Category: Nursing homework help

Critical appraisal aims to identify potential threats to the validity of the research findings and make informed decisions about the quality of research evidence. Using a Critical Appraisal of Research Evidence Download Critical Appraisal of Research Evidence allows consistency when reviewing several studies.
To complete the following:
Using the same three articles from the Table of Evidence” Assignment, complete the critical appraisal.
Read each article for this review carefully several times.
Use the handout “Critical Appraisal of Research Evidence Download Critical Appraisal of Research Evidence” tool to examine the article in-depth and type detailed notes on it.
Complete “Critical Appraisal of Research Evidence Download Critical Appraisal of Research Evidence” and
Upload on Canvas.

Benign Prostatic Hyperplasia (BPH) medications, such as alpha-blockers and 5-alpha reductase inhibitors, have different mechanisms of action, dosing regimens, and potential side effects. How can you ensure that the chosen medication is safe, effective, and tailored to the patient’s individual needs and preferences?

ANSWER

Ensuring that the chosen medication for Benign Prostatic Hyperplasia (BPH) is safe, effective, and tailored to the patient’s individual needs and preferences requires a comprehensive approach that involves thorough patient assessment, individualized treatment selection, and ongoing monitoring.

Patient Assessment

Detailed Medical History: A thorough medical history is crucial to identify potential contraindications, comorbidities, and risk factors that may influence medication selection. This includes assessing cardiovascular health, liver function, and family history of prostate cancer.

Symptom Severity: Evaluate the severity of the patient’s BPH symptoms, including urinary frequency, urgency, nocturia, and incomplete bladder emptying. This helps determine the urgency of treatment and the expected response to medication.

Prostate Size: Assess prostate size through physical examination or prostate-specific antigen (PSA) testing. Larger prostate sizes may require more aggressive treatment.

Patient Preferences: Consider the patient’s preferences regarding medication type, dosing frequency, and potential side effects. This patient-centered approach enhances treatment adherence and satisfaction.

Medication Selection

Alpha-Blockers: Alpha-blockers relax the smooth muscles in the prostate and urethra, improving urine flow. They are generally well-tolerated and provide rapid symptom relief. However, they may cause dizziness, hypotension, and ejaculatory dysfunction.

5-Alpha Reductase Inhibitors: 5-alpha reductase inhibitors shrink the prostate by blocking the conversion of testosterone to dihydrotestosterone (DHT), a hormone that stimulates prostate growth. They are effective in reducing prostate size and improving urinary symptoms but may cause sexual side effects, such as decreased libido and erectile dysfunction.

Combination Therapy: In some cases, a combination of an alpha-blocker and a 5-alpha reductase inhibitor may be considered for more severe BPH or for patients who experience inadequate symptom relief with monotherapy.

Individualized Treatment Tailoring

Initial Medication Choice: Based on the patient’s assessment, the initial medication choice should consider the severity of symptoms, prostate size, potential contraindications, and patient preferences.

Dose Titration: Medication dosage may need to be adjusted based on the patient’s response and tolerance. Regular follow-up visits are essential to monitor treatment efficacy and side effects.

Patient Education: Provide comprehensive patient education regarding the chosen medication, including its mechanism of action, dosing regimen, potential side effects, and expected outcomes.

Ongoing Monitoring: Regularly monitor the patient’s response to treatment, assessing symptom improvement, side effects, and potential interactions with other medications.

Alternative Treatment Options: If medication therapy is ineffective or intolerable, discuss alternative treatment options, such as minimally invasive procedures or surgical intervention.

By following these principles, healthcare providers can ensure that the chosen BPH medication is safe, effective, and tailored to the patient’s individual needs and preferences, optimizing treatment outcomes and patient satisfaction.

Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
Be sure to provide APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking.
Add a lessons learned section that includes the following:
A summary of the critical appraisal of the peer-reviewed articles you previously submitted
An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

Discuss the individual and/or community needs as it relates to the reason for your capstone research inquiry. Why do you believe your research inquiry/findings will address the identified needs that prompted your inquiry?
Expectations
Initial Post:
Due: Thursday, 11:59 pm PT
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years

Discussion Topic

1. Integrate risk / screening as it applies to genetics? How, what methods are used to screen for health conditions that may have genetic connections? What guidelines support evidence-based decision making in the area of genetics?
2. What is genetic risk assessment? How is it determined?
3. Explore and integrate genetic terminology, for example: Genomics, pharmacogenomics, genetic
epidemiology. Also, refer to HP2030
4. What are the components of a genetic risk assessment?
5. Can you discuss the interplay (connection) between genetics and the environment, how do they influence one another? Do they?
6. What is the Genetics Nondiscrimination Act?
Please be sure to adhere to the following when posting your weekly discussions:
1. Students are to write their name and the appropriate discussion number/discussion title in the title bar for each discussion. For example Discussion 1: Micheal Cabrera or Discussion 3: Sheila
Smith. This is important in identifying that students are submitting original posts as well as response posts as required.
2. Students are to submit their discussions directly onto Blackboard Discussion Board.
Attachments submitted as discussion board posts will not be graded.
3. As a reminder, all discussion posts must be minimum 500=550 words, references must be cited in APA format 7th Edition, and must include minimum of 3 scholarly resources published within the past
5-7 years (not part of the classroom coursework).

ANSWER

Discussion 1: Genetic Risk Assessment in Healthcare

Integrating Risk and Screening in Genetics

Genetic risk assessment plays a crucial role in modern healthcare, enabling clinicians to identify individuals at an increased risk of developing certain genetic disorders or conditions. This information can inform preventive measures, early detection, and personalized treatment strategies, improving patient outcomes and reducing healthcare costs.

Methods for Genetic Screening

Various methods are employed for genetic screening, each with its specific advantages and limitations. Some common methods include:

Targeted Gene Testing: This method focuses on specific genes known to be associated with a particular genetic disorder or condition.

Panel Testing: This method analyzes multiple genes simultaneously, allowing for the detection of a wider range of genetic disorders or conditions.

Whole Exome Sequencing (WES): This method sequences the entire protein-coding portion of the genome, providing a comprehensive overview of an individual’s genetic makeup.

Whole Genome Sequencing (WGS): This method sequences the entire human genome, offering the most comprehensive genetic information.

Guidelines for Evidence-Based Decision Making

Several guidelines support evidence-based decision making in the field of genetics. These guidelines provide recommendations for the appropriate use of genetic testing, interpretation of test results, and communication with patients. Notable examples include:

Guidelines from the American College of Obstetricians and Gynecologists (ACOG)

Recommendations from the American College of Medical Genetics and Genomics (ACMG)

Guidelines from the National Society of Genetic Counselors (NSGC)

Genetic Risk Assessment: Definition and Determination

Genetic risk assessment is the process of estimating an individual’s likelihood of developing a particular genetic disorder or condition based on their genetic makeup. It involves evaluating an individual’s family history, personal medical history, and genetic test results.

Components of Genetic Risk Assessment

The components of genetic risk assessment include:

Identifying genetic risk factors: This involves identifying specific genes or genetic variants that are associated with an increased risk of the disorder or condition.

Evaluating the contribution of genetic risk factors: This involves determining how strongly each genetic risk factor contributes to the overall risk of the disorder or condition.

Considering other factors: This involves considering other factors that may influence risk, such as environmental exposures, lifestyle choices, and other medical conditions.

Genetic Terminology

Genomics: The study of an individual’s entire genetic makeup.

Pharmacogenomics: The study of how genetic variations affect an individual’s response to medications.

Genetic Epidemiology: The study of how genetic factors contribute to the distribution and patterns of disease in populations.

HP2030: Precision Medicine Initiative

The Precision Medicine Initiative (PMI) is a U.S. government initiative aimed in advancing precision medicine, which tailors healthcare to an individual’s genetic, environmental, and lifestyle factors. Genetics plays a significant role in PMI, as it provides insights into an individual’s predisposition to certain diseases and their response to treatments.

Interplay between Genetics and Environment

Genetics and environment interact in a complex manner, influencing each other and contributing to an individual’s overall health. Genetics provide the blueprint for an individual’s biology, while environmental factors, such as diet, exercise, and exposure to toxins, can influence how those genes are expressed.

Genetics Nondiscrimination Act (GINA)

The Genetics Nondiscrimination Act (GINA) is a U.S. federal law that prohibits discrimination against individuals based on their genetic information. It protects individuals from being denied employment, health insurance, or life insurance based on their genetic test results or perceived genetic predisposition to a condition.

Conclusion

Genetic risk assessment is a valuable tool in modern healthcare, enabling clinicians to identify individuals at increased risk for genetic disorders or conditions, inform preventive measures, and improve patient outcomes. As genetic testing and research continue to advance, the role of genetic risk assessment will

Identify a clinical problem in your area of clinical interest. Discuss a gap in the current research literature that you can identify specific to your clinical problem . Think about variables you will need to investigate to fill the gap in knowledge share with your group.
For example (this is just an example), increased CAUTI in critical care is a clinical problem you are familiar with. You hypothesize that silver tip catheters decrease the incidence of CAUTIs in critical care. You as the researcher would like to investigate if this reduction in CAUTI can be attributed to silver tip catheters, but you are unable to find this in the literature. You develop a research problem stating this gap in the literature; Does the use of silver tip catheters in critical care units decrease the incidence of CAUTIS? The target population would be patients in critical care units with catheters.The variables include CAUTI and silver tip catheters. The setting is critical care.

Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.
Review the NCSBN and ANA websites to prepare for your presentation.
The Assignment: (8- to 9-slide PowerPoint presentation)
Develop a 8- to 9-slide PowerPoint Presentation that addresses the following:
a. Describe the differences between a board of nursing and a professional nurse association.
b. Describe the board for your specific region/area ( Illinois board of nursing).
c. Who is on the board?
d. How does one become a member of the board?
e. Describe at least one state regulation related to general nurse scope of practice.
f. How does this regulation influence the nurse’s role?
g. How does this regulation influence delivery, cost, and access to healthcare?
h. If a patient is from another culture, how would this regulation impact the nurse’s care/education?
i. Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).
j. How does this regulation influence the nurse’s role?
k. How does this regulation influence delivery, cost, and access to healthcare?
l. Has there been any change to the regulation within the past 5 years? Explain.
m. Include Speaker Notes on Each Slide (except on the title page and reference page)
RUBRIC FOR GRADING
1. Boards of Nursing vs. Professional Nurse Associations Develop a 8- to 9- slide PowerPoint presentation that addresses the following:· Describe the differences between a board of nursing and a professional nurse association.· Describe the members of the board for your specific region/area.· Who is on the board?· How does one become a member of the board?· Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.- Using sufficient evidence, the response accurately and thoroughly describes the differences between a board of nursing and professional nurse associations. …Response provides a complete and accurate description of who is on a board of nursing. …Response provides a detailed and thorough explanation of how one becomes a member of the board of nursing. …Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.
2. The Impact of State Regulation on Nurse PracticeDescribe at least one state regulation related to general nurse scope of practice.• How does this regulation influence the nurse’s role?• How does this regulation influence delivery, cost, and access to healthcare?• If a patient is from another culture, how would this regulation impact the nurse’s care/education?• Has there been any change to the regulation within the past 5 years? Explain.• Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide.- Response includes an accurate and thorough description of how one state regulation is related to general nurse scope of practice. …Response accurately and thoroughly explains how the regulation influences the nurse’s role. …Response accurately and thoroughly explains how the regulation(s) influences delivery, cost, and access to healthcare. …Response accurately and thoroughly explains how the regulation impacts the nurse’s care/education to provide care for other cultures. … Changes fully explained. …Presentation includes speaker notes that explain and elaborate the significant points of the presentation.
3. Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).• How does this regulation influence the nurse’s role?• How does this regulation influence delivery, cost, and access to healthcare?• Has there been any change to the regulation within the past 5 years? Explain.Speaker notes are included on every slide and are used to explain and elaborate the significant points on each slide. – Using sufficient evidence, response includes an accurate and thorough description of how one state regulation is related to Advanced Practice Registered Nurses (APRNs). …Response accurately and thoroughly explains how the regulation influences the nurse’s role. …Response accurately and thoroughly explains how the regulation(s) influences delivery, cost, and access to healthcare. … Changes fully explained. …Presentation includes speaker notes that explain and elaborate on the significant points of the presentation.
4. Written Expression and Formatting—Paragraph Development and OrganizationSpeaker notes make clear points that support well developed ideas, low 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 and conclusion are provided which delineate all required criteria. – Speaker notes and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
5. This criterion is linked to a Learning OutcomeWritten Expression and Formatting: English Writing StandardsCorrect grammar, mechanics, and proper punctuation. – Uses correct grammar, spelling, and punctuation with no errors.
6. Written Expression and Formatting: The presentation follows correct APA format for parenthetical/in-text citations, and reference list. – Uses correct APA format with no errors.
REQUIRED READING FOR REFERENCE (include 3-4 from this reference list)
· Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
o Chapter 4, “Government Response: Regulation” (pp. 57–84)
· American Nurses Association. (n.d.). ANA enterprise Links to an external site.. Retrieved September 20, 2018, from http://www.nursingworld.org
· Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care Links to an external site.. Nursing Outlook, 65(6), 761–765.
· Halm, M. A. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing Download Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280. doi:10.1111/wvn.12291
· National Council of State Boards of Nursing (NCSBN) Links to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htm
· Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care Links to an external site.. Nursing Outlook, 66(4), 379–385.
· Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case Links to an external site.. Medicine 2.0, 4(2), e4.

How should healthcare professionals proactively plan to update their knowledge and skills to respond to the major public health issues and challenges facing them and their clients?

* Research a bioterrorist incident. Provide the name of the incident you have chosen, and support your answers with evidence/examples. Please provide a working link and a citation for your source
* Give an example and details from national/international news of a bioterrorist attack.
Address all of the following questions:
1) What was the classification of the biological agent used in the attack?
2) Discuss the implications of the biological agent.
3) Discuss the therapy for the biological agent.
4) What are the decontamination procedures for the biological agent used in the attack?
5) Define the appropriate level of PPE required for this type of biological agent?

see below
Describe and evaluate the differences between evidence based practice and research.Describe the importance and application of health care information, data mining, and importance to application in patient care outcomesDiscuss how data mining and interpretation influences case management and utilizationDescribe participation in managed care and the importance of quality care initiatives and performance indicators (remember to use AHRQ as a resource) 2pg plus refernces