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Fistula Assessment and Care Paper

Assignment 

Purpose of Assignment:  The purpose of this assignment is for the student to become aware of the challenges of fistula care and, using best practice resources, explore assessment & management options. In addition, you will develop an appreciation for the work around the transfer of care when patients transition from hospital to home.

 Length and Value: This assignment is marked out of 100% and worth 15% of total mark. The length should be 10-12 pages excluding the cover page and the reference list. Assignments longer than 13 pages may be returned unmarked and given a 0%. Assignments must use APA formatting or risk a mark reduction. The assignment must be submitted in Microsoft word or equivalent format (the file should end with .doc, or .docx).

Case Study Part A Tom Jones is a 62-year-old self-employed electrician. Eight weeks ago he underwent an abdominal incisional hernia repair with a Surgical Mesh. He began experiencing serous drainage from the incision a few days post op. On Day 10 post op he returned to the surgeon who removed staples and a 10  centimeter section of his midline incision opened up. The wound was packed with saline soaked gauze and Tom went home. Two days later he started draining large amounts of liquid stool from this opening and the visiting Home Care Nurse sent him to the hospital. Mr. Jones was admitted late Friday night over the Labour Day weekend and the NSWOC was asked to see him on Tuesday.

Part B Mr Jones has been in hospital for 7 weeks and he is now well enough to go home to continue his recovery. He’s been off TPN for a week and is tolerating a GI diet but must be encouraged to drink enough fluids. He’s on Imodium 1/2 hr ac meals & hs which helps to keep the fistula output 700-850mls/ day. The wound is 5.4 cm L x 3.7 cm W x 2.3 cm D and a fistula pseudostoma is visible in the base. Tom, while happy to go home, is admittedly nervous about how he will manage everything.

Knowledge Acquisition Focus: Gain knowledge about the diagnostic tests and assessment parameters used in the presence of a fistula.

1. Briefly define an ECF. (2 marks)
2. Identify 3 diagnostic tests that may have been completed on Mr Jones upon admission with stool draining from his wound. Briefly describe the test highlighting what information it provides about an ECF. (3 marks each x 3 =9 marks)
3. Describe 5 fistula assessment parameters that the NSWOC must consider. These are the components you are going to assess when seeing a patient with a fistula. (25 marks)
4. Briefly explain the significance of the presence of mesh when one has an ECF. (2 marks) Knowledge to Practice Focus: Determine management options and communicate care needs.
5. a) Describe 3 nursing methods of fistula management to protect the skin and contain the effluent. Identify the advantages and disadvantages for each. Use a table for this answer, point form, single spaced for this table. (1 mark for method, 3 marks for advantages, 3 marks for disadvantages = 21 marks)
6. b) Select a nursing management method from the list above that is most appropriate for Mr. Jones and explain why you chose it. (6 marks)
7. As an NSWOC you will be involved with the transfer of care of patients with complex care needs from hospital to home or another care setting. Identify 6-8 things that should be included in the transfer of care information for Tom as he is discharged from hospital to home care. This section must have detailed clinical information of how the Home Care nurse would care for this man on discharge in his home setting. Include your rationale for including each (brief comment). Please answer this question using the layout you would use when creating a transfer of care sheet. It should be no more than 2 pages long and may be as creative as you like. (30 marks)
8. Presentation : Style and Clarity. Grammar, spelling, format (cover page, introduction, conclusion, citations, reference list). (5 marks)

Rheumatoid Arthritis: Symptoms, Causes, Treatment

Write an extended literature review using three sources on:
Rheumatoid arthritis: Risks/benefits of latest treatments
You will need to determine the focus of inquiry and determine which approach to analysis you should take based on the topic you choose.
For this review, be sure to:
Select three relevant and appropriate scholarly articles that address the topic you chose.
Present a thorough literature review of the three articles by summarizing, synthesizing, and evaluating the materials.
Incorporate citations into your body paragraphs; incorporate the essential and most relevant supporting evidence eloquently and appropriately.
Present your writing in a clear, organized manner.
Demonstrate understanding of the content presented in the articles.
Use proper APA format with proper citations. Review APA Citations Here
Your literature review should be 3–4 pages in length. Remember, you will need to use APA formatting in your literature review and include a title
page and a reference page.

Prevention and Control of Diseases Quad Chart Assignment

Instructions

Considering the current breast cancer incidence, death, recurrence, metastatic disease, risk factors, and treatment options, the Avon
Breast Cancer Crusade continues to search for new preventive strategies to address the growing number of cases around the globe.
The aim of this program is to support innovative, high impact research focused on ending breast cancer. This year, the Avon
Breast Cancer Crusade Research Program seeks proposals to advance understanding of prevention of breast cancer.
You are required by your employee – Streetsboro Department of Health – to prepare a quad chart of the synopsis of the
proposed research for this grant proposal.
**You are highly encouraged to conduct a literature review on breast cancer before preparing your applications. **
Summary of Learning Objectives:
1. Use library discovery tools to identify credible or professional journal articles.
2. Determine appropriate use of data, statistical methods, and laboratory procedures for problem identification and resolution, and
program planning, implementation and evaluation.
3. Summarize information from popular and professional articles.
4. Apply evidence-based biological principles to development and implementation of breast cancer prevention, control, or
management of programs.
PROCEDURE
A. General Instructions
• Please make a quad chart on one PowerPoint slide that describes your proposed project.
• You are expected to briefly inform the general public about the design and the merit of your work, that is, the information should be written for members of the general public, rather than for researchers or professionals.
• You are limited to one slide ONLY.
• Use 11 point Arial font (template default). If you do not have enough space, reduce the amount of text, not the size of the font.
• Please see the quad chart cheat sheet above and the template below for help.
B. Content
• Header: Project Information
• Enter Project Title, Principal Investigator (you) Name in the format: First, Last, and Degree(s)
• Enter research area addressed, program director/manager or company name
• Complete all the sections of the Quad chart
Quadrant 1: Project Description (Upper Left)
• Enter total $ award amount requested.
• Enter anticipated start date of the project.
• Enter the Key Research Aims.
• Provide a summary description of the design, noting the population, intervention and comparators, and primary outcome measure, as
applicable.
Quadrant 2: Project Benefits and Innovations (Lower Left)
• List the major (potential) scientific innovations of the project in the upper section.
• List the anticipated benefits and challenges to women in the lower section.
Quadrant 3: Figure (Upper Right)
• Illustrate the problem, conceptual model, study approach (graph or table of relevant data may be used).
Quadrant 4: Timeline (Lower right)
• Insert a simplified study timeline listing the tasks, funding, and the fiscal years the study will be active OR your measures of success
C. Submission

1. Save the file with your lastname_firstname_ProjectTitle (where “lastname” and “firstname” refer to your last and first names).
• Submit by due date on course blackboard page.
• Submit the reference list in APA format on a different page

Critique of Quantitative Research Article

Assignment Objectives:  At the completion of this assignment the student will be able to:

1. Synthesize information from nursing research to critique a quantitative research article.  The knowledge gained from this assignment will provide the students with a foundation to differentiate different components of research as well as research that can be utilized in evidence-based practice
2. Evaluate the credibility of sources of information, including but not limited to databases and Internet resources. (AACN III:4)
3. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.  (AACN III:2)

Directions:

The students will select a quantitative research study from a peer reviewed nursing journal.  All research articles used must be pre-approved by the faculty member 4 weeks prior to the assignment

The following questions should be answered in the critique of the article.  A yes or no answer will not be accepted.  All questions should be explained.

EVALUATION TOOL

 

Grade Sheet for Critique of Quantitative Research Article (Assignment 2)

 

Critical Element	Points	Points Earned	Comments
Introduction – What is the research problem and is it clearly stated in the paper? – How important is the problem to nursing? – What is the justification for this study? – Are there hypotheses, questions, or objectives stated? – What theoretical or conceptual framework was used for the study? Was it clearly identified or only implied? – How is the framework linked to the research purpose? – How current is the research literature reviewed (consider the publication date of the paper)? – Is the literature review organized logically? – Does the literature review adequately support the need for the study?	15
Methods -What is the study design? -Does the design fit the purpose of the study? (Explain your answer.) -How is the design linked to the sampling method and statistical analysis? -Describe the sample as stated in the article.  Is it adequately and clearly described in the article? -Is the sampling procedure discussed in detail? -What do the authors provide as justification for the size of the sample? -Describe the study protocol (treatment and/or procedures): is it clear and concise? -What instruments are described in the article? -Does each instrument measure the concept it is intended to measure? (Is the concept definition consistent with the Operational definition?) Methods (Cont’d) -Does the author(s) present information on reliability and validity of the instruments? -How does the author address threats to internal and external validity that are inherent in the study design? -What evidence is provided regarding human subject’s review and approval discussed? -Are there indications of any ethical concerns? -Is the study described with enough detail for replication?	20
Results -How are characteristics of the sample described? -Are the research questions/hypotheses answered separately? -What types of data were collected? -What data analysis procedures are used to answer the research questions? (Explain your answer.) -Are tables, charts, and/or graphs used to present the data? -Does the text supplement or repeat the data in the tables? -Briefly summarize the findings and analyze the results.	20
Discussion/Implications for practice -Does the author relate the findings to the study’s purpose (or research objectives/hypotheses/questions)? -How do the findings of the study compare with findings from previous studies? -Does the author discuss the findings that conflict with previous work? -What limitations of the study are discussed in terms of practice and future research? -What new research emerged from this study? -What is the potential for use in nursing practice?	20
Overall Presentation and final summary Does the title accurately describe the type of study, major variables, and target population? Does the abstract accurately represent the study? Is the report logically consistent? Is the writing style clear and concise?	15
Format APA Grammar/spelling Organization	10
Total	100

 

**This assignment is a component of this program’s “Outcome Assessment Plan” which evaluates the student’s critical thinking. Students who receive less than 77% will be required to modify their paper or re-present their oral presentation until a passing grade has been reached.  The student’s original grade will be the only grade counted towards the final grade