This week you have learned about common Endocrine disorders in the Adult and Geriatric patient. For the purpose of this discussion provide the following in your initial post on Hyper/hypothyroidism.

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This week you have learned about common Endocrine disorders in the Adult and Geriatric patient. For the purpose of this discussion provide the following in your initial post on Hyper/hypothyroidism.

  • Common Signs and symptoms seen
  • Screening assessment tools
  • Recommended diagnostic tests (if any)
  • Treatment plans both pharmacologic and non-pharmacologic based on current clinical practice guidelines

Endocrine Disorders: Hyper/hypothyroidis

 

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This week you have learned about common Endocrine disorders in the Adult and Geriatric patient. For the purpose of this discussion provide the following in your initial post on Diabetes

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This week you have learned about common Endocrine disorders in the Adult and Geriatric patient. For the purpose of this discussion provide the following in your initial post on Diabetes.

  • Common Signs and symptoms seen
  • Screening assessment tools
  • Recommended diagnostic tests (if any)
  • Treatment plans both pharmacologic and non-pharmacologic based on current clinical practice guidelines

Endocrine Disorders: Diabetes

 

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Begin researching what the job market looks like in your area, as well as what credentials and licenses you may need to advance within your chosen field in the future, Family Nurse Practitioner (FNP)

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Begin researching what the job market looks like in your area, as well as what credentials and licenses you may need to advance within your chosen field in the future, Family Nurse Practitioner (FNP)

 

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Begin researching what the job market looks like in your area, as well as what credentials and licenses you may need to advance within your chosen field in the future, Family Nurse Practitioner (FNP)

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Study daily 13

MSN-prepared nurses must be prepared to market themselves to others so that the key characteristics and contributions of their expertise and the role are recognized and valued in the healthcare environment.

Begin researching what the job market looks like in your area, as well as what credentials and licenses you may need to advance within your chosen field in the future, Family Nurse Practitioner (FNP)

The purpose of this assignment is to help you feel more prepared as you begin to think about your future career and the path that you are hoping to take. First, develop a job search strategy for your chosen advanced nursing practice role. You will educate your audience on the value you bring to the healthcare team and the opportunities which exist in your chosen labor market and profession.

This assignment will be prepared as a 7-10 slide PowerPoint presentation meeting the following criteria.

Directions:

Examine the advanced nursing practice role for which you are being prepared (NP, Executive Leader, or Nurse Educator) and briefly describe the role including the history of the role, education and certifications required or preferred by employers (i.e., DEA License), and major functions of this role.

For the Nurse practitioner role, please locate, research, and include the following information in your PowerPoint as well:

Projected Job Growth in state

Average Salary Range

Similar Job Titles

5 Employers who are hiring these roles in your area

Indeed

Create a marketing plan to support your value to the healthcare team. Address each of the 4Ps to market your advanced nursing practice role.

Investigate at least two of the Central and Core Competencies and how these competencies can influence and advance healthcare.

Your presentation must be presented in a single PowerPoint presentation. The presentation must be between 7 and 10 slides in length, not including the title and reference list slides.

 

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Identify the selected model or framework for change and discuss its relevance to your project.

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  1. Identify the selected model or framework for change and discuss its relevance to your project.
  2. Discuss each of the stages in the change model/framework.
  3. Describe how you would apply each stage of the model or theoretical framework in your proposed implementation.
 

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Post a description of the role of the staff nurse for promoting quality in a high-performing health care organization.

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Post a description of the role of the staff nurse for promoting quality in a high-performing health care organization. Define the organizational culture of your health care organization, or one with which you are familiar, and identify the leadership style of the CEO and CNO in your organization. Explain how your senior leadership supports—or does not support—changes that require financing/budget to support patient safety. Describe the strategies you might be able to implement to move your health care organization to a high-performing organization

 

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In adults with T2DM, in a primary care setting, will implementation of the Diabetes Self-Management Education and Support (DSMES) via mobile technology (text messaging) impact fasting blood sugars in 8- 10 weeks?            

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Adofo,

The purpose of the Doctor of Nursing Practice (DNP) project is to develop an intervention to address adults patients diagnosed with type 2 diabetes mellitus (T2DM). The DNP PICOT question is: In adults with T2DM, in a primary care setting, will implementation of the Diabetes Self-Management Education and Support (DSMES) via mobile technology (text messaging) impact fasting blood sugars in 8- 10 weeks?

A comprehensive literature review of the current research was conducted to identify current evidence-based practice interventions to decrease fasting blood glucose levels in patients with T2DM. A systematic literature review is vital to the review procedure and must provide a clear method as to how the literature findings were identified (Cooper et al., 2018). Thus, relevant literature search strategies are a very important part of translating research into practice (Herrstrom et al., 2020). The articles were searched through Cochrane, MEDLINE, CINAHL, EBSCO, google scholars, and OVID technologies databases for the literature review. The keywords of “type 2 diabetes”, “evidence-based intervention and technology” “technology and reduction of fasting blood glucose” as part of the PICOT question. The DNP student utilized Boolean phrases to narrow and or broaden my search. Database filters based on inclusion and exclusion criteria including no articles older than 5 years, peer-reviewed journals, were used and narrowed down the number of articles after reviewing abstracts.

The three main themes that emerge from the research findings are a) DSMES toolkit is effective in improving communication and enabling self-care behaviors, (b) promotion of active patients’ participation in T2DM management, and (c) duration of intervention program influences T2DM outcomes (Dobson et al.,2017; Duffy et al., 2019; Greenwood et al 2017; McMillan et al., 2017; Nkhoma et al., 2021; Russell et al., 2017). Six research studies were reviewed (Dobson et al.,2017; Duffy et al., 2019; Greenwood et al 2017; McMillan et al., 2017; Nkhoma et al., 2021; Russell et al., 2017) that described the DSMES based intervention to address the problem of T2DM. Researchers identified that the DSMES intervention program through short text messaging can effectively reduce fasting blood glucose levels of patients diagnosed with T2DM (Dobson et al.,2017; Duffy et al., 2019; Greenwood et al 2017; McMillan et al., 2017; Nkhoma et al., 2021; Russell et al., 2017).

I will continue to work on my DNP project implementation by preparing my IRB pre-screening documents for approval. I am still working on my pre-screening documents but have completed my DNP practicum form in week one. I will consider success as I wait for the review and edits of my DNP project.

References

Cooper, C., Booth, A., Varley-Campbell, J., Britten, N., & Garside, R. (2018). Defining the process to literature searching in systematic reviews: A literature review of guidance and supporting studies. BMC MedicalResearch Methodology, 18(85),1-15. https://doi.org/10.1186/s12874-018-0545-3 (Links to an external site.) (Links to an external site.)

Dobson, R., Whittaker, R., Pfaeffli Dale, L., & Maddison, R. (2017). The effectiveness of text message-based self-management interventions for poorly-controlled diabetes: A systematic review. Digital Health, (3), 1-12. https://doi.org/10.1177/2055207617740315 (Links to an external site.)

Duffy, S., Svenson, J., Chavez, A., Kelly, M., & Wise, P. (2019). Empowering community health workers with mobile technology to treat diabetes. The Annals of Family Medicine, 17(2), 176-176. https://doi.org/10.1370/afm.2361 (Links to an external site.)

Greenwood, D. A., Gee, P. M., Fatkin, K. J., & Peeples, M. (2017). A systematic review of reviews evaluating technology-enabled diabetes self-management education and support. Journal of Diabetes Science and Technology, 11(5), 1015-1027.https://doi.org/10.1177/1932296817713506 (Links to an external site.)

Herrström K., Larsson S., Einberg E., Nilsson M., Blomqvist K.,& Garmy P. (2020). Assessment of search strategies in literature-review-based candidate theses within a nursing program. Advances in Medical Education and Practice,11,71-77. https://doi.org/10.2147/AMEP.S227547 (Links to an external site.) (Links to an external site.)

McMillan, K. A., Kirk, A., Hewitt, A., & MacRury, S. (2017). A systematic and integrated

review of mobile-based technology to promote active lifestyles in people with type 2

diabetes. Journal of Diabetes Science and Technology, 11(2), 299-307.

https://doi.org/10.1177/1932296816656018 (Links to an external site.)

Nkhoma, D. E., Soko, C. J., Banda, K. J., Greenfield, D., Li, Y. C. J., & Iqbal, U. (2021). Impact of DSMES app interventions on medication adherence in type 2 diabetes mellitus: systematic review and meta-analysis. BMJ health & care informatics, 28(1). https://doi.org/10.1136/bmjhci-2020-100291

Russell, N. M., Vess, J., Durham, C., & Johnson, E. (2017). Text-messaging to support diabetes self-management in a rural health clinic: A quality improvement project: OJNI. On-Line Journal of Nursing Informatics, 21(2) Retrieved from https://www.proquest.com/scholarly-journals/text-messaging-support-diabetes-self-management/docview/1984822511/se-2?accountid=11250

 

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“For adult patients, on a medical-surgical unit, does implementation of the Enhanced Recovery After Surgery (ERAS) protocol, as compared to current practice, impact surgical site infection (SSI) rates in 8-10 weeks?”

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Born,

The DNP Project: Literature Synthesis

“For adult patients, on a medical-surgical unit, does implementation of the Enhanced Recovery After Surgery (ERAS) protocol, as compared to current practice, impact surgical site infection (SSI) rates in 8-10 weeks?”

Paragraph Example

A surgical site infection is ” an infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure or within 90 days if a prosthetic material is implanted at surgery” (U.S. Department of Health and Human Services, 2019). In the United States, surgical site infections affect as many as 300,000 patients annually and account for nearly 1 million additional inpatient days (Loyola University Health Systems, 2017; Centers for Disease Control and Prevention, 2021). The risk of surgical site infection following colorectal surgery is one of the highest when compared to any surgical specialty. Colorectal surgery places a considerable burden on health care systems related to high complication risks, notably surgical site infections, and contributes to poor outcomes and increased readmission rates (Leaper et al., 2020; Turner & Migaly, 2019). In 2020, 3,062 acute care hospitals reported a total of 6,094 surgical site infections related to colorectal surgery (Centers for Disease Control and Prevention, 2020). An increased length of stay not only causes a direct cost to the health care system and payer but also causes patient and social-economical ramifications from the cost of supplies, nursing care, and loss of work and productivity (Turner & Migaly, 2019).

Decreasing the incidence of surgical site infections in colorectal surgery patients is a common theme of all research studies evaluated. These studies all looked at outcomes on surgical site infection rates with the implementation of the Enhanced Recovery After Surgery (ERAS) protocol.

According to one observational study, it was found that participants who underwent colorectal surgery with the implementation of the ERAS protocol, had fewer complications and decreased length of stay (Arrick et al., 2019). The second independent study found that with the implementation of the ERAS protocol, patients had a decreased length of stay with a decrease in readmissions, and a reduction in postoperative complications (Johnson & Fogel, 2017).

Implementation Plans

I will continue to participate in the case study for this DNP project. It is my hope to be able to present this case study in the future to the organization in which I work once I have completed the case study and have solid evidence from my literature synthesis and data from research to present this to major stakeholders in hopes that the Enhanced Recovery After Surgery (ERAS) protocol can be implemented.

References:

Arrick, L., Mayson, K., Hong, T., & Warnock, G. (2019). Enhanced recovery after surgery in colorectal surgery: Impact of protocol adherence on patient outcomes. Journal of Clinical Anesthesia, 55, 7-12. doi:10.1016/jcliniane.20.18.12.034

Centers for Disease Control and Prevention. (2020). Colon surgical site infections. bhttps://arpsp.cdc.gov/profile/infections/colon (Links to an external site.)

Leaper, D., Holy, C., Spencer, M., Chitnis, A., Hogan, A., Wright, G., Po-Han Chen, B., & Edmiston Jr., C. (2020). Assessment of the risk and economic burden of surgical site infections following colorectal surgery using a US longitudinal database: Is there a role for innovative antimicrobial wound closure technology to reduce the risk of infection? Dis Colon Rectum, 63, 1628-1638. https://doi.10.1097/DCR.0000000000001799

Loyola University Health System. (2017, January 19). Surgical site infections are the most costly of hospital infections: Guidelines for preventing surgical site infections are updated.

Turner, M. & Migaly, J. (2019). Surgical site infection: The clinical and economic impact. Clin Colon Rectal Surg, 32(3), 157-165. https://doi.10.1055/s-0038-1677002

 

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Quality leadership does not happen overnight. It is something that an organization should help support and teach.

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I have worked in different departments and I can honestly say your leader can make all the difference. Where I currently work has had the best leadership in my 10 years of healthcare. Our leaders are trustworthy and communicate very effectively. I believe those are the top two things a good leader needs to master. Of course there are a bunch of other qualities that make up a good leader as well. A good leader should have a good understanding of their department. They should be organized. They should be good at making decisions based on factual information, and not react to the situation.
Quality leadership does not happen overnight. It is something that an organization should help support and teach. “Empowering leadership emphasizes followers’ autonomy, participation, and development through the encouragement of self direction, and thus empowering leaders are willing to share power with followers and support them. Accordingly, empowering leadership will elicit positive psychological reactions and attitudes from followers”  (Kim & Beehr, 2020, 2023) Empowering our leaders gives them support to be the best they can be. I can imagine it can be very draining to be in leadership or management. So giving them support and encouragement is very important. Transformational leadership encourages, supports, and recognizes their staff.
“On the model of transformational leadership, leaders motivate subordinates to achieve the shared vision. Thus, transformational leadership concerns both the people and the production; and is viewed as the most effective model of leadership” (Wais, 2017, 9). “Transformational leadership is the best style to lead, not only because it directs, but also provides opportunities for development and learning; hence, motivating nursing staff to feel responsible and retain within the profession. Transformational leadership involves four main concepts which include individualized consideration, intellectual stimulation, inspirational motivation, and idealized influence” (Wais, 2017, 9).

 

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