Post a response to your Blog in which you describe at least two of the most important needs/challenges/issues in your community or organization. Why are these needs/challenges/issues important? Be specific. Then, recommend at least two practice changes or interventions you would suggest to address these needs/challenges/issues in your community or organization. Be sure to align your role as the DNP-prepared nurse to the competencies identified in the AACN Essentials.

• American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdfDownload DNPEssentials.pdf
• Andrew, N., Tolson, D., & Ferguson, D. (2008). Building on Wenger: Communities of practice in nursing.Links to an external site.Nurse Education Today, 28(2), 246–252. https://doi.org/10.1016/j.nedt.2007.05.002
• Cook, D. A., Pencille, L. J., Dupras, D. M., Linderbaum, J. A., Pankratz, V. S., & Wilkinson, J. M. (2018). Practice variation and practice guidelines: Attitudes of generalist and specialist physicians, nurse practitioners, and physician assistants.Links to an external site. PLOS ONE, 13(1), e0191943. https://doi.org/10.1371/journal.pone.0191943
• Fukuda, T., Sakurai, H., & Kashiwagi, M. (2020). Efforts to reduce the length of stay in a low-intensity ICU: Changes in the ICU brought about by collaboration between Certified Nurse Specialists as head nurses and intensivists.Links to an external site. PLOS ONE, 15(6), e0234879. https://doi.org/10.1371/journal.pone.0234879
• Kislov, R., Walshe, K., & Harvey, G. (2012). Managing boundaries in primary care service improvement: A developmental approach to communities of practice.Links to an external site.Implementation Science, 7(97), 97–110. https://doi.org/10.1186/1748-5908-7-97

RUBRIC FOR GRADING

 Subjective Documentation in Provider Note Template: Subjective narrative documentation in Provider Note Template is detailed and organized and includes: Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS)ROS: covers all body systems that may help you formulate a list of differential diagnoses. You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe. =  Documentation is detailed and organized with all pertinent information noted in professional language….Documentation includes all pertinent documentation to include Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS). 

 Objective Documentation in Provider Notes – this is to be completed using the documentation template that is provided. Document in a systematic order starting from head-to-toe, include what you see, hear, and feel when doing your physical exam using medical terminology/jargon. Document all normal and abnormal exam findings. Do not use “WNL” or “normal”. You only need to examine the systems that are pertinent to the CC, HPI, and History. Diagnostic result – Include any pertinent labs, x-rays, or diagnostic test that would be appropriate to support the differential diagnoses mentioned. Differential Diagnoses (list a minimum of 3 differential diagnoses). Your primary or presumptive diagnosis should be at the top of the list (#1). =  Documentation detailed and organized with all abnormal and pertinent normal assessment information described in professional language….Each system assessed is clearly documented with measurable details of the exam. 

Choose a patient-care situation in which the RN should intervene and advocate for the patient.  An example of such a situation might be when a patient has not been given complete informed consent.

• Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.
• Apply the Bioethical Decision Making Model to the specific clinical ethical situation that you choose. Address each section of the model. Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.  

You must reference and cite 1-2 scholarly sources other than your text. Include a title page and a reference page to cite your text and adhere to APA formatting.

 The four principles, especially in the context of bioethics in the United States, has often been critiqued for raising the principle of autonomy to the highest place, such that it trumps all other principles or values. How would you rank the importance of each of the four principles? How do you believe they would be ordered in the context of the Christian biblical narrative? Refer to the topic Resources in your response. 

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