DQ102 RESPONSE

Anne Kolsky    3 posts   Re: Topic 10 DQ 2  Importance of EBP for BSN-RN  Sustainability of evidence-based practice has waned. One thing I have noticed in my workplace is that people (including myself) tend to take the path of least resistance. “It’s easier to…” My mentor and I have had many conversations about this. It’s easier to just give a ‘Band-Aid or bag of ice’ then take the time to assess the situation and treat appropriately. Another example, comparing my last workplace to current, one striking difference is stock medications. We did not give out or stock any kind of medication in the former. My new workplace not only stocks but does not require a doctor’s order to administer. Although it is more work, I insist on an order for stock medications. I also call the parent before giving, as appropriate. It is my license and it is for the safety of the students that are at stake.  I have already had conversations with staff and nursing staff about these practices.  Although they know the risks, they are choosing to keep status quo for themselves.  Of 6 nurses on staff, there is one other that holds similar practice.  She stated at our last meeting that “Kids come down asking for a Tylenol, just to get out of class.”  She made it clear that without an order and parent permission, she will not give out any medications.     Another difference noted is charting practices. Currently, other nurses use a one word drop down menu to chart. SOAP notes are not done consistently. I will continue to make notes. I will continue to chart more fully. It has saved my skin more than once when a student, a teacher, or even a parent will claim that “the nurse didn’t do anything.” It gives such good data for what is trending with that student, why wouldn’t one want to do that? I understand that the office is super busy, but so is the courtroom. I’m not here to make friends, I’m here to do my job.   Another practice I will continue to implement, but with a new perspective, are the various screenings given to students. I will make a more concerted effort to make sure the student and family is aware of all the services available. In my former workplace, I compiled a list of resources for families. I need to make a new one for this community. I have a new perspective towards screenings and a fuller understanding of how important these are in the bigger picture.  In the study by Meyer, et al., (2019) of 1,600 clinicians only 51 reported no obstacles to implementing new treatments. The biggest obstacles reported related to time, cost, location for training, demographic mismatch with resources and difficulty finding resources. New trainees are not given evidence-based training nor supervision experiences, either. Participants in the study requested greater access to existing resources. Handouts, journals, training modules, and workshops (Meyer, et al., 2019).   Meyer, A. E., Reilly, E. E., Daniel, K. E., Hollon, S. D., Jensen-Doss, A., Mennin, D. S., … Teachman, B. A. (2019). Characterizing evidence-based practice and training resource barriers: A needs assessment. Training and Education in Professional Psychology. doi:10.1037/tep0000261.supp (Supplemental)

DQ61 RESPONSE

Susan Rowley  
1 posts
Re: Topic 6 DQ 1
There are several aspects to consider when developing and  implementing a standardized patient handoff report sheet to be used for transferring patients from Labor and Delivery (L&D) and the Neonatal Intensive Care Unit (NICU). These include financial, quality, and clinical aspects. The only cost directly involved in developing the quality improvement project is printing the report sheets. The direct cost of implementing the quality improvement project includes compensation of bedside nursing staff to participate in the education of the project. Education can be included in staff meetings. However, some staff may be coming in on their off time to the staff meeting. Therfore, they will be paid for their time. There are indirect financial aspects to consider for this project. For example, by implementing this project, there will be a decrease in medical errors, which will decrease potential for law suits. When considering quality of care aspects of implementing this project, it is important to note that including nurses in evidence based practice increases the culture of performance improvement. Nurses need to understand that quality is directly impacted by improving care during paient handoff. Implementing this project will decrease the risk for missed medications, missed risk factors for sepsis, hyperbilirubinemia, hypoglycemia,and communicable diseases. Patients will have better outcomes due to more timely treatment because such risk factors will not be missed. Implementation of this project directly impacts the clinical aspect of care by making the nurse accountable for giving a thorough report when transferring the patient into the NICU from L&D. The standardized patient handoff report sheet will also help the nurse to give a thorough report so that nothing is missed. ReferenceGiomuso C., Jones L. et al (2014) A Successful Approach to Implementing Evidence Based Practice; Med-Surg Matters Jul/Aug 2014; 23 (4); 4-9 retreived from https://lopes.idm.oclc.org/login?

DQ52 RESPONSE

Profile Picture

Eugenia Uzoechi  
1 posts
Re: Topic 5 DQ 2
Technology and CLABSIs reductionAlthough sophisticated progress has been made in several areas, central line-associated bloodstream infections (CLABSIs) remain a national healthcare problem of crisis proportions. The stakes for healthcare institutions that have not effectively addressed CLABSIs continue to mount (Pageler et al., 2014). Also, the financial stakes for healthcare institutions with CLABSI problems have risen. With the direction from the Congress, the Centers for Medicare and Medicaid Services (CMS) has curbed reimbursing hospitals for hospital-associated conditions, particularly the ones considered preventable. Among the designated preventable conditions is CLABSIs. The above sends a strong message to facilities to implement aggressive CLABSI minimization programs. Among the programs that can be implemented are technological programs (Pageler et al., 2014).An example of a technological program that can be used to address the issue of CLABSIs is a unit-wide patient safety and quality dashboard. This type of technology helps users to measure the outcome metrics such as CLABSI rate, central line utilization and excess cost in relation to the intervention metrics such as hand hygiene and central line maintenance bundle compliance (Field, Fong & Shade, 2018). At the same time, this technology enables users to identify the hospital care location where patients are at increased risk of developing CLABSI. Moreover, it provides infection prevention surveillance teams with automated work lists, and it works by giving the surveillance team the ability to evaluate cases flagged as at-risk, along with supporting clinical details, to make the final determination of the CLABSI case (Field, Fong & Shade, 2018).I plan to use a unit-wide patient safety and quality dashboard because it will provide mw with the ability to rapidly find, assess and document CLABSI cases, efficiently review submission data and CLABSI rates, and easily identify trends in performance and CLABSI prevention bundle compliance. At the same time, this type of technology will help me understand CLABSI risk based on device utilization and bundle compliance a care location to identify and prioritize improvement interventions, and drill down to the facility, unit, service, or patient level to analyze performance, provide feedback, and support measurement of performance improvement interventions.ReferencesField, M., Fong, K., & Shade, C. (2018). Use of Electronic Visibility Boards to Improve Patient Care Quality, Safety, and Flow on Inpatient Pediatric Acute Care Units. Journal of Pediatric Nursing, 41, 69-76.Pageler, N. M., Longhurst, C. A., Wood, M., Cornfield, D. N., Suermondt, J., Sharek, P. J., & Franzon, D. (2014). Use of electronic medical record–enhanced checklist and electronic dashboard to decrease CLABSIs. Pediatrics, 133(3), e738-e746.

DQ31 RESPONSE

Violence Prevention Research articles pertaining to the reporting of workplace violence:     Arnetz, J. E., Hamblin, L., Ager, J., Luborsky, M., Upfal, M. J., Russell, J., & Essenmacher, L. (2015). Underreporting of Workplace Violence: Comparison of Self-Report and Actual Documentation of Hospital Incidents. Workplace health & safety, 63(5), 200–210. doi:10.1177/2165079915574684  This study examined differences between self-report and actual documentation of workplace violence (WPV) incidents in a cohort of health care workers. The study was conducted in an American hospital system with a central electronic database for reporting WPV events. In 2013, employees (n = 2010) were surveyed by mail about their experience of WPV in the previous year. Survey responses were compared with actual events entered into the electronic system. Of questionnaire respondents who self-reported a violent event in the past year, 88% had not documented an incident in the electronic system. However, more than 45% had reported violence informally, for example, to their supervisors. The researchers found that if employees were injured or lost time from work, they were more likely to formally report a violent event. Understanding the magnitude of underreporting and characteristics of health care workers who are less likely to report may assist hospitals in determining where to focus violence education and prevention efforts.  Strength- Approval for study was granted by the Internal Review Board at the University, and the Research Review Council of the hospital system. Article was peer reviewed. Analysis was completed by Chi-Square. The study was aimed at comparing self-report of WPV with actual documentation of violent incidents, it also intended to highlight which care areas had the highest incident of WPV,due to poor responsiveness of participants it highlights underreporting as a critical barrier to developing WPV prevention strategies.  Weakness- questionaires are limited by design, and it is hard to quantify underreporting of workplace violence among healthcare workers. Data collection was completed by a questionaire mailed to the homes of employees. Only 22% of employees responded to the questionaire. The questionaire asked respondents to retrospectively recall incidents from the past year, creating recall bias. Another limiting factor to the study, while hospital policy mandates violent episode reporting there may be underreporting as the study did not examine what types of violent expericences therefor some individuals may not deem certain behaviors as violent, such non-physical incidents,      Campbell, C. L., Burg, M. A., & Gammonley, D. (2015). Measures for incident reporting of patient violence and aggression towards healthcare providers: A systematic review. Aggression & Violent Behavior, 25, 314–322. https://doi-org.lopes.idm.oclc.org/10.1016/j.avb.2015.09.014  Patient violence and aggression towards healthcare providers is a significant health and public affairs problem receiving international attention. Such violence is found to occur regardless of healthcare setting or provider discipline. However, most of the evidence of a high frequency of incidents perpetrated against providers is anecdotal and solid data on the prevalence of these incidents is not yet available. Studies have shown that accurate incident reporting remains one of the primary impediments to creating organizational policies and procedures to ensure the safety of the clinical direct care healthcare provider. Yet there is no clear evidence base currently existing to suggest what measures are of most utility in remedying this underreporting. This article contributes to the literature by conducting a systematic review of existing instruments designed to measure and report incidents of patient violence against health care workers. It is hoped that this review of existing measures will stimulate health care agencies to employ routine provider reporting mechanisms in order to increase provider reporting, improve the data on patient violence and consequentially work towards combatting this public affairs problem.  Strength: This article is a systematic review of literature over the last 20 years. Both conceptual and systematic research articles were utilized for this review. Articles were excluded that were not published in peer review journals. The study included all articles written in English as part of its inclusion criteria. This meta-analysis found that violence in nursing is an international problem. The research did include three large scale studies, two national level studies from Australia and one international study. The conclusion highlights a lack of standardized measures for reporting and no standardized systematic approaches to handle WPV. But findings did suggest that violence is prevalent and underreported.  Weakness: the study was limited to only English written articles.  It is important to note that the research excluded articles of violence perpetuated by patient visitor.   Copeland, D., & Henry, M. (n.d.). Workplace Violence and Perceptions of Safety Among Emergency Department Staff Members: Experiences, Expectations, Tolerance, Reporting, and Recommendations. JOURNAL OF TRAUMA NURSING, 24(2), 65–77. https://doi-org.lopes.idm.oclc.org/10.1097/JTN.0000000000000269  Workplace violence (WPV) is a widely recognized problem in emergency departments (EDs). The majority of WPV studies do not include nonclinical staff and do not address expectations of violence, tolerance to violence, or perceptions of safety. Among a multidisciplinary sample of ED staff members, specific study aims were to (a) describe exposure to WPV; (b) describe perceptions of safety, tolerance to violence, and expectation of violence; (c) describe reporting behaviors and perceived barriers to reporting violence; (d) examine relationships between demographic variables, experiences of violence, tolerance to violence, perceptions of safety, and reporting behaviors; and (e) identify perceptions of viable interventions to improve workplace safety. A cross-sectional design was used to survey ED staff members in a Level 1 Shock Trauma center. Eleven disciplines were represented in 147 completed surveys; 88% of respondents reported exposure to WPV in the previous 6 months. Members of every discipline reported exposure to WPV; 98% of the sample felt safe at work and 64% felt violence was an expected part of the job. Most violence was not reported, primarily because “nobody was hurt.” Emergency department staff members expected and experienced violence; nevertheless, there was a widespread perception of safety. Perceptions of safety and reasons for not reporting did not mirror previous findings. The WPV exposure is not isolated to clinical staff members and occurs even when prevention strategies are in place. The definition of WPV and the individual’s interpretation of the event might preclude reporting.  Strength- this is a cross sectional study making the quality of evidence highly reliable. The study was multifactorial allowing for a broad examination of the perceptions of safety, toleration of violence, reporting behaviors and barriers, as well as demographic variables. It also identified potential interventions to improve workplace safety. One interesting note about the study is that while exposure to WPV was slightly higher than previous studies, respondents also noted a perception of safety greater than the exposure. This bears the question of whether actual versus perceived safety are congruent?  Weakness- small sample size, and only included one facility. Because most of the respondents were at least BSN prepared and were certified in their specialties with more than 11 years of experience, the perceptions and experiences of respondents may be different than nurses with less experience in handling challenging behaviors. Less experienced nurses may not recognize escalating behaviors or know how to de-escalate a situation prior to violence. This may ultimately change perceptions of safety comparable to peers. Because the study was multifactorial it is worth mentioning that there were docuemtned inconsistencies in “formal” reporting.   Hogarth, K. M., Beattie, J., & Morphet, J. (2016). Nurses’ attitudes towards the reporting of violence in the emergency department. Australasian Emergency Nursing Journal, 19(2), 75. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=edo&AN=115741170&site=eds-live&scope=site  The incidence of workplace violence against nurses in emergency departments is underreported. Thus, the true nature and frequency of violent incidents remains unknown. It is therefore difficult to address the problem. Aim To identify the attitudes, barriers and enablers of emergency nurses to the reporting of workplace violence. Method Using a phenomenological approach, two focus groups were conducted at a tertiary emergency department. The data were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results Violent incidents in this emergency department were underreported. Nurses accepted violence as part of their normal working day, and therefore were less likely to report it. Violent incidents were not defined as ‘violence’ if no physical injury was sustained, therefore it was not reported. Nurses were also motivated to report formally in order to protect themselves from any possible future complaints made by perpetrators. The current formal reporting system was a major barrier to reporting because it was difficult and time consuming to use. Nurses reported violence using methods other than the designated reporting system. Conclusion While emergency nurses do report violence, they do not use the formal reporting system. When they did use the formal reporting system they were motivated to do so in order to protect themselves. As a consequence of underreporting, the nature and extent of workplace violence remains unknown.  Strength: The method utilized for this study was a phenomenological approach, in this context the intention was to have participants describe and attach meaning to their experiences in relation to the underreporting of WPV. Ethics approval was obtained by the Monash University Human Research Ethics Committee and the relevant hospital ethics committee, the study was peer reviewed. Nurses did make reports informally, when nurses did complete formal reports they were able to track the progress and learn the outcomes which they perceived as beneficial  Weakness: Nurses did not formally report because the reporting system was too cumbersome and was not user friendly. Because the study was voluntary, participants may hold a strong degree of bias about the subject. Because the study was conducted in a public forum, some may feel reluctant to speak freely   Findorff MJ, McGovern PM, Wall MM, & Gerberich SG. (2005). Reporting violence to a health care employer: a cross-sectional study. AAOHN Journal, 53(9), 399–406. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=106545936&site=eds-live&scope=site  The purpose of this cross-sectional study was to identify individual and employment characteristics associated with reporting workplace violence to an employer and to assess the relationship between reporting and characteristics of the violent event. Current and former employees of a Midwest health care organization responded to a specially designed mailed questionnaire. The researchers also used secondary data from the employer. Of those who experienced physical and non-physical violence at work, 57% and 40%, respectively, reported the events to their employer. Most reports were oral (86%). Women experienced more adverse symptoms, and reported violence more often than men did. Multivariate analyses by type of reporting (to supervisors or human resources personnel) were conducted for non-physical violence. Reporting work-related violence among health care workers was low and most reports were oral. Reporting varied by gender of the victim, the perpetrator, and the level of violence experienced.  Strength: this was a cross sectional design, using a random sample of 100 employees from over 21,000 individuals who work for the healthcare organization. Review boards for the university and the healthcare organization approved the survey instrument. Peer reviewed. This study was specific to who was likely to report and how frequently participants had experienced violence.  This study was interesting to discern demographically who was more likely to report and what criteria prompted persons to report.   Weakness: The study size was small with only 100 potential participants out of 21,000 organizational employees. Limitations to the study were modest response and recall bias. Participants may only remember the more serious incidents, and or report the more serious events. Another resulting bias may have been that those who participated in the study may or may not have been more motivated to respond based on their experiences with violence. Interestng, that the researchers attempted to assure confidentiality of the study participants, some staffers expressed concern about how results would be reported to their employer, which does speak to other studies that express fear of retaliation from victims.      Stene, J., Larson, E., Levy, M., & Dohlman, M. (2015). Workplace violence in the emergency department: giving staff the tools and support to report. The Permanente journal, 19(2), e113–e117. doi:10.7812/TPP/14-187  Workplace violence is increasing across the nation’s Emergency Departments (EDs) and nurses often perceive it as part of their job. Through a quality improvement project, reporting processes were found to be inconsistent and nurses often did not know what acts constitute violence. As a result, nurses were under-reporting violence in the ED, and as a direct result resources were not recognized or provided. A staff nurse-led workgroup developed an initial survey to assess the perception and occurrence of violence within the ED in nurses and patient care assistants. This workgroup evaluated the survey responses and identified a need for development of a brief, concise reporting tool and an educational program. A reporting tool was created and education was provided in multiple venues and modalities. A follow up process and support were given from nursing leadership. A post-education survey was completed by nurses and patient care assistants to assess their comprehension of acts of workplace violence, and found their perception that workplace violence was part of their job was reduced by half, along with increased knowledge about what acts constitute workplace violence and what is reportable to law enforcement. As a result of the education, the reporting of the violent acts has increased and staff perceive the ED to be a safer environment. With the appropriate education, reporting tool and leadership support, ED nurses can create a culture with a zero-tolerance policy for violence within the department, creating a safer environment for staff and patients.   Strength- The article was peer reviewed and offered several key insights into the benefit of educational programs that help ED staff understand what constitutes workplace violence and by developing a concise and easy to use reporting tool staff members became more consistent reporters of workplace violence. The educational tool utilized several different modalities that help with retention of knowledge.   Weakness- the study have many different limitations, the study was not approved by a review committee to confirm the reliability of the study questions. The study also only followed a small sample of individual in one hospital, so it is difficulty to generalized the results as a sample of the general target population. The questions on the survery were not reviewed by a review board prior to administration of assure validity of key related items, this may mean that vital information is excluded or it does not represent all of the conditions that the target population may encounter. Not all participants in the before and after survey were the same.            Reply  |  Quote & Reply                               Previous |  Next                                                                                                                                                                                                        © 2019 BNED LoudCloud LLC   Terms & Conditions |    Privacy Policy |      Tech Support        [Ver: 7.1]      Bookmarks   E-mail –  Oct 28, 2019 7:56:13 AM Mountain Standard Time                                                                                                                                                                                                                                                                             Chrome   Firefox   IE Explorer   Safari                               Content loaded successfully

DiscussionDisc1 for $4

Ethical Resource Allocation

Work through the simulation titled Resource Allocation from the end of Chapter 8 of your course text.  Review the various options in the simulation, then select “Your Own Option” to type out your own solution to the scenario.  You will need to copy and paste your response from “Your Own Option” into the discussion board forum.  Here is a brief synopsis of the simulation regarding the hospital’s budget and dilemma:

Hospital costs in millions for one year:

  • One 35-year-old cancer patient who needs significant time with the doctor, medical supplies, tests, and around the clock care: Cost: 100
  • Emergency Room operations for daily care and treatment of about 100 people (~365,000/year) Cost: 100
  • 2 Senior Patients who need hip replacement surgery. Cost: 50
  • 10 patients (ranging in age from 18 to 45) receiving assistance in your inpatient drug/alcohol rehab unit: 100
  • An MRI unit that is on the fritz and could die any day. Replacement Cost: 170
  • One of your two X-ray machines is inoperable and must be replaced: Cost 100
  • Ambulance drive-in area was damaged and needs to be repaired: Cost: 25
  • Training needs for nursing staff for certification requirements: Cost: 55
  • TOTAL: $700 million

For this discussion, address the following:

  • You have $700 million in expenses and only $500 million to work with. How do allocate your resources?
  • Who gets treated and who has to wait?
  • What about your facilities?
  • Determine what you plan to do and explain your reasoning as well as the ethical considerations behind your decision.

Your initial response must be at least 250 words and must use at least two scholarly sources.

Week_10_Tea_Res

Please read my post followed by my professor’s response and answer her question regarding UTI. Should you have any questions please dont hesitate to ask. Thanks!

Also, this has to be a minimum of one paragraph, referenced with two citations less than 5 Years old, and no plagiarism. 

Weekly Post: The human body is prone to many diseases and infections. Human beings should care for their body to avoid the acquisition of diseases and infections. For instance the urinary tract infection which mainly occur in females and affect the bladder and the urethra. The infection is majorly caused by a bacteria known as Escherichia coli. The bacteria is majorly found in the gastrointestinal tract. The treatment to the urinary tract infection is by the use of antibiotics (Foxman, 2013).

Describe the advantage and disadvantage of one drug to treat urinary tract infections.

The antibiotics that treat the urinary tract infections have many advantages and disadvantages. The advantages are that, they fight infections and preserve lives. They also cure, preserve lives and don’t affect the normal body cells. The antibiotics also have many disadvantages in that they have side effects and may make the body to function abnormally (Nicolle, 2012). 

The antibiotics also kill healthy bacteria that are useful to the body and hence make the body weak. The antibodies help and also harm the body so they are not fully safe for human consumption.

Conclusion

In treatment of infection, the drugs provided should be taken according to the doctor’s prescription to avoid any inconveniences. Misuse of this drugs may cause great damage and may lead to death. The drugs should be used correctly to enable quick recovery.

References

Foxman, B. (2013). Urinary tract infection. In Women and Health (Second Edition) (pp. 553-564).

Nicolle, L. E. (2012). Urinary tract infections. Encyclopedia of Intensive Care Medicine, 2359-2364.

Professors response:  Please give me an example of a drug you would use for UTI and why would you choose it ?

Thanks,

Need a reference with doi or retrieval URL FOR THE BELOW WORK

Me    3 posts   Re: Topic 6 DQ 1  From a financial perspective, hand hygiene is the most cost effective evidence based measure in healthcare systems. Moreover, a lack of investment in hand washing results in increased healthcare costs, decreased productivity or loss of life. According to McLaws (2015), hand hygiene has a relation with job attendance, thereby affecting staff performance. The costs of operating healthcare facilities remain a cardinal aspect that greatly depends on hand washing.According to infection prevention and control specialists, hand hygiene is recognized as the single most crucial intervention deployed to reduce the spread of infections both in the clinical setting and the community. Based on the fact that hands are the most viable modes of transmission and contact between people as well as innate objects, it is important to use water and soap or any alcohol based hand wash. Hand hygiene is paramount to patient safety and quality of healthcare outcomes. Based on the assessment of McLaws (2015), there is a relationship between hand hygiene and healthcare associated infections. The hands of healthcare workers are the most common avenue for the transmission of pathogens from patient to patient. In this light, healthcare workers can dictate the quality of healthcare outcomes when attending to patients.The compliance of hand hygiene has been critical in addressing infections. Bacteria alone accounts for ninety percent of infections while ten percent comprises of fungi and bacteria. Infection control on open wounds and cuts should be considered. Against this backdrop, frequent hand wash audits should be conducted in healthcare organizations to improve compliance. Healthcare organizations should invest in hand wash products and make them accessible to doctors, nurses and visitors alike.      References  McLaws, M. L. (2015). The relationship between hand hygiene and health care-associated infection: it’s complicated. Infection and drug resistance, 8 (7).

DQ31 RESPONSE

Monica Bullock    1 posts   Re: Topic 3 DQ 1  Paz-Pacheco, E., Sandoval, M. A., Ardena, G. J. R., Paterno, E., Juban, N., Lantion-Ang, F. L., … Bongon, J. (2017). Effectiveness of a community-based diabetes self-management education (DSME) program in a rural agricultural setting. Primary Health Care Research & Development (Cambridge University Press / UK), 18(1), 35–49. https://doi- org.lopes.idm.oclc.org/10.1017/S1463423616000335  This study was done to assess the effectiveness of diabetes self-management in rural agricultural towns. It gives a great out line of how the programs were implemented and great statistics. This fits with the population that I deal with at my practicum sight. The down side is that the study was conducted in the Philippines. Not that the information is not valid it just makes it less relatable. On that not I think I would need more information for evidence based practice changes, something relatable to the US. For my capstone project I think it provides great ideas to solve the problem.  Carlos Vasconcelos, António Almeida, Maria Cabral, Elisabete Ramos, & Romeu Mendes. (2019). The Impact of a Community-Based Food Education Program on Nutrition- Related Knowledge in Middle-Aged and Older Patients with Type 2 Diabetes: Results of a Pilot Randomized Controlled Trial. International Journal of Environmental Research and Public Health, (13), 2403. https://doi-org.lopes.idm.oclc.org/10.3390/ijerph16132403  This study focused on food based interventions. Educating the community on food and how it will affect the body. Randomly people were assigned a workout program and diet program then tested the knowledge of food nutrients through a questionnaire before and after to produce results. I think this is a good study to use because it shows how food is a major role in life style changes and the effects on A1C. The down side is the study data is confusion to read and it does only focus on a specific demographic, but it does apply to the question I want to answer. This would be relatable and with the support of another study would be great for evidence based change.  Prezio, E. A., Pagán, J. A., Shuval, K., & Culica, D. (2014). The Community Diabetes Education (CoDE) Program: Cost-Effectiveness and Health Outcomes. American Journal of Preventive Medicine, 47(6), 771–779. https://doi- org.lopes.idm.oclc.org/10.1016/j.amepre.2014.08.016  The study looks at how effective community based teaching programs are with minority and low income groups. Once education was initiated the participants A1 C was tracked for a year to observe for any improvements. Cost was also evaluated vs benefits. I think this is a good one study to use since in recent years I have seen these type of programs pop up in the community. The study focuses on Mexican American who are uninsured, a large part of my community population. I think this would provide enough for evidence based practice changes since it is relatable to my community.  Bielamowicz, M. K., Pope, P., & Rice, C. A. (2013). Sustaining a Creative Community-Based Diabetes Education Program: Motivating Texans With Type 2 Diabetes to Do Well With Diabetes Control. Diabetes Educator, 39(1), 119–127. https://doi- org.lopes.idm.oclc.org/10.1177/0145721712470605  This is an interesting one that take place in Texas and uses cooking as the way to have patients take action in the their own self-care. Using a free healthy cooking class offered to anyone that signed up participants were interviewed at the beginning to see what they viewed as healthy life style changes and cooking. A1Cwere also measured and glucoses levels. At the end of the classes the same things were measured to show improvement and more interest in self-care. This is a unique way to have patients take responsibility for their care through the food they prepare. The down side is the person has to have an interest in cooking and food. On its own I think this would have a strong argument for evidence based changes, but would be stronger with added support from a different study.  Aguiar, E. J., Morgan, P. J., Collins, C. E., Plotnikoff, R. C., Young, M. D., & Callister, R. (2016). Efficacy of the Type 2 Diabetes Prevention Using LifeStyle Education Program RCT. American Journal of Preventive Medicine, 50(3), 353–364. https://doiorg.lopes.idm.oclc.org/10.1016/j.amepre.2015.08.020  This study looks at the PULSE program which contains education on weight loss through life style modifications. It followed high risk men for one year to see if there was improvements in A1C and glucose with the implementation. The program is gender tailored and individually tailored. Weakens would be it only focusses on men, but still could provide good information on life style changes and the effects.

FOR TERRY ROBERTS

Collaborative Leadership

For this discussion, assume you have been assigned to form a committee to develop a policy for patient falls on the medical-surgical unit where you work. As the team leader in charge of this project, you should:

  • Identify the other health care members that you will select to be part of the committee.
  • Provide a rationale for your choice of at least two of the members you invited to the committee.
  • Describe two concepts and skills you will consider as part of your team leader role.
    • What types of strategies will you include to facilitate cost-effective changes related to patient falls?
    • Specifically, how will accountability for care delivery and nursing delegation be impacted by this policy?
  • Provide a well-supported rationale as part of your explanation.

Your initial posting should be at least 150 words, and you must make reference to the work of another writer (either as a quotation, paraphrase, or summary) to provide support for your ideas. The source can be the course text, another relevant book, any assigned readings, or an article you find on your own.

 

Week_7 Answer

Below is my initial post. Please read teacher’s comment right below the line and answer her question and support your answer with two journals as instructed.

Generic Name:  docusate sodium       Trade Name: Colace   

Therapeutic class: laxatives                                Pharmacologic class stool softeners 

Actions: Reduces surface tension of the oil-water interface of the stool. 

Therapeutic effects: Advances fuse of water into stool, bringing about milder fecal mass, may likewise advance electrolyte and water emission into the colon

Dose Prescribed: 

Onset/Peak/Duration: PO    Onset: 24-48 hr. Peak: unknown Duration: unknown

NmL Dose: 50-500 mg once daily

Indications:  Prevention of constipation

Reason Client is prescribed: 

Common Side Effects: Mild cramps

Drug-Drug/Food Interactions or compatibility problems: Touchiness, Stomach agony, sickness, or regurgitating, particularly when related with fever or different indications of an intense belly. Nursing Considerations: Over the top or delayed utilize may prompt reliance. Long haul treatment may cause electrolyte awkwardness and reliance.

References

Engel, H O. (2013). A treatment for constipation.

Docusate sodium. (January 01, 2015). Nursing Times, 101, 13, 29. 

Hillier, K. (January 01, 2014). Docusate Sodium. 

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This patient tried and failed Miralax medication for IBS-Constipation. Docusate sodium is too weak of a medication for this patient. 

Have you considered Linaclotide 145 mcg po daily ?

Please research LInaclotide and look for 2 articles. 

Thanks.