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  • Q1:Instructions Answer needs to be in minimum 500 words AI usage or Plagiarism will be penalised Need only typed solutions Referencing and Formatting in APA style Times new roman, 12 size, double spacing/nCNE SERIES Instructions for Continuing Nursing Education Contact Hours appear on page 314. Recruitment Attributes Important to New Nurse Graduates Employed on Adult Medical-Surgical Units Susan Steele-Moses Eileen Creel Ann Carruth W orkforce data project a national shortage of 1 million nurses by 2025, with much of this occurring in med- ical-surgical nursing (U.S. Depart- ment of Health and Human Services, 2013). The aging registered nursing workforce is a major con- tributor (Hayward, Bungay, Wolff, & MacDonald, 2016), with one-third of nurses projected to retire by 2020 (Buerhaus, Auerbach, Staiger, & Muench, 2013). Recruitment and retention of medical-surgical nurses appear critical. As part of a larger study, the qualitative findings only are reported in this article. Literature Review Relevant literature for 2012-2017 was identified through a search of ProQuest, Medline, and CINAHL using the following key words: regis- tered nurse recruitment, nurse recruit- ment, and recruitment attributes. Of 13 identified articles, seven non- research articles were eliminated. Several elements were identified as important attributes for nursing recruitment and are described here. Compensation Although hospital administra- tors may believe money recruits nurses to their facilities, there is lim- ited research to support this posi- tion. In an electronic analysis of recruitment practices in Canada, Mathews and Ryan (2015) found financial incentives, such as salary, sign-on bonuses, and relocation expense reimbursement, were Recruitment of registered nurses to a medical-surgical unit is often challenging. This study addresses attributes nurses consider when making decisions for employment on a medical-surgical unit. viewed cautiously by the nursing workforce. While nurse turnover cost approximately one-half a nurse's salary to replace the position in a prospective quantitative study (N=156), the decision to leave a position rarely was based on salary (North et al., 2013). Thus, pay is not always a motivator. Unit and Shift Preference Unit and shift preference are cited in the literature as reasons nurse graduates select their first nursing positions, with specialty units often preferred (Mathews & Ryan, 2015; Phillips, Kenny, Esterman, & Smith, 2014; Pottinger, 2016). While nurse leaders may assume nurses prefer specialty units and day shift over other options, limited literature supports this belief. Pottinger (2016) conducted a pilot program to acclimate 12 nurse graduates to the intensive care set- ting. While graduates worked rotat- ing shifts with a nurse preceptor to acclimate them to critical care nurs- ing, no one shift was cited as pre- ferred. A National Workforce analy- sis in Australia determined new nurses preferred to work in primary care based on shift consistency (Gordon et al., 2014). There was no consistent support for the percep- tion that nurses make initial employment decisions based on shift preference. Nurse Orientation Limited research has been pub- lished about hospital selection based on the availability of a resi- dency or prolonged orientation. To prepare for succession planning, Jones and co-authors (2017) used the "valuable expert knowledge and wisdom of retiring nurses" (p. 64) to facilitate new nurse orientation in a new graduate residency program. Susan Steele-Moses, DNS, APRN-CNS, is Associate Professor and Dean, School of Health Professions, Franciscan Missionaries of Our Lady University, Baton Rouge, LA. Eileen Creel, DNS, RN, is Associate Professor and Department Head, School of Nursing, Southeastern Louisiana University, Hammond, LA. Ann Carruth, DNS, RN, is Professor and Dean, College of Nursing and Allied Health, Southeastern Louisiana University, Hammond, LA. Note: This study was funded by the Louisiana State Board of Regents (HCWF-OLOLC- RECRUITMENT-FY16). September-October 2018 . Vol. 27/No. 5 MEDSURGNURSING. 310 CNE Recruitment Attributes Important to New Nurse Graduates Employed on Adult Medical-Surgical Units Background Attributes inherent to a nurse's initial employment decision to work on a medical-surgical unit are not understood. Purpose Elucidate the factors new nurse graduates consider when making their first employment decisions. Methods Nurses from five acute care facilities participated. Results from the quan- titative survey, not reported here, were used to construct interview ques- tions to provide a deeper understanding of recruitment attributes. Findings Recruitment attributes inherently important to new nurses included a supportive manager, feeling valued, and work-life balance. While equi- table pay and benefits were important, nurses were more concerned with workload, scheduling, and the hospital's reputation. Limitations and Implications The sample was limited to five acute care facilities located in the South. Findings from this study supported transcendence to a transformational leadership style with a strong emphasis on work/life balance. Further, selecting staff who complement the nurses already in place is critical to creating a positive work relationship. Conclusion Position acceptance may be predicated on nurses' belief the manager cares about them. This pilot project began with 17 nurse graduates. It combined tradi- tional orientation practices with simulation-based education. After the 12-week orientation, ongoing support continued for the first year of employment. New graduate nurse turnover decreased from 6.4% to 2% (n=1). In a secondary analysis of two qualitative data sets (eight focus group interviews [N=67]) and participant responses to open- ended questions from an electronic survey (N=392), Phillips and co- authors (2014) found nurse satisfac- tion resulted when new nurse ori- entation was thorough, sustained, and well organized. These authors also determined initial career place- ment on a specialty unit was beyond nurses' skill set and required prolonged orientation. Hospital Reputation In a slightly older study, positive word-of-mouth employment infor- mation received early in the recruit- ment process positively influenced the employment decision more than any other recruitment process (N=612; r2=0.396; p<0.01) (Van Hoye & Lievens, 2009). In a second- ary analysis by Phillips and associ- ates (2014), qualitative data from eight focus groups were analyzed to identify transitions that impacted new graduate transition. This study identified the importance of a sup- portive institutional environment that fostered mutual respect as well as a fair, equitable patient care assignment. Hayward and co- authors (2016) interviewed 12 med- ical-surgical registered nurses con- cerning factors related to turnover. Using a qualitative inductive ana- lytic approach, authors determined nurse-patient ratio was a main rea- son nurses left their positions. Further, the work relationship with others and lack of leadership sup- port left them ill-equipped to per- form their jobs. These studies were not conduct- ed with medical-surgical nurses, and findings were inconclusive and conflicting. Thus, the purpose of this study was to elucidate the attributes important to new nurse graduates when making the deci- sion to begin their careers on a medical-surgical unit. Sample Selection Of 20 nurses who volunteered to participate in the interviews, 10 scheduled an appointment. Two participants were African-American females, one an African-American male, one an Asian female, and one a White male; the remaining five nurses were White females (age range 23-59). Participants represent- ed five hospitals, worked on a med- ical-surgical unit, and had been nurses for no more than 1 year. Ethics The study was approved by Institutional Review Boards from Franciscan Missionaries of Our Lady University (study number 1527) and Southeastern Louisiana Uni- versity (study number 16-077). Interviews were conducted in a pri- vate conference room away from the nursing units. Written informed consent was obtained by the researcher from each nurse before the interview commenced, and only the investigator knew who participated. Qualitative Framework, Design, and Methods A descriptive qualitative frame- work was used for the second phase of the study, appropriate when no specific qualitative tradition is fol- lowed (Polit & Beck, 2014). Semi- structured interviews guided the data collection phase to allow flexi- bility and clarity during the inter- view process. MEDSURG URSING September-October 2018 . Vol. 27/No. 5 311 CNE Data Collection Lunch was provided and each participant received a $25.00 hono- rarium at the completion of the interview. Interviews were audio- recorded, lasted approximately 1 hour, and were transcribed verba- tim. Anecdotal notes of the researcher's initial thoughts and impressions of the participant's demeanor were written following each interview. Saturation was achieved and no new themes emerged after 10 interviews were completed. Data Analysis Qualitative content analysis was used to analyze the data (Houser, 2015; Polit & Beck, 2014). As the semi-structured interview responses were transcribed, the primary re- searcher compared recorded inter- views with transcripts to ensure accuracy of wording and authentic representation of participants' words and experiences. Subsequently, three co-researchers independently read the transcripts to identify words or sentences that were espe- cially salient. Once identified, these words and sentences were analyzed for patterns and categories were named. Individual interviews were compared to the whole to analyze how each interview fit with the other, and how each interview fit within the whole. Trustworthiness criteria were used to assure the rigor of data analysis (Lincoln & Guba, 1985). Credibility was addressed through careful review for accuracy of partic- ipant voice in verbatim transcrip- tions, completing data analysis tri- angulation with three researchers, and interviewing until data satura- tion was reached. Dependability and confirmability were ensured through a detailed audit trail outlin- ing each researcher's decisions and then consensus decisions about final themes. This audit (memo) kept during data analysis included notes on how themes were chosen, researchers' thoughts on themes, and alternative speculations. Thick, vivid description in participants' words were used to facilitate trans- ferability (Lincoln & Guba, 1985). Results Two main themes emerged from analysis of nurses' interviews: Get on the Purple Bus and Word on the Street. These themes were related to new nurses' impressions of the support provided by facility administrators and other nurses, and reputation of the facility. Theme 1: Get on the Purple Bus This theme referred to being fully present, embracing the work of the facility in a positive manner, and being part of the team (Gordon, 2007). A past nurse administrator at one of the study facilities had coined the phrase "get on the purple bus" to indicate to employees they needed to be com- mitted wholly to the work of the facility, giving the best possible care to patients, and being supportive of each other. Interviewee 9 said the purple bus was a place where people showed "the love of human life and love of patients." If you're on the purple bus, it means you want to be here. You want to be here with a smile on your face. You want to be here to take care of your patients. You want to be here to work with your co-workers. You want to be here as a fami- ly. This main theme included two subthemes: Just Culture and See Me as a Person. Just culture: This is defined as a, ... process where mistakes or errors do not result in auto- matic punishment, but rather a process to uncover the source of the error. Errors that are not deliberate or malicious result in coaching, counsel- ing, and education around the error, ultimately decreasing likelihood of a repeated error. (American Nurses Association, 2010, para 1) This subtheme was manifested through new nurses' stories about being treated in a manner they con- sidered "supportive." They indicat- ed they could ask for and would receive help, or they were offered help before even having to ask; they were allowed to make a mistake, but were not judged harshly for the mistake. Specific examples included comments from interviewee 3: "people ask me and they help me ... I always feel like they help me ... like a sense of teamwork." Interviewee 6 said her peers and nurse manager gave her "the opportunity to learn without feeling as if you're doing something wrong and you're going to be reprimanded for it ... every- one's willing to let you learn." As interviewee 7 expressed, "You're looking for everyone to like, embrace you, and take you in ... knowing someone is there to help you and teamwork ... being patient ... understanding that you are new and ... still learning." Finally, interviewees 9 and 10 indicated they felt supported by their managers. Interviewee 9 said her supervisor was "someone I can go to when I have a problem ... she was my mentor." Interviewee 10 noted, "My first manager ... pulled me into the office weekly to ask how things were going. She made me feel like I can easily open up to her and come to her with my prob- lems." See me as a person. In this sub- theme, new nurses voiced how their supervisors saw them as more than a nurse (employee). They felt seen as persons with needs outside the workplace. New nurses said the supervisors and peers recognized their needs for time for school, fam- ily, and personal needs. Interviewee 1 said, If you have something come up with family, they support you. If you want to go on different ventures, they support you and they let you grow ... when somebody meets you, they know you by name the second time they see you. Interviewee 2 stated, " ... some- one who works with your schedule ... and understands your life." Interviewee 4 said she felt an "instant connection" when she and the supervisor " ... talked about South Florida ... talked about, you know, life in general and had a nice common ground." Interviewee 2 September-October 2018 . Vol. 27/No. MEDSURG JURSING 312 CNE Recruitment Attributes Important to New Nurse Graduates Employed on Adult Medical-Surgical Units also told the researcher she had a medical condition and the willing- ness of supervisors to see her as a person with special physical needs caused her to feel "blessed" to work where she worked. Theme 2: Word on the Street The second main theme related to one reason the new nurses decid- ed to take their first nursing posi- tions and to remain in those posi- tions within 1 year of hire. The new nurses researched the facilities' rep- utation in the community. They all mentioned having asked nurses who worked at the facility or other nursing students and faculty who had clinical experiences at the facil- ity about the work culture/environ- ment. In the original quantitative ques- tionnaire, the primary researcher intended the question to address the hospital's reputation for quality of care as exemplified through measures such as Magnet® designa- tion or Hospital Consumer Assess- ment of Health Care Providers and Systems (HCAHPS) scores. However, the interviewees instead defined the reputation of the facility based on testimonials about how welcoming, nice, and supportive the nurses and other staff at the facility were toward each other. Interviewees 1 and 7 said they followed their instructors' advice about picking a medical-surgical unit as their first position. Faculty for interviewee 1 reportedly told her to, " ... work on a med-surg unit for the first year." The interviewee also said she got "insider information" and "you start to hear things ... you're gonna like working there, they're great, or they're not" when she went to different facilities as a student nurse. Interviewees 5 and 10 described experiences as student nurses that influenced their first position decisions. According to interviewee 5, " ... they [the nurses on the unit] weren't very nice to me at all" and ... they were actually nicer to me than some of the girls. They [the nurses on the unit] acted like we were in the way" and "the nurses were bothered." Interviewee 10 said, "One of the first things I looked at was reputa- tion." She compared two experi- ences at two different facilities where she had completed clinical experiences, saying about one facil- ity, " ... they were catty toward us. Their attitude toward us was nega- tive." Concerning the facility she chose for her first position, she received feedback from " ... several people who work there and they were ... upbeat and very positive about the place." Interviewee 4 also said a nurse she knew had worked as a nursing assistant at the hospital she choose for her first job: " ... he said positive things about the hos- pital as a whole, about the people, the nurses as a whole." Interviewee 3 said a hospital's Magnet designation " ... didn't cross my mind," but she noted, "[I've] ... always heard good things about [the facility she choose for her first job]." Interviewee 9 commented, "Well, people hear things ... we hear horror stories [about a named hospital] ... horror stories ... I would never even apply! They call it hell." Many participants also men- tioned nurse-patient staffing ratios as a criterion they related to the hospital's reputation. The new nurs- es would hear from nurses who worked at a given facility or see the staffing ratios when they were stu- dents in the facility. Both overarching themes related to the attitude, work culture and environment, and treatment of new nurses by their supervisors and peers. However, a broader picture emerged of courtesy, respect, civili- ty, and a just culture supported by the facility administrators and all employees as integral factors to their decision regarding the first nursing position. New nurses want- ed to be supported by work col- leagues in a just culture that allowed them to learn and grow in a non-punitive, helping environ- ment. A factor that did not emerge as a theme but often is considered a recruitment tool was financial incentives (e.g., salary, hiring bonuses, tuition reimbursement, medical benefits). Participants indi- cated salary and benefits needed to be competitive with other facilities, but none of them identified this as the primary factor when choosing their first positions. They assumed salary and benefits would be similar and fair across facilities. Interviewee 8 said, "I can't say my decision was financially based. Pretty much throughout Louisiana the pay is the same. Tuition reimbursement's pret- ty much the same ... so I can't say that's why [facility name] was my first choice." Interviewee 6 summa- rized, " ... is it really worth a couple extra dollars to not feel comfort- able?" And she said the sign-on bonus " ... locks you into a position for a year ... it's too long of a time if you dislike the place." Interviewee 3 explained her feelings towards a sign-on bonus this way, "I just didn't want to be committed for 2 years, because I'm just not sure where life was going to take me." Interviewee 4 concluded, "I didn't want to be tied down. I didn't want to sign any kind of contract." Discussion According to the interviewees in this study, of greatest importance to new graduates is a manager who sees them for what they bring to the organization and how they fit with the team. While equitable pay and benefits were viewed as important, nurses were more concerned with their anticipated workload, flexibil- ity of their schedules, and reputa- tion of the hospital, specifically their unit. Participants overwhelm- ingly chose a hospital based on what others told them or they had experienced personally. What nurs- es say about a hospital or unit, at work and in the community, thus is a stronger recruitment aid than any paid advertisement. Nurses seem to want to know that the facility lead- ers, and more importantly the man- ager, care about them. Nurses want to feel valued and accepted in the work environment. Despite the stressors faced by the majority of new graduate nurses, graduate transition can be im- proved by supportive institutional practices that foster collegial respect (Chudyk, Klein, Mummery, & Keba, MEDSURG JRSING September-October 2018 . Vol. 27/No. 5 313 CNE Instructions For Continuing Nursing Education Contact Hours Recruitment Attributes Important to New Nurse Graduates Employed on Adult Medical-Surgical Units Deadline for Submission: October 31, 2020 MSN J1815 To Obtain CNE Contact Hours 1. For those wishing to obtain CNE contact hours, you must read the article and complete the evaluation through the AMSN Online Library. Complete your evaluation online and print your CNE certificate immediately, or later. Simply go to www.amsn.org/library 2. Evaluations must be completed online by October 31, 2020. Upon completion of the evaluation, a certificate for 1.1 contact hour(s) may be printed. Learning Outcome After completing this learning activity, the learner will be able to discuss recruitment attributes nurses consider when making decisions for employment on a medical- surgical unit. Learning Engagement Activity · Identify the most important factors to new nurse graduates when making first employment decisions. · What implications does this study have related to manager leadership style? Fees - AMSN Member: FREE Regular: $20 The author(s), editor, editorial board, con- tent reviewers, and education director reported no actual or potential conflict of interest in relation to this continuing nursing education article. This educational activity is jointly provided by Anthony J. Jannetti, Inc. and the Academy of Medical-Surgical Nurses (AMSN). Anthony J. Jannetti, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Com- mission on Accreditation. Anthony J. Jannetti, Inc. is a provider approved by the California Board of Registered Nursing, provider number CEP 5387. Licensees in the state of California must retain this certificate for four years after the CNE activity is completed. This article was reviewed and formatted for contact hour credit by Rosemarie Marmion, MSN, RN-BC, NE-BC, AMSN Education Director. 2016). Hospital leaders may consid- er a transformational leadership model with a strong emphasis on how each unit's manager cares about staff well-being, especially work/life balance. Nursing Implications An inherently important factor affecting recruitment for medical- surgical units is the leadership style of the manager. When managers work collaboratively with staff in a transformational leadership style, they are more successful in recruit- ing new nurse graduates. According to Lyons and Kuron (2014), young- er nurses (ages 20-29) are interested specifically in work/life balance and see work as a means to an end, not their sole existence. These authors suggested managing a blended group of older, more experienced nurses and younger new graduates can be a challenge unless the strength of each is leveraged. The younger workforce seeks ever- changing tasks within their work environment and become easily bored without new challenges; however, work/life balance is their priority. Older, more experienced nurses may create tension between the groups because they are extremely hardworking and may criticize the younger generations for a lack of work ethic and commit- ment to the organization. To be suc- cessful, leaders must leverage the gifts and talents of all staff, identify- ing their motives and empowering them to succeed. Nurse managers also must remember they are always visible. What current and future nurses say about the nurse manager and the unit is critical to future decision making of nurse graduates. Conclusion Recruitment of qualified nurse graduates to fill open medical-surgi- cal nursing positions is essential. Nurses want to work in a culture where it is safe to make mistakes and they are treated as individuals (Koloroutis & Abelson, 2017). Nurse graduates are attracted to institu- tions and nursing units with sup- portive managers and good reputa- tions, where nurses speak favorably of the organization and the unit and nurses are genuinely happy. Impressions portrayed to nurse graduates by current employees may be the greatest recruitment impact factor. MSN REFERENCES American Nurses Association. (2010). Position statement: Just culture. Retrieved from https://www.nursing- world.org/practice-policy/nursing-excel lence/official-position-statements/id/just- culture/ Buerhaus, P., Auerbach, D., Staiger, D., & Muench, U. (2013). Projections of the long-term growth of the registered nurse workforce: A regional analysis. Nursing Economic$, 31(1), 13-17. Chudyk, R., Klein, K., Mummery, R., & Keba, C. (2016). The effect of a preceptor's atti- tude on a new graduate's transition into the intensive care unit. Canadian Journal of Critical Care Nursing, 27(2), 37-37. continued on page 328 September-October 2018 . Vol. 27/No. 5 MEDSURGNURSING. 314 New Nurse Graduates continued from page 314 Gordon, C.J., Aggar, C., Williams, A.M., Walker, L., Willcock, S.M., & Bloomfield, J. (2014). A transition program to primary health care for new graduate nurses: A strategy towards building a sustainable primary health care nurse workforce? BMC Nursing, 13(1), 1-13. doi:10. 1186/s12912-014-0034-x Gordon, J. (2007). The energy bus: 10 rules to fuel your life, work, and team with posi- tive energy. Hoboken, NJ: John Wiley and Sons. Hayward, D., Bungay, V., Wolff, A.C., & MacDonald, V. (2016). A qualitative study of experienced nurses' voluntary turnover: Learning from their perspectives. Journal of Clinical Nursing, 25(9/10), 1336-1345. doi:10.1111/jocn.13210 Houser, J. (2015). Nursing research: Reading, using, and creating evidence (3rd ed.). Burlington, MA: Jones & Bartlett Learning. Jones, S., Deckers, C.M., Strand, D., Bissmeyer, H., Bowman, W.J.W., & Mathe, D.G. (2017). Succession plan- ning: Creating a case for hiring new graduates. Nursing Economic$, 35(2), 64-69, 87. Koloroutis, M., & Abelson, D. (2017). Advancing relationship based cultures. Mineapolis, MN: Creative Healthcare Management. Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage. Lyons, S., & Kuron, L. (2014). Generational differences in the workplace: A review of the evidence and directions for future research. Journal of Organizational Behavior, 35, 139-157. Mathews, M., & Ryan, D. (2015). Financial recruitment incentive programs for nurs- ing personnel in Canada. Nursing Leadership, 28(1), 41-52. North, N., Leung, W., Ashton, T., Rasmussen, E., Hughes, F., & Finlayson, M. (2013). Nurse turnover in New Zealand: Costs and relationships with staffing practises and patient outcomes. Journal of Nursing Management, 21(3), 419-428. doi:10.1111/j.1365-2834.2012.01371.x Phillips, C., Kenny, A., Esterman, A., & Smith, C. (2014). A secondary data analysis examining the needs of graduate nurses in their transition to a new role. Nurse Education in Practice, 14(2), 107-111. doi:10.1016/j.nepr.2013.07.007 Polit, D.F., & Beck, C.T. (2014). Essentials of nursing research: Appraising evidence for nursing practice (8th ed.). Phila- delphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. Pottinger, L. (2016). Critical care transition pro- gram for newly graduated nurses. Canadian Journal of Cardiovascular Nursing, 26(3), 5-5. U.S. Department of Health and Human Services. (2013). The U.S. nursing work- force: Trends in supply and education. Retrieved from https://bhw.hrsa.gov/ sites/default/files/bhw/nchwa/projec tions/nursingworkforcetrendsoct2013. pdf Van Hoye, G., & Lievens, F. (2009). Tapping the grapevine: A closer look at word-of- mouth as a recruitment source. Journal of Applied Psychology, 94(2), 341-352. September-October 2018 . Vol. 27/No. 5 MEDSURG JURSING 328See Answer
  • Q2: Important Note: I'm a doctorate scholar and I need help on writing my research proposal assignment, the title of my research is Capacity Building: Examining the role of leadership training and mentoring in the experience of the nurse educator to improve patient experience. Research method will be Quantitative so that you need to find a reliable validated Quantitative tool that I can use. In addition, a PPT of 10 slides of research proposal with speaker notes on each slide and in text citations and reference. The WD is the assignment details And the rest is some study materials was shared with me for reference if needed. 3000 words plus or minus 5% as detailed in the assignment 1100 for introduction, 1100 for Literature review, and 500 for the methodology. Then PPT is the second task which consists of 10 slides with speakers notes on each slide HARVARD REFERENCING STYLE. And it must be written in the UK English language With attachment of similarities and plagiarism reportSee Answer
  • Q3: Assignment for the AZBN observation. Orientation Video for AZBN Paper ROLE DEVELOPMENT-1.doc Download ROLE DEVELOPMENT-1.doc ROLE DEVELOPMENT Students will submit a 4-5 page paper (APA format) summarizing the following: Cover page, abstract and reference pages do not count in the 4-5 pages of text discussing the assigned topics and Arizona State board of Nursing The 2 topics I would like to address are: Diverting controlled substances from the workplace Breaching nurse-patient confidentiality Website: http://www.azbn.gov/ Links to an external site. You may attend AZBN sessions in person or you may review meeting minutes, notes and disciplinary actions taken against nursing licenses or institutions and regulatory events. Did you know that actions taken against and nursing license or institution is public record and accessible over the internet? If you cannot attend a AZBN meeting in person, you will need to review the session notes online. Session notes links are listed below. You may also watch previous sessions of AZBN on youtube.com. I then suggest that you write down a liscen number with action taken against it and then look up the notes that AZBN has placed on online about the Nurse and actions taken against the license. ● ● https://www.azbn.gov/board/board-meetings/Links to an external site. https://www.azbn.gov/services/license-verification Links to an external site. https://www.azbn.gov/laws-rules/nurse-practice-act/Links to an external site. https://www.azbn.gov/education/student-information- nursing/Links to an external site. This needs to be included in the paper 1. Integrate the information that you gathered from this meeting to the standards related to the RN scope of practice outlined by the AZ State of Board Nursing. 2. Discuss at least 2 examples of unprofessional conduct, due process, and the disciplinary actions that the AZ State Board of Nursing may impose to a RN who is found guilty of committing unprofessional conduct. 3. Summarize the information from the board meeting and address the following items: ● ● ● ● ● ● ● ● ● Brief description or background of the organization/ association What is the purpose of the meeting? Is this a regularly scheduled meeting or is it an emergency, weekly, monthly meeting? Is it a public open meeting - how did you learn about the meeting? Or members only - how were you able to attend the meeting (by invitation only, etc)? Who are in attendance? Identify the roles of the attendees – officers, guest speaker, etc? Do not mention specific names. How is the meeting conducted? Formal or informal? Any specific method (information only, informational with open discussion, teleconference, etc)? Any rules of conduct followed? Robert's rule? How is the individual item in the agenda presented? How is each item discussed? How much time is allotted for discussion of each item? Any action or recommendation to specific item? How do the members or the attendees of the meeting resolve any issues or concerns? If you were an observer to the meeting, how is your attendance addressed? Are you asked to make comments at anytime? How will you describe the overall meeting? Discuss your learning experience from this meeting./nSee Answer
  • Q4:STEP 1: The members of the group will collaboratively complete the following: 2/2/24 The Clinical Question & Article Search Reference Form (see attached) • To complete The Clinical Question & Article Search Reference Form: the members of the group must work together to: Identify the clinical question. Develop the clinical question into PICOT format. Complete a literature search in relation to the clinical question. (Utilize the resources in the library: the librarians will be helpful in completing a literature search for the focused question). 1. Articles must be from a nursing journal. 2. Articles need to be less than 7 years old. 3. Articles need to be a research or evidence-based practice study. STEP 2: Submit critique of article (15%) 2/23/24 After reading the article, fill out the Article Critique. (attached) Upload the Critique and the article to the Assignment area of Brightspace. 3/7/24 & 3/14/24 STEP 3: Group Presentation/Discussion (15%) Each student will present a 3-5-minute summary of their article and be prepared to discuss the group topic in a Virtual Conference. • Professor Kronenberger will provide information for the conference date and time. • Provide a one slide per student PowerPoint about your findings./n Received: 5 October 2020 Revised: 17 February 2021 Accepted: 22 February 2021 DOI: 10.1111/nhs.12825 REVIEW ARTICLE Shift-to-shift nursing handover interventions associated with improved inpatient outcomes-Falls, pressure injuries and medication administration errors: An integrative review Adriana Hada PhD candidate, MN, RN¹ | Fiona Coyer PhD, MScNsg, RN² ¹Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia 2Joint appointment with School of Nursing, Queensland University of Technology and Royal Brisbane and Women's Hospital, Metro North Hospital Health Service, Brisbane, Queensland, Australia Correspondence Adriana Hada, Division of Medicine, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD, 4102, Australia. Email: adriana.hada@health.qld.gov.au Nursing & Health Sciences WILEY Nurs Health Sci. 2021;23:337-351. Abstract The aim of this integrative review was to identify which nursing handover interven- tions were associated with improved patient outcomes, specifically patients' falls, pressure injuries and medication administration errors, in the hospital setting. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used to guide the review. A systematic search of seven electronic databases was con- ducted, and retrieved articles were assessed by two independent reviewers. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Eight studies met the inclusion criteria. The findings of this review indicate that improvements in handover communication had a clinically important positive effect on patient outcomes. Across the studies, reductions in falls varied from 9.3 to 80%, pressure injuries from 45 to 75%, and medication errors from 11.1 to greater than 50%. This review highlights that the implementation of bedside nursing handover and the adoption of standardized handover tools to improve nursing handover com- munication reduce patient adverse events, specifically falls, pressure injuries, and medication errors. These findings should be considered by clinicians to inform their clinical handover practice. 1 | INTRODUCTION Effective communication during the shift-to-shift nursing handover has been the focus of international research for many years, as the accuracy of information transferred can directly impact patient safety (Halm, 2013; Wainwright & Wright, 2016). Organizations such as the World Health Organization (WHO) (2006) and the Australian Commission for Safety and Quality in Health Care (ACSQHC) (2010) have identified communication during clinical handover as a priority. Australia is leading international initia- tives to improve clinical handover, having been designated as the lead country to develop and implement standardized solutions as part of the WHO (2006) Patient Safety Alliance "High Fives" initiative. This KEYWORDS medication administration errors, medication errors, nursing shift-to-shift handover, patient adverse events, patient falls, pressure injuries initiative focuses on supporting cross-national learning among seven countries, using evidence-based protocols within five key patient safety areas, including the prevention of handover errors. During the past decade, several definitions of the clinical hand- over have been identified, each focusing on the main functions and purpose of this safety aspect of patient care (Jeffcott et al., 2009). A commonly cited function of the clinical handover refers to the "trans- fer of professional responsibility and accountability for some or all aspects of care for a patient, or groups of patients, to another person or professional group on a temporary or permanent basis” (British Medical Association, National Patient Safety Agency, NHS Modernisa- tion Agency, 2005, p. 7). Furthermore, ACSQHC emphasizes that the transfer of responsibility and accountability for patient care includes wileyonlinelibrary.com/journal/nhs © 2021 John Wiley & Sons Australia, Ltd. 337 338 WILEY- Nursing & Health Sciences structured communication tools and the opportunity for both the clini- cians and patients to request, check, and confirm understanding of the information discussed (ACSQHC, 2017). Communication failures during the handover have been associated with poor patient outcomes includ- ing inaccurate clinical assessment and diagnosis, delays in diagnosis, delays in ordering tests, medication errors, inconsistent or incorrect results interpretation, duplication of tests, increased rates of in-hospital complications, increased length of hospital stay, and decreased patient and staff satisfaction. In addition, it has been identified that ineffective handover communication was one of the main root causes of greater than 60% of sentinel or catastrophic patient events (The Joint Commission, 2008). Therefore, it is essential that effective handover communication is in place to ensure clear sharing of patient information. The literature describes high variability in handover communica- tion. This variability is related to the situation on which the handover occurs (shift change, patient transfer, admission, or discharge), the method (face to face, by phone, recorded, using electronic handover tools), the place of handover (patient bedside, nurses station), and those involved in the handover process (nursing, medical, multi- disciplinary, patients and their families or carers). Various recommen- dations are provided in the literature regarding the content and processes of effective handover. The WHO (2007) recommends limit- ing communication exchanges to only necessary information in the handover process. Incorporating communication techniques such as the Situation, Background, Assessment, Recommendations (SBAR) has been suggested to provide a standard communication framework for patient care handovers (WHO, 2007). Furthermore, the ACSQHC (2010) developed the "Guide to Clinical Handover Improvement" to assist with the introduction of a standardized handover approach using a focused change management framework. This guide is based on research conducted on medical and nursing shift-to-shift hand- overs within acute care hospital settings and is intended for use by healthcare teams to achieve the goal of clinical handover improve- ment (ACSQHC, 2010). Consequently, during the past decade, research has focused on developing evidence-based solutions for improving clinical handover through improved and standardized handover practices (Bukoh & Siah, 2020). Interventions such as the implementation of bedside handover and adoption of standardized handover tools (SBAR, ISBAR) have demonstrated positive outcomes. These outcomes were reported as increased patient satisfaction with the newly adopted handover style (Forde et al., 2020; Hada et al., 2018; Sand-Jecklin & Sherman, 2014), increased nurse satisfac- tion (Athwal et al., 2009; Jukkala et al., 2012; Thomas & Donohue- Porter, 2012), decreased nursing workload (Bradley & Mott, 2012; Chung et al., 2011; Jukkala et al., 2012) and increased patient safety outcomes such as reduction in patient adverse events and complica- tions (Bradley & Mott, 2012; Chaboyer et al., 2010; Hada et al., 2018). A Cochrane systematic review conducted by Smeulers et al. (2014) explored the effectiveness of interventions designed to improve hospital nursing handover, specifically to identify interven- tions associated with improved patient outcomes (medication errors, complications, sentinel events or mortality) or improved process of care outcomes (information provided, compliance with the plan of HADA AND COYER care, timely delivery of care, decrease in information omissions). This review was limited to randomized controlled trials (RCT) and found no eligible studies; therefore, Smeulers et al. (2014) identified there was no evidence available to support conclusions about the effectiveness of nursing handover interventions for ensuring continuity of information exchanges of hospitalized patients (Smeulers et al., 2014). Furthermore, Mardis et al. (2017) conducted a systematic review of studies published January 2008 to May 2015 and focusing on shift-to-shift handover inter- ventions associated with improved patient outcomes. The patient out- comes included inpatient falls, reportable events, length of stay, mortality, code calls, medication errors, medical errors, procedural com- plications, pressure ulcers, weekend discharges, and nosocomial infec- tions. The findings of this review showed that while most studies demonstrated improvements in various patient outcomes, because of the heterogeneity of methods, limited number of studies, and inconsis- tent findings, there were no firm conclusions about specific interventions and associated outcomes (Mardis et al., 2017). Similarly, an integrative review of the different nursing handover models and processes available conducted by Bakon et al. (2017) con- cluded that while a structured handover can enhance patient safety through error prevention, there is no strong evidence that any model dis- plays superior efficacy (Bakon et al., 2017). Furthermore, Bukoh and Siah (2020) found no statistically significant results in their systematic review of literature published up to January 1, 2019, exploring the effec- tiveness of structured handovers in improving inpatient outcomes. How- ever, Bukoh and Siah (2020) included only RCTs and quasi-experimental studies in their review. This integrative review has adopted a broader approach to include both experimental and nonexperimental studies. Fur- thermore, patient outcomes reported by Bukoh and Siah (2020) included general patient complications, nursing-related medication errors, and gen- eral adverse events, whereas this current review has explored handover interventions specifically associated with reductions in the incidence of inpatient falls, pressure injuries, and medication administration errors. It is evident that the focus on interventions aimed to reduce the risk of miscommunication or omission of essential information during the clinical handover has increased. However, it has been highlighted that strong evidence from high-quality studies to determine the effectiveness of interventions designed to improve the nursing handover communica- tion is still required (Bakon et al., 2017; Bressan et al., 2019). Given the ongoing imperative to improve patient safety through communication in the handover process (Holly & Poletick, 2013), it is important to understand the effectiveness of interventions aimed at improving nursing handovers. Implementing practice changes for which the evidence is of poor quality poses the risk of wasting valu- able resources and the clinicians could be reluctant to implement other initiatives (Bressan et al., 2019). 2 | AIMS The aim of this review was to determine the nursing interventions designed to improve shift-to-shift nursing handover communication and specifically to identify which interventions were associated with HADA AND COYER improved patient safety outcomes (reduction in the incidence of falls, pressure injuries, and medication administration errors) in the adult acute hospital setting. 3 | METHODS An integrative review approach was used to allow the inclusion of diverse methodologies, including experimental and nonexperimental studies, which has the potential to enhance the application of findings from diverse data sources to clinical practice and evidence-based practice nursing initiatives (Whittemore & Knafl, 2005). The protocol is registered on the International Prospective Regis- ter of Systematic Reviews (PROSPERO ID: CRD42019147261). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement (Moher et al., 2009), and the Cochrane Hand- book for Systematic Reviews of Interventions (Higgins & Green, 2008) were used to guide the review process. 3.1 | Review question For acute care in-hospital adult patients what interventions designed to improve shift-to-shift nursing handover communication when com- pared to standard practice are associated with improved inpatient outcomes (decrease in falls, pressure injuries, and medication errors)? 3.2 | Search methods An electronic search was conducted by AH in seven databases: Cumu- lative Index of Nursing and Allied Health Literature (CINAHL); Cochrane Library (including Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews); Dynamed; MEDLINE; PubMed; ProQuest; and The Joanna Briggs Institute for Evidence Based Nursing and Midwifery. Searches were restricted to articles published in English between January 2007 (following the release of the WHO "High Fives" initiative in December 2006) and July 2020. Single search terms and combinations of terms were used and joined by Boolean connectors and medical subject heading (MeSH) terms: adverse events, continuity of patient care, handover, handoff, handover communication, intervention, improvement, medi- cation errors, nursing, patient falls, patient outcome, pressure injuries, quality initiative, quality of care, shift report, and transfer of care. Boolean operators included "and," "or," and "within." An example of search strategy in PubMed is presented in Appendix S1. 3.3 | Eligibility criteria and study selection The Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) diagram (Moher et al., 2009) is presented to show the study selection process (Figure 1). Nursing & Health Sciences -WILEY 339 Studies that met the following criteria were included: Studies: Prospective or retrospective quantitative, qualitative, and mixed-methods studies published in English between January 1, 2007, and July 31, 2020 Interventions: Any nursing intervention designed to improve nurs- ing handover compared with a previous or existing nursing handover practice or an alternative intervention Outcomes: Objectively measured quantitative and/or qualitative data reporting on inpatient outcomes (falls, pressure injuries, and medication errors) Studies conducted in emergency departments, intensive care units, operating theaters, perioperative areas such as postanesthesia care units, mental health units, and outpatient and ambulatory depart- ments were excluded as different formats of nursing handovers in these settings might not be consistent with those in acute inpatient wards. Studies conducted in subacute, rehabilitation, and oncology inpatient units were included. Retrieved articles were screened to remove duplicates and were assessed independently by two independent reviewers (AH and FC) by title and abstract against the inclusion criteria. Consensus for inclu- sion was achieved through discussion. Then, the same two reviewers independently screened the full-text articles that met the inclusion criteria. 3.4 | Methodological quality assessment The Mixed Methods Appraisal Tool (MMAT), Version 2018, was used to rate the methodological quality of all eligible studies. This tool is designed to appraise the methodological quality of differ- ent categories of studies: qualitative research, randomized con- trolled trials, nonrandomized studies, quantitative descriptive studies, and mixed-methods studies (Hong et al., 2018). Further- more, the MMAT is based on a literature review of systematic mixed study reviews (Pluye, 2013), has recognized content valid- ity and has been pilot-tested across all methodologies (Pace et al., 2012). After responding to two screening questions, each included study was rated in the appropriate category of criteria as either "yes," "no," or "cannot tell" (Table 1). While the 2018 MMAT version does not include a scoring system, it pro- vides a detailed presentation of the criterion for each of the rat- ings to inform the quality of included studies (Stretton et al., 2018). The two reviewers (AH and FC) independently rated studies, with a third person (LJ) consulted when consensus on assessment scores could not be reached. 3.5 | Data extraction The following data were extracted from eligible studies using a stan- dardized data collection form constructed with reference to Cochrane guidance (Table 2): author (year, country), design, sample, cohort, intervention, measures, main findings, and limitations. 340 WILEY- Nursing & Health Sciences Identification Screening Eligibility Included Records identified through database searching 3.6 | Data analysis (n = 435): CINAHL (n = 134) Cochrane Library (n = 1), Dynamed (n = 85), Medline (n = 67) PubMed (n= 33), ProQuest (n = 43), JBI (n = 72) Total records identified (n = 452) Records after duplicates removed (n = 186) Quantitative (n = 5) Records screened (n = 186) Additional records identified through other sources (n = 17) Full-text articles assessed for eligibility (n=29) Studies included (n = 8) FIGURE 1 Flow diagram of study searches and records (PRISMA, 2009) Descriptive and summary statistics (means, standard deviations) were used to analyze the quantitative data. There was substantial heteroge- neity regarding the interventions and outcome measures in the included studies; thus, the initial intention of pooling the quantitative study results was not a valid approach (Field & Gillett, 2010). The find- ings are therefore presented as a narrative summary (Popay Records excluded (n = 157) Full-text articles excluded, (n=21) reasons: no design or method stated, no clear results reported, Mixed methods (n = 3) HADA AND COYER et al., 2006). The three outcome measures-falls, pressure injuries, and medication errors-provided the framework for analysis of the rela- tionships within and between studies to guide an overall assessment of the robustness of the evidence. Furthermore, a qualitative thematic analysis of pooled data to assess emergent themes was not performed as there were no qualitative data in the included studies related to nursing handover interventions associated with improvements in falls, pressure injuries, and medication errors. TABLE 1 Mixed methods appraisal tool First author Year Screening questions 1. QUALITATIVE STUDIES 2. RANDOMIZED CONTROLLED TRIALS 3. NON-RANDOMIZED STUDIES 4.QUANTITATIVE DESCRIPTIVE STUDIES S1. Are there clear research questions? S2. Do the collected data allow to address the research questions? 1.1. Is the qualitative approach appropriate to answer the research question? 1.2. Are the qualitative data collection methods adequate to address the research question? 1.3. Are the findings adequately derived from the data? 1.4. Is the interpretation of results sufficiently substantiated by data? 1.5. Is there coherence between qualitative data sources, collection, analysis and interpretation? 2.1. Is randomization appropriately performed? 2.2. Are the groups comparable at baseline? 2.3. Are there complete outcome data? 2.4. Are outcome assessors blinded to the intervention provided? 2.5 Did the participants adhere to the assigned intervention? 3.1. Are the participants representative of the target population? 3.2. Are measurements appropriate regarding both the outcome and intervention (or exposure)? 3.3. Are there complete outcome data? 3.4. Are the confounders accounted for in the design and analysis? 3.5. During the study period, is the intervention administered (or exposure occurred) as intended? 4.1. Is the sampling strategy relevant to address the research question? 4.2. Is the sample representative of the target population? 4.3. Are the measurements appropriate? 4.4. Is the risk of nonresponse bias low? 4.5. Is the statistical analysis appropriate to answer the research question? Athwal 2009 No Cannot tell Bradley Burston Chaboyer 2012 2015 Yes Yes Yes Yes Yes Yes 2010 Yes Yes Yes Yes Yes Yes Cannot tell Yes T Yes Yes Sand- Jecklin 2014 Yes Yes Yes Yes Yes Yes Yes Sand- Jenklin 2013 Yes Yes Cannot tell Yes Yes Cannot tell Cannot tell Johnson 2016 Yes Yes Yes Yes Yes No Yes Hada 2018 Yes Yes Yes Yes Yes Yes Yes (Continues) HADA AND COYER Nursing & Health Sciences –WILEY 341See Answer
  • Q5:Unit VI: Ethical and Legal Issues related to Social Justice and Advocacy CO 8: Engage in ethical reasoning and actions to provide leadership in promoting advocacy and social justice. Readings: PLEASE DO THE ASIGNMENT ONLY ON THE ARTICLES PROVIDED AND BY WATCHING THE VIDEO ON THE WEBSITE. 1--Tobin-Tyler, E. and Teitelbaum, J. (2019). Essentials of Health Justice, A primer. Chapter 5, pp. 106-111 only. 2 Dr. Cheryl Holder. Ted med talk: The link between climate change, health and poverty. https://www.youtube.com/watch?v=jQTykJbN8yl (copy and paste link into your browser) 3- Dressel, A., Bell-Calvin, J., Lee, E., Hermanns, L., Anderko, L., Swaney, V., Steinberg, J, and Hawkins, M. (2021). Sustaining a Nurse-led community partnership to promote environmental justice. Public Health Nursing,38: 136-140. https://doi.org/10.1111/phn.12820 4- ANHE (envirn.org) (This is the website for the Alliance of Nurses for a Healthy Environment) Discussion Board Questions: 1. Choose one of the legal protections that relate to the social determinants of health, as presented in Chapter 5 (pp. 106-113) and explain its provisions and eligibility. How does this protection foster social justice for everyone? Discuss how you as a nurse can apply knowledge of this protection to improve care. 2. What is the new epidemic identified in the Ted Med talk by Dr. Cheryl Holder? Describe how this epidemic affects patients. What are the eight effects of climate change? How can nurses work to address this inequity? Discuss the ethical issues raised by her stories about her patients. 3. What is environmental justice, as defined in the article by Dressel et al., (2020)? What is environmental racism? Discuss the formation of the Westlawn Partnership for a Healthier Environment, and what activities the coalition was able to accomplish in the community. Is this a model that could work in other communities? Would you be comfortable advocating for a partnership similar to this in your community? Why or why not? 4. Go to the website for the Alliance of Nurses for a Healthy Environment. What are some areas of action identified on the website? Identify an area of interest for future advocacy actions, and discuss why this area is of interest to you.See Answer
  • Q6: 10:32 < To Do Assignment Details Transforming Nursing & HC-Spring 2024 <<Back to Module at a Glance The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies In the Discussion for this module, you considered the interaction of nurse informaticists with other specialists to ensure successful care. How is that success determined? Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is measured. Measuring patient outcomes results in the generation of data that can be used to improve results. Nursing informatics can have a significant part in this process and can help to improve outcomes by improving processes, identifying at-risk patients, and enhancing efficiency. Resources ◄ Previous Submit Assignment Next ▸ 1 l000 000 Dashboard Calendar To Do Notifications Inbox To Prepare: • Review the concepts of technology application as presented in the Resources. • Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies. The Assignment: (4-5 pages not including the title and reference page) In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient- care efficiency. Your project proposal should include the following: • Describe the project you propose. • Identify the stakeholders impacted by this project. Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide . examples. • Identify the technologies required to implement this project and explain why. Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team. • Use APA format and include a title page and reference page. • Use the Safe Assign Drafts to check your match percentage before submitting your work. • Use APA format and include a title page and reference page. • Use the Safe Assign Drafts to check your match percentage before submitting your work.See Answer
  • Q7: ASSIGNMENT INSTRUCTIONS TOPIC: Nurse-to-patient ratio legislation Overview As you are learning in ENG 190, the research process is an important part of writing a persuasive essay. In this assignment, you will work on creating a collection of sources. This is the first part of the project that you will submit in Module Seven. A crucial part of the research process is identifying credible and relevant sources that support your topic and argument. Your sources should support your topic and argument, identify counterarguments, and represent diverse perspectives. Directions In this assignment, you will compile your research by providing three sources that support your topic. You will also provide your revised research question. You may refer to the Module Three Project Draft exemplars located in the Supporting Materials section for an example of how to complete this assignment. Please note that there are two versions of this exemplar: one is specific to MLA format, and one is specific to APA format. Specifically, you must address the following: • • • • . State the purpose of your research. Consider the purpose of your research in relation to your topic. State your research question. State your revised research question. Based on your research, what is your potential answer to your question? Considering the potential answer to your research question now will help you write a thesis statement for your persuasive essay in a future assignment. The thesis statement will be an essential part of your essay. Describe the impact of using biased sources to support your topic. How does the presence of bias in your sources impact your argument? Describe how diverse perspectives from sources support your position. Consider the following: Are there multiple voices? How do these diverse perspectives from your research support your topic? List relevant sources to support your persuasive essay. Include at least one source from the Project Resources Document and at least two sources that you find through your own research using the Shapiro Library. Include an APA or MLA citation for each source. Remember, you will need to use the format you chose in Module One for the duration of the course, including all assignments and the project. Describe how each source supports your topic. Briefly summarize each source. State why the source is credible. State how the source is relevant to your research question. What to Submit Submit your assignment as a 2- to 4-page Microsoft Word document with double spacing, 12- point Times New Roman font, and one-inch margins. Sources should be cited according to APA or MLA styleSee Answer
  • Q8: Upload Assignment: Module 4, week 11, Assignment 2: Statistical Analysis ASSIGNMENT INFORMATION Due Date Friday, April 21, 2023 3:16 PM Points Possible 100 Assignment 2: Identification of statistical results 1. See the attached Assignment 2. 2. Answer the questions. Due 4/21/23 Assignment 2 Identification of Statistical Results(1).docx ASSIGNMENT SUBMISSION Text Submission Write Submission Attach Files Browse Local Files Browse Content Collection Browse Cloud Service Browse Dropbox When finished, make sure to click Submit. Optionally, click Save as Draft to save changes and continue working later, or click Cancel to quit without sav https://bbhosted.cuny.edu/webapps/assignment/uploadAssignment?content_id=_75385191_1&course_id=_2237454_1&group_id=&mode=view 1/2 Assignment 2: Application of Learning: 1. Here is a brief summary of a fictitious study. Read the summary and then respond to the questions that follow. Brink studied the effect of postural change on cardiovascular reactivity for a sample of healthy white and African American men and women. Change in systolic blood pressure (SBP) from supine to standing position was used as the measure of cardiac reactivity in a sample of 842 adults. Supine measurement of blood pressure was taken after participants had lain on an examination table for 15 minutes. Blood pressure was measured three times at 1-minute intervals using a preset automated blood pressure monitor, and the three measurements were averaged. Participants then stood up, and an additional three measurements were made over another 3-minute period and then averaged. Below is a table describing the characteristics of Brink's sample. Table 1 Characteristics of the Study Sample (N = 842) Sample Characteristic Frequency (N) Percentage or Mean (SD) Range Gender Female 408 48.5% Male 434 51.5% Age (years) 842 55.1 (5.3) 44.0-67.0 Race/ethnicity White, not Hispanic 701 83.3% African American 141 16.7% Smoking status Nonsmoker 698 82.9% Currently smokes < 1 91 10.8% pack/day 53 6.3% Currently smokes 1+ packs/day BMI 831 24.9 (4.1) 18.1-36.3 Answer the following questions a. Which variables in the table, if any, were measured on a nominal scale? b. Which variables in the table, if any, were measured on an ordinal scale? c. Which variables in the table, if any, were measured on an interval scale? d. Which variables in the table, if any, were measured on a ratio scale? e. Which measure(s) of central tendency, if any, are presented in this table f. Which measure(s) of variability, if any, are presented in this table g. If age were normally distributed, approximately what percentage of the sample would be older than 60? h. If BMI were normally distributed, approximately what percentage of the sample would have a BMI higher than 33?See Answer
  • Q9: Assessment Description Presentation skills include providing information in a concise format to patients, physicians, research panels, interview panels, conferences, meetings, and colleagues. Oral and visual communications are some of the most important business and life skills we can develop. Using the fictitious patient's history information and the clinical test results for glucose determination, enzymatic kinetics, and urinalysis you collected during your previous assignment, present the findings in the form of a visual PowerPoint and a verbal presentation in the form of a video. The video should be 7-10 minutes long and should be accompanied by a 7- to 10-slide PowerPoint presentation (not including the title slide). Include the following information to ensure successful completion of the assignment: 1. Sufficient overview/background information to introduce the unknown case. An assessment of and hypothesis based on the information provided within the patient history. 2. Data obtained from each of the tests performed (organized in charts or graphs). 3. Discussion of each of the clinical tests performed, what each test can reveal about the health of a patient, the chemistry behind each of the clinical tests completed (i.e., how that test works), and an explanation as to why each of the tests completed would be valuable to the diagnostic process. 4. Evaluation of the clinical test results provided for the unknown case study with a detailed explanation of how the results were interpreted. 5. Conclusion regarding the potential disease(s) present in the unknown scenario, the final diagnosis supported with specific clinical test results. 6. Potential treatment plan for the unknown case study patient. Record yourself using a digital video recording device, such as a web camera or cellphone. Use an online video platform such as YouTube or Vimeo to upload your recorded presentation. If you upload your video to YouTube, select the "unlisted" option. For directions on how to upload to YouTube, refer to the resource "Uploading a Video to YouTube Studio Guide," located in the Student Success Center. Verify that others can access your linked video, then copy + paste the URL onto the title page of your PowerPoint file and submit it to the digital classroom. 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. You are not required to submit this assignment to LopesWrite. Both the nursing and diagnostic processes are modifications of the scientific method. They each ask for the researcher to make observations, develop a hypothesis, test that hypothesis through experimentation, analyze the results, and make a conclusion. The purpose of this project is to expose nursing students to clinical tests encountered in the treatment and diagnosis of disease. For this assignment, you will be tasked with diagnosing a fictitious patient. To complete the diagnosis, you will receive the patient's history information and a set of diagnostic results for a variety of clinical tests. You must analyze and interpret the clinical test results for glucose determination, enzymatic kinetics, and urinalysis. Besides collecting the data in this assignment, you will present the findings from the clinical test labs on the fictitious patient in the form of a visual PowerPoint and a verbal presentation in the form of a video for your next assignment. Complete the activity in Pivot as directed.See Answer
  • Q10: PLEASE RESPOND TO THESE 3 FOLLOWING POSTS # 1 Patience A Summary COLLAPSE Patience, I am an independent nurse with MassHealth, and I care for patients in the comfort of their homes. I have been an independent nurse for over two years. I have had the opportunity to work with immigrants at some point during my career and realized that this vulnerable group faces many barriers that cause health disparities, which greatly affect their well-being and subsequently the country's economy. Immigrants make up about 14% of the US population, for a total of 45.5 million individuals who are here legally or illegally. They are a diverse group of individuals who chose to move to the US for different reasons: for work, to reunite with family, or for safety. Immigrants contribute greatly to the economy by opening businesses, which create jobs, and by paying taxes. With all that they are doing to make the US the number one power in the world, immigrants, especially undocumented immigrants, do not have access to quality healthcare. The lack of regular checkups, physical exams, or means of transportation to healthcare centers leads to undiagnosed illnesses, which negatively affect their health. They become stressed, which affects their mental health and their ability to function well. One of my patients migrated here for safety reasons; she left her husband and kids behind. When she got here, she found out she was pregnant. She started prenatal care at a local healthcare center. Unfortunately, she miscarried, in part because of the stress and anxiety related to her status. She is unable to get employment since she does not have documents. Everything is expensive, and she cannot afford to pay for food, rent, and transportation. Bills started piling up, with some being forwarded to collection agencies. Passing a bill for affordable and equitable healthcare for immigrants will help those who cannot afford insurance. Older immigrants will not have to wait five to ten years to qualify for Medicare or Medicaid. We will have fewer comorbidities, fewer emergency visits, and improved health conditions among the individuals in this population. I also think that it will be helpful if funds are allocated for immigrants to borrow from to get them started, which they can start paying back when they get a job. We can call it an immigration loan. It will also serve as an incentive for them to get to work as soon as they can. Passing this bill will also relieve the receiving families, who are saddled with the responsibility of taking care of their loved ones for extended periods. Given the challenges that immigrants face, I will recommend passing the Affordable Healthcare for Immigrants Act and passing a bill to allocate funds for immigrants to borrow from. # 2 Sarah N. Children with incarcerated parents are a vulnerable population that is at high risk for health care disparities. According to Turney, (2019), in 1970, 100 out of 100, 0000 individuals in United States were incarcerated, and today, 500 out of 100, 000 are incarcerated, with most of them being parents. Children with incarcerated parents face challenges including social isolation, stigma, poor school performance, low self-esteem, disturbed sleeping patterns, depression and post-traumatic stress disorders which are likely to cause adverse childhood experiences (Beresford et al., 2020). Studies suggest that children of incarcerated parents are likely to end up in the criminal justice system because of engagement in delinquent behavior, aggressiveness, and antisocial behavior (Poehlmann-Tynan et al., 2021). Policy changes are necessary to implement to mitigate negative effects of parental incarceration. The school system plays an important role in helping these children navigate through the challenges they experience. Educators can help these children and classmates understand that their parent's incarceration is not their fault which can reduce the stigma associated with parental incarceration. Children would also benefit from a mentor to provide guidance and support which promotes resilience in the face of challenges, and improves educational and behavioral outcomes (Turney, 2019). This writer also recommends that the Massachusetts Department of Corrections decreases the restrictive visiting policies placed on visitors which may discourage families from visiting especially those with young children. Visitors who visit incarcerated individuals in facilities go through various screening procedures, there is a barrier to physical contact, and lack of privacy which may strain relationships between children and their incarcerated parents. In person visits with parents create positive adjustment for these children to their parents' predicament, positive sense of family connection, and decreased negative emotions including anger and feelings of alienation (Kremer et al., 2022). In conclusion, children with incarcerated parents face challenges that can impact their wellbeing, but with implementation of the policies recommended above, positive outcomes can be promoted. # 3 Nicole COLLAPSE Attention Members of the Oncology Review Board, my name is Nicole Olsen, a former oncology medical assistant and nurse, and I bring the issue of Cancer Treatment Affordability for Low-Income Individuals to the forefront as a topic of discussion. Low-income individuals are already at risk for disparities such as less job flexibility, inadequate housing, transportation issues and nutritional deficits. Those receiving chemotherapy are at risk for immunotherapy compromises such as severe blood infection, organ failure and death. Together, individuals who are low-income receiving chemotherapy are at a heightened risk for pooper health outcomes and demise. 1 in 3 cancer patients say they have trouble paying for their medical bills in which they are cutting into their savings, visiting family less, cutting back on food and selling their assets, like vehicles and homes, to pay for care. Some are even delaying obtaining care and entering severe depression. Currently, physicians receive monetary compensation for prescribing more expensive chemotherapies. A study by Patlak says that "a generic version of paclitaxel costs about $312 per dose…. [while] physicians can prescribe Abraxane, a brand- named paclitaxel, for $6,000 per dose and receive $3,000 in reimbursement" (Patlak, 2014). Because of this, hospitals must bill insurance companies higher amounts. Patlak says that "the maximum out-of-pocket expense is reached in the first month of treatment and deductibles and coinsurance become irrelevant…... [that] a family of 4 with an annual income of about $47,000 must pay about $10,000 of out-of-pocket costs before they would reach the cap limit” and insurance would take over (Patlak, 2014). This introduces a toxic cycle of unaffordability and disparities for low-income individuals across the United States. With your help, I am proposing a policy statement in the hopes changes are made to help this vulnerable population. Individuals must receive dialog whenever a change from generic to brand-name drugs are considered. Institutions shall lower physician incentives whenever they prescribe a brand-name drug and incentives should be granted for prescribing generic drugs. Lastly, society must focus more on time spent together rather than on capitalism. With these changes, patients may receive more autonomy regarding treatment decisions in a time when choices are slim, and chemotherapy prices may be more affordable allowing for patients to spend more time with family. In a time when healthcare and innovation are at its highest, we must do our best to help all who are suffering so that future generations are set for success. Thank you for your consideration.See Answer
  • Q11: ASSIGNMENT INSTRUCTIONS Use PowerPoint to create a professional ePoster to present quality improvement results and analysis to your facility or professional conference You may use the poster template provided or another professional poster template of your choosing.Directions for using the template are on the template itself. You may rearrange the formatting of the poster including the arrangement of sections, size of sections, color, fonts, etc. so long as you maintain a professional appearance and the font size chosen is readable. This assignment is created in PowerPoint and submitted as a .pptx file This assignment represents a continuation of the scenario and Hospital Consumer Assessment of Healthcare Providers and Systems (HCPHPS) survey results from Homework B including the three unit graphs. However, at this time, you will be working on communicating specific information and providing an analysis/interpretation of the results to a professional audience and/or clinical committee of your peers using an ePoster. Although the poster could be professionally printed for an in-person presentation, for this assignment you will only create the electronic version. You will be graded on the professional appearance of your poster as well as your ability to explain how and why the analysis was done, identify the pattern of variation, and logically explain what might account for it. Narrative Content Title area - include an appropriate title, student name(s), and affiliations Background Provide background information about patient satisfaction surveys in general and the HCAHPS survey specifically. Support information with at least 2 current, professional sources that are cited and referenced scholarly. Purpose and Methods Explain the purpose of the data collected for your facility Explain the data collection, timeframe, assembly, and calculation process. Describe the characteristics of the survey and where the survey was administered. Identify the software product used for analysis. See the scenario details and data from Homework B. Results View the questions on the HCAHPS survey that is provided in the dropbox and determine the following: In each unit, identify patterns in question scores (i.e., column/question mean scores), strengths, and specific areas of improvement) In each unit, identify patterns in quarter scores (i.e., row/quarter mean scores, changes over time) Across all units, identify patterns in overall mean scores Conclusions Explain the implications, "next steps", or factors for the nurse manager to explore to improve the quality of care and patient satisfaction. State and explain specific interventions that should be implemented based on the results. References To save space, single space references and do not indent reference list Bar/column graphs Individual unit graphs - add the 3 vertical bar/column graphs from Homework B depicting the column/question mean scores (Q1-Q9) for each unit. If there were errors in the graphs noted in Homework B feedback, they need to be corrected before adding them to the poster. Graph of overall mean scores - create a 4th vertical bar/column graph depicting the overall mean for each unit on the same chart (3 bars). This graph should only have 3 bars/columns. Graphs should have appropriate titles and labels In total, there should be 4 graphs in the poster Graphics SPC logos (2) and CON banner - You must use the SPC ePoster template that has been provided in the dropbox. Using any other template is not acceptable and will result in no credit for the assignment. Resubmissions are at the discretion of your instructor. Point deductions will apply if you are granted the opportunity to resubmit. Figures - delete the template images (Figures 1 & 2) and replace them with your chosen images specific to the poster topic. Be sure figures are numbered and labeled underneath. Figures should add to the visual appeal of the poster.See Answer
  • Q12:Objectives • Identify electronic database search strategies (e.g., CINAHL, PubMed) Locating and evaluating sources of evidence Deliverables • Write a 3-5 page (not including the title and reference pages) paper APA 7 formatted paper with an introduction and conclusion. • • APA 7 headings for each section of the paper At least 3 peer-reviewed articles Step 1: Research • Interview a librarian or nursing scholar on methods for locating and appraising health and other relevant research literature and electronic database search on strategies. • You may want to base this research on your idea from your Capstone Project; however, you may not self-plagiarize your previous work. Step 2: Consider • Write a quality appraisal of the Library and resources. o What did you learn? o How do you locate and evaluate sources of evidence? Step 3: Write o Which electronic database would you use most and what types of search words would you use? o What are the strengths? o What are the weaknesses? o Is it adequate? Why or why not? Write a paper that addresses the questions above. Step 4 Save and submit • When you have completed your assignment, save a copy for yourself in an easily accessible place and submit a copy to Canvas.See Answer
  • Q13:write a journal about this topic How can Florence Nightingale's influence be seen in modern day nursing?See Answer
  • Q14: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. The Assignment: (Evidence-Based Project) Part 4: Recommending an Evidence-Based Practice Change Create an 8-to 9-slide narrated 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.)See Answer
  • Q15:1 Treat people as individuals and uphold their dignity To achieve this, you must: 1.1 1.2 1.3 1.4 1.5 treat people with kindness, respect and compassion make sure you deliver the fundamentals of care effectively avoid making assumptions and recognise diversity and individual choice make sure that any treatment, assistance or care for which you are responsible is delivered without undue delay respect and uphold people's human rightsSee Answer
  • Q16: Objectives Identify and discuss basic designs, corresponding or additional questions, analytical methods related to research questions, and limits on implications of findings (e.g., causal vs. relational) Deliverables Write a 3-4 page (not including the title and reference pages) paper APA 7 formatted paper with an introduction and conclusion. APA 7 headings for each section of the paper At least 5 peer-reviewed articles Step 1: Research Review the readings and video and research basic designs, corresponding questions, analytical methods related to research questions, and limitations on the implication of findings (causal vs. relational). You may want to base this research on your idea from your Capstone project; however, you may not self- plagiarize your previous work. Step 2: Consider Related to the research questions and limitations on implications or findings (causal vs. relational): What are the basic research designs? What are the corresponding or additional questions used? What analytical methods are used? Step 3: Write Write a paper that addresses the questions above. https://www.khanacademy.org/math/probability/ xa88397b6: scatterplots/estimating-trend-lines/v/ correlation-and-causalitySee Answer
  • Q17:TO DO: Need to response on 3 initial posts. 150 words (each) APA format with references and in text citations.See Answer
  • Q18:The Assignment (3-6 pages total): Part 1: Work Environment Assessment (1-2 pages) • Review the Work Environment Assessment Template you completed for this Module's Discussion. • • Describe the results of the Work Environment Assessment you completed on your workplace. Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed. Explain what the results of the Assessment suggest about the health and civility of your workplace. Part 2: Reviewing the Literature (1-2 pages) • Briefly describe the theory or concept presented in the article(s) you selected. Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment. Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples. Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1-2 pages) • Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment. Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.See Answer
  • Q19:Deliverables • Write a 3-5 page (not including the title and reference pages) paper • APA 7 formatted paper with an introduction and conclusion. • APA 7 headings for each section of the paper • At least 3 peer-reviewed articles ◄ Previous Submit Assignment Next BSN435-11 Scholarship and Evidence-Based Practice in Nur.... • Write a quality appraisal of the Library and resources. o What did you learn? • How do you locate and evaluate sources of evidence? • Which electronic database would you use most and what types of search words would you use? • What are the strengths? o What are the weaknesses? • Is it adequate? Why or why not?See Answer
  • Q20:IMPORTANT INSTRUCTIONS: Module 2 Article and Module 3 Article are attaches (in reference) After reading the article, read the task instructions and fill in the Critical Appraisal Tool Worksheet Template. After filling the template write 1 page, critical appraisal (addressing the problems mentioned in the task instructions) APA formatSee Answer

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