Category: Nursing

2 Discussion
Ethical Dilemmas
Your instructor will assign you with one (1) of the following ethical dilemmas. Please describe ways the problem can be anticipated and addressed in a proposal of study.
A prisoner that is being interviewed tells the researcher about a potential breakout from the prison that night. What is the researcher to do?
A researcher on a team copies sentences from another study and incorporates them into the final written report for the project. What should the researcher do?
A student collects data from a project from several individuals interviewed in families. After the fourth interview, the student indicates that IRB approval has not been received. What should the researcher do?
Submission Instructions:
Your instructor will assign you with one (1) of the following ethical dilemmas and your initial post will be focused on that one (1) dilemma.
You will reply to the other two dilemmas (One of each).
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) All replies must be constructive and use literature where possible.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
Grading Rubric Your work will be graded according to the grading rubric. To see the rubric, click on the option menu icon (3 vertical dots), and select Show Rubric.

Improvement Plan Tool Kit
For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan to understand or implement to ensure the success of the plan.
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Introduction
Communication in the health care environment consists of an information-sharing experience whether through oral or written messages (Chard & Makary, 2015). As health care organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to the dissemination of information and evidence-based findings and the development of tool kits, continuous support for and availability of such resources are critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in time of need or crisis and how to support one another in the workplace; wikis in particular enable nurses to continue that support beyond the work environment. Here they can be free to share their unique perspectives, educate others, and promote health care wellness at local and global levels (Kaminski, 2016).
You are encouraged to complete the Determining the Relevance and Usefulness of Resources activity prior to developing the repository. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.
References
Chard, R., & Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329–342.
Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1–7.
Professional Context
Nurses are often asked to implement processes, concepts, or practices—sometimes with little preparatory communication or education. One way to encourage sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help to reinforce attendees’ new knowledge as well as the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.
Scenario
For this assessment, build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan pertaining to a specific patient safety issue and put the plan into action.
Preparation
Google Sites is recommended for this assessment; the tools are free to use and should offer you a blend of flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or GoogleDocs login, or create an account following the directions under the “Create Account” menu.
Refer to the resources on the following list to help you get started with Google Sites:
Assessment 4: Google Sites reading list.
Instructions
Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.
It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.
Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on a specific patient safety issue. Each resource listing should include the following:
An APA-formatted citation of the resource with a working link.
A description of the information, skills, or tools provided by the resource.
A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to a specific patient safety issue.
A description of how nurses can use this resource and when its use may be appropriate.
Remember that you must make your site “public” so that your faculty can access it. Check out the Google Sites resources for more information.
Here is an example entry:
Merret, A., Thomas, P., Stephens, A., Moghabghab, R., & Gruneir, M. (2011). A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24–29.
This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse lead project can be implemented and used to improve collaboration and interdisciplinary teamwork, as well as improve the delivery of health care services. This resource is likely more useful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed prior to creating an interdisciplinary team for a collaborative project in a health care setting.
Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to a specific patient safety issue.
Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on a specific patient safety issue.
Analyze the value of resources to reduce patient safety risk related to a specific patient safety issue.
Present reasons and relevant situations for use of resource tool kit by its target audience.
Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.
Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your tool kit will focus on promoting safety with the quality issue you selected in Assessment 1. Note that you do not have to submit your bibliography in addition to the Google Site; the example bibliography is merely for your reference.
Assessment 4 Example [PDF] Download Assessment 4 Example [PDF].
To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.
Example Google Site: You may use the example found on the Assessment 4: Google Sites reading list, Resources for Improved Heparin Infusion Safety, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment but keep in mind that your tool kit will focus on promoting safety with the quality issue you selected in Assessment 1
Note: If you experience technical or other challenges in completing this assessment, please contact your faculty member.

In your current practice, what is a clinical practice issue you feel creates barriers to the delivery of high-quality, evidence-based nursing care?
Which of the principles for guiding quality improvement would be beneficial in resolving this issue and why?
How would qualitative or mixed-methods research findings be beneficial in addressing the issue to promote more positive patient outcomes?
What research methodology – qualitative or mixed-methods – do you feel best fits your identified clinical practice issue? Why?
APA citations are required for the original post.

No AI
APA Format
Minimum 250 Words
Group 3 Case Study Discussion
The Scenario: Dai
Dai is a 42-year old healthy married Asian female who is pregnant with her first child. She presents for her first obstetrics appointment, asking about newborn screening and whole-genome sequencing (WGS). She wants to be as proactive as possible in planning for her baby’s future health. As such, she would like to pursue WGS since this would fulfill the newborn screening requirement in the state where she will deliver her baby, as well as provide much more information about her baby’s long-term health. Dai feels it is important to begin inquiring about WGS now so that her baby could have WGS performed in place of the standard screening
required for newborns.
Case Study Discussion Questions: After you interview Dai on the Global Genetics and GenomicLinks to an external site.s Community (G3C) website, answer the questions below and submit them to this assignment page. The score that you receive on the G3C does not impact your course grade for this discussion.
1. What genetic screening tests are normally performed on neonates?
2. Discuss the advantages and disadvantages of whole-genome sequencing for neonates?
3. Discuss the current applications for whole-genome sequencing.
Accessibility
The Global Genetics and Genomics Community (G3C) website and activities do not have a formal accessibility policy available but indicated meeting the National Institutes of Health (NIH) and National Human Genome Research Institute (NHGRI) standards for Section 508 compliance. Florida SouthWestern State College eLearning has reviewed the activities for accessibility and found the website is keyboard accessible (with exception to the “Click here to choose another question” button at the bottom of each case page), accurate closed captions are provided for video clips, and the majority of PDF content has selectable text. Should you encounter any difficulties in accessing content, please make your instructor aware to assist in providing a more accessible form.

Main :
Choose one primary research (1) article used in the literature review-less than five years or if you prefer in the EBP project. It is preferable to use a randomized controlled trial or the highest level of evidence. Attach a copy of the article.
1. Begin your critique by identifying the:
• article’s title
• author(s)
• date of publication
• name of the journal or other publication in which it appeared
• and when was the article published
2. In your introduction, you should briefly describe the purpose and nature of the study and, if applicable, its theoretical framework. If the paper was not published in a peer-reviewed journal, consider the credibility of the publication in which it appeared.
3. If you are reviewing a research study, organize the body of your critique according to the paper’s structure.
4.Did the researcher identify the gaps in the knowledge?
5. Did the researcher identify the purpose of the study?
6. Write a brief description and analysis of the strengths and weaknesses of the research design and methodology. For example:
a. How does the method reflect other studies of the same topic? (sample, data collection, setting).
b. What makes this method feasible? (quantitative, qualitative, mixed methods).
c. How realistic is it? How does the method address questions of validity? (independent, dependent variables).
d. How does the researcher overcome the limitations of the method?
e. Are there large limitations or minor ones?
f. How will these limitations affect your ability to use this data to answer your research question?
6. Describe the results by answering:
a. How were the results interpreted?
b. How were they related to the original problem (author’s view of evidence rather than objective findings)?
c. Look at DISCUSSION are the author(s) able to answer the question (test the hypothesis) raised?
d. Did the research provide new factual information, a new understanding of a phenomenon in the field, a new research technique?
e. How was the significance of the work described?
f. Did the reported
observations/interpretations support or refute observations or interpretations made by other researchers?
g. Did the researcher report limitations.
7. Describe the significance of the research by answering:
a. Did the research make a significant contribution to human knowledge?
b. Did the research produce any practical applications?
c. What are the nursing implications of this research?
d. How do you evaluate the significance of the research?

Research change theories from scholarly literature resources. Choose a change theory and correlate the steps of the theory to a change that has occurred in your clinical area.
Did the change follow the steps well?
Was the change made successfully?
If it did not go smoothly, how would you have improved the process?

The purpose of this assignment is to differentiate quality improvement (QI), evidence-based practice (EBP), and research.
Create a graphic image or visual model differentiating quality improvement, evidence-based practice, and research. You can use PowerPoint, Smart Art in Word, or other software that creates a graphic. Be creative in your design. Include the following information in your graphic image or visual model:
Compare and contrast quality improvement, evidence-based practice, and research. Identify at least one similarity and difference for each.
Provide an example of quality improvement, evidence-based practice, and research.
Explain why quality improvement, evidence-based practice, and research would be applied in a health care setting.
This assignment requires a minimum of two peer-reviewed scholarly sources.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.

You will complete
the case study for Chapter 13. You will find this case study within
your online resources. Additionally, the case study with required
questions is included as follows:
Case Study | Questions
Katie is an advanced practice nurse who works in a busy neurosurgical unit in a large teaching health-care
center. She has become friends with several of the neurosurgeons who are nationally recognized for their skills.
One day she is approached by an RN friend of hers, Ginger, who works with immigrants in a free clinic, on behalf
of a patient who recently came to the United States from Costa Rica. The woman brought her twin sons who
were born joined at the head. She approaches one of her physician friends about examining the twins for
possible surgery. The physician agrees and, after the exam, is very excited about the prospects of surgery to
correct the defects and separate the twins. It would be a first-time, cutting-edge surgery, the results of which he
could publish in a major medical journal and also gain international recognition for. Unfortunately, the patient
will not be able to pay for the surgery.
The physician orders a number of image studies that appear to indicate that both infants should survive
the surgery, but they will need intensive hospital care for several months after the surgery. They will also need
long-term, outpatient rehabilitation and home care. Quite often, children who have severe neurological
problems will have lifetime deficits, including retardation and mobility issues.
After explaining the procedure to the chief of staff, the department expresses its interest in performing this
groundbreaking surgery. The physician and several other surgeons offered to perform the surgery without pay,
and the hospital, because of its status as a major teaching institution, agreed to provide postoperative inpatient
care at no expense to the family. However, no one has come forth to pay for the care after the twins leave the
ICU and for outpatient follow-up. Because the condition of the twins has been deteriorating, the physician
schedules the surgery in 2 days’ time.
Should the family’s ability to pay for long-term and home care for these children play a role in the
physician’s decision about when and whether to perform the surgery? Why or why not? 
What should Katie include in the teaching plan for this family?
If no funds are available for future care, should the surgeon operate? Where might the mother of the
twins find additional funding?
Is the surgeons’ and hospital’s willingness to forgo any payment purely altruistic? Why or why not? If not, how might they
leverage the media attention into funding the recovery of the twins?
How do you feel about people from foreign countries coming to the United States to receive advanced
health care for free?
Is there an issue of distributive justice in the use of scarce resources? Discuss.
Cite the sources used in APA 7th edition format (See your Student Resources).

APA format
Scholarly resources
Identify six sigma by providing a brief history and how it is used today 
identify how sick sigma can enhance patient care processes 
identify how six sigma can help to reduce errors in healthcare 
identify how sick sigma is helping develop new leaders in healthcare. 
How would I implement a mythology such as six Sigma to enhance your clinical setting or workplace today? 

Submit a problem-focused SOAP note for grading. You must use an actual patient from your clinical practicum who presents with one or more chief complaints. 
Use the format below for your SOAP note. 
Use the current APA format to style your paper and cite your sources. Review the rubric for more information on how your assignment will be graded. 
Problem-focused SOAP Note Format     
Demographic Data 
Age, and gender (must be HIPAA compliant) 
Subjective 
Chief Complaint (CC): A short statement about why they are there 
History of Present Illness (HPI):  Write your HPI in paragraph form. Start with the age, gender, and why they are there (example: 23-year-old female here for…). Elaborate using the acronym OLDCART: Onset, Location, Duration, Characteristics, Aggravating/Alleviating Factors, Relieving Factors, Treatment 
Past Med. Hx (PMH): Medical or surgical problems, hospitalizations, medications, allergies, immunizations, and preventative health maintenance 
Family Hx: any history of CA, DM, HTN, MI, CVA?  
Social Hx: Including nutrition, exercise, substance use, sexual hx, occupation, school, etc. 
Review of Systems (ROS) as appropriate: Include health maintenance (e.g., eye, dental, pap, vaccines, colonoscopy) 
Objective 
Vital Signs 
Physical findings listed by body systems, not paragraph form- Highlight abnormal findings 
Assessment (the diagnosis) 
At least Two (2) differential diagnoses (if applicable) with rationale and pertinent positives and negatives for each 
Final diagnosis with rationale, pertinent positives and negatives, and pathophysiological explanation 
Plan 
Dx Plan (lab, x-ray) 
Tx Plan (meds): including medication(s) prescribed (if any), dosage, frequency, duration, and refill(s) (if any) 
Pt. Education, including specific medication teaching points 
Referral/Follow-up 
Health maintenance: including when screenings eye, dental, pap, vaccines, immunizations, etc. are next due 
Reference 
Compare care given to the patient with the National Standards of Care/National Guidelines. Cite accordingly. 
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Rubric
Problem-focused SOAP Note
Problem-focused SOAP Note
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeSubjective
25 to >23.0 pts
Accomplished
Symptom analysis is well organized, with C/C, OLDCART, pertinent negatives, and pertinent positives. All data needed to support the diagnosis & differential are present. Is complete, concise, relevant with no extraneous data.
23 to >21.0 pts
Satisfactory
Symptom analysis well organized with C/C, OLDCART, pertinent negatives, and pertinent positives. Some extraneous data present and/or one minor data point missing.
21 to >17.0 pts
Needs Improvement
Symptom analysis is not well organized. Data is missing. There is too much extraneous data and/or 2-3 minor data points missing.
17 to >0 pts
Unsatisfactory
Symptom analysis is inadequate, is not organized. Objective or other data is mixed into the subjective data. Important data is missing.
25 pts
This criterion is linked to a Learning OutcomeObjective
25 to >23.0 pts
Accomplished
Complete, concise, well organized and well written and includes pertinent positive and pertinent negative physical findings. Organized by body system in list format. No extraneous data.
23 to >21.0 pts
Satisfactory
All relevant exams were done thoroughly but extraneous exams were also done. Somewhat organized in list format.
21 to >17.0 pts
Needs Improvement
Omitted important relevant exams and/or not in list format.
17 to >0 pts
Unsatisfactory
Omitted important relevant exams and/or subjective data are included. Lacking organization.
25 pts
This criterion is linked to a Learning OutcomeAssessment
25 to >23.0 pts
Accomplished
Diagnosis and differential dx are correct with ICD code and supported by subjective and objective data.
23 to >21.0 pts
Satisfactory
Diagnosis is correct with ICD codes and is supported by subjective and objective data, however the most accurate differential diagnosis not listed according to subjective and objective data.
21 to >17.0 pts
Needs Improvement
Diagnosis is correct but either does not include ICD code or is missing two or more important differential diagnoses according to the subjective and objective data provided.
17 to >0 pts
Unsatisfactory
Diagnosis is not correct, is not provided or is not reflective of the subjective and objective data provided.
25 pts
This criterion is linked to a Learning OutcomePlan
25 to >23.0 pts
Accomplished
Plan is organized, complete and evidence-based according to National Standards of Care. Addresses each diagnosis and is individualized to the specific patient and includes medication teaching and all 5 components: (Dx plan, Tx plan, patient education, referral/follow-up, health maintenance).
23 to >21.0 pts
Satisfactory
Plan is organized, complete and evidence-based according to National Standards of Care. Addresses each diagnosis and is individualized to the specific patient and includes medication teaching but may be missing 1-2 minor points.
21 to >17.0 pts
Needs Improvement
Plan is less organized and not based on evidence according to National Standards of Care. Does not address each diagnosis or may not be individualized to the specific patient. Missing medication teaching or one of the 5 components.
17 to >0 pts
Unsatisfactory
No Plan provided or is not organized. Does not address all diagnoses identified and/or does not include all 5 components of plan, including medication teaching.
25 pts
Total Points: 100