Discusssion

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APRNs are primary care providers, pivotal in providing primary health care and preventive services in communities. Advanced practice nursing is defined by the Nurse Practice Act but governed by the Board of Nursing in different states or territories. Where the Nurse Practice Act falls short in interpretation, the Board of Registered Nursing guides the form of an opinion (American Nurses Association, n.d.). Advanced practice nurses should understand how these laws and regulations shape practice.

            I am from California, and I chose Iowa for comparison. In both states, APRN nursing regulations allow advanced practice nurses to function as primary care providers with permission to certify disability pursuant to the unemployment insurance code section2708 (California Legislative Information, n.d.). Similarly, in both states, APRNs also sign POLST forms.

            APRNs in California can prescribe controlled substances after fulfilling specific requirements, including six months of physician supervision, a pharmacology course, and another specific course about schedule II-controlled drugs. Iowa Board of Registered Nursing also allows nurse practitioners to prescribe Schedule II drugs after registering with the pharmaceutical board. Both states require the prescriber to be registered with the Drug Enforcement Agency.

           Advanced Registered Nurse Practitioners in Iowa have autonomy in practice; alternately, they can collaborate with a physician or surgeon, but this is not a requirement of the Iowa Board of Nursing. APRNs in Iowa practice autonomously. California has a standardized procedure arrangement for advanced practice nurses to diagnose, treat, and prescribe. APRNs in California have career-long supervision, delegation, or team management by a physician. Largely, California regulations allow advanced nurse practitioners to approve, sign, or modify treatment plans after consultation with a physician.

          California Board of Registered Nursing allows for using marijuana by nurses as long as it is not used within the workstation. The legislation makes it unlawful for an employer to eliminate hiring someone based on that person using Cannabis away from their workstation. The legislation further guides that a nurse who uses cannabis for medical purposes should also be exempted from this policy. On the contrary, recreational use of marijuana is illegal under Iowa law. A nurse may be affected even if the positive drug screen was done in another state that allows the use of marijuana. Potential employers usually forward positive marijuana screens where a nurse has a license.

           Advanced Practice Registered Nurses with full legal authority to practice at full scope will have issues practicing autonomously in California because of the restricted practice legislation. One of the objectives of the ANA is to fight barriers to nursing practice so that nurses practice to the full extent of their education and training despite being in different territories. All nurses are licensed by their state of practice or by a multistate license. The Nurse Licensure Compact provides APRNs with a multistate license that allows nurses to practice in the home state and other compact states (NCSBN. (n.d.). Not all states are compact states.

            Nurses adhere to the rules through continuous education to keep up with the latest practices and technology. Many approved colleges provide the necessary certification; some are state-specific, and others can be found online. Joining Professional organizations is also useful for sources of the latest information in the medical world.

explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples. 

Week 6_ Drawing conclusions about research findings and their implications for clinical practice

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Please review the complete instructions.

Diabetes Mellitus Type 1

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Instructions: Select one of the topic mentioned below and discuses filling the attached form.

Topics: 

Diabetes Mellitus Type 1

Requirements

Ø The discussion must address the topic

Ø Rationale must be provided

Ø Use at least 600 words (no included 1st page or references in the 600 words)

Ø May use examples from your nursing practice

Ø Formatted and cited in current APA 7

Ø Use 3 academic sources, not older than 5 years. Not Websites are allowed.

Ø Plagiarism is NOT permitted

HEALTHY EATING FOR A HEALTHY WEIGHT

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Write a two page paper on healthy eating for weight loss. Include information on my page. Use resource from only the CDC website

U 8 551

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A 49-year-old female is discussing age-related changes with the nurse practitioner. She states that she is having irregular periods and “hot flashes.”

  1. What other assessment data would substantiate the diagnosis of menopause?
  2. What type of therapy would you expect this patient to receive? Why?

instructions: It is a discussion post, APA format, 1 page in length is fine. Must have 3 references.

Replies week 4 MSN5300

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 Please include a 200 words in two answers to peers 

 

1.The economic and human costs associated with Alzheimer’s disease have prompted various research studies into the matter. A key topic of research and evaluation is the family’s role or obligation in caring for Alzheimer’s patients, especially parents. Such studies need to incorporate ethical considerations as they involve human beings, sensitive and vulnerable medical and care information, and contribute to knowledge development of the matter; thus, they should be done in the right way to improve the credibility and reliability of the information in the research. Ethical considerations are guidelines and principles that guide research and ensure the research process does not violate any human rights or academic regulations.

Martinez et al. (2022) conducted a qualitative study to understand the dynamics of caregiving of patients with Alzheimer’s within the Latino community because of their emphasis on familism. The study conducted interviews as its primary data collection method, which mandated various ethical considerations. Therefore, Martinez et al. obtained approval from their university’s Institutional Review Board, and informed consent was obtained before the interview. In another study to understand the caregiver’s perception of the unmet palliative care needs in Iranian Alzheimer’s patients, Ashrafizadeh et al. (2021) conducted a qualitative study. In this study, the authors mention that they incorporated various ethical considerations, including approval by the respective university’s Ethics committee. Additionally, they incorporated the voluntary nature of participation, obtained informed written consent forms and anonymity of the participants, and informed them of their right to withdraw from the study at any point. Further, they ensured the confidentiality of the information provided by the participants and guaranteed of using the said information for the sole purpose of the research.

In a cross-sectional study that involved fifty formal caregivers and fifty informal caregivers of Alzheimer’s disease patients, Sołtys & Tyburski (2020) sought to understand the predictors of mental health problems among these caregivers. The authors ensured that all surveyed caregivers willingly agreed to participate, and an ethics committee approved the study. Also, participants provided informed consent. Ashrafizadeh et al. (2021) ethical approach was relatively different, as the key ethical considerations were approval and the participant’s rights. This is seen in how the study guaranteed anonymity by providing nicknames for the participants that also assured confidentiality of the information provided. The participants were also assured of the publication of the results. At the same time, the authors obtained both oral and written consent to ensure the participants understood their involvement, including their right to withdraw from the study. Ethical considerations are similar as long as they involve human participants, even through virtual communication. Rodríguez-Mora et al conducted their interviews virtually but also had to seek informed consent and approval, and in this case, ensure no harm came to the participants by upholding the containment measures as the study was conducted during the recent pandemic.

2. Ethical approaches in research studies entail setting principles that help achieve the goal of research designs and practices. The approaches help the researchers to achieve a code of conduct when interacting with people to collect data. The primary goals of any short or comprehensive research entail enhancing the research validity, maintaining scientific or academic integrity, and acknowledging researchers who performed various research earlier. These practices are mainly for the research conducted using printed or recorded data sources.

Human research entails comprehensive ethical considerations, with voluntary participation being one of them. There is no pressure or compulsion used on any research participants to participate. Everyone enrolled in the study can stop at any time without feeling obligated to continue (Newman et al., 2021). Participants cannot be coerced into justifying leaving the study. As a result, it is critical to make it evident to participants that declining to participate will not have any detrimental effects.

Another consideration is whether participants provided informed consent and where the data was collected. The prospective participants should be provided with and comprehend the information necessary for making a participation decision (Newman et al., 2021). This includes information about the study’s advantages, hazards, funding, and institutional endorsement. Participants should be given a text to read and asked if they have any questions before proceeding. They can initial or sign the consent form if they are willing to participate. When working with particularly vulnerable groups of people, remember that this might not be enough to obtain informed consent.

Further confidentiality must be integrated into research by granting all participants the right to privacy. The researchers must protect participants’ data for a long provided they hold it (Horton & Lucassen, 2023). this consideration should be maintained when the data is collected anonymously. Assumptions such as research process grant confidentiality automatically grants confidentiality should not be taken (Horton & Lucassen, 2023). Some research designs are not conducive to confidentiality, but it is essential to make all attempts and inform participants of the risks involved. Therefore, achieving confidentiality should be explicitly planned for and met by the researchers.

In conclusion, ethical approaches to conducting research should entail observing a code of conduct that enhances research validity when collecting, storing, and interpreting data. Academic integrity should be considered when dealing with records. In human research, participants should be allowed to provide data voluntarily. They should be informed of the research details before being subjected to the research participation. Confidentiality of personal information should be significantly upheld even when research designs do not appear to favor confidentiality. Thus, researchers must ensure that research validity is enhanced by taking the ideal measures of research ethics.

sociology discussion 6

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Respond to two (2) of the following prompts:

  1. Describe formal and informal education. From your experiences with schooling, provide specific examples of each and explain how they are built into the curriculum or culture of the school. (USLO 6.1)
  2. Reflecting on your own experience (or your child’s) with schooling, explain one sociological theory that best relates to your (or your child’s) academic journey. Describe two examples of how this theory applies to your schooling. (USLO 6.4)
  3. What do you think is the most significant concern with the education system today? Provide a suggestion for how this issue could be improved. (USLO 6.3)
  4. What is the difference between mainstreaming and inclusion? Which do you think is the optimal way to include people with disabilities in the classroom and why? (USLO 6.2)
  5. Karl Marx studied the social impact of religion and believed religion reflects the material base, which is comprised of the means and modes of production and the relations of production. Marx argued that religion maintains inequality and perpetuates the status quo. Is Marx’s argument that religion maintains inequality and perpetuates the status quo true? Present an example that supports your assessment of Marx’s argument. (USLO 6.8)
  6. Emile Durkheim argued that religion promotes social cohesion, and social control, as well as offering meaning and purpose to human life. Is Durkheim’s argument true? Present an example that supports your assessment of Durkheim’s argument. (USLO 6.8)
  7. What is required of a society for its political structure to be considered democratic? While this question might seem straightforward, it is not and is a topic of contentious debate in current political philosophy circles. The Democracy Index lists 60 different indicators that must be considered when discerning whether a nation is a democracy. While you in no way will be expected to discuss all indicators, please talk about a few of the conditions that must exist for a government to qualify as a democracy. Include textual evidence to support your view. (USLO 6.5, 6.6)
  8. In recent years in the United States, citizens have increasingly made claims that our judicial system is institutionally racist. Evidence provided for these claims has pointed toward unfair drug sentencing laws, stop and frisk policies, the use of police force, and the overwhelming number of black men in prisons and jails in comparison to the rest of the population. Select one claim and discuss whether these claims have merit, presenting specific examples to support your position. Include textual evidence to support your view. (USLO 6.7)

esw

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Respond to the following prompts: 

· How has learning about the history of research ethics impacted your view of biomedical research?

· In looking at the studies you reviewed for your PICOT question, do you feel that today’s researchers adequately protect the rights of human subjects? If not, what additional measures do you recommend?

EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH

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EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

· Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.

· Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.

· Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

LEARNING RESOURCES


Required Readings

· Melnyk, B. M., & Fineout-Overholt, E. (2023). 
Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

· Chapter 6, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 189–228)

· Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. 


American Journal of Nursing

Links to an external site.
, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c

· Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part II. 


American Journal of Nursing

Links to an external site.
, 110(7), 47-52

· Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence.

American Journal of NursingLinks to an external site.
, 110(11), 43-51. doi:10.1097/01.NAJ.0000390523.99066.b5

· Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. 

Journal of the American Psychiatric Nurses AssociationLinks to an external site.
, 15(3), 202–207. doi:10.1177/1078390309338733

·

Document: Critical Appraisal Tool Worksheet Template (Word document)

CDS

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Part 1:

  • Research and  review at least four peer-reviewed articles on evidence-based practice applied in clinical decision support (CDS). Must be within 5 years.

Matrix attached

Part 2: Clinical Decision Support (CDS) Recommendation

Develop a 10- to 12-slide PowerPoint presentation in which you present your research and data to support your clinical decision support (CDS) recommendation for quality improvement.

Based on your research, address the following in your presentation:

  • Synthesize your findings from your four articles, focusing on applicable models and/or theories relevant to CDS, quality improvement in your workplace, and on applicable evidence-based practice in nursing.
  • Recommend CDS or information to consider in clinical decision making and explain your rationale for the recommendation. Be specific.
  • Justify your recommendation. Be specific and provide examples.
  • Recommend how you would address possible limitations or challenges, including:
    • Explain how you would avoid alert fatigue.
    • Explain under what conditions you would allow an override to an alert.
    • Explain how you would monitor compliance.
    • Identify factors that might contribute to continuous overrides.
    • Justify conditions under which an override may be necessary.
  • Provide references in APA style at the end of your presentation—the reference slide or slides do not count toward your assignment total.