Dq2aa

  

Provide at least Five Targeted Questions you would ask the patient to build his or her health history and to assess his or her health risks.

“CASE STUDY #1”

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has ahx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”

Note: REMEMBER AT LEAST THREE REFERENCES AND APA FORMAT 

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq222

 Should drugs with an astronomical cost be discussed with patients if the cost will not be covered? Who should decide who receives the drug if government decides to cover the cost? 

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq21 Response

luise  Re: Topic 2 DQ 1  A clinical issue that is noticed is that some nurses lack the staff’s demands to efficiently and adequate deliver care to the patients and meet health care organization requirements. According to Stanton, “Greater numbers of nurses at the bedside help increase patient satisfaction, improve quality of care, and increase nurse morale, satisfaction, and retention” (Martin, 2015). Health care organizations expect that all the necessary documentation and tasks be completed while continuously adding more to the nurses’ workload without providing the required resources staff impacts the patient’s safety and the delivery of care. According to Stanton, “Hospital nurse staffing is of major concern because of the effects it can have on patient safety, and quality of care” (Martin, 2015). Nurses require more resources and appropriate staffing ratios to meet the needs of the patients and health care organizations. When nurses do not have adequate staffing, patient care is compromised, which leads to unsafe practices. With that being said, nurses need the help of health care staff members to meet the needs of the patient effectively. “For example, increasing nurse staffing does not mean changing RN duties to include housekeeping and transport. It does not mean eliminating ancillary staff; it simply means increasing the number of nurses caring for patients is adequate for the patient acuity (Stanton, 2004)” (Martin, 2015).    Furthermore, nurses that work in an understaffed health care setting get burned out and resign from the organization due to the lack of resources and support. According to Garnett, “Not only have higher nurse-to-patient ratios been shown to increase nurse burnout, it can have serious effects on the health and well being of the nurse. An unrealistic workload may result in chronic fatigue, poor sleep patterns, absenteeism, and job dissatisfaction” (Martin, 2015).       References     Martin, C. J. (2015). The Effects of Nurse Staffing on Quality of Care. MEDSURG Nursing, 4–6. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=113313811&site=eds-live&scope=site

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq21 Response 19399973

Nicole Hoffman    5 posts   Re: Topic 2 DQ 1  Healthcare workers and the public are aware that nurses did not directly impact the opioid crisis, however, studies show that nurses will have a direct impact on reversing the impact America is currently facing with opioid abuse and death. As many major medical companies and pharmacies face lawsuits and even bankruptcy in light of recent lawsuits, it is likely that nursing practice and evidence-based practices will change in an attempt to save lives and reduce opioid-related deaths. Working in a surgical center provides a unique nursing opportunity to address and change the opioid crisis, as many patients that begin abusing opioids begin their prescriptions either for chronic pain, or after injury or surgery (Demsey, Carr, Clarke, & Vipler, 2017).  Two ways that we can expect nursing practice to be impacted by the change in addressing our nation’s opioid crisis include patient teaching, and tracking medication use and pain levels (American Journal of Nursing [AJN], 2015). Patient education regarding opioid medications include educating the patient on the risks of opioid diversion, and the proper storage and disposal of opioid medication prescriptions (AJN, 2015). Studies show that approximately one-quarter of medications are diverted from legal prescriptions, while 71% of those diverted opioids were obtained either from friends or family, either for free or by theft (AJN, 2015). Educating patients about these facts as well as the importance of proper safe-keeping of medications and how or where to safely dispose of opioid medications is an important first step in correcting the opioid crisis.  Monitoring patient and tracking usage of opioids include patient teachings that focus on the correct usage, as well as appropriate indication and expectations (AJN, 2015). For example, patients after surgery should be educated that they will not be pain-free immediately following their procedure and that opioid prescription medications should not be used for any other indication other than pain, which includes induction of relaxation or sleep (AJN, 2015). It is also important to teach the patient about keeping a pain medication journal which includes the type of pain the patient is experiencing, the pain scale rating associated with the pain, as well as time and dosage of the medications taken, reviewing these journals with the patient can help the healthcare providers notice usage or patterns that could indicate a current or potential problem (AJN, 2015). Helping to identify issues before they become an actual problem are other interventions that the nurse provides to the patient that will aid in addressing and correcting the opioid crisis in the United States.  References  American Journal of Nursing. (2015, August). Nurses’ role in preventing prescription opioid diversion. Lippincott Nursing Center, 115(8), 34-40. Retrieved from https://www.nursingcenter.com/cearticle?an=00000446-201508000-00021&Journal_ID=54030&Issue_ID=3152763  Demsey, D., Carr, N. J., Clarke, H., & Vipler, S. (2017, October 1). Managing Opioid Addiction Risk in Plastic Surgery During the Perioperative Period. Plastic and Reconstructive Surgery. https://doi.org/10.1097/PRS.0000000000003742

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq21 Response 19399969

After research has been conducted and has been accepted, it becomes evidence-based practice. Evidence-based practice is largely based on outcomes (Hood, 2010). Exactly how are outcomes measured?     Please explain.     Reference:  Hood, L. (2010). Conceptual Bases of Professional Nursing (7th ed.). New York, N.Y.: Lippincott, Williams & Wilkins.

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq2 Response

Kimberly Morris    1 posts   Re: Topic 9 DQ 2  One potential barrier that may prevent my evidence-based practice proposal from continuing its enthusiasm is the fact that the community in which I will be presenting may lose interest in the topic of lead. Because this topic has been brought to the forefront due to a recent crisis, once the initial public health hazard has been taken care of, the community may go back to being ignorant or not caring about the topic. One way in which I can battle this is to stress the fact that elevated blood lead levels are not an acute problem for the general public but instead they are a chronic problem. While the initial threat of elevated blood lead levels in children due to the public water change in Flint has passed, there are still may ways in which children can obtain lead. Pointing this out and stressing this in my education will hopefully allow me to continue an active interest within the community.  Another barrier I can see would be a one-size-fits-all approach to my chosen topic. Evidence-based practice changes are scientific based and often people take a strict adherence to the guidelines set forth within these proposals (Surface, 2009). These guidelines may not always fit with the audience you are working with and should be a revolving set of guidelines based on research and evidence. Just like my topic – 25 years ago obtaining elevated blood lead levels from imported toys and food items was not a big problem but in today’s global economy it has become an area of concern.  Reference  Surface, D. (2009). Understanding evidence-based practice in behavioral health. Social Work Today, Vol. 9.  No. 4. P. 22. Retrieved from https://www.socialworktoday.com/archive/072009p22.shtml

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq2 Response 19372035

Nimmy James    3 posts   Re: Topic 1 DQ 2  Providing quality care to the patient very important in nursing the Evidence-based practice (EBP) takes a major role for this outcome. “The EBP process is a method that allows the practitioner to assess research, clinical guidelines, and other information resources based on high quality findings and apply the results to practice” (Spyder, 2018).  In this study, 2100 questionnaires were given to registered nurses find out their thoughts regarding on EBP. The positive expression towards the EBP were more than 64% (Majid et al., 2011). But the nurse’s workload in daily routine causes many issues which they cannot keep up to date with new evidence. The nurses felt that EBP training, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP.  There are many issues and barriers that might hold nursing practice from achieving this goal. The first issue is the overload of information, means there are thousands of articles are published monthly which cause confusion and attain wrong data. Another issue is lack of time to adopt the EBP, lack of resources, and the difficulty in understanding statistical analysis (Majid et al., 2011).  Although nurses showed a positive attitude toward EBP, certain barriers were a delay. It is important that hospital management develop a comprehensive strategy for building EBP competencies through proper training and education. With this EBP we will be able to provide safe quality care to the patient.  Reference:  Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011).Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association: JMLA, 99(3), 229–236. doi:10.3163/1536- 5050.99.3.010  Spyder. (2018, Aug 1). Evidence-Based Practice. Retrieved from  https://www.amsn.org/practice-resources/evidence-based-practice

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq2 Resonse

Me    5 posts   Re: Topic 2 DQ 2  Great post Dorothy also as a general rule, every policy should be reviewed every one to three years. But most experts recommend reviewing policies annually. Policy review doesn’t have to be as daunting a task as it sounds. By reviewing policies and procedures the organization is able to incorporate the current evidence-based practice and wed off the old ones.  Also, outdated policies can leave the organization at risk. old policies may fail to comply with new laws and regulations. They may not address the new systems or technology  Violations of the nursing standard of care can result in the actions against the individual, survey deficiencies especially if the nurse does not follow the facility policies and procedures in rendering the care. It is the facility responsibilities to educate staff and update their policies according to the new literature on Evidenced-Based Practice  Health care organizations need to consider multiple strategies to facilitate and promote evidence-based practice. Managerial support. facilitation and a culture that is receptive to changes are essential  Reference  K Gerrish, J Clayton-Journal of nursing management 12(2),114-123,2004  https://doi.org/10.1016/S1526-4114(11)60159-5Terri O’Brien    10 posts   Alimatu – substantive credit and APA 

Please work on the below recommendation 

 Alimatu,  You have a reference but the reference does not match either of the citations in your post and the two citations you posted do not have references at the bottom of your post.  Please recopy your post and correct this so I can give you substantive credit for the post.  Thank you.  Professor O’Brien

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq2wk2 Ans Jessica Hurst

 

Nursing is viewed by the public as a well-respected field of work. I have heard many people say “It takes a special person to be a nurse” or “you have such a big heart to do that, I could never do that”. Their perception of what “nursing” is or does is based on their experiences. I feel like they may not see nursing as what it is.

The different factors that could affect the public’s perception of nursing would include: past experiences, family members that are nurses, stories that have heard or read about, and tv shows that they have seen.

There are different ways to approach how you would educate the public on the professional nurse’s role and scope of practice within a changing health care system. I think it would be neat to have articles posted about the Professional nurse’s role during Nurses week each year. These articles could be up to date with the nurse’s cutting edge evidence-based practice and any new changes that occurred over the last year. Another way to educate the general public would be to be thorough in your nursing practice, by educating your patient and family member. Explaining what you are doing and why you are doing it, helps the patient and family member better understand the nurse’s role and responsibilities.

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW

Dq2wk2 Ans Brandy

 

I love that you discuss that TV can have a negative impact on our profession.  I also believe that internet searches have devleoped into “everyone is a nurse” mentality.  Yes, the public can research just the same as we do, but I believe that it takes the experience and knowledge that nurses have to truly understand and convey the right message or information.  

I am a firm believer in patient education.  MD’s too often stop in to talk to a patient (who is already stressed) leave in 5 minutes like you said.  It is up to us to make sense of the situation for the patient. I too explain the details of what I am doing almost to the point it sounds like I talk to myself, all the time.  But I am hoping my patient and their family/friends will abosrb the information and use it. 

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
ORDER NOW