Read the required readings/ Articles for Discussion F, answer two of the below questions in an original substantive post (see the syllabus for guidance on what is an original substantive post).
An original substantive posting:
Is limited to 150-200 words long.
Relates to the weekly topics and readings.
Uses the scholarly readings (giving citations) for support of ideas and the discussion to critically assess some area of practice.
It is expected that postings will be written in correct grammar, be well organized and be documented using APA style. References should be cited using APA style.”

Questions
The purpose of the faculty stimulus questions are to promote critical inquiry, reflective thought, and to lay the foundation for a scholarly dialog between members of this class relative to nursing science. Please consider the following questions:
1. Lähdesmäki and Nyholm (2007) envision the healthcare needs for the future to encompass “patients [who] will be more acutely ill and infections more common and serious” (p. 332). Their predictions are in line with the current Center for Disease Control (CDC) statistics on the epidemiology of global healthcare needs. The authors also predict that although the actual healthcare may become more automated, patients will still need human care in 2050.
Discuss ways in which nurses and nursing can preserve the human caring caritative in contemporary nursing practice to assure they remains as active parts of nursing’s role for the future.
2. According to Lähdesmäki and Nyholm (2007), while change in the intensive care (ICU) environments may improve patient care, the changes may also create ethical problems. Identify several ethical issues that are common in the intensive care environments/working with patients in ICUs in contemporary practice and discuss how nurses manage those issues.
Can any of the problem-solving be generalized to the issues, projected by the authors, of isolation from loved ones or the lack of physical human contact?
3. Wikberg (2007) addressed several significant phenomena that are occurring in the social and environmental world that will impact on nursing practice in 2050. According to the author, global warming may create an influx [to certain geographical areas] of environmental refugees, increasing the cultural mix of the society. Wikberg continues by stating the need for nurses “to develop a common ethos for caring that is compatible with all cultures” (p. 334).
In addition to Eriksson’s theory, discuss other nursing theories that can be used as frameworks for nursing practice to develop both the common ethos for caring and supports cultural sensitivity. Do you agree with Wikberg’s prediction? Why or why not?
4. According to Wikberg (2007), “Human suffering on a deep level, such as suffering related to life, cannot be assessed by a machine, no matter how advanced. Nurses will still be the ones to observe human suffering and assess human needs. Nurse robots will never replace human interaction” (p. 334).
Discuss ways in which nurses can position themselves to remain [as the focus] of the human interaction, to never be replaced by a nurse robot.
5. Wikberg, (2007), identified the incidence of depression as a significant contemporary healthcare concern. Depression is on the rise and is expected to continue to increase. People suffering with depression will have an impact on global healthcare in 2050.
Discuss ways nursing can provide theoretical frameworks in our contemporary times to support future nursing practice. What will be nursing’s role (s)?
6. What elements combine to describe the US healthcare system as the best in the world? How does nursing play a part in the present health care environment.

The post The purpose of the faculty stimulus questions are to promote critical inquiry, reflective thought, and to lay the foundation for a scholarly dialog between members of this class relative to nursing science appeared first on essay-paper.
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South American Adventures Unlimited

SA Adventures Unlimited was formed four years ago by Michael and Jill Rodriguez. Michael was a trained geologist, while Jill had a master s degree in Spanish. They were both avid outdoor enthusiasts and fell in love while trekking across the Andes in Chile. Upon graduation they seized upon the idea of starting their own specialized tour business that would focus on organizing and leading high-end adventure trips in South America. Their first trip was a three-week excursion across Ecuador and Peru. The trip was a resounding success, and they became convinced that they could make a livelihood doing something they both enjoyed.

After the first year, Adventures Unlimited began to slowly expand the size and scope of the business. The Rodriguezes strategy was a simple one. They recruited experienced, reliable people who shared their passion for South America and the outdoors. They helped these people organize specific trips and advertised the excursion over the Internet and in travel magazines.

Adventures Unlimited has grown from offering 4 trips a year to having 16 different excursions scheduled, including trips to Central America. They now had an administrative support staff of three people and a relatively stable group of five trip planners/guides whom they hired on a trip-by-trip contract basis. The company enjoyed a high level of repeat business and often used their customers suggestions to organize future trips.

Although the Rodriguezes were pleased with the success of their venture, they were beginning to encounter problems that worried them about the future. A couple of the tours went over budget because of unanticipated costs, which eroded that year s profit. In one case, they had to refund 30 percent of the tour fee because a group was stranded five days in Blanco Puente after missing a train connection. They were also having a hard time maintaining the high level of customer satisfaction to which they were accustomed. Customers were beginning to complain about the quality of the accommodations and the price of the tours. One group, unfortunately, was struck by a bad case of food poisoning. Finally, the Rodriguezes were having a hard time tracking costs across projects and typically did not know how well they did until after their taxes were prepared. This made it difficult to plan future excursions.

The Rodriguezes shared these concerns around the family dinner table. Among the members in attendance was Michael s younger brother, Mario, a student at a nearby university. After dinner, Mario approached Michael and Jill and suggested that they look into what business people called project management. He had been briefly exposed to project management in his Business Operations class and felt that it might apply to their tour business.

Instructions

By of this week, make an original post that responds to the following questions: below

· To what extent does project management apply to Adventures Unlimited?

· What kind of training in project management should the Rodriguezes, the administrative staff, and tour guides receive to improve the operation of Adventures Unlimited? Identify at least two major topics or skill sets that should be addressed in this training.

You will be writing critiqué on article from list below. The articles below have been selected as appropriate for your knowledge level. You are NOT permitted to use your own articles for this assignment, and under NO CIRCUMSTANCES are you permitted use Wikipedia as resources for this paper. All resource that you choose to cite MUST be from peer reviewed journals or of similar quality. If you are determined to have done either for any assignment in this class, you will receive an automatic zero (Ø) on the relevant assignment.

Please select ONE article and write your assignment based on that article

Article Links:
Alibi Believeability – The Impact of Salacious Alibi Activities.pdf

Addressing Sexual and Relationship Violence in the LGBT Community Using a Bystander Framework.pdf

False Confessions – Causes, Consequences, and Implications for Reform.pdf

Predicting Officer Physical Assaults at Domestic Assault Calls.pdf

The emotional male victim – Effects of presentation mode on judged credibility.pdf

The Kitty Genovese Murder and the Social Psychology of Helping.pdf

Violence and imitation.pdf

Posted: A Month AgoDue: 28/04/2018Budget: $10
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Reflect on the research articles you have reviewed to date that relate to your clinical question. Please refer to all the unit resources (e.g., readings, recordings, announcements, etc.) to facilitate this process. With these thoughts in mind, post your thoughts on the following:

In the articles you have reviewed, what statistical tests are being used for data analysis?

Are the statistical tests being used appropriately for the type of data being produced and the question being asked?

Do the authors appropriately indicate implications of the data analysis, or do they overstretch?

In the articles that have I reviewed listed below, I need to know what statistical tests are being used for data analysis?

· A key study for my PICOT project is titled “How Accurate are Self-Reports? An Analysis of Self-Reported Healthcare Utilization and Absence When Compared to Administrative Data” (Koerner & Zhang, 2017). The authors evaluated the data using Pearson’s correlation and multivariate logistic regression models.

· Correlation is a statistical method used to assess a possible linear association between two continuous variables, while Pearson’s correlation coefficient is a test statistics measuring the statistical relationship, or association, between two continuous variables (Mahan, Clark, Anderson, Koller, & Gates, 2017).. Pearson’s correlation coefficient (r) is a measure of the strength of the association between the two variables; it is the best method of measuring the association between variables of interest because it is based on the method of covariance, and covariance is a measure of the joint variability of two random variables (Koerner et al., 2017). If the data is normally distributed, in other words, bell-shaped, and symmetrical about the mean, tests such as the histogram, and normality tests may be used to evaluate if the distribution is normal (McCrum-Gardner, 2008).

· Are the statistical tests being used appropriately for the type of data being produced and the question being asked?

· The majority of studies may be evaluated with the proper evaluation of over 100 statistical tests to choose from. Tests are chosen depending on the type of research questions being asked, the type of data being analyzed, and the number of data sets or groups being evaluated.

· The first question to be asked is what scale of measurement the data will be, nominal, ordinal, or interval. The study in question involves interval data. The second question is the reason for the analysis; as an example, paired groups or independent groups?

· Yes, the statistical tests are appropriate for the type of data being produced, and for the type of questions being asked.

· Do the authors appropriately indicate implications of the data analysis, or do they overstretch?

· Based on our readings and videos, I saw no evidence of data-stretching. For example, data was collected over two calendar years, a lengthy, non-selective inclusion period. A potential confounding factor was that all participants had to have been enrolled in the company health insurance program a minimum of 320 days as a condition of inclusion in the study. Another potential confounding factor was that only hourly employees were included in the two-year study. In addition, pregnant employees were excluded from the study, as these employees are atypical of the general employee population in that their healthcare utilization would be temporarily altered. These factors may have influenced the results, by excluding participants with different reporting habits. After recognizing these potential limitations, their findings mirrored multiple studies previously conducted.

· The authors also noted potential improvements for future studies, including inclusion of a more diverse employee population, and examining why there exists a difference in self-reporting based on participant sex.

References

· Koerner, T. K., & Zhang, Y. (2017). Application of linear mixed-effects models in human neuroscience research: A comparison with pearson correlation in two auditory electrophysiology studies. Brain Sciences, 7(3), page 26. doi:http://dx.doi.org.prx-usa.lirn.net/10.3390/brainsci7030026

· Mahan, K.R., Clark, J.A., Anderson, K.D., Koller, N.J., & Gates, B. J. (2017). Development of a tool to identify problems related to medication adherence in home healthcare patients. Home Healthcare Now, 277-82. doi: 10.1097/nhh.0000000000000539

· McCrum-Gardner, E. (2008). Which is the correct statistical test to use? British Journal of Oral and Maxillofacial Surgery 46 (2008) 38–41

· Short, M., Goetzel, R., Pei, X., Tabrizi, M., Ozminkowski, R., Gibson, T., & … Wilson, M. (2009). How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data. Journal of Occupational & Environmental Medicine, 51(7), 786-796. doi:10.1097/JOM.0b013e3181a86671

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Types of Statistical use

There were six articles retrieved on my PICOT question, (3) were quantitative research, (1) is a mixed method, (2) qualitative research, and (1 )integrative review. The (3) quantitative research were critically appraised and used the following statistical analysis; central standard tendency (mean, median, mode), a probability value to test the significance of results, binomial regression, and binomial distribution, chi-square test, Fisher’s exact test, and measures of standard deviation. Lastly, a study about changing Intensive Care Unit (ICU) culture to reduce CAUTI the research study used statistical process control charts to see the process of improvement in the reduction of catheter-associated infection post-implementation (Maxwell, Murphy and McGettigan, 2018).

Appropriateness of the statistical test

The purpose or hypothesis of the study is in the introduction of each literature. The research question aims to evaluate the effectiveness of the CAUTI bundle in the pediatric intensive care unit and adult intensive care unit. To provide patient safety, the use of an appropriate statistical tool in research is essential. According to McCrum-Gardner (2007), using the right scale of measurement will convey accurate results in research. One research study use sample size is 390 (nominal) children ages from 1 month to 18 years old and admitted in the ICU for 48 hours that needed foley catheter insertion. The exclusions are positive urine culture and less than 48 hours of ICU admission. In addition, the Categorial variable is analyzed using X2 or Fisher exact test. The prevalence rate was calculated using the number of disease within the specified time over the population under risk x 100. The research study shows Foley catheter utilization was calculated by dividing the total number of device days by the total number of patient days (Sönmez Düzkaya, Bozkurt, Uysal, and Yakut,2016). Moreover, the three quantitative research use an appropriate tool and results show that daily CAUTI BUNDLE implementation and changing ICU culture regarding the standard practice showed a significant reduction of catheter-associated urinary tract infection in pediatric ICU and adult ICU.

Conclusion

The implication of the research study indicates that prevention of CAUTI with the use of CAUTI bundle checklist and application of process improvement had a significant impact on the decreasing morbidity, mortality and healthcare cost. Also, the length of study allowed the researchers to see a significant, consistent change in the reduction of CAUTI.

References

Maxwell,M.,Murphy, K., and McGettigan, M. (2018)Changing ICU culture to reduce catheter-associated urinary tract infections. Canadian Journal of Infection Control,33 (1) ,39-43 . Retrieved from https://ipac- canada.org/photos/custom/pdf/Marcia%20Maxwell_Spring2018.pdf

McCrum-Gardner, E. (2007). Which is the correct statistical test to use?British Journal of Oral and Maxiofacial Surgery, 46, 38-41. Retrieved from https://class.esa.edu/bbcswebdav/institution/USA1/201830/MSN/IPE_7050/readings/McCrumGardner_Which_is the_correct_ statistical_test_to_use_pdf

Sönmez Düzkaya, D., Bozkurt, G., Uysal, G., & Yakut, T. (2016). The effects of bundles on catheter-associated urinary tract infections in the pediatric intensive care unit.Clinical Nurse Specialist: The Journal For Advanced Nursing Practice, 30(6),341-346. doi:10.1097/NUR.0000000000000246

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Topic: Best wound care approach for patients with foot ulcers

(Or it can be a different topic, but needs to be approved first)

During this lesson, you will use the PICOT questioning format/formula to develop an answerable research question. All elements are listed below:

• P: Population/disease (age, gender, ethnicity, disorder)
• I: Intervention or variable of interest (exposure to a disease, risk behavior, prognostic factor)
• C: Comparison (a placebo or “business as usual” such as no disease, absence of risk factor, or prognostic factor B)
• O: Outcome (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome)
• T: Time (the time it takes to demonstrate an outcome; e.g., the time it takes for the intervention to achieve an outcome or how long participants are observed)
prepare an evidence-based practice (EBP) presentation on a topic of your choice that is relevant to advanced nursing practice education, leadership, quality improvement, or change

Your presentation should include:
1. Identification of an advanced practice nursing issue or practice problem of concern
2. Design a research question using the PICOT format
3. A brief literature review and findings related to best practices with at least three scholarly resources cited in APA (6th ed.) format
4. Plan, Do, Study, Act Process that could be used
5. Any implications that the investigation might have for nursing practice

Rubric:

The presentation includes an appropriate topic identification related to an advanced practice nursing issue or practice problem of concern. The topic is clearly stated in the introduction, developed and explained well through the literature review, and there is an appropriate conclusion statement.

PICOT Question Design
Population is fully defined and present in the research question. Includes specific interventions, identifies comparisons, and presents appropriate outcomes in a timely manner for the question. Overall, a well-built question using the PICOT method.

Literature Review
Includes a brief overview of the literature in the presentation and includes relevant details.

Plan/Do/Study/Act Process
Presentation includes a description of the study, study design, rationale, and inclusion of sampling information that the student is using.

Implications to Nursing
The significance and applicability to nursing is included and well presented.