[ANSWERED 2023] Read the case study presented at the end of Chapter 8 (Guido, p.133) which begins, “The patient was hospitalized for extreme low back pain
Read the case study presented at the end of Chapter 8 (Guido, p.133) which begins, “The patient was hospitalized for extreme low back pain Was there informed consent for the initial medications given to the patient? How would you determine that informed consent had been given for the MRI and the medications needed for sedation for the test? Was the informed consent deficient to the degree that there was a lack of informed consent for the patient for the second dose of medications? How would you decide this case? Read the case study presented at the end of Chapter 9 (Guido, p. 150) which begins, “Jimmy, a Floridian, has undergone two liver transplants.”: What questions would you anticipate the judge to ask Jimmy to ascertain his level of maturity, understanding of the full consequences of his lack of action, and possible alternative reasons for requesting that he be allowed to make his own medical decisions? How should the judge evaluate the mother’s response to her son’s request? Does the state of residency factor into the judge’s decision? Are there additional issues that should be addressed prior to deciding the outcome of this case? How would you decide the case? Jimmy Chang, a 20- year- old college student, is admitted for additional chemotherapy. Jimmy was diagnosed with leukemia 5 years earlier and has had several courses of chemotherapy. He is currently in an acute active phase of the disease, though he had enjoyed a 14- month remission phase prior to this admission. His parents, who accompany him to the hospital, are divided as to the benefits of additional chemotherapy. His mother is adamant that she will sign the informed consent form for this course of therapy, and his father is equally adamant that he will refuse to sign the informed consent form because “Jimmy has suffered enough.” You are his primary nurse and must assist in somehow resolving this impasse. What do you do about the informed consent form? Who signs and why? Using the MORAL model, decide the best course of action for Jimmy from an ethical perspective rather than a legal perspective. Now decide the best course of action based on a purely legal perspective. Did you come to the same conclusion using both an ethical and a legal approach? Please combine all of these responses into a single Microsoft Word document for submission. Submit only completed assignments (not partial or “draft” assignments). Be thorough in your responses to adequately address all aspects of each question. Submit only the assignments corresponding to the module in this section. Assignment Expectations Length: 1500 words; answers must thoroughly address the questions in a clear, concise manner. Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment. References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims. Format: Save your assignment as a Microsoft Word document (.doc or .docx). File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”) M6 Assignment UMBO – 4 M6 Assignment PLG – 4, 6 M6 Assignment CLO – 1, 2, 3, 7 The case study for Chapter 8: ” The patient was hospitalized for extreme low back pain so intense that he could not be scheduled for a magnetic resonance imaging (MRI) until his fifth hospital day. His physician explained to him that the Dilaudid and Ativan he would receive the next day to numb his pain for the MRI could cause respiratory depression or arrest in patients like himself who were on high doses of opiates. The patient agreed to be given the medications. At 8:15 A.M. the next day, a nurse gave the patient the medications, but the MRI had to be postponed. With the physician’s new orders and the patient’s verbal consent, the nurse gave a second dose of the same medications at 11:30 A.M. About 5:00 P.M., the patient became stuporous. Vital signs were taken, oxygen was initiated, and Narcan was prepared for injection. At 6:00 P.M., the critical care code team was called, as the patient was in full cardiopulmonary arrest. The patient was successfully resuscitated and was discharged the next day. The patient then sued, claiming residual psychologi-cal symptoms and failure to obtain valid informed consent for the second dosage of medications administered at 11:30 A.M.” The case study for Chapter 9: “Jimmy, a 15-year-old Floridian, had undergone two liver transplants. An only child, he lived with his mother, a sin-gle parent. He was prescribed immunosuppressant drugs that caused severe debilitating side effects in an attempt to prevent his body from rejecting the second liver transplant. Understanding that his life expectancy was limited and that the medications were causing the debilitating side effects, Jimmy elected to stop taking the immunosuppressive medi-cations. When his attending physicians discovered that he was no longer taking the prescribed medications, they instituted court proceedings against his mother for child endan-germent. Jimmy was readmitted to the hospital at the same time in an attempt to ensure that he restarted the immuno-suppressive mediations.A juvenile court judge held separate meetings with Jimmy, his mother, and the health care team in an attempt to resolve the issue. His mother, at her meeting with the judge, expressed anguish as she felt that not taking the medications would hasten her son’s death, but she was also resolved to the fact that she felt he was mature enough to fully under-stand the consequences of his non-actions. Jimmy assured the judge that he understood the consequences of his non-actions, but he was tired of taking medications that merely increased his pain and suffering and wanted, as stated in his final comment, “some time to be free of pain. I am go-ing to die anyway.” The health care team were unable to assure the judge that taking the medications would greatly increase Jimmy’s longevity.” Required resources: Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Prentice Hall. ISBN: 9780134701233. Read Chapter 8 & 9. Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). Jones and Bartlett. ISBN: 9781284144185. Read Chapters 12, 13, & 14. Expert Answer and Explanation Informed Consent This paper will give an insight into various issues surrounding informed consent. Three case studies will be used to provide context on the subject under discussion. Chapter 8 Case Study
[ANSWERED 2023] Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course
Students are required to maintain weekly reflective narratives throughout the course Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course. In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences: New practice approaches Intraprofessional collaboration Health care delivery and clinical systems Ethical considerations in health care Population health concerns The role of technology in improving health care outcomes Health policy Leadership and economic models Health disparities Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course. While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Expert Answer and Explanation Professional Capstone and Practicum Reflective Journal New Practice Approaches I am excited and nervous this week. Class started on the 24th May and I was still abroad because my return flight was canceled. I made it to the states three days after class started. I went right to work by reviewing class work and assignments due on week 1. I quickly realized that in this course student needed to plan early. I was overwhelmed the few days of class. I contacted my preceptor to check if she received an email from GCU to set up her thunder time account. She was very busy that day and was unable to check it. The following day, I met with her to facilitate setting up her account. She was successful. I started reading announcements, expectations and course requirements. By this time things starts to make sense. I then started working on assignments. On the other hand, planning to fulfil my 10 hours of clinical time for the week. I called my preceptor to know her availability on when she is going out to visit patients and my plan on how we can move forward in the course since its time consuming. Few clinical hours were done with preceptor, community and leadership. Interprofessional Collaboration Interprofessional collaboration is working with other professionals to accomplish the same goals. In nursing, interprofessional collaboration can be described as a situation where nurses work together with physicians, laboratory specialists, and other specialists to improve the health of a patient under their care (Reeves et al. , 2017). Interprofessional collaboration can ensure that patients receive quality and safe care because many qualified and experienced persons are working to ensure that they gain healthy status. Interprofessional collaboration can also reduce medical errors because it might promote healthy and effective communication between professionals working together (Tang et al., 2018). I have learned a lot about interprofessional collaboration in this week’s lesson. One of the things I have learned is that interprofessional collaboration cannot be achieved without effective and proper communication strategies. Communication is everything in interprofessional collaboration. Another thing I have learned is that for one to collaborate successfully with other professionals, one must be able to work in a team. Health Care Delivery and Clinical Systems A Healthcare delivery system can be defined as a collection of resources, institutions, and individuals to provide care services with the aim of meeting the target population. I have learned from this course that healthcare delivery has changed a lot. Most of the care delivery services are done using technologies. For instance, a preventive care service, such as the one focused on in this course can be delivered using technologies, such as social media and mass media tools, such as television. I have also realized that healthcare delivery in the current US health system is based on quality and not quantity. Healthcare delivery is currently done using a model known as a value-based model where nurses and other healthcare professionals are paid based on the quality of care they have provided and not the quantity (Putera, 2017). Another thing I have learned is that preventive measures, such as this capstone project can lower the cost of health care delivery by preventing readmissions and other factors increasing the cost of health. Ethical Considerations in Health Care Like any other sector, healthcare industry is also guided by various ethical considerations. My capstone project will be based on many ethical considerations. One of them is informed consent. The project will involve educating geriatric patients about proper handwashing techniques. Hence, the patients should give their consent before being included in the project. My role in this situation is explaining to the participants the purpose of this projects, how the results will be used, and who will view their private information. The information will help the participants make informed decision regarding the project they want to join. Another ethical consideration that will be included in the project is justice. Adashi et al. (2018) note that justice is one of the ethical principles in Belmont report. According to the authors, researchers should ensure that they observe equality when handling participants and including them in their report. Practices of Culturally Sensitive Care The US is one of the countries expanding rapidly in terms of culture. Dyble (2018) notes that more than 37% of the American population come from the minority racial groups. Nurses are therefore needed to remain as culturally sensitive as possible to provide just and equal care to all patients regardless of their ethnic groups. As a nursing project, this capstone activity should also remain as
[ANSWERED 2023] This weeks first assignment is STEP 3 – Literature Review and Critical Appraisal
This week’s first assignment is STEP 3 – Literature Review and Critical Appraisal This weeks first assignment is STEP 3 – Literature Review and Critical Appraisal. The student will complete the following items and submit a Word doc to the assignment link. Provide a title that conveys or describes the assignment. Literature Review – Provide the key terms used to guide the search for the evidence and provide at least five (5) summaries of research studies to support the evidence. Critical Appraisal of Literature – Discuss the strengths and weaknesses of the evidence, what is known from the evidence and any gaps in knowledge from the research evidence. References – Cite a minimum of five scholarly references in APA 7th ed format. Expectations Due: Monday, 11:59 pm PT Format: Completed paper with references in APA 7th ed. format File name: Save the file with Student First Name_Last Name_Part 3 Expert Answer and Explanation Intervention Protocol to Improve Adult Vaccination Rates Literature Review Article 1 Reminders through messages and calls are some of the effective but highly underutilized methods that improve adult vaccination and reduce mortality rates among individuals. Development of centralized reminder centers and dispatching accurate information to individuals scheduled for vaccination has proven to increase vaccination rates and reduced mortality from vaccinatable diseases (Hurley et al., 2018). The experimental study is carried out among adults between 19-64 years without high-risk conditions needing influenza, diphtheria, tetanus, or acellular pertussis shots, and older adults above 65 years with high-risk condition needing similar vaccinations were sent three reminders and recalls randomly. The outcome of the study showed that reminders increased influenza vaccinations among adults aged above 65 years without the risk of burdening medical practices or increasing cost for the activity. Therefore, a maximum of three reminders to adults scheduled for vaccinations improves the turn up rates without straining healthcare institutions or increasing overall costs. Article 2 According to Mark Doherty, Giuseppe, & Stefania, (2019), vaccination should be viewed as a medical intervention for health promotion among adults. Vaccination programs among children are scheduled regardless of the health condition of the child. It is therefore a strategy to promote quality life among children as opposed to a medical intervention as it is among adults. Overall, global population is increasing thus an increase in the aging population as well. To maintain a healthy older population, strategies ought to be put in place to promote vaccination rates among young and aging adults. To achieve this, adults should be educated on the importance of vaccinations as ways to improve life quality so that they are able to prevent diseases as opposed to curing, which is strenuous to the health facilities and to finances. In addition to vaccination programs, they should also be educated about maintaining quality diets and exercising. Article 3 The study by Srivastav et al., (2018) is an online survey carried to determine the under-utilization of adult vaccines in the society. According to the study, Vaccines are proven to reduce morbidity and mortality among individuals across all ages. The observation is carried out among US citizens whereby a small percentage of the adult populations is aware of these vaccines. This means that they lack the knowledge about existing vaccines and how they are scheduled for the patients. Clinicians and pharmacist also lack knowledge of these vaccines thus making it difficult to educate adults concerning the same. Therefore, one of the proposed interventions according to the study is to educate clinicians and pharmacist on available adult vaccines to enable them to pass the knowledge on to the patients that they interact. Also, they should be in a position to advice patients on health facilities that adults should visit and get access to these vaccines. Article 4 According to Prins et al., (2017), inequality in adult vaccination programs is gradually increasing in the US. The aim of the study is to understand the source of disparities among minorities in the US and provide solutions to mend the existing gap. The study is an internet survey whereby data is collected to identify tools and resources available to support adult immunization programs and where they are mostly emphasized in the US. The findings show that information concerning influenza vaccinations is issued to the majority populations while the minorities lack access to the information. Therefore, one of the major intervention towards increasing adult vaccination rates, is reducing the gap between the majority and minority through educating them equality and providing vaccination centers equally. Article 5 The study focuses on HPV vaccination programs that were launched in 97 countries by 2017. The vaccination program is part of the adult vaccination intervention as the first dose is offered to girls before reaching 15 years. HPV vaccination is tested and proven to prevent cervical cancer among women yet it still remains underutilized (Zimet, & Osazuwa-Peters, 2019). According to the survey, social media and the internet offer a platform to spread false information concerning the virus thus a reduced acceptability rate of the vaccine among women and girls. Clinicians and researchers therefore have a difficult time trying to campaign on the importance and the eligibility of the vaccine. However, the study views social media and internet as a platform for intervention and increasing vaccine awareness to increase vaccine rates among adults. Critical Appraisal of Literature The selected articles will provide information that is relevant to the research study and help find intervention protocols recommended to increase vaccination rates among adults. The first article emphasizes on the importance of sending reminders and messages to adults scheduled to receive vaccinations. Based on this article, reminders and recalls have shown an increase in vaccination rats and promoted stability in vaccination centers as well as stability in the overall costs. However, the study shows that older adults above 65 years responded better to reminders as opposed to younger adults. Therefore, the study may not have similar results when addressing younger populations. The second article insists on offering vaccines as strategies to promote health and improve quality of
[2024] How do various religious, cultural, and spiritual beliefs affect the patient’s perception of (1) how he or she will relate the symptoms to the caregiver and (2) the care the patient receives?
How do various religious, cultural, and spiritual beliefs affect the patient’s perception of (1) how he or she will relate the symptoms Week One Discussion Weekly Assignment: Discussion Board Discussion Board: How do various religious, cultural, and spiritual beliefs affect the patient’s perception of (1) how he or she will relate the symptoms to the caregiver and (2) the care the patient receives? How will this influence the diagnosis? Instructions: Provide an introduction of yourself to the class. Discuss your nursing background, nursing goals, hobbies and/or interests. Address all elements of the weekly discussion board topic. Follow discussion board rubric guidelines. To view other students postings you are required to post your initial posting. Week Two Discussion Discussion Board Discuss the impact of economic factors and living situations on patient food choices. Identify how different factors may positively or negatively influence a patient’s nutritional status. Assignment 1 Cultural Ethnic Assessment An important aspect of the professional nurse’s role is the ability to provide culturally competent nursing care. Reflect on the demographics of the area in which you live and cultures that are represented. In this assignment provide a 3-4-page APA formatted paper discussing the demographics of the area in which you live. Identify cultural assessment considerations for the ethnic groups in the area, and any social determinants of health associated with the ethnic groups. Identify and discuss one health promotion topic specific to the ethnic groups in your area. The paper must include at least three scholarly references, including a minimum of one peer-reviewed journal, as well as meeting turn-it in program requirements. Rubric Health Assessment Assignment 1 Health Assessment Assignment 1 Criteria Ratings Pts This criterion is linked to a Learning OutcomeIntroduction 10 to >6.0 pts Full Marks Identifies the necessity of culturally competent nursing care. Introduces the purpose of the paper. 6 to >0.0 pts Partial Marks Does not provide statements regarding the necessity of culturally competent nursing care, and/or does not introduce the purpose of the paper. 0 pts No Marks No explanation of the necessity of culturally competent nursing care, or attempt to explain the purpose of the paper. 10 pts This criterion is linked to a Learning OutcomeDemographic and Ethnic Assessment 20 to >12.0 pts Full Marks Thoroughly discusses the demographics of the area, including factors such as poverty, education, obesity and drug and alcohol use. Discusses the main ethnic group found in the demographic area. 12 to >0.0 pts Partial Marks Provides inadequate or minimal information regarding the demographics of the area, including factors such as poverty, education, obesity and drug and alcohol use, and/or the main ethnic group found in the demographic area is poorly identified. 0 pts No Marks Makes no attempt to discuss the demographics of the area, including factors such as poverty, education, obesity and drug and alcohol use, and/or fails to identify the main ethnic group found in the demographic area. 20 pts This criterion is linked to a Learning OutcomeSocial Determinants of Health 20 to >12.0 pts Full Marks Fully discusses the social determinants of health associated with the demographic area (e.g. education, economic stability, access to healthcare, social and community context, neighborhood and community). 12 to >0.0 pts Partial Marks Discussion lacking information on the social determinants of health associated with the demographic area (e.g. education, economic stability, access to healthcare, social and community context, neighborhood and community). 0 pts No Marks Minimal or no discussion regarding social determinants of health associated with the demographic area (e.g. education, economic stability, access to healthcare, social and community context, neighborhood and community). 20 pts This criterion is linked to a Learning OutcomeHealth Promotion 20 to >12.0 pts Full Marks Identifies and discusses one health promotion topic specific to the ethnic group identified in the demographic area. 12 to >0.0 pts Partial Marks Inadequate discussion regarding a health promotion topic specific to the ethnic group identified in the demographic area. 0 pts No Marks Inappropriate or no discussion of health promotion topic specific to the ethnic group identified in the demographic area. 20 pts This criterion is linked to a Learning OutcomeConclusion 10 to >6.0 pts Full Marks Conclusion included summarizing the aspects of the paper. 6 to >0.0 pts Partial Marks Conclusion does not appropriately summarize the aspects of the paper. 0 pts No Marks No conclusion included. 10 pts This criterion is linked to a Learning OutcomeWriting Mechanics, Grammar and APA Formatting 10 to >6.0 pts Full Marks No errors in grammar or writing mechanics. One or less APA formatting errors. 6 to >0.0 pts Partial Points Only 1-2 grammatical or mechanical errors. Four or less APA formatting errors. 0 pts No Marks Multiple grammatical or mechanical errors. Five or more APA formatting errors. 10 pts This criterion is linked to a Learning OutcomeReferences 10 to >6.0 pts Full Marks A minimum of three scholarly references included per instruction guidelines. Appropriate citations and reference page included. 6 to >0.0 pts Partial Marks Less than three appropriate scholarly references included. References lacking proper citation or reference page. 0 pts No Marks No evidence of scholarly research. 10 pts Total Points: 100 Week Three Discussion Weekly Assignment: Discussion Board Identify and discuss an evidence-based clinical practice approach to health promotion for the public regarding one of the following topics: Vaping, smokeless tobacco and associated cancer risks. Use of cocaine and effect to the nasal Septum. Environmental factors that may cause hearing loss. Instructions: Address all elements of the weekly discussion board topic. Follow discussion board rubric guidelines. To view other students postings you are required to post your initial posting. Week Four Discussion Weekly Assignment: Discussion Board Select one of the following discussion topics. Identify and discuss prevention measures to reduce breast cancer in the male or female patient. Identify and discuss how environmental factors and smoking affect the unborn fetus, infants and/or children. Instructions Address all elements of the weekly discussion board topic. Follow discussion board rubric guidelines.
[2024] A 72 year old male arrives at the emergency department complaining of shortness of breath for the past four days. He states that the shortness of breath is getting worse
A 72 year old male arrives at the emergency department complaining of shortness of breath for the past four days Weekly Discussion: Case Study to compare ADN and BSN Practice Applications A 72 year old male arrives at the emergency department complaining of shortness of breath for the past four days. He states that the shortness of breath is getting worse. His shortness of breath is worse when lying down and with exertion. He complains of a night time cough. The patient also reports increased swelling in his legs bilaterally. He states, “My feet are so swollen I cannot wear my shoes so I had to come here in my slippers.” He also complains of increased weight, particularly in the abdomen and around the waist. When asked how long the swelling had occurred, he reports he started “to gain weight about three weeks ago after the doctor took me off my Lasix.” The patient has a history of hypertension, chronic renal insufficiency, and chronic respiratory infections. He has recently completed a round of Rituximab for follicular CD20-positive non-Hodgkin’s lymphoma. His vital signs are as follows: BP 210/106, HR 118, RR 26, T 98.2. The patient has rales in the lung bases bilaterally and 1+ pitting edema in the lower extremities bilaterally. The patient is in no acute respiratory distress but states he feels better if he sits up. His oxygen saturation is 95%. Instructions: Using the DECs, describe how the care for this patient by an associate prepared nurse and a baccalaureate prepared nurse should differ. Use the DECs to support your answers. Apply the AACN Baccalaureate Essential for Professional Nursing Practice to this case. Follow discussion board rubric guidelines To view other students postings you are required to post your initial posting Week Two Assignment Weekly Assignment: The purpose of this assignment is for each student to become familiar with the mechanics of professional writing. Complete a series of activities reinforcing professional written communication using APA 7th ed. style and format. Utilize the week two assignment document. Identify the APA formatting error(s). Week Two Assignment Document Week 2 APA assignment Download Week 2 APA assignment Analyze the provided written narrative. Using the provided assignment identify the APA errors and highlight them. In a new word document correctly format the APA assignment in 7th ed. professional paper format. Include a title page (create a title for this assignment), introduction, at least two level one headings, conclusion, and reference page. Attach the original corrected APA assignment document and the new professional paper document and submit to canvas. ** The intext citations and the reference page WILL NOT MATCH. Correct the provided citations appropriately in the body of the paper and construct a reference page using the references provided. Further re-worded, clarified directions (the same as above just explained a different way) See if this helps. 1) On the document provided – download it and highlight all the APA errors you find in the text that follows the section steps. 2) Create a title page (professional paper format) for the text that is provided, then copy and paste the text to the next page on the word doc, but provide an introduction and divide the paper into two sections using level one headings, then the conclusion. Correct all APA errors and citations. 3) Follow the body of the paper include a reference page- copy and paste the references included on the provided assignment and correct them. Rubric Week Two APA Assignment Week Two APA Assignment Criteria Ratings Pts This criterion is linked to a Learning OutcomeTitle Page Identified and corrected errors. Cited 7th Edition APA Manual supporting correct formatting 20 to >10.0 pts Full Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Two or less errors not identified or corrected. 10 to >0.25 pts Partial Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Four or less errors not identified or corrected. 0.25 to >0 pts No Points Five or more grammatical or APA errors unidentified or corrected properly. 20 pts This criterion is linked to a Learning OutcomeHeadings, Paragraph indentation and Typeface Identified and corrected errors. Cited 7th Edition APA Manual supporting correct formatting 20 to >10.0 pts Full Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Two or less errors not identified or corrected. 10 to >0.25 pts Partial Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Four or less errors not identified or corrected. 0.25 to >0 pts No Points Five or more grammatical or APA errors unidentified or corrected properly. 20 pts This criterion is linked to a Learning OutcomeGrammar Structure Identified and corrected errors. Cited 7th Edition APA Manual supporting correct formatting 20 to >10.0 pts Full Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Two or less errors not identified or corrected. 10 to >0.25 pts Partial Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Four or less errors not identified or corrected. 0.25 to >0 pts No Points Five or more grammatical or APA errors unidentified or corrected properly. 20 pts This criterion is linked to a Learning OutcomeCitations Identified errors and corrected errors. Cited 7th Edition APA Manual supporting correct formatting 20 to >10.0 pts Full Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Two or less errors not identified or corrected. 10 to >0.25 pts Partial Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Four or less errors not identified or corrected. 0.25 to >0 pts No Points Five or more grammatical or APA errors unidentified or corrected properly. 20 pts This criterion is linked to a Learning OutcomeReference Page Identified and corrected errors. Cited 7th Edition APA Manual supporting correct formatting 20 to >10.0 pts Full Points Grammatical or APA errors are identified and corrected, citing correct 7th edition APA format. Two or less errors not identified or corrected. 10 to >0.25 pts Partial Points Grammatical or APA errors are
[ANSWERED 2024] A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services
A 27-year-old patient with a history of substance abuse is found unresponsive by emergency Discussion: Alterations in Cellular Processes At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally. Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans. For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts. To prepare: By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor. Scenario 4: A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate. The roommate states that he does not know how long the patient had been lying there. Patient received naloxone in the field and has become responsive. He complains of burning pain over his left hip and forearm. Evaluation in the ED revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm. EKG demonstrated prolonged PR interval and peaked T waves. Serum potassium level 6.9 mEq/L. By Day 3 of Week 1 Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation: The role genetics plays in the disease. Why the patient is presenting with the specific symptoms described. The physiologic response to the stimulus presented in the scenario and why you think this response occurred. The cells that are involved in this process. How another characteristic (e.g., gender, genetics) would change your response. Expert Answer and Explanation Alterations in Cellular Process Role of Genes in the Disease According to a study done by McCance and Huether (2019), genetic variables contribute to the commencement of addictive substances and change from use to addiction. The authors also note that 40 to 60% of one’s vulnerability to substance use is accounted for by genetic factors. Another research by Muro (2018) found that PSD-95 is a specific protein gene that connects learning, memory, and addiction. The researchers also found that mice with a low rate of PSD-95 could not find their way out of the maze easily and were highly sensitive to cocaine. The study also found that a higher amount of PSD-95 gene made mice more sensitive to alcohol, nicotine, heroin, and morphine. Another gene that is responsible for addiction is the DARPP-32 gene. Abbasian, Lockington, Megharaj, and Naidu (2016) report that when DARPP-32 was extracted from mice, it failed to respond to hard drugs. Therefore, the 27-year-old is addicted to drugs because he inherited either DARPP-32 or PSD-95 from his family. Reasons for Presenting Described Symptoms Opioid overdose may cause effects, such as slow breathing, blue skin from poor blood circulation, small pupils, respiratory failure, lessened alertness, confusion, and loss of consciousness. This patient was unresponsive because he may have used opioid drugs in excess. The former is evident because he became responsive after receiving naloxone treatment. Naloxone is a non-addictive medication used to treat patients with opioid overdose to neutralize life-threatening depression of the respiratory system and central nervous system to allow the patient to regain normal breathing (Zhang, 2019). The medication only works when one’s body has opioid substances. The burning pain is the side effect of naloxone. The presence of necrotic tissue on the forearm and greater trochanter was due to fall when the patient was unconscious. Physiologic Response The physiological response is an involuntary reaction triggering a physical response to stimuli. An example of a physiologic response is fight or flight response. The physiological response can manifest itself through shaking, dry mouth, faster breathing, sweating, panic attacks, and heart palpitations. Abbasian et al. (2016) mention that one of the physiological responses to opioids is slowing the functions of the GI tract. Opioids may slow down the GT tract’s functioning by inhibiting the release of acetylcholine from the motor neurons. As a result, the victim may experience low excretion. Other physiological responses to opioid include dilatation of pupils, increased breathing, heart rate changes, and blood pressure, sweating, changes in body temperature and skin, and piloerection (Liu & Tang, 2020). Cells Involved Various cells are involved in physiological response. Dark, clear, and myoepithelial sweat cells are some of the cells involved in the process. When one feels the urge to abuse opioids, the brain will send a message to the cells above to produce sweat as a response. Other cells involved in the process are brown adipose tissue (BAT) and thermogenesis. These cells will either increase or reduce body temperature to respond to the urge to abuse opioids. The neurons in the hindbrain known as medulla and pons are the cells that regulate how one will breathe in the response of opioid stimulus (Liu & Tang, 2020). Overall, all these cells must be coordinated by the central nervous system. How another Factor can Influence the Response Genes will change how one response to opioids. For instance, a person with either DARPP-32 or PSD-95 will show physiological response symptoms when presented with opioids while the individual without the genes will not show any signs. References Abbasian, F., Lockington, R., Megharaj, M., & Naidu, R. (2016). A review on the genetics of aliphatic and aromatic hydrocarbon degradation. Applied biochemistry and biotechnology, 178(2), 224-250. https://link.springer.com/article/10.1007/s12010-015-1881-y Liu, N., & Tang, M. (2020). Toxic effects and involved molecular pathways of nanoparticles on cells and subcellular organelles. Journal of Applied Toxicology, 40(1), 16-36. https://onlinelibrary.wiley.com/doi/full/10.1002/jat.3817 McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis,
[ANSWERED 2024] For your Signature Assignment create a PowerPoint presentation that discusses any five legal issues or ethical concepts
For your Signature Assignment create a PowerPoint presentation that discusses any five legal issues or ethical concepts of your choice that Module 8 Assignment Signature Assignment: Legal and Ethical Considerations in Healthcare For your Signature Assignment create a PowerPoint presentation that discusses any five legal issues or ethical concepts of your choice that you feel are particularly important to the improvement of healthcare. Explain the impact of these five concepts on nursing practice, the healthcare institution, and on the quality of patient care. For your presentation: Select at least four (4) legal issues or ethical concepts that you feel influence or hinder nursing practice, healthcare institutions or quality patient outcomes. Explain how the selected legal issues or ethical concepts impact nursing practice, the healthcare institution, and the quality of patient outcomes. Develop a policy proposal with measures and recommendations that could positively impact nursing practice, allow healthcare institutions to thrive, and improve the quality of patient outcomes. Detail how nursing could act or advocate to incorporate the policy proposal into practice. Review the Signature Assignment Rubric before starting your presentation. Assignment Expectations Length: 16-20 slides minimum; answers must thoroughly address the questions in a clear, concise manner. Structure: Title: 1 slide Objectives: 1 slide List legal issues or ethical concepts: 1 slide Explain the issues or concepts: at least 4 – 5 slides Present a policy proposal incorporating the issues and concepts with measures and recommendations: at least 5 slides Explain how nursing can act or advocate to incorporate the policy proposal into practice: 1-5 slides Conclusion: 1 slide References: 1 slide Additionally, because a good presentation has few words on the slides include a script with the verbiage you would say when presenting; script should be a minimum of 50 words per slide. References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least four (4) scholarly sources to support your claims, at least one (1) per legal issue or ethical concept in addition to required texts. Format: Save your assignment as a Microsoft PowerPoint document and a Word document (.pptx) and (.doc or .docx) or Open Office Impress. File name: Name your saved file according to your first initial, last name, and the module number (for example, “RHall Module1.pptx”). Additionally, because a good presentation has few words on the slides include a script with the verbiage you would say when presenting; script should be a minimum of 50 words per slide. Expert Answer and Explanation The core goal of this assignment is to identify common legal issues and ethical concepts in nursing and to explain how the selected issues and concepts influence or hinder nursing practice. Also, the presentation seeks to determine the implications of these issues and concepts to the quality of patient outcomes and healthcare institutions, to develop policy proposals that have measures and recommendations that could impact nursing practices positively, and to show how the identified policies ad proposals improve the quality of patient care and promote thriving in the institutions The common ethical and legal issues in nursing include Malpractice and Negligence; Patient confidentiality; Informed consent; DNR orders; Physician-assisted Suicide; Access to care Each of these issues affect the ability of physicians to deliver quality care to the patients, while respecting the idea of patient-centered and holistic care. Other ethical issues that may not be discussed in detail herein include Equity of Resources, Conflict of Interest, Ethics of Privatization, Opposite sex issues, and Patient Rights Patient confidentiality is one of the core ethical issues in the nursing settings, and it mainly affects some stakeholders such as patients, nurses, and patient families (Dove et al., 2019). Doctors who violate patient confidentiality could have legal consequences. The Health Insurance Portability and Accountability Act (HIPPA) requires healthcare givers to protect the security and privacy of medical records of patients However, gray areas in the HIPPA such as the idea of having more harm after failing to disclose the patient information could lead to loopholes in the issue Medical malpractices and negligence among healthcare givers is one of the ways in which individuals get medical errors. Medical errors, on the other hand, are common in all hospitals and in the US, they serve as the third leading cause of death, which makes it an issue of urgency (Papavramidou & Voultsos, 2019). In some of the facilities, negligence is cased by the absence of the proper tools of care, where the physicians can barely work to the patient expectations because of things such as delays in diagnosis and also defective medical equipment (Rynecki et al., 2019). Do-Not-Resuscitate (DNR) orders instruct healthcare providers not to perform CPR on patients if their heart stops beating. Patients who perform such requests have the intention of reducing the amount of suffering they may have to face if they are allowed to live in critical condition (Osinski et al., 2017). Accepting DNR orders is a way of patient-centered care as it upholds the individual patient interests. When capacitated patients are asked to choose DNR, there are numerous ethical issues that arise, and the physicians involved could face prosecution Physician Assisted Suicide refers to the action of physicians helping terminally-ill patients to end their life by things such as removing life support during their stay in the hospital. Legalizing PAS in the US is dependent on the individual state laws. One of the conditions in the PAS is that the patients should be terminally ill, and those who have acute illnesses that are disturbing have to receive extensive scrutiny before the PAS. An ethical issue that arises in PAS is that States that are against PAS argue that it could create pressure on terminally ill patients to remove the disease burden for their families. Access to care is a common issue that faces patients, especially those from vulnerable communities such as homeless individuals. Insurance coverage is one of the most campaigned for healthcare issues (Shenoy & Appel, 2017). One in five people who are uninsured do not seek medications on the basis of lack of funds, and this is a worrying statistic Emergency departments, on the other hand, are expensive for all patients who are not insured, as the basic routine care could cost them over $900. the WHO argues that health facilities should work on reducing the administrative costs and overall prizes. Policy changes are the solution to solving the challenges associated with the issues and concepts. Foundations of policy proposal lie on assessing the individual values of the healthcare organizations (McRae, 2017). The development of ethics programs may be limited by present
[ANSWERED] Prepare a 1000-1250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following
Prepare a 1000-1250 word paper that presents your assessment and proposes a strategic Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade. Prepare a 1000-1250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following: Describe the health care organization or network. Describe the organization’s overall readiness based on your findings. Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction. Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan. Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Expert Answer and Explanation Health Organization Evaluation One of the primary goals of healthcare organizations is providing different patient care and clinical services that are geared to eradicating some of the most common healthcare problems. In the recent few years, numerous technological developments have provided a window of improvement of healthcare organizations in their processes of delivering care to the citizens. Banner health is one of these organizations that serve as core contributors to the health and wellness of Americans (Kash, 2016). This essay explains some of the elements that show the readiness of Banner health in meeting the demands of citizens in the forthcoming decade. Whereas the organization is faced with different issues that negatively affect the organizational culture and operations, the application of PEST theory in managing the issues can help to align the organization to the right framework for delivering the objectives of care through the next decade. Description of the Organization Banner Health is a non-profit healthcare organization in the US that operates in different states offering health services ranging from rehabilitation, primary care, labs, long-term care, hospice, and hospital care. The history of the organization starts in 1999 when Samaritan Health System and Lutheran Health Systems merged to form one entity that operated in 14 states (Kash, 2016). Besides offering healthcare to populations, the organization offers teaching services, with the main institution being the Banner-University Medical Center, Phoenix. Also, it operates Medicare Advantage, and insurance plan called University Care Advantage and also a family based care called the Banner University Family care. The organization is impactful in some states more than others, such as in Arizona where it has more than 50,000 employees at present. The senior management of the organization, led by the President and CEO (currently Peter S. Fine), is the initiator of the major decisions throughout the organization (Sharma, Fleischut, & Barchi, 2017). Readiness of the Organization based on Evaluation The organization is ready to meet the rising healthcare demands of citizens in the next decade as it has been incorporating programs that allow efficient care in the light of the emerging technology. In 2006, the organization launched a telemonitoring program in which it extended patient care operations beyond the healthcare facilities (Sharma, Fleischut, & Barchi, 2017). One of the primary effects of this program was saving over 34,000 ICU days and reducing the mortality rates by a significant percentage (Sharma, Fleischut, & Barchi, 2017). Also, telemedicine operations reduced the overall length of stay in facilities and helped to boost the cost control operations. Specifically, organizations under Banner health would now spend less in the patient care operations and hence would optimize the costs of care to patients. Since the implementation of telemedicine, it is clear that there are many other technological developments that have helped banner health to achieve its current status (Pandian, 2016). Also, it is likely that it will be a pioneer in implementation of even higher forms of technology in primary care such as virtual reality and artificial intelligence, and hence it is generally ready to meet the healthcare demands in the coming decade. Another element that shows the readiness of the organization in meeting the upcoming healthcare demands is the culture of acquisition. In 2014, the organization acquired Casa Grande Medical Center, and in July 2020, it acquired Wyoming Medical Center. These acquisitions are valuable to the organization as they add to the overall productivity through direct injection of skills and resources to the present organization (Kash, 2016). In 2016, for instance, acquiring 32 of the urgent care facilities in Arizona left the organization almost as a monopoly of healthcare provision in the state, hence limiting the overall competition it faced. A continuous culture of acquisition is likely to make the organization reduce the hindrances of growth such as unhealthy competition and scarcity of skills through the next decade. The last element that shows the organization’s readiness to meet the healthcare demands in the next decade is the health education affiliation. While most of the healthcare organizations recognize the need for constant research and improvement of operations, very few of them get to the ground to produce results (Cairns, Bollinger, & Garcia, 2017). Most organizations tend to use knowledge that has been generated by other operators. For banner health, the present partnerships with different learning institutions serve as a core element of growth in the operations through the next decade. Strategic Plan to address issues within the Organizational Culture One of the issues that have negatively affected the organizational culture is the presence of data breaches and cyber-attacks. In 2016, banner health was caught in a security breach that exposed information of over three million patients and employees. If not addresses tactically, the issue can
[ANSWERED 2023] In a paper of 1000-1250 words, compare and contrast the health status of your selected minority group to the national average. Include the following:
In a paper of 1000-1250 words, compare and contrast the health status of your selected Select an ethnic minority group that is represented in the United States (American Indian/Alaskan Native, Asian American, Black/African American, Hispanic/Latino, Native Hawaiian, or Pacific Islander). Using health information available from Healthy People, the CDC, and other relevant government websites, analyze the health status for this group. In a paper of 1000-1250 words, compare and contrast the health status of your selected minority group to the national average. Include the following: Describe the ethnic minority group selected. Describe the current health status of this group. How do race and ethnicity influence health for this group? What are the health disparities that exist for this group? What are the nutritional challenges for this group? Discuss the barriers to health for this group resulting from culture, socioeconomics, education, and sociopolitical factors. What health promotion activities are often practiced by this group? Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective in a care plan given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice. What cultural beliefs or practices must be considered when creating a care plan? What cultural theory or model would be best to support culturally competent health promotion for this population? Why? Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance. Expert Answer and Explanation Health Disparity in Arizona’s American Indian Population The unequal nature of the United States (U.S.) as a country is noticeable in the country’s social problems including the health gap, and this gap takes on different forms. The rates of mortality incidences, for instance, differ across the country’s minority and non-minority populations. The former tends to experience higher rates compared to the latter, and one can attribute this to a wide spectrum of factors including the low social and economic empowerment opportunities in minority communities. However, the degree of the health disparity for a state may differ from that of the entire country, and one can notice this when comparing Arizona’s health gap rates to the country’s rates (Isaac et al., 2018). It is important to examine the health of American Indian Population in Arizona in terms of disparities, the barriers, promotion activities, and cultural considerations. Profile of the Minority Group Each U.S.’s state is diverse, and this is a case with Arizona which has white as well as minority populations including the Native Americans. Compared to other minorities including Hispanics, however, the American Indians are fewer. A high population of this minority population is found in Arizona, California and Oklahoma. These states host 31% of the country’s American Indian population. Based on the statistical data, this group consists of 1.7% of the U.S.’s population. 1.6 million Teenage Americans who are part of this group are below the adult age. Arizona recognize this group as part of the state’s tribes. This group speak different native languages ranging from the Ponca to Sioux. This together with the education-based barriers can be impediments to access to the care for this group. Currently, the state has a number of American Indian tribes (Liddell et al., 2018). Examples include the Navajo, Hopi and Apache. Most of these tribes engage in spiritual and cultural activities which sometimes may contradict practices of the modern medicine. The Health Gap for the Minority The American Indians face health concerns which other minority groups struggle with. This group is socially and economically disadvantaged. The mortality rates for this population exceeds that of the U.S. by approximately 40%. One can attribute this to the high rates of mortality for this group to the prevalence of the cases of chronic diseases in this group. The Center for Disease Control (CDC) prepares and publishes reports on health, and according to this agency, the life expectancy for this group is below the national level (Adakai et al., 2018). Equally, the quality of life for this group in Arizona is low compared to the national average. Individuals who are part of this group in the state of Arizona are likely to adopt poor nutritional health behaviors compared to the national population. For example, the rates of consumption of the sweetened beverages for this group reached 33%. Averagely, 28% of Americans use sweetened products. Health Barriers for the Minority People who identify as American Indians face various health obstacles which take on different forms. From the cultural perspective, the American Indians have an intrinsic view concerning the relationship between spirituality and health. For example, they would attach certain cultural meanings to the mental health issues, and this may cause a scenario where they do not seek medical care but rather resort to spiritual intervention. This population is socially and economically disadvantaged, and there are high rates of unemployment among members of this group. Equally, the group struggles with high rates of illiteracy (Wille et al., 2017). Due to these social and economic barriers, Native Americans residing in Arizona are struggling with access to care, and because of lack of education, some may not get to learn about the appropriate health behaviors. Equally, there is low political representation for this group, and this poses the problem of lack of advocacy for this group. Health Promotion Activities Native Americans’ health practices intertwine with their spiritual and cultural practices, and their perceptions concerning health. This group adopts traditional health
[ANSWERED 2023] In the realm of marketing, a successful branding strategy is one of the most important contributors to organizational success. A solid branding strategy can help add visibility
In the realm of marketing, a successful branding strategy is one of the most important contributors to organizational success. In the realm of marketing, a successful branding strategy is one of the most important contributors to organizational success. A solid branding strategy can help add visibility and credibility to a company’s products. Similarly, nurse-scholars can build a personal brand to add visibility and credibility to their work. You can begin building your brand by developing and maintaining an academic portfolio. Such an activity can help share the results of your efforts and contribute to your success. This Module’s Discussion asks you to consider and share strategies for building your portfolio. Note: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are required to participate in the Discussion on at least three different days (a different day for main post and each response). It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner. To Prepare: Reflect on strategies that you can pursue in developing portfolios or portfolio elements that focus on academic achievements. Review one or more samples from your own research of resources focused on portfolio development. By Day 3 of Week 8 Post an explanation of at least two strategies for including academic activities and accomplishments into your professional development goals. Then, explain how those goals may align with the University’s emphasis on social change. Be specific and provide examples. By Day 6 of Week 8 Respond to at least two of your colleagues’ posts by offering additional ideas regarding academic achievements to include or offering alternative ways of presenting the current achievements. Rubric Detail Select Grid View or List View to change the rubric’s layout. Name: NURS_6003_Module05_Week08_Discussion_Rubric Excellent Good Fair Poor Main Posting 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Post: Timeliness 10 (10%) – 10 (10%) Posts main post by day 3. 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) Does not post by day 3. First Response 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. Second Response 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no