Week 3 Critical Appraisal Of Practice Guidelines

  

While there are several tools to critically appraise practice guidelines, the most comprehensively validated appraisal tool is the AGREE II Instrument. The AGREE II Instrument can be used by individual practitioners to critically appraise health guidelines and by decision makers to inform policy decisions. The purpose of the AGREE II Instrument is to provide a framework to:

  1. Assess      the quality of guidelines.
  2. Provide      a methodological strategy for the development of guidelines.
  3. Inform      what information and how the information ought to be reported in      guidelines.

Overall assessment includes rating the overall quality of the guideline and whether the guideline would be recommended for use in practice.
 

Items are rated on a 7-point scale from 1 (Strongly Disagree) to 7 (Strongly Agree). A score of 1 is given when there is no information on that item or if it is poorly reported. A score of 7 is given if the quality of reporting is excellent and when full criteria have been met (Score explanations found in the AGREE II-GRS Instrument).
 

A quality score is calculated for each of the six domains, which are independently scored. Domain scores are calculated by summing up all the scores of the items in the domain and by scaling the total as a percentage of the maximum possible score for that specific domain.

For this assignment, you will choose a guideline and assess the overall quality and whether the guideline would be recommended for use in practice.

General Requirements:

Use the following information to ensure successful completion of this assignment:

  • Download      the AGREE II instrument.
  • Doctoral      learners are required to use APA style for their writing assignments. The      APA Style Guide is located in the      Student Success Center. An abstract is not required.
  • This      assignment uses a rubric. Please Review the rubric prior to the beginning to become familiar with the      expectations for successful completion.
  • You      are not required to submit this assignment to Turnitin.

Directions:

Perform the following tasks to complete this assignment:

  1. Using      the AGREE II instrument as your guide, create a table that discusses a      practice guideline in which you might have questioned the recommendations.      (Note: You may be able to copy and paste the instrument into a new Word      document and complete the information.)
  2. Each      domain must have its own cell (similar to the one shown in the manual) and      add domain scores and an overall guideline assessment. Be sure to include      comments and additional considerations that influenced your rating      decision and cite any sources used.

3. Apply Rubrics

 
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Week 3 Course Project Topic Selection

 

Required Resources
No specific resources are required for this activity. Conduct general research and/or skim the textbook to help you select a topic.

Introduction
You will work on a research project for the duration of this course that you will deliver as a presentation in Week 8. For this project, select a person whom you believe had a significant influence (positive or negative) on a movement for social, economic, and/or political change in the 20th and 21st centuries. Explore and address the following in your project:

  • Summarize the person’s ideas.
  • How did the ideas or changes affect the establishment and status quo?
  • What was the context in which this person proposed ideas/change?
  • How did the government or the people respond to the ideas/change?
  • What sort of following or support did he/she have?
  • How have the ideas/actions of the person influenced contemporary cultures and ideas?

For the final presentation, make sure to go beyond the surface information and go into depth about the person you are researching.

Here is a brief breakdown of the project so that you can plan your time in the course:

Week

Task

Week 3

Topic Selection

Week 5

Annotated Bibliography

Week 6

Script

Week 8

Presentation

Instructions
For the assignment this week, address the following:

  • State the topic.
  • For the stated issue, identify at least three (3) aspects of the issue that you think you will likely develop in your presentation. Briefly state why you have chosen each aspect.

You are not confined to three aspects only, but you must develop at least three. As you develop your presentation, you may find other aspects that you deem more relevant, and you may add or substitute those.

Writing Requirements (APA format)

  • Length: 1-2 paragraphs
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page (as needed)
 
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Week 3 Contemporary Issue Position Essay Ethics

Choose a case from the AMA Journal of Ethics Case Index   https://journalofethics.ama-assn.org/cases   and take a position. For this assignment you will evaluate the ethical arguments for or against the issue. Identify the potential legal arguments (consider current federal guidelines), indicate any potential professional code conflicts you foresee, and support your position with an explanation of your own ethical/moral foundation.

In your 2-3 page paper:

  • Identify the issue and state your ethical position.
  • How might this scenario play out or impact you in your role as a nurse practitioner? 
  • Defend your position with legal, ethical, and professional evidence.
  • As part of your position, propose strategies and solutions for addressing the issues.
  • What other ethical issues does this case bring to light, if any?

Support your position with at least one scholarly source (it may be your text).  Be sure to cite the article you choose, use APA format, and include a title page and reference page.

 
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Week 3 Discussion Pharmacology

For this questions, please read the following case study and then respond to the questions noted below.

Mr. JD is a 24-year-old who presents to Urgent Care with a 2-week history of cough and congestion. He says it started out as a “normal cold” and it will not go away. He has a productive cough for green mucous and has green nasal discharge. He says he has had a low-grade temperature for the past 2 days. John reports an intermittent frontal headache with this cold. He is otherwise healthy, with no known allergies.
In his assessment it is found that his vital signs are stable, temperature is 99.9 degrees F, tympanic membranes (TMs) are clear bilaterally, pharynx is erythematous with no exudate; there is greenish postnasal drainage; turbinates are swollen and red; frontal sinus tenderness; no cervical adenopathy, and lungs are clear bilaterally.

  1. Is there any additional subjective or objective information you need for this client? Explain.
  2. Would you treat Mr. JDs cold? Why or why not?
  3. What would you prescribe and for how many days? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.
  4. Would this treatment vary if Mr. JD was a 10 year-old 78 lb child? Include the class of the medication, mechanism of action, dosing, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings
  5. What health maintenance or preventive education is important for this client based on your choice medication/treatment?

Do 2 pages

Provide References

 
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Week 3 Discussion Ethical Dilemma

Ethical Dilemma

After reviewing The Invisible Patients documentary, define/describe in detail an ethical dilemma that was experienced by the NP. Please note, there are several ethical issues, so there should be diversity in the responses.  Explain how you would have handled the situation.

· How is the NP in the documentary a Disruptive Innovator?

· Discuss if there is a relationship between your personal beliefs and values and this ethical dilemma/barrier.

· Describe at least one mechanism to overcome the barrier discussed.

· Examine the potential cost and benefits to this barrier.

Remember there is no right or wrong answer for this ethical question. Suggested reference Look at the Nuremburg Code (US Department of Health & Human Services, 2005; Washington, 2012) as it was the major start of ethics in research and that can carry over to nursing practice.

US Department of Health & Human Services. (2005). The Nuremberg code.

Retrieved from http://www.hhs.gov/ohrp/archive/nurcode.html

 
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Week 3 Project 19413361

  

Instructions

Professional Practice Paper

Based on the AP role of the person that you interviewed in W1 Project, in a 3- to 5-page paper (excluding the title page, references, and appendices) describe the role, the type of organization, and address all the interview questions, and include:

· List the type of organization. For example: Primary care office, ED, Specialty, cardiology GI etc.

· List the type of and how many clients it serves. FP would see all ages. Research in your area the number of visits in a local office per year or # of visits seen local ED, specialty office etc. 

· the professional fit for advanced nursing role. “Fit” refers to the Qualifications in order to be an AP provider at that agency/organization. What license, credentialing (accrediting agency, and other expectations NPI, CMS)?

· Include a brief job description

· Discuss board of nursing NPA or scope of practice of the state. Include what the NPA in the state allows and restrictions.

Week one project bellow:

Week one Project

Advanced nursing practice is an essential component in the overall nursing and health care fraternity. The concepts used have been changing and are still changing over time. As there was a need and passion for improving on my skills and carrier as a nurse, I saw a need to join the South University for the advanced program in which I wanted to specialize in clinical nursing. As a clinical nurse specialist, I have been struggling in adaptation to meet challenges and the changing requirements of families. Patients and physicians Professor and Director Doctor of Nursing Practice Program Sacred Heart University Fairfield Connecticut Family Nurse Practitioner St Vincent’s Medical Centre Bridgeport Connecticut Susan M Denisco & Barker,2015). I have been facing a dilemma in which ambiguity and role confusion, and inability to explain the values of CNS economically. My main work as a clinical nurse specialist revolves around patient’s well-being and treatment.

In a hospital setting, there is an assignment that needs to be dealt with by clinical nurses, and others require non –clinical persons to ensure the safety of the patients in the access of health care services. There are roles to be played by managers who are not necessarily clinical officers. The managers have a moral and legal obligation in ensuring the patient’s care is of standards, and in the case of mediocre quality, they tend to improve them. The managers are in a position to dictate and authorize systems, policies, and the climate around the institution. The role of a clinical nurse about the role of (ANP) Adult nursing practitioners is that they order and perform routine screenings and accuracy in diagnostic of diseases and other illnesses to patients. Check-Ups to patients above 12 years old. They are involved in ordering laboratory tests and also participated in the determination of the appropriate form of treatment for the various diagnosis. The role of the two helps a vital role in the promotion of the patient’s outcome and safety as ordering laboratory tests a nurse diagnoses the ailment while the action of a hospital manager is to ensure the correct and right quality of service to the patients and efficient management.

An ANP role is that they focus mainly on adults from age 12 and above. The nurses are involved in dealing with chronic and acute illnesses (To practicing nurses to qualify as an ANP, passing in NCLEX-RN examination is mandatory for a certified registered nurse, while on top of that, there is a need to have experience of around and above two years. Concepts related to accreditation by the Commission on Collegiate Nursing Education (CCNE) or ACEN. This concept applies to people seeking masters, doctoral or postgraduate program (Sarah B, Keating; EdD; MPH; RN; C-PNP; FAAN & Stephanie S. DeBoor; APRN; ACNS-BC; CCRN,2017). After earning a certificate in adult nursing practitioners, the license must be renewed every five years. Most of the concepts used in advanced nursing practitioners are almost the same as those used in nursing during the analysis of diagnosis, treatment, chemical formulas of medicines, and body reactions to certain products towards certain drugs for medication. For specialty reasons, one can take the midwife field or registered nurse. Am determined to advance in clinical nursing hence the knowledge, and many concepts I attained during my previous course are applicable even in the advanced stage

Interview for a created post

Interview to take place on 11/Nov/2019 at 1300hours.

Name of the person: Hudson James Mahmud

Credentials: A highly qualified, energetic and capable to work despite challenges

Position: A senior general nurse practitioner

Questions 

1. The health provider is conducting an assessment on a patient who is taking properly for supraventricular tachycardia. Determine the assessment finding that may indicate the patient is experiencing the side effects of the drugs?

2. While caring for a patient suffering experiencing postoperative bleeding, the nurse notes the rhythm observed on electrocardiogram (EKG) didn’t produce a pulse. What action should a nurse take to resolve the problem?

3. A nurse working in an immunization center has to supervise medical assistance during a yellow fever vaccine administration. Who should the nurse question during the immunization on the schedule of the vaccine, and why?

4. Describe the lab test and results for a patient having vitamin k deficiency.

5. A nurse conducting a public education class on stroke prevention describes what must be included in the plan of teaching and the instructions to be given.

6. A patient suffering from mild heart failure is given hydrochlorothiazide, also known as (Microzide). Describe what a nurse should determine the teaching and overall medication of a successful procedure?

7. What questions should a nurse ask a patient prescribed with amitriptyline in the effort to manage depression when assessing the side effects?

8. To a patient who has social phobia, a nurse is applying the use of implosion therapy. What intervention would the nurse include in this type of behavioral therapy?

9. There was an incident in which a patient was brought in the emergency department after ingesting Ecstasy popularly known as MDMA, what symptoms should a nurse expect or anticipate?

10. When offering care for emphysema patient, the nurse instructs the patient on positioning to assist in breathing during dyspnea, describe the positioning which is suitable for the patient. 

 
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Week 3 Discussion Comment

Comment using your own words but please provide at least one reference for each comment.

Do a half page for discussion #1 and another half page for discussion #2 for a total of one page.

Provide the comment for each discussion separate.

 
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Week 3 Project 19405195

 

Professional Practice Paper

Based on the AP role of the person that you interviewed in W1 Project, in a 3- to 5-page paper (excluding the title page, references, and appendices) describe the role, the type of organization, and address all the interview questions, and include:

  • List the type of organization. For example: Primary care office, ED, Specialty, cardiology GI etc.
  • List the type of and how many clients it serves. FP would see all ages. Research in your area the number of visits in a local office per year or # of visits seen local ED, specialty office etc. 
  • the professional fit for advanced nursing role. “Fit” refers to the Qualifications in order to be an AP provider at that agency/organization. What license, credentialing (accrediting agency, and other expectations NPI, CMS)?
  • Include a brief job description
  • Discuss board of nursing NPA or scope of practice of the state. Include what the NPA in the state allows and restrictions.

QUESTIONS FROM WEEK 1 PROJECT 

  

1. What is the difference between the role you play, and the role played by other nurses? 

2. How long have you served a family nurse practitioner and what position were you serving before? 

3. What is the major challenge faced when serving as a family nurse practitioner? 

4. In which ways do you participate in the patient’s experience? 

5. How do you handle a situation when a patient request for a certain type of medication such as antibiotics which you feel is not necessary? 

6. In your line of duty, have you ever experienced a situation or an action happening which was unethical? 

7. What was the situation and what response did you offer as a solution? 

8. In a situation where one of your patients is not giving a positive response to the medication you have administered and request for more that the set amount, what do you do to solve this? 

9. Is there any one given time when you went far above in providing patient care which was exceptional? Explain the scenario and the result?

10.  Is there any time in your life when you and the physician disagreed on how to diagnose or treat a given patient? How did you deal with this situation?

 
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Week 3 Discussion Advance Practice

Apply information from the Aquifer Case Study to answer the following discussion questions:

  • Discuss the Mr. Rodriquez’s history that would be pertinent to his gastrointestinal problem. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.
  • Describe the physical exam and diagnostic tools to be used for Mr. Rodriguez. Are there any additional you would have liked to be included that were not? 
  • Please list 3 differential diagnoses for Mr. Rodriguez and explain why you chose them.  What was your final diagnosis and how did you make the determination?
  • What plan of care will Mr. Rodriquez be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?

Do 2 pages

Provide references.

 
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Week 3 Project 19234383

Instructions    

Research Proposal Draft  

By the due date assigned write a 2 page paper addressing the sections below of the research proposal.  

Introduction 

•Background and Significance of the Problem 

•Statement of the Problem and Purpose of the Study  

Research Questions, Hypothesis, and Variables with Operational Definitions 

•Research Question 

•Hypothesis: Research and Null 

•Identifying and Defining Study Variables 

•Operationalize Variables

 
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