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Care Delivery or Nursing Model Change on information delivery

This is an assignment that focuses on the Care Delivery or Nursing Model Change. Additionally, this will be on top of how to deliver information.

Care Delivery or Nursing Model Change on information delivery

There will be times when the doctorally prepared advance practice nurse will need to suggest a nursing model change or a change in care delivery. It will be important for the doctorally prepared advanced practice nurse to have an understanding of how to deliver information and what information should be shared with an audience. Also, this assignment will give you practice with presentation software along with preparing you to provide specific information for your proposed changes.

This is a two-part assignment that will also give you practice in presenting to administrators.

General Requirements: Use the following information to ensure successful completion of the assignment: • Doctoral learners are required to use APA style for their writing assignments. • This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included. • This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Directions:

Part One:

Firstly, create a 12-15 slide presentation (PowerPoint, include slide notes or voice over; Prezi, include voice over) that presents a proposed care delivery or nursing model change for a department that aligns costs, quality, and health that supports the care of patients across the continuum. Include the following:

1. Background of issue

2. The proposed solution

3. How solution meets need of population (stakeholders, cost, and payer to proposed change)

4. Proposed change process to implement delivery model

5. Expected outcomes

6. Implications that are realistic and aligned with current and future health care financing 10 references

Part Two:

1. Secondly, present your presentation to at least one administrator.

2. Thirdly, write a brief summary, 100-250 words, of the feedback given to you by the administrator(s).

4 references

Lastly, you are to complete your assignment using real-world application. Additionally, real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course.

The culmination of your assignment must present a viable application in a current practice setting. with 15 SLIDES SPEECH/PRESE‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍NTATION

40-year-old male with a persistent cough

Complete only the History, Physical Exam, and Assessment sections of the Aquifer virtual case: Family Medicine 13: 40-year-old male with a persistent cough.

Family Medicine 13: 40-year-old male with a persistent cough

Assignment
Complete only the History, Physical Exam, and Assessment sections of the Aquifer virtual case: Family Medicine 13: 40-year-old male with a persistent cough.

Scenario:
You are working in Dr. Wilson’s office. The first patient of the morning is Mr. Frank Dennison, a 40-year-old cisgender male.
As you and Dr. Wilson open the electronic medical record, you note past visits by Mr. Dennison for allergic rhinitis and refills of various antihistamines and nasal sprays. Then you look at today’s encounter which gives the following information:
Reason for visit: Cough for two months.
Vital signs:
Temperature is 36.8 C (98.2 F)
Pulse is 80 beats/minute
Respiratory rate is 16 breaths/minute
Oxygen saturation is 97%
Blood pressure is 118/68 mmHg
Height is 172.7 cm (68 in)
Weight is 86.2 kg (190 lbs)
Body mass index (BMI) is 28.9 kg/m2
Dr. Wilson asks you to “do a focused history, then let me know what you find.”
Before you go into the exam room, you review common conditions that can lead to a persistent cough.

HISTORY 1

Dr. Wilson has already obtained permission from the patient for you to see him.
You introduce yourself, and begin by asking:

“How may we help you today?”

Mr. Dennison responds, “I’ve had this nagging cough for two months.”

“Tell me more about your cough.”

“I don’t have a fever so I don’t think I have an infection. The cough is worse at night. In fact, I wake up some nights with coughing spells. Eventually, I cough up some clear mucous, and then I feel better. Sometimes I notice that my breathing gets noisy.”

 

“What kind of noise do you make when you are breathing?”

“It’s kind of a musical, whistling sound, especially when I breathe out.”

“How often do you notice this noisy breathing?”

“On one or two nights of the week, I will wake up coughing and get that noisy breathing at the same time. When I cough up some clear mucous, I feel better. I have never had the noisy breathing during the day. In fact, when I jog or bicycle, my breathing is fine.”

“Do you get any chest tightness or chest pain?”
“No.”

HISTORY 2

As you proceed to take the rest of Mr. Dennison’s history, you continue to consider the diagnosis of asthma. Bearing this in mind, you ask Mr. Dennison about his past medical history:

“I see that you have a history of allergic rhinitis. How is that going?”

“What medications do you take for this?”

 

“Why haven’t you been receiving your allergy shots regularly?”

“Let’s discuss some options to help you take your medications and receive your shots.”

Through these questions, you realize Mr. Dennison’s allergic rhinitis is not under ideal control. You wonder if treating his allergic rhinitis would help control his cough and wheezing.

Next, you wish to see if he has an underlying sinusitis since that also is a co-morbid condition of asthma that could explain some of his symptoms.

DISCUSSING DIFFERENT CLINICAL SCENARIOS

CLINICAL REASONING
You know that Mr. Dennison has had chronic nasal symptoms (sneezing, nasal congestion, and drainage) for three to four months, so it is unlikely that he has acute sinusitis. Dr. Wilson asks you to consider a different hypothetical scenario.
“What if Mr. Dennison presented with one week of upper respiratory symptoms including nasal congestion and drainage? On the day the symptoms began, he had a low-grade fever that has now resolved.

His nasal congestion persisted and he has now had yellow nasal drainage for five days with associated mild headaches. On exam, he is afebrile and in no distress. Examination of his tympanic membranes and throat are normal. Examination of his nose is unremarkable although a slight amount of yellowish-clear drainage is noted. There is tenderness when you lightly percuss his maxillary sinuses.”

ACUTE VERSUS CHRONIC TEACHING
You and Dr. Wilson turn your attention back to Mr. Dennison.
By definition, nasal symptoms lasting more than 12 weeks are not acute sinusitis. So you consider chronic sinusitis and recall what you know about the symptoms of chronic sinusitis and you realize with the patient’s chronic nasal congestion and mucopurulent drainage, he may have chronic sinusitis. There may be additional physical signs and diagnostic tests that will be needed later to confirm this.

HISTORY 3

“Do you have any other chronic conditions; have you had hospitalizations or surgeries?”

“Do you take any medications other than the ones we have discussed?”

“Do you have any allergies to any medications, particularly aspirin?”

“Have you ever smoked cigarettes or cigars or chewed tobacco?”

Mr. Dennison reports no alcohol or drug use. He lives with his wife and two children, who are all healthy. His father is deceased, but had allergic rhinitis and asthma.

You remember that there are still some potential asthma comorbid conditions to ask about such as overweight and obesity, gastroesophageal reflux disease, obstructive sleep apnea, stress and depression. Also, you review his current weight and BMI and note that his current BMI classifies him as overweight, but not obese.

You ask Mr. Dennison this series of questions and discover the review of systems is negative:
“Have you ever had any symptoms of heartburn?”

“Has your wife ever commented on the way you sleep—snoring a lot or breathing unusually?”

“How are you doing emotionally; are you stressed or depressed?”

You explain that you would like Mr. Dennison to change into a gown while you go discuss your findings thus far with Dr. Wilson. And, when you return in a moment, you will perform a physical exam.

You find Dr. Wilson in the hallway and give him a synopsis of the history you’ve obtained from Mr. Dennison.

Discussion Question 1

Based on your performance and the expert feedback in your HISTORY collection, describe two missed questions and your understanding of why they were important to collect for this case history. Use specific references from your text to explain.

Discussion Question 2
Based on your performance and the expert feedback in your PHYSICAL EXAM collection, describe two errors in your exam performance or documentation. Use specific references from your text to explain the importance of these findings in correct assessment of this client.

Discussion Question 3
Based on your performance on the PHYSICAL EXAM collection, describe one key finding that you included in your list and describe a specific physical exam that you can perform at the point-of-care to further evaluate the finding. Use specific references from your text.

Discussion Question 4

Based on your performance and the expert feedback in your ASSESSMENT identification of problem categories, choose one missed/incorrect category and use specific references from your text to explain the importance of this category in arriving at correct differential diagnoses for this client.

Discussion Question 5
Based on your performance and the expert feedback in your ASSESSMENT of differential diagnoses, describe one incorrect/missed differential diagnosis and use specific references from your text to support the inclusion of the diagnosis for this client.

Evidence Based Medicine Critical Appraisal study design

This is an assignment that focuses on the evidence based medicine critical appraisal study. The paper also focuses on the study design and treatment.

Evidence Based Medicine Critical Appraisal study design

Scenario: You are reviewing Mr Burns, a 59-year-old chronic smoker who was admitted to the ED 6 days ago for an acute myocardial infarction (ST-segment elevation). He is now stable; however, his latest blood tests show slightly elevated LDL Cholesterol (2.2 mmol/L). Mr Burns is currently taking 40mg of simvastatin. You will also ask yourself, should I switch him from simvastatin 40mg to simvastatin 40mg + ezetimibe 10mg? Task: To help you in answering this question, you are to critically appraise the study “Ezetimibe added to Statin Therapy after Acute Coronary syndromes (https://www.nejm.org/doi/full/10.1056/NEJMoa1410489) by answering the following questions: Study design questions

1. Firstly, what is the study design (e.g. RCT, cohort study, case series)? (0.5 mark)

2. Secondly, was the study placebo controlled? What was the study placebo controlled for? (1 mark)

3. Thirdly, are the treatment and control groups comparable? (1 mark)

4. Fourthly, why are blinding techniques used in clinical trials? Who was blinded in this trial? (1 mark)

5. Then, was the analysis methodology (of results) plan a priori or post-hoc? (1 mark)

6. Also, who funded the study? Are there any conflicts of interests involving researchers / investigators and is this likely to have biased the study findings? (1.5 marks)

7. Lastly, was the primary endpoint/outcome measure in this study clinically appropriate? (1 mark) Statistical Analysis, Reporting of Results and also Clinical Significance Questions

1. Were the results (of the primary endpoint) statistically significant (p< 0.05 or 95% CI relative risk/hazard ratio does not include 1)? (1 mark) 2. Secondly, determine the absolute risk increase (ARI) and numbers needed to harm (NNH) for this study with regards to reported myopathy adverse events between treatment groups. Are myopathy related events significantly more common in the intervention group? Comment on the risks of rhabdomyolysis or myopathy reported between treatment groups. (2.5 marks) 3. Who is the corresponding (primary) author for the report? Would he/she be an ‘Opinion leader’ in their field? (1 mark)

4. Additionally, is the data applicable to the current patient (age, sex, race, etc.)? (1 mark) 5. If Mr Burns had very impaired renal function (e.g. calculated creatinine clearance <20ml/min) would the study findings be applicable to him? (0.5 mark) 6. Were appropriate doses usage in the study? (1 mark) 7. Subsequently, what is the quality of the journal in which the results were report? (0.5 mark) 8. Is the report complete e.g. full article, or an abstract/poster? (0.5 mark) 9. Lastly, are the results from this trial clinically relevant for Mr Burns? (Non-assessed item)

Community health disparities in the nursing field

This is a paper that focuses on the examination of Health disparities issue in the nursing field. The paper also reviews morbidity or mortality.

Examination of Health disparities issue in the nursing field

T‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍he purpose of the paper is to critically examine a health disparities topic in their discipline . Additionally, to research literature in nursing and other disciplines to develop a proposal for addressing the health disparities issue you chose. Explore research on your topic.

In your paper:

Consequently, you will summarize evidence on disparities related to your topic and identify factors that contribute to those disparities. Next, you will propose solutions to address the health disparity, considering factors at the individual provider-patient, organizational, policy, and societal/structural levels.

Your paper should reflect your evolving understanding of how nursing (or your health profession. If you are not a nursing student) you can contribute to health equity. Write a 3 page paper, using APA formatting (OWL at Purdue APA Formatting/Style Guide is very useful). Topic guidelines: Rather than choosing a cultural, racial or ethnic group as a starting point, think about clinical diagnoses that interests you such as hypertension, a type of cancer in a given population, diabetes, sickle cell, HIV, prenatal care; or care settings such as ICUs, emergency services, or primary and preventive care settings. For example, you can choose specific topics such as racial disparities in bariatric surgery, disparities related to veterans primary care, or care for patients with deafness, etc. You can also choose a global health or community health topic. There are many possibilities.

Draft Guidelines:

1. You might introduce the topic and review available data on morbidity/mortality; differences in outcomes among certain groups; challenges in providing equitable care (e.g., cultural, language, gender, or other barriers, such as lack of insurance or access, discriminatory processes/policies) as identified in the research literature.

2. Paper details. This should include your plan for reducing disparities. Also, in achieving health equity, involving at least three levels of intervention (see 1-4 below). You should submit this paper in APA format if you want feedback on APA, citations, references list, etc. In your discussion of interventions/solutions, present evidence from scientific literature and suggestions made by scholars on your topic. You can also apply knowledge on reducing disparities from other sources not directly related to your topic as long as they are appropriate.

Nursing Reflection Assignment

This is a paper that is requiring the student to discuss and reflect on NURS 5051 Assignment. The paper also provides additional information to use in the writing of the assignment paper. Below is the assessment description to follow:

Discuss and reflect on NURS 5051 Assignment paper

NURS 5051 Assignment: The Nurse Leader as Knowledge Worker

8 slide PowerPoint Presentation

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?

Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.

In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a 8 slide PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker.

Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.

Discuss and reflect on NURS 5051 Assignment paper

To Prepare:

Firstly, review the concepts of informatics as presented in the Resources.

Secondly, reflect on the role of a nurse leader as a knowledge worker.

Thirdly, consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

Firstly, explain the concept of a knowledge worker.

Secondly, define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.

Thirdly, include one slide that visually represents the role of a nurse leader as knowledge worker.

Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and also what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.