Nursing And Community

Nursing And Community

Part 1:

Change proposal Issue:  Infection control and prevention in University Plaza Nursing and Rehabilitation center

Topics: cleaning and desinfection; standard precaution and cross contamination

Stakeholder support is necessary for a successful project implementation. Consider your internal stakeholders, such as the facility, unit, or health care setting where the change proposal is being considered, and your external stakeholders, like an individual or group outside the health care setting.

1. Why is their support necessary to the success of your change proposal, and how you will go about securing that support?

Part 2:

change proposal Issue:  Infection control and prevention in University Plaza Nursing and Rehabilitation center

Topics: cleaning and desinfection; standard precaution and cross contamination

Technology is integral to successful implementation in many projects, through either support or integration or both.

1. Name at least one technology that could improve the implementation process and the outcomes of your capstone project change proposal.

2. Do you plan to use this technology? If not, what are the barriers that prevent its use?

Part 3:

1. Describe the characteristics of the aging process.

2. Explain how some of the characteristics may lead to elder abuse (memory issues, vulnerability, etc.).

3. Discuss the types of consideration a nurse must be mindful of while performing a health assessment on a geriatric patient as compared to a middle-aged adult.

Part 4:

End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference.

1. What are the reasons for this trend?

2. Discuss what you can do as a nurse to support your clients regarding end-of-life care in accordance with their wishes.

Support your response with evidence-based literature.

Part 5:

A 41-year-old obese male patient is diagnosed with congestive heart failure (CHF). He is told to begin a moderate exercise routine with a healthy diet and is prescribed several medications — including a diuretic.

1. Based on your knowledge of the kidney and the disease of CHF, what factors would be important in selecting a specific diuretic? How would you explain to this patient how it works?
2. If this patient developed a disease that caused the renal blood flow to be diminished, how might this impact the medication he is taking for his congestive heart failure? As his health care provider, how would you change his treatment in this situation?

Part 6:

Post your cost comparison document from Unit 2 (See file 1). Assuming you might prescribe this drug for your patient

1. How would you minimize cost or assist the patient in getting the medication at the lowest cost possible.

2. What resources are available to reduce drug costs?

3. Find at least 2 resources for free or reduced cost medications and describe them.

Part 7:

Polypharmacy is defined as being on 5 or more medicines, and is a major concern for providers as the use of multiple medicines is common in the older population with multimorbidity, and as one or more medicines may be used to treat each condition.

1. Discuss two (2) common risk factors for polypharmacy. Give rationale for each identified risk factor.

2. Discuss two interventions you can take as a Nurse Practitioner in your clinical practice to prevent polypharmacy and its complications.

Part 8:

Health Resources and Services Administration (HRSA) is the primary federal agency for improving access to healthcare by strengthening the healthcare workforce, building healthy communities, and achieving health equity.

Integrated care involves a team of primary care, dental, and behavioral health practitioners working together using a systematic, cost-effective approach to patient care.

After the reading the following HRSA Report:

https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/primarycare-dentist/reports/actpcmd-14-report.pdf

Discuss what are the 4 main recommendations given on this report and the rationales for each one (See File 2).

Part 9:

CS/SB 614 authorizes an ARNP to prescribe, dispense, administer, or order any drug, which would include controlled substances.

ARNP disciplinary sanctions are added to the bill in s. 456.072, F.S., (Section 5) to mirror a physician’s sanctions for prescribing or dispensing a controlled substance other in the course of professional practice or failing to meet practice standards. Additional acts for which discipline may be taken against an ARNP relating to practicing with controlled substances that are added to the Nurse Practice Act (Section 10) include:

 Presigning blank prescription forms.

 Prescribing a Schedule II for office use.

 Prescribing, dispensing, or administering an amphetamine or sympathomimetic amine drug, except for specified conditions.

 Prescribing, dispensing, or administering certain hormones for muscle-building or athletic performance.

 Promoting or advertising a pharmacy on a prescription form unless the form also states that the prescription may be filled at the pharmacy of your choice.

 Prescribing, dispensing, or administering drugs, including controlled substances, other than in the course of his or her professional practice.

 Prescribing, dispensing, or administering a controlled substance to himself or herself.

 Prescribing, dispensing, or administering laetrile.

 Dispensing a controlled substance listed in Schedule II or Schedule III in violation of the requirements for dispensing practitioners in the Pharmacy Practice Act.

 Promoting or advertising controlled substances.

After reading the following news article http://c-hit.org/2015/04/06/high-prescribing-nurse-surrenders-drug-licenses/

1. Identify what issues may arise with prescriptive authority of controlled substances and how you may avoid these situations? 

Part 10:

1. What is the difference between high-, middle-, and low-range theories?

2. Explain your understanding of a middle-range nursing theory. Identify a research study in which a middle-range theory was applied.

3. Discuss the study results and implications for practice.

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