December 12, 2019

Identify the laws, professional ethical codes, and government regulations that enter into ones choices

Ethics in Nursing MORAL MODEL FOR ETHICAL DECISION MAKING Collect data that identifies the dilemma • Recognize that most problems have more than one component, • Identify the facts relevant to the ethical decision • Recognize the cultural, economic, and political contextual factors that are present • Identify the laws, professional ethical codes, and government regulations that enter into ones choices Identify who is responsible for making the decision (Ie who’s decision is it to make?) • Consider who has important stakes in the decision. Consider the opinions of the major players as well as their value systems. • Consider all claimants potentially affected by the decision, both the majority and the minority. Try to see from the other’s perspective O = OUTLINE THE OPTIONS • Clarify the options available and the consequences of each potential action. This step is used to better understand the options rather than make a final decision.
December 12, 2019

How to integrate Nola Pender’s Health Promotion Model with expectancy-value theory and social cognitive theory as a solution.

DIRECTIONS: Borrowed theory are nursing theory borrowed from other disciplines. Nola Pender developed the Health Promotion Model to guide nurses in promotion of wellness and illnesses prevention. The expectancy-value theory and social cognitive theory were the two borrowed theory integrated into the Health Promotion Model (HPM). Describes how borrowed theory (expectancy-value theory and social cognitive theory) along with the HPM can be utilize to improve patient education in primary care clinic. The paper should include the following: 1. A description of a borrowed theory (expectancy-value theory and social cognitive theory) that could be applied to improve health promotion patient education in primary care clinic. Is this borrowed theory appropriate? 2. A brief history of the borrowed (expectancy-value theory and social cognitive theory) theory’s origins. 3. A discussion of how the borrowed theory (expectancy-value theory and social cognitive theory) has been previously applied. 4. A discussion of the possible application of the borrowed theory (expectancy-value theory and social cognitive theory) to improve health promotion patient education in primary care clinic. 5. How to integrate Nola Pender’s Health Promotion Model with expectancy-value theory and social cognitive theory as a solution. -Prepare this assignment according to the guidelines found in the APA Style Guide. -3-5 references -1500 words
December 12, 2019

1 water fills a tank at a rate of 150 litres during the first hour,350 litres during thre second hour, 550 litres during the third hour and so on. Find the number of hours necessary to fill a rectangular 16m x 9m x 9m,

  1. 1 water fills a tank at a rate of 150 litres during the first hour,350 litres during thre second hour, 550 litres during the third hour and so on. Find the number of hours necessary to fill a rectangular 16m x 9m x 9m,
 
December 12, 2019

identify patients at risk of clinical deterioration in order to provide a timely response to request appropriately-trained nursing or medical staff to assess the patient

Response to peer discussion board-150 words-1 reference within 5 years-NURSING JOURNALS ONLY. There is a large push for evidence-based practice to become the main foundation of all clinical practices and clinical decision making. In order to provide the best up to date quality care evidence-based practice must be used. “By the year 2020, 90% of clinical decisions will be supported by accurate, timely, and up-to-date clinical information and will reflect the best available evidence” (Boswell& Cannon, 2017). Though it is ideal to have evidence-base practice driving health care practices there are many obstacles in the way of changing the culture of health care practices. There are many obstacles to change such as resistance to change from staff, available resources to support changes, lack of support and training from mentors, and “research findings incompatible with the realities of their practice” (Johnston, Coole, Feakes, Whitworth, Tyrell, & Hardy, 2016, p. 392). Working at Shands Hospital in Gainesville Florida there is most definitely a strong push for the best quality of care through evidence-based practice. Each unit throughout the hospital has a clinical leader. The unit’s clinical leader’s main job description is to assure the unit is clinically using practices that are evidence-based. The main obstacle that I have found on my unit has been “research findings incompatible with the realities of their practice” (Johnston et al. 2016, p. 392 ). Working on such a high acuity unit in the cardiovascular intensive care unit a lot of evidence-based hospital driven policies and practices have had to be adjusted specially to fit our unit. Hospital wide practices have had to be adapted because certain practices do not apply to the realities and acuity of our unit. One main example is the MEWS assessment. “The modified early warning score (MEWS) is an example of a physiological ‘track and trigger’ system designed to identify patients at risk of clinical deterioration in order to provide a timely response to request appropriately-trained nursing or medical staff to assess the patient and provide any interventions required” (Harris, 2013, p.432). MEWS is an extremely useful tool on floor units, but on my particular unit a majority of our patient population have such a high baseline MEW Score. If following our hospital protocol for our patients’ MEWS we would be constantly calling physicians and bringing them to the bedside. Our patients have extremely high acuity which is one of the reasons they are in the intensive care unit. Our physicians are aware of the acuity of our patients and therefore the hospital wide MEW score does not really apply to our unit. We had to adjust the triggers of the MEW Scores of when to notify a physician. On the floor a MEWS of 4 a physician is notified and needs to come assess the patient, but in the CICU the score for when a physician has to come to bedside was adjusted to a 6. MEWS is just one of the many obstacles present in implementing evidence-based practices on our unit. There are many obstacles to implementing evidence-based practices in our clinical practices, but it is imperative that we adjust or policies and practices to reflect the research found in order to provide the best quality care.
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