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Electronic Medical Record Fall Assessment

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Electronic Medical Record Fall Assessment

 

Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

 

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

  • Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
  • Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

  • Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

 

SAMPLE ANSWER

Electronic Medical Record Fall Assessment

Fall among patients is a critical health problem, which can be reduced through eMR fall risk assessment tools to reduce patient harm and guarantee safety. The eMR fall risk assessment tools can be used as an intervention strategy for particular risk levels to help ensure quality care.

McCarty et al. 2018 conducted a study to identify and implement evidence-based fall risk tool in emergency rooms and integrated into the health care delivery system by engaging nurses who would use the tool to promote quality care.  The study was not human subject research, and it employed the quantitative research approach, which involved the use of the Lowa Model of EBP to promote quality care. The Memorial Emergency Department Fall-Risk Assessment Tool (MEDFRAT) was used in the eMR and interventions developed for the fall risk levels. Data then collected through education sessions, which involved interviews, observations and focus group discussions on the impact of MEDFRAT implementation. The study results showed that the use of MEDFRAT led t a decrease in falls in the emergency department, and nurses appreciated to be part of the process and felt empowered with the EBT tool to improve patient care, which translates to decreasing falls in the emergency rooms. The main advantage of the project is that the Lowa Model helped to implement the EB quality care changes nurses to reduce patient falls. The major disadvantage of the study was that the study was carried out in only one healthcare setting and it did not consider the enjoyments of other health care systems to reach a more conclusive outcome.

Electronic Medical Record Fall Assessment

A study by Marier, Olsho, Rhodes, and Spector, (2015) examines how to improve the fall risk among patients using EMRs. The main purpose of the study is to determine how EMRs may improve ability to identify patients at highest risk for falls. A quantitative and a qualitative research approach was used in the study to evaluate the extend of preventing fall risk among inpatients.  The researchers collected data though observation of 13 control group nursing homes and medical records and reports from a large for-profit California nursing home chain were analyzed. Te study results showed that data from an EMR system helps to identify patients with high risk of fall. This improvement is based on the frequency that EMR data are updated. The main advantage of the study was that it provided critical evidence on EMR application for quality improvement, which in turn leads to large cost savings. The major disadvantage of the study was that the sample was significantly generalized by being restricted to nursing homes alone and it may unduly represent higher quality nursing homes with more quality use of EMR systems.

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Lytle, Short, Richesson, and Horvath, (2015) conducted a study on clinical decisions that can support and prevent fall risk among patients.  The purpose of the study was to improve documentation of fall risk assessments particularly for patients with high risk of fall and improve clinical outcome by reducing patent’s falls. The study employed a pre/ post-quasi-experimental study design and a qualitative and quantitative research approach to conduct clinical decisions that can support and prevent fall risk among patients. Data was collected through focus group discussions among nursing staffs and documents and reports on fall safety falls and falls with injury rates at Duke University Hospital. The results of the study showed that documentation of fall risk assessments and fall prevention plans of care increased significantly. Nurses also accepted and the fall risk program or the HER tool and reported that they were favorable as fall risk assessment reminders, which led to improvement in clinical outcomes. The primary advantage of the study was that the plan of care alert within the HER facilitated the admission of fall risk assessment at Duke University Hospital. The major disadvantage of the study was that the retrospective chart review did not have a fall prevention plan of care known which may have led to inconclusive results.

Electronic Medical Record Fall Assessment

Hong, Kim, Jin, Piao, and Lee, (2015) in their study aimed to determine the the risk factors that caused falls among patients using EMRs and to find out how falling influenced health outcomes of inpatients. The study employed a quantitative research approach as it used a retrospective case-control study design ton statistically test this formulated hypothesis. The researchers collected data using documents and reports on EMR that were implemented between 2008 and 2011.  The researcher also used observation to collect data by employing a fall group and a non-fall group in to the study. The study results indicated that fall have a number of risk factors and they influence patient’s outcome negatively according to the EMR data. Therefore, introducing a fall prevention tool will help to reduce fall risk. The main advantage of the study is that it guides pediatric nurses in delivering care to prevent falls among inpatients. The major disadvantage of the study was that focus groups are limited to generalization since the study respondents knew very little and the study outcome was not based on the actual use but reactions from focus groups.

Research Paper Help

Dahl (2017) carried out a study on the effectiveness of newborn Safety information to prevent newborn falls. The purpose of the study was a guide outcome of the clinical issue by evaluating the efficacy of newborn safety acknowledgment and information tool in influencing falls among newborn inpatients. The study used qualitative and quantitative study designs to collect evidence and evaluate the effectiveness of the Newborn Safety Information tool on the impact of falls in newborns. The researcher collected data using newborn case events, and additional quantitative and qualitative data were collected from incident reports and nurse’s narrative case records. The study found out that the newborn acknowledgment and information tool was used by nurses and mothers as intended and helped in communication between nurses and parents of newborns to improve safety and prevent falls of a newborn in an inpatient setting. The advantage of the study was that the Newborn Safety Information and Acknowledgement tool helped in communication between the nurses and parents of newborn babies. This helped to measure safety outcomes and interventions.  The limitation of the study was the short time frame of post-intervention evaluation as it only happened for three months. Besides, the newborn safety information and acknowledgement too had not been validated.

 

References

Dahl, C. L. (2017). The Effectiveness of Newborn Safety Information and Acknowledgement in

Preventing Inpatient Newborn Falls. PP. 1-79.

Hong, H. J., Kim, N. C., Jin, Y., Piao, J., & Lee, S. M. (2015). Trigger factors and outcomes of

falls among Korean hospitalized patients: analysis of electronic medical records. Clinical nursing research, 24(1), 51-72.

Lytle, K. S., Short, N. M., Richesson, R. L., & Horvath, M. M. (2015). Clinical Decision Support

for Nurses: A Fall Risk and Prevention Example. CIN: Computers, Informatics, Nursing, 33(12), 530-537.

Marier, A., Olsho, L. E., Rhodes, W., & Spector, W. D. (2015). Improving prediction of fall risk

among nursing home residents using electronic medical records. Journal of the American Medical Informatics Association, 23(2), 276-282.

McCarty, C. A., Woehrle, T. A., Waring, S. C., Taran, A. M., & Kitch, L. A. (2018).

Implementation of the MEDFRAT to Promote Quality Care and Decrease Falls in Community Hospital Emergency Rooms. Journal of Emergency Nursing, 44(3), 280-284.

 

 

 

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Rough Draft: Capital Punishment in Criminal Justice

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Rough Draft: Capital Punishment in Criminal Justice

Rough Draft Due Week 7 and worth 150 points Instructions: Writing Activity 3 has two sections to complete. You will use the writing templates in Webtext chapter 7 to complete them. Once you complete all templates, you will be able to download your work and submit it to Blackboard. The Webtext will guide you through the process.

 

Section 1 Rough Draft Create your Rough Draft by using the writing templates in Webtext chapter 7.

 

Your rough draft should include an introduction paragraph, 2-5 body paragraphs for all supporting points in your paper, a counter perspective, and a conclusion paragraph. While the rough draft should be complete, it does not have to be perfect. After you submit it, you will get feedback from your instructor to help make revisions before submitting the final version of your paper in week

 

SAMPLE ANSWER

Capital Punishment in Criminal Justice

Capital punishment, also referred to as the death penalty is a justice system where the offenders, when found guilty, are killed. Several justifications have been made for the penalty and against it and the debates have advanced with time. The death penalty dates back to Eighteenth Century B.C. in the Code of King Hammurabi of Babylon, which codified the death penalty for different crimes (Paternoster, 1991). The reasons for the penalty varied among different societies and they included sexual crimes, blasphemy, magic as well as a violation of religious obligations among others (McFeely, 2019). In history, capital punishment involved various ways of killing an individual including crucifixion, stripping the skin off an individual, stoning, burning, dismemberment and crushing among other methods. In the modern world, industrialized countries may use lethal injections among other modern forms. However, in the USA, capital punishment is given through the firing squad (McFeely, 2019). In the USA the punishment has been used for treason, murder, and people involved in the use of spies by governments to obtain political and military information (Vila and Morris, 1997). Although the pro-death crusaders argue that it serves as a deterrent to others who would want to engage in similar crimes, the argument is often tempered by some more critical factors.

The criminal justice system is tasked with the responsibility of reflecting the moral views of society. As a result, inflicting the penalty of death on its citizenry entirely violates religious teachings on the sanctity of life. In various religious beliefs, there is a supreme God that gives and takes life, and therefore, when one ends the lives of others, they seem to be assuming the role of God. Also, Capital punishments infringe on the inviolability, sanctity, and dignity of an individual’s life as only God should be allowed the right to take the lives of people. In addition, the action is morally wrong as it involves committing a crime as compensation for another crime or simply following the example of the criminal by carrying out an equally bad action (Binder et al. 2016). One main characteristic of capital punishment is that it ends up denying the offender the opportunity of rehabilitation, which is supposed to be the main goal of the justice system (Haney, Weill, and Lynch, 2015).

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Secondly, the criminal justice system has been filled with errors previously, and consequently, an innocent individual may be put to death for a mistake that they did not commit (Brown, & McGee, 2018). Also, the capital punishment process is expensive and there are several costs involved including special prison housing and staff costs. The governments spend a significant amount of tax payer’s money to fund such processes. The money would be used to carry out other important activities like educating the poor in society or coming up with programs that would seek to establish corrective behaviors or deter youths from getting into crime (Brown, & McGee, 2018).

The main argument that surrounds the topic is the ability of the capital punishment penalty to effectively serve as a deterrent to crime (Rice, 2017). The idea behind capital punishment is that when criminals are punished by being put to death, potential criminals will be discouraged from crime. However, this does not seem to be the case considering the proportional severity deterrent and economic theories of human nature. They establish that a penalty served for a crime is supposed to allow an individual to calculate the benefits of crime vis-à-vis the crime. If it was to be true that physiological pleasures of crime are weighed against the pain of execution, then there would be no cases of homicide as well as other cases that call for the death penalty. The growing statistics of homicides across different parts of eth United States of America dispute the fact that the death penalty serves as a deterrent to crime in modern times. Therefore this proves that there should be other methods that would be adopted to help people revert from their criminal ways and the death penalty is not effective.

Rough Draft: Capital Punishment in Criminal Justice

In conclusion, capital punishment should be abolished from the legal system because it is morally wrong and is very costly in addition to the fact that it gives man the position of God considering everyone has one life. Also, it has been established that it is not an effective tool to act as a deterrent to crime as evidenced by the increase in the levels of crime in the USA as well as in different parts of the world.

 

References

Binder, G., Fissell, B., & Weisberg, R. (2016). Capital punishment of unintentional felony

murder. Notre Dame L. Rev., 92, 1141.

Brown, L. L., & McGee, S. G. (2018). Social Work and Capital Punishment: a Call to

Action. Journal of Human Rights and Social Work, 3(4), 229-239.

Haney, C., Weill, J., & Lynch, M. (2015). The death penalty. In B. L. Cutler & P. A. Zapf

(Eds.), APA handbooks in psychology. APA handbook of forensic psychology, Vol. Criminal investigation, adjudication, and sentencing outcomes (pp. 451-510). Washington, DC, US: American Psychological Association. http://dx.doi.org/10.1037/14462-017

McFeely, W, S. (2019). Trial and Error: Capital Punishment in U.S. History. Retrieved

From: http://historymatters.gmu.edu/d/5420

Rice, S. K. (2017). Darkness to Light: Procedural Injustice as Crisis for Capital

Punishment Legitimacy. Seattle Journal for Social Justice, 15(3), 13.

Paternoster, R. (1991). Capital punishment in America (p. 20). New York: Lexington Books

Vila, B., & Morris, C. (Eds.). (1997). Capital Punishment in the United States: A documentary

history. Westport, CT: Greenwood Press.

 

 

 

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Writing Activity 2-Capital Punishment in Criminal Justice

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Writing Activity 2-Capital Punishment in Criminal Justice

Instructions:

Writing Activity 2 has four sections to complete. You will use the writing templates in your Webtext to complete them. Once you complete all templates, you will be able to download your work and submit it to Blackboard. The Webtext will guide you through the process.

Section 1 Outline

Create an outline. The outline is the plan for what to include in your essay. See chapter 4 of your Webtext for information on how to create a great outline.

Section 2 Working Thesis Statement

This is a one-sentence statement summarizing the main idea of your essay. It should tell your reader what your topic is, what your position is on the topic, and how you will support it. Use the template in chapter 4 of your Webtext to write your working thesis statement.

ENG215 Writing Activity 2 (rev. 2018-12) 2

Section 3 Starting Draft

Use the Webtext writing templates to set up your essay and write the first two paragraphs. Chapter 5 of the Webtext will provide you with guidance.

Section 4 Feedback Reflection

Use the writing templates in chapter 5 of the Webtext to: 1. List the feedback you received on writing activity one 2. Explain how you used feedback from writing activity one to write activity two 3. Discuss how the feedback on writing activity one will help you with future writing.

 

SAMPLE ANSWER

Capital Punishment in Criminal Justice

Part 1: Outline

  • Introduction
  • History of Capital Punishment in Criminal Justice
  • Crimes that required capital punishment
  • Capital punishment today across different parts of the world
  • Capital punishment in America today and methods used
  • Justification for capital punishment
  • Position against capital punishment
    • Capital punishment is morally wrong
    • Capital punishment however denies the offender the opportunity of rehabilitation
    • capital punishment process is also expensive
    • errors in capital punishments present irreversible consequences on innocent people
  • Conclusion

Chapter 2: Working Thesis Statement

The argument for capital punishment is that it serves as a deterrent to others who would want to engage in similar crimes, that argument is often tempered by some more critical factors.

Starting Draft

Capital punishment also referred to as the death penalty is a justice system where the offenders, when found guilty are killed. Several justifications have been made for the penalty and against it and the debates have advanced with time. In most cases, there have been more debates about the justifications and they seem to have taken center stage over the capital punishment issue itself. The main argument that surrounds the topic is the ability of the capital punishment penalty to effectively serve as a deterrent to crime. The idea behind capital punishment is that when criminals are punished by being put to death, potential criminals will be discouraged from crime. Although the pro-death crusaders argue that it serves as a deterrent to others who would want to engage in similar crimes, the argument is often tempered by some more critical factors.

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Since time immemorial, criminals have been executed as a punishment for the crimes that they have committed (Rice, 2017). The death penalty dates back to Eighteenth Century B.C. in the Code of King Hammurabi of Babylon, which codified the death penalty for different crimes. The reasons for the penalty varied among different societies and they included sexual crimes, blasphemy, magic as well as a violation of religious obligations among others (McFeely, 2019). In the Tenth Century A.D., hanging became the usual method of execution in Britain. In the following century, William the Conqueror would not allow persons to be hanged or otherwise executed for any crime, except in times of war. In the Sixteenth Century, under the reign of Henry VIII, the punishment was offered for capital offenses as marrying a Jew, not confessing to a crime and treason (Paternoster, 1991). In the USA the punishment has been used for treason, murder, and people involved in the use of spies by governments to obtain political and military information Vila and Morris, 1997)

Part 4: Feedback Reflection

The feedback received in the writing activity 1

  • Provides more citations for some of the information provided.
  • Provide appropriate Punctuation in compound intense
  • Work on the incomplete sentences
  • Provide more information on statistics or constitutional laws that support your argument.

The feedback will be useful in writing activity 2 because I will be keener on how I structure the sentences so that they can pass the message more coherently and effectively. The feedback is also useful in my research as I will delve into more research so that I can expand my knowledge to help me gain a better position on the topic and support my position more.

Writing Activity 2-Capital Punishment in Criminal Justice

The feedback is also beneficial for the future as I will incorporate the lessons into other different writings including those that are academic and those that are not. In doing so, I will be a more credible writer.

 

References

Binder, G., Fissell, B., & Weisberg, R. (2016). Capital punishment of unintentional felony

murder. Notre Dame L. Rev., 92, 1141.

McFeely, W, S. (2019). Trial and Error: Capital Punishment in U.S. History. Retrieved

From: http://historymatters.gmu.edu/d/5420

Rice, S. K. (2017). Darkness to Light: Procedural Injustice as Crisis for Capital

Punishment Legitimacy. Seattle Journal for Social Justice, 15(3), 13.

Paternoster, R. (1991). Capital punishment in America (p. 20). New York: Lexington Books.

Vila, B., & Morris, C. (Eds.). (1997). Capital Punishment in the United States: A documentary

history. Westport, CT: Greenwood Press.

 

 

 

 

 

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Capital Punishment in Criminal Justice

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Capital Punishment in Criminal Justice

ASSIGNMENT 1 Writing Activity 1: Prewriting & Research Assignment Due Week 3 and worth 100 points Instructions: Follow the three-step process outlined in Webtext chapter 3 to complete and submit Writing Activity 1. For additional help, watch the video tutorial in your course, which will walk you through the process. Step 1 Complete the following prewriting activities in your Webtext.

Week 1: Select Your Topic

Week 2: Develop Your Position and Draft Your Supporting Points

Week 3: Research Organizer

Step 2 Download and Edit Your Work

Download Complete all the activities and templates in your Webtext. Then download your Prewriting & Research Assignment from the Webtext. (*** You will need to finish all writing templates before you are able to download the assignment) Edit Your Work Run your Microsoft Word document through Grammarly to identify and correct any issues with grammar, spelling, punctuation, sentence structure, and style. NOTE: Refer to the Webtext to learn how to sign up for and use Grammarly. Remember to remove all of the Grammarly comments and underlined words before you submit! Step 3 Submit to Blackboard Go to week 3 in your course and upload your Prewriting & Research Assignment.

 

SAMPLE ANSWER

Capital Punishment in Criminal Justice

Background

Since time immemorial, criminals have been executed as a punishment for the crimes that they have committed (Rice, 2017). Capital punishment also referred to as the death penalty is a justice system where the offenders, when found guilty are killed. The reasons for the penalty varied among different societies and they included sexual crimes, blasphemy, magic as well as a violation of religious obligations among others (McFeely, 2019). In the USA the punishment has been used for treason, murder, and people involved in the use of spies by governments to obtain political and military information. Other parts of the world provide death punishment for different reasons. For instance, in the Middle East, the death penalty is given for people involved in sexual crimes including incest, sodomy, rape, and adultery. In China, it is given to people involved in corruption and human trafficking. In history, capital punishment involved various ways of killing an individual including crucifixion, stripping the skin off an individual, stoning, burning, dismemberment and crushing among other methods. In the modern world, industrialized countries may use lethal injections among other modern forms. However, in the USA, capital punishment is given through the firing squad (McFeely, 2019).

Position:

I am opposed to capital punishment being given to an individual irrespective of the crime that they have committed. The most common argument for capital punishment, which results in death, is that it serves as a deterrent to others who would want to engage in similar crimes (Rice, 2017). It means that other people in society will recognize the effect of the crime and consequently avoid getting involved. However, capital punishment is morally wrong and had more disadvantages than advantages.

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Morally, it is wrong to give capital punishment because it simply results in the executer following in the steps of the offender. It involves committing a crime as compensation for another crime or simply following the example of the criminal by carrying out an equally bad action (Binder et al. 2016). The process does not allow the offender to take time and change their lives and be better people in the future. This is because an individual may have committed a crime unintentionally, such as crimes of passion, which may be different from the premeditated crimes. The person may be given another chance at life instead of being killed. The capital punishment however denies the offender the opportunity of rehabilitation, which is supposed to be the main goal of the justice system (Haney, Weill, and Lynch, 2015).  Also, the criminal justice system has been filled with errors previously and consequently, an innocent individual may be put to death for a mistake that they did not commit (Brown, & McGee, 2018).

The capital punishment process is also expensive and there are several costs involved including special prison housing and staff costs. The governments spend a significant amount of tax payer’s money to fund such processes. The money would be used to carry out other important activities like educating the poor in society or coming up with programs that would seek to establish corrective behaviors or deter youths from getting into crime (Brown, & McGee, 2018).

Capital Punishment in Criminal Justice

When criminals face capital punishment, it seems as though an individual is being given the decision to decide when another person’s life will end. In various religious beliefs, there is a supreme God that gives and takes life and therefore, when pothers end the lives of others, they seem to be assuming the role of God. Capital punishments infringe on the inviolability, sanctity, and dignity of an individual’s life as only God should be allowed the right to take the lives of people. In conclusion, capital punishment should be abolished from the legal system because it is morally wrong and is very costly in addition to the fact that it gives man the position of God considering everyone has one life.

 

References

American Civil Liberties Union. (2019). The debate against capital punishment. Retrieved

from: https://www.aclu.org/other/case-against-death-penalty?redirect=capital-punishment/case-against-death-penalty

The article provides the reason why capital punishment is a process that is not only barbaric but also goes against the expectations of a democratic society.  It highlights the process as being expensive and consequently wastage of taxpayer’s money. It expounds on the fact that the process is inhumane and anachronistic or old fashioned. It also has a negative impact on the people that witness the process.  It shows several reasons why the process should be abolished and hence supports my argument on opposing the idea of capital punishment.

Binder, G., Fissell, B., & Weisberg, R. (2016). Capital punishment of unintentional felony

murder. Notre Dame L. Rev., 92, 1141.

The article delves into the eighth amendment and offers a description of an individual who is eligible for capital punishment. An example of a case is provided shedding more light on background information of the issue of capital punishment.

Brown, L. L., & McGee, S. G. (2018). Social Work and Capital Punishment: a Call to

Action. Journal of Human Rights and Social Work, 3(4), 229-239.

The authors highlight the stand by social work governing bodies that have called for an end to capital; punishment. The main idea is that it violates the eighth amendment and remains a threat to the mission of the profession and most importantly leads to violence. The article supports the position by arguing that the process is expensive. It suggests that the money that is used in capital trails and the appeals be used on other more appropriate roles such as law enforcement and a better society. It also establishes that the system is filled with errors hence proving the fact that innocent people may be convicted.

Haney, C., Weill, J., & Lynch, M. (2015). The death penalty. In B. L. Cutler & P. A. Zapf

(Eds.), APA handbooks in psychology. APA handbook of forensic psychology, Vol. Criminal investigation, adjudication, and sentencing outcomes (pp. 451-510). Washington, DC, US: American Psychological Association. http://dx.doi.org/10.1037/14462-017

The article discusses the concept of capital punishment and explains that although few people are involved in the punishment, it remains a controversial topic that has been studied widely. it is established the punishment differs from the other types of punishments in degree as well as in-kind based on the fact that it is irrevocable. This supports my position because it brings out that the process rejects the possibility of rehabilitation and hence does not allow the criminal to change their lives.

McFeely, W, S. (2019). Trial and Error: Capital Punishment in U.S. History. Retrieved

From: http://historymatters.gmu.edu/d/5420

The article provides information about capital punishment and the background of how it was used. It reveals the circumstances under which capital punishment was given including a description of the rimes from different parts of the world. It serves to highlight that some of the reasons were barbaric and did not deserve the sentence.

Rice, S. K. (2017). Darkness to Light: Procedural Injustice as Crisis for Capital

Punishment Legitimacy. Seattle Journal for Social Justice, 15(3), 13.

The article talks about the issue of capital punishment and the loops that exist in process. It serves to show that there are injustices that take place in the criminal justice system and as a result may have an impact on the capital punishment.

 

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Reviewing Research and Making Connections

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Reviewing Research and Making Connections

REVIEWING RESEARCH AND MAKING CONNECTIONS Due Week 4: 110 points For your first assignment, you will complete a short answer

activity in which you will analyze the article following the Ask, Research, Learn, Do process. This process was introduced in your webtext as a

simplified version of the sociological research process. It’s a useful tool to help you think critically, answer questions, and solve problems. REVIEW

THE RESEARCH Review the Article “Most Americans think the government could be monitoring their phone calls and emails”

http://www.pewresearch.org/fact-tank/2017/09/27/mostamericans-think-the-government-could-be-monitoringtheir-phone-calls-and-emails/ USE

THE RESEARCH Use the research information presented in the article to answer the questions below. You should write four paragraphs, one for

each step listed in bold. Use the Assignment 1 template to complete this assignment. Refer to Chapter 2 of the webtext as necessary.

 

1) Ask: • What was the topic of the research? • Who was studied in the research? • What was the research question that was answered by the

information in the article?

 

2) Research: • What research methods were used? • Summarize the process researchers used to collect data.

 

3) Learn: • What were the key findings of the research? • What conclusion was drawn from the research?

 

4) Do: • What are two additional follow-up questions that you have based on this research? • Why did you choose these follow up questions?

FORMATTING 5) Your assignment must follow these formatting requirements: • Use the Assignment 1 template to complete this assignment.

 

SAMPLE ANSWER

Reviewing Research and Making Connections

Article Title: Most Americans think the government could be monitoring their phone calls and emails

Ask

The topic for research is “Most Americans think the government could be monitoring their phone calls and emails.” The research was conducted by the Pew Research Center through a survey. The study target was adults and youth in the United States of America. Individuals of different gender, age as well as education levels were sampled for the study. The different demographic groups all had different views on the topic of discussion. The research question that was being answered was whether they believed that the government was monitoring their phone calls and emails.

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Research

The study adopted a qualitative study and a survey was used to determine what people thought about their government monitoring their phone calls as well as emails. The article brings out that the survey was conducted in the month of February of the year 2017. Interview questions were asked to various people of various backgrounds and the results were analyzed and presented in the article findings. The study also assesses whether the public approves of the government monitoring their phone calls and emails. It relates the findings to other studies that were carried out by the same institution in the years 2014 and 2015. These studies established that it is unacceptable for the government to do so. They also revealed that the government was monitoring their phone calls and emails as part of efforts towards anti-terrorism.

 

Learn

The key findings of the research showed that 7/10 of the adults in the United States of America believe that the government monitors their phone calls and emails. Also, about 13% of the population believes that the government is not likely to monitor their phone calls and emails. In addition, eight out of ten adults under the age of 50 believe that it is possible that the government tracks their communication through phone calls and emails. Furthermore, the same thoughts are held by six out of ten adults who are above 50 years of age. Also, there are more men than women that suspect the government of monitoring their communication activities. The concern of being monitored by the government is shared across the political divide and both democrats and republicans believe that there is a possibility of their communication being monitored by the government. The conclusion that was drawn from the research is that a large number of people in American believe that the government could be monitoring their phone calls and emails.

Do

Additional follow up questions?

  1. What are the factors that trigger the population to believe that the government of the United States of America could be monitoring their phone calls and emails?
  2. What is the implication of having the government monitoring the communication made by the people in the country?

These follow up questions are important because they justify the research that was one. It will be a significant attempt at explaining the statement of the problem that prompted the research. In addressing these questions, I will be able to understand the justification and significance of the study as well as the impact of the study.

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Major Regulatory Restrictions on NP Practice

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Major Regulatory Restrictions on NP Practice

Use the provided template to compare and contrast the three major regulatory practice models for NPs: Supervisory, Collaborative, and Independent. Please keep this assignment in the template format provided. This Assignment requires credible and up to date resources for each category. Include in each model at least one state that represents the scope of practice you are discussing. For example, Florida requires a supervisory relationship with a physician along with a practice agreement, formulary, and protocols. In order to apply and receive a DEA license to prescribe controlled substances, you must be approved by the state you are practicing in to prescribe these medications. I have chosen three states , I think they are in the right place.

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SAMPLE ANSWER

Major Regulatory Restrictions on NP Practice

Research Paper Help

 

Topic Supervisory Practice Collaborative Practice Independent Practice
List the name of a State that is representative of each regulatory model. Texas Louisiana Colorado
Evaluate how each model affects the NPs scope of practice? (include, if applicable, the use of protocols, formulary, written agreements, direct versus indirect supervision, referral policy, patient care, review of medical documentation, and payment reimbursement. Supervisory practices in Texas restrict NPs from providing certain primary care services. Using this model, regulatory bodies limit the scope in which NPs can operate in regarding the nature of services offered.

 

 

 

 

 The existing laws in Louisiana require a Collaborative Practice Agreement (CPA) with a physician before providing health services. The agreement indicates collaboration with other healthcare disciplines

 

 

 The independent practice model seeks to ensure that health providers practice effectively. No collaboration agreements or supervision is required (Hain & Fleck, 2014). Through this, the state allows assigned nursing agencies to control the quality of services independently.
How does model of practice serve as a barrier to access to care? The supervisory practice model proves to be challenging for NPs. This is mostly the case, for licensed practice, which limits providers’ delivery despite their qualifications (AANP, 2016). The model limits the providers’ capabilities and chances for providing proper care to patients suffering from acute illnesses. For the independent practice, providers are free to serve in their areas of specialization, with no limitations (Hain & Fleck, 2014).
Compare/contrast the prescriptive privileges of each model and example State The restrictions in Texas limit the operations of NPs, hence reducing the chances of providing services such as drug prescription. Unlike Texas, Louisiana only allows NPs to undertake practices that are described in their licenses, as well as maintaining constant collaboration among the NPs. In Colorado, though, NPs are given freedom to prescribe drugs with minimum supervision, compared to Texas.
Compare/ Contrast how each model impacts payer status for the NP NPs in Texas operate in healthcare centers and assume a role of employees. For Louisiana, NPs are subject to strict policies regarding payer levels, as one is only allowed to undertake licensed activities. NPs use independent models but are compensated based on their qualification levels.
Compare/Contrast how these models may impact NP job satisfaction. Regarding job satisfaction, the supervisory model comes with many restrictions that limit NPs, and does not motivate them (Hain  & Fleck, 2014). The model provides an average satisfaction rate for NPs since it has fewer challenges (AANP, 2016). Job satisfaction for this model is higher since NPs have more freedom that is not provided y the other models.

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Issues Affecting Intervention Studies

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Issues Affecting Intervention Studies

Discuss some of the possible problems or issues that could affect intervention studies.

Use the main book of the class to make the paper, include it in the references, please.

 

SAMPLE ANSWER

Issues Affecting Intervention Studies

The validity of interventional research is based on the theoretical framework, underlying hypothesis, and support for the conception level. The validity of the intervention studies is made during the intervention study design, which is made up of the construct validity, internal validity, external validity, and statistical conclusion validity (Burns & Groves, 1997).  Any factor that reduces the validity of the study is a threat is the main limitation of the study.

The construct validity is often due to the flaws in the study design linked to the intra-study social considerations, selected measurements, and imprecise operational definitions (Grove, Burns, & Gray, 2012).  However, the significant threats to construct validity include: inadequate preoperational clarification of constructs, confounding constructs and level of constructs, mono-operational bias, interaction of different treatment, interaction of testing and treatment, hypothesis guessing within the experimental conditions, evaluation apprehension, novelty effect, and compensatory rivalry (Burns & Groves, 1997).

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Internal validity is based on changes in the dependent variable caused by the actions of independent variables. The major threats include history threat that affects the value of independent variable, maturation that happen due to the changes that occur as a function of time, testing that happens due to pretest on subsequent posttest scores, and the statistical regression towards the mean that arise due to the display of the extreme scores.

External validity is based on the study results that may have been generalized back to the population. The major threats of external validity include design-dependent decisions in sampling strategy, which reduces the generalization of results, subject attrition, Subject refusal to participate, selection-treatment interaction, testing-intervention interaction, high differential attrition and reactive arrangements (Burns & Groves, 1997).

The statistical conclusion validity is the researcher’s correct decision on the statistical tests used in the study. Its significant threats include false data analysis conclusion that leads to low statistical power, type II error, and fishing or error rate problem (Burns & Groves, 1997).

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In summary, the validity of interventional research is the truthfulness of the study. It helps to address the study designs used during the study. However, the threats of interventional studies often decrease the validity of the study. The limitations of the intervention study always lead to threat validity (Munhall, 2012).  Thus, researchers need to scrutinize the threats that may arise during interventional researched.

 

References

Burns, N., & Groves, K. (1997). The practice of nursing research. Philadelphia, PA: WB

Saunders company.

Grove, S. K., Burns, N., & Gray, J. (2012). The practice of nursing research: Appraisal,

synthesis, and generation of evidence. Elsevier Health Sciences.

Munhall, P. (2012). Nursing research. Jones & Bartlett Learning.

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Organizational Development and Planning

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Organizational Development and Planning

Discussion: Organizational Development, Workforce Planning, and Succession Planning

 

Organizational development is focused on improving the efficiency and effectiveness of a workplace. As part of this process, strategic planning professionals often work with leadership teams to develop strategies for short-term and long-term organizational development, including workforce planning and succession planning. This helps ensure that health care organizations recruit, train, and retain employees that are capable of meeting strategic objectives. For this Discussion, examine the following scenarios and suggest strategies for organizational development, workforce planning, and succession planning.

 

Scenario 3: Myrtle Healthcare System is an integrated health care organization providing health care services in Colorado. Recently, an investigative reporter from the local television news station reported that leadership at Myrtle’s flagship hospital, Jackson Hospital, will be getting annual bonuses of $25k in December and a 10% increase in their salaries for the next year. This story comes at a time when frontline staff members have been complaining repeatedly about the deplorable working conditions and lack of pay increase in five years. Unfortunately, leadership has consistently refused to host an employee town hall meeting to discuss their concerns collectively. The employees are now asking for the union to intervene so that this matter may be quickly resolved to restore the employees’ trust in leadership and the public’s trust in the organization’s ability to provide quality patient care.

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To prepare:

  • Review the scenario assigned to you by the Instructor.
  • Consider strategies for short-term and long-term organizational planning, workforce planning, and/or succession planning.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post: a cohesive response to the following:

Briefly describe the scenario assigned to you by the Instructor. Recommend strategies for short-term and long-term organizational development, workforce planning, and/or succession planning. Defend your recommendations. Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.

Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.

By Day 5

Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7. Expand on this Discussion by providing additional insights or alternative perspectives to colleagues who were assigned different scenarios than you. For example, if you were assigned Scenario 1, respond to colleagues who were assigned Scenario 2 and Scenario 3.

 

SAMPLE ANSWER

Organizational Development and Planning

The current healthcare environment for healthcare facilities entails various issues that demand strategic planning. These issues include increased competition, government policies, poor management of funds, and employee payments among others (Payne et al., 2018). The scenario presents a case of Myrtle Healthcare System which operates in Colorado. A flagship hospital of Myrtle is reported to increase its leadership salaries at a time when its employees are opposing the firm’s working conditions and payment policies.

Strategies for Short-Term Development

The company should engage in developing cash-flow forecasts. This strategy is essential in estimating the facility’s cash collections within short periods. The facility’s leadership also needs to develop a situational analysis.  This strategy will enable the management to understand the problems that face the hospital. Moreover, the management needs to create communication with the employees. This move will eliminate doubt from the employees as it will provide answers for what the firm is planning. In addition, the facility can improve on its employee-leadership relations. This can be enhanced by creating a fair reward system such as promotions basing on merit. This strategy is prone to shift the management’s reputation in the eyes of the employees. As a result, there will be successful operations in the hospital (Maruyama & Braga, 2014).

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Strategies for Long-Term Development

In the long run, Myrtle needs to create a SWOT analysis to review its long-term viability. This act will enable the management to develop decisions basing on the analysis. This strategy will enable the leadership to make suitable payment and employee relations in the long run.  Moreover, the management needs to redesign its personnel objectives. This strategy enhances positive employee operations and relations in the long run. Engagement in employee training on leadership skills is suitable in creating future leaders for the hospital (Maruyama & Braga, 2014).

 

References

Maruyama, U.G.R., & Braga, M.A.B. (2014). Human resources strategic practices, innovation

performance & knowledge management. Proposal for Brazilian organizations. Independent Journal of Management & Production, 5(3), 710-732.

Payne, R. A., Hovarter, R., Howell, M., Draws, C., & Gieryn, D. (2018). Succession planning in

public health: addressing continuity, costs, and compliance. Nurse Leader, 16(4), 253-256.

 

 

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Advanced Practice Nursing Role

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Advanced Practice Nursing Role

This is an assignment and does not need to be in essay format, however all questions answered can be mixed within a paragraph or two and flow together. Please see attachment and keep the module sections divided. About one page of length per module section is ok. These questions are for Advanced Practice Nursing (APRN) practicing in Texas– this is important because the laws may differ from state to state.

Minimum of 2 references per section. References need to be provided in APA format.

Module 1.2

Can Advanced Practice Nurses (APRN) practice with any type of population focus or speciality?  Does the Texas BON regulate where APRN’s can practice? Does the Texas BON regulate what type of practice APRN’s can participate in? Does Medicaid or Medicare influence where APRN’s can practice or what type of practice?  Does the Texas Board of Medicine regulate what type of practice APRN’s can participate in?

Compare and contrast the differences between the various APRN credentialing organizations? Does an APRN need to be credentialed?  What purpose does credentialing serve?

Do APRN’s need to be certified? If so, why?  What purpose does APRN certification serve?  What are some types of APRN certification?  Who certifies APRN’s?

 

Module 1.3

Why is there a need for the consensus model?  What is the purpose of the consensus model?  If you move from state to state as a APRN to work, what do you need to ask yourself in order to stay out of trouble?  How did the consensus model come about?

Is Texas compliant with the consensus model? If so why or why not?

What is the proper order in the consensus model?  Please define the purpose of the Certifying organizations? Accrediting organizations? Licensing boards?  What are the four categories of APRNs?

 

Module 1.4

When you prescribe to patients can you prescribe to persons that live outside your state?  For instance, if a person is visiting from Alaska and gets sick and visits your clinic can you prescribe to them?

Can you prescribe to persons that reside in the U.S. Virgin Islands and they are visiting your town and get sick?

Can you prescribe to persons that live in Mexico and they are visiting their daughter that lives in your town?

Can you prescribe Adderall to 11-year-old patients by yourself?

Can you prescribe Morphine to a 50-year patient with chronic pain?

Do you need to keep any records of your prescriptions?

Should you carry insurance when you prescribe?  What type of insurance should you carry?

Should you get a DEA number?  If so what is the process of getting a DEA number?

What is the Texas Prescription Monitoring aware program (PMP)?  When should an APRN utilize this program?

If an APRN is working in Telemedicine and they prescribe medications to a patient that calls in with sinusitis and lives in the same state.  Does prescribing to a patient via telemedicine work differently? and if so how?

Advanced Practice Nursing Role

 

Module 2.1

Beside the Texas Board of Nursing what other agencies or government bodies regulate or create rules for APRN’s?

How can APRN’s influence their state representatives?

What other groups can APRN’s collaborate with to influence potential legislation?

Please include the government address of your state representative and state senator?

Write a letter to your state representative about an APRN issue that matters to you (Example: full practice authority or any other issue that affects APRN’s).  Make sure you address your state representative as Honorable State Representative (their last name).  Mail the letter to their Austin address.

How do APRN’s find out about rule changes or changes in the law?  How do laws become enacted in Texas?

When does the Texas legislature meet? When does the Texas Board of Nursing meet?

 

SAMPLE ANSWER

Advanced Practice Nursing Role

Module 1.2

The Texas Board of Nursing considers that nursing practice is dynamic. The advanced nursing practice evolves through technology development, evidence-based practice, acquisition of knowledge, experience, and the changes in health care delivery (NursingLicensure.org, 2019). The scope of practice shows the type of patients APNs need to perform and forms APNs ability to seek reimbursement for provided services. Therefore, APNs can perform new procedures, practice in new settings, and practice new skills during their practice.

APRNs can practice with any population as they can diagnose and treat the public on various health complications and manage chronic diseases. This means that APRNs can provide specialty care across all people through assessment, diagnosis, and treatment including reproductive and gynecological care (Texas Board of Nursing,2019). Thus, APRNs drive evidence-based care and best practices changes to ensure and improve patient outcomes.

Advanced Practice Nursing Role

The Texas BON regulate where APRN’s can practice. Graduates who complete nursing education in the US or who receive the licensure may be allowed to operate temporarily in Texas (Texas Board of Nursing, 2019). However, individuals graduating from outside the US looking for license in Texas cannot get temporary authorization. Besides, even if they file for NCLEX-PN® they cannot get temporary authorization to practice (NursingLicensure.org, 2019). Medicaid or Medicare does not influence where APRN’s can practice or what type of training. Their role is only to reimburse for services provided. The Texas Board of Medicine also does not regulate what kind of practice APRN’s can participate. The board is only concerned in investigating complaints against medical physicists, surgical assistants, nurse and physicians (Texas Board of Nursing, 2019). There are many APRN credentialing organizations, and APRNs can choose from NCC, PNCB, AACN, and AANPCB, for certification.

APRNs in Texas must have at least a master’s degree to be certified. The certification must be consistent with education (Texas Board of Nursing, 2019). However, there are instances where an individual does not meet Texas standards despite training. The main types of certifications include the American Midwifery Certification Board, the American Academy of Nurse Practitioners, American Nurses Credentialing, and American Association of Critical-Care Nurses (Texas Board of Nursing, 2019). Therefore, the certifications help nurses grow in nursing field, expand their knowledge, and evolve as professionals, which in turn lead to improvement of healthcare delivery.

Module 1.3

The APRN Consensus Model is a model that helps to outline the recommendations regarding APRN licensure, education, certification, accreditation in all states in the United States. The model was developed between 2005 and 2008 by the American Nurses’ Association (National Council of State Boards of Nursing, 2019). The implementation of the model got an endorsement of over 40 nursing organizations in 2008 (National Council of State Boards of Nursing, 2019). The model impacts APRN certification organizations because their certification requirements must reflect the model requirements. APRNs need to stay updated on the requirements of in their profession and population focus to ensure their licensure requirements meet practice in Texas. Thus, the APRN Consensus Model has helped ensure APRNs are trained to ensure public safety, and developing standards, which reaffirm the certification and qualifications of APRNs in medical environments (National Council of State Boards of Nursing, 2019).

Advanced Practice Nursing Role

The consensus model has been endorsed and adopted by the state board of nursing in Texas to help in their revision of the policies on the APRN scope of practice and licensure requirements.  The model has a particular order for APRN regulation such as Licensure, Accreditation, Certification, and Education (Milstead & Short, 2019). The uniform model is therefore designed to align the interrelationship aspects within the model as mentioned above.

The certifying organizations, accrediting organizations, and licensing boards are responsible for certifying APRNs based on their patient population focus. They provide tests to examinees looking to become certified nurses in the state of Texas.  The Consensus Model outlines the four types of APRNs, including nurse practitioner (NP), clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA), and certified nurse-midwife (CNM) (Milstead & Short, 2019).

Module 1.4

APRNs in Texas does not have a prescribing authority of prescribing drugs and offering health care services to persons visiting from a different state in the US such as Alaska. Texas regulates the scope of prescription and primarily prohibited independent prescription (NursingLicensure.org, 2019). The APRNs are required to have the federal DEA registration and must have the prescriptive authority before ordering and prescribing drugs to people visiting from other states.  APRNs still has to get the prescription authority to treat individuals who get sick while visiting the town and are from Mexico or Virgin Island. However, this regulation is always challenging because APRNs should not be deterred from prescribing appropriately for individuals who need emergency treatment while visiting the state since failing to provide care does meet the standard of nursing practice (NursingLicensure.org, 2019). Therefore, APRNs must provide appropriate assessment, treatment, and prescriptions for patients from outside the United States.

APRNs in Texas have limitations when prescribing Adderall to 11-year-old patients by themselves.  The APRNs are limited to prescribing a 90-day supply of Adderall to individuals of the age of 2 years and older. Physician consultation is always needed, and the consultation must be outlined n the patient’s chart (NursingLicensure.org, 2019). Besides, pharmacists are not allowed to fill a schedule of subscription filled by an APRN. Prescription within the hospital can only be done by physician delegation for Schedule II prescriptions.

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APRNs in Texas can prescribe Morphine to a 50-year patient with chronic pain under controlled practice conditions because they must have physician consultation before prescribing the morphine. The Texas Medical Board considers that the patient must first be evaluated before prescribing the morphine including assessment of patient medical history, morphine prescription data (NursingLicensure.org, 2019).  Besides, informed consent must be considered before providing a morphine treatment, and this is tracked through the prescription monitoring program (PMP). The complete medical records for prescriptions must be maintained to help review the patient’s medical data in their future morphine treatment. Besides, the board of nursing requires APNs to help patients with insurance procedures during prescription. Therefore, complying with the Texas Insurance Code §1467.0511 is critical (Texas Board of Nursing, 2019).

The DEA number is essential because all APRNs working in Texas must be registered with the federal Drug Enforcement Administration (DEA). APRNs are covered under the registration, and they get individual DEA registration number. The process of applying the DEA number include application in the DEA website in which you are given a registration ID number based on the state of practice (Texas Board of Nursing, 2019). The ID number is also essential during the renewal of registration.

The Prescription Monitoring Program (PMP) in Texas aims to collect and monitor prescription data for all controlled substances by pharmacies in the state or located in other countries.  The PMP helps APRNs to check and eliminate duplicate controlled substances, get substance history information, and obtain overprescribing of controlled substances (Nursing World, 2019). APRNs with the authority of a physician may treat patients through the use of telemedicine using his or her license. Prescription in telemedicine works differently because there must be an established patient-practitioner relationship and the practitioner must meet the standard of care for the individual.

Module 2.1

Apart from the Texas Board of Nursing, other government bodies and agencies that create rules for nurses include NCSBN, AANA, ACNM, and the Citizen Advocacy Center. These bodies help legislators to make decisions regarding APRNs scope of practice, including the regulatory and regulatory requirements (National Council of State Boards of  Nursing, 2019).  APRNs can influence legislation through policy work involving practice processes and standards and collaborate with patients to ensure quality health care delivery. Influencing policy change also affects resource allocation and provision of care.

Advanced Practice Nursing Role

APRN’s always found out about rule changes or changes in the law through the weekly publication called Texas registry after the Texas Board of Nurses submit all proposed changes (Texas Board of Nursing, 2019). The registry includes notices of rule review, repealed rules, notice of withdrawn, adopted standards, emergency rules, and proposed rules.

Laws are enacted in Texas through the legislations enacted by the Legislature that convenes after every 140 days after every two years (Nursing World, 2019). However, sometimes special sessions can be conducted by the governor in case of emergency issues that may impact the nursing profession more positively. Most legislation can also be amended during the sessions.

 

References

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).

Burlington, MA: Jones & Bartlett Learning.

American Nurses Association (ANA). (November 14, 2017). ANA Enterprise.

https://www.nursingworld.org/practice-policy/aprn/

National Council of State Boards of Nursing (NCSBN). (20191). APRN consensus

implementation status. NCSBN. https://www.ncsbn.org/5397.htm

National Council of State Boards of Nursing (20192). “Consensus Model for APRN
Regulation: Licensure, Accreditation, Certification & Education,” ncsbn.org, National Council of State Boards of Nursing, https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf

NursingLicensure.org, (20191). Advanced Practice Registered Nurse license requirements in

Texas. Nursing licensure. https://www.nursinglicensure.org/np-state/texas-nurse-practitioner.html

NursingLicensure.org, (20192). Advanced Practice Registered Nurse license requirements in

California. Nursing licensure. https://www.nursinglicensure.org/np-state/california-nurse-practitioner.html

Nursing World. (2019). “FAQ: Consensus Model for APRN Regulation,”
nursecredentialing.org, American Nurses Credentialing Center, https://www.nursingworld.org/certification/aprn-consensus-model/faq-consensus-model-for-aprn-regulation/
Texas Board of Nursing. (2019). National Certification Expectations for Entry-Level
NPS,” aanp.org, American Association of Nurse Practitioners, https://www.aanp.org/education/student-resource-center/starting-your-career/9-education/1060-certification-for-entry-level-nps

 

 

 

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Literature Search

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Literature Search

  • Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
  • Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

  • Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

 

SAMPLE ANSWER

Literature Search

The health care sector across the world requires the establishment of targeted clinical systems to help improve patient outcomes.  The development and application of evidence-based practices as best clinical systems approach can lead to delivery of health care. Best outcomes refer to the absence of the sign and symptoms of a disease, which can be achieved through quality improvement.   This paper addresses the application of The Dietary Approaches to Stop Hypertension (DASH), its outcomes and efficiencies, and lessons learned from its application.

Summary One

Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition, 103(2), 341-347. https://www.ncbi.nlm.nih.gov/pubmed/26718414

The study by Chiu, et al. (2015) examines the effects of substitution of full-fat with low-fat dairy food products in the DASH diet with a corresponding increase in fat and a decrease in the intake of sugar on plasma lipids, lipoproteins and blood pressure.  The Dash diet enhances low-density lipoprotein, lowering of high blood pressure and cholesterol that is high-density lipoprotein. The researchers used a sample size of three health persons to conduct a randomised crossover trial based on three periods. The individuals consumed a standard Dash diet, a control diet, a lower carbohydrate modification of DASH diet, and a high-fat diet for three weeks each which was separated by two weeks’ periods for washouts. The researchers then conducted laboratory measurements that included the concentration of lipoprotein particles determined by the mobility of ions, which was established at the end of each experimental diet.

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The study results showed that the HF-DASH and DASH diets profoundly reduced blood pressure compared to the control diet. There was a reduction in the concentration of medium and large very-low-density lipoprotein particles and triglycerides.  The HF-DASH diet also increased the peak particle diameter of LDL and decreased the HDL cholesterol, LDL cholesterol, apolipoprotein A-I, large LDL particles Intermediate density lipoprotein and the width of LDL peak compared with the control diet.

Literature Search

The DAS diet significantly lowered blood pressure to the same extent as the HF- DASH diet and also reduced the concentration of VLDL and plasma triglyceride without increasing the cholesterol. The findings of the study can help improve nursing practice in managing hypertension. Nurses should create awareness among patients and the community at large about the DASH and HF-DASH diet to help reduce the mortality rates and the costs of treatments.

Summary Two

Akita, S., Sacks, F. M., Svetkey, L. P., Conlin, P. R., & Kimura, G. (2003). Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship.  Hypertension, 42(1), 8-13. https://www.ncbi.nlm.nih.gov/pubmed/12756219

Akita et al. (2003) assess the effects of the DASH diet on the pressure-natriuresis relationship to identify its mechanisms of lowering blood pressure. The Dietary Approaches to Stop Hypertension can act as primary mechanism for lowering blood pressure through consumption of a diet with vegetables, fruits, and low-fat dairy foods. The article uses a controlled trial method where DASH sodium trial and randomised feeding trial were used. The participants were not healthy individuals as they had systolic blood pressure (SBP) ranging between 120 and 159 and Diastolic blood pressure ranging between 80 and 95 without blood pressure-lowering medication. Statistical analysis was conducted by comparing the x-intercept and the steepness of the curve of the pressure-natriuresis between DASH diets and the control diet as well as the subgroups and testing them by the use of Student t-test for the non-paired samples.

Literature Search

The results of the study showed that the DASH diet effectively lowered blood pressure groups though a diuretic action with high sensitivity of sodium. This means that the article provides proof on whether the DASH diet lowers blood pressure within the first five months if intervention by testing its effects on pressure-natriuresis. Nurses should consider Dietary Approaches to Stop Hypertension as one of the primary nonpharmacological approaches to stop high blood pressure.

From the study, it is critical to note that the DASH diet should be used as a primary nonpharmacological treatment of blood pressure. DASH diet is a significant intervention in lowering the levels of high blood pressure among urban African Americans.  It also helps nurses understand the mechanism of the DASH diet in lowering BP, which makes it possible for them to speculate on patients and those situations it can be beneficial.

Summary Three

Kim, H., & Andrade, F. C. (2016). The diagnostic status of hypertension on adherence to the

Dietary Approaches to Stop Hypertension (DASH) diet. Preventive medicine reports, 4, 525-531. https://doi.org/10.1016/j.pmedr.2016.09.009

Kim and Andrade (2016) address the status of hypertension after adhering to the DASH diet. DASH diet is primarily used for patients with hypertension. However, it is unknown if the diagnosis of hypertension can help patients adhere to the DASH diet and nutrient intake.  The authors use linear regression analysis to analyse the relationship between DASH diet and diagnosis of hypertension.  The study used a sample of patients with hypertension and a DASH score of between 0 and 10 to help measure the intake of nutrients.

Literature Search

The study results indicated that the increased consumption of protein, fat, and sodium was linked to the diagnostic status of hypertension. The patients who followed the DASH diet showed reduced effect of stroke and hypertension. However, patients who did not engage in health nutritional behaviour showed no effect after using the DASH diet. Therefore, most patients did not adhere to the DASH guidelines regardless of their health condition.

I have learned that although the DASH diet is critical in reducing hypertension among patients, most do not adhere to the guidelines which continue putting their health at risk.  Nurses need to create awareness on management of hypertension through the use of DASH diet by stressing the importance of diet in managing hypertension and the effect nutrition has when under medication.

Summary Four

Seangpraw, Auttama, Tonchoy, and Panta, (2019) analyses the effect of Dietary Approach to Stop Hypertension (DASH) diet on hypertension among elderly patients. The study employed quasi-experimental research by enrolling the elderly patients with hypertension as selected groups were then assigned to receive the DASH randomly. The sample size was 85, which was obtained after a full 90 days follow up intervention.

Literature Search

The study demonstrated considerable improvements in hypertension in intervention and control groups. The diastolic blood pressure and systolic blood pressure of the patients in the intervention group reduced. Nurses should consider the intervention as the primary prevention strategy for high blood pressure among seniors in various minority ethnic or racial groups in the United States. The findings of the study suggest that nursing education should highly consider training the nurses about DASH diet intervention to improve patient outcome.

I have learned that high blood pressure is reduced using DASH diet intervention among elderly patients. Nursing practice should emphasise increased use of DASH diet among the minority groups, especially elderly patients with hypertension, to reduce the risks of stroke and high blood pressure. It is the responsibility of the nurses to create awareness on the benefits of DASH diet in minimising the stroke cases, which can, in turn, reduce the treatment costs and reduce the mortality rates.

 

Summary Five

Kawamura, A., Kajiya, K., Kishi, H., Inagaki, J., Mitarai, M., Oda, H., … & Kobayashi, S.

(2016). Effects of the DASH-JUMP dietary intervention in Japanese participants with high-normal blood pressure and stage 1 hypertension: an open-label single-arm trial. Hypertension Research, 39(11), 777. https://www.nature.com/articles/hr201676

Kawamura et al. (2016) address the impact of the DASH-Japan Ube Modified diet Program (DASH-JUMP) dietary patients with stage 1 hypertension and high-normal blood pressure.  The DASH-JUMP diet emphasises the consumption of vegetables, fruits, whole grains, and low-fat dairy foods to reduce blood pressure and the risks of cardiovascular diseases. It is essential to include a variation in the composition of the macronutrients in the DASH diet while still enhancing the preservation of the benefits of lipid and blood pressure risk factors.

Literature Search

The study used fifty-eight participants who consumed a standard DASH-JUMP four weeks.  After the intervention, it was found that the DASH-JUMP significantly reduced the BMI, fasting serum glucose level and fasting insulin level. The extent of adherence to diet determines the effectiveness of the intervention of the DASH diet. This means that the DASH-JUMP diet was an effective nutritional strategy for reducing high blood pressure among patients.

Most people with the problem of following prescribed diets have difficulty if adhering to DASH-JUMP diet. It is the responsibility of the nurses to create awareness and advice patients to follow prescribed diets to increase the effectiveness of DASH-JUMP intervention. This would help effectively implement the use of the DASH-JUMP diet as a nonpharmacological treatment of blood pressure because it is effective in controlling the level s of high blood pressure within five years of intervention.

 

References

Akita, S., Sacks, F. M., Svetkey, L. P., Conlin, P. R., & Kimura, G. (2003). Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship.  Hypertension, 42(1), 8-13. https://www.ncbi.nlm.nih.gov/pubmed/12756219

Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition, 103(2), 341-347. https://www.ncbi.nlm.nih.gov/pubmed/26718414

Kawamura, A., Kajiya, K., Kishi, H., Inagaki, J., Mitarai, M., Oda, H., … & Kobayashi, S.

(2016). Effects of the DASH-JUMP dietary intervention in Japanese participants with high-normal blood pressure and stage 1 hypertension: an open-label single-arm trial. Hypertension Research, 39(11), 777. https://www.nature.com/articles/hr201676

Kim, H., & Andrade, F. C. (2016). The diagnostic status of hypertension on adherence to the

Dietary Approaches to Stop Hypertension (DASH) diet. Preventive medicine reports, 4, 525-531. https://doi.org/10.1016/j.pmedr.2016.09.009

Seangpraw, K., Auttama, N., Tonchoy, P., & Panta, P. (2019). The effect of the behaviour

modification program Dietary Approaches to Stop Hypertension (DASH) on reducing the risk of hypertension among elderly patients in the rural community of Phayao, Thailand. Journal of multidisciplinary healthcare, 12, 109. DOI: 10.2147/JMDH.S185569

 

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