PLEASE RESPOND TO THE PEER DISCUSSION BELOW.

By searching the Agency for healthcare Research and Quality grants database. I found one grant titled “Impact of Atypcial Antipsychotic Use on Health Care Utilization in the Elderly”(APARASU, ). This grant aims to describe the use of atypical antipsychotic agents in the elderly, overall number of elderly on this medication, and compare that usage to olanzapine, risperidone, and quetiapine. The age group in 65 years or older and the study hypothesis is that overall use of atypical antipsychotic use is more than typical antipsychotic use (APARASU, ).

            In order to search for a grant like this one using grant databases is key. Grant.gov is one area to look and AHRQ is another. I have noticed that more healthcare grants are on AHRQ than on Grant.gov. Using the key terms used in my research article I was able to narrow it down to a few grants available. In order to apply you would need to complete the SF424 form which is the initial application, PHS 398 if the funding opportunity announcement requires it, RPPR which is the research performance progress report guide, and the noncompeting progress report for muli-year funded award (Grant application forms.2015). While this is specific to this grant it is important to fully understand the grant requirements, demographics, and hypothesis of the grant in order to ensure it aligns with your own.

 

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PLEASE RESPOND TO THIS DISCUSSION 

 

Adhering to ethical principles and protection of human subjects are important considerations in all forms of research.

Ethical principals are the morals that one needs to follow when doing research. Protection of human subjects is a broad statement in my opinion. Protection of what their permission to study them (informed consent), their vulnerability, their risk/benefit of participating, will they be harmed in anyway. These are all topics that “human subjects” need to be protected from. These are also topics that need to be considered before the study is even conducted, they need to be considered in the very beginning.  

How stringent or similar should these ethical principles be to the standards placed on the conduction of clinical and/or educational research?

The same principles that are used to conduct the clinical research should also be used in educational research. When research is done in a clinical research and a d=education research “human subjects” are involved in both. There is also a risk/benefit ratio and everyone still needs to give consent. The risk/benefit ratio should be low risk to the all involved and the benefit may not exist but should most definitely cause no harm.

Offer examples where controversy exists regarding application of ethical principles in evidence-based practice projects, best practices in education versus clinical research?

During the Guatemala sexually transmitted disease study participants where not informed of what was going to happen to them. The participants were exposed to syphilis and other diseases and then they were treated. According to Murray (2014) the researcher should be one that is qualified to do research. Just as in the Guatemala study the researcher was not qualified to do the study so it was not preformed correctly and all participants were not protected.

Be sure to address HIPAA and FERPA depending on your focus – clinical practice vs academic education.

 HIPAA pertains to not just the patient’s privacy rights that come to mind when you hear the word. HIPAA encompasses the participant, participant’s rights and their personal records.  HIPAA would apply to a participant in the clinical practice. FERPA allows parents to be able to access their minor children’s records. FERPA is in place to protect minor participants and their parents. FERPA is used when the participant is in an academic educational setting.

References 

Grove, S. K., & Burns, N. (2017). The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence (8th ed.). St. Louis, MO: Elsevier Saunders.

Murray, J. S., PhD. (2014). Recognizing ethical issues in research. Clinical Scholars Review, 7(1), 63-69. Retrieved from https://prx-herzing.lirn.net/login?url=https://search-proquest-com.prx-herzing.lirn.net/docview/1515913240?accountid=167104

 

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Hello to all of my classmates and professor.  My name is Brent Braswell.  After serving in the US Air Force for almost a decade, I decided to become a nurse.  I started as a LVN (LPN) and a year later I went back for my RN.  I tried hospital nursing and while the acute experience is very valuable, I simply was not happy.  I soon found myself trying other things such as hospice and even the county jail, yet I could still not find that happy place I was searching for.  Then I discovered geriatrics and there was the icing on my cake! I absolutely found my calling in long term care and rehabilitation.  After a short time working as a floor nurse I was asked to fill in for the director of nursing while they were out on a family emergency.  After that I was addicted and have been a director of nursing for skilled facilities ever since and I have no regrets.  It has been amazing and while many times my frustration with the system can grow, I always know in my heart that geriatrics is my passion.

Leadership Style

                My leadership style is hard for me as I vary from one to another depending on the situation.  Predominantly I would have to choose democratic leadership as my primary choice.  A democratic leader encourages participation and exchange of ideas from her/his team regarding the directions the team should take and what actions they should prioritize. When faced with a complex problem, she/he will elicit ideas from others, listen attentively and build consensus, but may put off making difficult decisions (Chapman, Johnson, & Kilner, 2016).

Evidence

It is very important to me that I always include my staff in decision making. I am the boss, but that does not mean that I know everything or that I think of all possibilities.  Encouraging my staff to speak up and pass along their ideas brings about camaraderie and trust with each other. I also believe in autonomy. I have three assistants that are called unit managers. Until they were to give me a reason to micromanage their jobs, I simply will not. This allows me to show that I trust their judgment and knowledge.  The nurses who work the floor are full of ideas concerning the specific needs of their patients. I do not take care of these patients all day, so why on earth would I not ask their opinion when an issue arises? When there is a change in regulations it is my job to know and understand the details of that change and how it may impact daily routines. It is also my job to explain it to the staff so that they understand. At that point I will have already formed ideas of how to make it work, but I still call a meeting with my staff to teach the change and to share ideas of the best way to implement the change.

Chapman, A. L., Johnson, D., & Kilner, K. (2016). Leadership styles used by senior medical leaders: Patterns, influences and implications for leadership development. Leadership in Health Services; Bradford Vol. 27, Iss. 4, (2014): 283-298. , 8.

 

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Discussion 7

Madai

Current Roles of Advanced Practice Nurses

Advanced  practice nurses are specialized to perform different roles. “Nurse  Practitioners (NP) are specialized to order, perform and interpret  diagnostic tests in primary care” (Neto, Rewa, Leonello & Oliveira,  2018, p.720). Besides, NP prescribes medications, provide treatment of  injuries and oversee the overall patient health. Certified Nurse Midwife  (CN) is in charge of reproductive and gynecological health in the  provision of primary care. Clinical Nurse Specialist (CNS) collaborates  with other nursing staff in providing primary care, analyzing patient  data and outcomes, and performing nursing practices research. Lastly,  “Certified Registered Nurse Anesthetists collaborates with other medical  specialists to administer anesthesia and oversee the patient recovery”  (Heale, 2016, p.311).Therefore, APNs roles focus mostly on provision of  primary care.

Effective Tactics for APNs Strategic Positioning Regarding Pay Equality

Advanced  Practitioner Nurses can use several strategies to position themselves  regarding pay equality. First, collect the relevant data on FNPs pay in  other countries or states. The data collected should be analyzed based  on the date of hire, gender, job location, working hours per week,  overtime pay, and bonuses then used as a bargaining tool for pay  equality with the employer. Secondly, APNs can file legal suites against  the employer to remedy equality pay. APNs should first examine the pay  practices and policies then a file legal suit against the employer  (Gardner, Duffield, Doubrovsky & Adams, 2016). Lastly, agree with  the employer through labor unions to have measurable performance metrics  to serve as points of reference when increasing salaries. 

Reasons Nurse Practitioners Should Push for Comparable Worth, Same Service, and Same Pay

Advanced  practice nurses should push for comparable worth, same service, and  same pay because already there is a shortage of physicians and APNs  coordinate all primary care serves in most hospitals located in the  rural and suburban areas. Secondly, the kind of training given to  advanced practice nurses are sufficient to provide primary care hence  they deserve equal treatment (Heale, 2016). Lastly, the licensing body  for APNs, physicians and other clinical officers is different hence they  should push for comparable worth, same service, and same pay because  they are completely in independent professional bodies.

References

Gardner,  G., Duffield, C., Doubrovsky, A., & Adams, M. (2016). Identifying  advanced practice: A national survey of a nursing workforce. International Journal of Nursing Studies, 55, 60-70.

Heale, R. (2016). Advanced Practice Nursing from a Global Perspective. Canadian Perspectives on Advanced Practice Nursing, 311.

Neto,  M., Rewa, T., Leonello, V. M., & Oliveira, M. A. D. C. (2018).  Advanced practice nursing: a possibility for Primary Health Care?. Revista brasileira de enfermagem, 71, 716-721.

Elizabeth Gonzalez                 Week 9 Discussion Elizabeth Gonzalez  Collapse 

Nurses  as primary care and health promoters providers have a crucial part in  the sophisticated health train, that is the reason as Nurse  Practitioners we are able to apply strategies, along with techniques for  equal pay. The Equal Pay Act calls for that males and females get equal  pay for equal work in the exact same establishment. It’s not crucial  that the jobs are the same, though they should be substantially the  exact same. It’s the job written content rather than the job titles that  decide if the tasks are substantially the same. Companies can’t spend  unequal wages to women and men that perform tasks that need identical  ability, responsibility and effort and are done under comparable working  conditions inside the identical establishment.

As  a method it’s essential in an effort to remove discriminations that  could exist, to compensate for all the consequences of last  discrimination, as well to motivate the participation of all nurses to  generate methods for them being of common use in favor of the whole  state nursing organization..

The  Nurse Practitioner income is an extremely debatable topic also it’s  been reviewed in ways that are many, since they are saying the salary of  theirs isn’t consistent with the job they actually do (Donelan et, al,  2013). I believe that as future NP we should advocate that the job of  ours is correctly given plus it is done based on the services we offer  on the public. The latest scientific studies show NP is a really crucial  website link in the process of medicine as well as for that reason we  must be remunerated appropriately to the service we offer, that’s  saying, an equal pay (Pickard, 2014)

References

Donelan,  K., DesRoches, C. M., Dittus, R. S., and Buerhaus, P. (2013).  Perspectives of doctors as well as nurse practitioners on primary care  practice. Brand new England Journal of Medicine, 368(20), 1898 1906.

Pickard,  T. (2014). Calculating the worth of yours: understanding value and  productivity. Journal of the sophisticated specialist of oncology, 5(2),  128.

 

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What is the biggest barrier you face in providing care to Bana at this point? After reading this week’s patient scenario, the biggest barrier that I noticed in providing care to Bana includes a language barrier and a language deficit. During the interview process, when the interviewer asked Bana about the assault, she appeared not to understand and looks at her case manager for help.

What is the priority action for you to take at this time? The priority action that I would take would to get an interpreter that speaks Bana’s language, Arabic. Due to Bana’s limited English, she is relying on the case manager to explain the details of her situation, even though the case manager does not speak Arabic and thus cannot interpret for her. It is Bana’s right to have a certified interpreter that speaks her language in order to interpret information so that we may gather accurate subjective information and Bana’s in involved in her health care.  

What action is most important for you to take to ensure the health and safety of the fetus?The action that is most important for the provider is to ensure the health and safety of the fetus would include: the mother’s safety, food, water, shelter, transportation, and access to medical care. The mother and the fetus need a safe, warm shelter to live, and have access to food, water, and transportation to receive medical care to ensure the safety of the mother and the fetus.

Given Bana’s financial situation, you are concerned about her and her family having adequate nutrition. Which intervention would best address this concern?Given Bana’s financial situation, it is a concern that she and her family may not receive adequate nutrition. I would reach out to social services, get the case manager involved, and reach out government and local organizations such as the Shalom Center, Giving Tree, and other food pantries that may assist Bana and her family to ensure that receive adequate nutrition. Additionally, hopefully, the organizations that I mentioned could help with establishing a shelter, transportation, and medical costs. 

Reference

Primary Care of Women, 2nd Edition, 2017. [Bookshelf Ambassadored]. Retrieved from https://ambassadored.vitalsource.com/#/books/undefined/

 

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