Improving Obstetric Patient Outcomes
Order Description
Maternal morbidity and mortality is a national health problem. Preventing complications of pregnancy is included in the 2020 National Health Goals. The purpose of this written assignment is to describe how evidenced based findings can improve patient outcomes related to obstetrical care.
Tanya Kim, 36, G4 P4, was in labor for 36 hours when she had a cesarean birth for a failed induction of labor. She delivered a 9 pound 8 ounce male infant. Tanya’s labor was induced with oxytocin at 41 weeks gestation and continuous epidural was placed during active labor. The epidural was discontinued after delivery. She has iron deficiency anemia but otherwise an unremarkable medical history. She has no known allergies. Her obstetrical history includes 1 spontaneous abortion 6 years ago, vaginal delivery of twins 4 years ago, one singleton vaginal delivery 2 years ago and the cesarean birth today. Tanya plans to breastfeed her infant.
Two hours post-delivery the RN assesses the following:
Vital signs: BP 90/62, pulse 88, Respirations 22, temperature 98.6°F
Skin color: pink
Fundus: boggy, firms with fundal massage, midline and at umbilicus.
Lochia: Heavy rubra with nickel-sized clots
Pain: Uterine cramping rates pain 4 out of 10 on verbal pain scale
Intravenous fluids: 3000 mL Lactated Ringers with 20 units of Pitocin in each bag.
Urinary output: 200 mL since delivery (urinary catheter in place)
Patient comments: “I’m really tired. I have been up for the last two nights.”
One hour later the patient puts her light on and makes the following comment:
“I’m really bleeding a lot!” The RN comes in the room and notes increased vaginal bleeding. The patient is pale, diaphoretic, and the uterine fundus is boggy. The fundus does not firm with massage.
Using APA format, write a 2-3 page paper (excludes cover and reference page) that addresses the following:
Identify at least one (1) risk factor from the patient’s obstetrical history associated with the primary problem. Describe why this piece of obstetrical history places the patient at risk for the identified problem.
Early identification of emergencies in the obstetric setting is essential to save lives. Four (4) approaches are identified in the literature that can be utilized to positively impact patient outcomes: simulations, drills, protocols, vital sign alerts. Select one of these approaches and address the following:
Discuss two (2) benefits and two (2) limitations of the selected approach.
Describe two (2) ways by which this approach will improve patient outcomes in the perinatal setting.
A minimum of two (2) current professional references must be provided. Only one (1) textbook that is no more than one (1) edition old may be used.
Current references include professional publications that reflect nursing care provided within the United States. Current nursing professional references must be current (five [5] years or less). Reliable internet sources such as those offered by government agencies, academic institutions or nationally recognized professional organizations may also be used. Examples of unacceptable internet sources include but are not limited to: Wikipedia, medicinenet.com, allnurses.com, and any nursing blog site.
Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format.

 

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Workplace Related Legal and Ethical Issues

Order Description

Week 5 Assignment: Workplace Related Legal and Ethical Issues
Due Day 7 of Week 5
Write a four to five page paper addressing how your chosen work-related issue/problem from the week two discussion is addressed by your state Board of Nursing (BON) and other professional nursing organizations. Use the following guidelines and evaluation criteria.
Include level-one APA headings in your paper using the section headings below. Use a minimum of five references from the professional nursing literature in the assigned course readings and other references in the Walden Library. In addition, you may use one or two professional web sites if relevant to your topic.
Begin this paper with a brief paragraph that provides an overview of the assignment and its purpose. The heading for this paragraph is the same as the title of the paper. This should be no more than two to three sentences. The last sentence in this paragraph is a sentence that begins “The purpose of this paper is to. . . . The introductory paragraph is worth 20 points.
Workplace Issue – 40 points
Describe your chosen workplace issue from the week two discussion board (such as mandatory staffing ratios, mandatory overtime, or risks in the workplace) Provide a background to the issue and discuss why it is important to address.
The BON and Workplace Issue – 60 points
Explain your state’s Board of Nursing (BON) approach to your work-related issue in the BON’s Nurse Practice Act and the efficacy of the BON’s approach in the context of your workplace issue/problem. For example, how does your state BON’s approach to threats of patient abandonment apply to the issue of mandatory overtime?

The American Nurses Association and Your Workplace Issue – 60 points
Describe two American Nurses Association (ANA) sources from the ANA publication that address your work-related issue and the efficacy of the ANA’s approach in the context of your work environment. Resources are provided in the Week 5 Resources areas of the course,
Summary – 20 points
End the paper with a one-paragraph summary of the main points of the paper.
Format/Style
Proofread the paper and correct any typos, grammar, spelling, punctuation, syntax, or APA format errors before submitting your pape. Up to 30 points can be deducted from the grade for this assignment for these types of errors, or for not using at least the minimum number of required professional literature references.
Total points for assignment = 200 points.
When completed, save the assignment as APP5+last name+your first initial.doc. For example, Sally Ride’s Week 5 Application Assignment would be named “APP5RideS.doc.” Submit this assignment in the “Assignment Turnitin Week 5” area of the course. Click the View/Complete link. Follow instructions once the Turnitin submission site opens.

References
List your five different references here. Be sure that they are current (five years or less) and
formatted per APA Style.

Huston, C. J. (2014). Professional issues in nursing: Challenges and opportunities (3rd ed). New
York: Lippincott, Williams & Wilkins.

Mason, D. J, Leavitt, J. K., & Chaffee, M. W. (2014). Policy and politics in nursing and health care (6th ed). St. Louis, MO: Elsevier Saunders.

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REQUIREMENTS
Assignment Criteria for Presentation:
1. Provide an introduction to your policy-priority issue.
2. Articulate key points under each of the Formulating a Healthcare Policy Ungraded Worksheet #1 sections, using the headings in your paper.
3. Provide a critique of empirical evidence that supports your chosen policy issue and analysis.
4. Demonstrate the importance and impact of the chosen policy issue to nursing.
5. Provide concluding statements summarizing the content.
6. The paper will be a minimum of 4 pages and a maximum of five pages in length, in APA format 6th edition, excluding the title and reference page.
PREPARING THE PAPER
After completing Formulating a Health Care Policy Ungraded Worksheet #1, address all areas on the worksheet in the body of a scholarly paper. Include a minimum of five (5) classic or current references published within the past 5 years.
Category Points % Description
Introduction and Conclusion 35 20 Introduction clearly introduces your policy priority issue.Concluding statements summarizing content.
Key Points 40 23 Identification of all key points of your policy-priority issue (review sections of Healthcare Policy Ungraded Worksheet) are clearly analyzed and fully articulated.
Empirical Evidence 40 23 Provide a critique of empirical evidence that supports your chosen policy issue and analysis.
Impact and Importance to Nursing 35 20 Demonstrate the importance and impact of the chosen policy issue to nursing.
APA Format 10 6 Text, title page, and references are consistent with APA format.
Writing Quality 15 8 Rules of grammar, word usage, sentence, and paragraph format and punctuation.
Total 175 100
A quality assignment will meet or exceed all of the above requirements.

 

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How to detect Sepsis?

Paper details:

Reflective writing is one way of citing evidence of practice and learning in practice. Reflective writing involves thinking about and reviewing events to try and make sense of them, using acquired nursing knowledge and understanding.

Reflective journaling also provides insight into context and emotions and addresses the matching of intellect, decision-making and problem solving appropriate for a complex and dynamic situation.

A key component of this assignment will be your reflection on specific incidents occurring during your practicum experience. The reflective journal is more than a description of what you have seen and the tasks you have performed. This journal is a chance for you to comment on your actions and experiences in your practicum placement and to explore your feelings about the same. Include how these could/should impact your personal and professional development.

As a novice nurse, you will be required to plan, implement and evaluate your own performance; the reflective journal gives you the scope to begin to develop these skills while completing your practicum.

The reflective journal is a learning tool that can be used to look at your experiences and help you to do the following:

a) Review and reflect upon your development, and how you have grown on both an individual and professional level

b) Organize your thoughts

c) Demonstrate practical application of the underpinnings of knowledge; link theory with clinical practice and vice versa

d) Demonstrate practical competence

e) Decide what new learning you need; provide evidence to show where, when and how practice outcomes/standards of proficiencies have been achieved

Suggestions for developing your reflective journal entry:

1. What might your write about?

You may choose to write about any aspect of your practice which:

? You feel your intervention made a difference in a client outcome

? You feel went unusually well

? You feel did not go as planned

? You think captures the essence of your nursing practice

? You feel was particularly demanding

2. What might you include in your writings?

The focus should be on your nursing practice

? What was going on (the context of the situation)?

o Shift, time of day, resources, clinical scenario

? What happened?

o Detailed description of situation/incident/experience

? Why this incident is important to you?

? What were your concerns at the time?

o What were you thinking and feeling during and after the experience?

o What influenced your decision making?

o What, if anything, was the most demanding aspect of this experience?

o What was unexpected?

3. Reflect upon what you learned from the experience.

You may choose to write about the following:

? A reflection or evaluation of the situation showing the competencies and expertise you used (skilled communication, teaching, leadership). Support these with current evidence-based practice literature.

? What actions did you take? Include not just what you did, but more importantly the rationale for your actions. Support these with current evidence-based practice literature

? What new knowledge or insights were gained? How would you make recommendations for change in practice?

? Provide references to show evidence based practice (see guidelines below)

? Did you learn anything? If so what?

? Have you considered another way to manage your nursing practice as it relates to this experience? Has your nursing practice changed in any way?

Guidelines

1. Utilizing the above as suggestions for contextual writing; complete two (2) journal entries over the course of NUR 4180 (See AAG for assignment due dates).

2. Journal entries should exceed no more than two (2) pages in length (not including reference page).

3. Journal entries should include a minimum of one (1) citation from a peer-reviewed, evidence based journal. The inclusion of evidence based practice is an integral part of learning, critical thinking and growth.

4. APA requirement: Reference page only

5. See attached rubric for grading.

 

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