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give a positive feedback to this 4 post. One paragraph per post
Post#1 500 Yon: Evidence-based practice in nursing is providing nursing care that uses the most current research available to improve the safety, health, and well-being of patients. EBP in nursing focuses on the incorporating clinical expertise such as knowledge, critical reasoning, and judgment skills acquired through nursing training and professional experiences (Faubion, n.d.). The purpose of evidence-based practice in nursing is to use the best evidence available to make informed decisions about patient car. One example of EBP is repositioning patients every 2 hours to help maintain skin integrity. Also, using heel and elbow protectors, using additional air mattress to relieve pressure, and keeping skin clean and dry. Implementing these measures can reduce these risks for better quality outcome. Maintaining skin integrity in hospitalized or immobile patients is one of the most critical goals for a nurse. Developing pressure ulcers (bed sores) or skin breakdowns often leads to extended hospital stays, which will increase cost for individuals and the healthcare systems. This burden sometimes is shared with family members and community organizations.
Posr#2 500 María: EBP is a process that involves identifying a clinical problem, searching the literature, synthesizing the findings to critically evaluate the research evidence, and then determining appropriate interventions (McEwen, & Wills. 2017, pp. 254). An example of EBP practice is the prevention of deep vein thrombosis in hospitalized patients. According to the CDC (2022), estimates suggest that 60,000-100,000 Americans die of DVT/PE each year. Deep vein thrombosis prevention is of utmost importance due to the high risk of developing pulmonary emboli (PE) which can be life-threatening. This is one of the focuses of nursing care in the hospital I work at. The first step to preventing DVT is assessing/screening the patients risk upon admission. Patients that are high risk include those patients with broken bones, undergone surgery, or are on prolonged immobilization. In a study done by Cayley (2007), patients that are at low risk for DVT benefit from early ambulation and/or graduated compression stockings and intermittent pneumatic compression devices. Patients that are high risk should include pharmacological interventions such as anticoagulants (low molecular weight heparin, lovenox, warfarin, eliquis). There are many screening tools available such as the Wells Model, Padua Prediction Score, and Caprini Risk Assessment Model. At work, we use a 3-bucket model for assessing risk for VTE. We assess patients age which will indicate if the patient is at low risk (age less than 60), moderate risk (age 60-75), and high risk (greater than 75). Afterward, we indicated the interventions being implemented, which gives us an idea if the patient is receiving the right interventions. DVT prevention in hospitalized patients is an evidence-based practice standard, to help prevent negative outcomes.
Post#3 402 IdalmI: My topic of choice is based on the prevention of type 2 diabetes and ways to avoid and prevent the disease, by understanding diabetes and finding ways to prevent and avoid it. As well as preventing getting diabetes once already diagnosed with prediabetes. By looking at the ethical and cultural perspectives gives us great insight.
LEvel 1 Cultural question: Which cultures or societies are most affected by the issue and why? Considerably if all of that may seem overwhelming, certain racial and ethnic minorities in the US really have it even worse. A greater risk of diabetes and its fatal consequences exists in Latinos/Hispanics, African Americans, American Indians, Native Hawaiians, Pacific Islanders, Arab Americans, and Asian Americans. Why? The capacity of the pancreas to generate adequate insulin and/or the body’s ability to react to insulin are both influenced by genetics. Additionally, some of these ethnicities have a hereditary propensity to put on belly fat. The metabolic effects of this may raise the risk of diabetes, heart disease, and other illnesses. In addition, lifestyle choices like poor eating and insufficient exercise contribute to rising obesity rates, a significant risk factor for type 2 diabetes. Other non-medical problems can play a role in this issue. Diabetes cases that may have been avoided by addressing disparities in health literacy, access to care, and income. Additionally, some people find it difficult to avoid diabetes and effectively manage the condition due to cultural reasons.
Level 2 Cultural: The progression from high-risk states like being overweight or obese with impaired glucose regulation, or so-called prediabetes, to overt diabetes has been shown to occur at similar rates and responded similarly to preventive interventions among different racial/ethnic groups in the USA Diabetes Prevention Program, despite the significant differences in diabetes incidence rates among various populations around the world. The majority of behavioral or medicinal diabetes preventive strategies have been successful in racially and ethnically diverse populations all around the world. Clinical trials carried out in various nations produced varying decreases in type 2 diabetes incidence rates, however these variations may be attributable to variations in the types or intensities of treatments used in the studies rather than racial or ethnic differences. The benefits of metformin and lifestyle treatments on preventing progression to type 2 diabetes did not differ substantially by race/ethnicity; to our knowledge, only the USA Diabetes Prevention Program examined effects of the identical interventions provided to different racial/ethnic groups. Because of this, contemporary diabetes preventive strategies are the same regardless of a person’s race or ethnicity, despite racial and ethnic variances in diabetes prevalence.
Level 1 Ethical question: What ethical obstacles affect how the issue is addressed in the community? Negative health outcomes and inadequate glycemic control are consequences of ineffective diabetes treatment. The inability to meet glycaemic objectives in diabetic populations in areas with limited resources is generally due to a high incidence of medication non adherence among patients and therapeutic inertia among providers. The ethical conflict between avoiding danger from over treatment and preventing future harm from higher blood glucose levels is presented by the possible health concerns from intensifying medical therapy for aggressively decreasing glucose levels in Type 2 diabetic patients. However, the medical profession has paid little attention to the moral conundrums faced by practitioners in the majority of the developing world when deciding whether to prescribe more oral hypoglycemic medications or start insulin therapy.
Level 2 Ethical: Such moral conundrums, which are specific to under-resourced environments, frequently result from a lack of diabetes patients’ access to medications, diagnostics, and physician consultation time. Additionally, current evidence-based recommendations for the management of diabetes rely on a standard of care that is not present in these circumstances. This frequently forces practitioners in the poor world to depend completely on their clinical judgment when they are presented with such diabetes-related ethical issues, which may be unethically unfair and medically prone to mistake. In order to build best practice guidelines for optimal therapy results, more recent research must produce data while also addressing the fact that healthcare services are scarce in places with few resources. The ethical conflict between access to primary care vs technologically intensive care for complications is projected to become more acute in the next 25 years as a result of the burden of diabetes. Considerations for public health interventions are urgently required to lessen the burden of diabetes and to keep its financial and social consequences under control. Without primary preventive initiatives at the public health level, the number of diabetics who go misdiagnosed and untreated will rise, as will the number of problems that require more technical support. As a result, many patients would have less access to health care, which will have an influence on the distributive justice and access ethics. Prior to allocating scarce healthcare resources, scientific proof of therapy efficacy must also be taken into account. The route that will be beneficial and economical is toward primary preventive public health initiatives that prevent or postpone the onset of diabetes.
Post #4 402 Arely: Thesis: Telecommuting has challenges including distractions, unsecure communication, and technical problems. However, the benefits of telecommuting are increased productivity, higher employee engagement, and employee retention. This is effective because it enhances employee motivation and work-life balance.
Cultural Level 1: What cultural factors play a role in motivating telecommuting? Many cultural factors play a role in how motivated an individual is to successfully telecommunicate. Age, gender and parental status are significant factors to consider. According to The Pew Research, shows that among those working from home, younger workers are more likely to say they face barriers to productivity (Parker et al., 2020). Workers younger than 50 years old say it is difficult for them to do their work without interruptions or feel motivated (Parker et al., 2020). With most schools and daycare centers closed, those who fall under the parenting group say they find it difficult to transition from office to home while their children are also home. This was found to be a common belief among both parents, males and females. About four in ten mothers who work from home say they find it harder to balance work and family. The study also showed that women are more likely than men to say they would prefer to work from home all the time (Parker et al., 2020).
Cultural Level 2: How do cultural perspectives influence telecommuting? The major factor to consider in motivating telecommuting is perhaps age. A study conducted in 2019 by Virtual Vocations which included 1,141 survey responses showed how millennials, gen-xers, and baby boomers telework (Back, 2019). Millennials who are adults between ages 23-38 as of 2019 say that flexibility is the number one benefit from working remotely (Back, 2019). Gen-x adults between the ages of 39-54 believe that work-life balance is important, and telecommuting allows them to manage it better. Baby boomers are adults ages 55-73 who say the main benefit is that the day and workday are seamless (Back, 2019).
Ethical Level 1: What ethical challenges are involved with telecommuting? As more Americans telecommute or wish they could, employers face more ethical challenges. Managers must juggle these potential challenges including trust in remote workers, encouraging trust among team members, determining which employees may work from home and the ability to evaluate job performance in the same manner for both, in-office staff and remote workers. Management must monitor abuse of remote work and maintain data secure. Other challenges include maintaining professionalism, following the companys rules, accountability, non-office related work, and extended breaks. The ethical employer communicates trust in his or her employees when implementing telecommuting (The Institutes CPCU Society, 2020). Trust is a key foundation component for which successful telecommuting is built upon as it motivates employees to be more productive.
Ethical Level 2: How does trust between employees and employers impact the effectiveness of telecommuting? Trust is based on respect for the employees motivation and the recognition that the employee has needs that are important in establishing work-life balance (The Institutes CPCU Society, 2020). Telecommuting challenges can harm a company in a number of ways. Employees must trust that their managers are treating all employees equally when it comes to job performance, evaluations, and communication. Management must trust that employees are performing all tasks timely and professionally, taking breaks on time, and communicating properly.
