In earlier assignments in this course, learners completed and submitted individual components of the DPI Project Proposal and received and incorporated feedback from their DPI Project Committee. At this point in the course, learners should have a working draft of the DPI Project Proposal (Chapters 1-3 and Appendix A).
For this assignment, learners will submit the working draft soft submission in preparation for the submission of Benchmark – DPI Project Proposal: Draft Proposal (DNP 955 Topic 7 Initial Learner Self Review GCU Chapters 1-3 and Appendix A) in Topic 8. For the soft submission, students will combine the chapters and reference lists, add the 10 Strategic Points as Appendix A, and remove all criterion tables. The document will be submitted as one unit.
After the chapters are combined and the document is formatted in accordance with the “DPI Proposal Template,” the learner will complete a self-review of work-to-date.
Use the following information to ensure successful completion of the assignment:
Continue working on the content for Chapters 1-3 in preparation for submission in Topic 8.
Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement that reminds you, the learner, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10.
You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network.
To earn portfolio practice hours, enter the following after the references section of your paper:
I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.
HbA1c is the quantitative measure of glycated hemoglobin. The measurement is not affected by any diurnal changes. However, the assessment of the results would best be assessed after three months. The resulting quantitative data predict the possibility of diabetic complications such as neuropathy and retinopathy (Schnell et al., 2017). Persistently high A1c levels from the baseline measurement to the final assessment levels predict a poor prognosis of the patients on the particular intervention. An increment of the values from the baseline will show a negative association and poor outcomes of the intervention of interest. A reduction in levels of HbA1c from the baseline would show the effectiveness of the intervention.
The impact of confounders would greatly impact the measurement. The undesired patient factors may also reduce or increase plasma glucose leading to good or poor glycemic control over the three months. Measurement of A1c levels confers better accuracy and specificity than the direct assessment of plasma glucose (Owora, 2018). Its application in prediabetes assessment is invaluable (Kam-On Chung et al., 2017). The direct assessment of random or fasting plasma glucose is best for acute settings where glucose levels are affected by short-term changes and metabolic alterations.
Measurement of body mass index (BMI) will assess the quantitative and qualitative impact of teaching lifestyle modification. The baseline and final measurements will be acquired as well. Alongside comparisons of A1c levels, the impact of both interventions would be assessed through BMI calculations. Personal patient characteristics such as ethnicity, race, and genetics are expected to impact the reliability of this tool in assessing change.
Data Sources (Who is data collected from?)The source of the primary data would come from randomized control trials on African American participants with prediabetes. This evaluation will acquire secondary data from primary research studies and analyze them systematically. The eligibility of such studies will be evaluated using the PRISMA model (Tawfik et al., 2019). The Cochrane Collaboration’s Tool for Assessing the Risk of Bias would be used in the assessment of these studies.Data Collection (When is data collected and by whom?)The data would be collected over four months starting with article searching, screening, and critical appraisal. The researcher will commence by setting the inclusion and exclusion criteria that meet the desired clinical issue of interest.Data Analysis (How will you analyze the data?)Data analysis would be carried out by metanalysis of findings from the primary research finding. This is because the main sources of the research evidence would be randomized control trials (RCTs) (Ahn & Kang, 2018). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model that would be used in the data collection and sampling will enhance metanalysis (Campbell et al., 2020). The resultant research evidence would have the highest level of evidence from the metanalysis.
As of 2014 health care expenditures in the United States are near 17% of our gross domestic product (GDP), with a major portion of Medicare funding goes towards chronic illness and care at the last 6 months of life. The Patient Protection and Affordable Care Act has made some initial legislative changes in our health system, but not sufficient to address our growing expenditures and caring for our large aging population.
In this assignment, learners will synthesize issues in aging with health policy solutions by writing a paper on one health issue for older individuals addressed in the topic and offering a policy solution. Example of issue: In 2014, over 50% of the costs of institutional long-term care for older persons are paid for with public funds from Medicaid.
Use the following information to ensure successful completion of the assignment:
Write a 1,000-1,250 word paper that addresses a health issue for older individuals. Include the following:
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Communication is so very important. There are multiple ways to communicate with me:
DNP835 All Modules Discussions
After reading the learning materials for this module develop three challenges to healthcare and provide a short discussion of possible nursing leadership interventions.
Discuss how the nursing leadership role is instrumental in providing effective healthcare delivery.
Discuss value-based healthcare delivery. Include the role of nursing in this delivery paradigm.
Discuss how nursing leadership influences value-based healthcare delivery in systems management.
Identify a changing cultural dynamic in your community. Include discussion on how this dynamic is influencing the way healthcare is and will be delivered. DNP835 All Modules Discussions
As a nursing leader you are ask to identify the cultural challenges that will be facing your staff in the next five years. Discuss how you would recognize these needs and what tools you will use to develop a response to the challenges. DNP835 All Modules Discussions
Discuss transformational leadership as relates to the role of a nursing manager.
After reading the article found at http://www.medscape.com/viewarticle/771912, discuss three behavioral changes you will adopt as a nursing leader. DNP835 All Modules Discussions
Discuss a recent unsuccessful change in healthcare that you have experienced. Discuss how you would improve the outcome. DNP835 All Modules Discussions
Discuss how you would use value-based healthcare delivery to influence a change behavior on a nursing unit.
Discuss how you would use value-based healthcare delivery to influence a change behavior on a nursing unit. DNP835 All Modules Discussions
Discuss why many mission/vision statements do not drive healthcare decisions and why.
Identify a mentor that guided you through a key process of adopting professional practice behaviors. Discuss how the mentor assisted you with the process. DNP835 All Modules Discussions
Describe three methods you will use to recognize and share quality professional behaviors.
Discuss the how participating in change helps a nursing leader grow and mature in their professional practice. DNP835 All Modules Discussions
Describe how successful nursing leaders guide professional practice for those around them using this example: an employee has resigned and the resignation letter is angry and includes many negative comments about the organization. How would you respond to the employee?
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HCA 459 Week 4 Discussion Question 2
Case 1 Discussion: Allied health program
One of the most common questions asked about the nursing profession is whether nurses have to clean poop as part of their job duties. The simple answer is yes, nurses do clean poop, along with other bodily fluids, as part of their daily responsibilities. This may not be the most glamorous part of the job, but it’s definitely a crucial one. However, the frequency and extent of this task can vary depending on the specific areas of nursing and the healthcare setting.
The frequency depends on the healthcare setting and the specific needs of the patients. Registered nurses (RN’s) in certain departments may encounter and clean poop multiple times throughout their shift, while others, such as a labor and delivery nurse, may only need to deal with this task occasionally.
Several factors can influence how often you’ll have to encounter stool, including:
Despite the variability in frequency, nursing students must understand that cleaning stool is a part of a nurse’s job, and they will likely get a good idea of how often they’ll have to encounter stool during their clinicals. Nurses must prioritize this task alongside their other responsibilities and approach it with professionalism and respect for patient dignity.
Nursing involves close contact with patients and their bodily fluids. Stool is really a team effort, but it is only one of the many substances you’ll be dealing with. Other bodily fluids that registered nurses commonly encounter include:
Dealing with bodily fluids is an important part of providing patient care. It requires a strong stomach, a professional demeanor, and a commitment to maintaining patient dignity. Nurses clean up poop, and sometimes the tasks are shared with certified nursing assistants (CNAs), who are also responsible for helping with stool and other bodily fluids.
Cleaning stool is not just an unpleasant task; it is crucial to maintaining patient health and preventing the spread of infections. There are several key reasons why cleaning poop is so important in the healthcare setting:
Nurses and nursing assistants may encounter and clean stool in various situations, depending on the healthcare setting and patient needs. Some common scenarios include:
Nurses employ various tools and techniques to clean stool effectively and efficiently while maintaining proper infection control protocols. Some essential tools and strategies include:
Nurses may need to desensitize themselves to the sight and smell of stool in the various areas of nursing. Coping strategies, like breathing techniques, can help minimize the impact of unpleasant odors, and focusing on the health status of your patients can help you remain compassionate during difficult moments.
While nurses play a central role, nursing assistants (CNAs) and patient care technicians (PCTs) assist significantly in dealing with stool and administering medications. It’s definitely a team effort, with every member assisting in maintaining patient dignity.
Housekeeping staff also play a crucial role in maintaining a clean and hygienic patient care environment. These team members are responsible for tasks such as:
While most nurses deal with feces, some specialties, like operating room nursing or administrative roles, have less direct contact. However, all nurses should be prepared to handle such situations if needed.
Do nurses wipe poop? Nurses clean feces as part of their patient care duties, which include assisting with toileting and managing incontinence. This task is approached professionally to maintain patient dignity and prevent complications.
Patient care technicians regularly clean feces as part of their job responsibilities. They assist patients with toileting, change bedpans and adult diapers, and maintain patient hygiene.
Do CNAs clean poop? Generally, all Certified Nursing Assistants (CNAs) are expected to clean feces as it’s a fundamental part of their training and daily responsibilities. This includes assisting with toileting and managing incontinence for patients who need help.
Nurses often need to wipe and clean patients after bowel movements or incontinence episodes. This is essential to patient care and hygiene management, performed efficiently and compassionately.
As with many healthcare professions, nursing has a rich history of oath-taking, symbolizing nurses’ ethical and professional responsibilities. In most countries, including the United States, nurses are not legally required to take an oath. However, many nursing schools and professional organizations encourage nurses to take an oath, such as the Nightingale Pledge, as a symbolic commitment to upholding the ethical and professional standards of the nursing profession.
The Hippocratic Oath is an ancient Greek text that serves as a guiding principle for medical practitioners. It is named after Hippocrates, the famous Greek physician considered the father of modern medicine. The oath outlines the ethical responsibilities and guidelines that physicians should adhere to in their practice.
The Hippocratic Oath covers several key aspects of medical practice, including:
The Hippocratic Oath encompasses several foundational principles that guide the ethical conduct of physicians:
Traditionally, physicians took the Hippocratic Oath upon graduating from medical school. The oath served as a rite of passage, marking the transition from student to practitioner and symbolizing the physician’s commitment to the profession’s ethical principles. However, the practice of taking the Hippocratic Oath varies among medical schools, and some institutions have developed their oaths or declarations that better reflect contemporary values and challenges in healthcare.
In 1893, Lystra Gretter, a nursing instructor at the Harper Hospital in Detroit, Michigan, created the Nightingale Pledge as a nursing equivalent to the Hippocratic Oath. The pledge is named after Florence Nightingale, the founder of modern nursing, who established nursing as a respected and professional discipline. The Nightingale Pledge emphasizes the importance of loyalty, devotion, and maintaining professional standards in nursing practice.
The original Nightingale Pledge reads as follows:
“I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.”
In most countries, including the United States, nurses are not legally required to take an oath. The decision to take an oath is typically a personal choice or a requirement of the nursing school or professional organization. However, many nursing schools and organizations encourage nurses to take an oath as a symbolic gesture of their commitment to ethical practice and patient care.
Taking a nursing oath is a public affirmation of a nurse’s commitment to the ethical and professional responsibilities of the profession. By taking an oath, nurses acknowledge the trust placed in them by patients, families, and society. The oath reminds nurses of the core values and principles that guide nursing practice, including compassion, integrity, and dedication to patient well-being.
Nursing oaths also help to establish a shared identity and sense of purpose among nurses. By reciting the same words and committing to the same principles, nurses create a bond that transcends individual differences and unites them in their common goal of providing excellent patient care. This sense of unity and shared purpose can be especially important in times of crisis or uncertainty, when nurses may need to rely on each other for support and guidance.
Despite their symbolic importance, nursing oaths have not been without controversy. Some critics argue that traditional nursing oaths, such as the Nightingale Pledge, are outdated and fail to capture the complexity of modern nursing practice. They contend that the language used in these oaths is too vague or open to interpretation, which can lead to confusion or inconsistencies in practice.
Another point of contention is the religious language used in some nursing oaths. The Nightingale Pledge, for example, includes the phrase “I solemnly pledge myself before God,” which some nurses may find exclusionary or inappropriate in a secular healthcare setting. This has led to alternative oaths that use more inclusive language or omit religious references altogether.
There is also debate about the effectiveness of nursing oaths in promoting ethical behavior and patient care. Some argue that taking an oath does not guarantee that a nurse will act ethically or provide high-quality care and that the oath is merely a symbolic gesture with little practical impact. Others contend that taking an oath can have a powerful psychological effect, reminding nurses of their responsibilities and inspiring them to live up to the profession’s highest standards.
Whether a nurse takes a formal oath or not, the most important aspect of being a nurse is living up to the principles and values that define the profession. Taking an oath is not a guarantee of ethical behavior or high-quality patient care; it is a symbolic commitment to strive for these ideals in every aspect of one’s practice.
Living the oath means embodying the core values of nursing, such as compassion, integrity, and respect for patient autonomy. It means lifelong learning, seeking new knowledge and skills to improve patient outcomes and advance the profession. It means advocating for patients, families, and communities, fighting for policies and practices that promote health equity and social justice.
Living the oath also means being a leader and role model for others. Nurses who live up to the principles of their oath inspire their colleagues and the next generation of nurses to do the same. They demonstrate the power of nursing to make a positive difference in the lives of individuals and communities and help shape the future of the profession.
The oath that nurses take is called the Nightingale Pledge. It is a promise to care for patients with kindness, respect, and honesty. Nurses pledge to help people stay healthy, keep their information private, and avoid causing harm. It’s similar to the doctor’s Hippocratic Oath, but focused on nursing care. Some nurses recite a modern version of this pledge when they graduate from nursing school.
The modern nursing pledge is a promise made by nurses to provide care with compassion, respect, and integrity. It is a more updated version of the traditional Nightingale Pledge. Nurses vow to maintain patient confidentiality, continue learning, and work with others to improve healthcare. They also pledge to respect the dignity of all patients and provide care without discrimination. This modern pledge reflects the values and responsibilities of nursing in today’s healthcare environment.
· Hospital falls are among the most commonly reported adverse hospital events with more than one million occurring annually (Leone & Adams, 2016).
· Stroke patients were the largest diagnostic group accounting for all unassisted falls (Leone & Adams, 2016).
· Most of these incidents were related to stroke patients attempting to toilet themselves when they fell.
· There are some challenges for stroke patients to have awareness of their surroundings and ability effect by stroke.
b. Theoretical Foundations (models and theories to be foundation for study):
· The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective program (Day et al., 2011).
c. Review of Literature Topics With Key Organizing Concepts or Topics for Each One
· Research study found bladder training and prompted voiding share the two characteristics of cognitive behavioral modi?cation and active client participation (Roe, Milne, Ostaszkiewicz & Wallace, 2007).
· Timed voiding program has proved successful in decreasing unassisted bathroom-related falls in the stroke population (Mehdi, Birms & Bhalla, 2013).
d. Summary
e. Significance:
· Improving rate of hospital falls;
·.
Problem StatementWhile the literature indicates that it is important to develop new measures for fall prevention programs in stroke populations, it is unknown if the implementation of Bladder Training and Timed-voiding program would decrease unassisted bathroom-related falls in the stroke population.Clinical/PICO QuestionsCan a combination intervention (bladder training and timed-voiding) decrease unassisted bathroom related falls in post ischemic stroke patients within six weeks period on a rehabilitation unit at a local Rehabilitation Institute?Sample(L) – Local inpatient rehabilitation facility (Memorial Rehabilitation Institute in Hollywood, Florida).(P) – Population: post ischemic stroke patients.
(I) – Intervention: Implementing a Bladder Training and Timed-voiding program to decrease unassisted bathroom-related falls in post ischemic stroke population.
(C) – Comparison: Use multiple data collection and analysis from EHR and FIM score to compare before and after the new fall prevention program.
(O) – Outcome: Decreased unassisted bathroom-related falls in post ischemic stroke population.
(T) – Time: Quasi-experimental review of electronic medical records for all stroke patients who fell in six months period prior to the program need to be conducted. Then compare with Fall debrief survey score for post program will be measure in 6 weeks period.
Define VariablesDefine Variables:· Independent Variable: Bladder training and timed-voiding program.
· Dependent Variable: The effectiveness of decreasing unassisted bathroom-related falls post ischemic stroke population.
Methodology and DesignThis study will be using a quantitative methodology with quasi-experimental design.Purpose StatementThis quantitative quasi-experimental study is to explore and understand contributing factors of falls in the stroke population by using database from the electronic health record (EHR) at inpatient rehabilitation facility. Based on targeted pre-intervention findings from falls database, design and implement an intervention specific to decrease unassisted bathroom related falls in stroke patients through a multidisciplinary timed voiding program.Data Collection ApproachQuasi-experimental review of electronic medical records for all stroke patients who fell in six months period prior to the program need to be conducted. Then collect the score from Fall debrief survey score for post program to be measure in 6 weeks period. Survey specific patient-related data focused on demographics (age and gender), medical condition (type of stroke, comorbidities), days since admission, neurological deficits (mental status, physical or visual impairment), and potential value of the functional independence measure (FIM) score for predicting falls.Data Analysis ApproachFall debrief data contained descriptive details of the falls and its circumstances which included the time of fall, day of week, location, call bell usage, activity being attempted, effect of medications that may impact falls. EHR database provides valuable tools to help identify and assess risk factors for falls. These data also provide a method of evaluating and analyzing a new fall prevention program and pre and post program scores will be compared to determine its effectiveness.
Dorothy E Johnson Theory Critique Presentation
This is a formal paper of the assigned theorist. The student will critically assess the assigned theorist by defining the theory, and giving a historical overview of the theorist noting the assumptions and limitations of the theory, the social climate and conditions that influenced the theory development as well as other theorists and or disciplines. The paper should be no more than 3-5 pages of content, to include title and reference pages compliant with APA 7th edition.
This assignment is graded on content and quality of thought. (Rubric provided). The presentation portion of your theorist is the opportunity to share your assigned theorist with your colleagues via power point presentation. Please view the Power Point Format Presentation slide show, which will be used for all presentation assignments.
It should be no more than 15 slides in APA 7th edition including title and reference pages., and slide citation. All components must be utilized for maximum credit. (Rubric provided).read the course text chapter that relates to the selected theorist and support with at least 2 other references
Complete the theory analysis using the theory analysis rubric
create 3-5 page APA 7th edition compliant document and 20 slide presentation for class that complies with Pittman’s PPT guidelines.
Paper and Powerpoint on Dorothy Johnson: Behavioral System Model
1. Discuss the correlation between nursing education and positive patient outcomes. Include current research that links patient safety outcomes to advanced degrees in nursing. Based on some real-life experiences, explain whether you agree or disagree with this research. (Minimum 250 words and 2 sources).
2. Discuss the difference between a DNP and a PhD in nursing. Discuss which of these you would choose to pursue if you decide to continue your education to the doctoral level and explain why. (Minimum 250 words and 2 sources).
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Communication is so very important. There are multiple ways to communicate with me:
Epidemiologic surveillance is used in public and global health. For this Assignment, begin by locating a recent article about an outbreak of an infectious or communicable disease. The article can come from a newspaper or other source, but your paper must be supported with at least three scholarly sources of evidence in the literature which may include your text or course readings.
For this Assignment, review the following:
Link to 4000 Level Writing
https://academicguides.waldenu.edu/writingcenter/undergraduate/awe/4000
Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Communication is so very important. There are multiple ways to communicate with me:
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