Client Questions

Respond to this post with a positive response : Ask a probing question, substantiated with additional background information, evidence or research. Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library. Validate an idea with your own experience and additional research. Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings. Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. Use  references                                                        Initial Post My program is Nurse Educator and to do research on anything to do with this is a little difficult as there is not much information on it. I decided to do two types of searches based on how I might go with my master’s degree. The first search was nurse educators and what came up was an article on how to become a better nurse educator to nursing students. The most interesting statement made in this article hit close to home for me. “Teaching student nurses’ critical thinking and the ability to apply clinical reasoning skills remains a challenge in nursing education” (Wyngaarden, 2018). Being a nursing student is stressful but having to think outside the box but quickly can be even more difficult at times. Teachers are having a hard time connecting with students because not only is there a huge age gap between the student population but so many different learning barriers and language barriers they are trying to work around.  The second search I did was nurse educators to patients. I research this as well because I have also thought about being an educator to patients to have one-to-one conversations about their illness. I feel as though patients might listen and understand better if they are working with someone one-on-one rather than a different nurse/doctor every other day while in the hospital. While I was working for Shands, they had a diabetic nurse educator who would not only do education with the patients during their hospital stay, but she would go to the clinic and speak with patients. Once a month she would hold a newly diagnosed diabetes class for patients and then once a week she would hold classes on how to continue to control your diabetes. She would charge $5 for the continuing education class. The money that she would make from this would go to buying supplies to hand out to patients who did not have any or could not afford it.  For both searches, I used the Walden Library and found it to be the easiest way to look for my information. The Walden Library has a variety of articles/books/online journals to choose from. I will always recommend using the Walden Library for any type of research as this provides information from all over as well as the information is current.    References   Walden Library. Accessed December 16, 2018, from     https://class.waldenu.edu/bbcswebdav/library Flanders, S. A. (2018, January-February). Effective Patient Education: Evidence and Common Sense. MedSurg Nursing, 27(1), 55-58. Retrieved December 16, 2018, from https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=2&sid=17e9bf97-558e-4e18-8a46-a242c62be6ab%40pdc-v-sessmgr02 Wyngaarden, A. V. (2018). ASSESSING THE VALUE OF ACTION RESEARCH. South African Journal of Higher Education, 32(6), 519-531. doi:http://dx.doi.org/10.20853/32-6-2974

Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-900-word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following: Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family. Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions.  Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning. Using the model, outline the steps for a family-centered health promotion. Include strategies for communication. Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.  You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Conduct a literature search to locate a journal article related to the health or health care practices of Mexican.  Present a summary of the journal article, and examine how the information presented may impact your nursing practice. Please provide a copy of the journal article (or hyperlink) if possible. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722278/ 400 words

Discuss about the characteristics and  requirements that research tools should have on quantitative research to give validity to the study. Give some examples

1) **********minimum 4 full pages ( not words)**************************** (cover or reference page not included)  2)¨**********APA norms  3)********** It will be verified by Turnitin and SafeAssign  __________________________________________________________ Read well. Paper should be 1 page, and done differently 4 times (copy and paste is not accepted) you must answer the question four times on different pages in the same document (Word) ______________________________________________________________ Question:   Complete this week’s assigned readings, chapters 39-43. After completing the readings, post a short reflection, approximately 1 paragraph in length, discussing your thoughts and opinions about one or several of the specific topics covered in the textbook readings. Identify which one MSN Essential most relates to your selected topic (why) in your discussion. Topic 1:   Advanced Nursing Education and Career Progression The MHS places great importance on advanced nursing education. During war, health care continues to evolve based on the nature of combat as well as the challenges posed by working in the austere environments characteristic of the battlefield (Spencer & Favand, 2006). Military nurses must possess the advanced practice specialty skills needed during conflict. Additionally, master’s degrees are required to be obtained before being promoted to more senior military ranks. Professional growth and development is continuously provided throughout a nurse’s career in the MHS by way of leadership experiences, on-the-job training, and continuing education. A variety of educational programs, including postgraduate opportunities, are available. Full funding, in addition to continuing to receive full salary and benefits, is provided for nurses earning advanced practice degrees as well as those pursuing doctoral studies. The armed services are committed to advancing military nursing science to optimize the health of military members and their families. Graduate education in civilian programs is available for selected promising nurse researchers. Additionally, to further advance the nursing research needs of the MHS, in 1992 Congress established the TriService Nursing Research Program (TSNRP), which is the only program funding and supporting rigorous scientific research in the field of military nursing (Duong et al., 2005).   TSNRP funds a wide range of studies to advance military nursing science. For example, in 2011 a pilot study was conducted to determine the sensitivity and specificity of small animal positron emission tomography-computed tomography (PET-CT) in identifying metabolic changes in muscle tissue surrounding simulated shrapnel injuries, and comparing this imaging with traditional x-ray images. Results showed the PET-CT to be more sensitive in identifying tissue changes. Military nurses now have a unique opportunity to educate patients and military health care providers, as well as to inform policy changes, about the possibility of early tissue changes around embedded shrapnel fragments and the use of PET-CT imaging as a possible surveillance tool. Another study supported by TSNRP in 2010 sought to understand how posttraumatic stress symptoms (PTSS) affect couple functioning in Army soldiers returning from combat. Findings included that almost 50% of couples had at least one person in the relationship with a high level of PTSS. Based on these results, development of interventions and policies designed to mitigate, or even prevent, negative outcomes such as divorce, violence, and suicide for military couples facing combat deployment are under way (TSNRP, 2013). Topic 2:   Posttraumatic Stress Disorder The problem of posttraumatic stress disorders in veterans has existed for centuries; however, the condition is attracting high levels of current attention caused by the conflicts in Iraq and Afghanistan and the disorder now impacts up to 22% of veterans (Johnson et al., 2013; Murray & Garbutt, 2012; Sabella, 2012). VHA and MHS nurses, along with their behavioral health counterparts, have collaboratively developed evidence-based guidelines on assessment and effective treatments which include multiple treatment modalities such as trauma-focused psychotherapies (e.g., exposure therapy), anxiety management, stress reduction, guided imagery, relaxation techniques, cognitive processing and behavioral therapy, and social support (Johnson et al., 2013; Murray & Garbutt, 2012; Murray & Smith, 2013; Sabella, 2012). Current policies highlight requirements related to the timely assessment, treatment, and follow-up care of PTSD in both DoD and VHA clinical settings (U.S. Department of Veterans Affairs & Department of Defense, 2010). However, most military service members and veterans do not seek treatment for PTSD because of stigma, barriers to care, and negative perceptions associated with receiving mental health care (Hoge, 2011; Murray & Garbutt, 2012; U.S. Department of Veterans Affairs & Department of Defense, 2010). Policy issues requiring high priority include better understanding of the barriers to low mental health service use in the MHS and VHA (Hoge, 2011). Nurses are highly instrumental in understanding obstacles to care as well as working to develop and implement collaborative care models to increase outreach to veterans in need of mental health services. Topic 3:    Sexual Assault Although the DoD and VHA continue to address military sexual trauma (MST; sexual assault or repeated, threatening sexual harassment that occurs during military service) and to describe what is being done to tackle this issue, many members of Congress believe there is an epidemic in the armed forces. It is estimated that 6.1% of women and 1.2% of men serving in the armed forces experienced and reported unwanted sexual contact in 2012. These numbers are believed to be much higher given that incidents go unreported as a result of fear of retaliation which could impact careers and the lack of trust that appropriate action will be taken against the offender (Johnson et al., 2013). Most experiences (67%) happened at work on military installations (Department of Defense, 2012). This is not a new issue for the military. For over two decades senior military officials and members of Congress have proposed recommendations to address sexual assault and harassment. Despite these efforts, the 330 incidence of such events continues to increase annually. This creates substantial financial and emotional cost that affects several generations of veterans and lasts long after a victim leaves the military. At this point, the VHA picks up the costs associated with a variety of physical and mental health problems (primarily posttraumatic stress disorder and depression), which sexual assault and harassment can trigger. In 2013, Congress required a response to this ongoing problem. NDAA 2013 mandated immediate policy changes to include investigation of all occurrences of sexual misconduct, requiring an independent review of all legal proceedings and investigations surrounding MST, and improving victim protections and reporting policies (U.S. Department of Defense, 2013). VHA mental health providers, including nurses, are developing and evaluating therapies specific to MST. Furthermore, nurses are using telehealth technology to reach out to veterans in remote areas of the country. Topic 4:   Access to Care More recently, it has come to light that access to care for veterans is worse than previously thought. In May 2014, the Veterans Affairs (VA) Inspector General began to investigate patient wait times and scheduling practices on the basis of concerns that veterans were not receiving timely care. Preliminary findings showed that systemic patient safety issues and possible wrongful deaths occurred as a result of gross mismanagement of resources, unethical behavior, and possible criminal misconduct by VHA senior hospital leadership. Before the 2014 investigation, a 2013 U.S. Government Accountability Office (GAO) report determined that at least 50 veterans experienced delayed gastroenterology consultations for colon cancer, some of whom later died of the disease. Findings such as this provided evidence that delayed access to health care is associated with negative health outcomes (Chokshi, 2014), and these scheduling practices are not in compliance with VHA policy (U.S Department of Veteran Affairs Office of the Inspector General, 2014). Kizer and Jha (2014) noted that almost 20 years ago the VHA had to implement sweeping reforms to increase both quality and accountability. The reforms of the 1990s improved quality and increased access and efficiency (Kizer & Jha, 2014). The successes of the past reforms in the VHA provide clear evidence that the problems are fixable (Kizer & Jha, 2014) and new reforms are again needed to fix current challenges. One such attempt at reform is the VA Management Accountability Act of 2014, which has passed the U.S. House of Representatives and gives the Secretary of the VA greater authority to fire senior administrators. In addition, Senator Bernie Sanders (I-VT) along with John McCain (R-AZ) introduced a bipartisan comprehensive bill that supports veterans having access to community as well a federal health care providers. The bill also provides emergency funding for the VHA to hire more physicians, nurses, and other health care workers. Choose any of these Essentials for each of the topics and answer the question:  I. Background for Practice from Sciences and Humanities II. Organizational and Systems Leadership  III. Quality Improvement and Safety  IV. Translating and Integrating Scholarship into Practice  V. Informatics and Healthcare Technologies  VI. Health Policy and Advocacy  VII. Interprofessional Collaboration for Improving Patient and Population Health Outcomes  VIII. Clinical Prevention and Population Health for Improving Health   Question:    Complete this week’s assigned readings, chapters 39-43. After completing the readings, post a short reflection, approximately 1 paragraph in length, discussing your thoughts and opinions about one or several of the specific topics covered in the textbook readings. Identify which one MSN Essential most relates to your selected topic (Why) in your discussion.

Theories are derived from conceptual models and are comprised of concepts and propositions. The only concepts that are common to all nursing theories, in some shape or form, are patient, nurse, health, and environment. These are sometimes referred to as the basic metaparadigms of the nursing domain. Identify two additional concepts that are relevant to your personal practice of nursing and explain how they relate to your practice and why they are important to your practice.

Review the following article: https://journals.sagepub.com/doi/full/10.1177/0193945918820338 Mark, B. A., & Patel, E. (2019). Nurse Practitioner Scope of Practice: What Do We Know and Where Do We Go?. doi:https://doi.org/10.1177/0193945918820338This week assignment:  From above identify three challenges the Advanced Nurse Practitioner  encounter in their Scope of practice (SOP)

APA format 100% original work 3 paragraphs or 3 sentences each 200 words References and in text citations are needed. Read a qualitative nursing study. If a different investigator had gone into the field to study the same problem, how likley is it that the conclusions would have been the same? How transferable are the research’s findings?

Start by reading and following these instructions: 1. Quickly skim the questions or assignment below and the assignment rubric to help you focus. 2. Read the required chapter(s) of the textbook. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully. 3. Consider the discussion and the any insights you gained from it. 4. Produce the Assignment submission in a single Microsoft Word or Open Office document. Be sure to cite your sources, use APA style as required, check your spelling. Describe how you are impacted by the Accountable Care Organizations as a healthcare provider. How does this affect the patient? Assignment Description: This assignment will be at least 1000 words or more This week you will reflect upon accountability in healthcare to answer the following questions: How can you play your part in accountability?   Briefly define the Accountability Care Organization What challenges do we face? How do you see the role of the healthcare worker changing as a result of these challenges? Assignment Expectations: How will students be successful? Length: 1000-1250 words (4-5  pages); answers must thoroughly address the questions in a clear, concise manner Structure: Include a title page and reference page in APA style References: Two scholarly references are required; you should include the appropriate APA style in-text citations and references for all resources utilized to answer the questions Format: Save your assignment as a Microsoft Word (.doc or .docx), Open Office (.odt) or rich text format (.rtf) file type File name: Name your saved file according to your last name, first initial and the week (for example, “jonesb.week1”) Submission: Submit your assignment to the Drop Box

Minimum of 300 words with at least 2 peer review reference   What are the effects of nutritional deficits on cellular functioning and tissue healing? Support your answer with current research that has been conducted within the last 3 years. What is the difference between physiological and pathological atrophy? Provide at least two clinical examples for each.