Describe the mission and goals of the center, the services provided by the center, and the case mix of the participants.

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write 500–700 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.
Community health centers have long served as a health care safety net for vulnerable populations such as the underinsured and uninsured. Community health centers provide primary, dental, and urgent care. They are located in a federally-designated medically underserved area (MUA), or they serve medically underserved populations (MUP).
Complete the following for this assignment:
Visit a community health center Web site.
1. Describe the mission and goals of the center, the services provided by the center, and the case mix of the participants.
All sources should be cited using APA format. Grammar, spelling, punctuation, and format should be correct and professional.

ENSURE TO INCLUDE A REFERENCE PAGE.

What are the similarities and differences between emphysema and chronic bronchitis?

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Write 400-600 words on the following:
1. Mr. Rusch is being evaluated for multiple pulmonary emboli. What risk factors and clinical findings are commonly associated with pulmonary emboli?
2. What are the similarities and differences between emphysema and chronic bronchitis?
3. What are the differences when comparing prerenal acute renal failure, intrarenal acute renal failure, and postrenal acute renal failure? Give examples of each.
Support your response with at least 2 APA-cited scholarly references. One of the references must include UpToDate.

What are some important teachings you would give this client when administering the first dose? 

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You are a nurse at an outpatient clinic and are presented with a 68-year-old female client.  She is experiencing the following symptoms: decreased appetite, disturbed sleep pattern, fatigue, difficulty concentrating, disordered thought process, anhedonia, guilt, and low self-esteem. The doctor diagnoses the client with major depressive disorder.  Answer the following questions:

  • What medication do you think is likely to be prescribed for this client and why?
  • What are some important teachings you would give this client when administering the first dose?
  • When following up with the client 2 months later.  What are some changes you may expect to see with the client? If the client is not displaying the expected outcomes, what are some possible alternatives for the client?

Why, at this juncture in your life, have you decided to pursue a career in nursing rather than any other health science field?

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Why, at this juncture in your life, have you decided to pursue a career in nursing rather than any other health science field? What role does Columbia Nursing play specifically into your future plans? Assess your skills and how they will aid in your transition into becoming a Columbia Nursing student.
Additionally, discuss your understanding of your intended specialty and how prepared you are to pursue this role.

Compare and contrast the HIT innovation with older methods of workflow.

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  1. Review each of the following current applications of HIT on pp. 309 – 312 of your textbook (Blais & Hayes, 2016).
  • physician order entry
  • clinical information systems
  • wireless and portable devices
  • electronic health record
  • telehealth
  1. Choose three (3) current applications of HIT that you have experienced or witnessed within the healthcare practice setting to discuss in the boxes below.
  • Describe the HIT innovation.
  • Compare and contrast the HIT innovation with older methods of workflow.
  • Explain how the HIT innovation has improved patient outcomes. Support each answer with at least one (1) source of scholarly evidence.

Discuss a social justice movement that has public health implications.

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In this assignment, you will discuss a social justice movement that has public health implications. An analysis of the social justice trend will be supported by a selected social justice theory. You will discuss how the social justice movement will impact public health or the health care system. An evaluation of the legislative or policy response to the social justice movement will be provided. A discussion of the implication of these policies and legislative solutions will be guided by the World Health Organization (WHO) Health in All Policies initiative. The paper should be concluded by summarizing priority points related to the assignment. Information in the paper should be supported by evidence-based references with consideration of nursing resources.

Identify one disorder of coagulation and describe the pathophysiology and the subsequent results.

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Describe the coagulation cascade. Identify one disorder of coagulation and describe the pathophysiology and the subsequent results.

Analyze the relevance and potential effectiveness of evidence when making a decision.

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Create a 3-5-page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.

PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.

It stands for:

P – Patient/population/problem.
I – Intervention.
C – Comparison (of potential interventions, typically).
O – Outcome(s).
T – Time frame (if time frame is relevant).
The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search.

You are encouraged to complete the Vila Health PCI(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
Explain the findings from articles or other sources of evidence.
Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Competency 3: Apply an evidence-based practice model to address a practice issue.
Define a practice issue to be explored via a PICO(T) approach.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
Professional Context

As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.

PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related to the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question.

Scenario

For this assessment, please use an issue of interest from your current or past nursing practice.

If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.

Instructions

For this assessment, select an issue of interest an apply the PICO(T) process to define the question and research it.

Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.

If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful.

In your submission, make sure you address the following grading criteria:

Define a practice issue to be explored via a PICO(T) approach.
Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
Explain the findings from articles or other sources of evidence.
Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:Your assessment should meet the following requirements:

Length of submission: Create a 3–5-page submission focused on defining a research question and interpreting evidence relevant to answering it.
Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
APA formatting: Format references and citations according to the current APA style.

reating a question using the PICOT elements will provide a framework for the research you need to conduct an evidence-based study or to make an evidence-based decision.

PICOT Elements:
(P) – Population, Patients or Problem: The sample of subjects used in a study, or the problem being addressed.

(I) – Intervention: The treatment that will be provided to subjects enrolled in your study.

(C) – Comparison or Control: Identifies an alternative intervention or treatment to compare. Many study designs refer to this as the control group. If an existing treatment is considered the ‘gold standard’, then it should be the comparison group. A control group is not required for every type of study.

(O) – Outcome: The clinical outcome that measures the effectiveness of the intervention.

(T) – Time: Duration of the data collection. Some versions don’t include this element, and time may not be specified in cases where the question is focused on prediction or diagnoses.

PICOT Question Formats:
Intervention: In _______ (P), how does _______ (I) compared to _______ (C) affect _______ (O) within _______ (T)?

Prognosis/Prediction: In _______ (P), how does _______ (I) compared to _______ (C) influence/predict _______ (O) over _______ (T)?

Diagnosis or Diagnostic test: In _______ (P) are/is _______ (I) compared to _______ (C) more accurate in diagnosing _______ (O)?

Etiology: Are _______ (P), who have _______ (I) compared to those without _______ (C) at _______ risk for/of _______ (O) over _______ (T)?

Meaning: How do_______ (P) with _______ (I) perceive _______ (O) during _______ (T)?

Example PICOT Questions:
In acute care hospitals (P), how does having a rapid response team (I) compared with not having a response team (C) affect the number of cardiac arrests (O) during a three-month period (T)?
In women with gestational diabetes (P), how does a monitored diet and exercise program over the course of pregnancy (I &T), compared to the use of metformin only (C) reduce the incidence of high birth weight babies(O)?
In patients admitted for acute myocardial infarction (P), how well does the hospital’s new data model created from EMR data (I) compared to current practices (C) predict readmission rates (O) within 30 days after initial discharge (T)?

For patients of a rural health clinic (P), does the use of text message reminders (I), compared with telephone calls (C) reduce the number of missed appointments (O) over a six month period (T)?

Identify one disorder of primary hemostasis and describe the pathophysiology and the subsequent results.

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Describe primary hemostasis. Identify one disorder of primary hemostasis and describe the pathophysiology and the subsequent results.

Describe in detail the underlying pathophysiology related to the assessment findings.

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There will be two ISBAR scenarios provided, with patient information and images. Please choose only one of these scenarios to focus on for your written report.There are two main focus areas for the written report:

1) Describe in detail the assessment (‘airway and breathing’ or ‘circulation’) of an acutely unwell child. You must describe the assessment as indicated on the scenario;

2) Outline the likely findings from that assessment based on the information and images provided in the clinical scenario; and

2) Describe in detail the underlying pathophysiology related to the assessment findings.The assessment of the unwell child should cover the type of assessments you would undertake, what you are likely to find based on the information provided in the clinical scenario, and how these findings differ from the normal findings for that child if they were not unwell. The assessment should be relevant and specific to the child’s condition and developmental stage.

The description of the underlying pathophysiology should directly relate to the assessment findings. For example, what is the underlying pathophysiology that is causing the breath sounds heard when auscultating the child or infant’s chest? The description of the pathophysiology should be relevant and specific to the child’s condition and developmental stage.