Discussion

Discussion Question
There are many factors that make people healthy or ill. This week we will focus on the social factors and determinants that impact health.

My zip code is 10980 – stony point New York

Go online to the U.S. Census Bureau at https://www.census.gov/quickfacts/ (*note, you will be using this website in the Week 2 assignment, so you can get started on collecting all the required data if desired)
Input your local zip code, city, or county. Try to get as specific data as possible (city, township, county).
Next, identify the:
Total population
Median income
Percentage or number of persons living in poverty
Go to your local grocery store, use a flyer, or app. Include the stores name, city, and state. Identify cost for the following items (please note whether items are organic):
1 gallon of milk
1 loaf of bread
1 bag of apples (include price per pound)
1 bag of carrots
1 large container of yogurt
1 2-liter of soda
1 bag of chips
1 package of cookies
Utilizing the data collected, discuss social factors that might impact what groceries are purchased. Try to be as specific to your community as possible (location, availability, poverty levels, etc.).
Discuss how a community health nurse (CHN) could use one of the 17 intervention categories from the Public Health Intervention Wheel to address areas of food security (Nies & McEwen, 2019).
In your responses to classmates, include comparisons and contrasting information.
Your discussion post should look like:

Paragraph one: Utilizing the data collected, discuss a social factor that might impact what groceries are purchased. Try to be as specific to your community as possible (location, availability, poverty levels, etc.)
Paragraph two: Utilizing the data collected, discuss another social factor that might impact what groceries are purchased. Try to be as specific to your community as possible (location, availability, poverty levels, etc.)
Paragraph three: Discuss how a community health nurse (CHN) could use one of the 17 intervention categories from the Public Health Intervention Wheel to address areas of food security
Resources: Where did you find your data?

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Question 1:
Post and describe what you believe is most significant as a key issue with Big Data in which dissertation research has been completed, yet the data has not been analyzed or implemented.
• Please cite specific examples of research that was completed with potential for great social impact but was not implemented.
• What are some potential barriers for implementing the research analyzed?
• What potential gaps exist between evidence-based approaches and the research process?

To Prepare
• Review this week’s Lewin’s change theory media resource.
• Consider the importance of change theory, as well as reflect on the application of these theories to your healthcare organization or nursing practice.
• Research and select two additional theories or models related to change theory and systems thinking to focus on for this Discussion.

Question 2:
Post a response to each of the following:
• Describe the importance and application of Change Theory and Systems Thinking for healthcare organizations and nursing practice. Be specific.
• List two additional theories or models that you selected and explain how these might be applied in research. Be specific and provide examples.
• Explain how theories and models provide a framework to guide projects, including your DNP Project or dissertation.

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Choose two concepts in the theory you choose last week and describe:
How are the concepts defined in general (from other references)?
How does the theorist define each of the concepts you have chosen?
How do those concepts apply to your clinical practice? Give concrete examples.

In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples; and demonstrates a clear connection to the readings.

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Theories are derived from conceptual models and are comprised of concepts and propositions. The only concepts that are common to all nursing theories, in some shape or form, are patient, nurse, health, and environment. These are sometimes referred to as the basic metaparadigms of the nursing domain.

Describe the four metaparadigms: patient, nurse, health and environment. Cite the sources you use.
Choose a middle – range theory that finds practical application to your current area of clinical nursing practice, briefly describe the theory, and explain why you find this theory appropriate for your area of clinical practice.

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To Prepare:
• Review the Learning Resources for this week and reflect on the different quality improvement models presented.
• Select one quality improvement model from the following to focus on for this Discussion:
o Root Cause Analysis (RCA)
o A3
o Lean
o Plan, Do, Study, Act (PDSA)
• Reflect on the quality improvement model you selected and consider how it might be implemented in your healthcare organization or nursing practice.

Question:
Post a brief explanation of the quality improvement model you selected, including a description of the components that make up this model. Be specific. Then, explain how this quality improvement model might be implemented in your healthcare organization or nursing practice in response to an adverse event requiring quality improvement. Be specific and provide examples.

Required Reading / Learning Resources

Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.
• Chapter 15, “The Role of the National Committee for Quality Assurance” (pp. 389–414)

Scoville, R., & Little, K. (2014). Comparing lean and quality improvement. Institute for Healthcare Improvement http://www.ihi.org/resources/Pages/IHIWhitePapers/ComparingLeanandQualityImprovement.aspx

Tromp, R. (n.d.). A3 report. Lean Six Sigma Group. https://leansixsigmagroup.co.uk/a3-report/

UNC Institute for Healthcare Quality Improvement. (2021). Resources: A3. https://www.med.unc.edu/ihqi/resources/a3/

Required Media (click to expand/reduce)
Institute for Healthcare Improvement. (n.d.). Quality improvement essentials toolkit [Multimedia file]. http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx

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.How do you typically respond to change? Do you embrace it? Seek it out? Accept it reluctantly? Avoid it at all cost? Is this behavior like your friends and that of your family? Has your behavior always fit this pattern, or has the pattern changed throughout your life? If so, what life events have altered how you view and respond to change?

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please answer and all its entirety

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What has your nursing experience been with people age 65 and older? What do you anticipate learning in the course regarding geriatric patients? Citation and reference are required.

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What has your nursing experience been with people age 65 and older? What do you anticipate learning in the course regarding geriatric patients? Citation and reference are required.

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What has your nursing experience been with people age 65 and older? What do you anticipate learning in the course regarding geriatric patients? Citation and reference are required.

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What has your nursing experience been with people age 65 and older? What do you anticipate learning in the course regarding geriatric patients? Citation and reference are required.

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What has your nursing experience been with people age 65 and older? What do you anticipate learning in the course regarding geriatric patients? Citation and reference are required.

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What has your nursing experience been with people age 65 and older? What do you anticipate learning in the course regarding geriatric patients? Citation and reference are required.

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What has your nursing experience been with people age 65 and older? What do you anticipate learning in the course regarding geriatric patients? Citation and reference are required.

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What has your nursing experience been with people age 65 and older? What do you anticipate learning in the course regarding geriatric patients? Citation and reference are required.

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Introduction
Parents bring their 3-month-old infant to the urgent care you work at, complaining that he has had constipation for 5 days that was preceded by weakness for several weeks. Upon physical exam, you note hypotonia, hyperreflexia, and respiratory distress. You advise the parents you believe the child needs to be admitted to hospital and taken immediately to the local pediatric emergency room.

Discussion Guidelines
Initial Post
In your initial post answer the following questions:

The parents ask you why you are so concerned and tell you they would prefer you to give him something for the constipation. They would rather just take him home. How would you respond?
The parents persist that they do not think their son needs to be admitted to the hospital. As a clinician, you believe they are making the wrong decision and are concerned for the infant’s health. What alternatives might you consider to ensure the parents understand the gravity of their decision

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QD1 Suppose you were planning to conduct a statewide study of the work plans and intentions of nonemployed registered nurses in your state. Would you ask mostly open-ended questions or closed-ended questions? Defend your answer.

QD2Which level of measurement would you prefer to utilize for quantitative research? Defend your answer.

QD3A patient on a medical floor has an indwelling catheter that has been in for 2 weeks.

1. Why are patients with indwelling urinary catheters at an increased risk for urinary tract infections?

2. In caring for a patient with an indwelling urinary catheter, what nursing actions can be employed to decrease the patient’s risk for the development of a urinary tract infection?

QD4 A 67-year-old female patient presents to the emergency room you work at complaining of shortness of breath and pain on the right side of her chest. Upon auscultation of the lung field during the physical exam, you note flatness and diminished breath sounds over the right lung. Her temperature is 101.3°F.

a.  What are the possible causes of her symptoms and what tests might you expect to be ordered to determine the specific cause of this patient’s symptoms? Why?

b. This patient’s husband tells you that he does not understand why she feels short of breath. How might you explain to him the lung physiology that underlies her symptoms?

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