National initiatives driven by the American Nurses Association have determined nursing-quality outcome indicators that are intended to focus plans and programs to increase quality and safety in patient care. The following outcomes are commonly used nursing-quality indicators:
• complications such as urinary tract infections, pressure ulcers, hospital-acquired pneumonia, and DVT
• patient falls
• surgical patient complications, including infection, pulmonary failure, and metabolic derangement
• length of patient hospital stay
• restraint prevalence
• incidence of failure to rescue, which could potentially result in increased morbidity or mortality
• patient satisfaction
• nurse satisfaction and staffing
SCENARIO
Mr. J is a 72-year-old retired rabbi with a diagnosis of mild dementia. He was admitted for treatment of a fractured right hip after falling in his home. He has received pain medication and is drowsy, but he answers simple questions appropriately.
A week after Mr. J was admitted to the hospital, his daughter, who lives eight hours away, came to visit. She found him restrained in bed. While Mr. J was slightly sleepy, he recognized his daughter and was able to ask her to remove the restraints so he could be helped to the bathroom. His daughter went to get a certified nursing assistant (CNA) to remove the restraints and help her father to the bathroom. When the CNA was in the process of helping Mr. J sit up in bed, his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. She reported the incident to the CNA who replied, “Oh, that is not anything to worry about. It will go away as soon as he gets up.” The CNA helped Mr. J to the bathroom and then returned him to bed where she had him lie on his back so she could reapply the restraints.
The diet order for Mr. J was “regular, kosher, chopped meat.” The day after his daughter arrived, Mr. J was alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and observed that Mr. J had eaten approximately 75% of the meal. The meal served was labeled, “regular, chopped meat.” The tray contained the remains of a chopped pork cutlet.
The nurse notified the supervisor, who said, “Just keep it quiet. It will be okay.” The nursing supervisor then notified the kitchen supervisor of the error. The kitchen supervisor told the staff on duty what had happened.
When the patient’s daughter visited later that night, she was not told of the incident.
The next night, the daughter was present at suppertime when the tray was delivered by a dietary worker. The worker said to the patient’s daughter, “I’m so sorry about the pork cutlet last night.” The daughter asked what had happened and was told that there had been “a mix up in the order.” The daughter then asked the nurse about the incident. The nurse, while confirming the incident, told the daughter, “Half a pork cutlet never killed anyone.”
The daughter then called the physician, who called the hospital administrator. The physician, who is also Jewish, told the administrator that he has had several complaints over the past six months from his hospitalized Jewish patients who felt that their dietary requests were not taken seriously by the hospital employees.
The hospital is a 65-bed rural hospital in a town of few Jewish residents. The town’s few Jewish members usually receive care from a Jewish hospital 20 miles away in a larger city.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Analyze the scenario (suggested length of 2–3 pages) by doing the following:
A. Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying issues that may interfere with patient care.
B. Analyze how hospital data of specific nursing-quality indicators (such as incidence of pressure ulcers and prevalence of restraints) could advance quality patient care throughout the hospital.
C. Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor, could use to resolve an ethical issue in this scenario.
D. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Demonstrate professional communication in the content and presentation of your submission.
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Respond To The Following Items
/in Uncategorized /by developerRespond to the following items. Be sure to reference this week’s learning resources as appropriate.
Read:
Caregiver Resource Center, The. (2017). The caregiver. Greenwich, CT: Employment Assistance Professionals, Inc. Retrieved from http://www.caregiverresourcecenter.com/the_caregiver.htm
https://www.genworth.com/aging-and-you/finances/cost-of-care.html
Lewis, F. (2016, January 16). Caring for the caregivers [Video file]. Retrieved from: https://www.youtube.com/watch?v=duhJHedj82g
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Respond To The Following Scenario
/in Uncategorized /by developerNational initiatives driven by the American Nurses Association have determined nursing-quality outcome indicators that are intended to focus plans and programs to increase quality and safety in patient care. The following outcomes are commonly used nursing-quality indicators:
• complications such as urinary tract infections, pressure ulcers, hospital-acquired pneumonia, and DVT
• patient falls
• surgical patient complications, including infection, pulmonary failure, and metabolic derangement
• length of patient hospital stay
• restraint prevalence
• incidence of failure to rescue, which could potentially result in increased morbidity or mortality
• patient satisfaction
• nurse satisfaction and staffing
SCENARIO
Mr. J is a 72-year-old retired rabbi with a diagnosis of mild dementia. He was admitted for treatment of a fractured right hip after falling in his home. He has received pain medication and is drowsy, but he answers simple questions appropriately.
A week after Mr. J was admitted to the hospital, his daughter, who lives eight hours away, came to visit. She found him restrained in bed. While Mr. J was slightly sleepy, he recognized his daughter and was able to ask her to remove the restraints so he could be helped to the bathroom. His daughter went to get a certified nursing assistant (CNA) to remove the restraints and help her father to the bathroom. When the CNA was in the process of helping Mr. J sit up in bed, his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. She reported the incident to the CNA who replied, “Oh, that is not anything to worry about. It will go away as soon as he gets up.” The CNA helped Mr. J to the bathroom and then returned him to bed where she had him lie on his back so she could reapply the restraints.
The diet order for Mr. J was “regular, kosher, chopped meat.” The day after his daughter arrived, Mr. J was alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and observed that Mr. J had eaten approximately 75% of the meal. The meal served was labeled, “regular, chopped meat.” The tray contained the remains of a chopped pork cutlet.
The nurse notified the supervisor, who said, “Just keep it quiet. It will be okay.” The nursing supervisor then notified the kitchen supervisor of the error. The kitchen supervisor told the staff on duty what had happened.
When the patient’s daughter visited later that night, she was not told of the incident.
The next night, the daughter was present at suppertime when the tray was delivered by a dietary worker. The worker said to the patient’s daughter, “I’m so sorry about the pork cutlet last night.” The daughter asked what had happened and was told that there had been “a mix up in the order.” The daughter then asked the nurse about the incident. The nurse, while confirming the incident, told the daughter, “Half a pork cutlet never killed anyone.”
The daughter then called the physician, who called the hospital administrator. The physician, who is also Jewish, told the administrator that he has had several complaints over the past six months from his hospitalized Jewish patients who felt that their dietary requests were not taken seriously by the hospital employees.
The hospital is a 65-bed rural hospital in a town of few Jewish residents. The town’s few Jewish members usually receive care from a Jewish hospital 20 miles away in a larger city.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Analyze the scenario (suggested length of 2–3 pages) by doing the following:
A. Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying issues that may interfere with patient care.
B. Analyze how hospital data of specific nursing-quality indicators (such as incidence of pressure ulcers and prevalence of restraints) could advance quality patient care throughout the hospital.
C. Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor, could use to resolve an ethical issue in this scenario.
D. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Demonstrate professional communication in the content and presentation of your submission.
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Respond To The Post
/in Uncategorized /by developerI need a respond for these 2 classmates. Response posts must be minimum 100 words eaach. Double space. References must be cited in APA format (6th)
Peer 1
Tobacco Free Florida refers to the Florida’s education program that aims at helping tobacco users quit. The program includes helpful strategies, facts about nicotine as well as motivational information that powerfully encourages a tobacco-free life (Tobacco Free Florida, n.d.). Meanwhile, a range of media channels plays an increasingly important role in promoting the mentioned program. More specifically, social media sites, such as Facebook and Twitter, are extremely popular today, especially among the younger generation, which creates a comprehensive platform for raising awareness about the issue at hand and advertising the program’s website (Jane, Hagger, Foster, Ho, & Pal, 2018). Zika Free Florida is another program that provides help and consultation to prevent development of Zika, disease that develops due to a mosquito-borne virus. Instagram and YouTube are another powerful tool to promote the agenda. The format of a video can have a significant effect upon a viewer evoking a strong emotional response. Instagram presents a visually appealing source of receiving information that is readily used by many users around the world, especially by those who like to travel to foreign countries and do not know what exactly one should expect.
Childhood obesity is another important public concern that requires special attention in health policy development. Promoting awareness about the peril associated with childhood obesity is pivotal for maintaining the nation’s health and decreasing the burden of chronic diseases. Social media campaigns may help in this regard. Again, the use of Instagram may trigger the interest of policymakers, while providing parents with the necessary material aids (Edney et al., 2018). It should be noted that such social media as YouTube and Facebook may serve as a source of social support.The posts and videos in media challenge may contain information about the ramifications related to childhood obesity, which can help a user make a change in their lives. They may illustrate examples of how others have already achieved positive results, thereby increasing individual’s awareness about the effective strategies and health promotion techniques (Mason, Gardner, Outlaw, 2016). Users see that they are not alone with this program and may track each other’s progress getting inspired and motivated. Thus, social media can be considered as an active agent in raising awareness and encouraging to make a positive change in one’s lifestyle or environment.
Peer 2
Tobacco Free Florida refers to the Florida’s education program that aims at helping tobacco users quit. The program includes helpful strategies, facts about nicotine as well as motivational information that powerfully encourages a tobacco-free life (Tobacco Free Florida, n.d.). Meanwhile, a range of media channels plays an increasingly important role in promoting the mentioned program. More specifically, social media sites, such as Facebook and Twitter, are extremely popular today, especially among the younger generation, which creates a comprehensive platform for raising awareness about the issue at hand and advertising the program’s website (Jane, Hagger, Foster, Ho, & Pal, 2018). Zika Free Florida is another program that provides help and consultation to prevent development of Zika, disease that develops due to a mosquito-borne virus. Instagram and YouTube are another powerful tool to promote the agenda. The format of a video can have a significant effect upon a viewer evoking a strong emotional response. Instagram presents a visually appealing source of receiving information that is readily used by many users around the world, especially by those who like to travel to foreign countries and do not know what exactly one should expect.
Childhood obesity is another important public concern that requires special attention in health policy development. Promoting awareness about the peril associated with childhood obesity is pivotal for maintaining the nation’s health and decreasing the burden of chronic diseases. Social media campaigns may help in this regard. Again, the use of Instagram may trigger the interest of policymakers, while providing parents with the necessary material aids (Edney et al., 2018). It should be noted that such social media as YouTube and Facebook may serve as a source of social support.The posts and videos in media challenge may contain information about the ramifications related to childhood obesity, which can help a user make a change in their lives. They may illustrate examples of how others have already achieved positive results, thereby increasing individual’s awareness about the effective strategies and health promotion techniques (Mason, Gardner, Outlaw, 2016). Users see that they are not alone with this program and may track each other’s progress getting inspired and motivated. Thus, social media can be considered as an active agent in raising awareness and encouraging to make a positive change in one’s lifestyle or environment.
This is the original question if you needed to see what is about
Reflect on Florida’s current health education programs such as Zika Free Florida, Tobacco Free Florida and consider what part the media plays in such disease prevention programs. Identify a specific public health issue that you believe needs to be highlighted in health policy and based on your textbook readings discuss how social media can be used as a health promotion tool to improve public awareness on the selected topic.
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Respondebp1011
/in Uncategorized /by developerPlease find attached the instructions.
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Respondebp89
/in Uncategorized /by developerRespond to two colleagues.
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Respondinfowk910
/in Uncategorized /by developerPlease see attached for responses. Thanks
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Respondinfwk3
/in Uncategorized /by developerPlease Respond to two people, Ma and Eve Add 2 APA references. Thanks
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Responding 19191877
/in Uncategorized /by developerResponding to two classmates
1) My signature assignment topic that I have chosen is how computer hackers are able to hack into computers that healthcare professionals use to diagnose and treat patients daily. I am not sure what my title will be yet I am still working on it and thinking about it. I chose this topic because I think this very important and when I first learned about this it was pretty disturbing to me. To think that someone would interfere with possible treatment by manipulating a computer system is somewhat scary to think about. Everyday in healthcare, computers are used to make decisions, store patients personally information, determine results and outcomes and the list is endless. So the use of the computer and computer systems are largely used in health care regardless of what kind of healthcare setting it is. I usually choose google scholar to look up resources. So far I have not had any trouble finding articles that are related to my signature assignment. I will say that a lot of the articles are not related to healthcare. So its just a matter of finding a relevant article that fits my assignment. A article that has enough information for me to use and to quote from. There are many other websites that offer peer reviewed sources. To name a few of them are DOAJ, PubMed, Scienceopen, and Academic search. Every since I started with Aspen University I have used google scholar. One article stated that “beginning in 2016, healthcare organizations in the United States have been targeted for malware attacks, a specific type of cyberattack.” (Branch, Eller, Bias, McCawley, Meyers, 2018). Another article stated that the United States is not prepared to deal with an attack of this kind. I am hoping that the United States and any other country have expanded their technology in finding ways tp combat this problem of computer hackers.
2)
I am having more of a problem narrowing down my choices for sources actually more than anything. My topic is Electronic Health Records (EHRs), which is a very broad topic as EHRs encompasses many fields such as medical charting, medication administration, medical records, imaging test, real time lab test results, and Doctor’s notes. Researching and finding articles that give me the information I am looking for has always been one of my weaker points and is what consumes most of my time when it comes to writing. So far in my research process, the wording in the articles is not so difficult to comprehend compared to the textbook. The textbook for me is hard to understand and comprehend for some reason and requires me to read most sections multiple times before understanding. However, once I comprehend the information in the textbook, I find it very helpful and is usually my main source of information. I have been using the databases provided by Aspen University and Google Scholar.
“Reduce Errors with an EMR: It’s the most efficient way to keep records and improve patient care” is the first peer reviewed journal I have located. This journal advocates for using the EHRs to improve patient care by reducing errors because EHRs allow safeguards to be put into place that prevent errors. For example, medication administration errors. If a medication that the patient is allergic to is scanned before being given, a safeguard notification will pop up warning the nurse about the allergy.
“I.V. integration helps clinicians reduce medication errors” is the second academic journal I found in which EHRs have safeguard for high alert medications that provide safeguards for unfamiliar dosages and weight based dosage for pediatric patients. Basically, this means it stops the nurse from accidentally overdosing if a dose is entered into the computer that seems suspicious.
These are just a few examples of the advantages of EHRs and the technology capabilities that they possess. I am still looking for more resources but so far these have stuck out to me most. Many people do not like how time consuming EHRs and computer charting can be, but if the patient and nurse safety are the goals, then EHRs are far more effective than paper charting. With the right prioritization and time management, there is a way to make time for patient care and computer charting.
References
Hultman, J. (2012). Reduce Errors with an EMR: It’s the most efficient way to keep records and improve patient care. Podiatry Management, 31(3), 67–69. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=108172173&site=ehost-live
Rinda, J. (2012). I.V. integration helps clinicians reduce medication errors. Health Management Technology, 33(10), 12–13. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=104424094&site=ehost-live
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Responding 19199347
/in Uncategorized /by developer1)
The final presentation topic I have chosen explores the integration of health information technology within the nurse-patient relationship and how this relationship improves quality of care at the bedside. My topic also explores how health information technology can be utilized to improve nursing clinical workflow efficiency and quality. Some conclusions I have drawn from the literature research are that utilizing technology at the point of care delivery has made a significant impact on positive patient outcomes. It is important to note that the proper utilization of this technology is paramount in safe patient outcomes and in aiding the bedside clinician to improve workflow efficiency, quality, and patient safety. I believe that this is a very relevant topic, especially as we may have all recently learned that a former nurse at Vanderbilt University Medical Center in Nashville, Tennessee was arrested and charged with reckless homicide for making a medication error that resulted in a patient’s death. A full review of the plight of this nurse, and the judgement made against her is beyond the scope of this post, but its relevance can be related to the information systems and technology at the point of care that were involved in this incident.
According to Darvish, Bahramnezhad, Keyhanian, and Navidhamidi (2014), in an ever-changing advancing healthcare system, technology plays a major role in education and nursing work. Because of the ever-increasing pace that technology develops, the literature notes the need for appropriate education technology programs. Darvish et al. (2014) notes that in order to integrate information technology to effect positive outcomes and improve quality, there needs to be educational arrangements made within an organization to create short term and long-term specialized courses to focus on target groups and their various levels of education. By focusing on these groups and identifying their needs regarding information technology education, the goal is to increase quality of care, safety, and ultimately improve clinical workflow efficiency.
In my current practice a well-designed electronic health record system (EHRS) has been implemented for years. The system we are using currently is EPIC. We currently have excellent workflow efficiency in our extremely busy practice setting. Medication administration safety is enhanced with an integrated scanning system. The only potential issue from my current practice that I can identify as problematic, is that in an extremely rushed preoperative or PACU environment it is very easy to override the scanning tool and administer a medication urgently at the clinician’s discretion. In a PACU during a post-surgical emergency this is essential but when a clinician is just rushed to keep up with the workflow, then this presents a concern.
References
Darvish, A., Barhamnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014, June 24). The role of nursing informatics on promoting quality of healthcare and the need for appropriate education. Global Journal of Health Science, 6(6), 11-18. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825491/
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2)
Working on the final presentation has brought me to a few conclusions. First is that the nurse informaticists plays a key role in linking nursing and technology. This type of nurse takes their clinical knowledge and applies it to technology to improve patient outcomes. The nurse informaticists is crucial in being the change agent when it comes to introducing new technology or changes within technology at the bedside. Second conclusion is that using change theory is important for new technology to be accepted and successfully implemented into practice. The third conclusion is that technology is expanding at a rapid rate, the incorporation of electronic health records has made improvements in patient outcomes. The future of EHR applications have unlimited possibilities, however, ethical considerations need to be addressed. Just because technology can make improvements does not necessarily mean it should. And lastly, nurses at the bedside should be involved in the process of change. They are the stakeholders in change, the ones that experience the positives and negatives of incorporating changes into healthcare.
For the final presentation I am researching the interoperability of the EHR to improve triage accuracy. My focus is using EHR clinical systems such as clinical decision support systems to process data gathered during triage to support accurate triage acuity assignment. (Hebda, Hunter, Czar, 2019) Thus far in researching literature I have concluded that it is not just my experience in witnessing inaccurate triage assignments. Tam, Chung, and Lou (2018) research describes how worldwide there are problems in assigning accurate acuity levels despite the triage algorithm used. Experience and training are key factors in triage accuracy. Applying thinking algorithms could assist the triage nurse in making the important decision of how long a patient may safely wait to be seen in the emergency room. Monga (2017) discusses how incorporating “thinking” algorithms into EHRS can be done to guide practitioners in decision making. The question is should it be done? Ethical dilemmas arise, such as what if the algorithm applies the same biases as the nurse, or use of suggested acuity level is no longer a suggestion because the nurse becomes too dependent on the system. (Char, Shah, & Magnus, 2018) This application to the triage process would not create a change in nursing practice as it should be used as a support process and not a definitive decision process.
References
Char, D. S., Shah, N. H., & Magnus, D. (2018). Implementing machine learning in health care – Addressing ethical challenges. The New England Journal of Medicine, 378(11), 981–983. doi:10.1056/NEJMp1714229
Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of Informatics for Nurses and Healthcare Professionals (6th ed.). New York, NY: Pearson.
Monga, K. (2017). Using machine learning to increase agility in HIM. Journal of AHIMA, 88(7), 30-32. Retrieved from https://search.proquest.com/docview/1912093679?accountid=34574
Tam, H. L., Chung, S. F., & Lou, C. K. (2018). A review of triage accuracy and future direction.BMC Emergency Medicine, 18(1), 58. doi:10.1186/s12873-018-0215-0
200 words for each response
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Responding 19209359
/in Uncategorized /by developer1)
When I reviewed the assignment for this week, sheer panic took over. Then after reviewing all the tutorials on www.screencast-o-matic.com I felt a little relieved. The next tutorial reviewed from Professor Lease’s, and this one helped to pull it all together. This is one of those things that I had to get to website and navigate through a lot. I can easily record, stop, and erase after recording myself narrating. I use Microsoft online. I had a lot of trouble using PowerPoint Online, and trying to record by voice while using the slideshow view. This is impossible using the online version of PowerPoint. I had to click on “open in PowerPoint,” on the upper right hand side of my PowerPoint viewing area of the presentation. The computer asks if you want to switch apps. One must click “yes,” and it will bring you to the version used on the desktop. Before finding this out, I had a lot of trouble recording. The Screencast-O-Matic control board would completely disappear. This became very frustrating, and almost had me in tears. Finding out that PowerPoint online had to be changed to the regular PowerPoint used for the desktop was my saving grace. I was even able to record using the webcam. After saving the video, I could not find it but knew it was somewhere. On the top of the screen I clicked “for education.” This will lead to a different screen layout. There is an option for “my videos,” that is located next to your account e-mail address. After clicking on “my videos” this will bring one to all the videos saved. Downloading and installing was easy. I have a new laptop so on the upper right hand side of the screen are 3 dots. I clicked on that, then clicked on “pin this task to the toolbar.” It puts a little icon on the bottom of the computer. This icon acts as a direct link to the website. I use this for Aspen University’s Classroom, Aspen’s student portal, Microsoft online, and any other important places I need to get to quickly with a click of a button. I do have a question for you all. What does Professor Lease mean when she wrote “this can not be a voice over PPT?” My understanding is screencast is a PPT with voice recorded as a narrator, but what is voice over PPT? Does she mean we need to record our face as well?
2)
When I found out what the discussion question was going be for this week I was shaking in my boots. I thought to myself, here we go with something else I’ve never heard of and one more thing in life I must try and figure out. But to my surprise, with a little patience and not thinking it was the end of the world I was able to look up Screencast-o-matic with very few complications. Finding the website was easy. Looking at it for the first time I thought surly its not going to be as easy as logging in, but it was. The steps to recording wasn’t as bad a thought also. I tried to do it on my own but found later that it would have been best if I took the tutorial. After watching the tutorial, I was able to record the words on my first two slides. It was nice to learn to choose the section that I wanted to be heard within the PowerPoint. I must admit, I thought I sound quite crazy. The first thing I said was “wow is this what I sound like”. Then I quickly hit stop. After regrouping, I was couldn’t figure out how to get the screencast onto the PowerPoint. After playing around with it for a while and calling for help, I was able to set things up the way it needed to be presented. I don’t think the task of getting the screencast together was hard. I just think it was one more thing new that I had to become aware of, and we all know newness can be scary. I’m still having some trouble with the upload. Sometimes it worked for me and other times it didn’t. I’m sure if I go into it again when I have more time it will be fine. In the end it turned out to be not as bad as I thought it was. I admit that I didn’t know anything about screencast. Preparing those two slides were great. It was nice to learn something different and how other things beside graphs and pictures can be added to a PowerPoint. I look forward to seeing how my final presentation will turn out.
200 words for each response
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