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Critical Review of Mrs. J.’s Nursing Intervention

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Critical Review of Mrs. J.’s Nursing Intervention

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

  1. Is very anxious and asks whether she is going to die.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is “running away.”
  4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5kg.
  2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
  3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
  5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)
  5. Inhaled short-acting bronchodilator (ProAir HFA)
  6. Inhaled corticosteroid (Flovent HFA)
  7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mrs. J.
  2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
  3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
  4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
  5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
  6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
  7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

SAMPLE ANSWER

Critical Review of Mrs. J.’s Nursing Intervention

Introduction

In healthcare, critical thinking involves an intellectual process of synthesizing, analyzing, reasoning, and reflecting as guidance towards decision making. This process is essential as it helps practitioners to develop accurate and relevant decisions in difficult scenarios. The paper uses critical thinking to analyze a situation involving a 63 year old patient by the name Mrs. J. She has a health history of cardiovascular diseases and portrays symptoms of heart failure.

Clinical Manifestations

The subjective data reveals that the patient is anxious about her condition. Also, she does not feel pain and has a running heart. She feels exhausted and is unable to drink by herself. This data aligns with the practitioner’s findings about the disease. For instance, the objective data shows irregular heart rate. From another perspective, respiratory problems caused by pulmonary crackle may lead to complications.

Critical Review of Mrs. J.’s Nursing Intervention

Appropriateness of the Interventions

During admission, a patient with heart failure needs to undergo proper assessment. Other important symptoms need to be evaluated. The practitioner needs to increase the patient’s oxygen availability. Application of diuretics, ACE inhibitors, and beta blockers is essential in the control of the disease. In the scenario, the treatment upon admission includes the above measures. Therefore, it can be observed to be appropriate (Komajda et al., 2016).

Rationale for the Medication

IV furosemide is a diuretic. The drug is used to control overflow of fluid. It is also used to minimize heart workload, thereby reducing ventricular filling pressure and improvement in a patient’s condition. Enalapril is an ACE inhibitor. In the scenario, the drug is provided for vascular dilation, which results in improved blood flow and oxygenation of blood to the heart. It is also used to improve heart, kidney and nerve functioning in patients with diabetes type 1. Metrolol is a beta blocker which is applied in reducing a patient’s heart rate (Komajda et al., 2016).

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Morphine sulphate is an analgesic that is used for treating pain. It is also essential in improving vasodilation and relaxing the respiratory system. Inhaled short-acting bronchodilator is used for treatment of lung conditions and controlling effects of respiratory diseases such as chronic obstructive pulmonary disease. Inhaled corticosteroid is used for controlling respiratory conditions such as asthma. Lastly oxygen treatment is used to improve oxygen availability (Komajda et al., 2016).

Conditions Leading to Heart Failure

Arteriosclerosis: This condition involves hardening and narrowing of a body’s blood vessels. It is usually caused by conditions such as diabetes, smoking, and diet high in cholesterol. The condition can lead to poor blood flow to one’s heart, thereby overworking the heart. This feature may cause heart failure. Reduction of cholesterol intake and management of weight can reduce risk of attaining heart failure. Sleep apnea is a condition that involves breathing pauses during one’s sleep. Its obstructive version is associated with obesity Severe sleep apnea may lead to cardiovascular problems such as heart failure.  Sleep apnea can be controlled by being more active (Prabhakaran, Jeemon, & Roy, 2016).

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Hypertension is a condition where an individual experiences high blood pressure. It leads to increased risk of heart diseases due to increased pressure against the walls heading to the heart. This disease can be controlled by engaging in exercises and reducing weight. Coronary artery disease is a condition which entails formation of plaque inside an individual’s coronary arteries. The condition limits the blood flow to the heart. This condition can be controlled by engaging in exercises and reducing salt intake (Prabhakaran, Jeemon, & Roy, 2016).

Interventions in Multiple Drug Interactions

To eliminate issues caused by drug-drug interactions, a practitioner needs to review, the types of medications taken by the patient. By considering factors such as frequency, dosage, and reason for intake, a practitioner develops a proper way to control challenges caused by the interactions. Moreover, the practitioner may need to maintain an effective communication to ensure that the patient takes the right level of dosage. In addition, the practitioner may offer a warning to the patient to use the drug according to the recommendations. Creating a medication plan is also important. This strategy ensures that the drugs are kept in a safe place (Komajda et al., 2016).

Critical Review of Mrs. J.’s Nursing Intervention

Health Promotion Plan

Self-care education will be suitable in providing knowledge for the patient in both pharmacological and non-pharmacological measures. The plan needs to provide information on early planning of the hospital leave, reinforcement, improvement, and analysis of self-care abilities. Weight monitoring devices, medication monitoring devices will be essential in guiding the patient to get an effective control of her condition (Pandey et al., 2017).

Educational Method

When educating the patient, Abraham Marslow’s ABC’s theory would be applied. This method is essential in helping the patient group her needs depending on the necessity. For instance, teaching about self-care will focus much on taking medication more than engaging in exercise. The main objective of this approach is to ensure that the patient has an effective way of controlling the problem (Pandey et al., 2017).

COPD Risk and Management

Smoking and air pollution present the most common causes of COPD exuberating.  The patient needs to attend stop-smoking groups to get the motivation to reduce smoking. She should also avoid individuals who are smoking to ensure that she does not get tempted to smoke (Pandey et al., 2017).

 

References

Komajda, M., Anker, S. D., Cowie, M. R., Filippatos, G. S., Mengelle, B., Ponikowski, P., … &

QUALIFY Investigators. (2016). Physicians’ adherence to guideline‐recommended medications in heart failure with reduced ejection fraction: data from the QUALIFY global survey. European Journal of Heart Failure, 18(5), 514-522.

Pandey, A., LaMonte, M., Klein, L., Ayers, C., Psaty, B. M., Eaton, C. B., … & Berry, J. D.

(2017). Relationship between physical activity, body mass index, and risk of heart failure. Journal of the American College of Cardiology, 69(9), 1129-1142.

Prabhakaran, D., Jeemon, P., & Roy, A. (2016). Cardiovascular diseases in India: current

epidemiology and future directions. Circulation, 133(16), 1605-1620.

 

 

 

 

 

 

 

 

 

 

 

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Week 6: Short Answers

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Week 6: Short Answers

Please answer the following questions in regards to the attached article.  Note: no title page needed only the answers for the questions.

IMPORTANT:

  • 100 – 150 words required for each question answer, including each question within each question. (example two questions within a question = 200-300 words required total)
  • Question #2: requires 200-word count

 

1- What primary appeal (ethos. Pathos, logos) is the author using? Do you believe use of the appeal is convincing to his intended audience?  Provide an example from the text to support and explain your answer.  Also do you see any rhetorical fallacies the author is using?

2- What is your response (in 200 words) to the author’s position. Agree or disagree? Explain.

 

SAMPLE ANSWER

Week 6: Short Answers

  1. What primary appeal (ethos, Pathos, logos) is the author using? Do you believe use of the appeal is convincing to his intended audience?

The primary appeal that the author uses is the logos. Logos is also called the appeal to logic. It is where an author persuades the audience or readers using concrete reasons, facts or even figures. The author thus, looks at what the audience or readers can take as making sense and uses that to build his or her argument. The author does not make blanket statement but uses evidence rather than emotions. The writer presents the evidence is a way that the audience or the writer will understand well. In the reading, the author makes use of evidence in presenting his argument.

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I believe that the use of logos in the essay makes it more convincing to the readers although the author could have used credible sources in the essay. The author makes use of the logos appeal to persuade the audience to acknowledge that mass shootings are rare and consequently, it is irrational to live in fear of them. He seeks to encourage the audience that phobia of mass shootings is perpetrated by the media who should instead focus on other things that can cause death such as chocking. However, the appeal is not convincing because the sources cited are not credible. For instance, the author cites “according to a commonly cited chart” instead of providing credible sources that will support the argument.

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The author makes use of a number of rhetorical fallacies in the essay. For instance, the author claims that “You are three times as likely to die of choking on food than be in a mass shooting”. The author does not make sound reasoning in such an argument among many others. He just makes such argument in order to appeal to the audience. All over the paper, the author makes several arguments that are meant to appeal to the reader while they may not be supported by credible facts. The author does not give room to the reader to make their own minds about an argument but rather seems to convince them to accept his own view.

Week 6: Short Answers

  1. What is your response (in 200 words) to the author’s position? Agree or disagree? Explain.

I disagree with the author that people should not be afraid of mass shootings because there are many other reasons to die. Apart from chocking, there are several other accidents that can take place, which is true but should not prevent someone from having a phobia of something because it is rare. Mass shootings are a major issue and the biggest problem is that one can be caught up at any point. Also, although they are rare, mass shootings result in the death of several people at the same time hence it is normal for an individual to have the phobia of mass shootings. Also, it is appropriate for individuals to be aware of the issue so that they can have information on how best they can save themselves from the situation. This is because there are first aid principles that would be applicable in case one has an issue such as choking. The same can be applied in a mass shooting situation and people, who feel like they have the phobia, can have a strategy and gain a better understanding of how to save their lives. Therefore, the individuals are justified to fear mass shootings, contrary to what the author brings up. Secondly, the media can focus on it, even as it focuses on other issues.

 

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Community Health Promotion

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Community Health Promotion

A two-page (500-word) paper that summarizes the resources that are available in your community and recommendations for future programs

 

a. Write a paper that focuses on resources.

 

Address the following prompts in your paper:

 

· Describe the resources that promote health promotion that are available in your community.

o Include the level of community participation.

o Explain the specific health promotion resources that are available across the lifespan.

o Include the level of participation for and any particular characteristics of the populations that use the resources.

 

· Recommend a health promotion idea or ideas that may be developed into a health promotion program or programs in your community.

Identify the targeted populations with rationale to support the choice.

 

SAMPLE ANSWER

Community Health Promotion

Health promotion is the process through which the well-being of individuals within a community is improved and protected. Health is regarded as a resource that is essential for everyday living. As a result, the emphasis on increasing control and enhancing the concept of health is not only the responsibility of the health sector but also the people of a given community. Comprehensive achievement of physical, social, and mental well-being requires the individuals in the community to understand and evaluate their health needs, and how they can be satisfied. Community participation forms the basis of successful health promotion. It reduces the vulnerability to disasters and promotes a quick response as well as improved planning in preparedness for calamities. The paper focuses on the community in Florida, which is highly regarded as the gateway city to Latin America.

The community has various resources that facilitate public participation in health promotion. They include the Dade Area Health Education Center (HEC), children’s homes societies, services for the elderly, and mental health programs, among others. The AHEC facility promotes easy access to affordable healthcare services, important health education to the residents, and recruitment and training of healthcare providers for the community. The facility mainly focuses on marginalized groups like the uninsured, economically undeserving, and patients with critical illnesses to provide them with improved access to comprehensive care (El-Amin et Al., 2016). AHEC also offers a wide range of academic programs to the students from within and outside the community to incorporate health-enhancing behaviors, achieving health literacy, and promoting the health of others.

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The Catholic Charities of the Archdiocese also assists in health promotion within the community. The program is involved in providing adult day care services to the elderly. The program accepts adults diagnosed with medical, mental, or psychological disabilities, and provides them with an environment where they can interact with their loved ones and other patients with similar conditions. The program provides them with food, local field trips, and professional nursing care accompanied by counseling. The patients are engaged in activities like games and exercises to help in stimulating their mental functionality (Barrueco et Al., 2016). To be enrolled in Catholic Charities, one has to be a disabled adult of about 60 years or older and probably demonstrating signs of mild stages of Alzheimer’s. The eligibility is not dependent on a patient’s nationality, gender, religion, or political beliefs.

The Douglas Gardens Community Mental Health Center is another resource that aids in health promotion. The center offers extensive behavioral healthcare programs and services to people with mental illness. The resource has medical professionals with the necessary skills to handle individuals struggling with substance abuse and assist them in their management and recovery journey. The treatment processes in the center use assessment tools and Evidence-Based Practice (EBP) modules to manage the symptoms and help the patients to live comfortably within the community (Graham et Al., 2018). Interestingly, most of the services within the center are covered by private insurance, Medicare, and Medicaid.

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One of the recommendations that can be offered to the community would be to include smoking sensation programs detailing the adverse side effects of smoking. The plans may revolve around quit activities and brief interventions through written and audio-visual resources. The program would be of tremendous help because smoking of tobacco products is one of the leading causes of premature deaths globally. The targeted population for the program will mostly be high school students (who constitute 10% of the smoking population) and adults between 45-65 years old (who form 18% of the smoking population).

 

References

Barrueco, S., Wall, S. M., Mayer, L. M., & Blinka, M. (2016). Addressing the Needs of Young Children and Families: Early Childhood Education and Services in Catholic Schools and Catholic Charities. Journal of Catholic Education, 20(1), n1. Doi:10.2337/dc13-2195

El-Amin, S., Suther, S., Kiros, G. E., &Zaw, K. (2016). Practice Patterns for Sexual History-taking among Florida Nurses. Florida Public Health Review, 13(1), 17. Doi: 10.7748/nm.21.6.13.s14

Graham, R., Hodgetts, D., Stolte, O., & Chamberlain, K. (2018). Community meal provision and mental well-being. The Handbook of Mental Health and Space: Community and Clinical Applications. 10(E26). Doi: 10.5888/pcd10.120180

 

 

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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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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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General healthcare technology trends

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General healthcare technology trends

  • Reflect on the Resources related to digital information tools and technologies.
  • Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
  • Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.

By Day 3 of Week 6

Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.

 

SAMPLE ANSWER

Healthcare Technology

There are several general technology trends that stand out in the healthcare organization. One of them is the shift towards the use of cloud in the storage of data. The hospital has been using modern technology for a while in managing the data but has mostly used physical server located within the facility. However, in the recent past, it has increasingly focused on cloud as its preferred method of data storage. Another trend to note is telemedicine. The hospital has been at the forefront in promoting the use of telemedicine where patients can get medical services without having to physically visit the medical facility. With only a smartphone, the hospital has been able to work with various telemedicine apps developers to come up with solutions that make telemedicine including sharing the medical information more convenient and effective.

These technologies are based on the internet and the ability to share information through it. A standout risk that is associated with the use of the internet is data safety (NasserH.Zaied, Elmogy & Abd Elkader, 2015). Internet sources and especially cloud-based data storage is far more vulnerable to hacks and cyber ware attacks than data stored in physical servers especially when using those cloud storage providers that are not established. The same is true with the telemedicine apps were data on the patient can be stolen. Recent reports show that medical records are worth more to hackers than even the credit card information showing just how high the threat to internet-based data sharing is (NasserH.Zaied, Elmogy & Abd Elkader, 2015). This shows the huge challenges of making the trends secure

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An obvious benefit from the technologies is that when cloud storage is provided by top providers such as Apple then the data is highly secure. A risk is that almost all systems even from the best providers are open to possible hacks. Therefore, the medical records from the patients can end up in the hands of criminals that can use it for purposes that can harm the patients. On Legislation, Health Insurance Portability and Accountability Act of 1996 has been of benefit as it provides strict guidelines on the approaches to follow in ensuring that patient medical records are secure (Mintzer, 2018). However, a risk is that the legislation can sometimes be cumbersome resulting in slower implementation of Information technology and increased cost. On patient care, cloud based storage and telemedicine ensure easier storage and communication which makes the provision of care more effective and easier. It also can result in cost savings which can be passed to the patients making care more affordable. However, a risk with patient care and especially with telemedicine is that it can result in poor services offered because the doctors do not have a chance to physically assess the patient.

Cloud storage is very effective and easy to access information and is likely to be impactful on the nursing practice. Nurses need to access medical information on issues such as patient identity and prescription easily to ensure that they provide the best care (NasserH.Zaied, Elmogy & Abd Elkader, 2015). Cloud storage will ensure that this is possible and therefore increase the speed of care as well as reduce possible cases of mistakes when information is not readily available. Cloud storage is likely to result in efficiency as medical professionals will have better information availability (Englander, 2018). The patient records will be simultaneously available to the right staff members at all times meaning that they all can be able to locate and process information better. For example, prescription data stored on the cloud can be accessed by the nurse and the pharmacists at the same time meaning that the drugs will be made ready for the nurse to pick and give to the patient.

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References

Englander, L. (2018). Telehealth and Digital Technology. Telehealth And Medicine Today, 1(1). doi: 10.30953/tmt.v1.62

Mintzer, S. (2018). Potential Benefits and Harms of HIPAA. JAMA, 320(22), 2379. doi: 10.1001/jama.2018.17179

NasserH.Zaied, A., Elmogy, M., & Abd Elkader, S. (2015). Electronic Health Records: Applications, Techniques and Challenges. International Journal Of Computer Applications, 119(14), 38-49. doi: 10.5120/21139-4153

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Personal Leadership Development Plan

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Personal Leadership Development Plan

Unit outcomes addressed in this Assignment:

  • Design a personal leadership development plan.

Course outcomes addressed in this Assignment:

  • PU550-4:Create a personal leadership development plan.

Instructions:

In this scenarioyou have recently been hired at a healthcare organization. Your hiring manager has asked you to assess your leadership skills and develop a personal leadership development plan based on areas that need improvement.

  • Complete the Tier 3 Competency Assessment to determine how prepared you are to meet the requirements of a public health leader.
  • After completing the Assessment, copy and paste the “Your Results” section from the Assessment to the Assignment 9 Submission Template.
  • Develop a comprehensive plan for improving in the three areas with the lowest score.

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Requirements:

  • Tier 3 Competency Assessment Completed.
  • Results section from Tier 3 Competency Assessment copied and pasted into Unit 9 Assignment Submission Template Section I.
  • Section II Table completed – table includes three strategies or trainings to support development in areas of improvement.
  • 500–800 word summary of personal leadership development plan.

 

SAMPLE ANSWER

Unit 9 Assignment

 

SECTION I:

 

Domain Average Total
Analytical/Assessment Skills 3.1
Policy Development/Program Planning Skills 2.9
Communication Skills 3.4
Cultural Competency Skills 3.0
Community Dimensions of Practice Skills 2.8
Public Health Sciences Skills 2.8
Financial Planning and Management Skills 3.4
Leadership and Systems Thinking 2.5

 

 

SECTION II:

 

Area for Improvement Strategy/Training 1 Strategy/Training 2 Strategy/Training 3
Leadership and System Thinking Skills Conference

http://www.r4phtc.org/tag/leadership-and-systems-thinking-skills/

 Online training

https://www.open.edu/openlearn/money-management/management/leadership-and-management

 Workshop

https://www.disruptdesign.co/systems-thinking
Public Health Sciences Skills Conference

https://globalhealthtrainingcentre.tghn.org/resources/conferences/

 Workshop

https://www.cdc.gov/publichealthgateway/professional/index.html

 Lecture

https://publichealth.nyu.edu/
Community Dimensions Skills Online training

https://www.cdc.gov/publichealthgateway/professional/index.html

 Lecture

https://publichealth.nyu.edu/

 Workshop

https://www.cdc.gov/publichealthgateway/professional/index.html
       
       
       

 

 

SECTION III:

Personal Leadership Development Plan

Introduction

A personal leadership development plan is viewed to help one to define and direct his or her career goals.  In healthcare, this plan helps one to achieve better satisfaction in practice. It also improves the organization’s operations (Baron, 2016).  Reflection of my leadership skills reveals that m knowledgeable in many areas.  After doing the competence assessment tier, I have realized that I need to improve my skills in three areas. The paper develops a plan that is focused on improving my leadership and system thinking, public health sciences, and community dimensions skills.

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Leadership and System Thinking Development

From my assessment, the areas that need much focus in this domain include collaboration with individuals, creating opportunities to organizations, and interacting with systems. To improve my leadership and system thinking skills, I need to attend a workshop. While this training program is short, I view that it is suitable in developing my skills. Moreover, I view that workshops usually involve professionals who can focus on individual needs. Secondly, I would like to engage in online training. This approach needs much dedication as online lessons may occur during inconvenient hours. In addition, I also need to attend a conference. The conference will be held by a business organization. However, the attained leadership skills will be applied in my profession. The training period for this aspect will take two months (Bellack & Thibault, 2016).

Public Health Sciences Improvement

As a healthcare practitioner, some of the most important skills are public health sciences skills. They are essential in improving my professionalism at the workplace.  The assessment has depicted that the areas which need more focus in this domain include explanations of prominent events, applying public health sciences in organization management, and explanations of evidence. I will attend a workshop which aligns with public health issues. Moreover, I would need to engage in conferences because they will take a longer. Lastly, I would like to attend lectures.  Since I have much focus in this domain, I will employ many strategies. For instance, I will engage note taking, active listening, and asking questions to get clarifications in areas of difficulty. The training period for this aspect will take three months.

Community Dimensions

Community dimension skills are important in helping a practitioner work well in a community setting (Dong et al., 2017). My area of focus is in understanding suitable ways of enabling community inputs to be used in improving healthcare policies and programs. In this area, I need to engage in online training.  I find this approach to be suitable because most of the issues about the current society are found online. Workshops will also be suitable in understanding various issues in this domain. However, since workshops take a short period, I will also attend some lectures on community health issues. This dimension needs about a month to improve on my skills (Fernandez et al., 2015).

Conclusion

Leadership training is a common occurrence in healthcare organizations. The plan tries to reveal that competence in healthcare is very important. Moreover, it tries to reveal that improvement in various skills needs multiple strategies or training elements. The training is predicted to take about three months to complete. I believe that my chosen strategies and training will improve my leadership skills.

 

References

Baron, L. (2016). Authentic leadership and mindfulness development through action

learning. Journal of Managerial Psychology, 31(1), 296-311.

Bellack, J. P., & Thibault, G. E. (2016). Creating a continuously learning health system through

technology: A call to action. Journal of Nursing Education, 55(1), 3–5.

Dong, Y., Bartol, K. M., Zhang, Z. X., & Li, C. (2017). Enhancing employee creativity via

individual skill development and team knowledge sharing: Influences of dual‐focused transformational leadership. Journal of Organizational Behavior, 38(3), 439-458.

Fernandez, C. S., Noble, C. C., Jensen, E., & Steffen, D. (2015). Moving the needle: A

retrospective pre-and post-analysis of improving perceived abilities across 20 leadership skills. Maternal and Child Health Journal, 19(2), 343-352.

 

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Standardized Nursing Terminologies

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Standardized Nursing Terminologies

Among the Resources in this module is the Rutherford (2008) article Standardized Nursing Language: What Does It Mean for Nursing Practice? In this article, the author recounts a visit to a local hospital to view the recent implementation of a new coding system.

During the visit, one of the nurses commented to her, “We document our care using standardized nursing languages but we don’t fully understand why we do” (Rutherford, 2008, para. 1).

How would you respond to a comment such as this one?

To Prepare:

  • Review the concepts of informatics as presented in the Resources, particularly Rutherford, M. (2008) Standardized Nursing Language: What Does It Mean for Nursing Practice?
  • Reflect on the role of a nurse leader as a knowledge worker.
  • Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

In a 2- to 3-page paper, address the following:

  • Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies.
  • Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the Walden Library.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)
  • Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

American Nurses Association. (2018). Inclusion of recognized terminologies supporting nursing practice within electronic health records and other health information technology solutions. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/Inclusion-of-Recognized-Terminologies-Supporting-Nursing-Practice-within-Electronic-Health-Records/

Macieria, T. G. R., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Lopez, K. D., & Keenan, G. (2017). Evidence of progress in making nursing practice visible using standardized nursing data: A systematic review. AMIA Annual Symposium Proceedings, 2017, 1205–1214. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977718/

Office of the National Coordinator for Health Information Technology. (2017). Standard nursing terminologies: A landscape analysis. Retrieved from https://www.healthit.gov/sites/default/files/snt_final_05302017.pdf

Rutherford, M. A. (2008). Standardized nursing language: What does it mean for nursing practice? Online Journal of Issues in Nursing, 13(1), 1–12. doi:10.3912/OJIN.Vol13No01PPT05.

Note: You will access this article from the Walden Library databases.

Thew, J. (2016, April 19). Big data means big potential, challenges for nurse execs. Retrieved from https://www.healthleadersmedia.com/nursing/big-data-means-big-potential-challenges-nurse-execs

Topaz, M. (2013). The hitchhiker’s guide to nursing theory: Using the Data-Knowledge-Information-Wisdom framework to guide informatics research. Online Journal of Nursing Informatics, 17(3).

Note: You will access this article from the Walden Library databases.

Wang, Y. Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. doi:10.1016/j.techfore.2015.12.019.

Note: You will access this article from the Walden Library databases.

Required Media

Laureate Education (Executive Producer). (2012). Data, information, knowledge and wisdom continuum [Multimedia file]. Baltimore, MD: Author. Retrieved from http://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6051/03/mm/continuum/index.html

Laureate Education (Producer). (2018). Health Informatics and Population Health: Analyzing Data for Clinical Success [Video file]. Baltimore, MD: Author.

 

SAMPLE ANSWER

Standardized Nursing Terminologies

Introduction

Standardized nursing terminologies refer to a wide range of vocabularies that are used by nurses to describe standard care. The common language is understood by all nurses from different geographical areas and various health institutions. Nurses agree on a common form of communication to ensure that there is no confusion on patient health history even when given care by different nurses of health professionals in various hospitals, units, and countries. For instance, nurses document postpartum vaginal bleeding as large, moderate, or small. The terms small, large, and moderate describe a standard amount that is known by the nurse (Topaz, 2013). Thus, if a patient is treated in a different hospital by different nurses, their health information would remain clear without causing any confusion or inconveniences. This paper aims to review the concepts of informatics as described by Rutherford (2008), in “Standardized Nursing Language; What Does It Mean for Nursing Practice?”. The paper also describes the importance of standardized nursing terminologies.

In the “Standardized Nursing Language: What Does It Mean for Nursing Practice?”, the author describes how he visited a delivery and labor unit in a local community hospital with the aim of observing the implementation of the recent Nursing Outcome Classification and the Nursing Intervention Classification. One of the nurses commented that they document their care through the use of standardized nursing terminologies, but they do not understand why they do so. Therefore, Rutherford (2008) thought of writing an article describing the importance of Standardized Nursing Terminologies in improving patient care and evidence-based patient outcome for the nurses. Besides, based on various studies, there is a wide range of benefits of using the terminologies to both nursing practice and patient outcome.

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Benefits of Standardized Nursing Terminologies

Nurses should understand why they use standardized terminologies in documenting their care and their importance to nursing practice as well as patient outcome. Some of the benefits are outlined below:

  1. Improved Patient Care

The use of Standardized Nursing Terminologies helps in reducing misunderstandings and medical errors. The use of unstandardized data may cause a lot of challenges when it comes to data analysis and processing. When data is unstandardized, similar terminologies may have different meanings depending on the institutions since cultures and standards of care can considerably vary (Wang, Kung & Byrd, 2018). Medical errors and misunderstandings may lead to poor treatment of a patient which may lead to health emergencies such as the death of worsening of a patient’s health condition (Macieria, et al.2017). Therefore, nurses should be informed that its is highly beneficial to quality patient outcome.

  1. Improved communication among nurses and other health practitioners

The use of Standardized Nursing Terminologies enhances clear communication among health practitioners, such as administrators of health institutions and other health practitioners. For instance, through the use of the International Classification of Diseases, physicians can have a standard understating of various health conditions (Rutherford, 2008). The Diagnostic and Statistical Manual Disorders gives a common language for psychological disorders (Macieria, et al.2017). When a psychologist indicates the status of a patient on the patient chart using SNTs, other health practitioners, physicians, and nurses understand the diagnosis of the patient.

  • Enable Data Collection to Evaluate Nursing Care Outcomes

Application of Standardized Nursing Terminologies to document nursing care may provide the necessary consistencies when comparing care quality for different interventions. Many health organizations are adopting the use of electronic health records (Rutherford, 2008). When nursing care is documented electronically in a common language, data from large state, local and national institutions can be used for benchmarking with other institutions that give nursing care.

  1. Easy assessment of competencies in nursing

The use of Standardized Nursing Terminologies can be used in examining the competencies of nurses in the field. It is a requirement for the healthcare institutions by the joint commission to demonstrate the competency of the nursing staff (Macieria, et al.2017). The interventions which are described in the terminologies can be used to evaluate the competencies of nurses in performing those interventions (Rutherford, 2008). Besides, the documentation of care done by different nurses using the standardized language can be used to tell whether a nurse is giving the right care to a patient.

  1. Enhances the visibility of nursing interventions

Most nurses use non-formal notes or verbal communication when communicating with each other about patient care. Therefore, their interventions main remain invisible. Nurses need to understand that the use of Standardized Nursing Terminologies to document their care helps in making their interventions visible. Besides, the documentation of nursing interventions in computers helps describe their contributions to patient outcome, thereby making them more visible.

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Challenges in implementation of Standardized Nursing Terminologies

  1. Lack of professional practice understanding

One of the challenges in the implementation of Standardized Nursing Terminologies is that in most of the health institutions, nursing care is fails to be represented the documentation value of Standardized Nursing Languages (Topaz, 2013). Thus, there is no familiarity of nursing practice with Nursing Standardized Terminologies represented.

  1. Lack of proficiency with electronic health records and computers

Most nurses fail to understand the Standardized Nursing Terminologies. Besides, some nurses do not understand the application of Electronic health documentation and the use of computers (Topaz, 2013). Therefore, the implementation of the terminologies becomes a great challenge.

  • Technology and Information System barriers

Information System and technology barriers may include such factors as insufficient ability to retrieve or document nursing practice in form of Standardized Nursing Terminologies. Also,  its unavailability  in the Electronic Health Records poses great challenges during the implementation of SNTs. In addition, the Standardized Nursing Terminologies acts as one of the major challenges in the implementation of SNTs.

Conclusion

In conclusion, the nurses who commented that they do not understand why they document their care through Standardized Nursing Terminologies should first learn the importance of the common terminologies. They enhance easy communication between nurses, other health practitioners, and administrators in health institutions. The languages also reduce the instances of misunderstandings and medical errors when patients are treated by different health practitioners in different geographical areas and various health institutions. Besides, it is easy to assess the competencies of nursing interventions through the use of Standardized Nursing Terminologies. Data collection and benchmarking are also quickly done when Standardized Nursing Terminologies are used in healthcare.

 

References

Macieira, T. G., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Lopez, K. D., & Keenan, G. (2017). Evidence of Progress in Making Nursing Practice Visible Using Standardized Nursing Data: A Systematic Review. In AMIA Annual Symposium Proceedings (Vol. 2017, p. 1205). American Medical Informatics Association.

Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice. OJIN: The Online Journal of Issues in Nursing, 13(1), 243-50.

Topaz, M. (2013). Invited Editorial: The Hitchhiker’s Guide to nursing informatics theory: using the Data-Knowledge-Information-Wisdom framework to guide informatics research. Online Journal of Nursing Informatics (OJNI), 17(3).

Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126, 3-13.

 

 

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External Environment and Healthcare Planning

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External Environment and Healthcare Planning

Accountable health care leaders must respond to external factors in a way that is advantageous for the organization and the community. While health care organizations must strive to improve their financial positions, it should never be at the expense of the populations they are serving. For this Assignment, examine the following scenario and consider strategies to limit the negative impact of external factors and improve organizational success.

Scenario: A small independent hospital in rural Georgia is seeking to attain Magnet Status. This designation demonstrates to stakeholders that the organization is committed to delivering high-quality patient care. With this designation, the organization can easily attract and retain a highly-engaged clinical staff. Moreover, it provides the organization an opportunity to market itself to potential patients as the place to receive top-quality care. This means that the organization could realize a greater market share of insured and private pay patients traveling as far as 100 miles just to receive the quality services. It also positions the organization to enter into joint ventures with physician groups eager to provide new services, which would lead to increased revenue streams.

External Environment and Healthcare Planning

Although the designation sounds like a great opportunity for the organization, the board of directors is split on their support of this designation. The board members in support of the designation understand the great value that this program will bring to the facility; however, those in opposition learned from a research study that non-magnet hospitals had better infection control and less post-operative sepsis. They also learned from another study that working conditions in a magnet facility are not better than those in non-magnet facilities. Therefore, the dissenting directors have concluded that the organization should not invest its time and resources to seek this credential. The CEO must get support from an overwhelming majority of the board to move forward with pursuing this designation.

To prepare:

Review the provided scenario and consider external environmental factors that may impact the organization’s strategic planning (e.g., policy and economics, laws and ethics, health care quality, and population health).

Note: Your Assignment should show effective application of triangulation of content and resources in your conclusion and recommendations.

The Assignment

In a 2-page executive summary, do the following:

  • Identify and evaluate the impact of external environmental factors on the strategic planning of the organization in the scenario.
  • Recommend strategies to address these external factors and limit their influence on organizational operations.

Required Readings

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.). Chicago, IL: Health Administration.

  • Chapter 7, “The External Environment and Its Relationship to Strategy” (pp. 151-180) Note: This chapter was assigned in Week 3. Please review it for this week.

Wayland, M. S., & McDonald, W. G. (2016). Strategic analysis for healthcare: Concepts and practical applications. Chicago, IL: Health Administration Press.

  • Chapter 6, ““Five Forces in an Industry” (pp. 33–38)
  • Chapter 7, “PEST Analysis of the Environment” (pp. 43–45)
  • Chapter 23, “Ansoff Matrix” (pp. 151–152)

Cheng, W.-H., Kadir, K. A., & Bohari, A. M. (2014). The strategic planning of SMES in Malaysia: A view of external environmental scanning. International Journal of Business and Society, 15(3), 437–446.

Note: Retrieved from Walden Library databases.

Górecka, D., & Szalucka, M. (2014). Application of MCDA methods and stochastic dominance rules in the entry mode selection process in international expansion. Multiple Criteria Decision Making, 9, 5–31.

Note: Retrieved from Walden Library databases.

Metcalfe, L., & Lapenta, A. (2014). Partnerships as strategic choices in public management. Journal of Management & Governance, 18(1), 51–76.

Note: Retrieved from Walden Library databases.

Pliskie, J., & Wallenfang, L. (2014). How geographical information systems analysis influences the continuum of patient care. The Journal of Medical Practice Management, 29(5), 282–285.

Note: Retrieved from Walden Library databases.

Rajan, D., Kalambay, H., Mossoko, M., Kwete, D., Bulakali, J., Lokonga, J.-P., … Schmets, G. (2014). Health service planning contributes to policy dialogue around strengthening district health systems: An example from DR Congo 2008–2013. BMC Health Services Research, 14, 522–536.

Note: Retrieved from Walden Library databases.

Urban, B., & Mothusiwa, M. (2014). Planning flexibility and entrepreneurial orientation: A focus on SME performance and the influence of environmental perceptions. Management Dynamics, 23(1), 58–73.

Note: Retrieved from Walden Library databases.

 

SAMPLE ANSWER

External Environment and Healthcare Planning

Introduction

Like other businesses, the operations of healthcare facilities are surrounded by both internal and external environment.  Unlike internal factors, external factors emanate from outside and the firm does not have control over them. Better knowledge on external factors influencing the operations of the facility can enhance development of better strategies for improving services (Walston, 2018). The paper tries to depict issues related to the external environment of a small rural hospital in Georgia.

Impact of External Environmental Factors

Firstly, the facility’s strategic development will be affected by the legal environment. Policies set by healthcare controlling institutions at the State and Federal level require that facilities should engage in quality and safe practice. To get higher patient ratings and support of evidence-based activities, the facility needs to attain the Magnet Status. Secondly, the economic environment is also essential. In the scenario, the facility operates in the rural area, which has a lower economic status than the urban area. Under the current status, it is small in size, making it hard to enjoy economies of scale. Therefore, the firm needs to make a decision that will enable it to be sustainable under the economic environment (Cheng, Kadir, & Bohari, 2014)

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In terms of technological factors, many facilities in the United States are applying technologies such as robotic surgery, virtual information storage, and online payment of patient services. This feature makes it necessary for the management to develop strategies to align with the current technological applications in healthcare.  From another perspective, the firm is small in size and is situated in the rural area. This issue affects its competitive position in terms of rivalry with other facilities and its bargaining power to the customers. An increase of larger facilities in the region will make it difficult for the organization to operate well. Therefore, it needs to change its style of operations to increase its competitiveness. The facility is also affected by demographics as the population needs require better health outcomes (Vecchiato, 2015).

Strategies to Address the Factors

A significant strategy to address the issues is a change in the cultural and structural set up. This strategy is aimed at having a culture that appreciates changes in the environment. The organization my also need to develop overall cost leadership through aggressive development of efficient-scale operations, engagement in cost reduction, and reduction of other activities that would lead to more economic challenges. In addition, the facility should also engage in differentiation strategy. This plan involves developing something new. From this perspective, having a magnet status may be essential as many facilities in the rural areas may be lacking it (Vecchiato, 2015).

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The facility also needs to engage in market development. Being a rural organization, it needs to engage in more aggressive ways of promoting its services to a wider area. This would enable it to penetrate to other areas t the State and Federal levels (Vecchiato, 2015). The firm also needs to improve its information system. This would enable it to provide suitable information to all stakeholders and enhance better decision making. Innovation is also another strategy that may improve the status of the firm. This aspect needs the firm to engage in creative operations.  When complemented by a change in the organization’s culture, it will enable the facility to have sustainable operations with the changing external environment (Urban & Mothusiwa, 2014).

Conclusion

The scenario reveals that external environmental factors are important in determining the types of strategic plans for organizations. The healthcare sector is a dynamic area where shifts in external environment occur frequently. For the facility to improve its operations, aligning its strategies to the environmental changes is paramount.

 

References

Cheng, W.-H., Kadir, K. A., & Bohari, A. M. (2014). The strategic planning of SMES in

Malaysia: A view of external environmental scanning. International Journal of Business and Society, 15(3), 437–446.

Urban, B., & Mothusiwa, M. (2014). Planning flexibility and entrepreneurial orientation: A focus

on SME performance and the influence of environmental perceptions. Management Dynamics, 23(1), 58–73.

Vecchiato, R. (2015). Creating value through foresight: First mover advantages and strategic

agility. Technological Forecasting and Social Change, 101, 25-36.

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.).

Chicago, IL: Health Administration.

 

 

 

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PICOT Question and Literature Research-Hypertension

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PICOT Question and Literature Research-Hypertension

 As mentioned below, weeks 1-3 need to be referred back to when completing this assignment. There is a Research Critique Guidelines form that helps with the lay out of the assignment. The previous article citations are sufficient for use due to this being a final draft of previous assignments. I need the assignment by Sunday, September 22, 2019 at 7PM. I am also attaching the previous rubrics with comments from the instructor, so that it is clear where I was docked points and where there needs to be improvement. Thank you so much!!!***

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

PICOT Question and Literature Research-Hypertension

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

PICOT Question and Literature Research-Hypertension

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

PICOT Question and Literature Research-Hypertension

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

SAMPLE ANSWER

PICOT Question and Literature Research

Summary of Clinical Issue:

Hypertension is one of the highest health problems globally because it contributes to increased rates of mortality and morbidity. It is estimated that approximately 56% of coronary artery diseases and 48% of stroke incidences result from hypertension (Chiu et al. 2014). In the US, hypertension affects 29% of the population leading to risks of cardiovascular diseases and stroke.  Factors such as poor dietary practices, sedentary lifestyles, and physical inactivity are the primary contributors to hypertension. According to Osté (2010), physical inactivity augments the risk of hypertension 8-9 times. Lifestyle modifications, including exercise and diet changes are the central management and preventive measures against cardiovascular diseases and hypertension (Apovianet al. 2014).  Besides, lifestyle modifications increase the efficacy of antihypertensive drug and control of blood pressure. Therefore it is critical to maintaining levels of blood pressure through exercises and dietary changes to prevent damage of vital body organs.

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The PICOT question aims to determine whether the DASH and WTW improve blood pressure control among urban African Americans within five months of initiation of the intervention. According to Apovian et al. (2018), enhancing adherence to exercises and the DASH diet is essential to reducing an individual’s blood pressure. However, WTW is an intervention looking to reduce physical inactivity among individuals to help manage cardiovascular diseases and stroke. EBP intervention can be implemented and applied to determine whether they enhance or impede high-quality nursing care. This help to evaluate the outcome of the WTW and DASH on improving the level of patient’s high blood pressure.

PICOT Question:

Does the Dietary Approaches to Stop Hypertension (DASH) (I) in urban African-Americans with hypertension (P) improve blood pressure control (O) within 5 months of initiation of the intervention (T)?

 

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink 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

 Kwon, I., Choi, S., Mittman, B., Bharmal, N., Liu, H., Vickrey, B., Song, S., Araiza, D., McCreath, H., Seeman, T., Oh, S. M., Trejo, L., … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: A randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in senior community centers. BMC Neurology, 15, 91.

https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-015-0346-9
How does the Article Relate to the PICOT Question?  

The article proves whether the

(DASH) the diet hasa significant blood pressure (BP)-lowering action

  

The article analyzes whether the DASH Dietary Approaches to Stop Hypertension is a critical dietary modification for reducing cardiovascular disease and blood pressure (BP) risk.

 The article reflects how physical activity through the Worth the Walk” (WTW) can help prevent stroke by reducing blood pressure.
Quantitative, Qualitative(How do you know?) The article is quantitative because it is based on the collection and analysis of numerical data. The article is quantitative because it is based on the collection and analysis of numerical data. The article is quantitative because it is based on the collection and analysis of numerical data.
Purpose Statement The effect of the DASH diet on the pressure-natriuresis relationship to find out the mechanisms of its BP-lowering action. The effects of substituting full-fat for low-fat dairy foods in the DASH diet, with a corresponding increase in fat and a reduction in sugar intake, on blood pressure and plasma lipids and lipoproteins The relationship between the Worth the Walk” (WTW) intervention and biological markers of health including blood pressure, non-HDL cholesterol, and body-mass index,
Research Question Does Dietary Approaches to Stop Hypertension (DASH) diet, rich in fruits, vegetables, and low-fat dairy foods, have substantial blood pressure (BP)-lowering action? Does substituting full-fat for low-fat dairy foods in the DASH diet, with a corresponding increase in fat and a reduction in sugar intake affects blood pressure and plasma lipids and lipoproteins Does the WTW increase physical activity and improve self-efficacy for being physically active and reducing the risk of stroke.
Outcome The study outcome is to find out whether the DASH diet can lower high blood pressure among patients with hypertension. The DASH significantly reduces blood pressure,high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol in the body. The WTW intervention will increase physical activity and reduce the risk of stroke
Setting

(Where did the study take place?)

 The study was carried out in a hospital setting that is not mentioned n the study.

 

 The study was carried out at a clinical research center in Berkeley, California. The study was carried out at four ethnic-specific clusters at senior centers in Los Angeles.
Sample The study sample 412 participants were expected, but a sample size of n=375 was used in the study. The study sample involvesthirty-six participants who finished all the experimental diets and took part in the study. The study sample involves a total of 240 participants (60 participants from each of the four targeted ethnic groups).
Method The study employed a parallel-group design. The study employed a 3-period randomized crossover trial design. The study employed a single-blind randomized wait-list controlled trial design.
Key Findings of the Study The study showed that the DASH diet reduced BP effectively in groups with high sodium sensitivity.Besides, the DASH diet did not imply blood pressure at low intakes of sodium. The HF-DASH diet significantly reduced lipoprotein (VLDL) and triglycerides concentrations and significantly increased LDL compared with the DASH diet.

The DASH dietsignificantly reduced BP, LDL cholesterol, and HDL cholesterol.

 The results showed that the physical activity was improved through the WTW intervention and this, in turn, reduces the risks of stroke. Therefore, WTW intervention reduces hypertension and stroke.
Recommendations of the Researcher It is recommended that the DASH diet is a critical non-pharmacological measure for controlling BP. It is recommended that the modified HF-DASH diet can be used as an effective alternative to the DASH diet. It is recommended that the Worth the Walk should function as the primary stroke prevention model stroke patients.

 

Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink  

Apovian, C. M., Murphy, M. C., Cullum-Dugan, D., Lin, P. H., Gilbert, K. M., Coffman, G., … & Moore, T. J. (2010). Validation of a web-based dietary questionnaire designed for the DASH (dietary approaches to stop hypertension) diet: the DASH online questionnaire. Public health nutrition, 13(5), 615-622.

https://www.ncbi.nlm.nih.gov/pubmed/19912673

  

Osté, M. C., Gomes‐Neto, A. W., Corpeleijn, E., Gans, R. O., de Borst, M. H., van den Berg, E., … & Bakker, S. J. (2018). Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. American journal of transplantation, 18(10), 2523-2533.

https://www.ncbi.nlm.nih.gov/pubmed/29464830

 Staffiliano, A. B., Tangney, C, C., Fogg, L. (2018). Favorable Outcomes Using an eHealth Approach to Promote Physical Activity and Nutrition Among Young African American Women. The Journal of Cardiovascular Nursing. 33, 62–71.

https://www.ncbi.nlm.nih.gov/pubmed/28481823

 
How Does the Article Relate to the PICOT Question?  

The article looks at the DASH diet its correlation to lowering blood pressure and reduces the risk of heart disease, stroke, and osteoporosis.

The article addresses the Dietary Approach to Stop Hypertension (DASH) diet.

 

 The article analyzes improving healthy nutrition behaviors by including a DASH diet can reduce the risk of hypertension.
Quantitative, Qualitative(How do you know?) The study is qualitative research because itmarked by use of online questionnaires, to collect verbal information,perceptions,and understandings of the topic. The study is qualitative research because itmarked by use of online questionnaires, to collect verbal information, perceptions, and understandings of the topic. The study is qualitative research because itmarked by use of Web-based questions that are accessible via the Internet and mobile devices, to collect verbal information, perceptions, and understandings of the topic.
Purpose Statement Assess the validity of a new, short, online dietary questionnaire created to capture DASH food intake. Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. Favorable Outcomes Using an eHealth Approach to encourage Physical Activity and Nutrition Among Young African American Women
Research Question Does the validity of a new, short, online dietary questionnaire capture DASH food intake. Does the DASH diet lead to a lower risk of renal function? Does eHealth approach promote physical activity and nutrition among young African American women?
Outcome The DASH OLQ is a critical assessment tool for measuring DASH diet adherence.

The Dietary Approach to Stop Hypertension (DASH) diet reduces the risk of renal transplant among patients.

 To improve healthy nutrition behaviors to decrease health risk behaviors, and decrease the risk of hypertension based on the DASH diet.
Setting

(Where did the study take place?)

The study was carried out atBoston University Medical Center, Boston, Massachusetts. The study was carried out in a large single‐center prospective cohort of RTR at the University Medical Center Groningen. The study was carried out at the University Medical Center
Sample The study sample includes faculty and staff aged 20–70 years at Boston University Medical Center The study sample includes the 817 invited patients;however, 632 participants were eligible for analyses. The study sample of 142 participants was expected, but a sample size of 124 was used in the study.
Method The study employed a cross-sectional validation of the DASH OLQ method. The study employed the observational prospective cohort study, and data were collected through a validated 177‐item food frequency questionnaire. A randomized, pre-post design Web-based design was used in the study.
Key Findings of the Study The DASH OLQ is a critical assessment tool for measuring DASH diet adherence.The DASH diet lowers blood pressure, cholesterol and the risk of stroke, osteoporosis, and heart disease.

 

 The study showed that adherence to a DASH‐style diet is linked with a lower risk of renal function. The DASH participants showed that eHealth approach could be used for changing health behaviors patients with hypertension.
Recommendations of the Researcher It is recommended that the DASH OLQ is important in assessing the DASH diet adherence in clinical practice. It is recommended that a randomized clinical trial should be carried out to show whether adherence to the DASH diet risk of renal function. It is recommended that the eHealth approach is a critical program that can be used for changing health behaviors for other populations at risk.

 

The Link between the PICOT Question and Research Articles

DASH and WTW can help improve blood pressure control among urban African Americans within five months of initiation of the intervention. Hypertension is one of the highest health problems globally because it contributes to increased rates of mortality and morbidity. Physical inactivity and lifestyle modifications including exercise and diet changes are the main management and preventive measures against cardiovascular diseases and hypertension. Individuals can take control of the levels of their blood pressure through taking medication and adhering to lifestyle changes such as exercise, nutrition and weight management, and low sodium intake.

PICOT Question and Literature Research-Hypertension

Healthcare practitioners can provide non-pharmacological treatment and offer holistic care to patients with high blood pressure. The APNs can promote reductions of blood pressures by helping patients take their medications, increase patient’s physical activity, reduce patient’s sodium intake, and improve patient’s follow up visits. Thus, the WTW and DASH tools are successful in helping patients manage their lifestyle and manage their blood pressures and adhere to their treatment plan with the assistance of APNs.

Kwon, et al. (2015) carried out a randomized controlled trial to assess the effects of a culturally designed walking intervention (Worth the Walk) that is community-based to decrease the risk of stroke by increasing the rate of physical exercise among Latino, African American, Korean and Chinese seniors suffering from hypertension. The study demonstrated considerable improvements in knowledge about stroke and body exercise in the intervention group as compared to the control group (Kwon, et al. 2015). The findings of the study suggest that nursing education should highly consider training the nurses about physical exercise and implement the worth a walk intervention to improve patient outcome. Therefore, nurses should consider the intervention as the primary prevention strategy for stroke among seniors in various minority ethnic or racial groups in the United States.

PICOT Question and Literature Research-Hypertension

Chiu, et al. (2015) conducted a study on 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 participants of the study finished the three dietary periods. 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 (Chiu, et al.,2015). 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. The researchers did not mention any limitations of the study.

Besides, Akita, Sacks, Svetkey, Conlin and Kimura, (2003) consider that the extent of adherence to diet determines the effectiveness of the intervention of the DASH diet. Most people with the problem of following prescribed diets have difficulty if adhering to DASH diet. It is the responsibility of the nurses to create awareness and advice patients on how to follow prescribed diets to increase the effectiveness of DASH intervention (Akita, Sacks, Svetkey, Conlin & Kimura, 2003). It is also essential to include a variation in the composition of the macronutrients in the DASH diet while still enhancing the preservation to the benefits of lipid and blood pressure risk factors. Therefore, improving adherence to exercises and the DASH diet is essential to reducing an individual’s blood pressure. This is because of studies with exercise adherence

PICOT Question and Literature Research-Hypertension

Interventions to Address the Health Issue

Individuals can take control of the levels of their blood pressure through taking medication and adhering to lifestyle changes such as exercising, smoking and alcohol cessation, nutrition and weight management, stress management, and low sodium intake.

i.                Nutrition and Weight Management: Obesity and overweight are closely linked to increased levels of blood pressure (Orzech et al. 2014). Therefore, keeping track of how much and what an individual eat is essential. Eating foods with low trans fats, cholesterol, refined sugar, and saturated fats is essential (Staffileno, Tangney, Fogg, 2018). Besides, having vegetable and fruits as part of the diet every day is very critical.  Seeking the help of dietitian can help the patient plan eating habits and lose weight.

  1. Exercising: According to Paganas et al. (2014), regular exercises help to reduce the risks of cardiovascular diseases. It reduces LDL-cholesterol and increase HDL-cholesterol, reduces weight among obese individuals, reduces blood pressure, and reduce endothelial dysfunction. Therefore, exercising regularly helps in the management of hypertension. It is recommended that the exercises should involve a regular and safe exercise program.
  2. PICOT Question and Literature Research-Hypertension
  • Reducing sodium intake: Most patients with hypertension are sensitive to sodium in their food. With the help of a dietitian, individuals can evaluate their choices of food and eat foods low in sodium. Besides, using the DASH diet, patients can choose the sodium levels that meet their health requirements (Chiu et al. 2015). It encourages individuals to reduce their sodium level to help reduce hypertension and instead eat foods rich in nutrients such as magnesium, calcium, and potassium that help lower blood pressure.

Evidence Based Changes and Measuring Tools

  1. The Dietary Approaches to Stop Hypertension (DASH)

DASH is a dietary eating blueprint that focuses on whole grains, low-fat nutritional foods, vegetables and grains as the primary dietary modification for reducing high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) and blood pressure (Chiu et al. 2015).  Adherence to the DASH dietary regime is liked to reduce the risk of hypertension because the consumption of the DASH diet has lower LDL cholesterol compared to the Western diet that has saturated fats (Chiu et al. 2015). Therefore, the DASH diet has a lower content of saturated fats that may help reduce risks of blood pressure and cardiovascular diseases. The level of adherence to the DASH also strongly determines the efficacy of the intervention because poorer adherence does not provide benefits on blood pressure and lipid risk factors.

PICOT Question and Literature Research-Hypertension

  1. “Worth the Walk” (WTW)

The WTW is an intervention looking to reduce physical inactivity among individuals to help manage cardiovascular diseases and stroke (Kwon et al. 2015). The main tools objective is to measure to increase walking levels which are measured in mean steps per day to prevent sedentary lifestyle and inactivity. The tool also aims to determine the correlation between the intervention and its impact on c-reactive protein (CRP), glycosylated hemoglobin (HgA1c), non-HDL cholesterol, body-mass index, and blood pressure (Kwon et al. 2015). Finally, the tool also focuses on the self-efficacy and behaviors that help control risk factors of high blood pressure and stroke. Thus, WTW help to increase an individual’s physical activity, which can serve as the primary high blood pressure prevention among individuals.

PICOT Question and Literature Research-Hypertension

Conclusion

The major insights developed regarding the role of EBP is that APNs have the role and responsibility to provide a wide range of health care services to patients of all ages. Nurses must provide EBP practices to help improve the patient’s outcome based on the best available evidence. The DASH and WTW as an EBP intervention can improve blood pressure control among urban African Americans within five months of initiation of the intervention. The EBP intervention can be implemented and applied to determine whether they enhance or impede high-quality nursing care. This helps to evaluate the outcome of the WTW and DASH on improving the level of patient’s high blood pressure. Thus, EBP intervention on hypertension promotes an attitude of inquiry among nurses that can guide them to provide care more effectively as informed by the available evidence.

 

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

Apovian, C. M., Murphy, M. C., Cullum-Dugan, D., Lin, P. H., Gilbert, K. M., Coffman, G., …

& Moore, T. J. (2010). Validation of a web-based dietary questionnaire designed for the DASH (dietary approaches to stop hypertension) diet: the DASH online questionnaire. Public health nutrition, 13(5), 615-622.

https://www.ncbi.nlm.nih.gov/pubmed/19912673

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://doi.org/10.3945/ajcn.115.123281

Hagins, M., Rundle, A., Consedine, N. S., & Khalsa, S. B. S. (2014). A randomized controlled

trial comparing the effects of yoga with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1 hypertension. The Journal of Clinical Hypertension, 16(1), 54-62. https://doi.org/10.1111/jch.12244

Kwon, I., Choi, S., Mittman, B., Bharmal, N., Liu, H., Vickrey, B., Song, S., Araiza, D.,

McCreath, H., Seeman, T., Oh, S. M., Trejo, L., … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: a randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in senior community centers. BMC Neurology, 15, 91. doi:10.1186/s12883-015-0346-9

Migneault, J. P., Dedier, J. J., Wright, J. A., Heeren, T., Campbell, M. K., Morisky, D. E., Rudd,

P., Friedman, R. H. (2012). A culturally adapted telecommunication system to improve physical activity, diet quality, and medication adherence among hypertensive African-Americans: A randomized controlled trial. Annals of Behavioral Medicine, 43(1), 62-73. doi:http://dx.doi.org/10.1007/s12160-011-9319-4

Osté, M. C., Gomes‐Neto, A. W., Corpeleijn, E., Gans, R. O., de Borst, M. H., van den Berg, E.,

… & Bakker, S. J. (2018). Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. American journal of transplantation, 18(10), 2523-2533.

https://www.ncbi.nlm.nih.gov/pubmed/29464830

 

 

 

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