Essays on Clinical Practice

There are times when a nursing problem arises as a result of a number of findings, and these findings are pulled together into a summary in order to see the big picture created out of these findings. This act of pulling together is what Brown & Ochs (2018) calls a systematic research review (SRR) or systematic review, which helps researchers identify “what is known with certainty, what is tentatively known, and what the gaps in knowledge are regarding an issue” (p.175). It serves as a link between the individual studies performed and the decision making done in order to create ...

Genetic counselling has been described as the process by which an individual fully understands and adapts to the contribution of genetic makeup in the medical and physiological state of the individual along with its influence on the familial implications of a disease condition [1]. Genomic medicine is at an all-time high in these years of fast developing technology in medicine [2]. The traditional process of genetic medicine and counselling involves the collection of data and interpretation of the history of pathology in the familial background of the individual along with the assessment of risks, informed consent, and psychosocial analysis ...

Status of the document.

This document is a project proposal for the development of starch-based hemostatic products. Acknowledgement. Much thanks to the project supervisor who offered guidance in every step of the development of this proposal. Developing starch based hemostatic products Project summary. Purpose: This proposal is envisioned to develop a hemostatic agent from purified plant starch. In this case, the product of the reaction should be developed by the formation of microporous hemosphere particles after etherification, esterification and crosslinking of glucose molecules to form ethyl propanetriol (glycerol-ether links (1-3 deoxy propanol)). The second intention of this study is to investigate the properties ...

Introduction

The study of human body movement assists in understanding different biomechanical, psychological, and physiological mechanisms of the body. Taking care of a newborn from the time of birth to the age of about twelve months requires the mother or the caregiver to understand some concepts necessary for the survival of the baby. According to Davis, Cladis & Motoyama (2011), the breathing pattern of newborns from up to the age of six months is purely diaphragmatic (abdominal), hence; the need to understand various positions that allow the infant breath effectively. Understanding diaphragmatic breathing patterns acts as one of the major clinical ...

Introduction

Atherosclerotic cardiovascular disease (CVD) involves peripheral circulation, the brain, and the heart. The disease is a primary health issue in many countries around the world (Sawhney, et al., 2012). CVD develops through complex processes involving novel risk markers and common risk factors. Decades of research have demonstrated that a sibling’s or parent’s family history is linked to the development of atherosclerotic CVD (Gupta et al., 2013; Nelson, 2013; Imes and Lewis, 2014), which manifests as peripheral arterial disorder, stroke, and coronary heart disorder (CHD). Various Mendelian disorders have also been shown to contribute to atherosclerotic CVD. Although ...

Problem Statement

Nurse residency programs prove to be an effective means of facilitating the smoother transition of the qualified nurse professionals to clinical practice. This critical analysis explores the systematic requirement of developing the nurse residency programs with the objective of helping the nurse graduates in joining nurse residency following the successful accomplishment of their advanced practice degree program.

Recommendation

The configuration of multiple stages of a nurse residency program requires the systematic development of the program infrastructure in the context of evidence-based literature. Consistent execution of the nurse residency program requires its periodic evaluation and dissemination of the findings between the ...

The greatest human advancement that has been witnessed in the 21st century is the advent of technology. Technology has literally penetrated into every sphere of our lives and become part and parcel of everything that we do. From how we communicate, to our shopping practices, our reliance on technology is astounding, to say the least. Our workplaces have not been left behind. We have seamlessly integrated our professional duties with technology with the aim of reducing labor and improving efficiency and effectiveness. However, this integration has been met with many challenges because computers do not understand human language. Therefore, ...

Introduction

This scholarly paper identifies the advantages of pursuing a post graduation degree in advanced practice nursing through systematic exploration of evidence – based research literature. Healthcare facilities affected with an acute shortage of nursing professionals and resultantly the existing nurses remain overburdened with additional work responsibilities. Due to the limited scope of clinical practice of the nursing workforce, the autonomous administration of healthcare interventions in complex medical emergencies proves to be a biggest challenge that leads to the deterioration of psychosocial as well as physiological conditions of the affected patients. Therefore, skills enhancement of registered nurses is the need of ...

Introduction

Sub- capital fracture of the femoral neck is a common injury among the ageing population and is regarded as “unsolvable fractures”. This is a growing health concern in every country as the healthcare expenditure is very high. The surgical options, especially for elderly population, highly depend on the patient’s profile, their preference and the experience of the surgeon . Mrs. Pollard, 75- year- old, sustained a left sub- capital fractured neck of femur. Due to her age and her other complications such as hypertension and Type- 2 diabetes, a total hip replacement might be a better surgical option as ...

Abstract

Heart failure (2.6% prevalent worldwide) is a complex clinical syndrome, resulting from a structural or functional cardiac disorder and impairing ventricular filling or ejection capability. The current case of a 59-year-old male patient admitted on August 18, 2016 due to worsening shortness of breath and bilateral left extremity edema (one week) involved an existing diabetes mellitus type 2 (DM2). Physical and clinical profiles indicate a comorbidity between heart failure (HF) and DM2. Laboratory and imaging findings were not indicated, while diagnosis was based on the NYHA Classification guidelines. A review of literature revealed three crucial weaknesses in the diagnosis. ...

Slosar’s article Embedding Clinical Ethics Upstream: What Non-Ethicists Need to Know is simply a masterpiece as far as the importance and place of ethics in clinical practice is concerned (Slosar, 2016). At the core, the article illuminates on how and why ethics should be fitted into medical practice. This current paper provides a reflection on this article. Besides pointing the necessity of the integration of ethics in the medical profession in the efforts towards achieving person-centered care, this article moves a long way in addressing the misconception surrounding the role of ethics. Traditionally, people in both clinical and ...

Literature review

Kaasa, S. (2015). Is Cancer Pain Control Improved by a Simple WHO Pain Analgesic Ladder Approach Combined With Tumor-Directed Treatment?.Journal of Clinical Oncology, JCO647537.

Article summary

This article takes into consideration the role that the WHO analgesic ladder plays in addressing cancer pain in palliative care patients. The authors identify that cancer pain occurs in 90% of cancer patients but only half them are under proper pain management. To this effect, therefore, there is the need for applying opioids under the WHO ladder guidelines as a way of addressing cancer pain in oncology care patients.

This is a narrative qualitative research ...

Importance of Nursing Informatics in Healthcare

Introduction One of the key factors for effective decision-making for nurses and other healthcare practitioners is information. It is also integral to the quality improvement of the practice of nursing. In most of the activities of nurses such as from assessing the health care needs of patients up to the developing of health care plans, information acquisition and evaluation is required. Information is also involved in the communication patients regarding the information to and from the other health care practitioners (Canadian Nurses Association np). Lastly, information is also involved in the analysis of the staff’s work as well ...

Introduction

Hypertension is among the most progressive and widespread health problems that contributes to significant negative outcomes including increased mortality as well as morbidity rates especially among the African-Americans. Typically, African-Americans usually develop the disease in their early stages of life, have higher blood pressure levels on average and experience various severe hypertension-related illnesses as compared to the other racial groups (Ferdinand, 2013). Although hypertension is untreatable, the illness can be effectively managed through the use of medications and establishing the relevant lifestyle changes. Nonetheless, management of hypertension is suboptimal among the African-Americans due to various factors such as poor ...

This paper is a critical evaluation of a meta-analysis titled “Impact of resistance training in subjects with COPD: A systemic review and meta-analysis.” The study was carried out by Wen-hua Liao, Jin-wu Chen, Xin Chen, Lin Lin, Hai-yan Yan, Yu-qi Zhou and Rui Chen. The essay aims at summarizing, appraising, and analyzing the research study. In this paper, I will assess the databases utilized in the analysis, the types of articles used, as well as the timeliness of the write-up. I will also identify the level of evidence of the publication. Finally, I will discuss the contribution that the ...

Evidence-based practice is a systematic process that involves sufficient clinical innovation that is guided by the application of evidence as well as experiential learning. This implies that there should be systematic inquiry within the clinical setting to help identify the knowledge gaps that have otherwise diminished the expected outcomes (Melnyk & Fineout-Overholt, 2011). This activity helps the practitioners to move away from the ritualistic practice and towards a desired change and an ongoing evaluation. A majority of EBP processes seek to improve quality within a particular setting or at other times improve outcomes. All these are enabled by two major ...

Capstone Project Milestone #1:

PICO Worksheet Purpose: To identify a problem or concern that nursing can change and develop a PICO question to guide the change project. Directions: Use the form below to complete the PICO assignment in Milestone #1. This includes filling in the table with information about your research question and your PICO elements. Step 1: Select the key PICO terms for searching the evidence. Clearly define your PICO question. List each element P (problem, population, or problem), I (intervention), C (Comparison with other treatment/current practice), and O (Desired outcome). Is the potential solution something for which you (as nurse or ...

Why I choose AcuCare Centre?

As a part of the field assignment, I visited the AcuCare Centre, 12133 Pembroke Road, Pembroke Pines, FL33025. I choose this particular place for my assignment, as I wanted to know about the method of “healing through touch”, as I would call it. Reiki is an alternative medicine that is sought by many for stress and chronic diseases. My aunt is particularly supportive of the center and has recommended it to me. She has sought alternative medicine to treat her migraine problems. She found allopathic medicine ineffective and replete with side effects.

Initial impression of the center:

On entering the center, there was a ...

Program implementation is normally a process of change and it requires advance planning. While the owners of a project may foresee the program as a new method to increase productivity and quality of service, it is inevitable that those others affected by the change will in one way or another resist the entire program or some aspects that they think disrupt their normal activities (Sadeghi‐Bazargani, Tabrizi & Azami‐Aghdash, 2014). The work environment is significantly dependent on the work place culture and any change within the work place is seen as an attempt to change the organizational culture. Those ...

Ray WA, Chung CP, Murray KT, Hall K, Stein C. Prescription of Long-Acting Opioids and Mortality in Patients With Chronic Noncancer Pain. JAMA. 2016;315(22):2415-2423. doi:10.1001/jama.2016.7789.

Prescription of Long-Acting Opioids and Mortality in Patients With Chronic Noncancer Pain Wayne A. Ray, PhD1; Cecilia P. Chung, MD, MPH2; Katherine T. Murray, MD2,3; Kathi Hall, BS1; C. Michael Stein, MB, ChB2,3 [+] Author Affiliations JAMA. 2016;315(22):2415-2423. doi:10.1001/jama.2016.7789.

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Abstract ABSTRACT | INTRODUCTION | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES Importance  Long-acting opioids increase the risk of unintentional overdose deaths but also may increase ...

Cognitive behavioral therapy is a commonly applied treatment approach aimed to replace the dysfunctional behaviors and thoughts of patients with more accurate and constructive beliefs to relieve their emotional distress. The effectiveness of CBT lies in aspects such as collaboration between the patient and therapist, coping card, and cognitive strategies which help in the therapeutic effectiveness (Wright, 2006). The contribution of such aspects has been highlighted in several study findings in which treatment in both the clinical and research settings has been researched. When it comes to the use of CBT in treating mood disorders, most people would assume ...

Abstract

Notably, interracial couples and their families have faced various challenges including rejection and being stereotyped. These challenges have resulted in increased trauma and developmental delays among interracial people. The most common misperception about interracial couples is that one partner is black while the other one is white. The rate at which interracial marriages are growing in the US has increased steadily. Considering that the United States legalized interracial marriages, a high growth rate in interracial marriage is a significant move. The demand for interracial counseling is expected to rise as the number of multicultural couples increase. Education of counselors ...

The idea that schools should provide accommodations for those students who experience difficulty and disability is a relatively new one. In the past, primary, secondary, and tertiary educational institutions existed as institutions; however, as the sciences advanced and more became known about the nature of human learning disabilities, institutions of all different types and sizes began to realize that a learning disability is not necessarily associated with an intellectual disability. With this realization came the development of a number of important programs, all of which have one particular end goal: to develop an educational system in which people can ...

Advanced nursing practice is recognized as an advanced level of nursing care that uses in-depth nursing knowledge and nursing expertise to meet health care needs. Unlike traditional nursing practice, advanced nursing practice involves numerous streams of activities like: analysis, knowledge synthesis, critical thinking, decision making, interpreting, evidence based practice and managerial/administrative roles. The evolution of advanced nursing practitioners happened when nurses were expected to take extra responsibility in addition to their traditional role. Due to lack of a sufficient number of doctors to attend to people in remote areas and in families, nurses were given the added responsibility to ...

In order for proper implementation of the project, study participants, volunteers, and public representatives would have to be identified and recruited. The purpose of recruiting representatives/volunteers are to educate and promote the concept and importance of treatment and prevention of IAD among elderly women in acute care settings. The education and training of these volunteers should be kept as priority before the commencement of the project and the recruitment of study participants. The volunteers would also act as a mediator between the study team and the scientific committee involved in the conduct of the study. Each volunteer and representative ...

Ethical dilemmas are surely inevitable components of the counseling profession. Throughout their careers counselors are facing with various complicated moral choices that unconditionally need the common sense and profound reflection. Before taking any serious decisions, every counselor should take into consideration that the same ethical standard could differently manifest itself in a variety of everyday situations. Those dilemmas are aimed to test counselor’s reserve and prove that definitive resolution will surely eventuate far beyond the office door. Of course, it is very useful to have the appropriate resources, knowledge and skills while confronting any ethical dilemma. However, more ...

Introduction

In the recent years, CPGs (Clinical Practice Guidelines) have been widely incorporated into clinical practice to facilitate efficient as well as effective medical practice and improve the care of patients as well as their health outcomes. Essentially, CPGs are statements that are systematically developed mainly to assist healthcare professionals in making the relevant clinical decisions in regard to the suitable healthcare involved in specific clinical issues (Brouwers et al., 2012). As such, CPGs provide clear and succinct instructions on the screening and diagnostic tests that should be ordered in certain clinical circumstances, medical services to be offered, length of ...

The goal of every nurse practitioner is to work with the patients in achieving healing and good health. In this process, the nurse makes a number of decisions. For these decisions to be successful in providing the expected outcome, nurses are expected to base their decisions on well validated scientific evidences. This is called evidence based practice. It is important to know where one is getting with once decisions and this is the fundamental for evidence based practice. This will ensure that the clinical practice is based on the foundation of strong scientific knowledge. Likewise, diabetes specific evidence based ...

Communication errors

Communication is among the crucial aspects especially in nursing that promotes optimal care delivery. As such, effective communication among healthcare professionals especially during shift changes helps in preventing various medical errors like medication overdose as well as surgical complications. In addition, effective communication helps in enhancing the clinical outcomes of patients since medical errors are closely associated with various adverse events that have severe health as well as economic consequences on patients. According to Pham et al. (2012), effective communication among healthcare professionals especially during shift changes helps in minimizing the incidences of medical errors and subsequent injuries as ...

WGU

A. Table of Contents Professional Resume – presents my clinical knowledge, skills, experience, and philosophy to potential employers Executive Summary – provides an overview of the contents of the portfolio Professional Reference Questionnaire – presents the objective and subjective evaluation of my key behaviors and clinical performance by one of my professional references Importance of the Institute for Healthcare Improvement (IHI) – discusses the need to develop knowledge and skills in quality leadership in order to improve the quality and safety of patient care and promote holistic, patient-centered care

Copy of IHI certificate of completion – serves to validate my completion of the IHI Organizational Systems and Quality Leadership course

Evidence-based Practice – summarizes an evidence-based research project on hand hygiene Applied Leadership – summarizes my ...

Developing the question

The choice of the question “For hospitalized elderly patients how does hourly rounding compared to two hour monitoring help in reducing the occurrence of falls and their subsequent injuries?” was based on the need to explore the importance of regular and frequent monitoring for these patients to manage the cases of falls. There is enough evidence that supports that monitoring of these patients is the key to management of their healthy issues. It is important to know that patients in the geriatric care have unmet needs and they rely on the nurse to help meet these needs. These would ...

Personal and professional accountability

In regards to my personal and professional responsibility, I consider myself to be competent based on the Nurse Manager Skills Inventory because I have just worked as a registered nurse for few years. However, I have a high aspiration of ensuring that I become an expert in the field of nursing, I plan to achieve this by progressing my education to highest levels attainable within the nursing profession. I subscribe to the school of thought that self-fulfillment comes about when one achieves whatever goals he/she has set for himself/herself. Pursuing higher education will, therefore, help me achieve my career ...

Question 1

Compare and contrast the concept of metagenome and microbiome. The microbiome is a term used in describing the entire habitat; it includes microorganisms and their genomes and the surrounding environmental conditions. The microbiome is defined based on the biotic and abiotic factors in a specified environment. On the other hand, metagnome can be defined as a collection of genes and genomes normally from the members of the microbiota. Microbiota is an ecological community that includes symbiotic and pathogenic microorganisms that share our body space. The analysis of microbiome can be done for a large number of samples and can ...

(Author, Department, University,

Corresponding Address and email)

Evidence based practice refers to the use of best available research in clinical practice and decision making while considering the characteristics, preferences, and culture of patient (APA, n.d.). Therefore, it is considered as the integration of best available research evidence, clinical expertise, and the patient values (Buysse, Winton, Rous, Epstein, & Lim, 2012). Some researchers suggest that the information from local context is also an important element of evidence (Oliver, Innvar, Lorenc, Woodman, & Thomas, 2014). In the evidence based practice, best research evidence refers to the clinically relevant published studies showing the positive impact of an intervention ...

Banner health is a non-profit health organization in the U.S with its headquarters based in Phoenix in Arizona. This organization is currently operating in seven states in the country, that include Arizona, California, Alaska, Colorado, Nevada, Wyoming, and Nebraska. The organization is operating 25 acute-care facilities and several other special facilities. Banner health organization is also operating clinics, hospital care, emergency care, hospice, ambulatory surgery centers, rehabilitation services, long-term care, home health agencies, clinical laboratories and primary care (Banner Health, 2013). This organization has made itself unique as a healthcare institution in the sense that it’s committed to ...

Introduction

Psychologists are involved in the study of social, emotional, and cognitive behavior and processes by observing, recording, and interpretation of how people relate not only to one another but also to their environments. In 2015, psychologists earned an average of $72, 580 per year. In 2014, psychologist’s job opportunities were projected to grow at 19% for the period 2014-2024. 19% is one of the fastest rates than the average. While some psychologists work independently, others conduct research, work with patients, and consult with their clients. Some of them work in collaboration with healthcare staff such as social workers ...

Jane Doe

Psychologists have a very unique job in that they are often the people responsible for guiding others toward resolution in life. There is a sharing of private information by patients that must be honored by the Ethical Code of Conduct set by the American Psychological Association. Deviating from these guidelines can result in trouble for the therapist, which is why it is important to understand where issues like religion and spirituality fit within the ethical confines of the guidelines. Religion and spirituality do not yet fit into regular medical practices and procedures, which makes the topic of the issue ...

(Author, Department, University,

Corresponding Address and email)

How does conduct a "time-out" before starting a surgery is essential for preventing wrong-site, wrong-procedure or wrong-person surgery?” (e.g. National Guideline Clearinghouse). A time-out procedure is performed before starting a surgical procedure. Moreover, repeat time-out is prescribed for position changes or multiple procedures. Time-out is considered as the final safety stop prior to the surgical procedure to confirm the correct patient, procedure, and site. Every member of the surgical team has to stop any kind of activity before starting a procedure and take part in the process. Members of the team may include surgeon, student(s), ...

Abstract

Medication errors are common medical errors in healthcare settings that often lead to patient harm. Medication errors transpire during ordering, administration, and transcription of medications. Healthcare information technology is a promising strategy for prevention of these errors. In this paper, an article that reports on the application of technology to prevent medication errors was analyzed. The article is entitled “Effect of bar-code technology on the safety of medication administration”. It is authored by Poon et al. (2010) and reports on the methods and findings of a study that examined the impact of the use of eMAR technology on rates ...

Summary

Differences The Kaiser Permanente (KP) is an autonomous integrated not-for-profit health care organization. It comprises of the Kaiser Foundation Health Plan, Permanente Medical Groups, and Kaiser Foundation Hospitals. The organization has its services spread across eight regions. It focuses on the successful evolution of a system that encourages physician and managerial partnership for quality and efficiency in patient care. The Mayo Clinic is a non-profitable healthcare organization based in Rochester Minnesota. This organization concentrates on education, medical practice and research. It operates as one of the largest nonprofit organizations in the world that specialize in complex healthcare issues through ...

Introduction

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is one of the most essential diagnostic as well as classification tools used in clinical practice especially in psychiatry, research and other related fields. The tool serves as an authoritative guide in regard to the diagnosis that can used to determine the appropriate the treatment for various mental disorders (Jacob & Patel, 2014). In the light of this, the tool contains various descriptions, symptoms as well as other criteria that is used in the diagnosis of various mental disorders encountered in clinical practice. On the one hand, the tool provides a ...

Technology is the ever changing face of increased patient safety and efficiency in healthcare. My typical day as a nurse is augmented by technology from one task to another. Computerized documentation has made it possible for a faster and more direct communication between the various interdisciplinary teams. I am able to quickly glance at labs in report and any outstanding orders during shift report. As a nurse I am assigned a wireless phone that provides direct access to me. It prevents the frequent over head pagers for each and every staff member working on that floor. This enhances patient care quality because there ...

1. Define your question using PICO: Patient/Problem, Intervention, Comparison, and Outcome.

Patient/Problem: Children and young people under 19 years old who have nocturnal enuresis (bedwetting). Sub group to include patients with Special needs (learning disabilities, emotional and ADHD)

Intervention: Parent’s choice bed wetting Alarm alone (body worn, bed, vibrating, wireless, voice recorded, multi-tone, bell and pad)

Comparison: Choice compared to clinician’s choice: Treatment with medication desmopressin an ant diuretic hormone or arginine vasopressin Outcome: Reduction/change in number of wet nights, Dry for 14 consecutive nights, Dry for 6 consecutive months (continuing success), Dry for 2 consecutive ...