Part 6: Evaluation Plan

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Part 6: Evaluation Plan

In this part of the Evaluation Project, you construct an evaluation plan by aggregating all of your work on the project thus far into one cohesive document. The document should contain your PICO question, literature review (with summary table), evaluation methodology, and evaluation tool.

To prepare:

  • Consider the issues or concerns you might have when developing an evaluation plan. Reflect on the ethical issues you and your colleagues identified in the Week 9 Discussion.
  • Reflect on potential limitations and opportunities (Note: This topic will be addressed in the Week 10 Discussion).

To complete Part 6 of the Evaluation Project:

By Day 7 of Week 10

In no more than 10 pages, aggregate all of your work on the Evaluation Project so far into a single document. This document should contain:

1)       Your PICO question (See Attached PDF File)

2)       An explanation of the goals of your evaluation plan

3)       Literature review (with summary table as an appendix) (See Attached PDF File)

4)       Evaluation methodology (including research design) (See Attached PDF File)

5)       Evaluation tool (See Attached PDF File)

6)       A description of any ethical issues or concerns you may have with implementing your plan and how you could handle them if they arose (see the assignment on “Evaluations and Ethics”)

7)       A summary of the criteria you will use to define the success of your plan and how you will disseminate findings

8)       An outline of limitations to the scope of the plan and opportunities resulting from your evaluation plan (Note: based on week 10 discussion post on Identification of Opportunities and Limitations)

Required Readings

Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc.

  • Chapter 12, “Proposing and Communicating the Results of Evaluation Studies: Ethical, Legal, and Regulatory Issues” (pp. 338–361) 

This chapter covers both how to write a proposal to conduct an evaluation and how to present the findings. It highlights the importance of conforming to legal, regulatory, and ethical standards in the evaluation and write-up.

Berner, E. S. (2008). Ethical and legal issues in the use of health information technology to improve patient safety. HEC Forum, 20(3), 243–258.

Retrieved from the Walden Library databases.

 In this article, the author outlines key ethical and legal issues that need to be considered when using health information technology. These include issues with the establishment of a standard of care, increased availability of patient information, accuracy of information, the effectiveness of user training, and the fulfillment of informed consent obligations.

Goldstein, M. M. (2010). Health information technology and the idea of informed consent. Journal of Law, Medicine & Ethics, 38(1), 27–35.

Retrieved from the Walden Library databases.

 This article details the reasons behind the policy of informed consent and the challenges posed to providing privacy by electronic health records and the ease of gaining access to confidential patient information.

Goodman, K. W. (2010). Ethics, information technology, and public health: New challenges for the clinician-patient relationship. Journal of Law, Medicine & Ethics, 38(1), 58–63.

Retrieved from the Walden Library databases.

 The focus of this article is the challenge facing health care personnel in balancing the privacy of patients and the need to perform research on public health issues. The author discusses whether there is a moral obligation for patients and clinicians to be willing to share information for the “greater good.”

Goodman, K. W., Berner, E. S., Dente, M. A., Kaplan, B., Koppel, R., Rucker, D., et al. (2011). Challenges in ethics, safety, best practices, and oversight regarding HIT vendors, their customers, and patients: A report of an AMIA special task force. Journal of the American Medical Informatics Association, 18(1), 77–81.

Retrieved from the Walden Library databases.

 This article highlights recommendations by an AMIA special task force that analyzed ethical and safety issues dealing with the increased use of HIT systems. The recommendations covered such areas as the need for HIT regulation, the ability to provide ethics training to vendors, and organizational commitment to placing patient safety as the highest priority.

Nykänen, P., Brender, J., Talmon, J., de Keizer, N., Rigby, M., Beuscart-Zephir, M. C., & Ammenwerth. E. (2011). Guideline for good evaluation practice in health informatics (GEP-HI). International Journal of Medical Informatics, 80(12), 815–827.

Retrieved from the Walden Library databases.

 In this article, the authors highlight their efforts to develop a good practice guideline to plan and perform evaluation studies in health informatics. The authors put forth a list of sixty issues to function as a guideline for good evaluation practices.

Rothstein, M. A. (2011). Currents in contemporary bioethics: Physicians’ duty to inform patients of new medical discoveries: The effect of health information technology. Journal of Law, Medicine & Ethics, 39(4), 690–693.

Retrieved from the Walden Library databases.

The authors of this article analyze the duty of physicians to inform patients of relevant medical developments following their episode of care. Additionally, the authors make recommendations for promoting recognition of physicians’ duty to notify patients of new medical discoveries applicable to their health.

Rothstein, M. A. (2010). The Hippocratic bargain and health information technology. Journal of Law, Medicine & Ethics, 38(1), 7–13.

Retrieved from the Walden Library databases.

 This article highlights the sensitive nature of much of the information contained in Electronic Health Records and its current availability to a wide range of individuals. The author calls for the development of policy to protect the privacy of patients. He suggests allowing the segmentation of patient information so that the majority of sensitive information is difficult to access.

Med Term

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you will write 2 reports (referring to the departments of Dermatology and Cardiology) and use them as your script for your Week 3 Oral Report. Your writing section for this assignment will include 2 paragraphs for each department. 

In order to earn the maximum credit for the written report you need to incorporate at least 10 medical terms for each department (a total of 20 terms for this assignment), using them in a manner that demonstrates your knowledge of their meaning.

  • Include the major or most common diseases or conditions seen in each department.
  • Include at least three of the principal procedures that are relevant to each department.
  • Highlight pertinent laboratory and radiological diagnostic services relevant to each department.
  • Limit your analysis of each department to two paragraphs.

ROUGH DRAFT QUALITATIVE RESEARCH

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             THIS ASSIGMENT SHOULD BE BASED IN THE PREVIOUS ASSIGMENT: PICOT STATEMEN AND LITERATURE SEARCH..THE DOCUMENT IS ATTACHED BELLOW .. THE QUALITATIVE PEER REVIEWED ARTICLE ASSIGMENT HAS TO BE A SEPARATE  DOCUMENT FROM QUANTITATIVE PEER REVIEWED ARTICLE..  USE GRADING RUBRICS                                                  

                                              QUALITATIVE, PEER REVIEWED ARTICLE

Use the practice problem and a qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

                                                         QUANTITATIVE, PER REVIEWED ARTICLE

Use the practice problem and a quantitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

                                                          GRADING RUBRICS

John Smith is a 65-year-old retiree who is admitted to your unit from the emergency department (Ed). On arrival, you note that he is trembling and nearly doubled over with severe abdominal pain. John

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John Smith  is a 65-year-old retiree who is admitted to your unit from the emergency department (Ed). On arrival, you note that he is trembling and nearly doubled over with severe abdominal pain. John indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid back as a deep, sharp, boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. John experienced an acute onset of pain after eating fried fish and chips at a fast-food restaurant earlier today. He is not happy to be in the hospital and is grumpy that his daughter insisted on taking him to the emergency department for evaluation. 

After orienting him to the room, you perform your physical assessment. The findings are as follows: He is awake, alert, and oriented × 3, and he moves all extremities well. He is restless, constantly shifting his position, and complains of fatigue. Breath sounds are clear to auscultation. Heart sounds are clear and crisp, with no murmur or rub noted and with a regular rate and rhythm. Abdomen is flat, slightly rigid, and very tender to palpation throughout, especially in the RUQ; bowel sounds are present. He reports having light-colored stools for 1 week. The patient voids dark amber urine but denies dysuria. skin and sclera are jaundiced. 

Admission vital signs are blood pressure 164/100, pulse of 132 beats/min, respiration 26 breaths/min, temperature of 100° F (37.8° C), spo2 96% on 2 L of oxygen by nasal cannula.

Preoperative Laboratory Test Results 

·       WBC 11,900/mm3 

·       Hgb 14.3 g/dL 

·       Hct 43% 

·       Platelets 250,000/mm3 

·       ALT 200 units/L 

·       AST 260 units/L 

·       ALP 450 units/L 

·       Total bilirubin 4.8 mg/dL 

·       PT/INR 11.5 sec/1.0 

·       Amylase 50 units/L 

·       Lipase 23 units/L 

·       Urinalysis Negative

1.     What organs are located in the RUQ of the abdomen? (Start thinking about what organ is involved based on his chief complaint)

2.     What does a positive Murphy’s sign indicate when a health care provider performs deep palpation?

3.     Which lab results are abnormal, and what do they reflect?

4.     Which other data in the assessment are consistent with common bile duct obstruction?

5.     Explain the pathophysiologic changes that can cause these signs and symptoms associated with common bile duct obstruction.

A.    Clay colored stools

B.    Dark urine

C.    Steatorrhea

D.    Jaundice

E.    Pain with fatty food intake

The patient’s abdominal ultrasound reveals several stones in the common bile duct and gallbladder. He is admitted to the medical-surgical unit and placed on nothing by mouth (NPO) status and scheduled to undergo endoscopic retrograde cholangiopancreatography (ERCP) that afternoon.

6.     Explain the rational for the treatment of acute cholecystitits with the following interventions.

A.    NPO with possible NG suction

B.    Antibiotics (which route)

C.    Antispasmodics

7.     Define ERCP and indication for it based on this patient’s status.

8.     Which results are abnormal, and what do they reflect?

The patient then undergoes ERCP and the stones and bile are released, but imaging indicates a stone is still within the cystic duct and gallbladder. A surgeon was consulted and a laparoscopic cholecystectomy was ordered. 

9.     List four to five preoperative orders that will likely need to be done before the patient goes to surgery.

10.  If he had a laparoscopic cholecystectomy, which discharge instruction would the nurse advise the patient: (explain the rational for the correct choice). 

a.     Keep the incision areas clean and dry for at least a week

b.     Report he need to take pain medication for shoulder pain

c.     Report any bile-colored or purulent drainage from the incisions

d.     Expect some postoperative nausea and vomiting for a few days

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COMMENT JENNIFER

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Re:Topic 5 Mandatory Discussion Question

1.      What health risks associated with obesity does Mr. C. have?

High Blood Pressure, Diabetes, Physical Inactivity, Sleep Apnea, Cardiovascular Disease.

2.       Is bariatric surgery an appropriate intervention? Why or why not?

According to American Society for Metabolic and Bariatric Surgery (ASMBS). The qualifications for bariatric surgery in most areas include:

  • ·         BMI ≥ 40, or more than 100 pounds overweight (ASMBS, 2017).
  • BMI ≥35 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease (ASMBS, 2017).
  • Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts (ASMBS, 2017).

According to these qualifications he would be a candidate. He has elevated glucose making him at risk of diabetes and abnormal lipid being a risk of cardiovascular disease. He has evidence of high blood pressure and sleep apnea. His BMI is at 47.75.

3.      The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

0600 Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL)

0700 breakfast

1000 Mylanta 15ml PO

1100 Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL)

1200 lunch

1500 Mylanta 15ml PO

1700 Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL)

1800 dinner

2100 Mylanta 15ml PO

2200 snack/bedtime-

Ranitidine (Zantac) 300 mg PO, Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL

4.      Functional health patterns include

health-perception and management- he has always been heavy and needs help with obtaining correct nutritional structure to help with controlled calories, fats, sodium and sugar as well as increasing regular exercise program.

nutritional – metabolic- He has gained a large amount of weight over last few years. He needs to learn to control food consumption, also increase of activity. recognizing foods with high fats, high sodium, and making better choices.

Elimination- Nothing is mentioned so further assessment should be done. Watch for constipation of loose stools. An increase of fiber to help with constipation. Watch for change in bowels with new medications.

activity-exercise- Having an office job and perhaps no desire to exercise can lead to weight gain. He should increase activity by walking at lunch. Joining an exercise gym.

sleep-rest-  He is overweight and has sleep apnea, so sleep is probably restless, so a need of a CPAP to get quality sleep may be a good choice.

cognitive-perceptual- He is able to make his needs known, he works and with known information is able to care for himself

self-perception – self-concept- low self-esteem, feeling that he has always been heavy

role-relationship- He is a single man.

sexuality – reproductive- Needs further assessment

coping – stress tolerance- He may overeat due to stress or low self-esteem. He does watch his sodium intake to help cope with hypertension. He is wanting to change his appearance and enhance his health with a weight loss plan. Recommend exercise to help relieve any stress and help cope with change of lifestyle.

5.      What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

1.      Patient needs to see a nutritional consult to provide him with a healthy diet. This is important because he needs to learn a healthy pattern before having a surgery. He needs to recognize that his eating patterns are partially responsible for his weight gain.

2.      His sleeping needs to be improved. He cannot have a healthy mind when you are exhausted. Adequate sleep can help improve mental status and provide you energy to make lifestyle changes that are necessary.

3.      He needs to be educated about his high blood sugar. Again, meeting with a nutrition consult can help in this area. He need to have the appropriate equipment to check his own blood sugar.

4.      Patient needs to make sure that he is taking the medications at the appropriate times to benefit his peptic ulcer disease. He also need to make sure that he tells all consults about his medications to avoid adverse reactions with any new medications.

5.      Patient needs to continue to watch sodium intake and be educated about other causes of hypertension, like stress and lack of cardio exercise. Recommend his becoming involved in walking or joining a gym.

American Society for Metabolic and Bariatric Surgery (ASMBS). (2017). Patient Learning Center.  Retrieved August 28, 2017, from https://asmbs.org/patients/

p3

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

Sandeep Kaur 

1 posts

This patient is showing the sign and symptoms of systemic infection chills, sweating fatigue, malaise, muscle ache, sensation of heat.

The muscle groups that are most likely to be affected by this are the flexor hallucis longus, flexor digitorum longus, and tibialis anterior. All three muscles stretch from the medial malleolus to the popliteal joint. If the cellulitis were to continue further up the leg, more muscles would be affected. This infection can damage the lymphatic drainage system of the affected limb, causing chronic lymph edema.

This patient is showing the sign and symptoms of systemic infection chills, sweating fatigue, malaise, muscle ache, sensation of heat.

The muscle groups that are most likely to be affected by this are the flexor hallucis longus, flexor digitorum longus, and tibialis anterior. All three muscles stretch from the medial malleolus to the popliteal joint. If the cellulitis were to continue further up the leg, more muscles would be affected. This infection can damage the lymphatic drainage system of the affected limb, causing chronic lymph edema.

The significance of these findings is that they help guide us in how to care for the patient. IV antibiotics will need to be started ASAP to combat the infection which is indicated by several factors: elevated temperature, elevated WBC’s, neuts and bands, wound culture, cellulitis, and the thick yellow drainage from the wound and unable to bear weight. Miss G also need CT of left leg and MRI can give the better result with the other lab work like CMP, CK, ABG, HgbA1C to rule out DKA and also to know how well her blood sugar is. Miss G need monitoring of the vital sign. Because when a patient is septic the HR goes up or down. Surgical consult will be helpful too.

The fact that she cannot bear weight and reports being in bed for 3 days suggests that she is most likely dehydrated and suffers from malnutrition as well. An IV should be started for fluids, possibly a banana bag or LR in order to rehydrate as well as give her body the proper nutrients to help with wound healing.

This patient needs wound consult because of open leg wound with left leg redness. The wound should be cleansed and properly bandaged twice daily, depending upon the amount of drainage that continues. It’s possible that a wound-vac might be needed as the patient also suffers from diabetes and has poor circulation. Need to mark the red area in order to see if the redness is increasing. Leg should be elevated for the swelling. Calf measurement needs to be done to check if the leg size is increasing.

Since the patient is complaining of pain, which is evident by her not leaving her bed for 3 days, She needs around the clock medicine for pain.

Routine lab draws will need to be made as well until the infection is under control that way you can ensure that the infection is not getting worse and monitor the effects it is having on her body. Since diabetics function and process things differently than normal, a CBC and CMP would be helpful to monitor organ functions. Also, I would order a FSBS AC and QHS along with oral diabetic  medications depending upon the HgA1C level and FSBS results. This will not only help wound healing now but it will help control further issues in the future.

It is also obvious that Ms. G would greatly benefit from education on diabetes. Although we do not get the information to know how this started or what her blood sugar levels have been, it most likely started from a consequence of poorly managed diabetes. Since diabetics suffer from poor circulation, along with neuropathy, they do not feel wounds the same way a non-diabetic would. This could have started from something as simple as a nic from shaving her legs but, left untreated, it turned into something much worse. A diabetic should always check their feet and legs thoroughly each night before bed to ensure all skin is intact. Nutrition should also be something to educate on. Not only is nutrition a huge factor in managing diabetes, it also plays a vital role in wound healing. The body cannot heal without the proper nutrients and it is especially difficult if you are a diabetic. Pt needs podiatrist to have her feet checked and nails cut. Pt needs education on blood sugar check and how to give insulin and also a nutritionist to help understand DM.

Another thing to consider, upon discharge, is whether or not the patient will require home health services. Stating that she lived alone, no body to help with food and she is in the bed for three days. This shows the self-neglect of the patient. Assistance may be required until the leg is fully healed. Pt needs homecare and a program like Meals on Wheels that deliver meals for her. Other option is skilled nursing facility. This patient also need emotional support. Powerlessness is a huge issue with this patient. Her lack of function is the contributing factor. She is dependent on others. An equal portion is directly related to her perceived lack of control over decisions. This patient needs a therapeutic relationship. Nurses should spend one‐on‐one time with her, keep commitments, provide encouragement, listen attentively, be empathetic. Allow patient to share her feelings. Encourage participation in self‐care and self‐management activities so that patient feels less powerless. Giving realistic praise assists the patient in developing positive feelings and enhances self‐concept. All feelings are personal and have meaning for the patient. Support groups can serve as a helpful means to improve interpersonal coping strategies. Counseling with therapeutic goal setting has been shown to be helpful.

unit 5 health information

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Recent audit results revealed several data errors associated with hospital encounters of patients who speak English as a second language.

Assignment 2: Course Project—Part 1Your assignment for this week entails working on an introduction for your project. The introduction should:Contain the title of the lesson.Identify and describe th

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Assignment 2: Course Project—Part 1

Your assignment for this week entails working on an introduction for your project. The introduction should:

  • Contain the title of the lesson.
  • Identify and describe the learners.
  • Describe the educational setting: staff development, patient education, family education, and so forth.
  • Include learner assessments: educational level, developmental level, readiness to learn, and so forth.
  • Provide a purpose and rationale for selecting the topic/disease.
  • Describe the philosophical or theoretical basis for teaching approaches used in the lesson.
  • Focus on 1 disease/3 audiences.
  • Support answers with relevant examples and journal articles.

On a separate references page, cite all sources using APA format.

By the due date assigned, submit this week’s project assignment in a 5- to 6-page paper to the Submissions Area. Be sure to use appropriate APA formatting. Write in paragraph form; do not use a table format.

plagiarim less than 25% please

(200 Words)Appraise and defend a “perfect” health leader by explaining the knowledge, skills, abilities, and competencies of that “perfect” leader. Is this similar to the type of leader you wa

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(200 Words)

Appraise and defend a “perfect” health leader by explaining the knowledge, skills, abilities, and competencies of that “perfect” leader. Is this similar to the type of leader you want to be? Why or why not?