Read the article “Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing” by Christine Tanner, which is attached below:
In at least three pages, answer the following questions:
Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post
——You don't have to post this in APA format necessarily, it's just giving feedback to the student .
Good Evening Professor,
I work in one of the largest hospital systems in Atlanta. The facility I work for has the bed capacity for 686 patients. The hospital specializes in cardiovascular procedures (the implantation of the LVAD) and transplantation of liver, and kidneys. The hospital attracts people from across the country. People coming from literally every state, and sometimes from out of the country.
The area where I see the EHR impeding patient care, and again this might be in part, due to end-user negligence, are providers not utilizing the information and data contained within the patient's EHR frequently enough. We run off a system called EPIC (EHR). I have come to realize most hospitals in the state of Georgia, and other states use EPIC as well. Embedded within the EPIC system is a hyperlink called Care Everywhere. The Care Everywhere tab allows all providers on the EPIC system to see notes, documentation, tests results, frequency of visits, and more. This data covers every hospital, clinical, urgent care, and office visit the patient has encountered so as long as the facility is on the EPIC system. I believe the shear amount of medical information becomes overwhelming and time consuming to comb through, especially for medical providers who are already seeing numerous patients at the bedside and in specialty offices.
Despite medical documentation being readily available to providers across the healthcare spectrum, there seems to be little time for a busy Cardiologist to review necessary documentation from the patient's Pulmonary doctor, or the notes placed from Endocrinology. Often a patient comes for a visit due to CAD, but the patient is also a diabetic with uncontrolled elevated blood glucose. We know one disease process feeds the other, but in spite of the EHR containing valuable patient data, providers are still missing imperative clinical information required to treat the patients holistically.
The one department which I see consistently using chart review to coordinate care with patients, providers, and families are RN Case Managers within the hospital setting. RN Case Managers, and Care Coordinators are responsible for knowing what is missing in the patient continuum of care. The RNCM interfaces with the providers, and assists in providing education to both medical MDs and patients regarding critical clinical information which will advance the clinical process and bring better patient outcomes. McBride & Tietze (2018) discussed unintended harm, or consequences suffered by patients with the implementation of the EHR. One such consequence has to do with physicians required to research, and review copious amounts of previous documentation, as well as being required to spend greater amounts of time entering documentation. Such time consuming tasks often create information, and important patient data not being read, or documented in an effort to save time, and so providers can physically see more patients.
Resources
FAAN, S.M.P.R. C., & FAAN, M.T.P.R. F. (2018).
Nursing Informatics for the Advanced Practice Nurse (2nd ed.). Springer Publishing LLC.
https://ambassadored.vitalsource.com/books/9780826140555Links to an external site.
Williams, M. D., Asiedu, G. B., Finnie, D., Neely, C., Egginton, J., Finney Rutten, L. J., & Jacobson, R. M. (2019). Sustainable care coordination: a qualitative study of primary care provider, administrator, and insurer perspectives.
BMC health services research,
19(1), 92. https://doi.org/10.1186/s12913-019-3916
To Prepare:
The Assignment: (Evidence-Based Project)Part 4: Recommending an Evidence-Based Practice ChangeCreate an 8- to 9-slide PowerPoint presentation in which you do the following:
Rubric (please follow and read):Part 4: Disseminating Results/ Create a, 8-9-slide narrated PowerPoint presentation of your Evidence-Based Project: Briefly describe the following: your healthcare organization and culture, current opportunity for change, scope of issue, and EBP best practice recommendation. Explain how you would plan knowledge transfer and dissemination. Describe measurable outcomes with the implementation of EBP best practice. Summarize lessons learned. -The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation. -The presentation is professional; images are appropriately attributed; images are clear. The presentation text is readable. Presentation flows well and is presented in a logical order.
Nurse-scholars have a significant obligation to their community as well. Their work must have academic and professional integrity.
Module 04 Written Assignment Nursing Process – Case Study
Top of Form
Bottom of Form
Module 04 Content
1.
Top of Form
Please read the following case study and complete the questions below.
Daniel is a 16 year old boy who is an identical twin. He and his brother Jeff are very close and do most things together. While Daniel excels at sports he believe his brother is much better at most everything. Daniel, his brother, and their two sisters live with their parents in the Midwest. Recently Daniel has been feeling more tired than usual. He thought it was because of his schedule and school work, which he is fairly good at. He gets mostly Bs, but his grades have been slipping of late. One day he fainted while getting ready for a game. His coach called his parents to let them know Daniel was taken to the Emergency Room. While there the doctor decided to admit Daniel to the hospital for observation. At the time he was running a slight fever, his breathing was shallow, and he was sweating. He was also very sleepy and his blood pressure was high. He did have some abnormal laboratory work, but his doctor was not too concerned at present. Daniel also stated that he felt achy.
You are assigned to take care of Daniel today and when you walk into his room, his mother and brother Jeff are there. Daniel appears to be sleeping. In your written assignment, respond to the following questions applying the nursing process:
Assessment: What type of objective and subjective data can you collect with what you know? How will you collect these data? What further evidence do you need?
Analysis and Identification of the Problem: What do you believe Daniel's problem(s) are? What might be the nursing diagnoses? Use the following for identification.
Planning: Identify two goals and one nursing intervention for each, based on your nursing diagnoses.
While you will not be able to
implement or
evaluate, how well do you think your nursing interventions might help with Daniel's care.
Additional Resource
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
SOAP note peptic ulcer
As a baccalaureate-prepared nursing professional what role will you take to advocate for culturally diverse clients in your healthcare practice?
LITERATURE REVIEW: THE USE OF CLINICAL SYSTEMS TO IMPROVE OUTCOMES AND EFFICIENCIES
New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.
Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technological trends, informaticists and others have then benefited from consulting existing research to inform their thinking.
In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.
To Prepare:
· Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
· Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
· Identify and select 4 peer-reviewed research articles from your research.
· For information about annotated bibliographies, visit
https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographiesLinks to an external site.
The Assignment: (4-5 pages not including the title and reference page)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:
· Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
· Include an introduction explaining the purpose of the paper.
· Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
· In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
· Use APA format and include a title page.
· Use the Safe Assign Drafts to check your match percentage before submitting your work.
LEARNING RESOURCES
· McGonigle, D., & Mastrian, K. G. (2022).
Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
· Chapter 14, “The Electronic Health Record and Clinical Informatics” (pp. 293–316)
· Chapter 15, “Informatics Tools to Promote Patient Safety, Quality Outcomes, and Interdisciplinary Collaboration” (pp. 323–349)
· Chapter 16, “Patient Engagement and Connected Health” (pp. 357–378)
· Chapter 17, “Using Informatics to Promote Community/Population Health” (pp. 383–397)
· Chapter 18, “Telenursing and Remote Access Telehealth” (pp. 403–432)
· Benda, N. C., Veinot, T. C., Sieck, C. J., & Ancker, J. S. (2020).
Broadband internet access is a social determinant of health!Links to an external site.
.
American Journal of Public Health,
110(8), 1123-1125. https://doi.org/10.2105/AJPH.2020.305784
· Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S. …Bates, D. W. (2017).
Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study
Download Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study
.
Critical Care Medicine, 45(8), e806–e813. doi:10.1097/CCM.0000000000002449
· HealthIT.gov. (2018c).
What is an electronic health record (EHR)
?Links to an external site.
Retrieved from
https://www.healthit.gov/faq/what-electronic-health-record-ehr
· Rao-Gupta, S., Kruger, D. Leak, L. D., Tieman, L. A., & Manworren, R. C. B. (2018).
Leveraging interactive patient care technology to Improve pain management engagementLinks to an external site.
.
Pain Management Nursing, 19(3), 212–221.
· Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021).
Digital inclusion as a social determinant of healthLinks to an external site.
.
NPJ Digital Medicine,
4(1), 52. https://doi.org/10.1038/s41746-021-00413-8
· Skiba, D. (2017).
Evaluation tools to appraise social media and mobile applicationsLinks to an external site.
.
Informatics, 4(3), 32–40.
· Sharma, P., & Patten, C. A. (2022).
A need for digitally inclusive health care service in the United States: Recommendations for clinicians and health care systemsLinks to an external site.
.
Permanente Journal,
26(3). https://doi.org/10.7812/TPP/21.156
he/him/his
10/26/23, 9:26 PM NEW
Maintaining appropriate nutrition levels is crucial for older adults as it promotes overall health and well-being. However, there are various dietary concerns and barriers that older adults may encounter, which can lead to inadequate nutrition. Reduced physical mobility can make grocery shopping and meal preparation challenging. Older adults live longer, which means ailing health status and increased immobility as they try to maintain their autonomy and self-sufficiency. Access to nutritious foods may be limited, leading to reliance on convenience or processed foods, which are often less healthy. Loneliness or living alone can contribute to poor dietary choices and meal skipping. Eating alone can also reduce the enjoyment of meals. Limited income may lead to difficulty affording nutritious foods, forcing older adults to make compromises on food quality.
Educate the older adult and their caregivers about meal planning and preparation. Encourage them to plan balanced meals and provide assistance or resources for grocery shopping. Meal planning can mitigate some of the limiting factors associated with decreased mobility. Connect the older adult with community resources such as Meals on Wheels or senior meal programs that provide adequate meals. Encourage older adults to increase their social circle if possible. Integrating peers can reduce loneliness and encourage physical and mental activity. Provide them with resources to community centers and assist with activity searches. These teachings and collaborative efforts from the client can improve nutritional health.
Angela Antonczak
10/24/23, 11:24 PM
Top of Form
Nutrition is essential for the body so when older adults have dietary problems and barriers it is very difficult to maintain a healthy diet. The dietary concerns and barriers for an older adult to maintain appropriate nutrition levels are physical difficulties and medical conditions are two examples that are extremely difficult for older adults. Elderly people age and so does the immune system so when it weakens they get more prone to health issues. Obesity is a big problem for elderly people with diabetes type 2 because they are overweight. They might have to limit their sugar intake so they don’t have to take insulin shots. Another is osteoporosis when an older person has calcium deficiency or low calcium levels in their diet. My aunt had this disease and it hurt when she walked. She was told to take a calcium supplement, but she refused to take anything. Maintaining an healthy diet in general is extremely difficult for elderly people because they might be set in their own ways of eating which is a difficult thing like my family was. If older patients do not take consideration for their health and nutrition then they are at risk for many health related complications like heart disease from high fat content consumption. The two client teaching and nursing interventions for prevention of nutritional deficits as well as the consequences of inadequate nutrition and hydration are for nurses to teach the patient about their nutritional needs as far as a strict diet if they are suffering high blood pressure or eating way too much sugar. They should promote physical activity in their ADLs or some form of exercise to help maintain a healthy weight balance. The fluid intake should be limited if a person is suffering from pneumonia or edema which can result to more fluid intake especially if they are having renal failure. The kidneys are at risk because they can’t function normally and filter the blood properly and maintain normal urine. Staying hydrated is essential for the body but for some elderly they must reduce their fluids due to complications. When an older person has inadequate food they are can be at risk for malnutrition which is harmful for the body since an elderly can find it difficult to eat food properly or skip meals due to lack of appetite or no flavor in their meals.
Bottom of Form
.
Bioethical
Decision
Making
Model
1. Define
the
dilemma:
Use
your
own
words
to
describe
the
problem.
State
it
in
a
way
that
others
can
quickly
understand
your
dilemma.
Review
2. Identify
the
medical
facts:
Describe
the
facts
that
are
relevant
to
the
dilemma.
3. Remember
that
the
diagnosis
and
prognosis
are
medical
facts.
4. Identify
the
non-‐medical
facts
(patient
and
family,
external
influences):
a. Patient
and
family
facts
such
as
culture,
religion,
social,
economic,
the
existence
of
an
Advance
Healthcare
Directive,
verbal
preferences
made
by
the
patient,
how
the
patient
lived
his/her
life.
b. Those
that
you
discuss
should
be
relevant
to
the
situation.
5. External
influences
include:
organizational
policies,
federal
and
state
laws,
practice
acts,
code
of
ethics.
These
should
be
relevant
to
the
situation.
6. For
both
step
2
or
3,
separate
the
facts
from
the
assumptions:
Sometimes
all
healthcare
professionals
allow
assumptions
to
guide
their
decision-‐making.
These
must
be
identified
so
that
these
assumptions
do
not
interfere
with
the
process.
7. Identify
items
that
need
clarification.
Your
paper
should
identify
facts
that
you
need
to
clarify.
When
initially
discussing
an
ethical
situation,
it
is
not
unusual
to
not
have
all
of
the
answers.
8. Identify
the
decision
makers:
Is
the
patient
an
adult
competent
to
make
their
own
choices?
Is
the
patient
a
child
who
is
old
enough
to
have
a
say
in
the
decision.
If
the
patient
cannot
make
their
own
decision,
who
is
the
decision
maker?
How
was
this
person
selected?
9. Review
the
underlying
ethical
principles:
Review
which
ones
and
why
they
apply
t
this
particular
case:
beneficence,
nonmaleficience,
veracity,
fidelity,
autonomy
and
justice.
10. Define
alternatives:
One-‐Way
to
proceed
may
be
apparent
at
this
point.
However,
sometimes
there
are
different
choices.
They
should
be
addressed
identifying
the
benefits
and
burdens
for
doing
one
thing
versus
the
other.
11. Follow-‐up:
Define
the
process
to
be
used
with
the
chosen
alternative.
Reference
Source:
Levine-‐Ariff,
J.
&
Groh,
D.H.
(1990).
Creating
an
Ethical
Environment.
Nurse
managers'
bookshelf
a
quarterly
series:
2:1.
Baltimore,
Maryland:
Williams
&
Wilkins.
41-‐61.
Submitmyhomework.com is a unique service that provides guidance with different types of content. Please rest assured that the service is absolutely legal and doesn’t violate any regulations. It can be used for generating new ideas and thoughts for your own project, additional insight into the subject, or encouragement for further researches.
