Category: Nursing

PICOT Question:
In geriatric patients, how does at home physical therapy compared to no physical therapy treatments affect fall rates?
Please find 3 studies related to this PICOT question and synthesize them into attached synthesis tables.
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Assignment highlights:
Research a clinically focused health problem related to the care of older adults. Content should be reflective of the current understanding of the approach to a particular healthcare problem including the most current evidence-based treatment according to published research, guidelines or standards. A clinical problem is presented in PICOT format. Search the evidence and obtain three articles, using different research engines related to the PICOT question. Utilize three research engines, ie. PubMed, CINAHL, Cochran, etc… Articles cannot be duplicates. Once the evidence has been searched, synthesize the data by completing the synthesis tables. Based on the synthesis of the data, recommendations are made regarding the PICOT question.
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These three studies are already applied in synthesis tables and can’t be used:
1. Liu-Ambrose, T., Davis, J. C., Best, J. R., Dian, L., Madden, K., Cook, W., Hsu, C. L., & Khan, K. M. (2019). Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall: A Randomized Clinical Trial. JAMA, 321(21), 2092–2100. https://doi.org/10.1001/jama.2019.5795
2. Arena, S. K., Wilson, C. M., Boright, L., & Peterson, E. (2021). Impact of the HOP-UP-PT program on older adults at risk to fall: a randomized controlled trial. BMC Geriatrics, 21, 1-13. https://doi.org/10.1186/s12877-021-02450-0
3. Fairhall, N., Sherrington, C., Lord, S. R., Kurrle, S. E., Langron, C., Lockwood, K., Monaghan, N., Aggar, C., & Cameron, I. D. (2013). Effect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: a randomised controlled trial. Age And Ageing, 43(5), 616–622. https://doi.org/10.1093/ageing/aft204

Write a 3- to 5-page paper about how your state’s practice act encourages or discourages quality and effective patient care for a patient with comorbid conditions.
Consider this case:
A 35-year-old African-American male reports trouble with sleep for over 3 months. He has trouble both falling and staying asleep. He has increased his drinking habits at night to try and increase his sleepiness before bed. He states he is drinking 1–2 beers every night before bed. He also states he has a history of depression that was successfully treated with Prozac for 4 years. He has not been on medication for the last 24 months and states that his depression has been somewhere from a 1–2 on a 0–10 scale with 10 being the worst. He denies SI/HI, and A/VH. However, he does state an increase in anxiety when he does not sleep. He states he feels fidgety and out of it during the day. His vitals for today’s visit are:
9
HR72
1BP47/82
R20
Wt192
Ht5’9”
BMI: 28
Your paper should include:
Title page (APA)
Introduction to your state’s NP practice (Alabama)
Discussion of how the NP practice laws in your state affect patient care
Specific case and how it is affected by your state’s practice act
Conclusion
Include at least three scholarly articles, in addition to your textbooks.
1. Psychiatric-Mental Health Nursing: Scope and Standards of Practice
Edition: 3rd (2022)
2. American Nurses Association, Nursing Knowledge Center
Book ISBN: 978-1935213796
3. Diagnostic and Statistical Manual of Mental Disorders: DSM-5
Edition: 5th (2013)
Paper must be in APA format including, reference page, cover page, in-text citations, and overall paper format.

CO 3: Demonstrates effective communication with patients, colleagues, and other healthcare providers in managing safe/quality healthcare processes using evidence-based practices. (PO 3)
CO 4: Integrates clinical nursing judgment using effective communication strategies with patients, colleagues, and other healthcare providers. (PO 4)
CO 7: Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings. (PO 7)
CO 8: Selects evidence for best practices when planning professional nursing care involving systems, processes, and devices for individuals, families, aggregates, and communities. (PO 8)

Assess the New York-Presbyterian health system’s readiness for change using Bolman & Deal four frame model (with more focus on Human Recourses frame), and develop an initial plan to enhance the system’s openness to change.

Construct a 5- to 6-page paper discussing each of the four traditional mood stabilizer medications: carbamazepine, lamotrigine, lithium, and valproate products. Support your answers with five (5) evidence-based, peer-reviewed scholarly literature.
Note: APA style format will apply.
Your paper should include the following for each:
Proposed mechanism of action
Baseline assessment, laboratory considerations, and frequency of ongoing labs and assessments
Note: Discuss the importance of assessment and labs.
Special population considerations (birth assigned gender, age, other medical comorbidity considerations)
FDA approval indications
Typical dosing with discussion on therapeutic endpoints for psychiatric use
Major drug–drug interaction considerations
For each of these medications, please review potential drug–drug interactions listed below. Consider alternative dosing schedules, clinical implications for the drug interactions, additional patient education needed, any additional monitoring recommended, or collaboration needed with other medical professions (such as, primary care providers)
Lamotrigine + Valproate
Lamotrigine + Rifampin
Valproate + Estrogen containing birth control.
Valproate + Amitriptyline
Lithium + Furosemide
Lithium + Lisinopril
Carbamazepine + Lurasidone
Carbamazepine + Grapefruit juice
Discuss the ethical, legal, and social implications related to prescribing bipolar and other related mood-disorder diagnoses therapy for patients.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. For this Assignment, you are only required to include a title page. The Walden Writing Center Sample PaperLinks to an external site. provides an example of those required elements.
By Day 7 of Week 8
Submit by Day 7 of Week 8.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK8Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6630_Week8_Assignment_Rubric
NURS_6630_Week8_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeFor each of the four (4) traditional mood stabilizers, response includes proposed mechanism of action, baseline assessment, laboratory considerations, and frequency of ongoing. Discusses the importance of assessment and labs. Indication of special population considerations FDA approval. Discusses typical dosing with focus on therapeutic endpoints for psychiatric use of major drug-drug interaction considerations.
50 to >36.0 pts
Excellent
The response comprehensively and clearly describes all of the elements for each of the four (4) mood stabilizers.
36 to >24.0 pts
Good
The response clearly describes at least 75% the Assignment elements for three to four (3–4) mood stabilizers.
24 to >11.0 pts
Fair
The response describes at least 50% the Assignment elements for each mood stabilizer or only two (2) mood stabilizers discussed.
11 to >0 pts
Poor
The response includes inaccurate and vague examples that describe 25% or less of the Assignment elements for one (1) mood stabilizer, or some or all are missing.
50 pts
This criterion is linked to a Learning OutcomeReviews the potential drug–drug interactions of the following: *Lamotrigine + Valproate; *Lamotrigine + Rifampin; *Valproate + Estrogen containing birth control; *Valproate + Amitriptyline; *Lithium + Furosemide; *Lithium + Lisinopril; *Carbamazepine + Lurasidone; *Carbamazepine + Grapefruit juice. Consider alternative dosing schedules, clinical implications for the drug interactions, additional patient education needed, any additional monitoring recommended, or collaboration needed with other medical professionals.
20 to >18.0 pts
Excellent
Reviews all seven to eight (7-8) of the potential drug-drug interactions with clear and accurate Discussion of alternative dosing, patient education, monitoring recommendation, and when to collaborate.
18 to >15.0 pts
Good
Reviews five to six (5–6) of the potential drug-drug interactions with clear and accurate Discussion of alternative dosing, patient education, monitoring recommendation, and when to collaborate.
15 to >10.0 pts
Fair
Reviews three to four (3–4) of the potential drug-drug interactions with some Discussion and minor inaccuracies of alternative dosing, patient education, monitoring recommendation, and when to collaborate.
10 to >0 pts
Poor
Reviews up to eight (8) of the potential drug-drug interactions with vague and major inaccuracies noted in the Discussion, including alternative dosing, patient education, monitoring recommendation, and when to collaborate.
20 pts
This criterion is linked to a Learning OutcomeDiscusses ethical, legal, and social implications related to prescribing these medications to patients.
10 to >7.0 pts
Excellent
The response accurately and clearly discusses ethical, legal and social implications. The response includes relevant, specific, and appropriate examples that fully support the Discussion.
7 to >4.0 pts
Good
The response accurately discusses ethical, legal and social implications. The response includes relevant, specific, and accurate examples that support the Discussion.
4 to >1.0 pts
Fair
The response inaccurately or vaguely discusses ethical, legal and social implications. The response includes inaccurate and irrelevant examples that may support the Discussion.
1 to >0 pts
Poor
The response inaccurately and vaguely discusses ethical, legal and social implications, or it is missing. The response includes inaccurate and vague examples that do not support the Discussion, or it is missing.
10 pts
This criterion is linked to a Learning OutcomeThe paper is succinct and is 5–6 pages. Five (5) evidence-based, peer- reviewed scholarly references outside of course resources.
5 to >4.0 pts
Excellent
The paper is succinct and is 5–6 pages. Five (5) evidence-based, peer- reviewed scholarly references outside of course resources
4 to >3.0 pts
Good
The paper is succinct and is 7–8 pages. Four (4) evidence-based, peer- reviewed scholarly references outside of course resources
3 to >1.0 pts
Fair
The paper is somewhat succinct and is 8–9 pages. Two or three (2 or 3) evidence-based, peer- reviewed scholarly references outside of course resources
1 to >0 pts
Poor
The paper is not succinct and is 10+ pages. One (1) or no evidence-based, peer- reviewed scholarly references outside of course resources
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
4 to >3.0 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the Assignment is stated yet is brief and not descriiptive.
3 to >1.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the Assignment is vague or off topic.
1 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. No purpose statement, introduction, or conclusion was provided.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and proper punctuation.
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts
Good
Contains one or two grammar, spelling, and punctuation errors.
3 to >1.0 pts
Fair
Contains three or four grammar, spelling, and punctuation errors.
1 to >0 pts
Poor
Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent
Uses correct APA format with no errors.
4 to >3.0 pts
Good
Contains one or two APA format errors.
3 to >1.0 pts
Fair
Contains three or four APA format errors.
1 to >0 pts
Poor
Contains five or more APA format errors.
5 pts
Total Points: 100

systematic review
part 1 & 2 synopsis& protocol included in attachment
sources from the synopsis and protocol and relevant sources can be added

Instructions, Narrative template, Modules slice pictures and module transcripts, and PowerPoint are uploaded to this order.

Please see attached readings as well as SLOs then answer below questions:
After reviewing the assigned readings and module 2 start page, please answer the following:
Think about your work environment. What are some of the characteristics of the consumers you care for? How have they changed your practice?
What information does your hospital administration share about payers and stakeholders? If they don’t share, should they? Why or Why not?
Explain how the readings and discussion helped you achieve your SLOs this week.

Please find attached readings/SLO then answer questions below:
For this discussion, please answer the following questions. PLEASE NOTE I WORK IN A HOSPITAL ON ONCOLOGY MED SURG FLOOR
Talk about the importance of variance reporting and some of the areas you are likely to see the most costly variances.
In a value-based environment how can the nurse increase reimbursements and decrease revenue loss?
Describe how this week’s material has assisted you in achieving your student learning outcomes.

Assignment Instructions
Review the American Nurses Association (2021) definitions and concepts related to competence:
“A competency is an expected level of performance that integrates knowledge, skills, abilities, and judgment. Knowledge encompasses thinking, understanding of science and humanities, professional standards of practice, and insights gained from context, practical experiences, personal capabilities, and leadership performance. Skills include psychomotor, communication, interpersonal, and diagnostic skills. Ability is the capacity to act effectively. It requires listening, integrity, knowledge of one’s strengths and weaknesses, positive self-regard, emotional intelligence, and openness to feedback.” (American Nurses Association, 2021, p. 146).
In this paper, you will need to provide an explanation for how you have achieved the following key nursing competencies: patient-centered care, professional identity, spirit of inquiry, and nursing judgment. Additionally, you will address how you achieved the following competencies in your work in the program as you move into the final course of the program: NUR250 M7.5 Nurse Competencies Paper Writing Template.docDownload NUR250 M7.5 Nurse Competencies Paper Writing Template.doc
Here are the competencies to address:
Competencies:
Use of a caring holistic approach to provide and advocate for safe quality care for patients and families in an environment that values the uniqueness, dignity, and diversity of patients. (Patient-centered care)
Apply the nursing process to make nursing judgments, substantiated with evidence to provide safe, quality patient care across the lifespan. (Nursing Judgment)
Use of principles of management and delegation to implement plans of care with members of the interprofessional team to achieve safe, quality patient outcomes. (Professional Identity)
Apply principles of leadership and interprofessional collaboration to improve patient outcomes. (Professional Identity)
Integrated evidence-based findings and technology into the provision of patient-centered nursing care for patients. (Spirit of Inquiry)
Use specific detailed examples to explain and support how you achieved the competencies of patient-centered care and nursing judgment. (Spirit of Inquiry)
References
Provide a separate reference page with all sources cited within the text.
Use APA format (7th Edition) to cite any external sources used in the paper.
The paper must be in APA format and include at least 3 professional peer-reviewed resources dated within the last 5 years.
Writing
Use clear, concise writing that communicates meaning to the reader.
Consider using Grammarly by signing up for a free account at www.grammarly.comLinks to an external site.
Here is an outline to help you draft your paper along with a template. Click the link to download the template:
(Remove all instructions within the template before submitting your paper, otherwise, you will receive a high Turnitin score.)
Submit to the Canvas assignment dropbox via Turnitin (see Submission Guidance below).
Evaluation
Please review the Nurse Competencies Paper Rubric Download Nurse Competencies Paper Rubric prior to submitting your work.
This activity is used to assess an end-of-program student learning outcome (EPSLO) for the associate degree in nursing. You will see additional row(s) at the bottom of your rubric from your instructor along with assessment levels of Proficient/Competent/Advanced Beginner/Novice for each EPSLO. These rows do not factor into your grade.
Formatting Considerations
The paper must:
Follow APA format.
Be double-spaced.
Be approximately two to three pages in length (not counting the title page and reference section).
Have a title page that includes the paper title, your name, and the course number.
Include at least 3 professional peer-reviewed resources dated within the last 5 years.
Helpful Resources – click the links to navigate to these helpful pages in the Excelsior University Online Writing Lab (OWL)
Excelsior University OWL – Grammar EssentialsLinks to an external site.
Excelsior University OWL – Avoiding PlagiarismLinks to an external site.
Excelsior University OWL – Citation & DocumentationLinks to an external site.
Submission Guidance
This course has Turnitin® fully integrated into the course dropbox. Compose your work in a .doc or .docx file type using a word processor (such as Microsoft Word, etc.) and save it frequently to your computer.
Check your work and correct any spelling or grammatical errors. When you are ready to submit your work, click “Upload Submission.” Enter the submission title and then click on “Select a file to upload.” Browse your computer, and select your file. Click “Open” and verify the correct file name has appeared next to Submission File. Click on “Continue.” Confirm submission is correct and then click on “Accept Submission & Save.” 
Turnitin®
As part of your learning experience, you are provided access to a plagiarism prevention service called Turnitin. Using Turnitin serves as a learning experience and an opportunity to correct any areas in your papers involving plagiarism or improper citation. 
Once submitted, your assignment will be evaluated by Turnitin® automatically. You will be able to view an Originality Report within minutes of your first submission that will show how much of your work has been identified as similar to other sources such as websites, textbooks, or other student papers.
Use your Originality Report as a learning tool to identify areas of your assignment that you may not have cited appropriately. 
The overall match can be no higher than 15%, with any match no higher than 2%.
You may resubmit your assignment through dropbox as many times as you need to check to see if you have made improvements, until the due date of the assignment. However, once you have made your first submission, you will need to wait 24 hours after each subsequent submission to receive a new Originality Report. Plan accordingly as you draft your assignment. Once the due date has passed, your assignment submission will be considered final.
You should only submit your assignments to dropbox within the assignment area. Please do not submit your assignment directly to Turnitin.com.