[ANSWERED 2023] A 50 year old Caucasian female presents to the clinic with complaints of cough for almost 2 weeks. Positive productive green sputum with associated chills, sweating, and fever up to 101.5
A 50 year old Caucasian female presents to the clinic with complaints Examining Chest X-Rays Chest x-rays are an invaluable diagnostic tool as they can help identify common respiratory disorders such as pneumonia, pleural effusion, and tumors, as well as cardiovascular disorders such as an enlarged heart and heart failure. As an advanced practice nurse, it is important that you are able to differentiate a normal x-ray from an abnormal x-ray in order to identify these disorders. The ability to articulate the results of a chest x-ray with the physician, radiologist, and patient is an essential skill when facilitating care in a clinical setting. In this Discussion, you practice your interprofessional collaboration skills as you interpret chest x-rays and exchange feedback with your colleagues. Consider the three patient case studies and x-rays Case Study 1 35-year–old Asian male presents to your clinic complaining of productive cough for two weeks. Stated he has had mild intermittent fever with myalgia, malaise and occasional nausea. SH: works as a law clerk PE: NP noted low grade fever (99 degrees), with very mild wheezing and scattered rhonchi. Case Study 2 This is a 44-year–old Caucasian male being seen at your clinics with complaints of complaints of cough for 4 days and worsening. Stated he has had high grade fever. States he feels weak and has been in bed most of the last two days. Complains of exertional dyspnea, followed by dyspnea at rest, non-productive cough and pleuritic chest pain MEDS: Zovirax, Diflucan, magic mouth wash, Zofran, mycostatin, filgrastin PMH: HTN, Hep C, HIV/AIDS, thrush SH: Past IV Drug abuse; lives in a group home; PE: VS: Ht: 5’7, Wt: 150#, BMI 23, Anorexic male, febrile, tachypneic, tachycardic, with rales and rhonchi. You note decreased in breath sounds, dullness, and egophony Case Study 3 A 50 year old Caucasian female presents to the clinic with complaints of cough for almost 2 weeks. Positive productive green sputum with associated chills, sweating, and fever up to 101.5. She manages a daycare and states that many of the children have had upper respiratory symptoms in the last two weeks. PMH: DM diagnosed 7 years ago, controlled on medications. MEDS: Glyburide 10mg qd PE: She looks ill with continuous coughing and chills. BP 100/80, T: 102, HR: 110; O2Sat 97% on RA. Lungs: +Crackles, increased fremitus Labs: CBC 17,000 cells/mm3 , blood sugar is 120 To prepare: Review Part 10 of the Buttaro et al. text in this week’s Resources, as well as the provided x-rays. Reflect on what you see in the x-ray assigned to you by the Course Instructor. Consider whether the patient in your assigned x-ray has an enlarged heart, enlarged blood vessels, fluid in the lungs, and/or pneumonia in the lungs. Post an explanation of the primary diagnosis, as well as 3 differential diagnoses, for the patient in the case study you were selected or were assigned. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis. Expert Answer and Explanation Examining Chest X-Rays The Primary Diagnosis The primary diagnosis for this case is pneumonia. Pneumonia is either a bacterial or viral infection that affects one or all parts of the lungs. According to Zhu et al. (2020), pneumonia infection is often spread through droplets from an infected person. This disease has been selected as the primary diagnosis because the patient reports that she has bee interacting with children showing upper respiratory signs for the last two weeks. Some of the signs of pneumonia include fever, chills, a cough that produces mucus, and shortness of breath. The patient has reported almost all the signs highlighted above. The X-ray test showed that the patient has fluids in the alveoli, and according to Lapinsky, Leen, Mak, and Shafiee (2019), this is a sign of pneumonia. Differential Diagnosis 1. Asthma According to Chahin & Opal (2017), asthma is a chronic respiratory condition that causes a person’s airways to be inflamed, swollen, and narrow, making the individual experience difficulty breathing. Some of the symptoms of the disease include coughing that worsens, difficulty breathing, ad chest pain. This disease has been included in the diagnosis because it causes a cough that produces a lot of mucus as experienced by the patient. 2. Chronic Obstructive pulmonary disease COPD is a group of medical conditions that block a person’s breathing system and thus make it hard for the individual to breathe. Some of the diseases’ signs include lack of energy that can cause fainting, frequent respiratory infections, swelling of legs and ankles, and a cough that produces mucus (Zhou et al., 2020). This disease has been included in the diagnosis because one of its signs is a cough that produces mucus like the one reported by the patient. 3. Lung cancer Lung cancer is the growth of abnormal cells in the lung region. The disease symptoms include a new cough that does not fade, hoarseness, shortness of breath, bone pain, and losing weight (Yoon, Kim, Yang, & Ham, 2028). The disease has been included in the diagnosis because one of its symptoms is a prolonged cough, like the one experienced by the patient for two weeks. Role of Patient History in the Diagnosis The personal and medical history provided by the patient was so helpful when diagnosis the individual. The history was used to determine the causes of the ailment. Most of the respiratory problems are often caused by allergies. Therefore, information about allergies could help the medical doctor determine whether the patient’s condition is an allergic reaction (Zhou et al., 2020). By stating where she works, it was concluded that she contracted the disease from the children or the one who infected the kids. Another important history in the diagnosis is that it helped the medical professional risk factors that could have increased the patient’s chances of being infected by the germ. Patient history also provided the medical professional with information about the diagnostic tests the patient can afford. Potential Treatment Options The treatment of the patient will depend on the type of pneumonia the individual has. If the patient has bacterial pneumonia, she should be prescribed
[ANSWERED 2023] Health care planners could be more effective and efficient if they used the concept of the natural history of disease and the levels of prevention to design services that intervene at the weakest
Health care planners could be more effective and efficient if they used the concept of the Healthcare Systems Assignment Description: Complete ALL of the bullet points below: Health care planners could be more effective and efficient if they used the concept of the natural history of disease and the levels of prevention to design services that intervene at the weakest link in the chain of progression of specific diseases. Instead, most focus on high-technology solutions to preventable problems. Assess the characteristics of the medical care culture that encourage the latter approach. Hospitals and other health care institutions, whether voluntary or for-profit, need to be financially solvent to survive growing market pressures. Describe how this “bottom line” focus has changed the nature of the US health care system. The insurance industry plays a huge role in the American health care system and absorbs a significant portion of the health care dollar. A single payer system, whether it is a private company or the US government, would eliminate the complex insurance paperwork burden and free substantial funds that could be diverted to support care for the under-served. Why do you believe that so much resistance to a concept used in every other developed country has continued in the U.S.? Include the time management Weekly Planner to show when you will make room for your school work. Please submit one APA formatted paper between 1000 – 1500 words, not including the title and reference page. The assignment should have a minimum of two scholarly sources, in addition to the textbook. They want it in APA with the beginning of the paper stating what it is about and conclusion at the end Required Source: Sultz, H. A., & Young, K. A. (2017). Health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett. Read chapters 1 & 2. Expert Answer and Explanation US Healthcare System The US healthcare system has experienced a lot of changes in terms of medical care methods and treatment protocols and financing. In terms of treatment, the US health system has been positively impacted by technologies such as electronic health records among other healthcare technologies (Sultz & Young, 2017). These technologies have allowed healthcare professionals to provide quality and safe care. In terms of financing, the US health system has experienced huge reimbursement changes. Some of the policies that have changed US health financing include Medicare, Medicaid, and Affordable Care programs (Sultz & Young, 2017). The purpose of this assignment is to explain characteristics of the medical care culture that have encouraged US care professionals to focus on high-technology solutions to preventable problems, how the “bottom line” focus has changed the nature of the US health care system, and why universal health care is resisted in the US. Question 1 Certain characteristics are common in a medical culture which encourages healthcare professionals to use high-technology solutions to preventable problems. The characteristics become visible during patient examination and provision of other care services concerning the technologies. It is vital to identify the players in healthcare culture to accurately determine their characteristics and motives. In the US healthcare culture, two main players are the patients and healthcare professionals (doctors, nurses, and other specialists) (Sultz & Young, 2017). Other players include the hospital system and third-party payers (private and government insurance plans). One of the medical care cultures that encourage the latter approach is instant gratification. According to Sultz and Young (2017), most healthcare planers focus on high-technology solutions to preventable problems because of the medical culture of instant gratification. Instant gratification means instant cure (Deo et al., 2020). Most patients in the US need an instant cure for acute illness, chronic disease, and pain which cannot be provided by the former. High-technology solutions can provide instant care while the former cannot. When high technologies are used, the patient is cured almost instantly. The second characteristic is work satisfaction. Sultz and Young (2017) noted that work satisfaction is highly associated with the use of high technology to provide cures and promote disease prevention. The main objective of healthcare professionals is to provide patient care using standardized interventions. Healthcare professionals prefer to use high technology to attain healthcare goals because it prevents them from fewer difficulties as compared to the conventional approach which relies on identifying the history of the illness to create a treatment protocol (Harerimana et al., 2019). In other words, healthcare professionals use high technology to help their patients because it achieves their care goals faster than conventional methods and thus improves their satisfaction. The last characteristic is improved coordination of responsibilities and communication. Healthcare professionals prefer care methods that allow them to effectively coordinate and communicate when providing care to their patients. High-technology methods provide them with the opportunity to coordinate and effectively communicate making it a preferred method of care provision among the players in the US care system. Sultz and Young (2017) noted that US care providers have recently shown interest in Electrotonic Health Records as a tool to be used in providing care. The authors argued that the tool has helped healthcare providers easily and effectively coordinate and communicate with patients and other stakeholders to provide care. EHR technology provided healthcare professionals with a single platform where they can access patient data and communicate with peers, making the high-technology care provision method the preferred approach. Question 2 All healthcare organizations across the US strive to be financially solvent in the process of providing quality and safe care to their patients and this has greatly affected the nation’s healthcare system. One of the ways the “bottom line” focus has changed the healthcare system in the US is increasing the cost of care services. Dieleman et al. (2020) noted that Americans are paying more for their care today than in the last decade due to healthcare organizations’ focus on the bottom line. Healthcare organizations are forced to increase the cost of care services to be able to pay for their human workforce and procure necessary products needed for care providers such as
[ANSWERED 2023] JR 47 yo WM complains of having generalized abdominal pain that started 3 days ago. He has no
JR 47 yo WM complains of having generalized abdominal pain that started 3 days ago. He has no ABDOMINAL ASSESSMENT Subjective: CC: “My stomach hurts, I have diarrhea and nothing seems to help.” HPI: JR 47 yo WM complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards. PMH: HTN, Diabetes, hx of GI bleed 4 years ago Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs Allergies: NKDA FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys) Objective: VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs Heart: RRR, no murmurs Lungs: CTA, chest wall symmetrical Skin: Intact without lesions, no urticaria Abd: soft, hyperactive bowel sounds, pos pain in the LLQ Diagnostics: None Assessment: Left lower quadrant pain Gastroenteritis PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses. The Assignment Analyze the subjective portion of the note. List additional information that should be included in the documentation. Analyze the objective portion of the note. List additional information that should be included in the documentation. Is the assessment supported by the subjective and objective information? Why or why not? What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis? Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. REQUIRED READINGS: Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel\’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Chapter 6, “Vital Signs and Pain Assessment ”This chapter describes the experience of pain and its causes. The authors also describe the process of pain assessment. Chapter 18, “Abdomen” In this chapter, the authors summarize the anatomy and physiology of the abdomen. The authors also explain how to conduct an assessment of the abdomen. Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. Chapter 3, “Abdominal Pain” This chapter outlines how to collect a focused history on abdominal pain. This is followed by what to look for in a physical examination in order to make an accurate diagnosis. Chapter 10, “Constipation” The focus of this chapter is on identifying the causes of constipation through taking a focused history, conducting physical examinations, and performing laboratory tests. Chapter 12, “Diarrhea” In this chapter, the authors focus on diagnosing the cause of diarrhea. The chapter includes questions to ask patients about the condition, things to look for in a physical exam, and suggested laboratory or diagnostic studies to perform. Chapter 29, “Rectal Pain, Itching, and Bleeding” This chapter focuses on how to diagnose rectal bleeding and pain. It includes a table containing possible diagnoses, the accompanying physical signs, and suggested diagnostic studies. Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis. Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center. These sections below explain the procedural knowledge needed to perform gastrointestinal procedures. Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487) Chapter 115, “X-Ray Interpretation of Abdomen” (pp. 514–520) Note: Download this Student Checklist and Abdomen Key Points to use during your practice abdominal examination. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Student checklist. In Seidel\’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Seidel\’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Key points. In Seidel\’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Seidel\’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center. Expert Answer and Explanation Abdominal Assessment Assessment is a critical practice in nursing. Nursing assessment can be used to determine the current and future care needs of a patient (Ball, Dains, Flynn, Solomon & Stewart, 2019). Nursing assessment includes the recognition of abnormal versus normal physiology. The purpose of this assignment is to analyze the provided Episodic Note case study that describes abnormal findings in patients seen in a clinical setting and answer the provided questions. Additional Subjective Data to be included in the Documentation A lot of information was included in a subjective portion of the note. However, I feel that some critical data that can improve the assessment process are missing. For instance, the patient’s ethnic group was not mentioned. Some diseases are more prone in certain ethnic groups compared to others. Hence, identifying the race of the patient can help a nurse identify whether the client’s ethnicity is a risk factor for specific diseases. Another important data that should be added in the subjective portion of the note is the review of systems. The review of systems is the process of reviewing
[ANSWERED 2023] Search the GCU Library and find one new health care article that uses quantitative research
Search the GCU Library and find one new health care article that uses quantitative research. Search the GCU Library and find one new health care article that uses quantitative research. Do not use an article from a previous assignment, or that appears in the Topic Materials or textbook. Complete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template. See Chapter 5 of your textbook as needed, for assistance. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting 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 Article Analysis and Evaluation of Research Ethics Article Citation and Permalink (APA format) Article 1 Espeland, M. A., Lipska, K., Miller, M. E., Rushing, J., Cohen, R. A., Verghese, J., … & Pahor, M. (2017). Effects of physical activity intervention on physical and cognitive function in sedentary adults with and without diabetes. The Journals of Gerontology: Series A, 72(6), 861-866. https://doi.org/10.1093/gerona/glw179 Point Description Broad Topic Area/Title Effects of physical activity intervention on physical and cognitive function in sedentary adults with and without diabetes Problem Statement (What is the problem research is addressing?) More than a quarter of the US aging population suffer from diabetes mellitus. This condition has increased their chances of developing geriatric syndromes. Medication alone have not entirely reduced the effects of the condition. That said, this study has addressed physical activity and its effects on diabetic patients. Purpose Statement (What is the purpose of the study?) The purpose of this study was to explore the “effects of physical activity intervention on physical and cognitive function in sedentary adults with and without diabetes.” Research Questions (What questions does the research seek to answer?) The researchers used one primary research question to guide the study. The research question was “what are the effects of physical activity intervention on physical and cognitive function in sedentary adults with and without diabetes?” Define Hypothesis (Or state the correct hypothesis based upon variables used) Apart from the research question, a hypothesis was created to guide the study. The hypothesis for this study was that “the intervention may have different effects on physical and cognitive function, depending on individuals’ diabetes status.” Identify Dependent and Independent Variables and Type of Data for the Variables Two main variables were included in the study. The first variable is independent variable. This variable was represented by physical activity intervention. This variable belongs to quantitative data type. The second variable is dependent variable. It is represented by sedentary adults with and without diabetes. Its data type is categorical. Population of Interest for Study Researchers must identify the people or other populations targeted by their study. In this research, the target or population of interest were 65 years and above sedentary adults with and without diabetes. Sample The respondents in the research were 1,476 70–89 years old sedentary individuals who could walk for about 400 meters in 15 minutes regardless of their extreme inability to conduct daily function. Sampling Method Researchers must indicate how they conducted their sampling method to validate if the study was fair or not. In this research, random sampling approach was used to sample and select the participants for the study. Identify Data Collection Identify how data were collected Identifying a data collection instrument is vital because it can help in analyzing the research to determine its reliability and validity. Researchers in this study collected data using interviews as their main data collection instrument. Summarize Data Collection Approach The researchers collected data by administering three computer-based cognitive tests at either 18 or 30 months and at baseline, depending on when the respondents were included in the study. The interviewer-administered tests included the Wechsler Adult Intelligence Scale-III Digit Symbol Coding test (DSC), the Modified MiniMental State Exam (3MSE), and the Hopkins Verbal Learning Test-Revised (HVLT-D). Discuss Data Analysis Include what types of statistical tests were used for the variables. Descriptive analysis was used as the method to analyze data in the study. The authors analyzed data by comparing measures of cognitive and physical functions and baseline risk factors with diabetes groups and intervention based on the analyses of logistic regression and variance. Summarize Results of Study 90.3% of the participants successfully completed the study making it results reliable. The Lifestyle Interventions and Independence for Elders (LIFE) reduced the participants’ risk of developing major mobility conditions by increasing their physical activities. Physical activity alone was found to be beneficial because it increased the participants’ mobility speed but did not have effects on their cognitive health. However, LIFE has both cognitive and physical impacts. Summary of Assumptions and Limitations Identify the assumptions and limitations from the article. Report other potential assumptions and limitations of your review not listed by the author. The first limitation of the study is that it cannot be used to represent general population because few participants volunteered to participate. The second limitation is that the timeframe assigned the project was limited and could not be used to provide maximum results. The last limitation is that diabetes was underdiagnosed in the study. Ethical Considerations The first ethical consideration that may have occurred when sampling was informed consent. Informed consent is an ethical consideration that ensures that the researchers have not forced the participants to participate (Moore, Munguia Gomez & Levine, 2019). In other words, the element ensures that participants have voluntarily participated in the study. In the informed consent form, the researchers are ethically required to tell the respondents the purpose of the study, its importance, and how it will be used to improve healthcare. Another ethical consideration that might have occurred in the study was approved. Moore et al. (2019) mention that researchers should seek
[ANSWERED 2023] An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these
An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. Module 2 Assignment: Case Study Analysis An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other. Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact. An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans. In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health. To prepare: By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor. Scenario: A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF). your Case Study Analysis related to the scenario provided, explain the following Assignment (1- to 2-page case study analysis) In your Case Study Analysis related to the scenario provided, explain the following The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms. Any racial/ethnic variables that may impact physiological functioning. How these processes interact to affect the patient. By Day 7 of Week 4 Submit your Case Study Analysis Assignment by Day 7 of Week 4 GRADING RUBRIC: Develop a 1- to 2-page case study analysis, examing the patient symptoms presented in the case study. Be sure to address the following:Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms.– Excellent 28 (28%) – 30 (30%) Good 25 (25%) – 27 (27%) Fair 23 (23%) – 24 (24%) Poor 0 (0%) – 22 (22%) Explain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.– Excellent 28 (28%) – 30 (30%) Good 25 (25%) – 27 (27%) Fair 23 (23%) – 24 (24%) Poor 0 (0%) – 22 (22%) Explain any racial/ethnic variables that may impact physiological functioning.– Excellent 23 (23%) – 25 (25%) Good 20 (20%) – 22 (22%) Fair 18 (18%) – 19 (19%) Poor 0 (0%) – 17 (17%) Written Expression and Formatting – Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Written Expression and Formatting – English Writing Standards:Correct grammar, mechanics, and proper punctuation– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Total Points: 100 Expert Answer and Explanation Cardiovascular and Cardiopulmonary Pathophysiologic Processes The clinical interventions have seen some specific advancements that have improved medical professionals’ ability to provide safe and quality care to patients. However, medical professionals have found it hard to manage cardiovascular diseases despite the advancements present in the field of medicine as of now. Reamy, Williams, and Odom (2017) argue that the challenge of managing cardiovascular diseases can be reflected in the higher number of patients with the diseases being readmitted to hospitals even after holistic and intensive care. Also, a great number of patients have died of cardiovascular disease despite getting quality and safe medical interventions (McCance & Huether, 2019). Researchers have found that to provide better care to patients with cardiovascular diseases, clinicians should know the pathophysiologic processes resulting in the symptoms. The Cardiovascular and Cardiopulmonary Pathophysiologic Processes Various cardiovascular and cardiopulmonary processes resulted in the symptoms presented by the patient. The shortness of breath was caused by interactions between the cardiovascular system, oxygen carriers, neural responses, and the respiratory system (Coccia, Palkowski, Schweitzer, Motsohi, & Ntusi, 2016). The symptom occurred when the drive to breath was not matched by pulmonary ventilation. The process is often triggered by the mismatch between the lungs, chest wall structures, receptors in the airways, and the central respiratory motor activity. The patient experienced pleuritic chest pain because the two large layers of tissues separating the patient’s lungs were inflamed (Inamdar & Inamdar, 2016). The patient felt chest pain because the pleural membrane layers were swollen and rubbing against each other when he breathes. According to Ashton and Raman (2015), there are no clinical reasons for the symptoms of palpitations. However, the authors note that palpation occurs when the cardiac rhythm or rate changes or when the heart moves abnormally in the chest. Racial/Ethnic Variables that may Impact Physiological Functioning Many existing genetic variables may impact the physiological functioning of patients. One such variable is peroxisome proliferator activated‐receptor γ (PPARγ). One of the functions of this variable is regulating the fat cell. Also, activated PPARγ works with thiazolidinediones to block the channel activity of calcium smooth muscle cells, lower blood pressure, promote the secretion of the vasodilator C‐type natriuretic peptide, and prevents the release of
[SOLVED 2023] Select an adult patient that you examined during the last 4 weeks who presented with a disorder other than the disorder present in your Week 3 Case Presentation
Select an adult patient that you examined during the last 4 weeks who presented with a Create a Focused SOAP Note on this patient using the template provided in the Learning Resources. There is also a completed Focused SOAP Note Exemplar provided to serve as a guide to assignment expectations. Please Note: All SOAP notes must be signed, and each page must be initialed by your Preceptor. Note: Electronic signatures are not accepted. When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of each page that is initialled and signed by your Preceptor. You must submit your SOAP note using SafeAssign. Note: If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy. Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record. Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning. Ensure that you have the appropriate lighting and equipment to record the presentation. The Assignment Record yourself presenting the complex case study for your clinical patient. In your presentation: Dress professionally and present yourself in a professional manner. Display your photo ID at the start of the video when you introduce yourself. Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information). Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management. Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value. Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide: Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss patient mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and supported by the patient’s symptoms. Plan: What was your plan for psychotherapy? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Be sure to include at least one health promotion activity and one patient education strategy. Reflection notes: What would you do differently with this patient if you could conduct the session over? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow up, discuss what your next intervention would be. Learning Resources Required Readings (click to expand/reduce) Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer. Chapter 28, “Assessing Neurocognitive Disorders (Dementia and Delirium)” Expert Answer and Explanation Schizoaffective Disorder Subjective: CC (chief complaint): “They want to kill me but people do not believe me. I can even hear them talk.” HPI: JW is a 45-years-old male of Caucasian origin who came to the healthcare facility complaining of auditory and visual hallucinations. The patient has not been prescribed any medications at the moment until screening and testing are done. He complains that he has been seeing people around his home and hearing them planning his death. She has been reporting hallucinations for the past six weeks or so. He was accompanied by his wife to the office. The wife noted that the patient has been showing catatonic behavior for the past weeks. She narrated that the patient sometimes grabs his gun and speaks to himself by saying that he will kill them before they kill him. He has also been spotted echoing words as if he is repeating someone else’s words. The wife argued that when the client is not experiencing hallucinations, he experiences a depressed mood by not eating or wanting to be near anybody. When he is moody, he wants to be isolated and away from the world. The wife noted that the symptoms have pushed him away from his work and family. He was given leave to go and sought himself out. Substance Current Use: The patient has a history of taking drugs. He reports using illicit drugs such as cocaine and meth. However, he denies using alcohol or cigarettes. Medical History: He was diagnosed with hypertension but stopped taking medications noting that “they” want to kill him using medications. Current Medications: He is not on any medications at the moment. Allergies:No allergies. Reproductive Hx:He has not been able to engage in sexual activities in the past seven months. ROS: GENERAL: Wife reports weight loss. The client reports fatigue and weakness on some occasions. Denies fever or chills. HEENT: Eyes: No eye diseases or abnormalities. Ears, Nose, Throat: He denies hearing loss or infections. He denies a runny nose, sore throat, congestion, or sneezing. SKIN: No rash. CARDIOVASCULAR: No chest pressure, edema or palpitations, chest discomfort, or chest pressure. RESPIRATORY: No difficulty breathing, sputum, or cough. GASTROINTESTINAL: No abdominal pain, diarrhea, vomiting, nausea, or anorexia. GENITOURINARY: No odd color, hesitancy, odor, urgency, or burning during urination. NEUROLOGICAL: No tingling or numbness of the legs or fingers. No dizziness, headache, ataxia, paralysis, or bowel problems. MUSCULOSKELETAL: No stiffness or pain in the joints and muscles. No muscle, back pain, joint pain, or stiffness. HEMATOLOGIC: No anemia, clotting abnormalities, or abnormal hematologic status. LYMPHATICS: No enlarged nodes. ENDOCRINOLOGIC: Denies polydipsia, cold, sweating, polyuria, or heat problems. Objective: Physical Exam: Temp 36, BP 137/90, Ht. 6’2, Wt. 145lbs, P 78, RR 18. HEENT: Head: Face is symmetrical. Cranial nerves V and VII around the head are intact. He can move facial muscles at will. The shape of the head is rounded and there are no involuntary muscle movements.Eyes: Cornea, conjunctiva, lacrimal system, anterior chamber, and pupils are intact. The eye is not painful or red. Vision intact. Lacerations positions normal. Ears: Hearing
[ANSWERED 2023] Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient
Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones Case Study Assignment Assessing the Head, Eyes, Ears, Nose, and Throat Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test. Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions. Required Sources Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Chapter 11, “Head and Neck” This chapter reviews the anatomy and physiology of the head and neck. The authors also describe the procedures for conducting a physical examination of the head and neck. Chapter 12, “Eyes” In this chapter, the authors describe the anatomy and function of the eyes. In addition, the authors explain the steps involved in conducting a physical examination of the eyes. Chapter 13, “Ears, Nose, and Throat” The authors of this chapter detail the proper procedures for conducting a physical exam of the ears, nose, and throat. The chapter also provides pictures and descriptions of common abnormalities in the ears, nose, and throat. Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. Chapter 15, “Earache” Download Chapter 15, “Earache” This chapter covers the main questions that need to be asked about the patient’s condition prior to the physical examination as well as how these questions lead to a focused physical examination. Chapter 21, “Hoarseness” Download Chapter 21, “Hoarseness” This chapter focuses on the most common causes of hoarseness. It provides strategies for evaluating the patient, both through questions and through physical exams. Chapter 25, “Nasal Symptoms and Sinus Congestion” Download Chapter 25, “Nasal Symptoms and Sinus Congestion” In this chapter, the authors highlight the key questions to ask about the patients symptoms, the key parts of the physical examination, and potential laboratory work that might be needed to provide an accurate diagnosis of nasal and sinus conditions. Chapter 30, “Red Eye” Download Chapter 30, “Red Eye” The focus of this chapter is on how to determine the cause of red eyes in a patient, including key symptoms to consider and possible diagnoses. Chapter 32, “Sore Throat” Download Chapter 32, “Sore Throat” A sore throat is one most common concerns patients describe. This chapter includes questions to ask when taking the patient’s history, things to look for while conducting the physical exam, and possible causes for the sore throat. Chapter 38, “Vision Loss” Download Chapter 38, “Vision Loss” This chapter highlights the causes of vision loss and how the causes of the condition can be diagnosed. Note: Download the six documents (Student Checklists and Key Points) below, and use them as you practice conducting assessments of the head, neck, eyes, ears, nose, and throat. Document: Episodic/Focused SOAP Note Exemplar Download Episodic/Focused SOAP Note Exemplar (Word document) Document: Episodic/Focused SOAP Note Template Download Episodic/Focused SOAP Note Template (Word document) Document: Midterm Exam Review Download Midterm Exam Review (Word document) Shadow Health Support and Orientation Resources Shadow Health. (2021). Welcome to your introduction to Shadow Health Links to an external site.. https://link.shadowhealth.com/Student-Orientation-Video Shadow Health. (n.d.). Shadow Health help desk Links to an external site.. Retrieved from https://support.shadowhealth.com/hc/en-us Shadow Health. (2021). Walden University quick start guide: NURS 6512 NP students Download Walden University quick start guide: NURS 6512 NP students. Links to an external site. https://link.shadowhealth.com/Walden-NURS-6512-Student-Guide Document: DCE (Shadow Health) Documentation Template Download DCE (Shadow Health) Documentation Template for Focused Exam: Cough (Word document) Use this template to complete your Assignment 2 for this week. To Prepare By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor. Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case. With regard to the case study you were assigned: Review this week’s Learning Resources and consider the insights they provide. Consider what history would be necessary to collect from the patient. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. The Assignment Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources.
[ANSWERED 2023] For this week assignment, write a 1500-word essay addressing each of the following points/questions. Read the case study presented at the end of Chapter 10, which begins
For this week assignment, write a 1500-word essay addressing each of the following points/questions. Read the case study presented at the end of Chapter 10, which begins For this week assignment, write a 1500-word essay addressing each of the following points/questions. Read the case study presented at the end of Chapter 10, which begins “The elderly patient resided at the nursing home for almost a year before she died at the hospital.” Did the lack of documentation in the admitting nurse’s assessment and notes affect the ultimate outcome of this case? Was there negligence on the part of the nursing staff in the care of this patient? What could the nurse have done differently to facilitate a different outcome in this case? How would you decide this case? Using the sample professional liability insurance policy (Chapter 11 p. 191-192 Figure 11-1) locate the various provisions: Limits of liability Declarations Deductibles Exclusions Reservation of rights Covered injuries Defense costs Coverage conditions and supplementary payments Did you have difficulty finding some of the sections? Would this be a policy that you would consider purchasing for your own liability coverage? Why or why not? Read the case study presented at the end of Chapter 11, You Be the Judge, which begins, “During an unexpected heat wave,…” (Guido, p. 195): What provisions of an insurance policy would you consult to determine if an insurance company should pay such a claim, and what would the limits of the liability be? Is the nursing home insurance company correct in saying that this is a professional judgment issue? Which insurance company (the nursing home’s or that of the administrator of the nursing home, assuming she has coverage) should pay the court-ordered judgment? How would you decide the case? 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. Start by reading and following these instructions: Study the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully. Consider the discussion and the any insights you gained from it. Review the assignment rubric and the specifications below to ensure that your response aligns with all assignment expectations. Create your assignment submission and be sure to cite your sources, use APA style as required, and check your spelling. The following specifications are required for this assignment: 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). Expert Answer and Explanation Professional Liability Issues in Nursing Nurses are legally obliged to be competent, and to provide safe care by following appropriate guidelines and protocol to deliver safe care. In nursing practice, legal and ethical issues arise because of lack of the nurse’s understanding of the policy regulations that dictate and inform professional behavior. Carelessness coupled by stress overload can equally cause the nurse to compromise their moral obligation to the patient, leading to safety concerns (Azizian et al., 2021). Because of too much work, a nurse may neglect some of their obligations or responsibilities, and as a result, cause harm to the patient. When a nurse causes injury to the patient because of negligence, they may lose their license, job or face malpractice suit. In certain cases, an insurance company may pay the injured patient if a nurse has professional liability policy. However, the idea of compensating the patient in this case can be intricate as presented in the case study in chapter 11. It is important to examine the liability issues that occur in the nursing profession. Chapter 10 Case Study Analysis Whether the Lack of Documentation in Admitting Nurse’s Assessment and Notes affected the Outcome of the Case Given the details of the case study, there is a perspective from which one can explain the reasons for the outcomes of the case. The events of the case played out as they did due to the inability of the nurse to recognize missed diagnosis. With undocumented missed diagnosis, the nurse would not have managed to influence the outcomes of the case. The nurse was unprofessional in terms of how they handled the issue, and this could be because they lacked the experience of recognizing the patient’s needs including the diagnosis (Mello et al., 2020). Had the nurse had adequate experience, they would have placed the patient in a safer bed to minimize their risk of developing pressure ulcers. Evidence of Negligence on the Part of the Nursing Staff in the Care of the Patient The nursing staff neglected their duty to prevent the patient from developing the pressure ulcers by failing to perform comprehensive assessment of the patient. Had they comprehensively assessed the patient, they would have helped avert the problem. One of the defining features of this assessment is that it involves gathering pertinent patient’s information including their risks of developing serious health disorders (Dahlawi et al., 2021). Because the nurse’s failure to review the patient’s health, they failed to notice the possibility of the patient developing pressure ulcers. What the Nurse could have Done Differently to Facilitate a Different Outcome in the Case To facilitate different outcomes, the nurse should have documented the diagnosis information. With the information documented, the clinicians working with the patient would have been able to access it, resulting to effective management of the patient’s health. This information is equally important in the sense that it communicates the patient’s data including needs so that providers rely on it to make informed
[ANSWERED 2023] Conduct research on approaches to risk management processes, policies, and concerns in your current or anticipated professional arena to find an example of a risk management plan
Conduct research on approaches to risk management processes, policies, and concerns in The purpose of this assignment is to analyze a health care risk management program. The concepts in this assignment will be expanded on in the Topic 2 assignment and the Topic 3 benchmark assignment. Conduct research on approaches to risk management processes, policies, and concerns in your current or anticipated professional arena to find an example of a risk management plan. Look for a plan with sufficient content to be able to complete this assignment successfully. In a 1,000‐1,250-word paper, provide an analysis of the risk management plan that includes the following: Description of the health care organization to which the plan applies and the role risk management plays in that setting. Summary of the type of risk management plan you selected (new employee, specific audience, community‐focused, etc.) and your rationale for selecting that example. Description of the standard administrative steps and processes in a typical health care organization’s risk management program compared to the administrative steps and processes you identify in your selected example plan. (Note: For standard risk management policies and procedures, look up the Medicare Improvement for Patients and Provider Act (MIPPA)-approved accrediting body that regulates the risk management standards in your chosen health care sector, and consider federal, state, and local statutes as well.) Evaluation of your selected risk management plan’s compliance with the standards of its corresponding MIPPA-approved accrediting body relevant to privacy, health care worker safety, and patient safety. Analysis of the key agencies and organizations that regulate the administration of safe health care in your current or future area of concentration and an evaluation of the roles each one plays in the risk management oversight process. Proposed recommendations or changes you would implement in your risk management program example to enhance, improve, or secure the compliance standards. Proposed recommendation or changes you would implement to build and support a culture of compassion and concern for patients and health care employee safety. Base your response on the Christian worldview principle that work within the public arena should be performed with compassion, justice, and concern for the common good. In addition to your textbook and the GCU “Statement on the Integration of Faith and Work,” you are required to support your analysis with at least three credible health-related resources. 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 Class Resources if you need assistance. Benchmark Information This benchmark assignment assesses the following programmatic competency: BS Health Sciences 3.2 Discuss compliance with risk management protocol. Expert Answer and Explanation Risk Management Program Analysis Managing risks is a vital part of how healthcare works, ensuring that everyone involved benefits. Having effective criteria for risk management is crucial for the organization to achieve its goals and other important aspects, contributing significantly to its success. In essence, risk management involves evaluating risks and finding solutions to reduce these risks (Hick et al., 2020). Properly communicating about these risks is also a key part of a risk management plan. Nurses Service Organization (NSO) and Healthcare Providers Service Organization (HPSO) can provide valuable insights for developing effective management programs. Description of the Healthcare Organization The plan for managing risks serves as a useful tool for putting the overall risk management program into action within both inpatient and outpatient healthcare organizations. This program provides essential structure and guidelines applicable to the organization’s clinical and business services. Its aim is to enhance the quality of patient care while ensuring a safe working environment for the staff (Johnson et al., 2020). Following the principles of the risk management plan, the emphasis is on providing a simultaneous, thorough, and organized approach to decrease instances of risk for all involved parties. Activities within risk management encompass identifying, analyzing, investigating, and evaluating risks to assess the effectiveness of implemented changes (Johnson et al., 2020). These steps are then followed by choosing and applying the most suitable method to effectively address, manage, reduce, eliminate, or transfer issues related to unintentional injuries in the healthcare setting. Summary of Selected Risk Management Plan The primary aim of the chosen risk management program is to safeguard nursing staff, patients, and healthcare visitors from unintentional injuries. Additionally, the program is designed to protect the intangible and financial assets of the organization, including its standing in the community and reputation. Unintentional injuries, a significant form of healthcare-acquired illness, affect a considerable number of individuals in the healthcare sector (Hick et al., 2020). Hospital-acquired infections or illnesses impose unnecessary financial strain on the hospital and consume resources that could otherwise be used for the treatment and care of deserving patients. In the hospital setting, various inadvertent injuries such as patient falls, late diagnosis, and misdiagnosis pose risks to patients. The identified risk management program provides an analysis of the authorities involved and the roles that the risk manager plays in ensuring the program’s effectiveness. The organization appoints and empowers the risk manager to guarantee the program’s effectiveness and align the final outcomes with the projected goals (Hick et al., 2020). The program includes a governing body with roles and responsibilities that can be communicated verbally or through a written transcript. The risk manager is responsible for creating, implementing, and evaluating the program’s effectiveness, following set standards for quality, infection control, and patient safety management. Standard Administrative Steps and processes In a standard healthcare organization, the established administrative procedures follow a specific intervention model before resolution or elimination. The medical facility, which provides healthcare services, employs staff, including nurses and physicians, who interact with patients. These staff members adhere to company policies that define acceptable and unacceptable practices (Tuck & Hough, 2017). The staff and affected patients or interested parties are the
Assignment Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change
Assignment Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes. In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach. To Prepare: Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT. Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection. Consider the best method of disseminating the results of your presentation to an audience. Create an 8- to 9-slide PowerPoint presentation in which you do the following: 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. 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 (1 slide) An explanation about what you learned from completing the levels of evidence table (1 slide) An explanation about what you learned from completing the outcomes synthesis table (1 slide) Expert Answer and Explanation I am currently working in a nursing and rehabilitation center, which mainly deals with patients with diverse needs. Our main task is to ensure that patients receive safe and quality care that will assist them regain independence and functionality like they were before their illness. The current organizational culture is unsupportive of the change with poor leadership, lack of accountability, and laxity by staff being some of the factors contributing to this culture. Currently the organization is having high number of cases of falls and other safety issues, which has drastically affected the facility’s rating, patient outcomes and to some extent even work satisfaction of the employees working within the facility. This problem can be attributed to lack of urgency shown by the staff when answering call-lights and alarms Scope: The issue mainly affects patients under admission, where at times they require help from the nurses but laxity of the nurses to respond to call lights and alarms, delay the help they require, which in most instances lead to adverse outcomes, like patient falls. The issue also mainly revolves around nursing unit, who are supposed to be at the forefront in responding to alarms and call lights. The change needed should therefore target at improving the response of nurses in tending to the sensory alarms and call lights to improve patient outcomes. The stakeholders involved in the change include the following; The organization leadership – The organization leadership should show interest in the change given the impact of the issue on the performance of the organization. In support of the change, they should allocate the necessary resources needed to implement the change, and also be at the forefront in leading the change. Another stakeholder are the nurses, nurse practitioners and physicians who are in charge of delivering care to patients. They are supposed to actively participate in resolving the issue with the aim of improving patient outcomes. Technicians will also be among the stakeholders involved. Their role will be to ensure that the monitoring systems are properly functional to avoid false positives and false negatives which end up causing alarm fatigue and laxity by nurses to respond (Baker & Rodger, 2020). Quality assurance team should also be part of the initiative, with their role being to provide oversight on whether the change is meeting the intended quality- related outcomes The patients are also key stakeholders involved given that impact of the change in their outcomes. Some of the risks attached to implementing the proposed change include change resistance from nurses which will affect the success of the project. The other risk is increased nurse workload from what is currently is due to the requirement to increase their level of responses to sensory alarms and call lights. As it currently is, the nurses and other care providers have a lax attitude to respond to call lights and sensory alarms. One of the main causes of laxity to respond to sensory alarms and call lights by nurses can be attributed to alarm fatigue (Baker & Rodger, 2020). Studies have indicated that sensory alarms fatigue is caused by faulty monitoring systems, inadequate training on how to respond to the sensory alarms and organizational factors including poor culture and leadership (Bach et al. , 2018). Therefore the evidence based change that is suggested is to train nurses and introduce an online monitoring system that will reduce the number of false alarms, in turn improving response times and reducing alarm fatigue. The suggested intervention is linked with various studies as being effective including studies by Bach et al. (2018) and Ruskin and Hueske-Kraus (2015). To facilitate knowledge transfer for the change the following plan will be used. The first step is knowledge creation which will entail collection of evidence on good practices which can assist to improve nurse response times to sensory alarms. Knowledge will be created by collecting evidence on the current practice and its impact on patient outcomes and comparing it with best practices, through which the change