Utilizing the information on the periodic table on the first page of the textbook, identify 3 or more elements that are found on food items on a daily basis, give 2 examples for each element. Write one to two paragraphs specifying which ions are found in the body and sources to get them
MINIMUM OF 250 WORDS WITH PEER REVIEW REFERENCE
Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project. This could range from support of the evidence-based project proposal to communication gaps. How could you address these problems?
Assignment: Evidence-Based Practice and the Quadruple Aim
Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.
More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.
To Prepare: Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources. Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare. Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.
To Complete:
Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.
Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of: Patient experience Population health Costs Work life of healthcare providers
Rubrics:
Write a brief analysis of the connection between evidence-based practice and the Quadruple Aim. Your analysis should address how evidence-based practice might (or might not) help reach the Quadruple Aim, including each of the four measures of:
· Patient experience
· Population health
· Costs
· Work life of healthcare providers–
Levels of Achievement: Excellent 77 (77%) – 85 (85%) Good 68 (68%) – 76 (76%) Fair 60 (60%) – 67 (67%) Poor 0 (0%) – 59 (59%) Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.–
Levels of Achievement: Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3.5 (3.5%) – 3.5 (3.5%) Poor 0 (0%) – 3 (3%) Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.–
Levels of Achievement: Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3.5 (3.5%) – 3.5 (3.5%) Poor 0 (0%) – 3 (3%) Written Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–
Levels of Achievement: Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3.5 (3.5%) – 3.5 (3.5%) Poor 0 (0%) – 3 (3%)
Needs reorganization primarily. See instructor comments for improvements. See the attachment
For the middle-aged adult, exercise can reduce the risk of various health problems. Choose two at-risk health issues that regular physical exercise and activity can help prevent and manage. Discuss the prevalence of each of these health problems in society today. Describe measures that you would take as a nurse to assist clients with health promotion measures to incorporate exercise and physical activity into their lives. Include the kind of activities you would recommend, the amount of exercise, and the approach you would use to gain cooperation from the client. Support your response with evidence-based literature.
NR 507 Week No. 5 Discussion:
PART No. 1:
Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. She has a history of Type I diabetes. On admission her laboratory values show:
Sodium (Na+)
156 mEq/L H
Potassium (K+)
4.0 mEq/L N
Chloride (Cl–)
115 mEq/L H
Arterial blood gases (ABGs)
pH- 7.30; Pco2-40; Po2-70; HCO3-20
METABOLIC ACIDOSIS with respiratory compensation, High anion gap
Normal values
Sodium (Na+)
136-146 mEq/L
Potassium (K+)
3.5-5.1 mEq/L
Chloride (Cl–)
98-106 mEq/L
Arterial blood gases (ABGs)
pH- 7.35-7.45
Pco2- 35-45 mmHg
Po2-80-100 mmHg
HCO3–22-28 mEq/L
List three (3) reasons on why she may have become bed ridden? Flu? Pneumonia? Based on these reasons what tests would you order? Accu check? CXR? Lactic Acid level, serum and urine ketone levels Describe the molecular mechanism of the development of ketoacidosis. (p. 744) *Pt’s who develop DKA do so bc bicarbonate buffering does not occur, which begins the development of metabolic acidosis
pH 7.30 = acid
CO2 40 = Normal
O2 70 = Low
HCO3 20 = acid
PART No. 2:
A three-month-old baby boy comes into your clinic with the main complaint that he frequently vomits after eating. He often has a swollen upper belly after feeding and acts fussy all the time. The vomiting has become more frequent this past week and he is beginning to lose weight. Write three (3) differential diagnoses at this time? Is there any genetic component to the top of your differentials? What tests would you order?
PART No. 3:
Write a one (1) paragraph case study of your own for a patient with Ulcerative Colitis?
PEER:
NR 507 Week No. 5 Quiz:
1. Aldosterone synthesis and secretion are primarily regulated by the (Points : 2)
2. A surgical individual just arrived on the unit from the postanesthesia care unit. This person’s respirations are 4 per minute and shallow. As the nurse calls for assistance, the person suddenly feels jittery and breathing quickens. Which of the following feedback loops is operating for the nurse in this situation? (Points : 2)
3. What effect does aldosterone have on fluid and electrolyte imbalances? (Points : 2)
4. What effect does hyperphosphatemia have on other electrolytes? (Points : 2)
5. Where is oxytocin synthesized? (Points : 2)
6. Which mineral is needed for the synthesis of thyroid hormones? (Points : 2)
7. The portion of the pituitary that secretes oxytocin is the _____ pituitary. (Points : 2)
8. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of a _____ effect by a hormone. (Points : 2)
9. Which of the following hormones acts on its target cell via a second messenger? (Points : 2)
10. Target cells for parathyroid hormone (PTH) are located in the (Points : 2)
11. Which hormone is involved in the regulation of serum calcium levels? (Points : 2)
12. A person who has experienced physiologic stresses will have increased levels of which hormone? (Points : 2)
13. The first lab test that indicates type 1 diabetes is causing the development of diabetic nephropathy is (Points : 2)
14. A deficiency of which of the following may result in hypothyroidism? (Points : 2)
15. Diagnosing a thyroid carcinoma is best done with (Points : 2)
16. The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute (Points : 2)
17. Which of the following clinical manifestations is not common to both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS)? (Points : 2)
18. The signs of thyroid crisis resulting from Graves disease include (Points : 2)
19. What causes the microvascular complications of clients with diabetes mellitus? (Points : 2)
20. A man with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low. Although he has had no intake for 4 hours, there is no change in his polyuria. These are indications of (Points : 2)
21. Amenorrhea, galactorrhea, hirsutism, and osteopenia are each caused by a (Points : 2)
22. The most common cause of hypoparathyroidism is (Points : 2)
23. The level of thyroid-stimulating hormone (TSH) in Graves disease is usually (Points : 2)
24. The most probable cause of low serum calcium following a thyroidectomy is (Points : 2)
25. Hyperpituitarism is generally caused by (Points : 2)
No plagiarism will be checked with turnitin.
Assignment Directions: Case: Jane
For this Assignment, using the case information and best evidence, complete the chart below. Make sure to address all columns in the chart.
Case #1: Jane
Jane is a 42-year-old G4P2103. Jane is divorced and works long, hard hours as a real estate agent. Jane was having irregular and heavy menses for 6 months, and then they abruptly stopped 3 months ago.
Jane has been having nausea and vomiting for 6 weeks but attributed it to having the flu recently. She also admits to gaining about 10 pounds in the last few months and experiencing breast tenderness.
Jane comes to the clinic today to discuss menopause symptoms and treatment. During the visit, a urine pregnancy test came back positive. During the exam, you palpate a 16-week-size uterus and get fetal heart tones of 165. Jane is in disbelief.
Assignment 1: Initial Analysis for Program Planning
Needs Assessment
“As a concept, need is not only difficult to define but, once defined, difficult to measure” (Kettner, Moroney, & Martin, 2017, p. 63). Likewise, it can be challenging to define and measure assets—yet it is equally important to do so during this phase of program planning. This week’s Learning Resources provide foundational information and guidance for conducting needs assessments, which entails discerning needs that must be addressed in light of the assets that are present.
As you return to Assignment 1, the attention turns to conducting a needs assessment for the problem you have identified. What data collection strategies could be most useful? What issues would likely be encountered? How would you address them?
To prepare for this week’s section of Assignment 1: Continue (from the Discussion) to: Identify a viable approach for conducting a needs assessment for your problem. Identify method(s) of data collection. Assess potential challenges and propose alternatives/solutions.
The full Assignment 1 is due by day 4 (Thursday 12/20/18) of this week. Instructions have been provided in previous weeks to help you prepare.
By Day 4
To complete:
Write a 3- to 5-page paper, in APA format with at least 7 scholarly references in which you address the following level 1 and 2 header:
Also include an introduction and a conclusion as per APA guidelines.
1) Identification of a Problem and a Population Identify a problem and a target population.
(Note: Your problem should be clearly developed and related to a health-promotion and disease-prevention issue of national significance. You should select a target population so that your program can be designed to create maximum yet realistic impact at the aggregate level.)
2) Using a Theory or Model Analyze a theory or model that is relevant to your selected problem. Explain why this is the most appropriate model for you to use with this problem.
3) Literature Review (provide at least 4 scholarly articles less than 5 years old) ) Assess the literature as it relates to your problem. Use evidence from the literature to support your response to the following question: Why is it important to assist this population to resolve the selected problem?
4) Needs Assessment Describe an appropriate approach to conducting a needs assessment for your problem. Identify method(s) of data collection. Assess potential challenges and propose alternatives/solutions.
Required Readings
Hodges, B. C., & Videto, D. M. (2011). Assessment and planning in health programs (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.
Chapter 1, “Assessment for Developing Programs and Interventions: The Big Picture”
Chapter 1 notes the importance of looking not just at needs but also the assets associated with the target population and environment; that is, assessing what needs to be addressed given the assets that are present.
This report offers a guide for the use of the logic model in program planning and outcome-oriented evaluation for nonprofit projects.
Chapter 3, “Data Collection Strategies for Needs Assessments and Evaluations”
In Chapter 3, the authors examine data collection, a key element of needs assessments. They also indicate that it is wise to plan ahead and consider data collection strategies for evaluation at the same time. Chapter 2, “Paint a Picture of Your Target Population: Assessing Assets and Problems”
This chapter presents valuable information for identifying your target population during program planning. Note: Some of the information in this chapter extends into needs assessment, which will be addressed in Week 4.
Chapter 6, “The Importance and Use of Theories in Health Education and Health Promotion”
The authors describe various theories, noting that theories are not universally applicable to every program.
Kettner, P. M., Moroney, R. M., & Martin, L. L. (2017). Designing and managing programs: An effectiveness-based approach (5th ed.). Thousand Oaks, CA: Sage. Review Chapter 1, “Contemporary Issues in Social Services Program Planning and Administration” (See attached file). Review Chapter 3, “Understanding Social Problems” (See attached file).
Review these chapters as needed to help you identify a health care-related problem for program planning and evaluation. For instance, you may find the problem analysis information on page 13 and pages 38–39 beneficial.
Chapter 2, “The Contribution of Theory to Program Planning”
This chapter examines the application of theory in program planning.
Chapter 4, “Needs Assessment: Theoretical Considerations”
Chapter 5, “Needs Assessment: Approaches to Measurement”
These two chapters provide foundational information as well as guidance for conducting a needs assessment as part of program planning.
Adams, J. & Kaplow, R. (2013). A sitter reduction program in an acute health care system. Nursing Economics$, 31(2), 83–89.
Pinto, B.M., Waldemore, M., & Rosen, R. (2015). A community-based partnership to promote exercise among cancer survivors: Lessons learned. International Journal Behavioral Medicine, 22, 328–335 doi 10.1007/s12529-014-9395-5
Tompa, E., deBoer, H., Macdonald, S., Alarngir, H., Koehoorn, M., & Guzman, J. (2016). Stakeholders’ perspectives about and priorities for economic evaluation of health and safety programs in healthcare. Workplace Health and Safety, 64(4), 163–174 DOI: 10.1177/2165079915620201.
Leading Health Indicators. (n.d.). Retrieved March 22, 2017, from https://www.healthypeople.gov/2020/Leading-Health-Indicators
National Database of Nursing Quality Indicators. (n.d.). Retrieved March 22, 2017, from http://www.pressganey.com/solutions/clinical-quality/nursing-quality
U.S. Department of Health and Human Services. (2010). Healthy People 2020. (n.d.). Retrieved March 22, 2017, from https://www.healthypeople.gov/sites/default/files/HP2020_brochure_with_LHI_508_FNL.pdf
IOM Future of Nursing Report. (n.d.). Retrieved March 22, 2017, from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/IOM-Future-of-Nursing-Report-1
Berhane, A., Biadgilign, S., Berhane, A., & Memiah, P. (2015). Male involvement in family planning program in Northern Ethiopia: An application of the Transtheoretical model. Patient Education and Counseling 98, 469–475
Kroelinger, C.D., Rankin, K. M., Chamgers, D.A., Diez Roux, A.V., Huges, K., & Grigorescu, V. (2014). Using the principles of complex systems thinking and implementation sceice to enhance maternal and child health program planning and delivery. Maternal Child Health Journal, 18, 1560–1564. doi 10.1007/s10995-014-1586-9
Silverman, B., Champney, J., Steber, S., & Zubritsky, C. (2015). Collaborating for consensus: Considerations for convening Coalition stakeholders to promote a gender-based approach to addressing the health needs of sex workers. Evaluation and Program Planning 51,17–26 doi.org/10.1016/j.evalprogplan.2014.12.002
Smith, T.L., Barlow, P.b., Peters, J.M., & Skolits, G.J. (2015). Demystifying reflective practice: Using the DATA model to enhance evaluators’ professional activities. Evaluation and Program Planning, 52, 142–147.
Burrows, T., Hutchesson, M., Chai, L,K., Rollow, M., Skinner, G., & Collins, C. (2015). Nutrition interventions for prevention and management of childhood obesity: What do parents want from an eHealth program? Nutrients, 7, 10469–10479 doi:10.3390/nu7125546
Derguy, C., Michel, G., M’Bailara, K., Roux, S., & Bouvard, M. (2015). Assessing needs in parents of children with autism spectrum disorder: A crucial preliminary step to target relevant issues for support programs. Journal of Intellectual & Developmental Disability, 40(2), 156–166 doi.org/10.3109/13668250.2015.1023707
Millard, T., McDonald, K., Elliott, J., Slavin, S., Rowell, S., & Girdler, S. (2014). Informing the development of an online self-management program for men living with HIV: a needs assessment. BMC Public Health, 14, 1209 doi:10.1186/1471-2458-14-1209
Springer, A. E. & Evans, A.E. (2016). Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners. Health Promotion Perspectives, 6(3), 111–118 doi: 10.15171/hpp.2016.19
Required Media
Laureate Education (Producer). (2011). Design and evaluation of programs and projects [Video file}. Baltimore, MD: Author. “Defining a Population Health Problem” (featuring Dr. Melissa Willmarth, Dr. Debora Dole, and Dr. Donna Shambley-Ebron)
You may view this course video by clicking the link or on the course DVD, which contains the same content. Once you’ve opened the link, click on the appropriate media piece.
In these videos, Dr. Melissa Willmarth, Dr. Debora Dole, and Dr. Donna Shambley-Ebron provide insights related to defining health care-related problems.
Laureate Education (Producer). (2011). Design and evaluation of programs and projects [Video file]. Baltimore, MD: Author.
“Needs Assessment” (featuring Dr. Rebecca Lee, Shiniche Thomas, and Dr. Donna Shambley-Ebron)
You may view this course video by clicking the link or on the course DVD, which contains the same content. Once you’ve opened the link, click on the appropriate media piece.
In this week’s videos, Dr. Rebecca Lee and Dr. Donna Shambley-Ebron discuss needs assessments. Then, Dr. Rebecca Lee demonstrates a windshield assessment along with Seven Hills community resident Shiniche Thomas.
Optional Resources
Algera, M., Francke, A. L., Kerkstra, A., & Van der Zee, J. (2004). Integrative literature reviews and meta-analyses: Home care needs of patients with long-term conditions: Literature review. Journal of Advanced Nursing, 46(4), 417–429.
This article compares literature in the field to determine a profile for people with long-term health care conditions who utilize home care services.
Madden, S. G., Loeb, S. J., & Smith, C. A. (2008). An integrative literature review of lifestyle interventions for the prevention of type II diabetes mellitus. Journal of Clinical Nursing, 17(17), 2243–2256.
This article is an example of an integrative literature review that identifies aspects of nursing programs aimed at prevention of type II diabetes, effectiveness of such programs, and compliance with lifestyle changes after such programs.
Hulton, L. J. (2007). An evaluation of a school-based teenage pregnancy prevention program using a logic model framework. Journal of School Nursing, 23(2), 104–110.
This article describes the use of the logic model to develop, implement, and evaluate a nursing intervention in a school setting.
Johnson, S. S., Driskell, M., Johnson, J. L., Prochaska, J. M., Zwick, W., & Prochaska, J. O. (2006). Efficacy of a transtheoretical model-based expert system for antihypertensive adherence. Disease Management, 9(5), 291–301.
This article introduces the use of the transtheoretical model and stages of change as applied to interventions aimed at medication adherence for patients with hypertension.
Rogers, L. Q., Shah, P., Dunnington, G., Greive, A., Shanmugham, A., Dawson, B., & Courneya, K. S. (2005). Social cognitive theory and physical activity during breast cancer treatment. Oncology Nursing Forum, 32(4), 807–815.
The social cognitive theory is utilized to examine associations with physical activity in breast cancer patients. This article posits that the social cognitive theory can be used as a mediator for intervention evaluation with this population.
W. K. Kellogg Foundation. (2004). Using logic models to bring together planning, evaluation, and action: Logic model development guide. Battle Creek, MI: W. K. Kellogg Foundation. Retrieved from http://www.wkkf.org/resource-directory/resource/2006/02/wk-kellogg-foundation-logic-model-development-guide.
I need help writing this paper
Explore various science-based theories. Select two theories to describe to your peers. How is each of these theories relevant to application for a DNP-prepared nurse.
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