Questions and Topics We Can Help You To Answer:
Paper Instructions:

Develop a client termination summary. 
To prepare:
Identify a client who may be ready to terminate therapy.
•    For guidance on writing a client termination summary, review pages 693–712 of Wheeler (2014).
To complete: 
With the client you selected in mind, address in a client termination summary (without violating HIPAA regulations) the following:
•    Identifying information of client (e.g., hypothetical name and age)
•    Date the client initially contacted therapist, date therapy began, duration of therapy, and date therapy will end
•    Total number of sessions, including number of missed sessions
•    Whether termination was planned or unplanned
•    Presenting problem
•    Major psychosocial issues
•    Types of services rendered (e.g., individual, couple/family therapy, group therapy)
•    Overview of treatment process
•    Goal status (goals met, partially met, unmet)
•    Treatment limitations (if any)
•    Remaining difficulties and/or concerns
•    Recommendations
•    Follow-up plan (if indicated)
•    Instructions for future contact
•    Signatures
Include a clear purpose statement. 
Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.
References:
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer
•    Chapter 20, “Termination and Outcome Evaluation” (pp. 693–712)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Questions and Topics We Can Help You To Answer:
Paper Instructions:

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is "running away."
Reports that she is exhausted and cannot eat or drink by herself.
Objective Data

Height 175 cm; Weight 95.5kg.
Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
Intervention

The following medications administered through drug therapy control her symptoms:

IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Inhaled short-acting bronchodilator (ProAir HFA)
Inhaled corticosteroid (Flovent HFA)
Oxygen delivered at 2L/ NC
Critical Thinking Essay

Critically evaluate Mrs. J.'s situation. Include the following:

Describe the clinical manifestations present in Mrs. J.
Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients' transition to independence.
Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.'s current and long-term tobacco use, discuss what options for smoking cessation should be offered.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubr

Questions and Topics We Can Help You To Answer:
Paper Instructions:

Choose a time in our history that interests you, identify and describe the US health care system that was in place at that time.  What were the social determinants of health as related to the population you've identified?  Topics of interest should include:

political philosophy,

policy process,

changing and financing of the US Healthcare System,

legislation and initiative presented and passed,

evaluation and outcome measurement; is it effective? 

how nursing advocacy and leadership were demonstrated.

Questions and Topics We Can Help You To Answer:
Paper Instructions:

Using the information from the case study below, discuss the following issues from the perspective of an Nurse Practitioner:
·
Standards of care – what were the standards of care that were violated? Who was responsible for the violations?

In your role as an practitioner, what risk management steps needs to be taken before or after the incident to alleviate the issue?

Page length should be 3-4 pages exclusive of cover page and references.
Support your paper with a minimum of three scholarly references.


Case Study: Malpractice Action Brought by Yolanda Pinellas

Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.
During the evening shift the infusion pump began to beep. The RN found that the IV was dislodged and discontinued the infusion, notified the physician and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an infiltration to the IV.
Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient is alleging that because of this, she is no longer able to perform as a musical conductor.
The risk manager had noted when doing chart reviews over the last 3 months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings, and nights then coming back and working the evening shift. The risk manager also noted a pattern of using float nurses to several units.

Questions and Topics We Can Help You To Answer:
Paper Instructions:

1: Describe the stages of each type of cell reproduction process from a normal patient whose body cells can repair themselves and normal cell division during the reproductive development of the unborn baby.
2: Explain the disadvantages and advantages of each type of cell division.
3: Discuss how the patient experiencing problems with the cells repairing from the cut and the child's reproduction development malfunctions can alter haploid and diploid cell development.

Questions and Topics We Can Help You To Answer:
Paper Instructions:

Final Research Project Outline-Section Subheadings
Topic:  A link between mental health and child obesity?

Sections should include the following areas written in paragraph form with subheadings:

Introduction
Short introduction of the proposal (2-3 sentences)
Statement of the Problem (1-2 sentences)
Purpose of the Study (2-3 sentences)
Limitations (about 1 sentence per limitation)
Hypothesis(es) (1 sentence per hypothesis)
Definition of Terms (1 sentence per term)
Significance of the Study (or Need for the Study) (1 paragraph)
Literature Review-a. Introduction (1 paragraph) b. Review of the Literature (2-3 paragraphs) c. Summary (1 paragraph)
III.      Methods and Procedures

Participants (2-3 sentences)
Research Design (2-3 sentences)
Instruments (subheadings for more than one) (1-2 sentences per instrument)
Procedures (1-2 paragraphs)
Proposed Statistical Analysis (1 paragraph)
Implications of results and future research (1-2 paragraphs)

Questions and Topics We Can Help You To Answer:
Paper Instructions:

Creating a Culture for EBP

This week APA paper will focus on two areas...but it is only one paper. 

Please use level one headings to separate the two parts of the assignment.

As we review the EBP process, please notice each student has already begun his or her own journey on the EBP Process.

Each one has already created a PICOT question, searched for evidence and practiced evaluating the evidence.



From this point, Nurses need to learn how to implement the information/evidence for his or her PICOT question into their Clinical setting. (See chart 9.3)

Next

    What barriers might you face in implementing a new practice to address your research topic (as identified in Module 1)? 
    Describe strategies that could be used to increase success including overcoming barriers.

Barriers



Then for the second part, one will:

Describe six sources of internal evidence that could be used in providing data to demonstrate improvement in outcomes for your change project. (see pages 227-228)

Suggested Headings:

Steps Integrating EBP Clinically

Steps (Individually; Discuss each of the 8 steps of integrating an EBP change into the clinical setting)

Barriers and Strategies

Sources of Internal Evidence

Conclusion

Questions and Topics We Can Help You To Answer:
Paper Instructions:

Healthcare policies, including financial and regulatory, directly and indirectly
influence the nature and functioning of the healthcare system and thereby are
important considerations in professional nursing practice.

Questions and Topics We Can Help You To Answer:
Paper Instructions:
Assume you met a CEO of the Community Health Center (CHC) who tells you a story that he opened a community health center (serving Medicaid, Medicare, uninsured, and underinsured patient) because he was moved by the loss of his daughter and desire to dedicate his live serving the vulnurable population. Write two page summary what motivated and insired this CEO to do so.  No references required and do not use any. 

Questions and Topics We Can Help You To Answer:
Paper Instructions:

write a 1,500-1,750-word white paper that proposes a solution to a problem you have witnessed or experienced related to the COVID-19 pandemic. Your proposal should be addressed to someone (or a group) who has the power to address your problem (even if they can't fully solve your problem, you can prompt them to address at least part of it). Your writing and arguments should cater to that audience. Additionally, you should use evidence requisite for your audience. As always, the content, structure, and style should be suitable for the type of writing you are doing: a white paper. Make adjustments as necessary for the situation and your audience.It is an argumentative proposal, written as a white paper, that you would likely use to address your audience. It should offer a justifiable solution to a problem you have experienced or witnessed in relation to the COVID-19 crisis

Questions and Topics We Can Help You To Answer:
Paper Instructions:

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
Select an existing healthcare program or policy evaluation or choose one of interest to you.
Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
The Assignment: (3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

Describe the healthcare program or policy outcomes.
How was the success of the program or policy measured?
How many people were reached by the program or policy selected?
How much of an impact was realized with the program or policy selected?
At what point in program implementation was the program or policy evaluation conducted?
What data was used to conduct the program or policy evaluation?
What specific information on unintended consequences was identified?
What stakeholders were identified in the evaluation of the program or policy? Who would benefit the most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
Did the program or policy meet the original intent and objectives? Why or why not?
Would you recommend implementing this program or policy in your place of work? Why or why not?
Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

Questions and Topics We Can Help You To Answer:
Paper Instructions:

critical thinking in nursing education and nursing practice. how a student can use critical thinking effectively in school and as a nurse in the healthcare field, provide examples and quotations.