Influencing Multiple Systems Through Evidence-Based Change
As an advance practice nurse, your work is informed by many factors beyond your direct reach, and your influence extends beyond the immediate context in which you labor. Likewise, the changes you propose as a nurse leader are influenced by multiple systems and, in turn, can have an impact on many different groups. One of the ways to distinguish yourself as a leader is to be knowledgeable about these spheres of influence and to promote awareness of the potential effects that may result from a change.
Indeed, with the fluid and persistently evolving nature of change, it is essential that you stay abreast of latest developments that may affect the practice environment. This is especially critical for maintaining or adapting a change once it has been implemented. As discussed in Weeks 8 and 9, you may need to make adjustments based on evaluation of outcomes; in addition, you must also be prepared for adjustments based on developments within or outside your targeted environment.
To prepare:
- What are some possible adjustments that you might need to make based on the evaluation of outcomes? Consider insights from the Discussion in Weeks 8 and 9.
- Consider the evidence-based change you are proposing for your practicum setting: What other systems or components of a system are within the sphere of influence of this change? How could evolving issues internal to the setting, such as budget, staffing shortage, regulations or external to it, such as supply, funding, national priorities, and disasters, affect the implementation—and ultimately the sustainability—of such a change?
- How might your proposed change, in turn, affect policy or practice at other levels beyond your initial focus?
By tomorrow Wednesday 5/1/19 2pm (America/New York time), write a minimum of 550 words essay in APA format with at least 3 references (see list or required readings below). Include the level one headers as numbered below:
Post a cohesive response that addresses the following:
1) Describe at least three evolving issues that are internal or external to your practicum setting that could affect the implementation and sustainability of your proposed change.
2) From what systems level do those issues originate (e.g., organizational, local, state, national, global) and what other systems are then involved in response to that factor?
3) How might your proposed change, in turn, lead to shifts at other levels beyond your initial focus?
Required Readings
White, K. M., & Dudley-Brown, S.(2016). Translation of evidence into nursing and health care practice. (2nd edition) New York, NY: Springer Publishing Company.
- Review Chapter 11 “Information Technology: A Foundation and Enabler for Translation”
- Review Chapter 15 “Best Practices in Translation: Challenges and Barriers in Translation”
Braithwaite, J., Westbrook, M., Nugus, P., Greenfield, D., Travaglia, J., Runciman, W., & … Westbrook, J. (2013). Continuing differences between health professions’ attitudes: the saga of accomplishing systems-wide interprofessionalism. International Journal for Quality in Health Care, 25(1), 8-15. doi: 10.1093/intqhc/mzs071
Hoyle, C., & Johnson, G. (2015). Building skills in organizational and systems change. Nurse Practitioner, 40(4), 15-23. doi:
10.1097/01.NPR.0000461948.38539. fc
Jeungok, C., & Zucker, D. M. (2013). Self-assessment of nursing informatics competencies for Doctor of Nursing practice students. Journal of Professional Nursing, 29(6), 381-387. doi: 10.1016/j.profnurs.2012.05.014
Toussaint, J. S. (2015). The Framework for a Whole-System Transformation. Journal Of Healthcare Management, 60(6), 386-389.
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Inflammatory Bowel Disease 19372163
/in Uncategorized /by developerInflammatory Bowel Disease
Case Study
The patient is an 11-year-old girl who has been complaining of intermittent right lower
quadrant pain and diarrhea for the past year. She is small for her age. Her physical
examination indicates some mild right lower quadrant tenderness and fullness.
Studies Results
Hemoglobin (Hgb), 8.6 g/dL (normal: >12 g/dL)
Hematocrit (Hct), 28% (normal: 31%-43%)
Vitamin B12 level, 68 pg/mL (normal: 100-700 pg/mL)
Meckel scan, No evidence of Meckel diverticulum
D-Xylose absorption, 60 min: 8 mg/dL (normal: >15-20 mg/dL)
120 min: 6 mg/dL (normal: >20 mg/dL)
Lactose tolerance, No change in glucose level (normal: >20 mg/dL rise in
glucose)
Small bowel series, Constriction of multiple segments of the small intestine
Diagnostic Analysis
The child’s small bowel series is compatible with Crohn disease of the small intestine.
Intestinal absorption is diminished, as indicated by the abnormal D-xylose and lactose
tolerance tests. Absorption is so bad that she cannot absorb vitamin B12. As a result, she has
vitamin B12 deficiency anemia. She was placed on an aggressive immunosuppressive
regimen, and her condition improved significantly. Unfortunately, 2 years later she
experienced unremitting obstructive symptoms and required surgery. One year after surgery,
her gastrointestinal function was normal, and her anemia had resolved. Her growth status
matched her age group. Her absorption tests were normal, as were her B12 levels. Her
immunosuppressive drugs were discontinued, and she is doing well.
Critical Thinking Questions
1. Why was this patient placed on immunosuppressive therapy?
2. Why was the Meckel scan ordered for this patient?
3. What are the clinical differences and treatment options for Ulcerative Colitis and Crohn’s
Disease? (always on boards)
4. What is prognosis for patients with IBD and what are the follow up recommendations for
managing disease?
note:
reference at least two updated, and APA format, with plagiarism rate 0%, if possible attach%
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Inflammatory Bowel Disease 19384031
/in Uncategorized /by developerCritical Thinking Questions
1. Why was this patient placed on immunosuppressive therapy?
2. Why was the Meckel scan ordered for this patient?
3. What are the clinical differences and treatment options for Ulcerative Colitis and Crohn’s Disease? (always on boards)
4. What is prognosis for patients with IBD and what are the follow up recommendations for managing disease?
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Inflammatory Bowel Disease 19385183
/in Uncategorized /by developerCase study
APA format
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Inflammatory Bowel Disease Case Study
/in Uncategorized /by developerReview the case study and answer all questions.
APA Format
Include 2 scholarly references
Turn it in Score must be less than 20%
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Influencing Health Care Through Advocacy
/in Uncategorized /by developerChoose a legislator on the state/federal level who is also a nurse and discuss the importance of the nurse’s role as advocate for improving health care delivery. What specific bills has the nurse sponsored or supported that have influenced health care.
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Influencing Multiple Systems Through Evidence Based Change
/in Uncategorized /by developerInfluencing Multiple Systems Through Evidence-Based Change
As an advance practice nurse, your work is informed by many factors beyond your direct reach, and your influence extends beyond the immediate context in which you labor. Likewise, the changes you propose as a nurse leader are influenced by multiple systems and, in turn, can have an impact on many different groups. One of the ways to distinguish yourself as a leader is to be knowledgeable about these spheres of influence and to promote awareness of the potential effects that may result from a change.
Indeed, with the fluid and persistently evolving nature of change, it is essential that you stay abreast of latest developments that may affect the practice environment. This is especially critical for maintaining or adapting a change once it has been implemented. As discussed in Weeks 8 and 9, you may need to make adjustments based on evaluation of outcomes; in addition, you must also be prepared for adjustments based on developments within or outside your targeted environment.
To prepare:
By tomorrow Wednesday 5/1/19 2pm (America/New York time), write a minimum of 550 words essay in APA format with at least 3 references (see list or required readings below). Include the level one headers as numbered below:
Post a cohesive response that addresses the following:
1) Describe at least three evolving issues that are internal or external to your practicum setting that could affect the implementation and sustainability of your proposed change.
2) From what systems level do those issues originate (e.g., organizational, local, state, national, global) and what other systems are then involved in response to that factor?
3) How might your proposed change, in turn, lead to shifts at other levels beyond your initial focus?
Required Readings
White, K. M., & Dudley-Brown, S.(2016). Translation of evidence into nursing and health care practice. (2nd edition) New York, NY: Springer Publishing Company.
Braithwaite, J., Westbrook, M., Nugus, P., Greenfield, D., Travaglia, J., Runciman, W., & … Westbrook, J. (2013). Continuing differences between health professions’ attitudes: the saga of accomplishing systems-wide interprofessionalism. International Journal for Quality in Health Care, 25(1), 8-15. doi: 10.1093/intqhc/mzs071
Hoyle, C., & Johnson, G. (2015). Building skills in organizational and systems change. Nurse Practitioner, 40(4), 15-23. doi:
10.1097/01.NPR.0000461948.38539. fc
Jeungok, C., & Zucker, D. M. (2013). Self-assessment of nursing informatics competencies for Doctor of Nursing practice students. Journal of Professional Nursing, 29(6), 381-387. doi: 10.1016/j.profnurs.2012.05.014
Toussaint, J. S. (2015). The Framework for a Whole-System Transformation. Journal Of Healthcare Management, 60(6), 386-389.
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Info 19413865
/in Uncategorized /by developerShare your experiences with healthcare information systems, past or present. Has it been an easy transition or difficult? Why do you believe your experience has been positive or negative? If you are currently not working in a healthcare setting, how has the medical record exposure in nursing school impacted your current knowledge?
3 paragraphs, In text citation with references
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Info 3 19423305
/in Uncategorized /by developerStandardized Terminology and Language in Informatics is an important part of healthcare. Nurses and healthcare workers need to understand and be able to communicate clearly. Please select one of the following options and discuss your understanding of the role in healthcare and its potential impact on your practice.
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Info 4 19432015
/in Uncategorized /by developerCase Study: A 65-year-old woman was just been diagnosed with Stage 3 non-Hodgkin’s lymphoma. She was informed of this diagnosis in her primary care physician’s office. She leaves her physician’s office and goes home to review all of her tests and lab results with her family. She goes home and logs into her PHR. She is only able to pull up a portion of her test results. She calls her physician’s office with this concern. The office staff discussed that she had part of her lab work completed at a lab not connected to the organization, part was completed at the emergency room, and part was completed in the lab that is part of the doctor’s office organization.
The above scenario might be a scenario that you have commonly worked with in clinical practice. For many reasons, patients often receive healthcare from multiple organizations that might have different systems.
As you review this scenario, reflect and answer these questions for this discussion.
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Info 5
/in Uncategorized /by developerSelect ONE of the following trends and discuss your understanding of this trend in healthcare and its potential impact on your practice as a nurse. What are the legal, privacy, and ethical considerations of this trend? (Everyone attempt to choose a different topic so that we will learn about the many advancements in technology).
Nanotechnology
Consumer health informatics (CHI)
Social media healthcare applications
Health-focused wearable technology
eHealth
Artificial Intelligence
Simulation
Computerized provider order entry (CPOE)
Bar Code Medication Administration (BCMA)
Creative measures in healthcare for use with 3D printers
Smart Pumps
Smart Rooms
Robotics in healthcare
Mobile technology in outpatient care
Web-based tools and software technology
Risk Management tools
Chatbots or Bots in healthcare
Telenursing
Telemedicine
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