APA format 2 pages long 3 references 1 from walden university library

please use one of the references from this post

 

     An educational program’s worth is determined by a process that is defined as an evaluation (Keating & DeBoor, 2018).  “Evaluation is a broad term that describes the process of determining the value, worth, or quality” (Billings & Halstead, 2016, p. 385).  There are several evaluation models that are utilized by nursing programs and nursing educators. 

     During this week’s assigned readings, I found two models that could be used for the evaluation of an educational intervention in a healthcare setting.  One is the RSA Model which was developed by Roberta Straessle Abruzzese, a nursing educator.  This model is a triangle that progresses in a hierarchy fashion moving from process evaluation (the lowest level) to content evaluation, outcome evaluation, and the highest level – impact evaluation (DeSilets, 2010).  Another attractive model is the CURRICULUM Model which includes context, content, and conduct.  Under context the letters C – consider context and U – understand learners; content includes the letters R – wRite goals, R – wRite objectives, I – identify content, C – choose methods and materials, and U – unite resources; and conduct includes the letters L – lead implementation, U – undertake evaluation, and M – monitor outcomes (Kalb, 2009).

     Although the above-referenced evaluation models are appropriate for an educational program within a healthcare setting, our team has chosen the Kirkpatrick Evaluation Model combined with a Shared Governance Model approach.  The Kirkpatrick Evaluation Model “evaluates four levels of change:  reaction, learning, behavior, and results” (Billings & Halstead, 2016, p. 389).  Each of these levels must be evaluated before expanding upon the next.  This model will be useful for the nurse and the educator as it will show if the training yields the desired outcomes; the degree of change on the nursing units; and the amount of content learned (Kirkpatrick Partners, 2019).  Moses Cone Hospital already has a Shared Governance model in place which will aid in achieving quality patient care by aligning nursing professional practice with organizational values and beliefs (Nursing World, 2004).  This model can help nurses by encouraging one another to provide evidenced-based care and live the mission, vision, and values of the Cone Health organization. 

     According to Billings & Halstead (2016, p. 395), “to design and implement an evaluation plan and then ignore the results would defeat the purpose of evaluation.”  Evaluation of an educational program not only reveals the success of the said program; it can also assist the nurse educator in any changes that need to be made for future reference.  “Implementing an educational model that is based on outcomes reflects the influence of education on practice” (Dickerson, Shinners, & Chappell, 2017).    

References

Billings, D. M., & Halstead, J. A. (2016). Teaching in Nursing: A Guide for Faculty (5th ed.)

DeSilets, L. D. (2010, January). Another Look at Evaluation Models. The Journal of Continuing Education in Nursing, 41(1), 12-13. Retrieved from the Walden Library databases.

Dickerson, P. S., Shinners, J., & Chappell, K. (2017). Awarding credit for outcomes-based professional development. The Journal of Continuing Education in Nursing, 48(3), 97-98. Retrieved from the Walden Library databases.

Kalb, K. A. (2009, May/June). The three Cs model: The context, content, and conduct of nursing education. Nursing Education Perspectives, 30(3), 176-180. Retrieved from the Walden Library databases.

Keating, S. B., & DeBoor, S. S. (2018). Curriculum development and evaluation in nursing education (4th ed. New York, NY: Springer.

Nursing World. (2004). Shared governance models: The theory, practice, and evidence. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/

ANAPeriodicals/OJIN/TableofContents/Volume92004/No1Jan04/SharedGovernance

Models.aspx

 

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MSN APA format 3 references 1 from Walden University Library, 

Due 3/14/19 7pm EST 

 

Needs Assessment: External Factors that Impact Curriculum and Program Development

            When a potential student is deciding on attending a new college or university, there are many factors that could change that decision.  The desire to attend a nationally accredited school can play a large part in the decision-making process.  Potential employers know that accredited institutions undergo rigorous processes to achieve and maintain the high quality standards set by accrediting bodies that looks great on a student’s resume.  During this weeks post, I will post a brief description of the setting my team selected for the course project.  I will explain which accrediting body or agency they have accreditation from and why.  Then I will identify the standards I selected and explain if the setting meets the outlined expectations.

Accrediting Body

            The northeast region team has selected Seton Hall University for this course’s project.  The main campus of Seton Hall is located in South Orange, New Jersey with their health and sciences campus in Clifton and Nutley, New Jersey.  This university has accreditation from the Commission on Collegiate Nursing Education, or CCNE.  This agency is the national voice for academic nursing education and works to, influence the nursing profession to improve healthcare, establish quality standards for nursing education while assisting schools in implementing them, and promotes public support for research, practice, and professional nursing education (American Association of Colleges of Nursing, 2012).  It is the responsibility of the educators in the facility to make sure that the curriculum components such as the mission, vision, philosophy, organizational framework, student-learning outcomes, and the program of study are well outlined and taught appropriately (Keating & DeBoor, 2018).  Seton Hall continues to use this accrediting agency to make sure that their education is up to date and they are preparing students for the world of nursing. 

Standards

            The CCNE accreditation process is based on core values, I will discuss a few of them in this post and describe if Seton Hall meets the expectations.  The first is to foster an educational climate that supports program students, graduates, and faculty in their pursuit of lifelong learning (Billings & Halstead, 2016).  According to the Seton Hall University website (2019), students and faculty are encouraged to pursue their education and continue learning with multiple graduate nursing programs, graduate courses, doctoral programs, and certificate courses.  The second standard is to encourage programs to develop graduates who are effective professionals and socially responsible citizens (Billings & Halstead, 2016).  Seton Hall University obliges with this standard in a few different ways.  They offer multiple clinical settings to allow the student to become an effective professional, and they have classes discussing legal issues, research, leadership, and management.  Giving a student these tools will provide them with the skills to be socially responsible citizens as well as effective professionals.  The final standard is to facilitate and engage is self-assessment.  The University has a department whose sole focus is on self-assessment.  They consistently perform assessments on programs in the university and recommend improvements that should be made within each program (Seton Hall University, 2019).  As we continue to explore this university’s curriculum, I will continue to evaluate how Seton Hall is doing as a nursing program, and see what changes need to be made.  The CCNE standards discussed are currently being met, but there is much more to explore, and there are always improvements that could be made.

References

American Association of Colleges of Nursing. (2012). CCNE accreditation. Retrieved

            from http://www.aacn.nche.edu/ccne-accreditation

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th

            ed.). St. Louis, MO: Elsevier.

Keating, S. B., & DeBoor, S. S.  (Ed.). (2018). Curriculum development and evaluation

            in nursing (4th ed.). New York, NY: Springer.

Seton Hall University. (2019). Retrieved from http://www.shu.edu/nursing/

 

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APA format in a SOAP Note format.  1 page long with questions as to which diagnosis would be accurate and why.  I have included the references I need 3 peer review articles to be included

 

Patient Information:

Initials: JS  Age: 11   Sex: M  Race: Caucasian

SJ

CC: Patient complaining of a mild right earache for the last two days and trouble hearing from that ear.

HPI: James Jones is an 11 year old Caucasian male who presents to the clinic with complaints of a right earache for the last two days. The patient reports worsening pain at night when trying to fall asleep and difficulty hearing out of that ear.  The patient rates is earache pain 5/10 and describes it as sharp and constant. The patient has taken 600mg ibuprofen with minimal relief of pain. The patient reports that he has been spending a lot of time swimming in the pool this summer.

Current Medications:

1.  Ibuprofen 600mg PRN for earache pain

Allergies: NKA

PMHx: Up to date on all immunizations. No significant PMH.

Soc Hx: Patient lives with two siblings and supportive parents in a safe neighborhood in Boston. The patient is currently in middle school and enjoys playing soccer, fishing with his dad and swimming in his pool during the summer. 

Fam Hx: Maternal grandmother died of a stroke at the age of 70. No other significant family history.

ROS: 

GENERAL: No fever, fatigue or chills. No weight loss. 

HEENT: Eyes:  No visual loss, blurred vision, double vision or yellow sclerae. Ears: Patient reporting pain in right ear and hearing loss. Nose, Throat:  No sneezing, congestion, runny nose or sore throat. 

SKIN: No rashes or itching.

RESPIRATORY:  No shortness of breath, cough or sputum.

GASTROINTESTINAL:  No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.

NEUROLOGICAL:  No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

LYMPHATICS:  No enlarged nodes. No history of splenectomy.

ALLERGIES:  No history of asthma, hives, eczema or rhinitis.

O.

GENERAL: Patient comes to the clinic with his grandmother, patient appears uncomfortable, is rubbing his right ear and having difficulty hearing. 

HEENT: PEERLA. Ears: Right ear canal is erythematous and edematous with pus present, tympanic membrane is difficult to visualize. Hearing difficulty with right ear. Left ear canal is intact without erythema or edema, tympanic membrane is clear and intact. Nose: Nose is patent without any rhinorrhea. Throat: Oropharynx is clear, without erythema or exudates, mucous membranes are moist, pink and intact. (Sullivan, 2012).

SKIN: Skin color is normal for patient, intact, without rashes or lesions. Skin turgor is good. 

RESPIRATORY: LS CTA bilaterally, no sternal retractions noted.

GASTROINTESTINAL: Abdomen is soft, nontender, nondistended. + BS in all quadrants. No bruits noted. No splenomegaly or masses present. 

NEUROLOGICAL: Cranial nerves II to XII are grossly intact w/out focal neurological defecits (Sullivan, 2012).

LYMPHATICS: No enlarged nodes. 

ALLERGIES: No known allergies. No history of asthma, hives, eczema or rhinitis.

Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines)

Otoscopy: Otoscopy of the ear canal demonstrated erythema, swelling and there was difficulty visualizing the tympanic membrane as there was watery discharge present. According to Lieberthal (2013), otoscopy is usually sufficient enough to reach the diagnosis of  otitis externa in children, however, certain cases require additional diagnostics, especially when occurring in infants presenting with fever. 

Labs: N/A

A.

Differential Diagnoses:

1.  Otitis externa – I chose this as the primary diagnosis because of the patient’s presenting symptoms and the context in which the patient experienced the symptoms. The patient complained of worsening ear pain and hearing loss in the right ear. The patient also reported that he had been swimming in the pool a lot recently. According to Wald (2018), otitis externa often occurs in children after swimming, causes pain and conductive hearing loss if pus or discharge is present and clinical findings include an erythematous, edematous ear canal and difficulty visualizing the tympanic membrane.

1. Acute otitis media- Acute otitis media is another possible diagnosis for this patient because of his presenting symptoms. According to Thomas (2014), acute otitis media generally occurs in patients after a respiratory tract infection and symptoms can include fever, fatigue or malaise. Additionally, Thomas (2014) discusses how purulent discharge is usually present with a bulging tympanic membrane. However, the patient did not report respiratory tract infection related symptoms and was not febrile.   
2. Otitis media with effusion- Otitis media with effusion cannot be ruled out because there is often discomfort in the affected ear with conductive hearing loss, however, there is not usually any purulent fluid in the canal, nor is it associated with swimming (Thomas, 2014).
3. Upper respiratory infection- upper respiratory infection is another possible diagnosis for this patient as it can cause blocking or painfulness in the ear as well as an erythematous tympanic membrane (Pettigrew, 2011). Additionally, upper respiratory infections often times precede otitis externa or other ear infections.
4. Furunculosis- Furunculosis is another possible diagnosis for this patient. Furunculosis is

usually an infected hair follicle in the ear canal that leads to otalgia and tenderness of the

ear which this patient presented with. However it is not too likely as it usually affects the

cartilage of the year and does not lead to conductive hearing loss (Ibler, 2014).

                                                            References

Ibler, K., & Kromann, C. (2014). Recurrent furunculosis – challenges and management:

a review. Clinical, Cosmetic and Investigational Dermatology, 7, 59-64.

            doi:10.2147/ccid.s35302

Lieberthal, A. S., Carroll, A. E., Chonmaitree, T., Ganiats, T. G., Hoberman, A., Jackson,

M. A.,  . . Tunkel, D. E. (2013). The diagnosis and management of acute otitis      

            media. Pediatrics, 131(3), 964-999. Retrieved September 25, 2018, from 

            http://pediatrics.aappublications.org/content/pediatrics/131/3/e964.full.pdf

Pettigrew, M. M., Gent, J. F., Pyles, R. B., Miller, A. L., Nokso-Koivisto, J., &     

            Chonmaitree, T. (2011). Viral-bacterial interactions and risk of acute otitis

            media complicating upper respiratory tract infection. Journal of Clinical     

            Microbiology, 49(11), 3750-3755. doi:10.1128/jcm.01186-11

Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F.

            A. Davis.

Thomas, J. P., Berner, R., Zahnert, T., & Dazert, S. (2014). Acute Otitis Media—a

            Structured Approach. Deutsches Ärzteblatt International, 111(9), 151-160.

            Retrieved September 25, 2018, from

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3965963/pdf/Dtsch_Arztebl_Int-                           

            111-0151.pdf.

Wald, E. R. (2018). Acute otitis media in children: diagnosis. UpToDate. Retrieved         

            September 25, 2018, from https://www.uptodate.com/contents/acute-otitis-media-

 

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APA format 1 1/2 pages long 3 references 1 from the discussions reference list

due 10/24/19 at 7pm

 

 Incorporating Technology in Community-Based Learning

            Unique learning needs exist in all patient populations.  However, identifying the need and then designing a technology-based intervention requires a careful analysis of both the population and the planned action.  The purpose of this discussion is to describe a community-based population, describe a selected learning need for this population, and explain how I would design a PowerPoint presentation that would address that need. 

Community-Based Population

            I work in a Federally Qualified Health Center (FQHC) that provides primary care to patients across the lifespan.  FQHCs receive funding from the Health Resources and Services Administration Health Center Program to provide care in medically underserved communities (Health Resources & Services Administration [HRSA], 2018).  Over 28 million people receive care at FQHCs in the United States (HRSA, n.d.).  FQHCs use a sliding scale fee, ensuring patients have access to affordable medical care (HRSA, 2018).  While FQHCs are intended to serve the medically uninsured, over 77% of the patients receiving care at FQHCs have private insurance, Medicare, Medicaid, or another governmentally funded health insurance (HRSA, 2019).  Females represent 57.65% of the patient population, with patients between the ages of 25 and 69 years old presenting most frequently (HRSA, 2019).  However, the FQHC patient population possesses unique barriers to care.  A significant hurdle for FQHCs to overcome is language, as 23.63% speak a language other than English (HRSA, 2019).  Additionally, 68.23% of the patient population is at or below the poverty level (HRSA, 2019).  Complicating continuity of care with this patient population is the high number of migratory and seasonal workers and homeless individuals receiving care (HRSA, 2019).  All combined, these factors create a patient population with sub-par health literacy.

Learning Need

            Indigent patient populations are more likely to have decreased health literacy levels (Whitley, Jones, Hansen, & Vora, 2019).  Additionally, patients with diminished health literacy are less likely to return for follow-up care as scheduled (Thompson et al., 2015).  Patients who are chronically under- or uninsured do not return for follow-up appointments as medical is not always viewed as a necessity.  Failure to follow-up for appointments as scheduled has been shown to increase emergency department visits and worsen patient outcomes (Arora et al., 2015).  Therefore, a means to address the FQHC patients’ knowledge deficit of the need to return for follow-up appointments should be identified and implemented. 

Addressing the Learning Need

            As previously identified, members of FQHC patient populations have decreased health literacy resulting in noncompliance with follow-up appointments and poorer patient outcomes.  However, a systematic review of 60 studies identified text messages as an effective intervention to improve patient compliance, thereby increasing patient outcomes (Hirshberg, Downes, & Srinivas, 2018).  Text messages provide a low-cost, highly scalable intervention to improve patient follow-up (Arora et al., 2015).  Additionally, few members of society do not have access to a mobile phone.  Text messages sent seven days, and one day before scheduled appointments are effective intervals for improving patient follow-up (Arora et al., 2015).  Potential obstacles for this intervention include patients changing their mobile numbers, having limited data usage, and the inability to know whether the message was received.  However, using text messages to reinforce the need for compliance with follow-up care will address the learning deficit for this patient population.  Additionally, orientating the office staff and then including them in the implementation of this intervention will address the staff’s learning need.  Therefore, a PowerPoint presentation should be designed to orient the staff to this technology-based, evidence-based intervention.

Summary

            Learning needs exist in all patient populations.  Ongoing advances in technology are providing new methods for addressing these needs.  By taking advantage of these technologies, evidence-based interventions can successfully be implemented in the practice setting.     

Reference

Arora, S., Burner, E., Terp, S., Nok Lam, C., Nercisian, A., Bhatt, V., & Menchine, M. (2015). Improving attendance at post–emergency department follow‐up via automated text message appointment reminders: A randomized controlled trial. Academic Emergency Medicine, 22(1), 31-37.

Health Resources & Services Administration. (2018, May 8). Federally Qualified Health Centers. Retrieved from https://www.hrsa.gov/opa/eligibility-and-registration/health-centers/fqhc/index.html

Health Resources & Services Administration. (2019). 2018 Health Center Data. Retrieved from https://bphc.hrsa.gov/uds/datacenter.aspx?q=tall&year=2018&state=

Health Resources & Services Administration. (n.d.). HRSA Health Center Program. Retrieved October 1, 2019, from https://bphc.hrsa.gov/sites/default/files/bphc/about/healthcenter factsheet.pdf

Hirshberg, A., Downes, K., & Srinivas, S. (2018). Comparing standard office-based follow-up with text-based remote monitoring in the management of postpartum hypertension: A randomised clinical trial. BMJ Quality & Safety, 27(11), 871-877. doi:10.1136/bmjqs-2018-007837

Thompson, A. C., Thompson, M. O., Young, D. L., Lin, R. C., Sanislo, S. R., Moshfeghi, D. M., & Singh, K. (2015). Barriers to follow-up and strategies to improve adherence to appointments for care of chronic eye diseases. Investigative Ophthalmology & Visual Science, 56(8), 4324-4331. doi:10.1167/iovs.15-16444

Whitley, M. Y., Jones, E. M. V. W., Hansen, B. K., & Vora, J. (2019). The impact of self-monitoring blood glucose adherence on glycemic goal attainment in an indigent population, with pharmacy assistance. Pharmacy and Therapeutics, 44(9), 554. doi:10.43 21/s1885-642×2006000400006

 

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