Reasoning In A Specialty Area

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Reasoning in a Specialty Area

Bring to mind an important practice-related decision you have made recently. How did you approach this decision? What aspects of your specialty expertise informed your decision-making?

Evaluate your decision now in light of the principles of clinical reasoning presented in the Learning Resources this week. What new insights arise about your decision making as you look at it through this lens? What questions emerge as you reflect how you use reasoning in your practice?

In this Discussion, you and your colleagues examine the application of reasoning strategies in your specialty area of practice, particularly as it is connected to your EBP Project question.

To prepare:

  • Consider the definition of clinical      reasoning and how it is distinguished from other terms in the      Simmons article. (see attached file)
  • Bring to mind key characteristics of your      specialty area. Is the concept of clinical reasoning relevant and      sufficient to describe the process you utilize as you      make decisions and solve problems in your area of specialization? Why or      why not? If not, what terminology would be more useful for defining or      characterizing this process?
  • Review the literature to identify at least two specific examples of reasoning strategies used in your specialty area. These may be part of your literature review related to your EBP Project question(s). (see PIICOT Question below      at the end of the page)
  • Reflect on your EBP Project      question(s) (see PIICOT Question below at the end of the page).      Reexamine your project question(s) through this lens of clinical, or      alternately termed, reasoning.

By Day tomorrow 09/04/18 12 by 10 pm, write a minimum of 550 words in APA format with at least 3 references from the list of required resources below. Include the level one headers as numbered below:

Post a cohesive scholarly response that addresses the following:

1) How are reasoning strategies most often applied in your specialty area? Provide at least two specific examples supported by the literature.

2) How can you apply reasoning strategies to the refinement of your EBP Project question(s)? (see PIICOT Question below at the end of the page)

Required Readings

Terry, A. J. (2018). Clinical research for the doctor of nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter      1, “The Importance of Research in the Doctor of Nursing Practice Degree”
         Read pages 12-18 beginning with “The DNP Graduate with an Aggregate Focus”      (see attached File)

         In this section of Chapter 1, the author explains relationship between the      DNP clinician, the research process, and developing an effective      evidence-based practice. The author also discusses facilitating change in      practice based on critically appraised and validated evidence. In      addition, Carper’s four essential patterns of “knowing” in nursing and      Rosswurm and Larrabee’s six-phase model for reviewing research are      highlighted.

Balakas, K., Sparks, L., Steurer, L., & Bryant, T. (2013). An outcome of evidence-based practiced education: Sustained clinical decision-making among bedside nurses. Journal of Pediatric Nursing, 28, 479-485.

Harkanen, M., Voutilainen, A., Turunen, E., & Verhvilainen-Julkunen, K. (2016). Systematic review and meta-analysis of educational interventions designed to improve medication administration skills and safety of registered nurses, Nurse Education Today, 41, 36-43. 

Lee, J., Lee, Y., Bae, J., & Seo, M. (2016). Registered nurses clinical skills and reasoning process: A think-aloud study. Nurse Education Today, 46, 75-80.

Simmons, B. (2010). Clinical reasoning: Concept analysis. Journal of Advanced Nursing, 66(5), 1151-1158.

PIICOT Statement

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients 

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients 

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months

 
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Reconstruction And The Compromise Of 1877 19361599

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Required Resources Read/review the following resources for this activity:

  • Textbook: Chapter 15, 16
  • Lesson
  • Minimum of 1 scholarly source (in addition to the textbook)

Initial Post Instructions  For the initial post, craft a response comparing the three (3) Reconstruction plans:

  • Proclamation of Amnesty and Reconstruction (10% Plan) – Lincoln
  • Andrew Johnson’s Reconstruction Plan
  • Congressional Reconstruction Plan (Congress)

Then, address the following for your selections:

  • Analyze if the South should have been treated as a defeated nation or as rebellious states.
  • Explain how the American culture and society changed in the North versus the South during Reconstruction.
  • Analyze the impact of the Compromise of 1877 that ended Reconstruction on African-Americans.

Follow-Up Posts  Compare your selections and analysis of selections with those of your peers. If they chose different events, examine how yours are similar and/or different. If they chose the same events, build on their posts by providing additional information about the events that you have not already noted in your own post.Writing Requirements

  • Minimum of 3 posts (1 initial & 2 follow-up)
  • APA format for in-text citations and list of references

Professor’s post: If only President Lincoln had lived so he could implement Reconstruction. If John Wilkes Booth thought he did a favor for the South in assassinating Lincoln, he was mistaken. Lincoln, as you’ve seen, was more lenient on the South than others in Congress. And the two remaining viewpoints were held by the new President, Andrew Johnson, and the Radical Republicans, who were virtually at war with each other over these reconstruction ideas (McPherson, 1982, ch. 27).

So let’s talk about how Reconstruction was implemented, and these three different plans that were offered.

Reference

McPherson, J. M. (1982). Ordeal by fire: The Civil War and Reconstruction. New York,  NY: Alfred A. Knopf.

 
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Recommending An Evidence Based Practice Change

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To create an 8- to 9-slide PowerPoint presentation:

  

· Briefly describe your healthcare organization, including its culture and readiness for change. 

· Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.

· Propose an evidence-based idea for a change in practice using an evidence-based practice approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered. 

· Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. 

· Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. 

 
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Recommending An Evidence Based Practice Change 19490127

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The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes. 

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

  • Reflect on the four peer-reviewed articles you critically appraised in Module 4. 
  • Reflect on your current healthcare organization and think about potential opportunities for evidence-based change. 

The Assignment: (Evidence-Based Project)

Part 5: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide PowerPoint presentation in which you do the following:

  • Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
  • Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
  • Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
  • Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. 
  • Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
  • Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
  • Add a lessons learned section that includes the following:
    • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
    • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)
 
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Recommendation Letter 19233775

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Need a sample of a glorious recommendation for a PA Program ( Physician Assistant)  of an individual who shadowed and scribed a Nurse Practitioner  .

 
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Ref Week 1 Culture

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Ref Patho Week 6

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OPRN

 
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Ref Cul

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Dyer-Berenson, Ch. 1 & 2

1.In reference to Dyer-Barenson, describe the process to obtain cultural competency. Has this course helped you begin this process? What else do you need to do?

2. What is the difference between ethnicity and race,? What are primary and secondary characteristics of a culture?

Summary: The purpose of the weekly reflective journal exercises is to allow for analysis, synthesis and evaluation of nursing theory using guided questions. Reflection has been referred to as a process that happens internally, privately or in isolation (Hill & Watson, 2011).  Also a useful definition of reflection has been referred to as the examination of an issue of concern, as a consequence of experience, creating clarity and meaning in terms of self, and which results in a change of perspective ( Boyd & Fales, 1983).

book :

Dayer-Berenson, L. (2014). Cultural competencies for nurses: Impact on health and illness, 2nd edition. Sudbury, MA: Jones and Bartlett. ISBN: 1-978-1-4496-8807-3

 
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Ref 19323713

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 Reflection Journal

Reflect on your final project and how you incorporated your evidence-based resources to support your recommendations. 

Final Project Topic – Pressure Ulcers and vulnerable population (elderly)

Final Project attached below

 
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Reexamine The Six Rules Of Creating Synergy Why Is It Critical That All Members Of A Team Understand And Enact All The Various Rules Why Is It Necessary For All Members To Value The Purpose Of An Endeavor Or Project

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Reexamine the six rules of creating synergy. Why is it critical that all members of a team understand and enact all the various rules? Why is it necessary for all members to value the purpose of an endeavor or project? one page and references

 
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