2 Pg Public Health Hivaidsfinal Project Stage Iannotated Bibliography

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DUE 6/24 5P.M EST

TOPIC: HIV/AIDS IN LOWER INCOME COMMUNITIES

 

his week, you explore annotated bibliographies, which are part of a larger systematic review of literature. The main purpose of the annotated bibliography is to delve into the current knowledge base surrounding a chosen problem. Reviewing the literature and discovering the current state of the research will help to identify gaps in the knowledge or questions not yet answered about the problem. An annotated bibliography is usually your “first look” at the published literature relating to a problem of interest. Annotated bibliographies help identify the all-important research question that needs to be addressed related to that problem. According to the Walden Library, an annotated bibliography combines “a set of notes, comments, or critiques” with “a list of references that helps a reader identify sources of information” 

What type of information should be included in these notes, comments, and critiques? The annotations should summarize the key information in the article or resource without merely paraphrasing the content. The intent is to provide a succinct analysis of the “why” behind the study you read in the published material. It should be based on your opinion of why the author(s) believed the study was necessary and chose the particular methods of investigation used. Annotations might also include theories and conclusions postulated by the authors. An effective annotation includes the strengths of an article, but even better, the weaknesses or deficiencies as well.

 

The Assignment: INCLUDE THIS IN PAPER

Paper (2pages)

Section I

  • Summarize the health problem related to the particular community you identified for your Final Project.
  • Develop a research question related to a problem.
  • Provide a rationale for your selection of this question, along with supporting data.

Section II

Create an annotated bibliography of research related to this problem. In your annotated bibliography, include the following:

  • Six to eight resources on the identified public health problem related to the research question.
  • For each source, write a brief summary of the key points of the study. Include the problem, main research question, study type, and an analysis of the major findings. You may also include any information or notes that you believe are relevant and would be useful to you as you revisit your bibliography later.
  • An explanation of the problem areas and gaps in the existing research revealed by the annotated bibliography.

The majority of the resources should be primary research. Annotations should describe relevancy and timeliness and should indicate whether the research is primary or secondary.

 
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2 Part Assignment Due Essay 800 Words And 8 Slide Powerpoint Presentation With Speaker Notes Due June 9 No Plagiarism Must Be An A Paper

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Identify a research or evidence-based article that focuses comprehensively on a specific intervention or new diagnostic tool for the treatment of diabetes in adults or children.

In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 Part 2 of assignment 

Based on the summary of research findings identified from the Evidence-Based Project—Paper on Diabetes that describes a new diagnostic tool or intervention for the treatment of diabetes in adults or children, complete the following components of this assignment:

Develop a PowerPoint presentation (a title slide, 6-12 slides, and a reference slide; no larger than 2 MB) that includes the following: Presentation Notes A Must 

  1. A brief summary of the research conducted in the Evidence-Based Project – Paper on Diabetes.
  2. A descriptive and reflective discussion of how the new tool or intervention may be integrated into practice that is supported by sound research.
 
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2 Pg Paper Public Health Scholar Practitioner Project Surveillance Subject And Data Sources

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Due 6/10 10 p.m est  FOLLOW APA FORMAT!!!!

2 PAGES NOT INCLUDING REFERENCE PAGE (MIN)

For this week’s Scholar-Practitioner Project assignment “HIV/AIDS in lower income areas),one that has multiple data sources and elaborate on many of the data considerations you must take into account in monitoring the disease.

The disease or condition you select will be the subject of a disease surveillance system you create throughout the duration of this Project. As such, the portion you submit this week should serve as a preliminary plan for your surveillance system.

To complete this portion of your Scholar-Practitioner Project, write a 2-pg paper that addresses the following: 

(Must Be Included In Paper)

· Identify a disease or condition that will be the subject of your Scholar-Practitioner Project surveillance system.

· Identify the population most at risk for the disease or condition you selected.

· Describe the data that you will need to perform the surveillance on your selected disease/condition, including the primary and secondary data sources you will need.

 
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2 Papers

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1- 4 pages not including cover and reference sheet

1- 5 pages not including cover and reference sheet

 
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2 Papers Nursing 6231 Healthcare Systems And Quality Outcomes

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Section 5

To prepare:

Review your work on the Course Project thus far, particularly Sections 3 and 4.

Think about how your quality improvement initiative could be evaluated. Consider the following:

Which stakeholders need information related to this initiative? What do they need this information for?

How would you assess the outcomes in the short-term and long-term?

How would you analyze related processes, including but not limited to the one you redesigned in Section 4?

How should an analysis of organizational structures be integrated into your evaluation?

How would you identify and evaluate any unintended consequences that may arise?

What metrics should the organization use to gauge progress and the effectiveness of the quality improvement initiative? How would these metrics incorporate the measures and indicators that you identified in Section 3? Are there additional measures and indicators that you now think should be included?

How should the organization track and display data for an interdisciplinary audience? How could the use of a dashboard or balanced scorecard be of value?

How could the organization create an integrated view of performance that links finance and quality?

To complete:

Develop a 2- to 3-page evaluation plan that includes the following:

An outline of the methods that you would propose for evaluating the quality improvement initiative and the financial implications

A description of specific metrics that integrate your previously identified measures and indicators and any others that you have deemed important

A recommendation of how the organization could represent data related to this quality improvement issue for ongoing monitoring and to determine the value or success of the initiative

An explanation of how the organization could create an integrated view of performance that links finance and quality

Section 6

To prepare:

Begin to develop a plan for implementing your quality improvement initiative, including the redesigned process that you identified in Section 3. Consider the following:

How would you undertake the process of determining a timeline for planning, implementing, and evaluating this quality improvement plan?

What are some reasonable milestones for this initiative? What are the daily, weekly, monthly steps/goals?

To complete:

Write a 2- to 3-page summary of your quality improvement action plan.

 
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2 Papers 19220153

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1 paper 4 pages not including cover page or reference sheet

 
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2 Papers 19059329

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I have one teaching brochure and one RUA Safety Goal due. I prefer to have them both done no later than Dec 7 (Friday). I am charging 50 for the brochure and 40 for the RUA. (90$). 

 
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2 Please Answer Based On These Answers As They Are Listed Each One Must Be Answered In Apaform And Not Less Than 150 Words 19038477

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4-One very common area of nursing that is a growing problem is the nursing shortage. “Most studies agree, RNs constitute the largest healthcare occupation, with 2.3 million jobs. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) reports that 126,000 nursing positions are unfilled in hospitals, accounting for an overall vacancy rate of 13% for nursing positions” (Robinson, Jagim, & Ray, 2004). The nursing shortage is a personal and proffesional hazard not only to the nurses, but the patients as well.”If staffing is inadequate, nurses contend it threatens patient health and safety, results in greater complexity of care, and impacts their health and safety by increasing fatigue and rate of injury” (Gooch, 2015). I work in a small ER in California. Now, most people will say, “California has mandated staffing ratios”, but I am here to tell you by experience that that statement is not 100% accurate. There are MANY nights where we are understaffed and over ratioed, with only 3 nurses to triage, asses, start IV’s, medicate, chart, discharge and sometimes  handle multiple codes and traumas in one night. And no, most nights we do not have any ED techs or CNA’s to help with EKG’s, placing people on monitors or any of those types of task. Being short staffed is physically and mentally draining and extreamly unsafe for patient care and overworked nurses. So the question is why is there such a nursing shrotage? Is nursing school/state boards to strict? Is it because the  aging workforce is moving into retirment and into less stressful roles? Is it because of overall job dissatisfaction with the heavy workloads, underpay, and inadequate staffing? All of these could be a reason as to why there is a large nursing shortage and should be further evaluated to help promote nurse and patient safety. 

References:

Gooch, Kelly. (2015, August 13). 5 of the biggest issues nurses face today. Becker’s Hospital Review. Retrieved from https://www.beckershospitalreview.com/human-capital-and-risk/5-of-the-biggest-issues-nurses-face-today.html

Robinson. K, Jagim. M, Ray. C. (December, 2004). Nursing Workforce Issues and Trends Affecting Emergency Departments. Lippincott Nursing Center. Retrieved from  https://www.nursingcenter.com/journalarticle?Article_ID=532283&Journal_ID=420955&Issue_ID=532279

 

 
 

5-One of the most commonly seen errors in the nursing fields
that has become a growing and significant problem, can be seen in patients
being incorrectly administered their medications. All too often, patients are
given the incorrect medications; whether this is due to the nurses who are
administering the medication, the doctors who write out the initial
prescription, or the pharmaceutical workers who fill the prescriptions in the
first place (Keers, Williams, Cooke & Ashcroft, 2013). The errors seen are
not entirely on the medical side of this, as it can be seen that patients can
also incorrectly dose themselves as well (Wright, 2013). Aside from being given
the incorrect dosage of medication, patients can often be given the incorrect
medication in general, or given their medications in either too short, or too long
of a time span (Wright, 2013).

            Medical malpractice is an incredible cause of
concern, not only for the issues that can arise from a legal standpoint by
making errors in medication distribution, but from the severe risk of harm
coming to the patient, or even the death of the patient due to receiving a high
dosage of a medication that was incorrectly given (Makary & Daniel, 2016).
Medical malpractice is the third highest cause of death in the United States,
and in order to remedy this dire state of the medical field and for the public
to regain their trust in medical professionals, hospitals must take steps
towards correctly administering their medications (Makary & Daniel, 2016).
This is a role that must be worked at diligently, by not only the nurses at the
facility, but the doctors and pharmaceutical workers as well (Keers et al,
2013).

References

Keers, R. N., Williams, S. D., Cooke, J.,
& Ashcroft, D. M. (2013). Causes of medication             administration errors in hospitals:
A systematic review of quantitative and qualitative        evidence. Drug Safety, 36(11),
1045-1067. doi:10.1007/s40264-013-0090-2

Makary, M. A., & Daniel, M. (2016). Medical
error—the third leading cause of death in the US. BMJ, i2139.
doi:10.1136/bmj.i2139

Wright, K. (2013). The role of nurses in medicine
administration errors. Nursing     Standard, 27(44),
35-40. doi:10.7748/ns2013.07.27.44.35.e7468
 

 
 

         6- One area that I observed that could be studied more is the long shifts that nurses are required to work. This leads to fatigue and risk of medical mistakes. Industrial research over much of the 20th century indicates worker productivity declines significantly after 10 to 12 hours of work (ANA journal, 2017). A tired nurse is more likely to make errors, putting themselves and patients at risk. Its normal for nurse to work 12 hours shift, however, many times after a challenging 12 hour,s nurses are expected to put in another 4 or so hours when the need arises. Furthermore, many nurses have a long commute home, so they are up for another 6 -8 hours, as they need to take care of their families. After which, possible a few hours’ sleep and back to another long challenging shift. With all this, many nurses are studying and must find time for classes and assignment, which mean less time for rest.  According to U.S. Army studies, staying awake for 17 hours is functionally equivalent to having a blood alcohol concentration (BAC) of 0.05%; staying awake for 24 hours equates to a BAC of 0.10%. (In most states, it’s illegal to drive with a BAC of 0.08% or higher.) It further states that loss of even one night’s sleep can lead to short-term memory deficits and impaired cognitive functioning and the risk of bloodborne-pathogen exposure for workers increases during the last 2 hours of a 12-hour shift (ANA journal, 2017).

               Injury risk and the risk for patient error as risen significantly. These risks are not worth the convenience of 12-hour shifts, therefore more studied should be done to highlight the negative effect overwork has on the body and the risk associated with nursing fatigue. The aim is to improve patient safety, nurses’ safety and job satisfaction and not vice versa.

Reference

Are extended work hours’ worth the risk? (2017, November 08). Retrieved from https://www.americannursetoday.com/are-extended-work-hours-worth-the-risk/

 
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2 Please Answer Based On These Answers As They Are Listed Each One Must Be Answered In Apaform And Not Less Than 150 Words 19055285

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   4- Sampling is process where certain number of people are selected from the population, these selected people will represent the whole targeted population and the theory concerning sampling process is known as sampling theory (Grove, Gary, & Burns, 2015).

    The sampling theory is commonly used to gather information related to population in medical, social, business, psychological sector. The sampling is done as it is not possible to do research on everyone thus, they are selected based on the topic or area of research (Ullah, 2018). For example, a research is to be conducted on “average age of marriage of women in Nepal.” Here, sampling can be done by selecting 10 families from each state, that includes 10 different states, from the whole country, this makes the data collection easier as it includes 100 families and is unbiased as number is equally distributed.

    Generalizability is the effectiveness of the research, as effective and successful research is known to have good Generalizability. It is essential in Nursing research as our research are mainly related to health of people or health related problems of them.

References:

Grove, S. K., Gray, J., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice. St. Louis, MO: Elsevier.

Ullah, M. I. (2018, November 02). Sampling theory, Introduction and Reasons to Sample. Retrieved from http://itfeature.com/statistics/sampling-theory-introduction-and-reasons-to-sample

 

 
 

    5-   Sampling theory is the field of statistics that is involved with the collection, analysis and interpretation of data gathered from random samples of a population under study.  In the application of the sampling theory, it is concerned with the proper selection of observations from the population that will constitute the random sample, the use of probability theory, along with prior knowledge about the population parameters, to analyze the data from the random sample and develop conclusions from the analysis. The normal distribution, along with related probability distributions, is most heavily utilized in developing the theoretical background for sampling theory (Sampling Theory, n.d.). For example, finding out the percentage of damaged tools produced during a given 5-day week in a specific factory by examining 30 tools daily at a specific time. All the tools produced in this case during the week represents the population, while the 150 selected tools during 5-days constitute a sample.

     Generalization is the act of reasoning that involves drawing broad inferences from particular observations, it is widely-acknowledged as a quality standard in quantitative research but is more controversial in qualitative research (Polit & Beck 1970). It is important in nursing research as it provides the ability to generalize results allows researchers to interpret and apply findings in a broader context, making the finding relevant and meaningful.

References

Key Issues in Quantitative Research – Center for … (n.d.). Retrieved from https://cirt.gcu.edu/research/developmentresources/research_ready/quantresearch/keyissues

Polit, D. F., & Beck, C. T. (1970, January 01). Generalization in quantitative and qualitative research: Myths and strategies. – Semantic Scholar. Retrieved from https://www.semanticscholar.org/paper/Generalization-in-quantitative-and-qualitative-and-Polit-Beck/a2018b430beae56c41d4c293a051aded822a2f19

sampling Theory (n.d.). Retrieved from https://course-notes.org/statistics/sampling_theory

 

6-Sampling theory is a study of relationships existing between a population and samples drawn from the population. Sampling theory is applicable only to  random  samples . For this  purpose  the population or a universe may be defined as an aggregate of items possessing a common trait or traits.  

Example:  We may wish to draw conclusions about the percentage of defective bolts produced in a factory during a given 6-day week by examining 20 bolts each day produced at various times during the day. Note that all bolts produced in this case during the week comprise the population, while the 120 selected bolts during 6-days constitute a sample.  

Generalizability refers to the extension of a research finding as well as conclusions from the study conducted on sample population to the large population.  

Example:   W hen a person wants to find out the percentage of people who smoke in a certain country. A sample would be taken in order to represent the entire population as well as findings taken to represent the general population.    

References  

Burns, N., Grove, S. (2011).  Understanding Nursing Research, 5th Edition. [ Pageburstl ]. Retrieved from https://pageburstls.elsevier.com/#/books/978-1-4377-0750-2/ 

 
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2 Please Answer Based On These Answers As They Are Listed Each One Must Be Answered In Apaform And Not Less Than 150 Words 19038467

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1-There are many areas in nursing where evidence-based practice has improved care processes and patient outcomes including the bundles of checklist to prevent pneumonia related to mechanical ventilation and central line-associated blood stream infection or CLABSI.

To prevent healthcare-associated infection such as the ventilator-associated pneumonia (VAP) for patient who had been intubated for more than 48 hours, the VAP bundles of care are often used. Recommended bundle of interventions for the prevention of VAP includes elevation of the head of the bed at a 30° to 45° angle to prevent aspiration of gastric content, reducing the duration of mechanical ventilation by daily sedation interruption (DSI) and daily spontaneous breathing trials (SBT), peptic ulcer disease (PUD) prophylaxis, and deep-vein thrombosis (DVT) prophylaxis. Moreover, performing oral care every two hours and as needed, maintaining ET tube cuff pressure above 20 cm H20, and managing ventilator circuits and changing only when visibly soiled showed improvements in VAP in critically ill patients.

Another area where evidence-based practice has improved patient outcome is through the use of bundles or interventions to prevent or decreased central line-associated blood stream infections. Those recommended bundle of interventions for the prevention of CLABSI includes proper hand hygiene, skin preparation using chlorhexidine solution greater than 0.5%, adhering to aseptic technique and use of sterile gloves, regular assessment and inspection of site, and daily evaluation whether the use of central line is still necessary.

According to the ANA (2018), when patient received the optimal intervention bundle, the expected time for any ventilator-associated pneumonia to occur takes almost 3.5 times longer that those who did not. At the hospital I work for, when we chart our lines/drains/airways one of the question we are asked is if the patient still meets the criteria for continuing the line. When no longer necessary, it prompts immediate consideration for removal. The bundles/checklist does not only act as a learning tool but also serves as a guideline. By knowing the bundles of interventions we can better care for our patients and avoid unnecessary and preventable infections.

References:

Stevens, K.  (2013, May 31). “The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas”  OJIN: The Online Journal of Issues in Nursing  Vol. 18, No. 2, Manuscript 4. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html

American Nurse Today. (2018). Preventing ventilator-associated pneumonia: A nursing-intervention bundle. Retrieved from https://www.americannursetoday.com/preventing-ventilator-associated-pneumonia-a-nursing-intervention-bundle/

Perin, D. C., Erdmann, A. L., Higashi, G. D., & Sasso, G. T. (2016). Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review. Revista latino-americana de enfermagem, 24, e2787. doi:10.1590/1518-8345.1233.2787

 

 
 

2-In wound care it seems like new products are becoming available everyday and current products are continually evolving to improve patient outcomes. Thankfully, the clinic that I work in is smaller and there are only three nurses on staff, so our continuous education is typically done as a group. We usually meet with the product representative face to face and receive instant feedback regarding any questions and concerns we may have about the product. When information needs to be disseminated throughout the facility and to all nursing staff, the education happens is various forms. Least common is face to face in servicing as it is often difficult to get multiple staff members in the same location at the same time (due to staffing shortages). The most utilized form of education is online via an electronic learning forum (E-Learning) staff members can access the “assignments” 24 hours a day 7 days a week from most computers within the facility. Assignments are assigned with a due date and typically have a test following the educational portion in which the staff members must pass to receive credit and meet the educational requirement.

 

3-The implementation phase of any change can be difficult. In the nursing profession, evidence-based practices have been observed as the best and safest practices as there is proof in the research. However, there will always be those who question, or doubt said proof because some people are afraid of change, even if the change benefits them or others. To implement change, I would begin by addressing the following key factors: why, what, and how. First, the why- what is the issue that lead to the change. Next, the what- the research, the facts, the failures and successes that became the change. Lastly, the how- the demonstration or explanation of the change. Depending on the change and the aspects of our practice that would be affected determines the length of time the implementation phase would take. In my experience (when allowable) taking time to incorporate change over a period has proven least likely to create resistance from others.

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