Category: Nursing

Improvement of Surgical Care Paper

Improvement of Surgical Care
Improvement of Surgical Care

Improvement of Surgical Care

Order Instructions:

he M6A4: case study counts as 10% of your grade for this course.

We suggest that you develop and outline and use the following time-line as your guide for completing your paper:

Week 1: Review the requirements for the paper.
Week 2: Begin developing an outline for your paper.
Week 3: You should have your outline completed.
Week 4: You should be using your outline to write your paper.
Week 5: Continue work on your paper.
Week 6: Finalize your paper and submit by the end of the week.
Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page.

Information on using an outline and writing a scholarly paper is available through the Excelsior College Online Writing Lab (OWL).

If you have questions, reach out to your instructor via My Messages.

linked item M6A4: A Patient with Musculoskeletal Limitations Complicated by a Medical Illness
The Surgical Care Improvement Project (SCIP), was implemented as a commitment to improving the safety of surgical patients by reducing post-operative complications. Although some surgical complications are unavoidable, surgical care can be improved through better adherence to evidence based practice.

Case Study: A 60-year old patient with a long standing history of right knee pain has been diagnosed with osteoarthritis, and has been recommended a total left knee arthroscopy to improve chronic discomfort and improve mobility.

The patient’s past medical history includes hypertension and an irregular heart rate. The patient denies any allergies.

The patient reports to the hospital at 1 p.m. for a left knee replacement. A medication reconciliation is completed, and the patient reports taking the following medications with a sip of water at 8:00 p.m.:

• Lisinopril 10 mg PO daily

• Toprol 25 mg PO daily

• Celebrex 200 mg PO daily

While in the pre-operative holding area, vital signs are taken and are within normal limits. No hair removal was performed. The patient was ordered and received Ancef 1 gram IV mini bag, at 2:30 p.m. The patient was transferred to the operating room, where anesthesia monitoring began at 3:00 p.m., a urinary catheter was placed, and a forced air warming device was placed to maintain the patient’s temperature.

After recovering in the post anesthesia care unit (PACU), the patient was transferred to a surgical floor. Post-operative orders included:

• Ancef 1 gram IV mini bag every 8 hours

• Long leg TED hose and sequential compression stockings to right leg while in bed

• Lovenox 30 mg subcutaneously every morning, starting the following morning

• Urinary catheter to be discontinued at 3:00 p.m. on post-operative day 1

The patient progressed well, both with pain control and mobility. TED hose and sequential compression stockings were worn while in bed. On the first post-operative day, the first dose of Lovenox was administered at 1000 a.m. and the last dose of Ancef was received at 2:30 p.m. The patient was able to void after removal of the urinary catheter. The patient progressed well and was discharged home on post- operative day 5.

Evidence shows that more than 45 million operative procedures are performed in the United States each year. Approximately 40% of operative procedures result in a surgical complication. The Surgical Care Improvement Project (SCIP) was implemented to improve quality of care of surgical patients, by reducing surgical complications. Nurses play an important role in this process by following and adhering to evidence based and best practice protocols.

Using evidence based practice from two professional nursing journals, and/or your nursing textbooks, answer the following questions:

1. Explain one of the SCIP core measures, and how it has impacted the prevention of surgical complications. 2. Explain why no hair removal was required for the surgical procedure. If hair removal were ordered, explain the appropriate technique.

3. What methods were used to ensure that the recommended VTE/DVT prophylaxis was implemented, and why is the timing important? Explain your rationale with evidence.

Using APA format, write a two (2) to three (3) page paper (excluding the cover and reference page) that addresses the case study. A minimum of two (2) current professional references must be provided. Current references include professional nursing publications dated within five (5) years, and/or a textbook(s) used for the course that is no more than one (1) edition old. Websites are not to be used as professional resources or references.

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. Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page. Assistance with APA format, grammar, and avoiding plagiarism is available for free through the Excelsior College Online Writing Lab (OWL). Be sure to check your work and correct any spelling or grammatical errors before you submit your assignment.

You are required to submit your paper to Turnitin (a plagiarism prevention service) prior to submitting the paper in the course submission area for grading. Access is provided by email to the email address on record in your MyExcelsior account during week 2 of the term. Once you submit your paper to Turnitin check your inbox in Turnitin for the results. After viewing your originality report correct the areas of your paper that warrant attention. You can re-submit your paper to Turnitin after 24-hours and continue to re-submit until the results are acceptable. Acceptable ranges include a cumulative total of less than 15% for your entire paper, and no particular area greater than 2% (excluding direct quotes and/or references).

See the videos below for instructions on how to submit your paper to Turnitin and view your Originality Report.
Video – Submitting a Paper
Video – Viewing Your Originality Report

When you’re ready to submit your work for grading, click Browse My Computer and find your file. Once you’ve located your file click Open and, if successful, the file name will appear under the Attached files heading. Scroll to the bottom of the page, click Submit and you’re done.

This activity will be assessed according to the NUR213 M6A4: Case Study Rubric.

SAMPLE ANSWER

Improvement of Surgical Care

Project Outline

Week 1

In the first week, the learner will focus on understanding the requirement of the paper. The student will understand the presented case scenario and get ready to research on various concepts as the study topic would suggest. The learner will seek clarification from the instructor on areas that may not be clear. So as to acquire all the necessary information, the learner will refer to reliable sources and build up a strong background regarding the study topic. The researcher will figure out the requirements of the paper and purpose to include all vital concepts in the project. The student will design appropriate approaches of answering the questions presented in the paper. Also, the learner will purpose to apply evidence-based techniques to the project. By the end of the week, the researcher will have a comprehensive understanding of the requirements of the paper.

Week 2

The student will start developing an outline of the paper by the second week. The outline should satisfy the requirements of the paper. The learner will set objectives that would be achieved within a given period. The learner will ensure that the objectives are measurable, strategic, applicable, and that they are reliable. The outline should include the major activities that the leaner would engage in. As such, the learner will refer to the outline and the tool will serve the purpose of a reminder. The outline will be set in a way that the completion of a particular task would facilitate that of subsequent ones. The researcher will establish the outline in a way that would be easy to develop it and make changes where necessary. The initial components of the outline will incorporate introductory concepts to the study project.

Week 3

                The learner will complete the outline in the third week. The completed outline will serve as a guide in addressing the study problem. The researcher will use the outline to assess different issues and make independent judgments. The outline will summarize the requirements of the paper and match their expected time of completion. The learner will focus on addressing the entries in the outline and make achievements within the specified time. The outline will be organized in such a way that it would be possible to address the requirements of the project strategically. The learner will purpose to apply the completed outline to the presented case study. By the time of completing the outline, the learner will have understood most of the concepts included in the project. The format of the paper will match that of the completed outline both in its arrangement and content.

Week 4

By the fourth week, the learner will start writing the paper while referring to the outline. The student will meet the objectives of the outline when addressing the issues highlighted in the case study. By the fourth week, the learner will have addressed about the first third of the requirements included in the outline. The student will refer to scholarly work when researching the issues highlighted in the timeline. The paper will address various concepts exhaustively and include authoritative references so that readers can easily validate the writer’s strong assertions. The paper will be well-organized and its presentation will be friendly to readers.  The concepts addressed in the first part of the paper will later be applied to subsequent parts so that the entire paper will be coherent. Having questions thoroughly addressed will facilitate the handling of subsequent issues in the outline.

Week 5

The learner will continue applying the outline to address issues included in it. By the end of the week, the researcher will have handled about two thirds of the paper. The learner will interlink the topics of week four with those of week five so that the paper would have a high degree of consistency. The student will address the requirements of the paper in such a way that the paper interlinks with the case study and it meets the objectives included in the outline. The paper will reflect a scholarly structure in its organization and format. Concepts addressed in week five will apply to the subsequent week, and it would be necessary to make validated assertions. The student will ensure that the paper maintains high quality mainly by enhancing its consistency with the outline and the case study.

Week 6

It will be the last week of the paper, and the learner will complete the remaining part of the task. The student will merge different sections of the paper so that they are in a presentable format. The learner will go through the whole paper and ensure that it is coherent from the beginning. The student will correct any errors that may have occurred and ensure that the general presentation of concepts meets scholarly standards. The learner will make a summary of the addressed issues since the first week to the sixth. The summary will be tied to the outline developed at the beginning of the project. The researcher will also make a conclusion at the end of the paper regarding the studied topic. The researcher will then present the paper to the instructor for marking.

Improvement of Surgical Care

Care for the patient in the case study was directed toward the prevention of acquisition of surgical site infections. The involved health professional was directed by the guidelines of Surgical Care Improvement Project (SCIP). Some of the practices performed were the core measures advocated by SCIP (Weston, Caldera, & Doron, 2013).

Core Measure: the Prophylactic Administration of an Antibiotic Medication within an Hour to Surgical Operation

The patient in the case study received a dose of intravenous cefazolin (Ancef) prior to undergoing the operation. The drug is a cephalosporin and it works against a wide range of bacteria. Therefore, the medication would protect the patient from acquiring bacterial infections that would be most possible when bacterial colonies get into contact with open surgical wounds. SCIP measures recommend the application of antimicrobial medications at most an hour to the first incision or performance of surgery. The early administration of the agent gives it enough time to establish and attain a bactericidal serum concentration by the time of the operation (Goede, Lovely, Thompson, & Cima, 2013, Pg. 563). Untimely application of prophylactic antimicrobials would raise the risk of patients acquiring nosocomial infections regardless of whether they receive the medication or not (Turk, Karagulle, Serefhanoglu, Turan, & Moray, 2013, Pg. 583). Studies relate longer time durations between antibiotic treatment and the beginning of surgery to a high likelihood of acquiring bacterial infections.

The practice had beneficial yields as the patient did not report complications after the operation (Weston, Caldera, & Doron, 2013). In addition to promoting patient safety, the move was also important in upholding hospital guidelines of standard care. Guidelines specifying the procedural activities involved and the specific antimicrobials for use would promote the development of a healthy culture in the healthcare institution (Wang, Chen, Ward, & Bhattacharyya, 2012).

The Basis for Avoiding Hair Removal during the Operation

Hair removal is not always necessary when performing a surgical operation (Poggio, 2013, Pg. 171).  There is substantial scientific evidence against hair removal under certain circumstances. Previously, the activity was understood to improve hygiene at the surgical site hence protecting patients from infections. Later understandings revealed possibilities that the practice predisposed people to disease infections (Poggio, 2013, Pg. 171). Usually, hair removal creates an avenue for the entry of bacteria into the body. Bacteria get entry into the body through abrasions and microscopic nicks created after hair removal. It was necessary to avoid the practice so as to maintain the integrity of the patient’s skin and promote his safety.

Had hair removal been ordered, it would have been necessary to perform it in the safest way possible. The practice should have been performed in a way that it does not create abrasions that would later be the entry points of bacteria into the body. The practitioner would have considered shaving the surgical site approximately twelve hours to the operation rather than just before it. The clinician would also have used electric clippers rather than manually operated shaving razors (Crolla, van der Laan, Veen, Hendriks, van Schendel, & Kluytmans, 2012). Clippers are not as much likely to cause many tears as razors would have resulted. Other reasons for the selection of electrical clippers at the expense of the manually operated ones include patients would not experience razor burns, and instead, the method would leave hair stubbles on the skin surface. It is conclusive that use of electric clippers would place patients at reduced risks of infections than would have been the case had manual razors been the choice.

Methods that Ensured the Implementation of VTE/DVT Prophylaxis

There are several practices in the case study involving the prevention of deep vein thrombosis and venous thromboembolism. They include the use of compression stockings as approaches to preventing DVT and VTE. The TED hose applied on the patient in the case scenario prevent the occurrence of DVT by facilitating venous blood flow and lymphatic drainage in the legs of the patients. The stockings would work best when patients are lying as in the case study. Usually, the stockings are supposed to compress blood vessels from the ankle up the legs to facilitate the return of blood to the heart. They therefore overcome the risk of developing DVT whose pathophysiology entails poor blood flow to the lower limbs, blood pooling, and the eventual formation of emboli. Compression stockings are usually made of elastic material and fiber and clinicians should ensure that they recommend the use of compressional stockings of the appropriate strength.

There were also pharmacological approaches applied to prevent the two complications in patients. Lovenox is an effective medication in the prevention and management of DVT (Pannucci, Wachtman, Dreszer, Bailey, Portschy, Hamill, & Wilkins, 2012, Pg. 165).  The agent prevents the formation of blood clots and so emboli. It was necessary to administer the drug to the patient as surgical patients have a high predisposition to the development of blood clots and embolism.  Before administering lovenox, prescribers should first assess the patient for indications suggesting that they have a low count of platelets. 2the use of the drug in such patients could have severe adversities such as prolonged bleeding. The drug works well in patients undergoing surgical treatment and its use in the case study was appropriate. 

References

Crolla, R. M. P. H., van der Laan, L., Veen, E. J., Hendriks, Y., van Schendel, C., & Kluytmans, J. (2012). Reduction of Surgical Site Infections after Implementation of a Bundle of Care. PLoS ONE, 7(9), e44599. http://doi.org/10.1371/journal.pone.0044599

Goede, W. J., Lovely, J. K., Thompson, R. L., & Cima, R. R. (2013). Assessment of Prophylactic Antibiotic Use in Patients with Surgical Site Infections. Hospital Pharmacy, 48(7), 560–567. http://doi.org/10.1310/hpj4807-560

Pannucci, C. J., Wachtman, C. F., Dreszer, G., Bailey, S. H., Portschy, P. R., Hamill, J. B., … Wilkins, E. G. (2012). The effect of post-operative enoxaparin on risk for re-operative hematoma. Plastic and Reconstructive Surgery, 129(1), 160–168. http://doi.org/10.1097/PRS.0b013e318236215c

Poggio, J. L. (2013). Perioperative Strategies to Prevent Surgical-Site Infection. Clinics in Colon and Rectal Surgery, 26(3), 168–173. http://doi.org/10.1055/s-0033-1351133

Turk, E., Karagulle, E., Serefhanoglu, K., Turan, H., & Moray, G. (2013). Effect of Cefazolin Prophylaxis on Postoperative Infectious Complications in Elective Laparoscopic Cholecystectomy: A Prospective Randomized Study. Iranian Red Crescent Medical Journal, 15(7), 581–586. http://doi.org/10.5812/ircmj.11111

Wang, Z., Chen, F., Ward, M., & Bhattacharyya, T. (2012). Compliance with Surgical Care Improvement Project Measures and Hospital-Associated Infections Following Hip Arthroplasty. The Journal of Bone and Joint Surgery. American Volume, 94(15), 1359–1366. http://doi.org/10.2106/JBJS.K.00911

Weston, A., Caldera, K., & Doron, S. (2013). Surgical Care Improvement Project in the Value-Based Purchasing Era: More Harm Than Good? Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 56(3), 424–427. http://doi.org/10.1093/cid/cis940

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Post-operative care; Nursing Essay Paper

Post-operative care
Post-operative care

Post-operative care;Nursing

Order Instructions:

THIS A MASTER LEVEL PAPER

correct my wrong english in the essay

http://webconf.acu.edu.au/assess3

this is above video link

Post-operative Care of one client(Karen)

After watching the video, reflect on the nursing care given to the patient in the video. When writing the guided reflection, consider the following questions:

1. Identify the assessments performed. Were these assessments adequately prioritised?

2. How effective was the communication between the two nurses? Did it promote teamwork?

3. How effective was the communication between the nurses and the patient?

4. Identify the post -op orders. Were all of these discussed?

  1. Based on literature, are there any recommendations to improve for future practice,

SAMPLE ANSWER

Introduction

Post-operative care is aimed at preventing or recognizing post-operative complications in order to help the patient get back to their normal physiological activity, a prioritized and complete assessment should also be applied (Tollefson, 2012). I am going to carry out an in-depth reflection about a video that of a Ward nurse that receives a clinical handover of a patient who has undergone an appendectomy. I am going to provide an insight on some nursing interventions as well as nursing assessments that were carried out by the nurses. Moreover, I am going to comment on the interaction and communication between the nurses and Karen, the patient. My paper will also identify the post op orders that were performed.

Five Assessments Required for Postoperative Care.

The assessments conducted on the patients were prioritized to ensure that the patient recover well.
In the video, I observed how the PAR nurse provided a verbal report to the surgical nurse about the patient in the beginning after which they performed thorough nursing assessments. I noted that the nurses performed a head to toe assessment by starting with the neurological assessment. The neurological and neurovascular assessments that they did aimed at identifying vital diagnostic signs that would then be used to assess any post-operative complication such as hypovalaemia, pain; respiratory complications, infection, or electrolyte imbalance that can cause disorientation, restlessness, and delirium. I learned from the literature that long surgical procedure that takes quite a long time with prolonged anesthetic administration may result to redistribution of heat in the body from the centre to the periphery this exposes the patient to hypothermia risk (Brown & Edward, 2012). The nurses appropriately performed neurological assessments and a GCS score of 15 with reactive and equal eyes were their results.

When neurovascular assessment was conducted, the nurses determined that the patient had normal pulse as well as blood pressure. They then sought to examine if they could identify any signs of swelling, warmth on the legs. They further checked the peripheral pulse, which was normal too. According to Tollefson (2012), a patient cannot walk effectively after surgery and therefore, he/she has higher chances of developing Deep Vein Thrombosis (DVT) therefore clinicians should apply Ted stockings to promote circulation of blood in the legs. The nurse, however, did not explain adequately the rationale of using the Ted stocking. Respiratory assessment was also conducted. Chest infection and pneumonia are some of the complications of the respiratory system that are likely to be determined by this assessment. (Brown & Edward, 2012). Moreover, analgesic opioids can induce respiratory distress (Bryant & Knights, 2010). In addition, the nurses assessed the wound at the surgical site to identify if there was any sign of bleeding and redness. During the assessment they noted that the wound was oozing and this prompted the need of a cotton pad application as surgical dressing. However, I observed that hand hygiene technique was not properly observed before touching the surgical wound. This is against clinical practice which recommends that aseptic techniques should be put into consideration especially when handling wounds (Koutoukidis, Lawrence and Tabbner, 2008).

The fourth assessment done was on Karen’s circulation, which includes color and appearance of skin (Brown & Edwards, 2012). The nurses learned that Karen had no swelling and good peripheral pulses. This was an indication that Karen was less likely to have potential circulation problems. Nurses also assessed Karen’s urinary function through asking her urgency to go to the toilet. Brown and Edwards (2012) stated that both quality and quantity of urine should be examined for postoperative patients, because potential complication may happen such as impaired urinary elimination or urinary retention. The assessment approach of the nurses was good but then they should have gotten an informed consent from Karen and carry out an assessment on her level of pain before commenting the respiratory exercises of the patient. I also observed that they checked for redness, inflammation and blockage at the IV site and also ensured that the Patient Controlled Analgesia (PCA) used for pain control was functioning well. The two nurses generally did a good assessment and in a systematical order. However, it is better to assess breath sounds at first before neurological assessment, and assess limb movement when carrying out neurological assessment.

Communication between Nurses and the Patient

Communication is one of the most important aspects when providing care to patients and should therefore be taken into account. Literature defines clinical handover refers as the transfer of professional obligations, duties, and accountability of patient care from one healthcare official to another (Government of South Australia, 2014).In the video, communication between healthcare officials, that is, between nurses and also between the patient and nurses was not effective. For instance, the two nurses began the handover without introducing themselves, especially the receiving nurse since she was the new person to Karen this could be a source of confusion to the patient. However, the PACU nurse explained the handover clearly about Karen’s situation and showed good teamwork when performing the assessment. Team work was exercised when they were examining vital signs and when the receiving nurse asked the PACU nurse to put the side rail up together.

In a few cases, the communication between the patient and the nurses was not therapeutic. They performed some procedures without getting Karen’s consent.  An example is when they took the blanket off Karen’s legs and lifted the rails of the bed without letting her know about it. It seemed that she felt nervous prompting her to ask why they were doing it. Then, the PAR nurse explained the rationale to the patient. They should have informed her prior to the procedure. However, in some occasions the nurses interacted with Karen appropriately. For instance, the nurse aided patient in performing the respiratory exercise such as taking deep breaths and coughs. She also supported the incision with pillow and explained the reason for doing it. The nurses already had established a conducive environment that made the patient feel at home. The tone of voice, facial persons, and eye contact and body gestures of the nurses helped in creating siren environment for negotiation. The patient responded appropriately to the queries the nurses asked which helped to gain in depth understanding about how she was feeling and she provided her another blanket when she reported that she was feeling cold. At last, the nurse showed Karen her PCA buzz and told her that she would come back to check her shortly, this might decrease her anxiety and showed good therapeutic interaction.

Post-operative Orders

According to the Department of Health and Human Services (2014), post-operative orders should include surgical care, DVT prophylaxis, medication, IV fluids and nutrition order. In the video, the receiving nurse asked orders related to Karen’s care while doing the assessment, which included the antibiotics and antiemetics as well as oral paracetamol for pain which belongs to medication order; TED stockings which refer to DVT prophylaxis; when can Karen eat and drink which is the nutrition order. The wound dressing order was done through surgical care in the video and also the IV fluids order was also taken into account. I therefore, think that the post-op orders were all well discussed in this video.

Based on the available literature, one recommendation that requires improvement for future practice is ensuring that the patient is under continuous surveillance and care. Nurses should provide psychological care to enhance recovery of the patient. The focus should not concentrate solely on the physical care as sometimes patients are mentally affected and are therefore affected when they are discharged. When practiced accordingly, this will achieve greater heights by ensuring the quick recovery of the patient. It is also important to uphold ethical standards at all times when rendering health care to patients. Furthermore, I think they should have documented the vital signs as they were been taken, because if it’s not documented it’s not done.

Conclusion

After watching the video and reflecting, I must admit that proper communication between the nurses when rendering various services such as, clinical handover, are crucial for the patient’s safety. Another factor that should be observed monitored closely is therapeutic communication between the patient and the nurse since it promotes the patient’s health.

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Evaluation of Doctoral Study Assignment

Evaluation of Doctoral Study
                    Evaluation of Doctoral Study

Evaluation of Doctoral Study

Order Instructions:

For this paper, the writer need to pay attention to details and follow the instructions of the rubric as indicated. The writer will have to carefully study the Rubric and respond to all items requested. The writer must clearly show all responses for all part mention in the order form, and must clearly use in text citations throughout the evaluation.

Evaluation of Doctoral Study—Foundation of Study

Using the Doctoral Study Rubric in the study you were assigned for Week 1 complete the assessment of the five elements (The Background, The Problem Statement, The Purpose Statement of the Study, and Central Research Question, Conceptual/Theoretical framework) according to “Section 1: Foundation of the Study”

Important note: Keep in mind that new elements of this evaluation assignment will be coming up in Weeks 5 and 6.The final evaluation and write-up will be due in Week 6.

I will email the details again containing the Rubric and the article to be use in the evaluation.

SAMPLE ANSWER

Evaluation of Doctoral Study

The study is set in an ethical background that is found in the lack of ethical decision-making in a business environment. The ethical implications of some decisions made in a business background impose negatively on the operations of a business or organization. Furthermore, the effect of the decisions made with no regard to ethics in a business setting affects the performance of shareholders in the environment greatly. The situation in the current business world holds true to the statements made in the background of the study. More and more businesses and organizations have turned to ill-motivated methods in an effort of maximizing output against the input made. It is commonplace for business in the current age of to make more profit with no regard to the implications of the way the profit was being created.  This makes a good illustration of the impact of the unethical way of conducting business operations can have on the business world.

The world of business is now so much bent on the benefits of short-term profit. Consequently, the world of business has also gave a blind eye to the fact that trust has been eroded thus giving way to the unacceptable way of conducting business transactions in an unethical manner. The trust aspect in business has been eroded to a point that it has an irreversible impact on the organization. The problem statement of the doctoral study clearly states the relationship between short-term profit and the impact of the unethical means of getting the profit has quite an implication on the level of trust of shareholders (Saunders et al., 2012). However, the certainty of the problem arises from the characteristics of conduct ethical definition in the context of the stakeholder’s interest.

The main purpose of the doctoral study was to define the unique attributes of the unethical conduct of the decision-making a process of the business activities adequately. The implications of the decision-making process were evident on the stakeholder’s level of trust in the organization. The purpose statement regarded the explicit relationship between these two entities of the modern age of business operations. The situation in the business environment has become so much bent in short term profit that it has become the basis on which most business transactions are built on. The research design was formulated in such a way that it focused on the significance of the current influence that ethical considerations have in the modern world of business. Seeing that most businesses currently think little of the ethical considerations of decisions making and think highly of the short-term profit made from the transactions.

The research question focused on the main point of the study. The main research question being the focus put on the qualitative design of the research part. The methodologies used in the research or study proved to be effective on the type of demographics that was considered. In the study, the focus was on a semi-structured interview format way of acquiring sensitive data from the sample of people chosen. The chosen sample seemed to be conducive for the type of research question at hand. Considering the relationship of the sample with the organizations that had established ethics programs.

References

Ridley, D. (2012). The literature review: A step-by-step guide for students. Sage.

Panadero, E., & Jonsson, A. (2013). The use of scoring rubrics for formative assessment purposes revisited: A review. Educational Research Review, 9, 129-144.

Saunders, M., & Lewis, P. (2012). Doing research in business and management: An essential guide to planning your project. Financial Times Prentice Hall.

Sisk, R. J. (2011). Team-based learning: systematic research review. The Journal of nursing education, 50(12), 665-669.

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Roles of Assistant In Nursing Research Paper

Roles of Assistant In Nursing
Roles of Assistant In Nursing

Roles of Assistant In Nursing

Order Instructions:

See attached files

SAMPLE ANSWER

Introduction

To qualify as a registered nurse, one needs to complete their undergraduate nursing course and register to be licensed to practice. For specialist nurse, then one is expected to take graduate studies. However, recent studies indicate that there have shortages in the number of the registered nurses (RN) and Advance nurse practitioners (APN). Therefore, there is a need to establish an effective strategy that will address the shortages of the nurses (Unruh & Zhang, 2012).

One of the strategies suggested by the evidence-based practice is the use of assistant in nursing to help in the healthcare setting. The issue of the integration of the AIN is highly debatable, with many studies highlighting their advantages as well as the disadvantages. This paper aims at defining the role of AIN, and the impact of their utilization in the healthcare settings. This aims at identifying their role in helping the RN achieve the set competencies and nursing practice goals.

Roles of Assistant In Nursing

The AIN is the word used to describe nurses who have completed nursing certificate at level III in a healthcare service. The Nursing and Midwifery board of Australia (NMBA) indicates that AIN are supervised and delegated duties by the RN. In some cases, AIN are also referred to as multi-skilled worker, technician, personal care assistants, and nurse extenders. Traditionally, AIN have been employed in aged care sector and in midwifery. The NMBA indicates that midwife have vital roles in counseling, education of the community especially during antenatal education and reproductive health. However, there have been changes in the recent past where AIN are increasingly being used to support RN in broad range of healthcare settings. The AIN roles and responsibilities include helping the patient during meals where they prepare table over the patient’s bed and help the patient position safely to feed (Unruh & Zhang, 2012).

Where necessary, AIN are required to feed the patients physically who cannot feed themselves but rather require the assistance when feeding. The AIN are also required to help the patient perform their daily living activities. These include activities such as bathing, bed washes and oral hygiene, brushing and the cleaning of dentures. They are required to make observations on changes on the patient’s physical appearances and report them to the RN. The AIN are also required to help the patients with mobility such as moving patients from bed to chairs, re-application of the ant-embolic stockings and bed positioning. They are also supposed to help the patients with voiding, including helping the patient go to the toilet or provide bedpan, and recording the urine collected in the drainage bags (Weiss, Yakusheva, & Bobay, 2011).

The AIN are expected to communicate any abnormalities to the RN. During this step, they are expected to uphold the key nursing principles and to maintain patient privacy, dignity and demonstrate empathy towards the patients. The AIN are expected to ne diplomatic and report any disputes to the RN. AIN are also used to relay patient educative information regarding the disease management especially on matters that regards hygiene (Heale, 2010). The AIN are required to maintain a stable environment that will facilitate quick recovery. These includes  making up of post operative beds, implementation standards that reduce infection control  such as hand hygiene, moping the spills and notify the RN if specific cleaning procedures such as use of radioactive  procedures is required (Richer, Ritchie, & Marchionni, 2010).

RN roles

According to  the Nursing  and Midwifery board of Australia (NMBA)  registered nurses have various roles. Their roles as a coordinator imply that they are expected to coordinate plans. This is through piecing together of the fragmented care includes preparation of discharge with the liaison with other healthcare team. RN roles as communicators include establishing a good rapport between the healthcare providers and service users. This helps in their establishment of therapeutic care through analysis of verbal and non-verbal communication (Unruh & Zhang, 2012).

RN roles as teachers include the educating the patient to empower them with the benefits of self-care abilities. They are also responsible in affecting knowledge to the patients to enable them make informed decisions. This include training them with the relevant skills that will help the patients promote health, restore health, promote coping and prevention of further complication (Fitzpatrick, Campo, & Lavandero, 2011). They strategize the teaching learning process by identifying the specific teaching domains. These include cognitive learning, psychomotor learning, and affective learning. The RN is also counselors and is expected to provide emotional support to the patients to enable them handle the challenges they face with positivity. It is important, the RN are expected to know that they are team player. They are expected to collaborate and should not work in isolation when promoting patient healthcare. (Van Walraven et al., 2015).

RN responsibilities when working with the AIN

Some of aforementioned responsibilities of RN can be assigned to the AIN. The AIN can help the RN on duties such as teaching, assisting patients to feed, bath, and mobility as described above. This way, the RN can concentrate on leadership, by supervising the RN. This is because RNs are trained to have visions to energize other medical staff through motivation to work as team players and encourage them to achieve goals (Unruh & Zhang, 2012). As leaders, RN are expected to encourage AIN to work their best and collaboratively. The RN roles as managers are wider than that of managers. They are equipped with leadership skills during training, which includes cognitive skills, interpersonal skills, legal skill, ethical skill, management skills, problem solving skills and communication skills (Tyler, 2010).

With the help of AIN, the RN is supposed to note the barriers as well as challenges that hinder effective delivery of care. This includes barriers such as language barriers, cultural barriers, cognitive barriers, health literacy levels, and stress levels (Wayhlin & Idvall, 2010). Then, develop strategies to overcome these barriers. This is done using the nursing process, which includes assessment, planning, implementation and evaluation processes. RN is also advocate and is expected to support all patients by being assertive and promoting self-determination (Aubry, Etheridge, & Couturier, 2012).

Impact of utilization of Assistant in nursing (AIN) 

As mentioned above, the role of Registered nurses are varied and very complex. Quality delivery of care requires the nurses to take different roles during different phases of care. They are expected to fulfill all their roles to the best of their abilities. However, nurse shortage and poor working environments have led to nurse shortages (Hebert, Moore, & Rooney, 2015).  This has led to numerous challenges in the delivery of care in the healthcare settings, especially in patient safety concerns such as medication errors, diagnostic errors, hospital acquired infections, and patient hospital falls. This calls for a rapid measure to ensure that patient’s outcomes are positive and care delivered is safe and of quality (Van Walraven et al., 2015).

One of the strategies suggested by the Department of healthcare and supported by evidence-based practice is the utilization of AIN in healthcare settings. The benefits of integrating the AIN in health settings are that they will be a viable solution to the micro-political health issue (Taylor-Ford, 2013). The utilization of AIN will address the shortages of RN. This is because the AIN can aid the RN with some of the clinical settings chores under their supervision, as the RN works focuses on other responsibility (McHugh, Berez, & Small, 2013).

A typical nurse day begins with   the analysis of the reports from the nurses in the previous shift and end with the filling of their own reports. In between these two responsibilities, the RN is expected to perform all other aforementioned tasks including administering of medication, wound care, physical assessments, and coordinate care with the other healthcare professionals. Lunch breaks and tea breaks are usually nonexistent. This sometimes leads to nurse burn out, which increases the risk of medical error, poor hand hygiene, and poor patient outcome (Tyler, 2010).

One study has indicated that the utilization of AIN in the health care settings found an association between the proportions of total hours the RN with the assistant with the AIN   improved six outcomes in patients under care. These included reduction of hospital stays and well as the reduction of hospital acquired infections (Richer, Ritchie, & Marchionni, 2010).

Other studies indicate that nurse shortages leads to working for log hours with high nurse to patient ratio. This had been associated high increase of mortality, reduced patient empowerment. The patients are discharged too soon before their medical complication has established (Armmer & Ball, 2015). Consequently, the readmission rates are higher and in most cases, the patients report with more complications. With the integration of AIN in the healthcare settings, their  patient ratio is lower, and the RN in collaboration with the AIN, they are able to deliver patient centered care  and the patient are empowered such that they are able to manage their healthcare complications. Additionally, these nurses are able to notice and intercept medical errors. They also get ample time to advocate for the patients to the medical care in insurance companies to ensure that the patient get all their demands (Castle & Anderson, 2011).

One research associates nurse burnout with increase of infections. The aforementioned RN responsibilities lead to nurse burnout with extra patient assigned or extra overtime assigned to nurse. The study has indicated increase in the rate of catheter infection of one person for every 1,000 (Heale & Butcher, 2010). One study that integrated that utilization of AIN reduced burnout from 30% to 10%, and would reduce about 4,160 infections. The mortality rates would reduce to 11% with reduced burnout (Tyler, 2010).

Another study indicated that the utilization of AIN to help the RN with some of the nursing practices reduced the RN’s overtime hours. This was correlated with better care, fewer emergency departments within the first month of hospital discharge. This translated to reduced cost of care. This study also found correlation between utilization of AIN with the staffing ratios and with the patient satisfaction (Castle & Anderson, 2011).

A study that conducted cost benefit analysis study indicated that increased overtime hours increased patient cost of care by $197.92 per hospitalized patient. With the utilization of AIN, approximately $607.51 taxpayer’s money is saved (Heale & Pilon, 2012). Studies indicated that reduction of overtime work by 0.07 hours saved hospital cost by $8.18 per patient and $10.98 in savings of the taxpayer’s money. The annual net savings reported by this article was $11.64 (Weiss, Yakusheva, & Bobay, 2011).

From this analysis, the body of research indicates that utilization of AIN translates into quality care, low mortality rates, shorter hospitalization stay, and fewer health complications. However, the main disadvantages is that healthcare productivity could decline if the RN are replaced with AIN (Ulrich et al., 2010). This is because RNs are all encompassed. There are concerns that this approach could increase the risk of “failure to rescue” in departments with less RNs. This refers to cases where the situation requires further treatment due to the deterioration of the patient status. The AIN may not fully identify such situations early enough. There is need to  conduct more further research to identify the most effective nursing staffing  mix is  effective to sustain quality care.

Conclusion

The study concluded that to manage effective delivery of care, the healthcare facilities should invest in reducing RN workloads strategies such as the utilization of AIN. This results to improved quality of care, reductions of readmissions, HAIs, patient falls, and emergency visits. This strategy is cost effective and improves quality of care.

References

Armmer, F., & Ball, C. (2015). Perceptions of horizontal violence in staff nurses and intent to leave. Work, 51(1), 91-97. http://dx.doi.org/10.3233/wor-152015

Aubry,, F., Etheridge, F., &  Couturier, Y.,(2012). Facilitating Change Among Nursing Assistants in Long Term Care. The Online Journal Of Issues In Nursing, 18(6). http://dx.doi.org/10.3912/OJIN.Vol18No01PPT01

Castle, N. G., & Anderson, R. A. (2011). Caregiver staffing in nursing homes and their influence on quality of care, Medical Care, 49(6), 545-552. http://dx.doi.org/10.1097/mlr.0b013e31820fbca9

Fitzpatrick, J., Campo, T., & Lavandero, R. (2011). Critical Care Staff Nurses: Empowerment, Certification, and Intent to Leave. Critical Care Nurse, 31(6), e12-e17. http://dx.doi.org/10.4037/ccn2011213

Heale, P. (2010). Nurse-Perceived Barriers to the Implementation of Nondirected Pushing. Journal Of Obstetric, Gynecologic, & Neonatal Nursing, 39, S103-S103. http://dx.doi.org/10.1111/j.1552-6909.2010.01127_1.x

Heale, R., & Butcher, M. (2010). Canada’s First Nurse Practitioner’s “Led Clinic: A Case Study in Healthcare Innovation. Nursing Leadership, 23(3), 21-29. http://dx.doi.org/10.12927/cjnl.2010.21939

Heale, R., & Pilon, R. (2012). An Exploration of Patient Satisfaction in a Nurse Practitionerâ’s“Led Clinic. Nursing Leadership, 25(3), 43-55. http://dx.doi.org/10.12927/cjnl.2012.23056

Hebert, K., Moore, H., & Rooney, J. (2015). The Nurse Advocate in End-of-Life Care. The Oschnoerjournal, 11(4), 325-329. http://dx.doi.org/PMC3241064

McHugh, M., Berez, J., & Small, D. (2013). Hospitals With Higher Nurse Staffing Had Lower Odds Of Readmissions Penalties Than Hospitals With Lower Staffing. Health Affairs, 32(10), 1740-1747. http://dx.doi.org/10.1377/hlthaff.2013.0613

Richer, M., Ritchie, J., & Marchionni, C. (2010). Appreciative inquiry in healthcare. British Journal of Healthcare Management, 16(4), 164-172. http://dx.doi.org/10.12968/bjhc.2010.16.4.47399

Tyler, D. A. (2010). Nursing home culture, teamwork and culture change, Journal of Research in Nursing, 16(1), 37-49. http://dx.doi.org/10.1177/1744987110366187

Taylor-Ford, R. (2013). Moral Distress in End-of-Life Care: Promoting Ethical Standards of Executive Nursing Practice. Nurse Leader, 11(3), 51-54. http://dx.doi.org/10.1016/j.mnl.2013.01.005

Ulrich, C., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., & Grady, C. (2010). Everyday ethics: ethical issues and stress in nursing practice. Journal Of Advanced Nursing, 66(11), 2510-2519. http://dx.doi.org/10.1111/j.1365-2648.2010.05425.x

Unruh, L., & Zhang, N. (2012). Nurse Staffing and Patient Safety in Hospitals. Nursing Research, 61(1), 3-12. http://dx.doi.org/10.1097/nnr.0b013e3182358968

Van Walraven, C., Dhalla, I., Bell, C., Etchells, E., Stiell, I., & Zarnke, K. et al. (2010). Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. Canadian Medical Association Journal, 182(6), 551-557. http://dx.doi.org/10.1503/cmaj.091117

Wayhlin, I., Ek, A., & Idvall, E. (2010). Staff empowerment in intensive care: Nurses’s and physicians’ lived experiences. Intensive And Critical Care Nursing, 26(5), 262-269. http://dx.doi.org/10.1016/j.iccn.2010.06.005

Weiss, M., Yakusheva, O., & Bobay, K. (2011). Quality and Cost Analysis of Nurse Staffing, Discharge Preparation, and Postdischarge Utilization. Health Services Research, 46(5), 1473-1494. http://dx.doi.org/10.1111/j.1475-6773.2011.01267.x

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Nursing Best practice Research Assignment

Nursing Best practice Research Assignment Order Instructions: The writer should pay attention to details and use recent scholarly articles to cite the paper. The writer must also include the DOI for all articles that he uses that are coming from the web and require them. It is critical that the writer gives an in-depth

Nursing Best practice Research Assignment
Nursing Best practice Research Assignment

discussion in response to all the questions raise here and support them with recent publications.

Best Practice

Discuss best practice guidelines to avoid medical lawsuits in your future practice area as an Advanced Nurse Practitioner. Also should Advance Practice Nurse purchase liability insurance, why or why not?

Nursing Best practice Research Assignment Resources

Please retrieve and read the following journal articles

Adkins, N., & Corus, C. (2009). Health literacy for improved health outcomes: Effective capital in the marketplace. Journal Of Consumer Affairs, 43(2), 199–222.

The Difficult Patient: Should You End the Relationship? What Now? An Ethics Case Study

Preventive Care and the Affordable Care Act

Nursing Best practice Research Assignment Sample Answer

Nursing Best practice

Best Practice

Few nurses have not been in a position to give a deposition to give a lawsuit. However, most have wondered on what it could be if they are sued for malpractice. This makes it necessary for the nurses to analyze facts and issues case by case to ensure that the actions they make ethical decisions when confronted by the ethical dilemmas. This is because nurses are held accountable for their judgments and the outcomes. Malpractice refers to the nurse practices that can be classified as misconduct, breach of duty and negligence by a nurse, which results to injury to service users. To avoid lawsuits, evidence-based research indicates that most of the lawsuits are due to the failure of following the set standards of care as required by the universal nursing practice if the healthcare facility. The nurse must never use medical equipment of healthcare procedures that she or he is unfamiliar (Hyman et al., 2010).

The nurse must learn strategies of effective communication. Most of the lawsuits are due to poor communication between a nurse and other medical practitioners. If nurses have some doubts, they should always make inquiries. Research indicates that lack of communication has equal weight as failure to rescue. Additionally, it is very important to document all treatments performed. This is because any practice that is not documented is perceived, as it was not done. Poor documentation could result to patient being administered similar intervention (medication) twice which could result to toxicity putting the patient life at risk. Documentation in nursing not only helps substantiate once innocence at legal point of view but also to promote continuity of care (Rodwin & Silverman, 2015).

As mentioned above, nurses could be sued for any reason and in most cases; the allegations brought forth are usually unfounded. This is terrifying, damages nurse’s self-confidence, and could ruin his or her reputation. For this reason, should nurses be insured for malpractice? The answer is yes, nurses should be insured. This is because the employers’ policy only protects specific needs, and thus will cover the nurse only to some extent. It is common to get opposing reactions by the employers where they discourage nursed from getting their individual policy. This is because the organization wants their own attorney, who will ensure that they put the organizations interests first, represent their nurse. It is important for the APN nurse to understand that the malpractice insurance policies have specific limits (Carroll & Buddenbaum, 2013).

The main reason why an APN needs liability insurance is that the nurse malpractice coverage is attached to the nurse actions and practices provided when the nurse is within the scope of employment. This implies that if the action is committed when one is at the job not as an employee, the liability cover does not cover the APN (Adkins & Corus, 2009). For instance, when one is at home and a neighbor child develops a high fever, is vomiting, and has frequent diarrhea; then an APN gives his or her opinion and respond. So long as the nurse responded, he or she immediately forms the nurse-patient relationship voluntarily and you are giving your advice in the capacity an APN, the nurse is held accountable for their actions. Due to these legal responsibilities that are attached to a person as a nurse, it therefore important for APN to purchase individual coverage for malpractice (Durand et al., 2015).

Nursing Best practice Research Assignment References

Adkins, N., & Corus, C. (2009). Health literacy for improved health outcomes: Effective capital in the marketplace. Journal Of Consumer Affairs, 43(2), 199–222.

Carroll, A., & Buddenbaum, J. (2013). High and low-risk specialties experience with the U.S. medical malpractice system. BMC Health Services Research, 13(1), 465. doi:10.1186/1472-6963-13-465

Durand, M., Moulton, B., Cockle, E., Mann, M., & Elwyn, G. (2015). Can shared decision-making reduce medical malpractice litigation? A systematic review. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0823-2

Hyman, C., Liebman, C., Schechter, C., & Sage, W. (2010). Interest-Based Mediation of Medical Malpractice Lawsuits: A Route to Improved Patient Safety?. Journal Of Health Politics, Policy, And Law, 35(5), 797-828. https://www.doi:10.1215/03616878-2010-028

Rodwin, M., & Silverman, J. (2015). Why the Medical Malpractice Crisis Persists Even When Malpractice Insurance Premiums Fall. SSRN Electronic Journal. https://www.doi:10.2139/ssrn.2484015

Building a comprehensive health history 

Building a comprehensive health history 
Building a comprehensive health history

Building a comprehensive health history

Order Instructions:

Take the role of a clinician who is building a health history for one of the following new patients.

pre-school aged white female living in a rural community

With the information presented in chapter 1 of Ball et al. 2015) do the following:

1) How would your communication and interview techniques for building a health history differ with each patient?

2) How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?

3) What risk assessment instruments would be appropriate to use with each patient?

4) What questions would you ask each patient to assess his or her health risks?

5) focus your discussion on patient above (pre-school aged white female in rural community)

6) Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

7) Select one to the risk assessment instruments presented in chapter one or 26 of the course text, or another tool with which you are familiar, related to selected patient.

8) Develop at least 5 targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

***ONE REFERENCE HAS TO BE THIS ONE AND YOU MAY SELECT 2 MORE*********

1) Ball, J.W., Dains, J.E., Flynn, J.A., Solomon,B.S., & Stewart, R.W. (2015). Seidel’s gude to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

SAMPLE ANSWER

Building a comprehensive health history 

The interview technique and communication will be selected cautiously because the patient is a child and from rural community. The interview technique applied is oral interview skills using open-ended communication. Additionally, purposeful silence, and active listening will be applied. This will help building a trustful patient-physician relation, thereby improving communication. The target questions will be assessed to avoid misinterpretation and miscommunication especially when dealing with concepts such as the patient age, gender, ethnic background and the environment. These include patient’s age, gender, medical history and their environment (Ball et al., 2015).

The risk assessment instruments that is appropriate for this patient is the AHRQ clinical care tools, particularly the Put Prevention into Practice (PPIP). This tool is chosen because it captures patient’s experiences as well as their lifestyles. This facilitates the assessment of the patient’s health condition. The five-targeted questions for this patient (pre-school aged white woman from a rural community) will mainly be addressed to the parent, as the child cannot express herself appropriately (Keeton, Soleimanpour, & Brindis, 2012). These include;

  1. What are the child’s name, age, and ethnic background?
  2. What are your child’s basic meals?
  3. Is the child exposed to smoking?
  4. Has the parent noticed any lost of interest to things that the child enjoyed in the recent past?
  5. Has the child been hospitalized for any health reasons in the last three months? Explain the reason.

From the analysis, the following potential health related risk factors are identified; the first risk factor is obesity. The child is lives a sedentary life, and her diet is mainly fast food with high fat content. The child is also likely to suffer from respiratory disorders and cardiovascular disorders such as asthma and hypertension respectively.

References

Ball, J.W., Dains, J.E., Flynn, J.A., Solomon,B.S., & Stewart, R.W. (2015). Seidel’s gude to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Keeton, V., Soleimanpour, S., & Brindis, C. (2012). School-Based Health Centers in an Era of Health Care Reform: Building on History. Current Problems In Pediatric And Adolescent Health Care, 42(6), 132-156. https://www.doi:10.1016/j.cppeds.2012.03.002

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Managing Chronic Disease in the Primary Care Setting

Managing Chronic Disease in the Primary Care Setting
Managing Chronic Disease in the Primary Care Setting

Managing Chronic Disease in the Primary Care Setting

Order Instructions:

For this paper, the writer must pay attention to details as indicated below. The writer cannot use any articles older than 5 years and APA is critical throughout the paper.

Managing Chronic Disease in the Primary Care Setting

Caring for clients with a chronic illness will mean multiple visits and careful managing of their plan of care to include medications, screening exams, and referral. More than 75% of all health care costs in the United States due to chronic illness. The impact that this has on the healthcare system is staggering. With the population aging and more chronic illness occurring, it has never been more important to properly manage this epidemic through the use of cost-effective, evidence based care where it begins: In the primary care setting.

In a 4 page APA paper minimum with a minimum of three APA references,

• Discuss the impact of chronic disease on health care as a whole.

• Examine how evidence based plans of care can reduce the health care cost burden placed on Americans and discuss cost effectiveness achieved by the use of evidence based plans of care.

• Discuss the role that advanced practice nurses play in caring for patients with chronic illness from the standpoint of health promotion, medication management, and symptom management, and the importance of this role.

Assignment Requirements
The finished Assignment should be a 4 page minimum descriptive and exploratory essay, excluding the title page and references. The viewpoint and purpose of this Assignment should be clearly established and sustained. (But must remember to include title page and reference page in APA)

Before finalizing your work, you should:

• be sure to read the Assignment description carefully (as displayed above)

• utilize spelling and grammar check to minimize errors; and

• review APA formatting and citation information found online, or elsewhere in the course.

Your Assignment should:

• follow the conventions of Standard American English (correct grammar, punctuation, etc.);

• be well ordered, logical, and unified, as well as original and insightful;

• display superior content, organization, style, and mechanics; and

• use APA 6th edition format for organization, style, and crediting sources including:

• properly formatted header

• 12-point, double-spaced, Times New Roman font

• use of in-text citations

• title page and reference page

• use of headings (if applicable)

Resources:

Artnak, K. E., McGraw, R. M., & Stanley, V. F. (2011). Health care accessibility for chronic illness management and end-of-life care: A view from rural America. Journal Of Law, Medicine & Ethics, 39(2), 140–155.

Hunt, L., Kreiner, M., & Brody, H. (2012). The changing face of chronic illness management in primary care: a qualitative study of underlying influences and unintended outcomes. Annals Of Family Medicine, 10(5), 452–460.

Lindsay, S., Kingsnorth, S., & Hamdani, Y. (2011). Barriers and facilitators of chronic illness self-management among adolescents: A review and future directions. Journal of Nursing & Healthcare of Chronic Illnesses, 3 (3)186–208.

Newsom, J., Huguet, N., McCarthy, M., Ramage-Morin, P., Kaplan, M., Bernier, J., & … Oderkirk, J. (2012). Health behavior change following chronic illness in middle and later life. The Journals Of Gerontology. Series B, Psychological Sciences And Social Sciences, 67(3), 279–288.

Pai, Ahna L.H., & Ostendorf, H. (2011). Treatment adherence in adolescents and young adults affected by chronic illness during the health care transition from pediatric to adult health care: A literature review. Children’s Health Care, 40(1), 16–33.

Strunk, J. A., Townsend-Rocchiccioli, J., & Sanford, J. T. (2013). The aging Hispanic in America: Challenges for nurses in a stressed health care environment. MEDSURG Nursing, 22(1), 45–50.

SAMPLE ANSWER

Order Instructions:

For this paper, the writer must pay attention to details as indicated below. The writer cannot use any articles older than 5 years and APA is critical throughout the paper.

Managing Chronic Disease in the Primary Care Setting

Caring for clients with a chronic illness will mean multiple visits and careful managing of their plan of care to include medications, screening exams, and referral. More than 75% of all health care costs in the United States due to chronic illness. The impact that this has on the healthcare system is staggering. With the population aging and more chronic illness occurring, it has never been more important to properly manage this epidemic through the use of cost-effective, evidence based care where it begins: In the primary care setting.

In a 4 page APA paper minimum with a minimum of three APA references,

• Discuss the impact of chronic disease on health care as a whole.

• Examine how evidence based plans of care can reduce the health care cost burden placed on Americans and discuss cost effectiveness achieved by the use of evidence based plans of care.

• Discuss the role that advanced practice nurses play in caring for patients with chronic illness from the standpoint of health promotion, medication management, and symptom management, and the importance of this role.

Assignment Requirements
The finished Assignment should be a 4 page minimum descriptive and exploratory essay, excluding the title page and references. The viewpoint and purpose of this Assignment should be clearly established and sustained. (But must remember to include title page and reference page in APA)

Before finalizing your work, you should:

• be sure to read the Assignment description carefully (as displayed above)

• utilize spelling and grammar check to minimize errors; and

• review APA formatting and citation information found online, or elsewhere in the course.

Your Assignment should:

• follow the conventions of Standard American English (correct grammar, punctuation, etc.);

• be well ordered, logical, and unified, as well as original and insightful;

• display superior content, organization, style, and mechanics; and

• use APA 6th edition format for organization, style, and crediting sources including:

• properly formatted header

• 12-point, double-spaced, Times New Roman font

• use of in-text citations

• title page and reference page

• use of headings (if applicable)

Resources:

Artnak, K. E., McGraw, R. M., & Stanley, V. F. (2011). Health care accessibility for chronic illness management and end-of-life care: A view from rural America. Journal Of Law, Medicine & Ethics, 39(2), 140–155.

Hunt, L., Kreiner, M., & Brody, H. (2012). The changing face of chronic illness management in primary care: a qualitative study of underlying influences and unintended outcomes. Annals Of Family Medicine, 10(5), 452–460.

Lindsay, S., Kingsnorth, S., & Hamdani, Y. (2011). Barriers and facilitators of chronic illness self-management among adolescents: A review and future directions. Journal of Nursing & Healthcare of Chronic Illnesses, 3 (3)186–208.

Newsom, J., Huguet, N., McCarthy, M., Ramage-Morin, P., Kaplan, M., Bernier, J., & … Oderkirk, J. (2012). Health behavior change following chronic illness in middle and later life. The Journals Of Gerontology. Series B, Psychological Sciences And Social Sciences, 67(3), 279–288.
Pai, Ahna L.H., & Ostendorf, H. (2011). Treatment adherence in adolescents and young adults affected by chronic illness during the health care transition from pediatric to adult health care: A literature review. Children’s Health Care, 40(1), 16–33.

Strunk, J. A., Townsend-Rocchiccioli, J., & Sanford, J. T. (2013). The aging Hispanic in America: Challenges for nurses in a stressed health care environment. MEDSURG Nursing, 22(1), 45–50.

We can write this or a similar paper for you! Simply fill the order form!

Differences in Nursing Essay Assignment

Differences in Nursing
Differences in Nursing

Differences in Nursing

Order Instructions:

Differences in Nursing
Write a 2-3 page (not including title and reference) paper in 6th edition APA format. What are the similarities and differences between parish nursing and the role of other nurses in community health? Do the standards, functions, and roles differ between parish nursing and regular practice?

references should base on state of Maryland and Prince Georges county.

SAMPLE ANSWER

Differences in Nursing

Introduction

Nursing is a profession in the health sector focusing on the care of the community, individuals and also the families for the purpose of attaining quality life (Kosevich et al, 2014). There is a wide diversity of practice areas under which the nurses perform their roles. Nurses protect, optimize and also promote the health and abilities of the individuals and the community. The nurses also help in the alleviation of suffering through the diagnosis and treatments administered (Kosevich et al, 2014). The main role and function performed by the nurses in the profession is care provision. There are different types of nurses in the nursing profession. In this case, the community or public health nurses and the parish nurses will be explored in this paper. The area of specialization, roles and functions are the biggest contributing factors to the different types of nurses in the nursing profession. The parish nursing will combine health ministry and professionalism. The nurses emphasize on healing within a community of faith. Public health is a focused population practice that works to improve the overall health of the community and safeguarding people’s safety (Driscoll et al, 2015).

There are some similarities and some identifiable differences although not so distinct as they all fall under the nursing profession. There is the similarity in the role of the two types of nurses in that both try to ensure there are sufficient education and resource allocations to the community. The two nursing professions have the role of providing interdisciplinary programs that anticipate, monitor and also give responses to the community and individuals (Kosevich et al, 2015). They perform the same role as health educators. The health screening role performed by the public health nurses is also incorporated into the practices performed by parish nurses as they carry out health advocation. Both the parish and public health nurses assist the individuals to navigate through healthcare systems. The parish and public health nurses perform the same role of infections control in their different areas of work (Driscoll et al, 2015). Group leadership is another common role performed by both the parish and public community nurses. There are also emerging differences in the roles performed by the two type of nurse. However, the differences are not very substantive. The main difference between the two types of nurses is that parish nurses provide care to people in their religious community.

While the community health nurses aim at the provision of care and services to the entire community, the parish nurse only focuses on the church population (Kosevich et al, 2014). The public community health nurses provide invasive screening procedures while hands-on care and services by parish nurses are non-invasive services. The parish nurses are focused on health promotion and outreach during their time in service without much emphasis on implementation and utilization of services. Contrary to that, the community health nurses spend most of their time in ensuring evaluation of services and also their utilization (Driscoll et al, 2015). The parish nurses have their roles conscious of partnering the health issues with the individuals or family’s faith. The public health community is focused on the general health of individuals with no faith consideration at any one time. Most of the parish nurses are volunteer roles in the health sector while the public community health nurses perform paid roles in their profession (Kosevich et al, 2014).

Standards of practice in other nurses are also intended to be used by the parish nurses. The difference in functions and standard of practice arise due to specialization factors. The differences between the nurses are brought about by the roles performed by each. The standards are the same in the two type of nursing. The standards include professional practice and accountability in their work, holistic nursing care and also ensure evidence-informed practice (Kosevich et al, 2014). Collaboration, communication and advocacy of ethics is another standard common in both the parish and public nursing. The standard for facilitation of spiritual care stands out among the parish nurses. The main function of parish nurses is the integration of faith in health activities. The main function of the regular nurses is the provision of assurances, the assessments and also policy development in the health sector (Drsicoll et al, 2015). The main functions in each show the differences between parish nurses from other regular practice nurses. The only major reason that makes the parish nurses differ from those in the regular practice is because they are practices are religious oriented.

Conclusion

In a nutshell, the assessment of the function, roles, and standards in the two type of nursing reveals that there are more similarities than differences in both. The distinctive difference is brought about by the specialization of parish nurses on health matters while incorporating religious matters (Kosevich et al, 2014). The collaboration of the parish nurses and regular health practice in their practices will improve performance in care delivery and provision of all services to individuals and the general community (Driscoll et al, 2015).

Reference

Driscoll, D. W., & Darcy, J. (2015). Indoor Tanning Legislation: Shaping Policy and Nursing Practice. Pediatric Nursing, 41(2), 59-88.

Kosevich, G., Leinfelder, A., Sandin, K. J., Swift, E., Taber, S., Weber, R., & Finkelstein, M. (2014). Nurse practitioners in medical rehabilitation settings: A description of practice roles and patterns. Journal Of The American Association Of Nurse Practitioners, 26(4), 194-201. http://www.doi:10.1002/2327-6924.12038

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Maryland Health Department Nursing

Maryland Health Department Nursing Order Instructions: Write a 2-3 page (not including title and reference) paper in 6th edition APA format. Look up your state’s health department; what trends do you see relating to health in the school system?

Maryland Health Department Nursing
Maryland Health Department Nursing

How do you feel nurses are implementing this within the school systems in your own communities? How do they evaluate outcomes?

Maryland Health Department Nursing Sample Answer

One of the issues that have of being of interest within the Maryland Health Department is that there has been a growing trend in the number of nurses not who do not meet the set standards of practicing as independent practitioners due to their educational qualifications. In recent years, the needs of patients have been described as a spectrum that broadens by the day. The education received by most of these nurses does not qualify or prepare them to serve as the first point of contact when it comes to providing healthcare services to patients. Organized medicine has always stated education as the main factor in discrediting nurses who seek to provide independent care.

Corresponding studies have shown that most nurses are only able to provide quality healthcare services in treatment and management in only limited cases. Despite studies done by the Office of Technology Assessment (OTA) showing nurse practitioners and physicians have equal quality of care in a range of comparable services; physicians have had a monopoly in the providing of health care services since they act as independent practitioners. (Aktan, 2015, pg 74)

This issue narrows down to the school system. This has seen national and international reports being published as part of a comprehensive health care reform. For example, one that was published by the Institute of Medicine describing strategies that can be used to enhance the role of nurses in healthcare. It has been cited that in many settings such as the state of Maryland, there are a number of outdated regulations and policies that may provide a barrier in the process of ensuring that the role of nurse practitioners is strengthened. This has led to nurses, whether at an individual or organizational level, to come up with a number of strategies that can be implemented within the school system as a means of ensuring that the role of nurses as independent practitioners is strengthened.

The American Association of Nurses has come up with recommendations of ensuring that all advanced nurses practice nurses masters-level programs will be developed to a doctorate of nursing practice by 2015 and this doctorate will encompass a restructuring of traditional health professionals’ education to include an emphasis on issues such as evidence-based practice and quality improvement. (In Cherry & In Jacob, 2014, pg 107) With this restructuring of school systems, nurses are expected to gain a number of more enhanced skills that will enable them practice as independent practitioners.

There has also been a technological upgrade in most school systems. Practices such as surgery require an individual with advanced knowledge in technological equipment used in the surgery practice. The technology can, therefore, familiarize them with surgical technology. (In Cherry & In Jacob, 2014, pg 109) With this knowledge, it is expected that nurses will now be able to perform some roles on their own which they were not able to perform due to technological barriers.

Over the years, physicians and specialists have always been entrusted to provide health care services in situations regarded as being complicated at the expense of nurses. This has been attributed to the fact that nurse practitioners lack vast knowledge in quality and safety issues. A number of efforts have been put forward by the Quality and Safety Education for Nurses (QSEN) to integrate quality and safety education in the school systems. One such effort has been through the introduction of a national initiative, the Institute for Healthcare Improvement (IHI), which oversees the integration of both quality and safety education in school systems. (In Cherry & In Jacob, 2014, pg 112) The quality and safety education is meant to provide students with skills which will ensure that they are able to provide relevant healthcare services to patients in more complex environments.

Some policies used in the school systems have also played a role in this issue. For example, in the process of social professional socialization and role transitioning, it is a policy in most schools’ systems that licensed practice nurses (LPNs) are subordinate to registered nurses (RNs) and that their ideas are of a lesser magnitude when It comes to the implementation of strategies and concepts in the practicum setting. Such a policy greatly helps in the lowering of self-confidence in most of these nurses; even years after graduating and practicing as nurses. This has been confirmed through a number of studies conducted. Such policies have such a negative impact due to the psychological effect that is left in the nursing students that they cannot practice independently. In some schools, the RNs have started implementing strategies such as incorporating LPNs’ ideas in their practice as a means of ensuring that there is a sense of appreciation in the LPNs

The outcomes of these strategies have been evaluated through a number of ways. For example, the formation of the Institute for Healthcare Improvement (IHI) to assess the integration of quality and safety education in school systems. Surveys have also been conducted in a number of health facilities where nurses are allowed to practice independently so as to assess whether or not these implemented strategies are effective in promoting the role of nurses acting as independent practitioners. Lastly, there has also been an assessment of patients who have received healthcare services from independent nurse practitioners so as to establish their standards of health provided by the nurses as independent practitioners. (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, Robert Wood Johnson Foundation, & Institute of Medicine, 2011, pg 55)

Maryland Health Department Nursing References

Aktan, N. M. (2015). Fast facts for the new nurse practitioner: What you really need to know in a nutshell.

Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation., & Institute of Medicine (U.S.). (2011). The future of nursing: Leading change, advancing health. Washington, D.C: National Academies Press.

In Cherry, B., & In Jacob, S. R. (2014). Contemporary nursing: Issues, trends, & management.

Child, Adolescent and Family Nursing

Child, Adolescent and Family Nursing
Child, Adolescent and Family Nursing

Child, Adolescent and Family Nursing

Order Instructions:

Dear sir, how are you today

Thank you so much for helping for this assignment. Please have a look and try to make a good essay so I can get the good marks.

Essay Part B

NRSG 257 Child, Adolescent and Family Nursing

Critical Evaluation of Artefacts for one of the following essay topics

Topic

Evaluate the psychosocial effects of living with asthma in relation to nursing care of the primary school aged child. Discuss how this information will guide evidence based Australian nursing practice.

In part A I submitted the list of artifacts and their screenshot and why you think those artifacts are good for your critical evaluation. Which i submitted 17/08/2015

Part B (Now we have to concentrate on this part please)

The essay is aimed at critically evaluating the content of the artefacts in the portfolio and the importance of using and evaluating evidence-based artefacts, when caring for children, adolescents and their families in relation to current Australian nursing practice. This should include the following;

• Demonstration of what learning was achieved through the content of the artefacts selected for the portfolio relevant to the chosen essay topic.

• Evaluation of evidence and value of the information or message within the chosen artefacts. The essay will demonstrate the ability to critically evaluate the research contained in the artefact portfolio. This will be undertaken whilst discussing the importance/value of the evidence-base for future nursing practice.

• This assessment task will allow students to demonstrate their critical thinking and reasoning, as well as their research skills. Students will also demonstrate how evidence based information can be implemented into contemporary Australian Nursing practice.

I am going to include list of artefacts which I used for Assignment part (A). Please have a look

Please include the following questions in given essay

• What are the strength of each artefact?

• What are the weakness of each artefacts?

• What are the limitation of each artefacts?

• How these artefacts can relate to evidence based learning?

• How these artefacts will work for Australian nursing perspectives?

Dear sir, you can use other supportive article’s references to support the essay.

1. APA Referencing

2. At least 25 genuine references from 2010 to 2015 study based,

3. 90 % references has to be research based Journal article

4. Australian and New Zealand based study article preferable.

5. Please have a look Rubric guideline for given topic, I need good grades in this assignment so please do me a favour and try to make a good essay

If you need any other information, please let me know

Thank you so much for you help and support.

Regards

SAMPLE ANSWER

Family Nursing

Australian Institute of Health and Welfare (2011) summarised various aspects concerning asthma in Australia. The strengths of the artefact include its coverage of a broad scope of aspects that are of interest to the study topic. The artefact gives factual information including the prevalence of asthma in children (Saini, Krass, Smith, Bosnic-Anticevich, & Armour, 2011, Pg. 190). It also highlights the impacts of asthma from varied viewpoints. Weaknesses of the artefact include its focus on basic concepts regarding asthma, but failure to highlight treatment and management concepts of the disease (Katelaris, Sacks, & Theron, 2013, Pg. 507). It also has limitations such as its failure to identify the impacts of the disease from a psychosocial perspective. Nevertheless, the artefact gives important information that could propel epidemiologic studies that would in turn facilitate evidence-based practice (Lim, Kobzik, & Dahl, 2010). Indication of a high prevalence of the disease in Australia would motivate stakeholders to take necessary measures for countering the occurrence (Gibbs, 2015; Pal, Dahal, & Pal, 2009; Rosenkranz, Rosenkranz, & Neessen, 2012). The item offers information that is relevant to nursing practice in Australia. Nurses would understand that the Australian population has a higher predisposition to asthma, and they would need to offer intensive patient education to promote the health of their community (Goeman, Abramson, McCarthy, Zubrinich, & Douglass, 2013). The artefact also describes financial expenditures directed to asthma management. Such data gives nurses a rich background concerning the financial impacts of the disease on the Australian population.

Blanchard, Morris, Birrell, Stephens-Reicher, Third, & Burns, (2014) examined the young population in Australia for asthma. The researchers noted that asthma had undesirable impacts on the quality of life that people led. They indicated that asthma has negative impacts on patients from psychological social and developmental perspectives (Kozyrskyj, Kendall, Jacoby, Sly, & Zubrick, 2010, Pg. 540). The strengths of the artefact include its comprehensive reporting of the scientifically-conducted research. The article gives high-level evidence concerning psychosocial impacts of asthma on the lives of patients. In their methodology, the investigators offered respondents an opportunity to point out concerns that affected their well-being (Blanchard et al., 2014, Pg. 6). The practice was advantageous as it resulted in first-hand data concerning psychosocial impacts of asthma. However, some aspects of the study reported in the artefact present weaknesses and limitations. For instance, the researchers used pre-validated instruments of measuring the impacts of asthma on the quality of the lives of patients (Blanchard et al., 2014, Pg. 14). The survey is also limited in that it addresses people of ages between twelve and twenty-five years, a group that does not coincide with the school-age children. The study offered recommendations whose implementation would promote evidence-based practice. It described a need for practice that purposes to facilitate the education of populations concerning asthma and its impacts on people’s lives. The study sought to influence nursing practice by recommending that the practitioners in health care undertake more education regarding the managements and handling of asthma patients (Evers, Jones, Iverson, & Caputi, 2013).

National Asthma Council Australia (2015) defined and described the diagnoses of asthma in children (National Asthma Council Australia, 2015, Pg. 8). The handbook also explained the difficulties encountered when diagnosing asthma in juveniles (Potter, 2010, Pg. 1). The strengths of the artefact include a high level of the credibility of its results. It was sourced from a government agency, and it offers detailed and specific principles concerning asthma. The handbook offers a clear distinction between concepts of asthma that present in children and the ones that occur in adults (Martel, Malo, Perreault, & Beauchesne, 2009, Pg. 197; The Cancer Council, 2015). It also explained how various psychosocial factors influence the management of asthma in patients (National Asthma Council Australia, 2015, Pg. 41). The handbook also identifies psychosocial factors that trigger the occurrence of asthma (Suglia, Chambers, Rosario, & Duarte, 2011; The Australasian Society of Clinical Immunology and Allergy (ASCIA), 2014). Its weakness is that it dwells solely on practice and, it does not include investigative work. Therefore, the handbook is limited to practice, and it does not offer much of research. The artefact applies to evidence-based practice as it gives standardised guidelines concerning the management of asthma in pediatrics. It is a handy tool for nursing practice as it offers guidelines on various management practices for patients with asthma (Baiardini, Braido, Bonini, Compalati, Canonica, 2009, Pg. 230).

Collins, Gill, Chittleborough, Martin, Taylor, and Winefield (2008) explored psychosocial impacts of asthma on school-age children. The researchers purposed to use a representative sample to examine the effects that asthma has on the psychosocial lives of children. They found that children who had asthma were often unhappy, and their health status was generally poor. The strengths of the article include its high degree of relevance to the study topic. The article uses keywords that relate directly to childhood asthma and its psychosocial impacts in the lives of patients (Suglia, Duarte, Sandel, & Wright, 2010, Pg. 636). The study also included a large number of participants, hence ensuring that the results obtained were a representation of large children population. There was also an elevated response rate in the participation of respondents in the study, an event that enhanced the reliability of the study (Collins et al., 2008, Pg. 490). Findings from the research also concurred with those of other studies making them realistic. Weaknesses of the study reported in the article include failure to take objective measurements of asthma for instance by applying the peak flow rate to assess lung functionality (Bruzzese, Sheares, Vincent, Du, Sadeghi, Levison, Evans, 2011, Pg. 998). It had major limitations such as a possible bias considering that participants had to respond to phone calls that some may have missed. The study applies to evidence-based practice by involving a scientific research to identify psychosocial impacts of asthma on school children. The investigation influences nursing practicing by establishing a connection between asthma and mental morbidities (Collins et al., 2008, Pg. 491; Feitosa, Santos, Barreto-Carmo, Santos, Teles, Rodrigues, & Barreto, 2011, Pg. 160).

Brown, Gallagher, and Fowler (2013) examined the self-efficacy of parents of school-age asthmatic children in managing the disease. The study offers an authoritative reference to the study topic. The researchers identified factors that influenced care and management of asthma in children as offered by their parents. Among the factors were parents’ health education and social disparities (Giallo, Bahreinian, Brown, Cooklin, Kingston, Kozyrskyj, 2015). Weaknesses presented in the study include the involvement of a small sample size that would generate controversy concerning generalisation of findings. Another critical weakness of the study was its employment of instruments that had not been widely explored in other research works. The study had limitations such as bearing influence from insufficiency of previous studies addressing major concepts in research. The study propels evidence-based learning as it identifies and describes the necessary interventions of enhancing self-efficacy of the parents of asthmatic juveniles. It impacts on nursing practice as nurses would drive educative programs to such parents.

The Royal Children’s Hospital Melbourne (2015) gave guidelines concerning asthma management in children. The hospital defined asthma and related it to other health complications linked to it. The artefact explained the pathophysiology of asthma among children and described different pharmacological interventions applied in the management of the ailment for pediatrics (Lowe, Carlin, Bennett, Hosking, Allen, Robertson, Dharmage, 2010). The artefact is authoritative in that it is from a reputable healthcare institution in Australia. It applies perfectly to the study topic by describing appropriate assessment and management strategies for the disease. The artefact grades asthmatic conditions on the basis of severity. It would be necessary for the study to relate disease severity to the psychosocial impacts it has on children. Weaknesses of the artefact include its failure to describe impacts of asthma on patients’ lives. The resource is also limited in that it does not offer investigative information but just gives guidelines (National Asthma Council Australia, 2014). The article has significant impact on evidence-based learning as it outlines standardised assessment and treatment strategies for the disease (Schultz & Martin, 2013, Pg. 13). It influences the Australian nursing perspective by recommending particular practices in asthma management and treatment (Perzanowski, Miller, Tang, Ali, Garfinkel, Chew, Barr, 2010, Pg. 118). Nurses would refer to such guidelines when handling and treating asthmatic patients.

References

Australian Bureau of Statistics. (2013). Asthma. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4338.0main+features152011-13

Australian Institute of Health and Welfare. (2011). Asthma in Australia. Retrieved from http://aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421255

Baiardini I, Braido F, Bonini M, Compalati E, Canonica GW. (2009). Why do doctors and patients not follow guidelines? Curr Opin Allergy Clin Immunol, 2009(9), 228–233.

Blanchard, M., Morris, J., Birrell, E., Stephens-Reicher, J., Third, A., & Burns, J. (2014). National Young People and Asthma Survey: issues and opportunities in supporting the health and wellbeing of young people living with asthma (1st ed.). Melbourne. Retrieved from http://www.asthmaaustralia.org.au/uploadedFiles/Content/State_Content/National/Media_releases/2015_Media_releases/YW-Asthma-Survey.pdf

Brown, N., Gallagher, R., Fowler, C., & Wales, S. (2013). Asthma management self-efficacy in parents of primary school-age children. Journal Of Child Health Care, 18(2), 133-144. doi:10.1177/1367493512474724

Bruzzese, J.-M., Sheares, B. J., Vincent, E. J., Du, Y., Sadeghi, H., Levison, M. J., … Evans, D. (2011). Effects of a School-based Intervention for Urban Adolescents with Asthma: A Controlled Trial. American Journal of Respiratory and Critical Care Medicine, 183(8), 998–1006. doi:10.1164/rccm.201003-0429OC

Collins, J., Gill, T., Chittleborough, C., Martin, A., Taylor, A., & Winefield, H. (2008). Mental, Emotional, and Social Problems Among School Children with Asthma. J Asthma, 45(6), 489-493. doi:10.1080/02770900802074802

Evers, U., Jones, S. C., Iverson, D., & Caputi, P. (2013). “Get Your Life Back”: process and impact evaluation of an asthma social marketing campaign targeting older adults. BMC Public Health, 13, 759. doi:10.1186/1471-2458-13-759

Feitosa, C. A., Santos, D. N., Barreto-Carmo, M. B., Santos, L. M., Teles, C. A. S., Rodrigues, L. C., & Barreto, M. L. (2011). Behaviour problems and prevalence of asthma symptoms among Brazilian children. Journal of Psychosomatic Research, 71(3), 160–165. doi:10.1016/j.jpsychores.2011.02.004

Giallo, R., Bahreinian, S., Brown, S., Cooklin, A., Kingston, D., Kozyrskyj, A. (2015) Maternal Depressive Symptoms across Early Childhood and Asthma in School Children: Findings from a Longitudinal Australian Population Based Study. PLoS ONE 10(3), e0121459. doi:10.1371/journal.pone.0121459

Gibbs, J. E. M. (2015) Eucalyptus Pollen Allergy and Asthma in Children: A Cross-Sectional Study in South-East Queensland, Australia. PLoS ONE 10(5): e0126506. doi:10.1371/journal.pone.0126506

Goeman, D. P., Abramson, M. J., McCarthy, E. A., Zubrinich, C. M., & Douglass, J. A. (2013). Asthma mortality in Australia in the 21st century: a case series analysis. BMJ Open, 3(5), e002539. doi:10.1136/bmjopen-2012-002539

Katelaris, C. H., Sacks, R., & Theron, P. N. (2013). Allergic rhinoconjunctivitis in the Australian population: Burden of disease and attitudes to intranasal corticosteroid treatment. American Journal of Rhinology & Allergy, 27(6), 506–509. doi:10.2500/ajra.2013.27.3965

Kozyrskyj, A. L., Kendall, G. E., Jacoby, P., Sly, P. D., & Zubrick, S. R. (2010). Association Between Socioeconomic Status and the Development of Asthma: Analyses of Income Trajectories. American Journal of Public Health, 100(3), 540–546. doi:10.2105/AJPH.2008.150771

Lim, R. H., Kobzik, L., & Dahl, M. (2010). Risk for Asthma in Offspring of Asthmatic Mothers versus Fathers: A Meta-Analysis. PLoS ONE, 5(4), e10134. doi:10.1371/journal.pone.0010134

Lowe, A. J., Carlin, J. B., Bennett, C. M., Hosking, C. S., Allen, K. J., Robertson, C. F., … Dharmage, S. C. (2010). Paracetamol use in early life and asthma: prospective birth cohort study. BMJ : British Medical Journal, 341, c4616. doi:10.1136/bmj.c4616

Martel, M. J., Rey, E., Malo, J. L., Perreault, S., Beauchesne, M. F. (2009). Determinants of the incidence of childhood asthma: a two-stage case-control study. Am J Epidemiol., 2009(169), 195–205.

National Asthma Council Australia (2015). Australian Asthma Handbook- Quick Reference Guide. (1st ed.). Melbourne. Retrieved from http://www.asthmahandbook.org.au/uploads/555143d72c3e3.pdf

National Asthma Council Australia. (2014). New National Asthma Management Guidelines Released. Retrieved from http://www.nationalasthma.org.au/news-media/d/2014-03-04/new-national-asthma-management-guidelines-released

Pal, R., Dahal, S., & Pal, S. (2009). Prevalence of Bronchial Asthma in Indian Children. Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine, 34(4), 310–316. doi:10.4103/0970-0218.58389

Perzanowski, M. S., Miller, R. L., Tang, D., Ali, D., Garfinkel, R. S., Chew, G. L., … Barr, R. G. (2010). Prenatal acetaminophen exposure and risk of wheeze at age 5 years in an urban low-income cohort. Thorax, 65(2), 118–123. doi:10.1136/thx.2009.121459

Potter, P. C. (2010). Current guidelines for the management of asthma in young children. Allergy, Asthma & Immunology Research, 2(1), 1–13. doi:10.4168/aair.2010.2.1.1

Rosenkranz, R. R., Rosenkranz, S. K., & Neessen, K. J. (2012). Dietary factors associated with lifetime asthma or hayfever diagnosis in Australian middle-aged and older adults: a cross-sectional study. Nutrition Journal, 11, 84. doi:10.1186/1475-2891-11-84

Saini, B., Krass, I., Smith, L., Bosnic-Anticevich, S., & Armour, C. (2011). Role of community pharmacists in asthma – Australian research highlighting pathways for future primary care models. The Australasian Medical Journal, 4(4), 190–200. doi:10.4066/AMJ.2011790

Schultz, A., & Martin, A. C. (2013). Outpatient Management of Asthma in Children. Clinical Medicine Insights. Pediatrics, 7, 13–24. doi:10.4137/CMPed.S7867

Suglia, S. F., Chambers, E., Rosario, A., & Duarte, C. S. (2011). Asthma and obesity among 3 year old urban children: The role of sex and the home environment. The Journal of Pediatrics, 159(1), 14–20.e1. doi:10.1016/j.jpeds.2011.01.049

Suglia, S. F., Duarte, C. S., Sandel, M. T., & Wright, R. J. (2010). Social and environmental stressors in the home and childhood asthma. Journal of Epidemiology and Community Health, 64(7), 636–642. doi:10.1136/jech.2008.082842

The Australasian Society of Clinical Immunology and Allergy (ASCIA). (2014). Food Allergy and Anaphylaxis Update. Retrieved from http://www.allergy.org.au/health-professionals/hp-information/asthma-and-allergy/food-allergy-and-anaphylaxis-update-2014

The Cancer Council. (2015). Health effects of secondhand smoke for infants and children. Retrieved from http://www.tobaccoinaustralia.org.au/4-7-health-effects-of-secondhand-smoke-for-infants

The Royal Children’s Hospital Melbourne,. (2015). Asthma Acute. The Royal Children’s Hospital Melbourne. Retrieved 15 August 2015, from http://www.rch.org.au/clinicalguide/guideline_index/Asthma_Acute/

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