I NEED A POSITIVE COMMENT BASED IN TIS ARGUMENT..BETWEEN 100-120 WORDS

Identify two GCU Library scholarly databases that will help you find the best research articles to support your EBP proposal. Discuss why these two databases are better than Google Scholar or a general Internet search.

The GCU library databases are a lot of different things to use to make your writing easier. The GCU database is better than google search because it is focused on our topics and what we need to learn and not just everything on the internet. One of the main things that will help when writing your papers and to help support your EBP proposal is ask the librarian. This can help you when you get stuck and can’t figure out the next step. Also if you can’t figure out how to navigate the library the ask the librarian database is something that will help support your EBP. The other database that will help support your EBP proposal is CINAHL. This database has access to thousands of articles from other healthcare professionals and other people in the field that understand what nurses go through. Using this will help to support your EBP because you can read other people’s thoughts that have been in the same place other nurses have. These two things are the most helpful for me but the GCU library has many databases that are better than google because the results we get from GCU are from people that understand what nurses go through.

References:

Grand Canyon University. (2016). About the GCU Library.| www.gcu.edu. Retrieved 13 November 2017, from https://www.gcu.edu/future-students/campus-experience/library.php

Grand Canyon University. (2017). http://library.gcu.edu/Database/Subject?subject=Nursing_And_Health_Sciences

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I need a positive comment based in this argument.. between 100-120 words

Etiologies, Trends, and Predictors of 30-Day Readmission in Patients with Heart Failure 

Summary: Heart failure is the most common discharge diagnosis across the United States, and these patients are particularly vulnerable to readmissions. A study of heart failure patients was completed with specific qualifiers.  Readmission causes were identified using International Classification of Diseases, Ninth Revision, codes in primary diagnosis filed. The primary outcome was 30-day readmission. The study showed readmission after a hospitalization for HF is common. Although it may be necessary to readmit some patients, the striking rate of readmission demands efforts to further clarify the determinants of readmission and develop strategies in terms of quality of care and care transitions to prevent this adverse outcome.

Strength: Discusses causes of readmissions of heart failure patients.

Weakness: The study needs further clarification of why heart failure patients are being readmitted.  

Arora, S., Patel, P., Lahewala, S., Patel, N., Patel, N. J., Thakore, K., & … Gopalan, R. (2017).      Heart Failure: Etiologies, Trends, and Predictors of 30-Day Readmission in Patients With        Heart Failure. The American Journal Of Cardiology, 119760-769.    doi:10.1016/j.amjcard.2016.11.022

Using Teach-Back Method to Prevent 30-Day Readmissions in Patients with Heart Failure: A Systematic Review

Summary: Heart failure is one of the most common readmission diagnoses. A review of the literate is presented to identify a role for teach-back patient education in reducing readmissions in patients with heart failure.

Strength: The study showed reduced readmission rates when using the teach back method of education.

Weakness: The study did not state the actual teaching methods to reduce readmission rate of heart failure patients.

Almkuist, K. D. (2017). Using Teach-Back Method to Prevent 30-Day Readmissions in Patients    with Heart Failure: A Systematic Review. MEDSURG Nursing, 26(5), 309-351.

Care of Patients with Cardiovascular Disorders: Improving quality of life and decreasing readmissions in heart failure patients in a multidisciplinary transition-to-care clinic

Summary: A pilot for a four-week transition-to-care program on heart failure patient’s due to the critical time in between discharge and readmissions. The study used a pre and post test to determine the quality of life related to hospital readmissions. The study showed improved quality of life and decreased readmission rates following the transition-to-care program.

Strength: Has significant results showing a positive effect of a transition-to-care clinic on reucing readmission rates of heart failure patients.

Weakness: the study size was quite small at 50 patients.    

Whitaker-Brown, C. D., Woods, S. J., Cornelius, J. B., Southard, E., & Gulati, S. K. (2017). Care             of Patients With Cardiovascular Disorders: Improving quality of life and decreasing         readmissions in heart failure patients in a multidisciplinary transition-to-care clinic. Heart     & Lung – The Journal Of Acute And Critical Care, 4679-84.     doi:10.1016/j.hrtlng.2016.11.003

Brief Report: Strategies for Reducing the Hospital Readmission Rates of Heart Failure Patients

Summary: The purpose of this article is to review current HF readmission prevention strategies for effectiveness.

Strength: discusses the costs associated with heart failure readmissions and makes good recommendations for action on how to reduce readmissions.

Weakness: focuses on the role of the nurse practitioner

McClintock, S., Mose, R., & Smith, L. F. (2014). Brief Report: Strategies for Reducing the            Hospital Readmission Rates of Heart Failure Patients. The Journal For Nurse          Practitioners, 10430-433. doi:10.1016/j.nurpra.2014.04.005

An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomized controlled trial (the FAMILY study).

Summary: The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission.

Strength: the study showed a lower readmission rate when family centered self-care was implemented.

Weakness: the study was completed in Lebanon

Deek, H., Chang, S., Newton, P. J., Noureddine, S., Inglis, S. C., Arab, G. A., & … Davidson, P. M. (2017). An evaluation of involving family caregivers in the self-care of heart failure        patients on hospital readmission: Randomized controlled trial (the FAMILY study).             International Journal Of Nursing Studies, 75101-111. doi:10.1016/j.ijnurstu.2017.07.015

Repeat Hospitalizations Predict Mortality in Patients with Heart Failure

Summary: The goal of the study was to evaluate the impact of repeat heart failure hospitalizations on all-cause mortality and to determine risk variable related to patient mortality.

Strength: the study showed that repeat admissions were a strong predictor of mortality.

Weakness: the study did not offer suggestions to help reduce the mortality of heart failure patients following readmissions.

Lin, A. H., Chin, J. C., Sicignano, N. M., & Evans, A. M. (2017). Repeat Hospitalizations Predict Mortality in Patients With Heart Failure. Military Medicine, 182(9), e1932-e      1937. doi:10.7205/MILMED-D-17-00017

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUENT..BETWEEN 100-120 WORDS

Evidence-based practice projects are fundamental in medical practice. This is the reason as to why such projects emanate into results that are statistically significant. A distinction between clinical significance and statistical significance will be discussed in its relation to evidence based projects (Gillani, 2011). The use of clinical significance in supporting positive outcomes in the project will also be highlighted.

Clinical significance refers to that ability displayed by a treatment to enable a patient return to his or healthy state of body functioning. However, it differs from statistical significance in a sense that it is more objective i.e. it determines whether the prescribed treatment was able to achieve the intended purpose (Sedgwick, 2014). Statistical significance, though a determinant that was only used sometimes back is expressed as a variable meaning that it is never exact on whether the treatment recommended is going to restore a patient’s normality. It operates on the principle of probability.

The ultimate aim of the evidence-based practice project is to bring forth positive outcome. Incorporation of clinical significance can prove to be of great help in achieving this. Carrying out a clinical interpretation in the entire research process will be fundamental in ensuring that the patient’s safety, as well as efficacy need, is put into consideration when it comes to decisions made. This will significantly enhance positive outcomes of the research work.

A critical evaluation of the research project by clinicians so as to qualify internal as well as external validity will trigger positive results. The employment of all these aspects of clinical significance will see to it that Evidence-based practice project becomes not only meaningful but also helpful to those seeking medical solutions to their unhealthy conditions.

                                                  References

Gillani, S. (2011). Is statistical significance a relevant tool for assessing clinical significance?. Journal Of Pharmaceutical Negative Results, 2(2), 121. http://dx.doi.org/10.4103/0976-9234.90227

Sedgwick, P. (2014). Clinical significance versus statistical significance. BMJ, 348(mar14 11), g2130-g2130. http://dx.doi.org/10.1136/bmj.g2130

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Any new endeavor is often approached with both excitement and reticence. I felt this way as I began my course work last week. While I was thrilled to be starting the final leg of my academic journey, I was fearful and overwhelmed by all that life was throwing at me. Course work, family, professional life, Thanksgiving holidays—all coming at me to add a great deal of stress. As I completed discussion posts and began working on assignments, several thoughts occurred to me and questions arose.

The first of these questions was how I could best manage my time to maintain a successful work life, school life, and personal life balance. One component of my time management plan was to approach my manager about changes to my work schedule that will optimize my hours worked in relationship to pay (working shifts that provide a shift differential) and allow me to work fewer hours overall. Another component of my time management plan was to plan specific days for structured schoolwork that I schedule away from my house where I would have many distractions from laundry to leisure reading to video games. By spending this structured time at a coffee shop or library, I will be able to get the most benefit from my time. A third component of my time management plan is to budget my time as I would my money by scheduling time for school, family, personal time, etc. In budgeting personal time, it is important to allot adequate time for sleep, exercise, and time with friends and family (Roque & Handing, n.d.). I am curious what strategies my fellow students find beneficial in budgeting and managing their time.

One of the people I listed on our network assignment is my academic advisor. In the video “The Walden Journey to a Masters in Nursing: Strategies and Resources for Success,” the use of our academic advisors is emphasized as a valuable resource (Laureate Education, 2018). While I know from my online courses at the school where I completed my BSN that your academic advisor can be helpful in navigating your program and overcoming obstacles, I am unsure of what the interaction with an academic advisor looks like here at Walden. I am sure some of my fellow students completed their bachelors degrees through Walden and would already have experience working with a Walden academic advisor. I would love to hear about your experiences with an advisor and suggestions on how to gain the most benefit from this resource.

There is one final concern that I am evaluating following my first week as a student at Walden. As I was exposed to many of the resources available to me here at Walden, I was given the opportunity to become a part of the Facebook group. I joined anticipating great benefit as I remember the Facebook group I participated in during nursing school was especially beneficial. One study of university sponsored Facebook groups demonstrated benefits including the sharing of research, volunteer opportunities and academic requirements (Malouff & Johnson, 2015). Despite my initial positive feelings about the Facebook group, I began to be overwhelmed and panicked as I would read posts. “Did I miss something?” became a repeated thought as I read post and comments alike. I am usually a student who is confident in my abilities to read the syllabus and assignment instructions and rubrics and then complete the tasks, but as I read the questions posed and the replies, I found that I was doubting this ability. I was overthinking every assignment and going back again and again to the course material to make sure I hadn’t missed something or done something incorrectly. As a result of this, I have contemplated changing the settings on the group so that I am not following all of the posts and they are not just randomly populating my Facebook feed and adding stress to my life. Has anyone else experienced this? In addition, I am concerned that people are utilizing the Facebook page to query peers instead of actually using Blackboard and reading the course material. This will inevitably lead to failure because the way to be successful in any course is to meet the requirements laid out in the syllabus and assignment rubrics. Does anyone have any suggestions for how this should be approached? In addition, do you think the potential benefits of the group outweigh the potential for stress and misinformation?

This new endeavor will certainly have its challenges, but I am already starting to feel more comfortable with the path that lies ahead. Already, one of the people I listed on my networking template has offered the availability of using her organization for a clinical site. In addition, I have received excellent advice from two of the people listed in terms of how to approach my assignments and keeping from feeling overwhelmed. The path ahead will be full of challenges, but the end reward will be worth them all.

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Identify the Population   Health concern you selected.

Unfortunate Elevation   of Suicide Rate in America

Describe the Population   Health concern you selected and the factors that contribute to it. 

Suicide is mental illness   when people direct violence at themselves with intent to end their life which   is a major public health problem and leading cause of death in America.   According to Center of Disease Control and Prevention (CDC) suicide is tenth   leading cause of death in US claiming the lives of over 47,0000 people.   During 2001 – 2017 total rate increase is 31 percent from 10.7 – 14.0 per   100,000 and in male suicide is four times higher than female (National   Institute of Mental Health).

Administration (President   Name)

(Current President)

Donald J Trump

(Previous President)

Barack Obama

(Previous President)

George W Bush

Describe the administrative   agenda focus related to this issue for the current and two previous   presidents.

President Trump issued a   “National call to Action to Empower Veterans and End the National tragedy by   Veteran Suicide”, this administrative agenda focuses on improving the quality   of life of America’s Veterans and ending the tragedy of veteran’s suicide.   Despite significant efforts and billions of dollar investment veteran’s   suicide has raise to 26 percent from 2005-2016. President’s aim through this   agenda is to revolutionize the VA healthcare system (U.S. Department of   Veterans affairs,2016).

President Trump signed, the   National Suicide Hotline Improvement Act of 2018, which made civilian to   access suicide crisis prevention by direct 3-digit number rather than long 10   digits (American Foundation for Suicide Prevention,2018).

In Obama’s administration,   Affordable Care Act played crucial role in extension of mental health and   substance use disorder benefits and parity protection among individuals who   were suffering from mental health illness. Obama also focused in prevention   of American Veteran suicide by making easy access to the mental health   providers. President proclaimed September 10,2015 as world suicide prevention   day by making awareness to citizen, government agencies, organization, health   care institute and research institute. He focused on prevention of bullying   and harassment which is major leading cause of suicide among teenagers

(The Whitehouse,2015).

In Bush’s administration, suicide   was introduced as one of the serious mental health problems among civilian   and veterans. In 2001 Bush’s agenda was focused in serving all person at risk   of suicide in US through network of local, certified crisis call center. This   program now called the National Suicide prevention lifeline. Agenda primary   focus was to make it available 24/7. In 2009 on supervision of Bush VA added   1-1 “chart service” for veteran who prefer to reach through internet (US   Department of Health and Human Services, 2012).

President Bush signed H.R.   327, the “Joshua Omvig Veterans Suicide Prevention Act” and H.R. 1284 the “   Veterans compensation cost-of-living adjustment act,2007) into law which   required VA to develop and implement a comprehensive program to reduce the   incidence of suicide among veterans and increase beneficiaries of veteran’s   disability compensation(Office of press secretary,2007).

Identify the allocations of   financial and other resources that the current and two previous presidents   dedicated to this issue.

The executive orders on   president’s Roadmap to empower Veteran’s and End a National Tragedy of   suicide establishes a task force that includes the secretaries of VA,   Defense, Health and Human services and Homeland security. Frequent meeting of   the taskforce is held for topic prevention of suicide which includes head of   other executive department and agencies to other senior officials in the   Whitehouse office. President Trump secured a record $73.1 billion in funding   for the VA to provide quality medical care which includes $8.6 billion for   mental services and $206 million for suicide prevention (Whitehouse, 2018).

The president has expanded   access to telehealth services to help reach more veterans through “Anywhere   to Anywhere” effective VA health care initiative (Whitehouse,2018).

Affordable Care Act (ACA)   created Prevention and public health fund which funded 27 grants for   prevention of suicide (US Department of Health and Human Services, 2012).

President George W Bush   signed the Garrett Lee Smith Memorial Act on October 21, 2004, turning bill   into law, the measure provides $82 million in grants to school, colleges,   universities and American Indian organization for development of suicide   prevention program (Kelvin,2004).

Explain how each of the   presidential administrations approached the issue.

President’s roadmap to   empower Veterans include a national research strategy for engaging with   public and private sector stakeholders to better understand the underlying   factors of suicide and lead to earlier identification and intervention, it   also includes a proposal for equipping state and local government with the   resource and tools to empower veteran communities. This roadmap helps to   create on active engagement with each veteran because 70 percent veteran   suicide without any mental assessment and intervention, it helps each veteran   for easy access of healthcare (Whitehouse,2018).

Mr. Trump’s order made a wide   range of mental health services available to all veterans as they transition   back to civilian society. Trump directed the department of VA for expansion   of health care to telemedicine, which has the potential to connect veteran   with care no matter where they live, and its use of technology allows former   service members to schedule appointment online. If VA can’t serve them   quickly then Veteran can go for private and allowance will be given (White   house,2018).

The Affordable Care Act   extends mental health and substance use disorder benefits and parity   protection to over 60 million Americans, helping men and women across country   to access critical care. Protection under the health care law prohibit   insurers from denying coverage because of pre- existing conditions, like a   diagnosis of mental health illness and require most insurance plan to cover   and recommended prevention service without co pays, including behavioral   assessment for children and depression screening( The White House,2018).

In February, Obama signed the   Clay Hunt suicide prevention for American Veteran Act to help fill serious   gaps for serving veterans with PTSD and other illness. Obama announced 19   executive actions to make it easier for veterans to access care, including   increasing the number of mental health providers at the department of   Veterans Affair (The White House,2018).

Suicide prevention national   strategy was first released in 2001, assembled by president George W Bush in   2002,the commission was asked to study mental health service delivery system,   to make recommendations that would enable adults with serious mental health   illness and children with serious emotional disturbance at work and    school. Participating fully in their communities, after one year of   study, reviewing and testimony the group issued its final report, which   identified six goals and corresponding recommendation. Activity in the filed   of suicide prevention has grown dramatically since the national strategy was   issued in 2001.Government agencies at all levels, school, nonprofit   organization and business have started program to address suicide prevention   (US Department of Health and Human Services, 2012).

The network of local   certified crisis call center was established in such a way that people in   crisis get their call transferred in nearest place so that suicide prevention   team can be in place of crisis quickly. There are greater than 100 suicide   call centers in 49 states. In October 2011, lifeline answered about 3 million   calls. (US Department of Health and Human Services, 2012).

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