This is an easy assignment, I just don’t have time for it. Needs two references. Reflection Paper #2 (15 points) Students will write 2-page paper (excluding title page and references page) about a contemporary topic that affects nursing or nursing students. The paper may not exceed two pages. Topic -Access to health care in medically underserved communities
Personal Philosophy of Interprofessional Collaboration (200 pts). Here you will summarize in a personal document the results of your personality tests. This is a personal philosophy so you may use personal pronouns but remember to use APA formatting, references for your work and a professional tone as this will become part of your professional portfolio. This paper should be formatted in APA. It should have a title page, no abstract, and the body of the paper should have the headings. You will need an introduction with a stated purpose but no Introduction heading is needed per 7th edition APA. Paper contents/APA format/professional tone: (100 pts) Title page with Running head No abstract page Introduction [no heading per 7th ed. APA] aim and purpose of personality tests 1-2 paragraphs] – 1/2 page In the paper, you will summarize in a personal document the results of your personality tests. You may use personal pronouns but a professional tone should be maintained. This document will begin with an introductionthat contains a purpose statement that explains the significance of personal traits, strengths, and weaknesses and interprofessional collaboration. Much of this background information can be found in the materials we have covered in the modules in this class. Personality test results: [1st level heading] 1-2 pages Myers-Briggs (second level heading) 1-2 paragraphs Big Five (second level heading) 1-2 paragraphs Emotional Intelligence (second level heading) 1-2 paragraphs Kolb’s Learning Inventory (second level heading) 1-2 paragraphs Leadership (second-level heading) what is desired leadership style 1-2 paragraphs Significance of Test Findings for Interprofessional Collaboration – first-level heading – Whats strengths and weaknesses did the varying test reveal and how might these affect your ability to initiate or participate in IPC opportunities and groups [ 2 paragraphs] 1/2 page to 1 page
Read this discussion and agree or disagree with their chosen plan. Support your postings with evidence based practice. APA format with 1 reference cited not older than 5 years easily retrievable. 250 words minimum. Spironolactone is used in Transgender populations for its effects on androgen receptors and suppressive effect on Testosterone synthesis. (Deutsch, 2016) Spironolactone is a potassium sparing diuretic as well, which would alert the clinician that hyperkalemia would be a concern. When ordering labs for Martha, I would be sure to order a comprehensive metabolic panel to monitor her electrolytes and hydration status since it does have diuretic effects. I would also order hormone levels to assess how she is responding to her current dose of Estrogen. I would order labs for every three months to start with since she is just establishing, although she has been on treatment for over one year as a precaution. Estrogen can cause an increased risk of clots especially if you smoke or are over the age of 35, so monitoring a d-dimer level could be beneficial to assess for clots. In a study done by Deutsch et al., it was found that transgender women on Estrogen therapy had a decrease in blood pressure; so, it is important to also monitor Martha’s blood pressure at each visit and outpatient. Estrogen can also effect lipids so I would order a lipid panel to understand Martha’s baseline and check those again in three months when we rechecked labs. The greatest concern among male-to-female (MTF) transgender individuals is the potential increase in thromboembolic events associated with estrogen therapy. (Weinand & Safer, 2015) Due to this concern, it would be contraindicated for a patient to take Estrogen that has a personal history of a DVT, PE, VTE, or Ischemic Stroke and should be used with caution in patients who smoke. In a study conducted by Weinand & Safer, three transgender women experienced a myocardial infarction (average 48 years old) within two years of estrogen therapy. Due to this finding, patients with existing cardiac conditions (specifically MI’s) should proceed with caution when using Estrogen therapy. Patients with a strong family history of breast cancer should also proceed with caution when taking Estrogen therapy, as this could increase their risk of breast cancer as well. To minimize these risks, patients could undergo genetic testing if they choose to proceed with Estrogen administration. Another patient population that would be a contraindication for Estrogen therapy is a patient who has a history of liver disease, is a heavy drinker, or has a family history of liver disease. Oral Estrogen can affect the liver and these patients may benefit from transdermal or injectable Estrogen. As with anything, the benefits must outweigh the risk for our patient who is undergoing treatment. To us, we may think that these risks are not worth taking Estrogen; but to our patients who have struggled with gender identity and wish to undergo transition, the benefits may vastly outweigh these risks. As providers, we must remember to equip our patients to make the best choice for them and their current situation. If these at-risk populations chose to move forward, we would need to bring them in for screenings more frequently and educate them on warning signs and symptoms for development of these serious conditions.
Read this discussion and agree or disagree with their chosen plan. Support your postings with evidence based practice. APA format with 1 reference cited not older than 5 years easily retrievable. 250 words minimum. When replacing hormones in a transgender patient, it is important that we follow up closely with laboratory blood tests to see how the patient is responding internally to their medications even though their outside appearance is changing as expected. In an article in the Translational Andrology and Urology journal, there is a table that outlines which blood tests should be monitored while a patient is receiving hormone therapy. Before hormone therapy starts, baseline hemoglobin and hematocrit, lipids, bone mineral density, prolactin, testosterone, and estradiol should be obtained. Throughout therapy, testosterone is monitored every month for 6 months until levels than <55n/dL and estradiol should be monitored monthly until levels are 100-200 pg/mL (Unger, 2016). Labs like hemoglobin and hematocrit, bone density, prolactin, and lipids can be monitored annually or at 6-month intervals depending on provider preference. Feminizing hormone therapy has risks such as hyperprolactinemia, hyperkalemia, development of type 2 diabetes, development of high triglycerides, and blood clots (Mayo Clinic, n.d.). Because of these, CMPs and CBCs should be done routinely to check for electrolyte imbalances and blood glucose levels and their correlating anion gaps. Martha takes spironolactone as well so we would need to watch that her potassium levels don’t rise above the therapeutic serum range. Feminizing hormone therapy is lifelong and very involved. While a transgender patient may want or need it to feel comfortable in their skin, a prospective hormone replacement patient must be medically cleared to start the therapy in order to mitigate the potential risks associated with it. In an article written by a clinic in Ontario for TransPrimaryCare, it is contraindicated to begin therapy in patients who have unstable angina, estrogen-dependent cancer, end stage liver disease, psychiatric conditions which limit the ability to provide informed consent and make informed decisions, and hypersensitivity to one or many of the components of the therapy formulation (Sherbourne Health, 2020). While the above information is very important in how it pertains to Martha’s health, a provider must focus on the patient-provider relationship so that the patient feels comfortable enough to continue seeking healthcare. The prompt states that Martha has not been to a doctor in 2 years while being on hormone therapy. There are far too many complications and risks associated with hormone therapy and it is not in a patient’s best interest to avoid or be denied care. For her safety, Martha should be seen at least yearly and it is our job to ensure that not just her physical health needs are met, but that her mental and emotional health needs are addressed as well.
Read this discussion. Respond by sharing insight on their post, compare and contrast your post with theirs, or correlate their post to a relevant article identified from the literature. APA format with 1 reference cited not older than 5 years easily retrievable. 250 words minimum. Technology is an ever-evolving subject that advances at a rapid rate. Everyday it seems that there is something that is even more new and improved than the day before, especially in healthcare. When COVID-19 debuted, panic and fear fell among the masses and keeping everyone safe and healthy was at the utmost importance. Although health was at the forefront of everyone’s mind, there are also other health conditions that still required necessary attention. This is when telehealth and telemedicine became largely popular. This was not a new trait to some physicians and practices, but was adopted by many more. Although the terms strongly resemble each other, they are widely different and can often times get confused. According to the Amercian Academy of Family Physicians, (2021) “Telehealth is different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine”. My understanding between the two is that telemedicine refers to medical treatment and opinion being given in order to treat a patient. An example of this that comes to mind is a service we offer at my hospital. When we have psychiatric patients that are in need of treatment recommendations, we use our “telepsych” carts. These are computers that we set up in patient’s rooms where a psychiatrist, who is in a remote location, is able to communicate with a patient via computer. On the other hand, there is telehealth. This refers to “remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services” (Cranford, 2020). Telehealth once again has many different components. It can be synchronous or asynchronous. Synchronous refers to a telehealth visit that is in real time. An example of this is outlined by Mechanic, et al (2017), and is called FVV or Facilitated Virtual Visit. “An example of a facilitated virtual visit occurs when the patient is located at an accessible site (i.e. clinic) where diagnostic equipment is available and the medical provider is at a distant site (Mechanic et al, 2017). In comparison, asynchronous refers to “store-and-forward” technique, whereas a patient or physician collects medical history, images, and pathology reports and then sends it to a specialist physician for diagnostic and treatment expertise” (Mechanic et al, 2017). The advances in technology are a wonderful thing in the healthcare setting, however in my personal opinion, they can also pose issue. The concept behind telehealth and telemedicine are great but I do feel they take away a lot of the objective we take in to consideration as practitioners. You can tell a lot by physically touching a person not to mention the ability to actively do an assessment on them. In combination, there are restrictions that apply under the Affordable Care Act that may make the use of tele visits more difficult or less financially appealing to a patient such as specific settings, licensing and communication preferences. I believe there is a time and place for everything and when considering the use of telehealth, it should be on a case by case basis.
Read this discussion. Respond by sharing insight on their post, compare and contrast your post with theirs, or correlate their post to a relevant article identified from the literature. APA format with 1 reference cited not older than 5 years easily retrievable. 250 words minimum. Telehealth is a broad range of technologies and services to provide patient care and improve the healthcare system when compared to telemedicine. Telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing education. The World Health Organization recognizes telehealth as surveillance, health promotion, and public health functions. Telemedicine, a subset of telehealth, refers directly to the provision of health care services and education over a distance, through the use of telecommunications technology. Telemedicine refers specifically to remote clinical services, and uses electronic communications and software to provide clinical services to patients without an in-person visit. Telemedicine is used for follow-up visits, management of chronic conditions, medication management, specialist consultation, and other services that can be provided remotely via a secure platform (Cranford, 2020). Synchronous telehealth refers to the delivery of health information in real-time. With this option, a live discussion with the patient or provider can happen so that medical expertise can be delivered. A facilitated virtual visit is a type of synchronous telemedicine, such as a patient at a clinic and a medical provider at a distant site. A tele facilitator, such as a nurse, can gather objective measures using equipment and transmit this data to the provider. Asynchronous telemedicine does not occur in real-time (Mechanic, et al., 2021). For example, with synchronous telehealth, should a patient present to a hospital with complaints of stroke symptoms, a prompt consultation by a neurologist in the event a stroke is clinically suspected could occur. With asynchronous telehealth, a patient could take a digital photo of a skin condition and forward the image to their dermatologist for review and determination of treatment if needed (Resnick, 2019). Telemedicine is great for a number of reasons. Telemedicine helps to increase access to healthcare for patients who face barriers such as distance, transportation, or caretaker availability. And, those who are immunocompromised do not have to risk acquiring infectious diseases. Furthermore, while a physical exam via video should not be looked down upon because providers can still receive information via a visual exam through the camera, it is done without auscultation and palpation. These two methods during an assessment are vital for accurate and sound condition diagnosis and treatment. While attempting to obtain a health history, the patient can become disconnected due to internet concern or may have difficulty logging on. Or, the video may be distorted, which makes hearing the patient difficult and the provider unable to accurately assess the patient. But overall, the goal with both is to expand access to care, make health management easier for patients, and improve the efficiency of the healthcare delivery network. This has become a new normal, due to technological advancements, which became especially prevalent due to the pandemic.
Discuss why evidence-based practice ( EBP) is an essential component of the practice of a BSN-prepared RN. Identify two ways in which you will continue to integrate evidence into your practice and encourage it within your work environment. What obstacles could challenge this plan, and what steps will you take to minimize their impact?
Investigate how school health is delivered within your local school system. You can look at one specific school, or an entire school district. Do the schools in your area have a school health nurse assigned? If not, how are health care needs within the school district managed? What are ways in your area schools in which health promotion and management of existing health problems are addressed?
Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook.
• Write a 4-5 page critical appraisal of an organization’s strategic plan from the perspective of a nurse executive, taking into consideration the organization’s mission, vision, and other contextual factors. Introduction A strategic plan is constructed from a clear, well-articulated vision and a comprehensive environmental scan. An analysis of the internal and external environments provides a clear picture of the current state and the potential hurdles to overcome in reaching the desired future state. Leaders can then establish goals and objectives that are specific, measurable, acceptable, realistic, timely, and rewarding. Strategic objectives balance short-term and long-term opportunities and consider the needs of all key stakeholders. From the objectives flow the strategies and tactics for achieving the goals. Building skill in strategic planning positions the DNP nurse as one who makes things happen. This assessment provides an opportunity for you to critically examine an organization’s strategic plan. An understanding of the organization’s vision, mission, and strategic priorities is crucial to departmental strategic planning that aligns with, and supports, organizational priorities. Preparation For Assessments 2, 3, and 4, you will appraise an organizational strategic plan, develop a departmental strategic plan, and propose a quality improvement initiative, respectively. The choice of health care setting as the context for this work is up to you. You may choose the organization in which you currently work, an organization in which you worked previously, or an organization about which you would like to learn more. You will use this health care organization, and a department or division within the organization, as the basis for the remaining assessments in this course. Note: The assessments in this course must be completed in the order presented; subsequent assessments should be built on both your earlier work and your instructor’s feedback on earlier assessments. If you choose to submit assessments prematurely, without considering and integrating your instructor’s feedback, your assessment may be returned ungraded, resulting in your loss of an assessment attempt. After choosing your organization, obtain a copy of the organization’s strategic plan. Most large health systems post their strategic plans, visions, and missions on the Internet. Instructions Write a critical appraisal of the organization’s strategic plan. Identify strategic priorities and orient yourself to the key performance indicators (KPI) the organization uses to drive quality. Include the quantitative metrics of the scorecard. Note: Lessons learned from your appraisal will inform your work in Assessments 3 and 4. Appraisal Format and Length Format your document using APA style. • Use the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your appraisal. Be sure to include: o A title page and references page. o An abstract and running head are not required. o Appropriate section headings. • Your appraisal should be 4–5 pages in length, excluding the title page and references page. • Use the following section headings to ensure thorough content coverage and flow. o Strategic Plan Analysis. o Validity of Data and Analytical Strategies. o Stakeholder Input. o Balanced Scorecard. Evaluation The following tasks correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. • Select an organization and analyze their strategic plan. o Approach your analysis from a systems perspective. o What priorities appear to take precedence? o How well do the priorities align with the mission and vision of the organization? • Evaluate the validity of data and analytical strategies used to develop organizational priorities. o What data was most likely used to develop key performance indicators (KPIs)? o For example: patient satisfaction data, 30-day readmission data, other internal performance indicators or external regulatory measures. o What was the source of the data? o For example: Centers for Medicare and Medicaid Services (CMS), internal data, public health data, financial data. • Explain how input from stakeholders might have been elicited and incorporated into the development of strategic priorities. o For example, strategic priorities can be developed by the board of directors, elicited from employee focus or patient advocacy groups, or derived from a combination of these approaches. o You may need to interview an organizational stakeholder for this information. If this information is unavailable to you, identify the stakeholders you would approach for their inputs. • Create a balanced scorecard for an organization. o Use four standard balanced scorecard domains: 1) financial, 2) customer, 3) internal processes, and 4) learning and growth. o o Include quantitative measures for each domain. o Are the organization’s strategic priorities balanced, or do one or more priorities receive more emphasis than the others? • Articulate meaning relevant to the main topic, scope, and purpose of the prompt. o Write with a specific purpose and audience in mind. o Adhere to scholarly and disciplinary writing standards. o Proofread your writing to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your appraisal. • Apply APA formatting to in-text citations and references. Competencies Measured By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria: • Competency 1: Analyze organizational priorities at the system level. o Analyze an organization’s strategic plan. o Evaluate the validity of data and analytical strategies used to develop organizational priorities. o Explain how input from stakeholders might have been elicited and incorporated into the development of strategic priorities. o Create a balanced scorecard for an organization. • Competency 5: Address assessment purpose in effective written or multimedia presentations, incorporating appropriate evidence and communicating in a form and style consistent with applicable professional and academic standards. o Articulate meaning relevant to the main topic, scope, and purpose of the prompt. o Apply APA formatting to in-text citations and references. • SCORING GUIDE Use the scoring guide to understand how your assessment will be evaluated. VIEW SCORING GUIDE
Style: APA7 Theorist : Katharine Kolcaba The project includes a five-page paper that summarizes the application and overall impact of the selected theorist. The paper should have a minimum of 7-10 references that include primary sources by the theorist, a secondary source written about the theorist and 2-3 articles that represent research studies based on the theorist work. The Power Point presentation should include a brief overview of the theorist ‘background, discussion of the theorist’s definitions of the four basic metaparadigms, the theory’s basic assertions or propositions, and an analysis and a critique of the model with a focus on the theory’s implications for nursing practice, nursing education, and nursing research. Demonstrated understanding of the theorists 30 points Organization and clarity of the presentation 20 points Comprehensiveness of the presentation including Summary paper on 30 points the selected Theorist Compilation of packet of posted materials 10 points PowerPoint presentation technique and APA Formatting 10 points