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Assignment 1
This competency assessment assesses the following Outcome(s):
MN502M1-1: Apply a conceptual framework focused on advanced nursing roles.
Introduction
Nursing science is developed through the work of nurse scientists and theorists who describe and explain what nursing is and what nurses do. Important to the development of nursing science are the foundational structures of nursing:
Conceptual frameworks and grand theories of nursing, which are more abstract, give the disciple a unique perspective of the metaparadigm concepts and provide a path for more concrete theory development.
Directions
In this assessment, you are going to locate a conceptual framework or grand theory that you could use in advanced nursing practice. After explaining it, you will then describe how your chosen conceptual framework or grand theory of nursing relates to each of the metaparadigm concepts of person/client, nurse, health, and environment as described by the theorist. Lastly, you will apply the conceptual framework or grand theory to advanced nursing roles. In particular, how does this conceptual framework or grand nursing theory apply to advanced nursing practice, education, and research?
Assessment Details
Minimum Submission Requirements
If the work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision. If the work submitted does not meet the minimum submission requirements by the end of the term, you will receive a failing score.
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Grand theories and conceptual frameworks define the nursing practice, why, and why nurses do what they do. Grand theories provide frameworks related to health components. Most of these theories result from the individual’s experience in care delivery. Their postulations align with empirical evidence, and their implementation leads to improved professional practice (Mintz-Binder, 2019). Grand theories have broad scopes of applicability and widespread acceptability in nursing practice (Mintz-Binder, 2019). Sister Callister Roy is a grand nursing theorist and the proponent of Roy’s adaptation model. This paper expounds on nursing metaparadigms, Roy’s adaptation model, its explanation of nursing metaparadigms, and its application to advanced nursing practice.
Metaparadigms are a framework of theories or ideas that outline the structure of a discipline’s function (Bender, 2018). There are four nursing metaparadigms; person, environment, nursing, and health—the metaparadigms focus on the nursing core value of caring and holistic patient care. The person component refers to the care recipient and the people connected to them, such as their family. Care systems focus on spiritual, social, and health needs. The individual’s physical and social interactions determine their health. The environment component consists of factors that affect an individual’s health. These internal and external influences include social interactions, culture, economic condition, and physical environment (Bender, 2018). These conditions can be modified to improve a patient’s wellness. The health component entails the degree of wellness and access to health that an individual has. The component focuses on how a holistic approach that involves spiritual, social, emotional, and intellectual is leveraged for maximum health benefits (Mintz-Binder, 2019). Nursing is the last component, and it comprises promoting optimal patient health outcomes through mutual agreement and collaboration in a conducive care environment. These components of the nursing metaparadigm outline the structure of nursing practice.
The grand theory of choice is Roy’s adaptation model. The theory’s central idea is adaptation. Roy states that an individual’s health depends on their adaptation to the environment. The four modes for adaptation are physiologic, self-concept, role function, and interdependence modes (Callis, 2020). According to Roy, these modes produce behaviors classified as adaptive or ineffective responses depending on their ability to produce the desired results. The theory holds that the patient is an adaptive system that responds to stimuli (environment) and adapts (goal of nursing) to promote their health and well-being (Roy, 2019). In addition, Roy holds that patients’ values and beliefs should be respected
The theory’s primary goal is to promote integrating adaptation levels for patients to advance their quality of life and ensure death with dignity (Callis, 2020). Nurses utilize the theory to modify the environment and assist the individual in adapting to the environment to promote their well-being. The model applies to various areas of nursing such as patient care, nursing research, and research education and entails care throughout all the stages of life.
Roy explained the person component as a bio-psycho-social being in constant interactions with the surroundings (environment). The person can be an individual, family, community, or society and uses innate and external mechanisms to adapt. Despite being an adaptive system, the patient is a living being and should be treated with dignity even in death. The person is the focus of care. The individual is explained as a conglomeration of differently functioning parts that work in unity and affect the person’s health. Roy describes the environment component as the immediate surrounding confronting the person. They are all the conditions, influences, contexts, interactions, and circumstances affecting an individual’s behavior and development (Harris, 2021). According to Roy, health is an inevitable life dimension accurately explained using a health-illness continuum. It is both a state and process of integrating the various areas that determine its wholeness (Harris, 2021). Nursing, according to Roy, is a system that helps individuals adapt to the environment. It promotes adaptation using the four adaptive modes. Nursing assesses behaviors and influences that negatively or positively affect adaptive abilities and intervene to ensure personal benefits from their interactions with the environment (Harris, 2021).
The core of the nursing profession is caring, and advanced nursing increases their knowledge and skills to provide better quality care. The model increases the discipline’s fund of knowledge by provoking nurses to improve their practice (Roy, 2019). Nurses with advanced knowledge and skills better understand their patients’ problems and better understand their environments. Advanced practice nurses have more knowledge and teach patients to add or portray better adaptive behavior in disease management (Tesh, 2019). APRNs also have advanced skills and can manipulate the ‘environment’ to enhance patient recuperation and holistic care delivery. In addition, RAM is vital in research that involves understanding and modifying human behavior because it focuses on manipulating the environment and utilizing the patient as an adaptive system (Callis, 2020).
RAM is integral in psychiatric/mental health advanced practice nurses. The first-line treatment for most mental health illnesses is cognitive behavior therapy, focusing on adaptation. Understanding the coping processes is the basis of effective patient teaching and optimum patient outcomes. PMH-APRNs have advanced knowledge and skills in understanding, explaini9ng, and modifying human behavior. RAM deeply interacts with PMH-APR in gathering patient data, understanding human behavior and error sources, tentative behavior judgment, and many other roles (Keliat et al., 2020). Sister Callista Roy’s adaptation theory is thus essential to advanced nursing practice roles, especially psychiatric/ mental health roles.
Grand theories provide essential frameworks in guiding nursing practice activities. The nursing metaparadigms outline the core concepts in nursing, and Roy’s model focuses on adaptation as the core of human wellness. Roy views health as the interaction of a person with the environment and the person’s ability to cope with the environment. Nurses play a significant role in understanding the intrinsic and external factors affecting coping and assisting the individual in coping, thus sustaining optimal health. Roy’s adaptation model provokes nurses to seek knowledge and understand patients and their environments for proper care. Hence, the theory is vital in advanced practice roles, especially psychiatric/mental health.
Bender, M. (2018). Re?conceptualizing the nursing metaparadigm: Articulating the philosophical ontology of the nursing discipline that orients inquiry and practice. Nursing Inquiry, 25(3), e12243 https://doi.org/10.1111/nin.12243
Callis, A. M. B. (2020). Application of the Roy Adaptation Theory to a care program for nurses. Applied Nursing Research, 56, 151340. https://doi.org/10.1016/j.apnr.2020.151340
Harris, R. (2021). Sister Callista Roy: Adaptation Model. Nursing Theorists and Their Work (10thEd.). E-Book, 247.
Keliat, B. A., Riasmini, N. M., Daulima, N. H. C., & Erawati, E. (2020). Applying the community mental health nursing model among people with schizophrenia. Enfermería Clínica. https://doi.org/10.1016/j.enfcli.2020.10.024
Mintz-Binder, R. (2019). The connection between nursing theory and practice. Nursing made Incredibly Easy, 17(1), 6-9. https://doi.org/10.1097/01.NME.0000549615.05397.55
Roy, C. (2019). Nursing knowledge in the 21st century: Domain-derived and basic science practice-shaped. Advances in Nursing Science, 42(1), 28-42. https://doi.org/10.1097/ANS.0000000000000240
Tesh, A. (2019). Nursing Theory: The Basis for Professional Nursing. Professional Nursing E-Book (9th Ed.). Concepts & Challenges, 198.
This competency assessment assesses the following Outcome(s):
MN502M2-2: Apply a model of practice to the advanced nurse roles.
Introduction
Theoretical Models used in Practice
A model demonstrates the theorist’s interpretation of how concepts are related to one another and are developed. Models are frequently illustrated with a graphical representation. Theoretical statements, the characteristics of the model, are used as precursors to more specific theory development. Nursing may utilize theoretical models from a variety of other disciplines such as from sociology, business, organizational leadership, biomedicine, or education.
Directions
In this assessment, you will:
• locate a model from a different discipline (other than nursing) that you could apply to nursing. Theoretical models can be found in a variety of other disciplines such as leadership, business, education, technology, sociology, etc.
• explain why you have chosen the model
• apply the model to your advanced practice role.
Assessment Details
Minimum Submission Requirements
• This assessment should be a Microsoft Word document and contain 3-4 pages of content in addition to the title and reference pages.
• Five (5) credible sources of support are required. Use your textbook, the Library, and the internet for research.
• Use APA 7th Edition for format and style.
• Respond to the questions in a thorough manner, providing specific examples of concepts, topics, definitions, and other elements asked for in the questions.
• Your writing should be well ordered, logical, and unified, as well as original and insightful.
• Your submission should provide a clearly established and sustained viewpoint and purpose.
• Your submission must be written in Standard English and demonstrate exceptional content, organization, style, and grammar and mechanics.
• Review the writing resources for APA 7th edition formatting and citation found in Academic Tools. Additional writing resources can be found within the Academic Success Center.
This competency assessment assesses the following Outcome(s):
MN502M3-3: Apply a model of practice to advanced nursing roles.
Introduction
There is a strong relationship between nursing theory, research, and practice. Nursing theory is foundational to nursing research and practice, and theory is also informed and developed by the results of research and practice. Nurses may select a theory to describe or explain phenomena encountered in practice, and during application in practice the theory is further defined. Nurse researchers test theories’ applicability in practice through clinical research, and nurse scientists develop new theories to explain research findings.
Directions
In this assessment, you will identify a grand nursing theory used in a research article and a middle-range nursing theory used in a research article. You will examine how each theory was applied within the respective research study and then analyze the utility of grand and middle-range nursing theories to advance the discipline of nursing and its impact upon your advanced nursing practice.
Assessment Details
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Nursing practice is grounded on theory and research. Several major theories in nursing inform nursing practice and nursing education. Practices, research, and education programs founded on theoretical frameworks have various characteristics that promote aspects of the nursing profession. The research outcomes, shaped by these theories, vividly portray the differences in these theories. Theories can inform advanced nursing roles in education, practice, and research. This essay evaluates the application of grand and middle theories in nursing research and their differences, the importance of theories to FNP, and research to nursing practice.
Grand theories address significant areas of concern in nursing, addressing a variety of propositions and concepts in nursing (Roy, 2018). Middle-range theories focus on a concept and not the whole discipline and often have the concepts name in the title, for example, The self-care theory. Practice-level theories are narrower and more specific than grand and middle-range theories and address particular problems or interventions. Theories at this level are the best in proposing best nursing practices and best solutions or strategies for specific problems.
The major difference between grand theories and middle-range theories is that those grand theories provide a comprehensive scope of concept abstracts, most often the discipline as a whole. In contrast, middle-range theories focus on an aspect of nursing and often result from the research (Roy, 2018). The concepts in middle-range theories tend to be more focused and can be hypothetically tested. Grand theories can be tested, but their abstractness makes them challenging. Thus, middle-range theories are a product of grand theories and nursing practice. These theories all inform nursing practices, education, and research, as shall be explored in other paper sections.
Sister Callister Roy is a grand nursing theorist who developed the grand theory- Roy’s adaptational model (RAM). RAM’s conceptual framework focuses on an interconnected and holistic view of an individual’s interaction with the environment. Its primary focus is manipulating the patients’ environment to promote their health and holistic well-being. Dharma et al. (2018) carried out a study to investigate the effect of a caregiver educational program based on RAM. The study utilized the adaptation themes as a framework for their educational interventions. RAM was used to explain the stroke patient adaptation process.
The education program is based on RAM’s postulation that the human being is an adaptive system capable of adapting to various situations across the lifespan (Dharma et al., 2018). In addition, using coping strategies leads to an adaptive response. The researchers found themes of adaptive responses, which they divided into stressors or stimuli, adaptive coping strategies, and effective adaptation behavior and integrated them with RAM (Dharma et al., 2018). They then decided on the best medical and educational interventions based on merit. The education content also borrows from RAM postulations and focuses on increasing patients’ and their families’ adaptive responses, coping with various disabilities, and resuming optimal life post-stroke. The research utilizes the theory’s abstractions and postulations to develop an effective education program for post-stroke patients.
Jean Watson is a mid-range nursing theorist and the proponent of Watson’s Theory of Human Caring. The theory postulates that humans cannot be treated as objects or be separated from others, self, nature, or. The theory primarily applies to interpersonal relationships, especially the nurse-patient relationship. Evangelista et al. (2021) carried out an explorative qualitative study to analyze nurses’ role in palliative care, especially spiritual care, utilizing the mid-range theory- Watson’s theory of human caring. The research observes the principles of intentionality, authentic presence, and caring to safeguard humanity. The researchers describe that showing care rejuvenates a patient’s strength, leading to optimal life and a calm dying process (Evangelista et al., 2021). It also improves their quality
Assignment 1
This competency assessment assesses the following Outcome:
MN504-1: Discover evidence based data used in clinical practice.
Assignment Details – Discover Evidence-Based Data Used in Clinical Practice
Purpose:
This assignment helps identify areas of clinical interest that you may have in integrating evidence into the population of interest. You will begin to find evidence as it relates to your practice of interest. (FNP)
An introduction, discussion, and conclusion are expected in the overview on this topic.
Directions:
Minimum Submission Requirements
If the work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision. If the work submitted does not meet the minimum submission requirements by the end of the term, you will receive a failing score.
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METIdentified three evidence-based references to formulate a valid clinical question [Clearly Identified three relevant evidence based references related to a clinical question] Defined the clinical question. [Succinctly defined the clinical question as it relates to the topic] Summarized evidence for PICOT [Clearly and precisely summarized the evidence for the PICOT] Identified relevant databases [Clearly identified databases relevant to the clinical question] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the course outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
Family Nurse Practitioners are important practitioners in primary care. Unlike other advanced practice nurses, they do not work with a specific population and thus function as general specialists in primary care. They identify gaps in care delivery for all populations across the lifespan. Their advanced knowledge and skills make it possible to provide advanced care to diverse populations. An FNP analyzes current problems and prepares well-structured and highly efficient care plans for the healthcare problems. Diabetes is a significant healthcare problem with high healthcare costs and mortality and morbidity rates. This essay analyzes a diabetes clinical question, reviews useful databases for research, and presents formidable data for the clinical question.
Clinical Question: Among elderly diabetic patients, does standardized patient education compared to traditional education improve self-management, adherence to interventions, and follow-up visits in six months?
Nursing research requires various considerations to ensure the data is reliable, relevant, and applicable. Thus, identifying the best and most relevant databases is vital in getting quality evidence. For diabetes care, there are several reliable and relevant databases. These databases include PubMed (NCBI), CINAHL Plus with Full Text (EBSCO), Academic Search Complete (EBSCO), and Cochrane Library (Wiley) (Welch Medical Library, 2021). PubMed (NCBI) is a database developed and managed by the national center for biotechnology information. The database is a free search engine containing medical-related articles, abstracts, and references. PubMed’s main aim is to improve health both globally and personally hence it has a collection of healthcare research articles that provide reliable evidence for application in managing healthcare problems. The database is reputable in providing all kinds of publications. However, the primary resources are rather wide-spreading, making accreditation and filtration of these resources difficult. Thus, the website may not be a reliable source of evidence.
CINAHL Plus with Full Text (EBSCO) database provides the top available nursing literature and other closely related health disciplines (Welch Medical Library, 2021). The database is vital because it allows for full-text nursing literature, not readily available in other databases. The researchers get all information without incurring costs or being limited by less available knowledge. The articles available are also peer-reviewed, making them reliable and applicable. Academic Search Complete (EBSCO) database is a leading source of scholarly literature. The database is designed for institutions, and thus the database is accessible through the institution library. It contains literature from all disciplines, including social sciences. The database has a higher preference for high-level evidence articles such as systematic reviews and randomized control trials. The articles in this database are also full text making it easy to read, understand, and apply evidence.
Cochrane Library (Wiley) is the database of choice for the Picot question. The database collects systematic reviews, which provide the highest level of evidence in research and evidence-based practices evaluation and implementation (Welch Medical Library, 2021). The systematic reviews identify an intervention for a healthcare condition or problem and analyze evidence to determine the effectiveness of the intervention. The database is free and open, with open access to majorly of the research articles. They are critically filtered and reviewed before being published, making the database a globally recognized and reputable database for systematic reviews in healthcare. These databases are vital for providing evidence for developing the PICOT question.
Diabetes is a severe clinical problem. It is the most expensive chronic illness and has a high mortality and morbidity rate; hence it is a disease of clinical significance (Riddle & Herman, 2018). Diabetes care is palliative and requires the collaboration of the patient, primary caregivers, and healthcare providers (Lee et al., 2019). Diabetes education is a vital aspect of diabetes care. Most interventions in diabetes management depend on the patient. The quality of patient education determines their self-efficacy, self-management, and overall success in diabetes care. The components of diabetes education are insulin injection and injection sites, medications and side effects, diet, exercise, disease complications (for early identification and management), and patient follow-up interventions and their importance (Ghisi et al., 2021).
Traditional patient education has no clear framework for delivering the education. Healthcare providers teach patients about diabetes care, but there is a high possibility of ignoring or forgetting components. Ignoring some aspects leads to patient knowledge deficits hence deficiencies in self-care and self-management. Structured patient education is a formidable tool in ensuring patients receive education in all diabetic care interventions (Chatterjee et al., 2018). In addition, it ensures that patients receive uniform and quality care, hence better patient outcomes. The primary aims of diabetes management are stabilizing blood sugars, achieving therapeutic targets (HbA1c tests), increasing self-efficacy and self-management, and minimizing complications (Zheng et al., 2019).
Education removes negligent excuses and promotes ethical responsibility. Diabetes follow-up visits are also vital in diabetes management. The components of follow-up visits include diabetic foot and diabetic eye examinations, HbA1c tests, treatment modality evaluation, and drug replenishment (Lee et al., 2019). Individuals rely heavily on merit systems to gauge interventions. Emphasizing the importance of follow-up visits is integral to ensuring individuals take the initiative, plan, and attend these follow-up visits without fail. These interventions are essential to providing high-quality disease management and early detection and treatment of complications. According to Rahaman et al. (2018), diabetes education on foot care decreases diabetes foot complications and increases diabetes foot examinations rates. Educating patients will improve their care-seeking behavior. Diabetes education reminds patients of the importance of these follow-up visits and the consequences of attending follow-up visits.
As mentioned earlier, standardized nursing technologies ensure patients receive uniform education (Chatterjee et al., 2018). Preparing the education checklist will require advanced knowledge and skills. As an FNP, I will utilize my advanced knowledge and skills, care collaboration, and leadership skills to gain buy-in from the healthcare leaders and develop a diabetes education checklist for the institution. The checklist will be uploaded in the electronic health system and signed when education is delivered. The checklist will be part of diabetes patient care and stored in the patient falls for record purposes and future references.
FNPs are advanced practice nurses with advanced knowledge which can be used to improve the health outcomes of populations across the lifespan. Formidable databases that provide articles for evidence-based practice include PubMed, Cochrane Library, Academic Search Complete (EBSCO), and CINAHL Plus with Full Text (EBSCO). They have extensive collections of articles for interventions in diabetes care. Structured diabetic patient education improves adherence to medications, increases patient follow-up visits, and improves self-management and self-efficacy. Structured patient education is thus more effective than traditional patient education. Hospitals should utilize structured patient education and diabetes education checklist to help improve diabetic patient outcomes.
Chatterjee, S., Davies, M. J., Heller, S., Speight, J., Snoek, F. J., & Khunti, K. (2018). Diabetes structured self-management education programs: a narrative review and current innovations. The Lancet Diabetes & Endocrinology, 6(2), 130-142. https://doi.org/10.1016/S2213-8587(17)30239-5
Ghisi, G. L. D. M., Seixas, M. B., Pereira, D. S., Cisneros, L. L., Ezequiel, D. G. A., Aultman, C., Sandison, N., Oh, P., & da Silva, L. P. (2021). Patient education program for Brazilians living with diabetes and prediabetes: findings from a development study. BMC Public Health, 21(1), 1-16. https://doi.org/10.1186/s12889-021-11300-y
Lee, D., & Zonszein, J. (2022). Outpatient Management of Type 2 Diabetes Mellitus. In A Case-Based Guide to Clinical Endocrinology (pp. 369-385). Springer, Cham. https://doi.org/10.1007/978-3-030-84367-0_40
Rahaman, H. S., Jyotsna, V. P., Sreenivas, V., Krishnan, A., & Tandon, N. (2018). Effectiveness of a patient education module on diabetic foot care in outpatient setting: An open-label randomized controlled study. Indian Journal of Endocrinology and Metabolism, 22(1), 74. https://dx.doi.org/10.4103/ijem.IJEM_148_17
Riddle, M. C., & Herman, W. H. (2018). The cost of diabetes care—an elephant in the room. Diabetes Care, 41(5), 929-932. https://doi.org/10.2337/dci18-0012
Welch Medical Library (2021). Databases for Nursing Research. Nursing Resources. The John Hopkins University of Medicine. https://browse.welch.jhmi.edu/nursing_resources
Zheng, F., Liu, S., Liu, Y., & Deng, L. (2019). Effects of an outpatient diabetes self-management education on patients with type 2 diabetes in China: a randomized controlled trial. Journal of Diabetes Research, 2019. https://doi.org/10.1155/2019/1073131
This competency assessment assesses the following Outcomes:
MN504-2: Examine the key elements of evidence based practice.
Assignment Details – Descriptive Statistics Overview
Purpose:
The purpose of this assignment is to review the statistics presented in the articles you reviewed in relation to your clinical topic. You will provide a brief overview of statistics in the studies.
Directions:
Minimum Submission Requirements
If the work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision. If the work submitted does not meet the minimum submission requirements by the end of the term, you will receive a failing score.
Textbook Readings
Evidence-Based Practice in Nursing and Healthcare
Journal Readings
Please retrieve and read the following Journal articles from the Library. Articles can be located through a search in the CINAHL database, OVID database, Course Resources, or by using the link at the end of the reference if provided.
Jesson, J., & Lacey, L. (2006). How to do (or not to do) a critical literature review. Pharmacy Education, 6(2), 139–148.
Pierce, L. (2009). Twelve steps for success in the nursing research journey. Journal of Continuing Education in Nursing, 40(4), 154–164.
Salmond, S. W. (2007). Advancing evidence-based practice: A primer. Orthopedic Nursing, 26(2), 114–125.
Schardt, C., Adams, M. B., Owens, T., Keitz, S., & Fontelo, P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Medical Informatics & Decision Making, 7(1), 16–26
Web Resources
Review the following website, specifically the Continuing Education articles under Tools and Resources, and the About Us section.
Review the sites below that detail ongoing research efforts.
Review the NCQA website, paying special attention to the clinician’s website, specifically the Patient Experience Reporting section.
It is expected that you spend approximately 1–2 hours reviewing this resource.
Practice
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METDefined key clinical question with reference to evidence-based databank (for example, Pubmed, Medline, CINAHL, etc). [Clearly defined the key clinical question as it relates to the evidence] Reviewed database results (based on key clinical question search) [Succinctly reviewed database detailed results] Referenced randomized control study research and systematic review of randomized control studies (Level 1 and 2 Evidence). [Clearly referenced randomized control study research studies , representing Level 1 and 2 of evidence with clarity] Provided an overview of the evidence using descriptive statistics, including the sample size, p-factor and strength of evidence. Clearly provided and overview of the evidence with descriptive statistics used throughout to define the strength of the evidence and study. Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the course outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
CLA and Grade Criteria Chart
CRITERIACLA ScoreGradePointsMeets all bold criteria and 50%-100% of mastery criteria5A1,000Meets all bold criteria and 0%-49% of mastery criteria4B850Meets 75%-99% of bold criteria3Not yet competent (F at term end)0Meets 50%-74% of bold criteria2Not yet competent (F at term end)0Meets 1%-49% of bold criteria1Not yet competent (F at term end)0Meets no bold criteria0Not yet competent (F at term end)0No submissionNANot yet competent (F at term end)0MN504-3: Differentiate statistical output for data analysis.
Assignment Details
Evidence-Based Clinical Question Search Assignment
Purpose:
The purpose of this assignment is to give you a practical application to implement your compelling clinical question idea, supported by the evidence-based research you have obtained during your systematic review. You will apply evidence-based research findings discovered from your clinical question, and then integrate those to support your suggested change in nursing practice.
Directions:
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METDescribe systematic review and include an errors analysis. [Clearly described the systematic review with errors analysis integrated] Summarize the case study (RCT) selected including the study approach, sample size, and population studied. [Clearly summarized the case study with a detailed overview of case details such as sample size, control group, and study approach] Evaluate the study outcomes, identifying the validity, reliability, and bias. [Provide a clear description of the study including any unique approach, reliability, validity, and bias noted] Apply the evidence from this review to your practice specifically in your overview. [Clearly applied the evidence from the review to practice including detailed descriptions of the study] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the course outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
CLA and Grade Criteria Chart
CRITERIACLA ScoreGradePointsMeets all bold criteria and 50%-100% of mastery criteria5A1,000Meets all bold criteria and 0%-49% of mastery criteria4B850Meets 75%-99% of bold criteria3Not yet competent (F at term end)0Meets 50%-74% of bold criteria2Not yet competent (F at term end)0Meets 1%-49% of bold criteria1Not yet competent (F at term end)0Meets no bold criteria0Not yet competent (F at term end)0No submissionNANot yet competent (F at term end)0Clinical questions help improve nursing practice, education, and research. They require extensive research to validate or refute claims and gain insight into the topic to ensure it is of high quality and efficacy. A proper analysis of randomized control trials provides high-level evidence, and their results are applicable in various ways in healthcare settings. The information can also be used in various ways to inform care interventions. Advanced practice nurses are majorly managers of the healing environment, and they utilize research to prepare and improve care interventions. They also utilize their knowledge, skills, and positions to improve healthcare institutions and care delivery. This essay evaluates a clinical question and supporting literature and utilizes the evidence to improve FNP practice.
Among elderly diabetic patients, does standardized patient education compared to traditional education improve self-management, adherence to treatment modalities, and follow-up visits in six months? This short review evaluates evidence that informed the clinical question and any modifications to ensure the change is impactful and relevant to the selected healthcare settings. The review also gives reasons and insights that led to the development of the question. Diabetes among elderly patients is a rummaging condition, affecting about 20-30% of adults above 65 years old (Sinclair et al., 2020). The condition is also very expensive due to the daily treatment modalities such as insulin. In addition, elderly patients have declining cognitive, physical, and physiologic functions primarily due to old age and associated conditions. Decreasing immunity, physiologic function, and activity are leading causes of poor prognosis in managing diabetes in the elderly. Thus, the group is exposed to higher mortalities and morbidities than other groups creating the need for vigorous management.
Standardized or structured patient education is education based on a checklist or education tailored to meet all patient needs and offer vital skills and knowledge. It focuses on the outlined components of health education that are carefully selected and appraised as vital to achieving the desired output (Chatterjee et al., 2018). For example, the care provider can teach patients specific exercises for older adults considering their physical and physiologic limitations instead of just telling them to exercise, as in traditional patient education. It is organized in chronological order of relevance and importance to promote patient understanding and minimize time wasted gathering education materials (Ernawati et al., 2021). The checklist also provides a vital follow-up tool that improves professionals’ responsibility and adherence to the interventions. Traditional education lacks order of education increases the chances of missing out on information or the education exercise because it provides no care provider follow-up intervention. Thus, structured education is integral for diabetic patients to promote better health outcomes.
The disease is preventable through education and collaborative intervention between healthcare providers and patients. Knowledge and skills to manage diabetes are vital. Educating patients to help ensure they adhere to routine medication administration, diet/ eating habits, and exercise/ physical activity. Individuals with skills have a likelihood of utilizing them (self-efficacy). Treatment adherence is also expected to increase when patients learn the importance of adhering to the modalities. Diabetes complications are notorious and take a long to manage, and thus, it is vital to prevent them (Ghisi et al., 2021). They are prevented through up and periodic visits to determine patterns leading to their development and thus preventing them from developing early in their development stages. Diabetes follow-up entails diabetic foot examination, eye examination, and HbA1c tests. Educating patients helps them understand the importance of adhering to these visits, thus increasing their adherence to follow-up care which helps prevent complications and promote effective glycemic control.
Diabetes management interventions take time to produce change. Individuals also take time to adapt to new interventions hence the need for six months. The change has been clearly and carefully crafted to produc
This competency assessment assesses the following Outcome(s):
MN505M1-1: Interpret epidemiologic data on morbidity and mortality related to acute and chronic disease states.
Individual Screening
Directions
Individual Screening
Review the clinician provider guidelines and recommendations of the United States Preventive Services Task Force A and B Recommendations. https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/
For the MSN-prepared nurse, knowledge of epidemiology and its application to preventive screening guidelines is important in many clinical areas: administrative, education, and nurse practitioner fields. Consider you are working in a clinic and need to order a preventive screening on a patient for one of the conditions listed below. While this is a preventive measure, it also can be a diagnostic tool in other circumstances. For this assignment, the screening is a secondary prevention measure.
Please select one screening below. Your screening methodology must come from the United States Preventive Services Task Force guidelines.
Condition and Screening
Epidemiology of Condition
Methodology
Guideline
Critical Analysis
Summary
Provide a summary conclusion of the screening guideline, general benefit to the individual and why it is important.
Format expectations:
Master’s-prepared nurse educators, leaders, nurse practitioners, and all specialty nursing fields contribute to health promotion in populations across the life span. You will demonstrate understanding and correct interpretations of preventive screening guidelines. You should be able to apply this knowledge to your specialty focus related to health promotion and epidemiology.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET MET Condition and screening Competency Condition and type of screening is appropriate. Mastery Condition and type of screening is clearly defined. Epidemiology of condition Competency Epidemiology of condition is present. Mastery Epidemiology of condition is well addressed; comprehensive and appropriate. Methodology Competency Methodology with screening measures and support are applied to a population addressing risks and related factors. Mastery Methodology with screening measures and support are properly applied to a specific population addressing risks and related factors. United States Preventive Services Task Force followed CompetencyGuidelines are identified and relate to the screening population, and some features per directions. MasteryGuidelines are identified and are relevant to the screening population, and key features per directions. Critical Analysis CompetencyConducts a preliminary literature review of the support used in the guideline. MasteryConducts a thorough literature review of the support used in the guideline. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Preventive healthcare is integral in preventing mortality and morbidity. Preventing health interventions range from primary to tertiary interventions. Health screening is essential as a preventative measure and also a diagnostic measure. Healthcare providers should assess patient needs to determine the best screening interventions for them. This essay evaluates a condition, the best screening intervention, and the supporting literature for the intervention.
The condition of interest is breast cancer. The choice screening is Cervical Cancer screening for women aged 21-65. Cervical cancer is the hyperproliferation of cervical epithelial cells. The type (name) and severity of cervix cancer depend on the affected cells and their location. Cervical cancers are named after the cells involved, and the major type of cervical cancer is squamous cell carcinoma. The choice screening is Cervical cancer screening: women aged 21 to 65. The risk for cervical cancer increases with age and other factors. USPSTF recommends screening for cervical cancer every three years with cervical cytology alone in women aged 21 to 29. For women aged 30 to 65 years, the USPSTF recommends screening every three years with cervical cytology alone, every five years with high-risk human papillomavirus (hrHPV) testing alone, or every five years with hrHPV testing in combination with cytology (co-testing) (Fontham et al., 2020).
Cervical cancers are the fourth most diagnosed/common cancer and the fourth leading cause of death. The five-year survival rate for cervical cancer differs in age, ethnicity, and race, with an average of 66%: 71% in white women and 58% in black women (Islami et al., 2019). In 2018, Cervical cancer was the leading cause of cancer death for women. However, the increase in diagnostic and preventive measures has greatly improved prognosis over the last 40 years, reducing mortality and morbidity. Around 600 000 cases and 300000 deaths are reported each year (Islami et al., 2019). Cervical cancer management entails surgical procedures, chemotherapy, and radiotherapy, emphasizing retention of reproductive system integrity. Cervical surgery and hysterectomy in metastatic cancer lead to loss of fertility and pelvic integrity. Thus, cervical cancer leads to mortalities and morbidity in a majority of the surviving population.
Cervical cancer screening among women between 21-65 is integral. The growth of reproductive system cells is under hormonal influence. The guideline addresses two risk factors which are sexual activity and hormonal regulations (Fontham et al., 2019). AS mentioned earlier, cell division and growth in the reproductive organs are dependent on hormonal levels. Hormonal imbalance may lead to hyperproliferation of cells creating cell abnormalities, hence cancer development. Infection of the cervix is prevalent in sexually active women because the human papillomavirus has to access the cervix to cause an infection (Kim et al., 2018). The risk is higher in women with higher parities hence the need for additional tests- cytology for women aged 30 to 65 years (Bookswofie et al., 2020). Hormonal regulation is absent or markedly decreased in women. Cytology studies study abnormal cells and diagnose them based on cell characteristics. Unlike other cancers, cervical cancer majorly involves squamous cells. A high vaginal swab collects cells for cytology from women in the mentioned age category. Testing for human papillomavirus is vital because HPV is the leading cause of infective cervical cancer; it causes over 99% of cervical cancers (Swiecki?Sikora et al., 2019).
The USPSTF recommended intervention in cervical cancer screening has three options: hrHPV, cytology, and co-testing. It recommends every three years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every three years with cervical cytology alone, every five years with high-risk human papillomavirus (hrHPV) testing alone, or every five years with hrHPV testing in combination with cytology (co-testing). Sexually active women are given more priority in this testing. HPV causes over 99% of all cervical cancers. The American Cancer Society updated the cervical cancer screening tests and recommended preliminary hrHPV testing as the preferred screening option for average-risk women aged between 25 and 65 years in 2020 (Fontham et al., 2020). It also recommends the rise of HPV tests to begin at age 25.
The hrHPV tests are preferred to diagnose cervical cancer but are associated with low specificity (hence a high number of false positives) and colposcopy (Bedell et al., 2020). Cytology alone has low sensitivity in detecting high-grade cervical intraepithelial neoplasia. According to Fontahm et al. (2020), hrHPV and cytology tests are recommended for women at higher risks for cervical cancer aged 25 to 65 years. ACS also recommends phasing out cytology testing due to their widespread shortfalls. The acceptability and application of hrHPV tests are limited by the small number of FDA-approved tests (there are only two FDA-approved tests apparently) and their costs. According to Guo et al. (2018), national rates of HPV vaccines have been increasing gradually, hence a gradual decrease in HPV infections and the corresponding cervical cancer rates. However, Swiecki?Sikora et al. (2019) state that the vaccination rates in the country fall way below the national targets. The vaccination coverage and vaccination resistance in the nation are high. Raising the age would place the vulnerable populations without HPV vaccine at risk for developing cervical cancer unnoticed. Thus, that consideration can be made after achieving national HPV vaccination targets. Despite expanding cervical cancer screening options, cervical cytology, hrHPV, and co-testing effectively diagnose precancer and cancerous lesions (Rerucha et al., 2018). Fontham et al. (2020) emphasize that the specific strategy is less important than the overall adherence to testing. Healthcare providers should stress the importance of adherence to cervical screening.
The screening guideline discussed above helps detect cervical cancer early, thus providing room for treatment. Women of reproductive age and post-menopausal women are the populations of interest due to the risk exposure. Cytology, hrHPV, and co-testing are the available cancer screening methods. These screenings also give room for health education to the clients. As seen above, adherence to these screening tests is more important than deciding on the test of choice because they are all effective. Preventing cancer development is integral to reduce the associated mortalities and morbidity.
Bedell, S. L., Goldstein, L. S., Goldstein, A. R., & Goldstein, A. T. (2020). Cervical cancer screening: past, present, and future. Sexual Medicine Reviews, 8(1), 28-37. https://doi.org/10.1016/j.sxmr.2019.09.005
Buskwofie, A., David-West, G., & Clare, C. A. (2020). A review of cervical cancer: incidence and disparities. Journal of the National Medical Association, 112(2), 229-232. https://doi.org/10.1016/j.jnma.2020.03.002
Fontham, E. T., Wolf, A. M., Church, T. R., Etzioni, R., Flowers, C. R., Herzig, A., Etzioni, R., Flowers, c. r., Herzig, A., Guerra, C. E., Oeffinger, K. C., Shih, T. C., Walter, L. C., Kim J. J., Andrews, K. S., DeSantis, E. C., Fedewa, S. A., Manassaram-Baptiste, D., Saslow, D., and & Smith, R. A. (2020). Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA: A Cancer Journal For Clinicians, 70(5), 321-346. https://doi.org/10.3322/caac.21628
Guo, F., Cofie, L. E., & Berenson, A. B. (2018). Cervical cancer incidence in young US females after human papillomavirus vaccine introduction. American journal of Preventive Medicine, 55(2), 197-204. https://doi.org/10.1016/j.amepre.2018.03.013
Islami, F., Fedewa, S. A., & Jemal, A. (2019). Trends in cervical cancer incidence rates by age, race/ethnicity, histological subtype, and stage at diagnosis in the United States. Preventive Medicine, 123, 316-323. https://doi.org/10.1016/j.ypmed.2019.04.010
Kim, J. J., Burger, E. A., Regan, C., & Sy, S. (2018). Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force. JAMA, 320(7), 706-714. https://doi.org/10.1001/jama.2017.19872
Rerucha, C. M., Caro, R., & Wheeler, V. (2018). Cervical cancer screening. American Family Physician, 97(7), 441-448. https://www.aafp.org/afp/2018/0401/p441.html
Swiecki?Sikora, A. L., Henry, K. A., & Kepka, D. (2019). HPV vaccination coverage among US teens across the rural?urban continuum. The Journal of Rural Health, 35(4), 506-517. https://doi.org/10.1111/jrh.12353
Community Needs and Health Screening Initiative
Directions
For this assignment, you will pick one recommended screening from United States Preventive Task Force A and B Recommendations.
An initiative is a project, an event, so something in the community is ideal. Workplace location for employees is fine too. Please include the following suggested level one headings so content is clear and easily identified.
Theory or Conceptual Model
Population Screening Purpose
Location/ Setting
Screening Activity
Screening activity plan meets the preventive guidelines process, is descriptive, and includes:
Cost
Detailed cost analysis to perform screening is provided in table form includes the six following line items but not limited to a table containing:
(May use volunteer staff but not donations of items. Cost analysis for feasibility needs demonstrated.) Cost analysis total and summary statement should be included.
Summary
Provide a summary of your screening, general benefit to the community, and why it is important. A person should be able to read your paper and understand fully what you are screening, where, when, the costs, and how it is supported in the guideline. Ideally, a person would be able to duplicate your screening initiative based on the clarity you present.
Format expectations:
Master’s-prepared nurse educators, leaders, nurse practitioners, and all specialty nursing fields are contributors to health promotion in populations across the life span. This assignment is focused on preventive screening applications in the community, workplace, or school settings. You should be able to apply this knowledge to their specialty focus related to health promotion and epidemiology.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET MET Conceptual model Competency A health promotion theory or conceptual model chosen. Mastery A health promotion theory or conceptual model chosen and applied to initiative. Population Screening purpose Competency Reason for screening population is noted via community statistics/ assessment data and supported in the guideline. Mastery Reason for screening population is explained in detail via community statistics/ assessment data and supported in the guideline. Location/Setting Competency Setting for screening is provided and is appropriate for community or workplace preventive intervention. Mastery Setting for screening is provided with details, and is appropriate for community or workplace preventive intervention. Screening Activity with Explanation of Outcome/Goals CompetencyScreening activity plan is included and lists some components. MasteryScreening activity plan is descriptive and includes all components Cost CompetencyCost analysis to perform screening is provided including table and components. MasteryDetailed cost analysis to perform screening is provided including table and components. Summary CompetencySummary includes components in directions including general benefit to the community. MasterySummary includes components in directions including general benefit to the community and why it is important. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
PC-4.3: Apply concepts of multiculturalism and diversity to become an agent of change.
Health Statistics and Populations
Directions
Consider you are preparing for a project to evaluate multicultural impact and diversity within a health condition. You will select a health topic of interest such as breastfeeding, domestic violence, or juvenile diabetes that affects a specific population such as older adults, women of reproductive age, or race diversity related to a condition. Locate health statistics for your selections. You must include national and state data, and may also include local county or city data if available.
Access the Assignment Grid. Follow the guide directions in the left-hand column of the grid for each section. Research content regarding concepts of multiculturalism and diversity, and include interventions that address health disparities.
Population of Interest and Condition
Search Process
Health Information
Research Findings
Summary
You will provide a summation of your review. Examples of concepts may include personal beliefs and values, the benefits of diverse perspectives, the importance of tolerance, etc. Provide examples of how to bridge cultural differences and build effective relationships for improved health outcomes on the topic.
Tab 2
Format Expectations
Carefully consider the directions in each section of the table. There should be substantive information in the last two sections particularly. Do not alter the left-hand column.
Master’s-prepared nurse educators, leaders, nurse practitioners, and all specialty nursing fields contribute to health promotion in populations across the life span. This assignment is focused on the analysis of epidemiological and health information, including illness prevention, risk factors disparities, and intervention. Students should be able to integrate these concepts in a multicultural context to their specialty focus related to health promotion and epidemiology.
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET MET Population of interest and condition Competency A population of interest and health condition or event are represented. The population and condition are present. Mastery A population of interest and health condition or event are clearly represented. The population and condition are clearly defined. Search process Competency The search process is summarized. Heath sources are presented. Mastery The searcThis competency assessment assesses the following Outcome(s):
MN506M1-1: Apply theoretical frameworks and concepts to ethical dilemmas in the advanced practice role.
Assessment Guidelines:
Based on your specialization, use the options below to create an ethical and legal decision-making dilemma involving an advanced practice nurse in the field of administration, education, or a nurse practitioner.
Apply relevant codes of conduct that apply to nursing and the chosen field of the APN.
Describe one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts.
Construct a decision that demonstrates integrity, and that would prevent violation of the ethical principle and prevent the law from being violated.
List three recommendations that will resolve advanced practice nurses’ moral distress in the dilemma you have presented. Support your paper with a minimum of three scholarly references.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METEthical-Legal Dilemma Competency Creates an ethical legal decision-making dilemma involving an advanced practice nurse. Mastery Ethical Legal decision-making dilemma has sufficient details, addresses the relevant field of the APN, and demonstrates critical thinking. Codes of Conduct Competency Applies relevant codes of conduct that apply to the practice of nursing and your chosen field. Mastery All codes of conduct are identified, all codes of conduct identified are relevant to the chosen APN field. Ethical Principles and Laws Competency Describes one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts. Mastery Describes one ethical principle and one law that could be violated. Identifies correctly if the violation would constitute a civil or criminal act based on facts. Decision Integrity Competency Constructs a decision that demonstrates integrity and that would prevent violation of the ethical principle, and prevent the law from being violated. Lists three recommendations that will resolve advanced practice nurses’ moral distress in the proposed dilemma. Mastery Describes three or more recommendations that will resolve advanced practice nurses’ moral distress in the dilemma presented. All recommendations are pertinent to the APN specialty area. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Ethical dilemmas are common in healthcare settings. Advanced practice nurses use their advanced nursing knowledge, skill, and judgement to solve ethical dilemmas and provide quality and safe care in primary care settings. Nursing codes of conduct and ethical principles guide nursing practice. Breaking some of these codes and principles may amount to criminal charges; thus, nurses pay hefty fines, lose licenses or serve some time in jail. This essay analyzes an ethical dilemma, nursing code of conduct, ethical decision-making, and recommendations to avoid moral distress.
Ms. Terry, a 16-year-old Hispanic American, comes to the outpatient department accompanied by her furious and fuming mother. She presents complains of lower abdominal pains, and the mother interjects care and claims that she suspects that her daughter is pregnant. The nurse requests Terry’s mother to go to the waiting room, to which she agrees after making demands that she should know all details about her condition. Inside the nurse’s room, Terry confirms that she has been involved in unsafe sex lately but uses a long-term family planning method, hormonal implants, which her mother does not know. She also asks the nurse not to share the information with the mother. She also adds that she feels pain in micturition has vagina discharge with a foul odor. On comprehensive assessment, the doctor diagnoses her with chlamydia and confides with the nurse to provide the best care to the patient. The nurse is torn between sharing this information with the parent because she is a minor or withholding it.
There are several codes of conduct that guide nursing practice. Some of the relevant codes of conduct are a) Nurses maintain public confidence in the nursing profession, b) Nurses act with integrity to maintain patients’ trust, and c) Nurses maintain patients’ trust by providing safe and competent care (Cowin et al., 2019). Nurses use their knowledge, skills, and judgment in assessing patient needs. They are also responsible for upholding relevant laws and regulations regarding patient care. Maintaining patient privacy and confidentiality is paramount. Failure to fulfill these requirements have criminal/law implications. Nurses act promptly to protect and prevent patient harm. These actions include failure to share patients’ information inappropriately. Nurses should understand that they are responsible for their actions. They are also responsible for their health and should take corrective measures when they perceive that the health problems will affect their ability to provide safe and quality patient care (Gágyor et al., 2019). Lastly, nurses should communicate clearly and detail the care interventions and discuss them with their patients.
Confidentiality is an ethical principle that could be violated in this situation. The patient confided in the nurse and doctor. Being a minor, her mother demanded to know everything about her care. Confidentiality breaches can be acceptable in some instances, especially when withholding that information can cause severe harm to patients and others (Pathak & Chou, 2019). However, confidentiality is considered a criminal offense when it causes adverse effects on a patient’s health or safety. Minors have a right to confidentiality (though limited by their dependence on and the involvement of their parents in their care) (Pathak & Chou, 2019).
On the contrary, hospitals, in some instances, can be sued in courts of law for concealing information to prevent disclosure of the information under the Data Protection Act of 2018 section 173 (Price & Cohen, 2019). Healthcare institutions can also be sued for disclosing information that jeopardizes patient safety under the same act. However, care providers should ensure they provide data that does not jeopardize the client’s or institution’s safety.
Most states, including this state, say that when adolescents are old enough and give instructions regarding sharing their information, it is regarded as confidential. In this situation, the best decision is to determine the administrative laws and policies if they conform to the state provisions and make a judgment based on those policies (Rainer et al., 2018). This situation involves severe risk to the nurses’ job and their licenses. Thus, there is a need to ensure the institutional and state laws allow confining of the health information.
The national association of clinical nurse specialists (NACNS) recognizes that nurse specialists face many ethical dilemmas in ethical dilemmas. These recommendations for moral distress are derived from the 4Rs moral distress strategy. The first recommendation is for the nurse to determine the severity, possible consequences of various actions, and attitudes of everyone (Shukla et al., 2019). This step helps the APN to make the right decision and avoid distress. The next recommendation is detaching personal feelings, views, and experiences from the situation. This step helps prevent stress bias in decision-making. The last recommendation is staying open to other people’s opinions and approaches and accepting their perceptions (Shukla et al., 2019). The FNP can include the interprofessional team in decision-making to ensure they make the best decision to minimize moral distress associated with ethical dilemmas.
Adolescents in the US are not protected by the laws in the confidentiality of their information. However, some state laws protect their information, as seen above. FNPs should understand laws and regulations that regulate nursing practice and certain ethical dilemmas. These laws help avoid law violations that could jeopardize their practice. They should also intentionally enhance their psychological health to ensure moral distress does not affect their practice.
Cowin, L. S., Riley, T. K., Heiler, J., & Gregory, L. R. (2019). The relevance of nurses and midwives code of conduct in Australia. International Nursing Review, 66(3), 320-328. https://doi.org/10.1111/inr.12534
Gágyor, I., Heßling, A., Heim, S., Frewer, A., Nauck, F., & Himmel, W. (2019). Ethical challenges in primary care: a focus group study with general practitioners, nurses and informal caregivers. Family Practice, 36(2), 225-230. https://dx.doi.org/10.1093/fampra/cmy060
Pathak, P. R., & Chou, A. (2019). Confidential care for adolescents in the US Health Care System. Journal Of Patient-Centered Research And Reviews, 6(1), 46. https://dx.doi.org/10.17294/2330-0698.1656
Price, W. N., & Cohen, I. G. (2019). Privacy in the age of medical big data. Nature Medicine, 25(1), 37-43. https://doi.org/10.1038/s41591-018-0272-7
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461. https://doi.org/10.1111/jocn.14542
Shukla, R., Baker, R., Moody, K., & Allen, J. (2019). Improving Moral Distress and Provider Perceptions with an Integrated Palliative Care Conference in the Neonatal Intensive Care Unit (NICU)(TH370B). Journal of Pain and Symptom Management, 57(2), 394-395. https://doi.org/10.1016/j.jpainsymman.2018.12.092
This competency assessment assesses the following Outcome(s):
MN506M2-2: Analyze ethical-legal principles and dilemmas related to health care.
Using the information from the case study (below), discuss the following issues from the perspective of an APN role:
Standards of care — Which standards of care were violated and who was responsible?
In your role as an educator, administrator, or practitioner, what risk management steps should be taken before or after the incident to alleviate the issue?
Case Study: Malpractice Action Brought by Yolanda Pinellas
Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.
During the evening shift, the infusion pump began to beep. The RN found that the IV was dislodged, discontinued the infusion, notified the physician, and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons, and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an IV infiltration.
Two weeks after the event, the patient developed necrosis of the hand, required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient alleges that she is no longer able to perform as a musical conductor because of this.
While reviewing charts, the risk manager noted that there were short-staffing issues during the 3 months prior to this incident, and many nurses were working double shifts (evenings and nights) then coming back to work the evening shift again. The risk manager also noted a pattern of using float nurses among several units.
Assessment Requirements:
Before finalizing your work, you should:
Your writing assessment should:
Minimum Submission Requirements.
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METRole of the APN Competency Identifies the role of the APN, content of paper pertains to the identified role. Identifies all standards of care violations pertaining to the identified APN role (administrator, practitioner, or educator). Clearly identifies who violated the standards of care, and how the standards of care were violated. Mastery The individuals responsible for the violations were identified. Each individual’s standards of care violation is described, including how the violation happened. Risk Management Steps Before Competency Identifies risk management steps relevant to the APN role (Administrator, Practitioner, or Educator) before event to prevent such adverse events. Mastery All risk management measures described are relevant to the APN role identified. Risk Management Steps After Competency Identifies risk management steps to be taken that are relevant to the APN role (Administrator, Practitioner, or Educator) after event to prevent future adverse events. Mastery All risk management steps described are relevant to the APN role identified. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
his competency assessment assesses the following Outcome(s):
MN506M3-3: Analyze the effects of contemporary health policy on providers and consumers.
For this assessment, select a local or state health care policy or legislation that was enacted in the last 5 years. Then:
To view the Grading Rubric for this assessment, please visit the Grading Rubrics section of the Course Resources.
Assessment Requirements:
Before finalizing your work, you should:
Your writing Assessment should:
How to Submit:
Submit your assessment to the unit Dropbox before midnight on the last day of the unit.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METPolicy Identification & Summary Competency Identifies a healthcare policy/legislation, names the policy/legislation and the date of implementation, identifies the state, county or local area pertaining to the policy. Summarizes policy/legislation, all relevant facts are included, and the role of the APN is integrated throughout the paper. Analyzes one strength and one weakness of the policy/legislation. Mastery Identifies and analyzes one strength and one weakness of the policy/legislation. The strength and weakness identified are significant and has major impact on the providers and consumers. Policy Impact on Consumer Stakeholders Competency Discusses impact of policy on all consumer stakeholders. Mastery All the consumer stakeholders are identified, positive and negative impacts are discussed. Policy Impact on Provider Stakeholders Competency Discusses impact of policy on all provider stakeholders. Mastery All the provider stakeholders are identified, positive and negative impacts are discussed. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Healthcare institutions function under laws, policies, and regulations. These policies and regulations are dynamic and keep changing with changing demands to meet the consumer and provider needs. They also ensure that all individuals receive care with maximum benefit. Advanced practice nurses should be aware of these regulations to implement them in their practice. When these policies arise, they affect consumers and care providers differently. Legislations are statutory laws put in place by the governing body or bodies. This essay discusses recent local/state healthcare legislation and its implications.
Falls are unplanned events that can be prevented because the major causes of falls are environmental factors such as poor lighting, lack of handrails, slippery floors, present obstacles, and high staircases; thus, individuals are unable to climb safely (Kiel et al., 2019). Falls, especially among elderly individuals, have increased lately, provoking the state governments to develop legislation and policies t