Describe your perspectives about the nursing profession. Discuss your personal beliefs about your role as a nurse. Explain your approach to caring for others.

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Module 04 Written Assignment – Developing a Philosophy of Nursing

Module 04 Content

The definition of philosophy is having a personal and specific outlook and approach you can use to make decisions and take action. Your nursing philosophy could include your attitudes about working in healthcare facilities, working as part of a team, or how you feel about people.

In a 1-page paper, include the following:

Describe your perspectives about the nursing profession.
Discuss your personal beliefs about your role as a nurse.
Explain your approach to caring for others.

Paper must be in APA format, 7th edition.

Describe your organization as a closed or open system. Discuss how thinking differs between the two. Is there a difference in systems thinking in traditional healthcare versus complex adaptive systems?

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Responding to post week 3 nr-534

  • Describe your organization as a closed or open system. Discuss how thinking differs between the two. Is there a difference in systems thinking in traditional healthcare versus complex adaptive systems?

 

In advanced heart failure patients, how does Cardiomems device implantation compared to only medical management reduce reoccurring hospital admissions after the first year of device use?

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Advanced Heart Failure: Cardiomems vs. Medical Management Only

  • Jackie Rice
  • Purdue Global University
  • MN 504 Scientific and Analytic Approaches to Advanced Evidence-Based Practice
  • Dr. Kristene Diggins
  • January 9, 2023

Advanced Heart Failure: Cardiomems vs. Medical Management Only

Some patients with heart failure (HF) progress to advanced heart failure. This number is growing notably, an aspect attributed to a host of factors, including the increasing prevalence rate and improved survival of HF patients and increasing population aging (Subramaniam et al., 2022; Tomasoni et al., 2022). As a result, many clinicians experience treatment challenges because the patients develop severe symptoms and impaired quality of life, making them less responsive to treatment therapies and at enhanced risk of hospitalizations and death (Tomasoni et al., 2022). In line with this assertion, it is prudent for clinicians to adopt interventions that could help in reducing reoccurring hospital admissions. Therefore, this paper compares the efficacy of Cardiomems device implant versus only medical management in reducing reoccurring hospital admissions.

Discussion

Clinical Question

The clinical question this paper explores is: In advanced heart failure patients (P), how does Cardiomems device implantation (I) compared to only medical management (C) reduce reoccurring hospital admissions (O) after the first year of device use (T)?

Databases

Several databases were considered appropriate sources of evidence-based references related to the clinical question. However, two electronic databases, CINAHL and PubMed, were considered most appropriate and used to search for references relevant to the clinical question. Search terms used included ‘Cardiomems device implantation,’ ‘advanced heart failure medical management,’ ‘advanced heart failure,’ and ‘advanced heart failure therapies.’

 

Evidence-Based References

The search identified ten evidence-based references. Four references were excluded as they were more than five (5) years, while one (1) was excluded as they did not relate to either of the two interventions. Another reference was excluded as it was not a research article but a commentary article; hence considered appropriate and relevant for the clinical question. Four (4) evidence-based references were considered relevant to the clinical question. These references include Brugts et al. (2021), Volterrani et al. (2019), Assaad et al. (2019), and Abraham et al. (2020). The references were analyzed for evidence regarding the PICOT questions. The findings are presented in the next section.

Findings from the Evidence-Based References

The obtained evidence-based references showed that the Cardiomems device implant reduced reoccurring hospital admissions compared to only medical management. In the first evidence-based reference, Brugts et al. (2022) analyzed and summarized clinical evidence for remote patient care for an HF patient using Cardiomems. In this article, Brugts et al. (2022) described the Cardiomems device as capable of monitoring pulmonary artery pressure remotely, enabling clinicians to implement proactive medical interventions. In this evidence-based reference, Brugts et al. (2022) cited the CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients (CHAMPION) trial published in 2011 as the first clinical trial that proved that implantable devices such as Cardiomems could reduce the number of HF hospitalizations. The study involved 550 advanced HF patients, with 270 patients on the Cardiomems HF system and a control group comprising 280 patients (Brugts et al., 2022). The results revealed that the control group had 120 advanced HF hospitalizations while the Cardiomems group had 84 hospitalizations (Brugts et al., 2022). A 6-month follow-up showed that HF-related hospitalizations for the Cardiomems/treatment group reduced by 37% compared to the control group. In the second evidence-based reference, Volterrani et al. (2019) analyzed the use of implantable devices for advanced HF management. They focused on the Cardiomems device. They based their analysis on a sub-study conducted on 245 Medicare-eligible subjects. The results revealed a 49% reduction in HF-related hospitalizations in the treatment group compared to the control group. In the third evidence-based reference, Assaad et al. (2019) explored the effectiveness of the Cardiomems device in reducing HF-related readmissions. In their study involving 27 patients, the total number of HF-related hospitalizations prior to Cardiomems implantation was 46 compared to 9 hospital readmissions post Cardiomems device implantation (Assaad et al., 2019). According to Assaad et al. (2019), there was an 80.4% reduction in HF-related hospitalizations compared to the control group. In the fourth evidence-based reference, Abraham et al. (2020) summarized published data on Cardiomems. Their analysis revealed a 28% reduction in HF-related hospital admissions among patients with Cardiomems implants compared to patients receiving standard care (Abraham et al., 2020). The findings from these four evidence-based references show that the Cardiomems device implant significantly reduced hospital reoccurring HF-related hospitalizations compared to only medical management/standard care.

Conclusion

This paper has explored the efficacy of the Cardiomems device in advanced heart failure management compared to only medical management. Findings from the four evidence-based references obtained from CINAHL and PubMed databases revealed that the Cardiomems device significantly reduced HF-related reoccurring hospitalizations compared to standard care. Based on this finding, clinicians and healthcare systems should consider adopting this device in patient care for advanced HF patients. This intervention will enable them to monitor patients remotely and take proactive therapeutic interventions to prevent reoccurring hospitalizations.

 

References

Abraham, J., McCann, P.J., Guglin, M.E., Bhimaraj, A., Benjamin, T.S., Robinson, M.R., Jonsson, O.T., Feitell, S.C., Bhatt, K.A., Bennett, M.K., Heywood, J.T., & Hemodynamic Frontiers in Heart Failure (HF2) Investigators (2020). Management of the patient with heart failure and an implantable pulmonary artery hemodynamic sensor. Current Cardiovascular Risk Reports, 14, 12. https://doi.org/10.1007/s12170-020-00646-4

Assaad, M., Sarsam, S., Naqvi, A., & Zughaib, M. (2019). CardioMemsVR device implantation reduces repeat hospitalizations in heart failure patients: A single center experience. JRSM Cardiovascular Disease, 8, 1-7. http://dx.doi.org/10.1177/2048004019833290

Brugts, J. J., Radhoe, S. P., Aydin, D., Theuns, D. A., & Veenis, J. F. (2021). Clinical update of the latest evidence for CardioMEMS pulmonary artery pressure monitoring in patients with chronic heart failure: A promising system for remote heart failure care. Sensors (Basel, Switzerland), 21(7), 2335. https://doi.org/10.3390/s21072335

 Subramaniam, A. V., Weston, S. A., Killian, J. M., Schulte, P. J., Roger, V. L., Redfield, M. M., Blecker, S. B., & Dunlay, S. M. (2022). Development of advanced heart failure: A population-based study. Circulation Heart Failure, 15(5), e009218. https://doi.org/10.1161/CIRCHEARTFAILURE.121.009218

Tomasoni, D., Vishram-Nielsen, J. K. K., Pagnesi, M., Adamo, M., Lombardi, C. M., Gustafsson, F., & Metra, M. (2022). Advanced heart failure: Guideline-directed medical therapy, diuretics, inotropes, and palliative care. ESC Heart Failure, 9(3), 1507–1523. https://doi.org/10.1002/ehf2.13859

Volterrani, M., Spoletini, I., Angermann, C., Rosano, G., & Coats, A. J. (2019). Implantable devices for heart failure monitoring: the CardioMEMS™ system. European Heart Journal Supplements: Journal of the European Society of Cardiology, 21(Suppl M), M50–M53. https://doi.org/10.1093/eurheartj/suz265

Identify appropriate expected outcomes for your project. Identify the strategies to implement your project.What specific questions will your project address? How are these questions related to one another?

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Capstone Project

Part 1– (2 pages)

Objective

Identify appropriate expected outcomes for your project.
Identify the strategies to implement your project.

Deliverables

Write a 2-3 page (not including the title and reference pages)
APA formatted paper with an introduction and conclusion.
APA headings for each section of the paper
At least 5 references

Step 1: Capstone Project

Write a paper identifying the Expected Outcomes, Approach, and Budget for your capstone.

Step 2: Consider

Expected Outcomes at least 5
What specific questions will your project address?
How are these questions related to one another?

Approach
What will you actually do to address the actionable questions?
What will you do to create “improved outcomes”?

Budget
Step 3: Write

Write a paper that addresses the criteria above.
Use the template attached below.

Part 2– (1 page)

Budget Template

Objectives

Identify a budget for your project

Deliverables

Complete the Budget Requirements Template Assignment attached below.

Select one of the two documents for the response. Provide a brief synopsis of what you learned from the document. Explain how are you plan on using systematic review to support your research?

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Discussion Board

The aim of this Discussion Board is for you to learn more about two topics with systematic reviews, as evident by the two chapter supplements:

Chapter Supplement A: Publication Bias in Systematic Reviews
Chapter Supplement A.pdf Download Chapter Supplement A.pdf
Chapter Supplement B: Supplementary Resources for Qualitative Evidence
Chapter Supplement B.pdf Download Chapter Supplement B.pdf

Take a moment to read both documents.

Select one of the two documents for the response.
Provide a brief synopsis of what you learned from the document.
Explain how are you plan on using systematic review to support your research?
Provide one reference to support your answer.

Based on your reading, propose one population-focused intervention to improve on the issue raised in the article. Provide details and specifics for the intervention. Make sure that you use APA format to properly cite the article.

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Week 4 Discussion: Explore the Health Needs of a Population 15 15

To create your initial post to this discussion forum, complete the following steps.

Step 1: Find an article.
Identify one peer-reviewed article from a nursing journal focused on the health needs of one of the following populations in the United States:

  • People with disabilities
  • People who are incarcerated (in jail or prison)
  • People who are refugees
  • People who are homeless

Step 2: Read the article.
Critically read the article. While you read, note the purpose of the article, the methodology of data collection, how evidence is incorporated into the nursing implications, the major ideas of the article, whether the article makes sense, whether the conclusions are logical, and so on.

Step 3: Summarize the article and propose a population-based intervention Summarize the article, including the evidence and conclusions, as well as the implications for population-based nursing.
Based on your reading, propose one population-focused intervention to improve on the issue raised in the article. Provide details and specifics for the intervention. Make sure that you use APA format to properly cite the article.

Step 4: Post to the discussion forum.
Post the summary of your article to the discussion forum.
In addition to your original post, be sure to provide a meaningful response to at least two of your peers’ posts by Friday night at 11:59pm Mountain Time. Read other students’ article summaries and respond to at least two other students’ postings that focused on the health needs of two populations that were different from the one you chose. (Step 1 lists the three populations.) What else do you want to know about the health need? Comment and/or expand on the implications for population-based nursing posed for the other two populations. Give suggestions for enhancing the proposed interventions. Expand on aspects of population-based and community-based nursing as defined by others that are different from or complementary to your own ideas.

Search entries or author

Your initial post should be 2-3 paragraphs long and follow the requirements outlined in the discussion rubric. Please add to the discussion in your peer responses with informative responses, instead of posts similar to “great idea! I really agree with you.” The initial post and the peer responses have different deadlines. Make sure that your discussion adheres to these deadlines.
APA guidelines and plagiarism prevention matter in discussion posts just like with other scholarly assignments. Cite all references appropriately using APA format

Using your reading in this course so far and other research, discuss the ethical ramifications of this statement.

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Week 4 Discussion: Natural Law and Human Rights 6 6

Your Instructor will post a response to your post by Friday 11:59 pm MT.
Respond to your instructor’s comments by Sunday 11:59pm Mountain Time

Step 1
Choose either Option A or Option B and post a 150+ word discussion by Wednesday, 11:59 pm MT, Be specific and give examples, using at least two outside references, to buttress your argument. Cite all sources in APA format.

Option A:
“The Natural Law theory is a product of a Christian society. It does not arise outside of a Christian framework.”

Discussion:
Using your reading in this course so far and other research, discuss the ethical ramifications of this statement.

Option B:
“The hungry man needs food above all else, the cold need clothing, the homeless shelter. Poverty creates the kind of suffering that degrades man and excludes the possibility of a properly human and spiritual life. Thus the battle against poverty is a battle for the rights of the human spirit. (Sergei Bulgakov, “Economic Ideal,” p. 43)

Discussion:

Using your reading in this course so far and other research, discuss the ethical ramifications of this statement.

 

Step 2
Read your instructor’s response and post a response to him by Sunday, 11:59 pm MT. Click on the Discussion Board link above to participate in this week’s discussion. Select reply to join the discussion. For grading details, select the three dots above to see the rubric.

Using research, what are specific provisions within the ACA that will directly impact the delivery, type, and/or method of care you give to your patients?

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DISCUSSION ESSAY

Post a response to the discussion board by answering the following question related to the Affordable Care Act and how the provisions affect the type and delivery of care to patients.

Using research, what are specific provisions within the ACA that will directly impact the delivery, type, and/or method of care you give to your patients?

Choose two or three areas of prenatal care that you would want to discuss with Mary, and then write brief notes about what you know and/or need to learn about Amish values to discuss perinatal care in a way that is culturally congruent.

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CASE STUDY

Mary and Elmer’s fifth child, Melvin, was born 6 weeks prematurely and is 1-month old. Sarah, age 13, Martin, age 12, and Wayne, age 8, attend the Amish elementary school located 1 mile from their home. Lucille, age 4, is staying with Mary’s sister and her family for a week because baby Melvin has been having respiratory problems, and their physician told the family he will need to be hospitalized if he does not get better within 2 days.

  1. Choose two or three areas of prenatal care that you would want to discuss with Mary, and then write brief notes about what you know and/or need to learn about Amish values to discuss perinatal care in a way that is culturally congruent.
  2. Discuss three Amish values, beliefs, or practices to consider when preparing to do prenatal education classes with Amish patients.

should be at least 500 words, formatted and cited in current APA style, (in-text) citations with support from at least 2 academic sources

 

What should members of Congress know about China’s problems and aspirations in health policy? What lessons from abroad would be most relevant in reforming the U.S. health system?

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Case Study

Case Study is on the word document on the last page

You are an employee of a think tank in Washington, DC. The director has been asked to testify before a congressional committee on the following question: In reforming the ACA, what lessons should the United States learn from relevant experience abroad? Your job is to write a memorandum that will help the director answer this question. In writing this memo, you should address the following questions:
1. How can learning from abroad help policy makers engage in a process of self-examination of health policy at home?
2. Compare the NHS and NHI systems.
3. What should members of Congress know about China’s problems and aspirations in health policy? What lessons from abroad would be most relevant in reforming the U.S. health system?