Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live.

Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live.
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Question: An explanation of the role of the advanced practice nurse in facilitating the discussion of end-of-life care with patients and their families. Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live. Then, explain when it is appropriate to involve hospice and how to approach patients and/or families who refuse hospice services. Finally, explain potential outcomes of the patient in the case study you selected and how you would facilitate the discussion of end-of-life care with this patient’s family. We are in a unique position to guide patients and their families through an increasingly complex health care system toward the goal of a “good death” one that is comfortable and self-determined.

Answers:

An explanation of the role of the advanced practice nurse in facilitating the discussion of end-of-life care with patients and their families

With the aging of the US population, the number of seriously ill patients with complex conditions is expected to rise and the overwhelming majority of deaths occur among the older adult population. Older adults typically die slowly of chronic diseases, with multiple coexisting problems, progressive dependency on others and heavy care needs that are met mostly by family members. The dilemma of end-of-life care becomes a crucial issue for the advance practical nurses. As a nurse practitioner, we have a crucial role in facilitating end-of-life care discussion with patients and families. It is not that easy to explain to them about hospice or comfort measures. A lot of patients and families have misconception about end-of-life care. They are thinking about the literal word of killing or giving up someone’s life. We are here to assist elderly patients with their advanced chronic illness and their families as they experience the final phase of life. We are here to serve the patients and family members caring for patients to promote excellent communication with family, encourage appropriate advance care planning and decision making, support home care, demonstrate empathy for family emotions and relationships, and attend to family grief and bereavement (Rabow, 2004). We should have the ability to listen which is the most valuable skill that can be used and allow them the opportunity to tell “their story.” End-of-life issues are very sensitive. That is when we are all most vulnerable, cared and thinking of what we did or did not do in our lifetime. NPs who can be empathetic and “be” with the patient at this very important time will have one of the most rewarding experiences of their career (Knox, 2010).

The value of the advanced practice palliative nursing role extends beyond specialized and expanded knowledge, critical thinking, and evidence-based practice to enhanced communication skills that facilitate direct patient care through informed decision-making, patient and family education, and psychosocial-spiritual care. Nurses have the communication skills necessary to engender trust and draw patients and their families into a partnership of care. Their commitment to quality and safety motivates them to continuously improve the care they provide and make valuable contributions to the interdisciplinary team (Yeager, 2014).

The interdisciplinary team helps ensure that the right care at the right time and in the right place is going to happen for the person. The NP often calls on the case manager, social worker and chaplains to assist with identifying and meeting the critical needs in a timely manner. As a nurse practitioner in palliative care, we need to be skilled in communication, diagnosis, treatment and pharmacology, and they need to counsel and support patients and families emotionally. Providing pain and symptom management and addressing patient suffering are important parts of the role (Knox, 2010).

Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live

The amorphous relationship between practitioners and the families of patients at the end of life presents both challenges and opportunities for which nurse practitioner’s may be unprepared. Families play important roles in the practical and emotional aspects of patient care and in decision making at the end of life. At the same time, family members may carry significant burdens as a result of their work. The discussion of death and dying is one that most people and also most healthcare professionals find very difficult to talk about. As a nurse practitioner, I would be more empathetic and be a good listener on their feelings about the situation. I will let them tell their stories, verbalized their feelings and thoughts and find the reason why they want everything done for the patient. Being a good listener and empathetic to their feelings will help them be more comfortable in discussing the prognosis of the patient. I will respect their opinions but at the same time I will explain to them thoroughly the minimal benefits that the patient could get if will do everything for him. I will be more realistic to them and show them the outcome if patient will go for an aggressive treatments. I will make a reasonable effort to clarify their doubts, questions, and communicate with them the risk and its potential benefits. Considering the patient’s advanced age and poor prognosis, I will have them a clear understanding of the patient’s prognosis and the pros and cons of doing everything for the patient like CPR. Although all patients who require CPR have severe acute illness by virtue of needing CPR, there may be differences in the type or severity of the acute illness leading to CPR that could influence outcomes. I will emphasize to them the minimal benefits that the patient gets from such procedures and at the same time I will explain to them the advantages and benefits that the patient gets from palliative care and the quality of life that he would have on his last days of his life. The final months of the patient is the most precious one and we want the patient to spend the rest of his life in a comfortable and peaceful way of living (Ehlenbach, et al, 2009).


 

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Describe strategies that are used to ensure the accuracy and safety of data entered into information systems used in nursing practice.

Describe strategies that are used to ensure the accuracy and safety of data entered into information systems used in nursing practice.
Care

For this Application Assignment, you are to write a 4- to 5-page paper on the issues of data quality, patient safety, and access to health care. Reflect on your own practices and review your readings and the media programs about how information technology improves patient safety and quality of care.

Conduct additional research using the Walden Library. Then, addressing the following:

Describe strategies that are used to ensure the accuracy and safety of data entered into information systems used in nursing practice.
Explain the importance of data integrity for health care institutions.
Summarize how information technology contributes to patient safety and to access to health care.
Make sure to refer to your Application Assignment Rubric prior to submission. Support your position or those of others with references from the professional literature.


 

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Discuss the MSN specialty track you have selected? Family Nurse Practitioner.Demonstrate how the skills outlined in the AACN Essentials are applicable to your selected master’s-prepared role.

Discuss the MSN specialty track you have selected? Family Nurse Practitioner.Demonstrate how the skills outlined in the AACN Essentials are applicable to your selected master’s-prepared role.

MASTER’S-PREPARED ROLE ELECTRONIC PRESENTATION

Paper instructions:
1.Discuss the MSN specialty track you have selected? Family Nurse Practitioner
2.Demonstrate how the skills outlined in the AACN Essentials are applicable to your selected master’s-prepared role.
3.Identify three ways a master’s-prepared nurse would use the AACN Essential skills in nursing practice, i.e., nursing leadership, clinical outcomes, management, etc., and providing empirical evidence to support your selections.
4.Concluding statements summarize content.
5. 15 slide presentation with speaker notes in APA format not including title and reference slides.
Please include a few pictures where applicable.


 

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IDENTIFY THE PROCESSES AND BARRIERS TO POLICY CHANGE 2. DEMONSTRATE CRITICAL THINKING SKILLS IN DETERMINING THE FEASIBILITY AND THE STEPS REQUIRED TO FACILITATE CHANGE IN POLICY IN NURSING PRACTICE

IDENTIFY THE PROCESSES AND BARRIERS TO POLICY CHANGE 2. DEMONSTRATE CRITICAL THINKING SKILLS IN DETERMINING THE FEASIBILITY AND THE STEPS REQUIRED TO FACILITATE CHANGE IN POLICY IN NURSING PRACTICE

Incorporating Evidence-based Practice Paper

Once a nurse decides that the evidence is strong enough to support a change in practice, there must be a process in place to disseminate this evidence throughout the institution, facilitate discussion about the evidence, and initiate a change in policy.
This assignment challenges you to assess the resources and processes already in place at your place of work, determine who would need to be involved in discussions about the evidence and subsequent policy changes, and the steps you would take to establish processes or initiate change.

Assignment Objectives

The students will
1. Identify the processes and barriers to policy change

2. Demonstrate critical thinking skills in determining the feasibility and the steps required to facilitate change in policy in nursing practice

3. Demonstrate critical thinking skills in determining a plan to establish a culture of evidence-based nursing practice

Assignment Guidelines

Write a 4 TO 5 page paper using the following outline:

1. Introduction of the policy (either the policy you investigated for the Review of Literature or another policy that you have determined needs changing)

2. Sources, resources, and processes already in place to assist in facilitating evidence-based policy changes.

3. Challenges or barriers you would find in making these changes.

4. Steps you would take to initiate a change in policy.

5. Steps you would take to establish a culture of evidence-based practice.

6. Conclusion

7. References

Guide to writing the paper
Find out where the problem is. What are you going to do about it? What are planning to change? Why? Are you going to establish new polices? Why do you want to change the current practices? This is a hypothetical change. What can you make better?
Do you have resources to do that? Do you have a special committee?
What are the barriers?
What steps are you going to initiate to make this change?
You need to establish evidence-based practice. What are the steps to change the practices? What are you going to do?
Design a protocol and plan it.
Make sure to write conclusion, summary.
5 articles
4-5 pages
The goal is to improve quality of care.
Look at systematic review on the topic. Plan implementation. What factors will make your plan successful, what factors will make it less successful. Stay away from weak evidence. Change has to be feasible and applicable to your population. What will facilitate the change? Work environment, right setting, and right mindset of the coworkers. You need to have a good plan. Involve all stake holders (PTs, nutritionists, etc.)
Do you have resources in place?

I will upload the 5 articles needed asap. Keep in mind that this paper is a continuation of the previous one you wrote on CAM in pediatric sickle cell. I did revise the conclusion part a little so i will also upload the revised paper for you as well


 

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Leaders in a health care organization have identified risk management as an opportunity for improvement for the upcoming year. The organization has hired you as a consultant to help assess the organization’s current status and define the future plan for addressing risks.

Leaders in a health care organization have identified risk management as an opportunity for improvement for the upcoming year. The organization has hired you as a consultant to help assess the organization’s current status and define the future plan for addressing risks.
Resource: Risk Management Assessment Summary Grading Criteria and Sample Executive Summary located in the Center for Writing Excellence
• Navigate to the Center for Writing Excellence in the University Library.
• Under Writing Resources, click Tutorials & Guides.
• Under Samples, click Sample Executive Summary.
Select an organization type in the health care industry as the basis for this assignment. The organization may be your employer or a health care organization of particular interest to you. Types of health care organizations include, but are not limited to, the following:
• Hospital, nursing facility, physician office, emergency medical services, managed care organization, home health care, community health department or provider, pharmacy, laboratory, drug manufacturer, medical device manufacturer, durable medical equipment supplier, and electronic medical records software suppliers
Research the key concepts of risk management in health care and the factors that influence risk management for your chosen type of organization.
Write a 1,050- to 1,400-word executive summary in which you complete the following:
• Describe the purpose of risk management in health care organizations in general and in your chosen organization in particular.
• Explain key steps this organization may take to identify and manage their risks.
• Identify three typical or actual risks in your chosen organization. Describe how each risk might negatively affect your organization and its stakeholders.
• Summarize the types of education, training, or policies that would help this type of organization mitigate these risks.


 

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What comparisons can be found between the university Mission and Domains/CON Mission and Program Competencies (for your selected specialty track, links located in the Course Materials) with the AACN’s Essentials for Master’s Education for Advanced Practice Nursing (link located in the Week 1 Topic Materials)? Explain your rational.

What comparisons can be found between the university Mission and Domains/CON Mission and Program Competencies (for your selected specialty track, links located in the Course Materials) with the AACN’s Essentials for Master’s Education for Advanced Practice Nursing (link located in the Week 1 Topic Materials)? Explain your rational.

NUR-502 Topic 1 DQ 1

What comparisons can be found between the university Mission and Domains/CON Mission and Program Competencies (for your selected specialty track, links located in the Course Materials) with the AACN’s Essentials for Master’s Education for Advanced Practice Nursing (link located in the Week 1 Topic Materials)? Explain your rational.


 

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. Compare current professional nursing practice roles with historical roles of the nurse.

. Compare current professional nursing practice roles with historical roles of the nurse.

Course Project Milestone 1: Guidelines
Purpose

To apply lessons in nursing history to living nurses contributing to nursing history through an interview and recording of historical information

Course Outcomes

The Course Project enables the student to meet the following Course Outcomes:

CO 1. Incorporate appropriate historical perspectives into current professional nursing practice. (PO #2)

CO 4. Compare current professional nursing practice roles with historical roles of the nurse. (PO #7)

Points

The entire project is worth 600 points. Milestone 1 is worth 100 points of this total.

Due Date

Submit your completed NR390 Milestone 1 by Sunday at 11:59 p.m. MT at the end of Week 1.

Requirements and Guidelines
1. Nursing history is being made today by exemplary nurses throughout the world. Select one registered nurse who is creating nursing history to be the subject of this project. This RN must have at least 15 years of RN licensure. The nurse could be a family member, friend, colleague, acquaintance, manager, former instructor, or other nurse who is creating, delivering, or influencing the practice of nursing in your area. Do not select a former or current patient. Remember that a nurse does not have to create a nursing theory, write textbooks, or be the head of a nursing organization to make nursing history. The chief nurse executive who manages to deliver quality care in a small rural hospital with a tiny budget has a story worth telling. The nurse who served in the military has a story that is important to document as nursing history. The staff nurse who consistently provides high-quality care is making history. History is not merely the major accomplishments or events, but includes the activities nurses everywhere do in their nursing lives. Milestone 1 is due at the end of Week 1.

2. Clearly explain to the selected nurse that statements made in the interview will be recorded (audio, video, and/or written) and submitted to instructor. The interview is not intended for public access.


 

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Read the Teaching Transcultural Nursing Through Literature article.

Read the Teaching Transcultural Nursing Through Literature article.

Teaching Transcultural Nursing
One of the biggest challenges in nursing education is to develop culturally sensitive graduates. Although theory and lecture are appropriate to introduce cultural issues the application of those skills is limited by the kinds of clinical experiences and patient populations students may treat.
Instructions:
1 Read the Teaching Transcultural Nursing Through Literature article.
2 Answer the following questions:
Did you read any of the books listed in Table 1 on page 525 of the article?
If so list the books you have read.
If not place those books on your to-do-list for reading.
Select one question from Table 2 and answer. Share your thoughts knowledge and experiences.


 

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History and Process of Nursing Research, Evidence-Based Nursing Practice, Quantitative and Qualitative Research Process.

History and Process of Nursing Research, Evidence-Based Nursing Practice, Quantitative and Qualitative Research Process.

Nursing Research Article Yagihashi, S., Yamagishi, S. I., & Wada, R. (2007). Pathology and pathogenetic mechanisms of diabetic neuropathy: correlation with clinical signs and symptoms. Diabetes research and clinical practice, 77(3), S184-S189. Topic Causes, signs and symptoms of diabetes. Summary The causes of diabetes mellitus vary depending on the type. There are two types of diabetes namely: type 1 and type 2 diabetes. Even though type 1 is inherited, it may be caused by some infections.


 

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How does the campaign address the problem? What social economic political and ideological theories does (or did) the campaign employ?

How does the campaign address the problem? What social economic political and ideological theories does (or did) the campaign employ?

 

LEGAL ETHICAL AND PROFESSIONAL ISSUES IN HEALTHCARE
Information
Due Date
Sunday February 14 2016
11:59 PM
Points Possible
15
. .
Legal Ethical and/or Professional Case Review for Week 5
1. Identify a Legal Ethical and/or Professional Dilemma relevant for integrated care settings related to one of the following topics: billing reimbursement coding documentation or a high risk dilemma (e.g.: suicidal homicidal malpractice public relations concerns quality assurance diagnostic).
2. Identify differing professionals or ethical lenses for the dilemma to be viewed through.
3. Write a short 1-2 page summary (not including title or reference pages) addressing the following headings: Introduction of the Dilemma How the Dilemma is Typically Addressed and How the Dilemma Is Handled with Shared Decision Making
Legal Ethical and/or Professional Case Review Rubric
Criteria/Points
Excellent
Satisfactory
Unsatisfactory
Paper Structure/Writing Style
Length (not including title and reference pages)
References: Minimum of 2 references
1. Length: 1-2 pages not including title and reference pages
2. References are integrated throughout paper to support/provide justification for student critique.
3. Cited primary sources and included course texts
4. Included title and reference page
(1 point)
One of the below is met:
1. Length: 3-4 pages
2. Integrated references with limited rationale so that literature does not clearly support student opinion. Citations consist of mostly secondary sources
3. Did not include title or reference page
(.5 point)
1. Length: More than 4 pages
2. No references
3. No title or reference page
(0 points)
APA Format
and required headings
Used required headings of:
Introduction of the Dilemma
How the Dilemma is Typically Addressed
How the Dilemma Is Handled with Shared Decision Making
Correct APA format with only 1-2 grammatical and/or spelling errors. References cited and/or reference list only contains 1-2 errors
(1 points)
Very good attempt at APA format with only 3-5 grammatical and/or spelling errors. References cited and/or reference list contains 3-5 errors
and/or did not use required headings
(.5 point)
Poor attempt at APA format with more than 6 grammatical errors or APA format not used; grammatical & spelling errors great enough to confuse the meaning of sentence and/or paper. References not cited in body of paper and/or no reference list (0 points)
Paper Content
Introduction and Summary of Ethical Legal and/or Professional Dilemma
What of the Dilemma
Why of the Dilemma
1.Described the ethical legal and/or professional dilemma. .
2.Address autonomy beneficence nonmaleficence and/or justice. .
3.Integrated care dilemma.
(3 points)
One of the below is met:
1. Dilemma is vague
2. Described dilemma without using ethical principles (autonomy beneficence nonmaleficence and/or justice).
3. Not an integrated care dilemma.
4. Missed identifying a significant ethical legal or professional dilemma associated with the described case example.
(2 points)
Described without clear indication of whys and what the dilemma is.
(1 points)
How this Dilemma is Typically Addressed without shared decision making or case review
Consequences of individualized decision making in integrated care
e.g. Confidentiality consent legal physical and/or emotional harm professional scope of practice culture power financial public relations business concerns
1.Identified the ethical codes or principles of the professionals who are involved .
2.Describe how each different integrated care professional would handle the dilemma/ their decision making.
3.Identified alternative choices.
4.Identify the consequences to individualized decision making or non-shared review and understanding of integrated care practice ethics professionalism and/or legal considerations.
(6 points)
One of the below is met:
1.Described without being concise or clear. .
2.Only addressed medical or behavioral (did not address multiple types of integrated care professionals).
3.Did not address consequences.
(4 points)
1.Described in vague terms.
2.Without clear indication of how this issues is typically addressed.
3.Without understanding of consequences to non-shared decision making.
(0-3 points)
How the Dilemma is handled with shared decision making and review
1.Decision making addresses shared medical and behavioral ethical legal and/or professional considerations.
2.Identified how the decision reduces conflict and consequences.
(4 points)
One of below is met:
1.Lacking integrated care perspective.
2.Did not identify how decision reduces conflict or consequences.
(3 points)
1.Lacking integrated care perspective.
2.Did not identify how decision reduces conflict or consequences.
(1 points)
Total Points: ____/15
.
2. Assignment Submission
Text Submission

Meredith S. Murphy September 18, 2017
Public Health Order Description Report on a public health campaign. is Breast Ca
Public Health
Order Description
Report on a public health campaign. is Breast Cancer ( Breast Screening )
assignment should be contain:
Executive summary
Commonality
Population
Risk factors
Campaign Approach
Analysis of Campaign
Future action
References ( Should be from 2010 onward )
Also when give citation needs to give PAGE NUMBER as well.
Assignment needs to be addressed to all the following questions:
How common is the health issue in Australia?
What is its distribution of the problem in the population? Are particular population groups more at risk? If so which groups?
What are the risk factors? How can the problem be prevented?
How does the campaign address the problem? What social economic political and ideological theories does (or did) the campaign employ?
Is the campaign working or did it work? Critique the campaign using evidence and relevant social economic political and ideological theories.
What more needs to be done to reduce the problem and why?


 

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