Comment 2 18596875

 

To some people, the link     between nursing and politics might seem tenuous to some people, but     to those who have put aside their stethoscopes for an office in     their state capitals, the relationship is a natural one. Nurses are     in the unique position of representing the interests of their fellow     nurses and the health care needs of the general public (Larson, J.,     2016). 

        Black was elected to     the House of Representatives in 2010 and represents     Tennessee’s 6th district, comprised of 19 counties across     middle Tennessee. She has been a nurse for more than 40 years and her  real-world experiences as a nurse have uniquely       positioned her as a credible and effective leader on health care       policy in Congress. She is focused on fully repealing the       president’s disastrous health care law and advancing true       market-based, patient-centered reforms that will bring down the       rising cost of care by increasing private sector competition and       consumer choice . Black serves as Chairman of the powerful House Budget     Committee and a member of the Ways and Means Committee.     (Blackhouse.gov). She is an advocate of Telehealth and has this to     say about its usefulness. Telehealth focuses on     harnessing innovative technology to increase convenience for     patients and caregivers, enhance the quality of care and save both     patients and the Medicare program money. In Tennessee’s rural     communities, the wider offering of telehealth services means more     access to care,”. “For patients in suburban and     urban communities throughout the state, telehealth offers the     benefit of reducing the number of in-person visits to healthcare     providers. As a nurse, I am proud to advance this bill so that     Medicare Advantage plans can offer vital telehealth services as a     basic benefit, rather than a supplemental service for our     seniors.” (Press Release, 2017).

It was stated that, under current law, traditional Medical plans     may only cover telehealth services in an extremely limited set of     circumstances, such as when the beneficiary resides in a qualified     rural area and is physically present in a hospital or     physician’s office. The Increasing Telehealth Access to     Medicare Act starts reform with Medicare Advantage, where plans have     an incentive to ensure cost savings.  Estimates have calculated     that a telehealth consultation can save the Medicare program $45     versus an in-person visit (Press Release, 2017).

        She authored the bill on     “Increasing Telehealth Access to Medicare Act (H.R. 3727),     which was unanimously passed in the U.S. House Ways and Means     Committee.  This bill will increase access to     telehealth services for Medicare Advantage enrollees and allows     plans to build as a core part of their care model. This congressman     must be very influential for this bill which she presented to have     passed the house. It is very interesting to know that those with     medicare can now have access to telehealth all because of the     influence of this powerful nurse. With this development, more nurses     should be encouraged to join politics as they are better advocate     for the people.  

I NEED YOU TO COMMENT FROM THIS POST, 150 WORDS NEEDED AND A REFERENCE PLEASE

 
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Comment 19219033

#1:

 

After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects.

#2: 

Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?

 
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Comment Of Health Belief Model

The Health Belief Model (HBM) is a psychological model developed in the 1950’s to try to explain and predict a patient’s response to health issues (Edelman, 2013). This model was developed to explain why some people fail to adopt preventative health measures even when the treatment is free. This model suggests that a message will have the maximum effect and behavior change if targets perceived barriers, benefits, self-efficacy, and threat (Jones et al., 2016).

The following components are edited for the text book Health Care Promotion Throughout the Life Span.

  • Individual perceptions or readiness for change
  • The value of health to the individual compared with other aspects of living
  • Perceived susceptibility to a health problem, disease, or complications
  • Perceived seriousness of the disease level threatening the achievement of certain goals or aims
  • Risk factors to a disease attributed to heredity, race or culture, medical history, or other causes
  • Perceived benefits of health action
  • Perceived barriers to promotion action

Lifestyle changes can be the toughest to integrate into daily activities because they require the patient to consciously practice new behaviors. One way for the nurse to help make these changes permanent is to evaluate the readiness to change. The nurse should use questions to elicit responses that indicate the patient is ready to change behavior. Without a willing participant all other information may not lead to the desired changes.

The framework of the HBM allows the nurse to choose the appropriate intervention that is achievable and permanent. Each component guides the nurse by identifying barriers and identifying ways for the patient to adhere to the new behaviors

 
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Comment Karen 18580201

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Current statistics show that at present, there are 1,048 Associate Degree Nursing (ADN) colleges and 696 Baccalaureate Degree Nursing (BSN) institutions in the United States (Cherry & Jacob, 2017). Recent studies show that a correlation exists between patient safety outcomes and whether a nurse has an ADN or BSN. Linda Aiken, PhD, RN, who is associated with the Robert Wood Johnson Foundation (RWFJ), believes that hospitals who employ more BSN-prepared nurses have better patient outcomes and lower mortality rates (RWJF, 2014).

          In 2003, Aikens reported on studies done in Pennsylvania hospitals showing a 5% decrease in patient deaths at hospitals that staffed a 10% increase in BSN-prepared nurses (RWJF, 2014). Challengers of Aikens note that these studies raise further questions (Sentinel Watch, 2014). For example, what were the actual causes of death of these patients, and were they related to the action of an ADN nurse? Could there be other factors or causal relationships that affected patient care in these circumstances?

          In defense of Aikens, the Sentinel (2014) states that no one is calling ADN nurses “bad nurses”. In fact, errors, infections, and adverse events are often due to process and system problems. Aikens maintains that by promoting evidence-based practice and leadership, the BSN curriculum will better prepare nurses to correct problems and implement solutions.

          I agree that it is advantageous for nurses to expand their knowledge by obtaining a BSN degree, but I do not feel that deaths and adverse outcomes are the result if ADNs care, or lack of. Many other factors need to be considered. For example, poor staffing, long shifts, poor communication, fatigue, documentation errors, etc. affect everyone no matter what type of degree they hold. I have been at the hospital where I am currently employed for almost 20 years and have seen no evidence that the care given by ADNs is substandard to the care given by BSN-prepared nurses.

References

Cherry, B. & Jacob, S. (2017).Contemporary nursing, issues, trends, & management. St. Louis: Elsevier

Robert Wood Johnson Foundation. (2014).  Building the case for more highly

          educated nurses. Retrieved from http://www.rwjf.org/en/library/articles

The Sentinel Watch. (2014). How does your nursing degree affect patient

          mortality rates? Retrieved from http://www.american sentinel.edu 

 
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Comment Ijeoma 18589531

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Choose one legislator on the state or federal level who is also a nurse, and discuss the importance of their role as advocate for improving health care delivery. What specific bill(s) have they sponsored or supported that has/have influenced health care?

Congressman Diana Black, representing Tennessee’s 6th Congressional district. She practiced as a nurse for 40 years.

It is important to have a nurse represented in the house, where laws and policies are passed, because an insider who knows the needs of nurses and healthcare system would be passionate to vote and advocate for the healthcare. There are millions of topics been discussed in the house on state and federal levels, but healthcare issues are very important, because health is universal, everyone use the healthcare system. It is very crucial for a nurse to be part of lawmaking process, not only to speak out for the nurses and make a positive impact on nursing profession, but also as a role model to other nurses, aspiring nurses to go for legislative positions where they can be part of change-making process in the society; which could be beneficial to the patients.

Black supported the passing of Increased   Telehealth Access to Medicare Act, this bill increases access to telehealth services for Medicare Advantage users, in this age of technology, health care access is made easier and affordable using technology. Telehealth focuses on the use of innovative technology for the convenience of patients and caregivers to enhance the quality of care while saving money for both Medicare program and the patients (Black, 2017). This service enhances access to healthcare and reduces the number of in-patient visit to healthcare providers, covered by traditional Medicare plans under the current law (Black, 2017)

                                                                                      Reference

Black. D (2017) Committee Votes to Increase Telehealth Access for Medicare Enrollees. Health. Retrieved September 25th. From https://black.house.gov/media/press-releases/committee-votes-increase-telehealth-access-medicare-enrollees

 
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Comment If I Agree Or Disagree And Because With 100 Words

 

   Throughout my nursing career I have had multiple coworkers go back to school to complete the BSN.  I’ve witnessed them move on to advance to higher positions in our organization, teaching, and just having the option to move unilaterally if they so wished.  I secretly wanted to go back to school but never verbalized it to anyone.  Honestly, I believe my fears have prevented me from taking the necessary steps to complete the BSN.  I recently got up the courage to talk to my husband and daughter about wanting to go back to school.  I admitted to them, and most importantly, to myself, that the fear of learning the technology, writing papers, and doing something that is going to take hard work, was preventing me from fulfulling a dream.  I have received nothing but support and encouragement.  So here I am. Taking the first steps to accomplish my goal of graduating with a Bachelors Degree in Nursing.

     I have several concerns as I embark on this journey.  Mainly, it is wondering if I am going to be able to balance working full time night shift with school.  I’ve not written papers in years.  The thought of reintegrating myself into the writing mode and learning the technology facets that are now used is a daunting thought.  As I start to read the posts by all of you I am realizing I am not alone.  I am willing and frankly determined to accomplish this goal.

     After reading the course materials, I am definately realizing I will have to manage my time.  I will organize my day to specifically set aside time to study and be realistic about it.  The one strategy in particular that has hit a chord with me and that I will have to work on most, is asking for help.  I have to acknowledge to myself that if I need help it is okay to ask for it.  It doesn’t mean I am a failure.  Also, I will work on enjoying this journey.  

 
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Comment Eve 18696071

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Substantial evidence has now been provided that stakeholder involvement is essential for management effectiveness in clinical research and implementation of new proposals. Feedback from stakeholders has critical value for research managers in as much as it alerts them to the social, environmental, and ethical implications of research activities. Additionally, those who are directly affected by program development and clinical research, the patients, their families, and others, almost universally have a strong motivation to be involved in the planning and execution of new program changes. Stakeholders are the customers, suppliers, the general public, and any other group, which are likely to be affected by the organization’s ultimate decisions. The process of incorporating the ideas and input from these groups has been termed “stakeholder engagement.” It reflects an increasingly accepted attitude that organizations not only have an ethical obligation to involve the participation of stakeholders in their collective activity but also in so doing their overall organizational effectiveness will be enhanced (Pandi-Perumal, Akhter,  Zizi,  Jean-Louis,  Ramasubramanian, Freeman,  & Narasimhan, 2015).  The process of identifying, engaging stakeholders must begin well in advance so that dialog is seen to play an important part of project implementation; no decisions should be already made before commencing stakeholder engagement on project-related issues. Stakeholder engagement is intended to help administrators fully realize the benefits of applying community and patient interest in hospital programs, and to ensure that research and program changes benefit those who are most directly affected. The stakeholder focus group is a communication medium through which the opinions of individuals or groups of individuals who are impacted by the research can be elicited. Focus groups can also serve to clarify each stakeholder’s role and responsibilities, as well as promoting an overall understanding of the project requirements. Such processes also provide stakeholders with an environment in which they can express their opinions and feel that they have been heard (Pandi-Perumal, Akhter,  Zizi,  Jean-Louis,  Ramasubramanian, Freeman,  & Narasimhan, 2015).

Pandi-Perumal, S. R., Akhter, S., Zizi, F., Jean-Louis, G., Ramasubramanian, C., Freeman, R., & Narasimhan, M. (2015). Project Stakeholder Management in the Clinical Research Environment: How to Do it Right. Frontiers in Psychiatry, 6, 71. http://doi.org/10.3389/fpsyt.2015.00071

 
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Comment Eve 18675903

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100 -120 WORDS

Knowledge of nurses about the intervention for the prevention of pneumonia associated with mechanical ventilation: This article seeks to investigate the knowledge of pneumonia prevention interventions. There seems to be a disconnect between the evidence research has made available and clinical practice. One strength is that the method used allows for honest results. However, the weakness is that the study was conducted at one hospital, in one unit so the generalizability is unknown.

Wagner, B. V., Alves, E. F., Brey, C., Waldrigues, M. C., & Caveião, C. (2015). KNOWLEDGE OF NURSES ABOUT THE INTERVENTION FOR THE PREVENTION OF PNEUMONIA ASSOCIATED WITH MECHANICAL VENTILATION. Journal Of Nursing UFPE / Revista De Enfermagem UFPE, 9(5), 7902-7909. doi:10.5205/reuol.6121-57155-1-ED.0905201521

Evaluation of a bundle to prevent ventilator-associated pneumonia in an intensive care: This article is aimed at evaluating compliance with a bundle to prevent ventilator-associated pneumonia in an Intensive Care Unit. Bundles are only effective if used appropriately and consistently. Nurses must understand and comply in order to reduce VAP in the ICU setting. One strength is that samples were taken from many settings and consisted of nearly 1,500 participants. One weakness is that VAP bundles are not universal and vary between facilities.

Guterres da S, Raquel Kuerten de S, Eliane Regina Pereira do N, Kátia Cilene Godinho B, Cibele D’Avila Kramer C. (2014). Evaluation of a bundle to prevent ventilator-associated pneumonia in an intensive care. (3):744

Ventilator-associated pneumonia bundled strategies: an evidence-based practice: Ventilator-associated pneumonia (VAP) is an ongoing challenge for critical care nurses as they use current evidence-based strategies to decrease its incidence and prevalence. This article aims to provide a review of the literature on VAP bundle (VAPB) practices, describe the etiology and risk factors and define bundled practices, discuss an explanatory framework that promotes knowledge translation of VAPBs into clinical settings, and to identify areas for further research and implications for practice to decrease the incidence of VAP. One strength is multiple resources were used to provide reliable results. One weakness is that though bundles were proven effective overall, it does not specify or account for the different interventions that are in each bundle.

O’Keefe-McCarthy, S., Santiago, C., & Lau, G. (2014). Ventilator-associated pneumonia bundled strategies: an evidence-based practice. Worldviews On Evidence-Based Nursing, 5(4), 193-204

Critical care nurses’ knowledge of, adherence to and barriers towards evidence-based guidelines for the prevention of ventilator-associated pneumonia: There is an ongoing need for improvements in education and effective implementation strategies. Barriers in prevention of VAP include education or lack thereof and appropriate and consistent implementation. Strength is that it includes all barriers and provides a clear picture of the issues. A weakness is it relies on nurses to be honest about lack of compliance with existing bundles.

Jansson, M., Ala-Kokko, T., Ylipalosaari, P., Syrjälä, H., & Kyngäs, H. (2013). Critical care nurses’ knowledge of, adherence to and barriers towards evidence-based guidelines for the prevention of ventilator-associated pneumonia – A survey study. Intensive & Critical Care Nursing, 29216-227

Practical Nursing Assistants and Pneumonia Prevention Associated with Mechanical Ventilation in ICU: Assesses the knowledge of nurses in pneumonia prevention practices associated with mechanical ventilation in patients hospitalized in  intensive care unit. It identified the importance of the nurses´ role to care practices in the care of critically ill patients and the importance of recognizing the clinical findings to establish a diagnosis. The results provide subsidies for a reflection on the role of nurses in intensive care healthcare practices in the prevention of pneumonia in patients who are undergoing mechanical ventilation. One strength is that it includes the roles of support staff and their contributions to compliance. A weakness is that the roles of support staff are given through the opinions of ICU nurses.

Oliveira Gonçalves, É., Santos de Lima, M., de Lima Melo, J., Rodrigues Pontes, M. S., Barros Sousa, A. O., & Pinheiro Albernaz, M. (2015). Practical Nursing Assistants and Pneumonia Prevention Associated with Mechanical Ventilation in ICU. Journal Of Nursing UFPE / Revista De Enfermagem UFPE, 9(12), 1069-1077

Bundle to Prevent Ventilator-Associated Pneumonia: A Collective Constructive: This article reports on a qualitative convergent care research, which was aimed at the collective construction of a bundle to prevent ventilator-associated pneumonia by nursing and physiotherapy professionals at the intensive care unit. The construction of the VAP bundle was guided by the evidence-based practice criteria and consists of four preventive care acts: oral hygiene with 0.12% chlorhexidine; headboard elevated (30-45º); endotracheal cuff pressure between 20-30 cmH2O; and care with the aspiration of tracheal secretions. The implementation of these recommendations can support healthcare practice, contributing to reduce ventilator-associated pneumonia rates. A strength is it provides evidence of what an effective bundle is and how it can reduce incidence of VAP. A weakness is it does not provide evidence for each individual intervention or others that are included in bundles at other facilities.

Da Silva, S., do Nascimento, E., & de Salles, R. (2013). Bundle to Prevent Ventilator-Associated Pneumonia: A Collective Constructive. 21(4), 837-844

 
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Comment Chinyereugo

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Databases are highly organized and allow students to search for information on a topic by keyword, subject, author, title, and phrase.  But the Scholarly Database aims to serve researchers and practitioners interested in the analysis, modeling, and visualization of large-scale data sets. However, Grand Canyon University (GCU) Library has lots of databases. And one of the benefits of being a student at GCU is the access to the institution’s vast online library resources. Effective learners, students, and researchers will conduct most of them inquire using many various databases found within the GCU Library, which has “92 databases with access to over 70, 000 full-text journals and the articles”.

   The two GCU scholarly database that will help one find the best research articles are CINAHL Complete database and ProQuest Health and Medical Complete. CINAHL Complete is the ultimate research tool for nursing and allied health professionals with entry to the top nursing and allied health journals. Includes full text for more than 1,300 journals titles with indexing for more than 5,000 journal titles (GCU library, n.d). Covers more than 50 nursing specialties, speech-language pathology, and nutrition. CINAHL also provides access to health care books, nursing dissertations, selected conference proceedings, standards of practice audiovisual and book chapters etc. It is an essential tool for nursing research, CINAHL Database provides an easy-to-use interference with basic and advanced search features and searchable cited references. ProQuest has many different databases, though it is one of the most popular and prolific databases used by learners from various disciplines because it contains scholastic and popular resources from core academic subject areas (GCU, n.d.) It includes 28 databases in total. Its broad catalog enables learners to locate peer-reviewed articles from many different periodicals, as well as access dissertations and theses. The search function allows users to explore the database using a basic or advanced search that will generate a list of titles and identify full-text availability. The result page will provide users with a list of 20 titles per page with the newest publication at the top.

   These two databases I selected would be better to use than Google scholar or a general Internet search because they carry peer-reviewed articles. These databases also will offer me a more refined search that carters to my field of study. Generally, the Cumulative Index to Nursing and allied health literature they carry are taught to be a good source to search when conducting a review of qualitative evidence. Google Scholar is not a database, but its ability to extend its search to peer-reviewed journals, scholarly books, reports, and abstracts, as well as a link to library catalogs (including Grand Canyon University), makes it is a valuable research tool.

 

References

Grand Canyon University library. Becoming a Researcher/scholar/chapter 4 Effective Research. Retrieved from http://lc.gcumedia.com/res811/find-your-purpose-the-path-to-a-successful-doctoral-experience/v1.1/chapter-4-searching-for-materials.html

Grand Canyon University. (n.d.). Journal databases-Nursing and health sciences. Retrieved From:

https://library.gcu.edu/Database/Subject?subject=Nursing_And_Health_Science

Grand Canyon University

 
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Comment Audre

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT…BETWEEN 100-120 WORDS

Within the Grand Canyon University (GCU) Library there are multiple resources available to access scholarly journal articles. In the field of nursing and health sciences two scholarly databases include CINAHL Complete and OVID Nursing Essential Collection (Grand Canyon University [GCU], n.d.). CINAHL Complete is a database geared towards nurses and other health care providers and covers nursing specialties, nutrition, and speech language pathology. It contains the full text for more than 1,300 journal titles, many of which are peer reviewed (GCU, n.d.). OVID Nursing Essential Collection contains 112 full text journal titles along with Lippincott, Williams, & Wilkins Nursing & Health Professions Premier Collection which provides access to 64 journal titles (GCU Library, n.d.). Within the GCU Library these are the two scholarly databases I use the most. These databases are better to use than an internet search or Google Scholar because they contain articles that are often from peer reviewed journals that can be trusted. Journal articles found through these databases include an author or authors, dated material which allows for a search of current information, and most contain facts backed by evidence that is cited and often contain statistical data (Grand Canyon University [GCU] Library, n.d.). Information from website searches may be biased, out of date, or lack concrete evidence to back up claims or opinions. By using information from one of the GCU Library scholarly databases I can be sure that the information I am using is trustworthy.

References

Grand Canyon University Library. (n.d.). Evaluating web sites tutorial transcript. Retrieved from Grand Canyon University Library: http://lc.gcumedia.com/mediaElements/evaluating-websites-tutorial/v2.1/documents/transcript.pdf

Grand Canyon University. (n.d.). Journal atabases- Nursing and health sciences. Retrieved from Grand Canyon University Library:

http://library.gcu.edu/Database/Subject?subject=Nursing_And_Health_Sciences

 

 
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