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                           Discussion: Critical Thinking

Recall your early clinical nursing experiences—what guided your decisions? Did you practice nursing ‘by the book’? Now, consider how you make decisions today. How have your clinical experiences fostered a greater depth of knowledge and critical thinking?

This week’s Learning Resources explore skill development and levels of knowledge acquisition based on clinical experience. For example, Benner suggests that as a nurse gains more experience, knowledge and skill level increases. Nurses move from novices—making decisions based on rules—to experts who are able to see connections between actions and outcomes using critical thinking. This Discussion focuses on the role of critical thinking in nursing practice and the connection between critical thinking, clinical competence, and scholarship.

                                               To prepare:

Review the Learning Resources focusing on critical thinking and Benner’s interpretation of the Novice to Expert theory.

Reflect on how critical thinking is used in clinical practice. How does critical thinking relate to, or support, clinical competence?

What critical thinking strategies do you use to improve your clinical competence and thus move from novice to expert?

Consider the connection between critical thinking, nursing practice, and scholarship.

Post your observations on how critical thinking is used in clinical practice (provide examples); how you employ critical thinking strategies to improve clinical competence; and your thoughts on the connections between critical thinking, scholarship, and practice.

Support your Discussion assignment with specific resources used in its preparation using APA formatting. You are asked to provide a reference for all resources, including those in the Learning Resources for this course.

CHECK THE DOCUMENTS ATTACHED BELLOW

USE REFERENCES

 
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The Discussion this week focuses on the use of the Population-Based Intervention Model outlined in the course text Health Care Delivery in the United States, as well as how this model can be applied to strengthen advocacy programs

                                                 To prepare:

Select one of the behavioral risk factors from the Healthy Population 2010 Objectives (listed in Table 7.1 on p. 122 of the course text) that is of interest to you.( USE BOOK: HEALTH CARE DELIVERY IN THE UNITED STATE-ATTACHED BELLOW)

    Using the Walden Library and other credible websites, research how this risk factor is affecting your community or state.

    With your selected risk factor in mind, review the information on the Population-Based Intervention Model on pp. 132-137 in the course text, Health Care Delivery in the United States.

 In particular, focus on the concept of downstream, midstream, and upstream interventions. 

Consider at least one intervention that could be put into place at each stage.

Post a description of the behavioral risk factor you selected and how this factor is impacting your community or state. Using the Population-Based Intervention Model, suggest at least one intervention that could be put into place at each stage (downstream, midstream, and upstream) to ensure that a health prevention program addressing the behavioral risk factor would have a greater chance at succeeding. Justify why each intervention you identified would be effective.

 
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                             Discussion: Using the Walden Library

Where can you find evidence to inform your thoughts and scholarly writing? Throughout your degree program, you will use the research literature to explore ideas, guide your thinking, and gain new insights. As you search the research literature, it is important to use resources that are peer-reviewed and from scholarly journals. You may already have some favorite online resources and databases that you use or have found useful in the past. For this Discussion, you explore databases available through the Walden Library.

                                                    To prepare:

Review the information presented in the Learning Resources for using the Walden Library, searching the databases, and evaluating online resources.

Begin searching for a peer-reviewed article that pertains to your practice area and is of particular interest to you. (SELECT- MENTAL HEALTH NURSING)

Identify the database that you used to search for a peer-reviewed article in your area of practice and interest.

Reflect on your experience with searching the database. Did you note any difficulties when searching for an article? 

What steps/strategies did you find helpful for locating a peer-reviewed article? Would this database be useful to your colleagues? 

Would you recommend this database?

Once you have select your peer-reviewed article, evaluate its strengths and weaknesses in terms of scholarly writing, bias, opinion, quality of evidence, and appropriateness to its target audience.

Post a brief summary of your peer-reviewed article, the database you located your article in, your database searching experience, key words utilized in the search, and analysis of the strengths and weaknesses of the article.

Support your Discussion assignment with specific resources used in its preparation using APA formatting. You are asked to provide a reference for all resources, including those in the Learning Resources for this course.

 
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                                       Discussion: Cardiovascular Disorders

Veins and arteries are vital elements of the cardiovascular system. They carry the blood supply through the body and are essential for proper function. Sometimes veins and arteries malfunction, resulting in cardiovascular disorders. Malfunctions of arteries and veins are similar to malfunctions of a water hose. Consider the structure and function of a hose. A tap releases water, which then travels through the hose and comes out the other end. If the hose has been dormant for several months, dirt and rusty particles might build up inside, resulting in a restricted flow of water. Similarly, buildup of plaque inside the coronary arteries restricts blood flow and leads to disorders such as coronary heart disease. This disease is one of the most common cardiovascular disorders, and according to the National Heart, Lung and Blood Institute (2011), is the leading cause of death for men and women in the United States. In this Discussion, you examine the pathophysiology of cardiovascular disorders such as coronary heart disease.

                                                             To Prepare

Review this week’s media presentation on alterations of cardiovascular functions, as well as Chapter 24 in the Huether and McCance text. Identify the pathophysiology of cardiovascular disorders.

Select one patient factor: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of cardiovascular disorders.

Select one of the following alterations of cardiovascular disorders: peripheral arterial disease, myocardial infarction, coronary artery disease, congestive heart failure, or dysrhythmia. Think about how hypertension or dyslipidemia can lead to the alteration you selected. 

Post a description of the pathophysiology of cardiovascular disorders, including how the factor you selected might impact the pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the alteration you selected for patients with the factor you identified.

This is the link for the book:

https://drive.google.com/file/d/12MGt6z2PicuM1y4rM-SN8rpGD09-Tmkj/view?usp=sharing 

 
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To effectively develop policies and programs to improve population health, it is useful to use a framework to guide the process. Different organizations and governmental agencies (for example, Healthy People 2020) have created a variety of such frameworks, which establish measures for assessing population health. These measures frequently are derived from the examination of epidemiologic data, which include key measures of population health such as mortality, morbidity, life expectancy, etc. Within each measure are a variety of progress indicators that use epidemiologic data to assess improvement or change. 

For this Discussion, you will apply a framework developed by Kindig, Asada, and Booske (2008) to a population health issue of interest to you. This framework includes five key health determinants that should be considered when developing policies and programs to improve population health: access to health care, individual behavior, social environment, physical environment, and genetics. 

                                                 To prepare:

Review the article “A Population Health Framework for Setting National and State Health Goals,” focusing on population health determinants.

Review the information in the blog post “What Is Population Health?”

With this information in mind, elect a population health issue that is of interest to you-(SELECT CHILDHOOD OBESITY)

Using this week’s Learning Resources, the Walden Library, and other relevant resources, conduct a search to locate current data on your population health issue.

Consider how epidemiologic data has been used to design population health measures and policy initiatives in addressing this issue.

Post a summary of how the five population health determinants (access to health care, individual behavior, social environment, physical environment, and genetics) affect your selected health issue, and which determinants you think are most impactful for that particular issue and why. 

Explain how epidemiologic data supports the significance of your issue, and explain how this data has been used in designing population health measures and policy initiatives.

(CHECK THE DOCUMENT AND VIDEOS ATTACHED BELLOW)

 
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Discussion: Scholarly Writing and Plagiarism

As a nurse embarking on an advanced degree, you are developing the characteristics of a scholar-practitioner, which includes strong communication skills. Writing in a scholarly manner involves supporting your thoughts with evidence from the literature and appropriately using APA formatting.

One of the challenges of scholarly writing is paraphrasing the thoughts of others in your work. Paraphrasing, and correctly citing the original author for his or her ideas, allows you to take the ideas of others, summarize them, and incorporate them into your own writing. 

When summarizing the ideas of others, it is important to avoid plagiarizing (copying the words and ideas of others as though they were your own). In addition to expanding your knowledge of APA, this week’s Learning Resources help you to distinguish between paraphrasing and plagiarizing.

                                             To prepare:

Think about the sometimes subtle difference between plagiarizing and paraphrasing.

Read the following paragraphs, which were written by Patricia O’Conner:

A good writer is one you can read without breaking a sweat. If you want a workout, you don’t lift a book—you lift weights. Yet we’re brainwashed to believe that the more brilliant the writer, the tougher the going.

The truth is that the reader is always right. Chances are, if something you’re reading doesn’t make sense, it’s not your fault—it’s the writer’s. And if something you write doesn’t get your point across, it’s probably not the reader’s fault—it’s yours. Too many readers are intimidated and humbled by what they can’t understand, and in some cases that’s precisely the effect the writer is after. But confusion is not complexity; it’s just confusion. A venerable tradition, dating back to the ancient Greek orators, teaches that if you don’t know what you’re talking about, just ratchet up the level of difficulty and no one will ever know.

Don’t confuse simplicity, though, with simplemindedness. A good writer can express an extremely complicated idea clearly and make the job look effortless. But such simplicity is a difficult thing to achieve because to be clear in your writing you have to be clear in your thinking. This is why the simplest and clearest writing has the greatest power to delight, surprise, inform, and move the reader. You can’t have this kind of shared understanding if writer and reader are in an adversary relationship. (pp. 195–196)

Source: O’Conner, P. (2003). Woe is I: The grammarphobe’s guide to better English in plain English. New York: Riverhead Books.

Paraphrase this passage from O’Conner using no more than 75–100 words. Remember that paraphrasing means summarizing the essence of the original text. It does not mean creating a thesaurus-based revision of the author’s original words or copying the piece, or any part of it, word for word. For this activity, do not use any direct quotes.

Review the other tools, resources, and services available to you through the Walden Writing Center that support your growth as a scholarly writer.

Consider which of these resources you find to be most useful.

Review learning resources on APA formatting rules and information within the Walden Writing Center on APA

Post a description of your experience of using Grammarly and SafeAssign and share at least one insight you gained about paraphrasing and avoiding plagiarism as a matter of academic integrity.  

Recommend at least one other online resource that supports scholarly writing, and explain your rationale. Lastly, share two APA formatting rules with the class and a specific page number in the APA manual where this rule can be located

Support your Discussion assignment with specific resources used in its preparation using APA formatting. You are asked to provide a reference for all resources, including those in the Learning Resources for this course.

IMPORTANT: CHECK THE MEDIA PRESENTATION VIDEOS ATTACHED BELLOW TO COMPLETE THE DISCUSSION QUESTION

                        

 
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                                  Discussion: Nurses as Health Advocates

What does it take to be an effective health advocate? As a nurse, you have many opportunities to advocate for patients and populations, whether formally or informally. Being an advocate involves more than knowing how to lobby or to whom to write letters. It requires passion and compassion, commitment and courage.

In this Discussion, you will consider the attributes of an effective advocate for population health and/or the nursing profession. You will analyze those attributes that help nurses be a powerful force in improving the quality of health care and in this case especially, the needs of returning veterans and their families.

                                                     To prepare:

Review the article “On Being a Good Nurse: Reflections on the Past and Preparing for the Future” and “War, its aftermath, and U.S. health policy: Toward a comprehensive health program for America’s military personnel, veterans, and their families” found in this week’s Learning Resources.

    Consider the multiple health care needs of returning veterans and their families.

Post two types of health needs returning veterans and their families might need. How might you advocate for the needs of this population. What type of advocacy skills would you need and how could you develop them. What responsibility does a nurse have to be an advocate? Give specific examples.

CITE AT LEAST 3 REFERENCES

CHECK THE DOCUMENY ATTACHED BELLOW TO COMPLETE THE DISCUSSION QUESTION

 
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                                  Discussion: Health Care Policy

In this week’s media presentation, Dr. Trautman, Dr. Wakefield, and Ms. Coyle discuss how public policies initiated at the national or state level ultimately influence what occurs at the institutional and local level of nursing practice and health care delivery. Health care policy usually is developed to address health care cost, quality, or access, or a combination of the three. Due to the nature of their interaction with patients, nurses are well situated to be effective, knowledgeable advocates for their patients.

In this week’s Discussion, you will examine how current policies impact how you as a nurse provide health care. You will then select an issue of interest and determine how you could advocate for policy in that area. 

                                                   To prepare:

Select one public policy that currently is impacting you and your practice. Consider the following:

What health care driver was the policy designed to address: cost, quality, access, or a combination?

Does the policy appear to be achieving its intended results? On what data are you basing your assumption?

What have been the effects (adverse or positive) of this policy on health care cost, quality, and access?

How is this policy affecting your nursing practice?

Next, select a health care issue—something you see or experience on a daily basis—about which you would like to influence a practice change through the policy process. 

Review the Learning Resources, focusing on Kingdon’s Model. How would you utilize this model to guide your policy development?

Post a brief description of a public policy that is having an impact on your practice; summarize your analysis of the policy using the bulleted list above as a guide. Then, summarize the issue you would like to influence though a change in public policy, and outline how you would utilize Kingdon’s Model to guide your policy development.

                                             Required Readings

Milstead,  J. A. (2019). Health policy and politics: A nurse’s guide (6th ed.).  Burlington, MA: Jones and Bartlett Publishers.

Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. xvi -13) 

This chapter explains public policy and the nurse’s role in directing health care issues to the government and securing a response.

Chapter 2, “Agenda Setting: What Rises to a Policymaker’s Attention” (pp. 16-34) 

This chapter provides examples of the process of moving a problem to the attention of the government so the solution can be considered at the state and federal levels.

Chapter 3, “Government Response: Legislation” (pp. 36-54) 

This chapter explores the multiple factors that influence the development of public policy through the legislative branch of government.

NOTE: CHECK THE BOOK, DOCUMENT AND MEDIA PRESENTATION ATTACHED BELLOW TO COMPLETE THE ASSIGNMENT

 
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Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course mentor that you will take into consideration for your own change project.

 
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 During your practicum, determine what clinical problem or issue the organization is facing. Discuss two implications for nursing 

 
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