demonstrate an understanding of the material.
78.75 to >61.95 pts
Below Expectations
There is minimal introduction establishing a vague framework for the rest of the presentation. The conclusion is abrupt or unclear. Presentation contains some inaccurate and incomplete information. Ideas, facts, and information provided demonstrate little understanding of the material.
61.95 to >0 pts
Not Meeting Expectations
Introduction is missing No framework is established for the presentation. The conclusion is missing. There may be multiple instances of inaccurate or incomplete information. No understanding is demonstrated.
105 pts
This criterion is linked to a Learning Outcome Organization
105 to >91.35 pts
Meets Expectations
Information is presented in a clear, logical order with an apparent beginning, middle, and end. The speaker introduces the topic, identifies the topic skillfully.
91.35 to >78.75 pts
Approaches Expectations
Information is generally presented in a clear, logical order with an apparent beginning, middle, and end. The speaker introduces the topic.
78.75 to >61.95 pts
Below Expectations
Information is presented in a way that shows little organization or order. The speaker fails to introduce the topic or does so in a way that is confusing.
61.95 to >0 pts
Not Meeting Expectations
Information is not presented in a logical, cohesive order. Topic is unclear.
105 pts
This criterion is linked to a Learning Outcome Slide Presentation
60 to >52.2 pts
Meets Expectations
Use of visual aids/ images is appropriate. Slides are easy to read, interesting, and relevant to the content. All main ideas are presented succinctly. Contains the required number of slides.
52.2 to >45.0 pts
Approaches Expectations
Use of visual aids/images generally appropriate. Slides generally easy to read, somewhat interesting and relevant to the content. Some main ideas are presented succinctly. May be missing some of the required number of slides.
45 to >35.4 pts
Below Expectations
Use of visual aids/images not fully appropriate. Slides generally not easy to read. Main ideas missing or difficult to find quickly. May have irrelevant visual aids or images. Missing several of the required number of slides.
35.4 to >0 pts
Not Meeting Expectations
Use of visual aids /images not appropriate. Slides not easy to read. Missing most required slides. Slides missing main ideas.
60 pts
This criterion is linked to a Learning Outcome Mechanics and APA
30 to >26.1 pts
Meets Expectations
The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly.
26.1 to >22.5 pts
Approaches Expectations
The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly.
22.5 to >17.7 pts
Below Expectations
The assignment generally follows current APA format with several mistakes and grammatical, spelling, or punctuation errors. Most sources are cited and referenced incorrectly.
17.7 to >0 pts
Not Meeting Expectations
The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Sources are missing.
30 pts
Total Points: 300
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Classmate Response (2) PUB 655- Topic 7 DQ 2 Reproductive Health And Nutrition (Please see upload for question and classmate’s essay)
This order is for a response to a classmate’s post. I have uploaded the question and the classmate’s essay that requires a response
Respond to the classmate essay by-
1. sharing an insight to the question and asking a probing question.
2. Also add other points related to the topic.
3. offering and supporting an opinion from this classmate’s essay- Please elaborate on the point the classmate made on “malnutrition of children and women in Malaysia” please elaborate on one or two points from the classmate’s essay. Please do not just re-write what the classmate wrote.
4. validating an idea
5. making a suggestion
-Please use your own words and do not copy what she wrote
– Sources must be published within the last 5 years. It must be from 2017 and after and appropriate for the paper criteria and public health content.
– Please do not use blogs as references
-References should be in APA 7th ed.
-Add references to reference page
-Add the hyperlink/DOI for each reference in APA 7th edition format.
Thank you.
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Solution
Response
Greetings, thank you for your consideration. I am humbled to participate in this discussion. Firstly, I would like to appreciate your efforts in structuring a well grammatically comprehension with good language that enables any reader to understand easily. Your post gives a reader or examiner a quick insight and picture of how Malaysia is suffering from malnutrition. Such focus on the topic is essential to motivate the reader to research more on the issue and present ideas, thus providing a mutual ground for diverse decision-making in solving global problems. I will add a few points regarding your post.
Malaysia is a country with diverse people from all over the world. Therefore, there is room for consuming different traditional foods (Muda et al., 2019). The problem is not lack of food but actually what the people in Malaysia consume as nutritious food. The country constitutes almost 80% of the rural population. This called upon the national interventions, such as post-nutritional programs that focused on nutritional education, especially in schools and communities back in the 1960s. Despite the slight progress, the nation still has a long way to ensure that malnourished children and women are educated instantly through evidence-based interventions.
Public health has contributed to ensuring that the malnutrition problem is controlled through nutrition programs in schools and community sectors. Public health has focused on socioeconomic factors like healthcare, environmental exposure, and human behaviors in reducing malnutrition problems. In Malaysia, the main focus is to reduce health problems such as obesity and chronic illnesses like heart problems resulting from malnutrition. Therefore, public health has been mandated to educate and provide nutritional foods to various schools in Malaysia and other low-income countries to curb the situation (Shahar et al., 2019). Technology advancement has contributed to human behaviors such as consuming fast foods, unlike making nutritious foods. Therefore, public health has managed to create awareness in training the communities on healthy farm produce that reduces health problems and increases life expectancy.
References
Muda, W. M. W., Sundaram, J. K., & Gen, T. Z. (2019). Addressing malnutrition in Malaysia.https://www.researchgate.net/profile/Wan-Manan-2/publication/338403360_Addressing_Malnutrition_in_Malaysia/links/5e130a5ca6fdcc283759b96d/Addressing-Malnutrition-in-Malaysia.pdf
Shahar, S., Lau, H., Puteh, S. E. W., Amara, S., & Razak, N. A. (2019). Health, access and nutritional issues among low-income population in Malaysia: introductory note. BMC Public Health, 19(4), 1-5. https://link.springer.com/article/10.1186/s12889-019-6852-8

Evidence-Based Teaching Strategies
Assessment Description
An effective nurse educator has current, researched knowledge of teaching strategies to use in the educational setting. Effective evidence-based teaching strategies allow learners to collaborate with peers and participate in higher-order thinking.
The purpose of this assignment is to compile an annotated bibliography of evidence-based teaching strategies for your practicum setting.
Provide a 6-entry annotated bibliography of peer-reviewed/scholarly literature related to your chosen practicum topic and appropriate teaching strategies. Include a 150-word summary for each resource that includes the following:
Description of the evidence-based teaching strategy and its application to your practicum topic.
Description of the relevancy and accuracy of the source.
Description of the quality of the source.
Utilize ”Preparing Annotated Bibliographies,” located in the Student Success Center, to review general guidelines and specific examples for creating an annotated bibliography.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
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Solution
Teaching in the educational setting requires that an educator has adept knowledge of the effective strategies that can be applied in different scenarios. For example, delivering educational content in the practicum setting needs evidence-based practice teaching strategies to optimize the output and understanding. The implication is that an effective nurse educator has to be current and research-oriented to acquire sufficient knowledge of the teaching strategies to apply (Melrose, 2019). Solving problems such as falls in adult care facilities requires teaching to deliver fall control and management strategies to the patients and individual adults. Therefore, this write-up purposes of formulating an annotated bibliography on evidence-based teaching strategies that can be applied in the adult care facility to reduce falls.
Kiegaldie, D., Nestel, D., Pryor, E., Williams, C., Bowles, K. A., Maloney, S., & Haines, T. (2019). Design, delivery and evaluation of a simulation?based workshop for health professional students on falls prevention in acute care settings. Nursing open, 6(3), 1150-1162. https://doi.org/10.1002/nop2.318
Authored by Kiegaldie et al., this article explores the use of simulation as a teaching strategy to the health professional’s knowledge on reducing the rates of patient falls. Upon the use of simulation as a teaching strategy, these researchers found out that there was a significant drop in the cases of patient falls. Hence, this teaching method is appropriate. Simulation entails an imitation of real-world processes and activities in a safer environment. Therefore, the strategy offers the learners an experience as close to the real world as possible. Among the barriers to effective fall prevention in any setting is a breakdown in communication and Poor Corporation. Therefore, this teaching method can be applied in my practicum settings to improve physician/nurse teamwork by improving communication, collaboration, lowering the breakdowns in respect perceptions, and role misunderstanding behaviors. These will ensure that the professionals collaborate more appropriately and work towards lowering the rates of falls among the elderly. This source is of high quality since it’s a peer-reviewed journal.
Curley, L. E., Wu, Z., & Svirskis, D. (2018). Using technology in pharmacy education: pharmacy student performance and perspectives when visual aids are integrated into learning. Frontiers in pharmacology, 9, 1062. https://doi.org/10.3389/fphar.2018.01062
Curley et al., 2018, accomplished a study to evaluate the efficacy of using visual aids as a teaching method. The researchers used a pre-and post-intervention to study the impact of using visual aids. Upon the implementation of the visual aid as a teaching strategy, the authors noted that students’ scores significantly improved in comparison to the pre-intervention period. This teaching strategy involves the use of visual aids that can help the learners to stay interactive and to learn better. This teaching strategy can be applied in my practicum setting to train the nursing staff on strategies or guidelines to help prevent falls among the individuals living in the adult care facility. Through the use of visual aids and presentations, the staff gets to understand better the strategies that can be used in controlling and reducing falls. Like the previous articles, this source is a high-quality source as it is a peer-reviewed journal, hence dependable.
Nasr-Esfahani, M., Yazdannik, A., & Mohamadiriz, S. (2019). Development of nursing students’ performance in advanced cardiopulmonary resuscitation through role-playing learning model. Journal of education and health promotion, 8. https://dx.doi.org/10.4103%2Fjehp.jehp_125_18.
Nasr-Esfahani et al., 2019 studied the impact of role-playing as a teaching method among nursing students as compared to the traditional methods of teaching. Even though it was applied in resuscitation, the method was found to be effective. The analysis of the data showed significant improvement when the post-intervention data were compared to the baseline data. In addition, the method gave better results compared to the group where the traditional teaching method was applied. Role-play as a teaching strategy involves the instructor making the students pretend or act some part of the activity to depict someone or an activity that they are not. This teaching method leads the students into an exploration of realistic situations through interactions. This teaching strategy can be applied in my practicum setting by directing the staff responsible for the care of the elderly individuals to perform various activities that help prevent falls through role-play such as prompt response to alarms, accurately identifying if a patient is at risk of falling. The source is also of high quality since it has been obtained from a peer-reviewed journal.
Yumei, Z. H. A. N. G., Lin, W. A. N. G., Aimin, C. H. E. N., Jianli, X. U., & Chunxia, F. E. N. G. (2018). Application of the reinforced teach-back method in health education of falls prevention for long-term hospitalized patients in the psychiatric hospital. Chinese Journal of Integrative Nursing, 4(10), 135. https://doi.org/10.11997/nitcwm.201810038
Yumei et al., 2018 performed this study to evaluate the impact of using a teach-back method as a teaching strategy in reducing the cases of falls in a psychiatric setting among long-term hospitalized patients. The nurses applied the use of the teach-back method to educate patients on a weekly basis on appropriate skills and knowledge that can help reduce the incidences of falls. The researchers noted a substantial increase in the relevant skills and knowledge about falls as well as reduced cases of falls. The Teach-back method allows the nurse educators to assess for any lapses in understanding and recall to have an idea on what to emphasize. The patients are given a chance to reiterate and recall what they have been taught. This teaching method can be applied in my practicum setting to teach elderly individuals what to avoid and what to do to prevent falls. They can then be asked to restate what has been learned in their own words to ensure that they understand the contents, reducing the chances of falling. This source is also of high quality and relevant as it is a peer-reviewed source.
Rhodes, B., & Burgess, A. (2018). An innovative educational intervention to improve nursing students’ knowledge, attitudes, and skills surrounding breastfeeding. Teaching and Learning in Nursing, 13(4), 197-201. https://doi.org/10.1016/j.teln.2018.05.003
Rhodes & Burgess (2018) studied the use of workshops as a teaching strategy in improving the nursing student’s skills, attitudes, and knowledge. The researchers used the workshop to deliver various relevant content to the students. After using the workshop, improved attitudes, skills, and knowledge were observed among the students who took part. The workshop model as a teaching strategy entails giving a mini-lesson, a workshop, and debrief. It enables students to be responsible for their learning and be creative as they need to actively take charge of their learning process. This strategy can be applied in my practicum setting, where the patients are taught various strategies for managing falls. The nursing staff can also be taught to appropriately follow various protocols for managing falls through the workshop model. The quality of this source is also commendable since it is from a peer-reviewed journal.
Schmutter, L., & St Fleur-Delbrune, A. (2021). Proactive toileting to prevent inpatient falls. Nursing Management, 52(11), 42-47. Doi: 10.1097/01.NUMA.0000795628.24632.4d.
This research was authored by Schmutter & St Fleur-Delbrune, 2021; this research applied coaching as an evidence-based teaching strategy to initiate a proactive toileting program to address the increasing rates of patient falls. A specialist who operated as a coach coached the nursing staff in various aspects of fall prevention such as lean daily management and quality improvement. The researchers noted that the program was successful but indicated that the use of coaching as a teachings strategy was key in ensuring that outcomes improved. This method entails efforts to help individuals improve their performance. Coaching as a teaching method can be applied in my practicum setting to improve the staff competency in preventing and managing patient falls. At the adult care facilities, the staff has different expertise and competence; therefore, coaching as a teaching strategy can only work to improve their performance in terms of controlling patient falls. This source is also of high quality as it has been obtained from a peer-reviewed journal.
Conclusion
In conclusion, teaching in a practicum setting requires the use of effective strategies. Evidence-based strategies have been shown to be effective in content delivery as they optimize the delivery process. Therefore various evidence-based teaching strategies have been explored in this write-up.
References
Curley, L. E., Wu, Z., & Svirskis, D. (2018). Using technology in pharmacy education: pharmacy student performance and perspectives when visual aids are integrated into learning. Frontiers in pharmacology, 9, 1062. https://doi.org/10.3389/fphar.2018.01062
Kiegaldie, D., Nestel, D., Pryor, E., Williams, C., Bowles, K. A., Maloney, S., & Haines, T. (2019). Design, delivery and evaluation of a simulation?based workshop for health professional students on falls prevention in acute care settings. Nursing open, 6(3), 1150-1162. https://doi.org/10.1002/nop2.318
Melrose, S. (2019). What works? A personal account of clinical teaching strategies in nursing. Sherri Melrose Publications: A Virtual Memory Box.
Nasr-Esfahani, M., Yazdannik, A., & Mohamadiriz, S. (2019). Development of nursing students’ performance in advanced cardiopulmonary resuscitation through role-playing learning model. Journal of education and health promotion, 8. https://dx.doi.org/10.4103%2Fjehp.jehp_125_18.
Rhodes, B., & Burgess, A. (2018). An innovative educational intervention to improve nursing students’ knowledge, attitudes, and skills surrounding breastfeeding. Teaching and Learning in Nursing, 13(4), 197-201. https://doi.org/10.1016/j.teln.2018.05.003
Schmutter, L., & St Fleur-Delbrune, A. (2021). Proactive toileting to prevent inpatient falls. Nursing Management, 52(11), 42-47. Doi: 10.1097/01.NUMA.0000795628.24632.4d.
Shaw, L. K., Kiegaldie, D., Jones, C., & Morris, M. E. (2021). Improving hospital falls screening and mitigation using a health professional education framework. Nurse Education Today, 98, 104695. https://doi.org/10.1016/j.nedt.2020.104695
Yumei, Z. H. A. N. G., Lin, W. A. N. G., Aimin, C. H. E. N., Jianli, X. U., & Chunxia, F. E. N. G. (2018). Application of reinforced teach-back method in health education of falls prevention for long-term hospitalized patients in the psychiatric hospital. Chinese Journal of Integrative Nursing, 4(10), 135. https://doi.org/10.11997/nitcwm.201810038

Assignment 2: Practicum – Assessing Client Progress
Learning Objectives
Students will:
Assess progress for clients receiving psychotherapy
Differentiate progress notes from privileged notes
Analyze preceptor’s use of privileged notes
To prepare:
• Reflect on the client you selected for the Week 3 Practicum Assignment.
• Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.
The Assignment
Part 1: Progress Note
Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):
Treatment modality used and efficacy of the approach
Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)
Modification(s) of the treatment plan that were made based on progress/lack of progress
Clinical impressions regarding diagnosis and/or symptoms
Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)
Safety issues
Clinical emergencies/actions taken
Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)
Treatment compliance/lack of compliance
Clinical consultations
Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)
Therapist’s recommendations, including whether the client agreed to the recommendations
Referrals made/reasons for making referrals
Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
Issues related to consent and/or informed consent for treatment
Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
Information reflecting the therapist’s exercise of clinical judgment
Note: Be sure to exclude any information that should not be found in a discoverable progress note.
Part 2: Privileged Note
Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment.
The privileged note should include items that you would not typically include in a note as part of the clinical record.
Explain why the items you included in the privileged note would not be included in the client’s progress note.
Explain whether your preceptor uses privileged notes and if so, describe the type of information he or she might include. If not, explain why.
Assignment 2: Practicum – Assessing Client Progress
Learning Objectives
Students will:
Assess progress for clients receiving psychotherapy
Differentiate progress notes from privileged notes
Analyze preceptor’s use of privileged notes
To prepare:
Reflect on the client you selected for the Week 3 Practicum Assignment.
Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.
The Assignment
Part 1: Progress Note
Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):
Treatment modality used and efficacy of approach
Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)
Modification(s) of the treatment plan that were made based on progress/lack of progress
Clinical impressions regarding diagnosis and/or symptoms
Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)
Safety issues
Clinical emergencies/actions taken
Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)
Treatment compliance/lack of compliance
Clinical consultations
Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)
Therapist’s recommendations, including whether the client agreed to the recommendations
Referrals made/reasons for making referrals
Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
Issues related to consent and/or informed consent for treatment
Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
Information reflecting the therapist’s exercise of clinical judgment
Note: Be sure to exclude any information that should not be found in a discoverable progress note.
Part 2: Privileged Note
Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment.
The privileged note should include items that you would not typically include in a note as part of the clinical record.
Explain why the items you included in the privileged note would not be included in the client’s progress note.
Explain whether your preceptor uses privileged notes and if so, describe the type of information he or she might include. If not, explain why.
By Day 7

Research Article Critique – Nursing
Research Article Critique
A research critique demonstrates your ability to critically evaluate an investigative study. For this assignment, choose an original or primary research study related to nursing or medicine. The purpose of this assignment is to review a research study in-depth and to decide whether or not it is a valid research study that can be used in practice. It is your written evaluation of the study, not just a summary of the study.
The body of your paper should follow APA Style guidelines, and it should 4–6 pages double-spaced plus a cover page and reference list. The full article must be attached to the critique for credit.
Note: Because submission of the article is part of the assignment requirements and is necessary for grading, any assignment submitted without the accompanying article will be considered incomplete. An incomplete assignment will be initially assigned a zero. The student has the opportunity to submit the article to complete the assignment. However, if it is submitted after the due date and time, the late penalty will apply. After five days, submissions will not be accepted, as per University policy, and the grade will remain a zero.
Articles used for one assignment cannot be used for the other assignments. (Students should find new research articles for each assignment.)
The selected articles should be original research studies. Review articles, concept analysis, meta-analysis, meta-synthesis, integrative review, and systemic review should notbe used.
Mixed-methods studies should not be used.
Your critique should include the following:
Research Problem/Purpose
Describe the problem as it is presented in the study.
State the purpose of the research.
Have the investigators placed the study problem within the context of existing nursing or healthcare knowledge?
Will the study solve a problem relevant to nursing?
Review of the Literature (may be part of the author’s introduction or conclusion)
Identify the concepts explored in the literature review.
Are the references current in relation to the publication date of the study? If not, what are the possible reasons for using older sources?
Theoretical Framework
Do the authors identify their overall assumptions or a theoretical framework for the study? Are these assumptions appropriate for the study?
Does the research draw only on nursing theory, or does it draw on theory from other disciplines?
If a formal theory is not identified, suggest one (preferably a nursing theory) that might be suitable for the study. Various nursing theories can be found at http://www.nursing-theory.org/theories-and-models/(Links to an external site.)
Variables/Hypotheses/Questions/Assumptions
What is the research question or the hypothesis? Is it clearly stated or implied?
What are the independent and dependent variables in the hypothesis or research question?
Are the variables clearly defined so that the reader understands the researchers’ interpretation of the variables?
Is the dependent variable concrete and measurable?
Methodology
What type of design (quantitative, qualitative) was used in this study?
Was inductive or deductive reasoning used in this study?
State the sample size and study population, sampling method, and study setting.
Did the investigator choose a probability or non-probability sample?
Describe how the independent variable was tested or surveyed in the study.
Describe how the dependent variable was measured.
Discuss the reliability and the validity (quantitative) or the credibility (qualitative) of the measurement tools.
How were ethical considerations addressed? What ethical considerations were necessary for this type of study?
Data Analysis
What data analysis method was used?
How were the results in the study presented to the reader?
Discuss at least one (1) finding from the authors’ results and relate it to the dependent variable of the study.
Summary/Conclusions, Implications, and Recommendations
What are strengths and limitations of the study other than those stated by the authors?
Can the researcher generalize the findings to other populations? Explain.
What is the significance of the findings and conclusions for you in your personal nursing practice? For nursing as a profession?
The body of your paper should be 4–6 pages double-spaced plus a cover page and a reference page. The critique must be attached to the article and follow APA Style guidelines.
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Solution
Research Problem/Purpose
Abir et al. (2019) focus on the challenge of crowding, which is a significant challenge among emergency departments and will be associated with poor outcomes. The purpose of Abir et al., (2019) study is to evaluate the effects of high occupancy in the emergency department on the different disposition decisions, hospitalizations, and return emergency department visits among patients. Abir et al. (2019) has therefore placed the study problem in the context of existing nursing knowledge by highlighting that only a few scholarly studies have tried to investigate the effects of crowding in the emergency department on patient disposition decisions. Past studies have therefore been conducted on small healthcare facilities and have provided no association between the likelihood of patient admission versus discharge and crowding. The findings of previous studies need to be confirmed in a larger setting. Abir et al. (2019) seek to solve a problem relevant to nursing in that the study seeks to fill the knowledge gap related to the effect of crowding in the emergency department on disposition patterns of patients and the subsequent outcomes among the discharged patients.
Review of the Literature
Abir et al., (2019) study explore various concepts in the literature review, including the increase in the number of patients in the emergency department visits in the US by more than twice in the past two decades. According to the literature I explored in Abir et al. (2019) study, the increase in the number of people visiting the emergency department in various healthcare facilities across the US has therefore contributed significantly to the challenge of crowding patients and has also experienced numerous challenges related to the timely access of emergency care. According to the literature reviewed by (Abir et al. (2019), the challenge of emergency department crowding is of great concern because such crowding will be associated with adverse clinical outcomes. Studies across the US have therefore shown that crowding correlates significantly to increased mortality and morbidity among patients’ non-compliance to treatment guidelines, delays in treatment, low length of stay, and high provider errors. Emergency department crowding also contributes significantly to high costs, high return visits, and readmissions elopement, and decreased patient satisfaction. According to the literature reviewed in Abir et al.’s (2019) study, emergency department crowding will also be a significant concern because it will significantly affect the disposition decisions among healthcare practitioners to either admit or discharge patients.
Abir et al. (2019) rely on current studies published within ten years of the studies conducted, with only two exemptions of studies being older than ten years. The two exemptions of the studies that are older than ten years include a practice guideline that had not been revised.
Theoretical Framework
Abir et al. (2019) do not identify a theoretical framework for their study but highlight the main assumptions of their study, which include providing a null hypothesis that high emergency department occupancy will have a significant impact on this position decision, hospitalizations, and return emergency department visits in a healthcare facility.
Abir et al., (2019)) study does not clearly identify a nursing theory that it relies on. One of the formal theories that can be applied to Abir et al., (2019) study includes Nightingale’s environmental theory. Nightingale’s theory focuses significantly on the environment in which nursing care is provided among patients. According to Nightingale, altering the patient’s environment can therefore go a long way in providing a lasting change in the health care of such patients. Different environmental factors can therefore affect the health of patients, which include pure water, fresh air, sufficient food supply, cleanliness, efficient drainage, and light. The lack of a clean environment in healthcare settings can therefore play a significant role in diminishing the health of patients (Gilbert, 2020). The role of nurses in patient recovery is to modify the environment so as to create the optimal conditions that might be necessary to allow the patient’s body to heal itself. In some cases, this would mean a better diet, minimal noise, or delivery of timely health care services. Nightingale’s theory can therefore be applied in Abir et al., (2019)) study because the study focuses on environmental factors that can affect the quality of healthcare services in the emergency department. Abir et al.’s (2019)) study highlights that crowding is a significant challenge in the emergency department that can be associated with poor outcomes among patients. The application of Nightingale’s environmental theory can therefore help the researchers to understand the impact of crowding, which is an environmental factor on patient outcomes in an emergency department.
Variables/Hypotheses/Questions/Assumptions
The research question in Abir et al., (2019) study is what is the effect of high occupancy in the emergency department on disposition decisions of healthcare practitioners, hospitalization, and return emergency department visits? The research question in Abir et al., (2019)) study is clearly stated and not implied. The independent variables in the research question include high occupancy rates in the emergency department, while the dependent variables include hospitalizations, disposition decisions among health care practitioners, and return of emergency department visits.
The variables in Abir et al., (2019)) study are clearly defined in a way that allows the readers of the study to clearly understand the researcher’s interpretation of the variables. In Abir et al. (2019), the variables are concrete and measurable, which include disposition decisions among Healthcare practitioners’ return of emergency department visits and hospitalizations among patients who visit the emergency department.
Methodology
Abir et al., (2019)) study relied on the quantitative research design approach. The study also utilized inductive reasoning, which included making inferences based on observations of the study Abir et al., (2019) quantitative study relied on the retrospective approach to analysis. The study was conducted in a tertiary care teaching hospital in an urban setting, with the facility having 86 beds in the emergency department. Approximately 85,000 study participants were reviewed during the study period. The study relied on the convenience sampling method, which included evaluating the emergency department of a tertiary care Teaching Hospital. The study relied on a probability sampling approach.
Abir et al., (2019) study relied on a logistic regression model to test the independent variable, which included the level of occupancy in an emergency department, on the other hand, the dependent variables in the study, which included hospitalizations, disposition decisions among health care practitioners, and return of emergency department visits were measured using the electronic health records in a healthcare facility.
The logistic regression models utilized in the study were valid and reliable. The Charlson-Deyo index is also reliable and has been effectively tested in past studies.
The ethical considerations that were necessary for Abir et al., (2019) study included confidentiality, privacy, and informed consent among research participants. The research participants were patients in the emergency department. The researchers needed to ensure that they protected personal information related to the study participants in that they did not reveal any personal information related to patients from third parties.
Data Analysis
The statistical analysis method and ANOVA tests were used to analyze data with different variables either being classified as having statistically significant observations or not. The results of Abir et al., (2019) study were presented to the readers through A descriptive analysis that highlighted the statistical significance of the different variables. One of the central findings of Abir et al., (2019) study was that there was a statistically significant decrease in the odds of admission after disposition decisions were conducted during high-occupancy hours in the emergency department.
Summary/Conclusions, Implications, and Recommendations
The main strength of Abir et al., (2019) study is relying on a large sample size of more than 85,000 patients observed over a period of more than four years. The high number of research participants increases the reliability and validity of the study results and allows for the generalizability of study results in larger populations. On the other hand, the most significant limitation of the study is relying on only a single setting or Teaching Hospital, which can significantly affect the generalizability of study in wider populations.
Abir et al.’s (2019) study conclusions are that crowding in the emergency department can play a significant role in reducing the likelihood of hospitalization while also not increasing the probability of patients returning to the emergency department within a two-week period. Therefore overcrowding in the emergency department might be associated with outcomes among patients. Such effects may not be quite significant, with the most significant effect being on patient satisfaction. Healthcare facilities should therefore adopt approaches to reduce crowding in the emergency department so as to increase patient satisfaction rates.
References
Abir, M., Goldstick, J. E., Malsberger, R., Williams, A., Bauhoff, S., Parekh, V. I., Kronick, S., & Desmond, J. S. (2019). Evaluating the impact of emergency department crowding on disposition patterns and outcomes of discharged patients. International Journal of Emergency Medicine, 12(1). https://doi.org/10.1186/s12245-019-0223-1
Gilbert, H. A. (2020). Florence Nightingale’s Environmental Theory and its influence on contemporary infection control. Collegian, 27(6), 626–633. https://doi.org/10.1016/j.colegn.2020.09.006