Visit the _________ website and select two documents or articles about fundraising issues to discuss. Can you identify issues that are specific to nonprofit organizations? Which do you think is/are the most critical for a nonprofit to resolve?
Submission, APA, 3 paragraphs
This final will be on one of the principal themes of the course. Double spaced. Works Cited. 4 citations from class texts. Follow the MLA guidelines posted in the syllabus for formatting and review the rubric to help guide your writing as well. This is an academic paper between 900-1000 words.
Oral History Project -
Gender Studies and the Chicana/Latina Experience
What is an oral history?
And Peter Pan
We all have stories to tell, we organize the memories of our lives into stories. Oral history listens to these stories. Especially for people whose stories have been left out of dominant history, oral history is a way to validate those marginalized histories. If we do not collect and preserve these memories, those stories, they will continue to be marginalized and forgotten.
Oral history is the systematic collection of living people’s testimony about their own experiences. Oral historians attempt to verify their findings, analyze them, and place them in an accurate historical context. Oral history can reveal a person’s role in shaping the past and/or how larger trends impacted the individual. When an oral history places the experience of an individual within the context of a historical period, it can help illuminate both the individual’s experience and the historical period.
The Assignment:
You will conduct an oral history interview with a mother/grandmother/auntie (chosen) family member of your choosing who can be speak to their Chicana/Latina Experience.
She does not need to be famous. She can be anyone in your life. You will then write an presenting the experiences and/or perspectives of the individual, and place her experience and medicina within the larger historical and social context covered in class. You will need to use the following steps to complete this assignment:
Sometimes people try to destroy you, precisely because they recognize your power- not because they don't see it, but because they see it and they don't want it to exist. - bell hooks
Do you see conversations on social media on socialization, cultural context, social institutions, history, race and communication media?
PLEASE SEE ATTACHED DOCUMENT FOR INSTRUCTIONS AND RUBRIC
2 PAGES
CAN'T BE MORE THAN 10% PLAGIARISM
FOLLOW STRICTLY THE INSTRUCTION PLEASE
DUE DATE AUGUST 7, 2025
A HISTORY OF NURSING ETHICS The Nuremberg trials at the close of WWII offered disturbing questions. How can “good” people in traditionally honor-bound professions become complicit in some of the worst violations of humanity in history? What happens when individual professionals are not held to account by their peers, professions, and society as a whole? The trials showed how moral individuals within organizations can engage in morally “wrong” functions. “I was just following orders,” complicit healthcare providers, doctors, and nurses claimed.
Morality refers to principles that help determine what is “right” and what is “wrong.” Ethics is the related field that puts these principles to work to: apply moral principles to choose “right” actions, conduct relationships in an ethical manner, and manage situations where a “right” action is clear but for some reason not possible.
Using what we have learned this week- read the ethical dilemma below and explain your response and actions:
Nurse Is Instructed to Have Patient with Low Literacy Level to Sign Consent for Treatment
Scenario: Nurse Gloria is instructed by the attending physician to have Mr. Isaacs sign a consent form before a scheduled colonoscopy. As Nurse Gloria goes over the form with the patient, she notices he seems confused and is unsure where or how to sign the paperwork.
Ethical Dilemma: It is common for nurses to be the ones to get signatures on consent forms, especially for procedures like the one described in this scenario. When faced with a situation like the one here when the nurse is
not sure that the patient understands what he is being told or if he can read, the decision of whether to delay a busy schedule to have the doctor come back and talk to the patient or explain to the best of her knowledge and get the patient's signature may seem difficult to make.
Now that you have read the ethical dilemma below:
WHAT IS THIS PERSON FOCUSING ON EMOTIONALLY? What are the ASSOCIATED ETHICAL PRINCIPLEs AT PLAY IN THIS SCENARIO? WHAT ARE THE IMPLICATIONS OF THE NURSE'S ACTIONS? explain your responses and your current actions.
Actions should incorporate EI, your actions and priorities, and the EBP behind your decisions.
This assignment is to be submitted as an essay- with an introduction, questions developed at the graduate level, and a conclusion to summarize and synthesize key points. A minimum of 2 pages not counting cover and reference pages- APA must be strictly followed.
Please note the grading rubric.
Learning Activity Question 50% of total result
Excellent The learning activity questions are answered comprehensively. The word count if applicable has been met, and it is accurate, non-evaluative, coherent, readable, and concise. All the following elements are included: a. The problem or issue you are presented and clearly explained, and b. the
author's conclusions are clear and concise are explained. There is an introduction and a conclusion to the submission.
Reference Page 25% of total result
Excellent Utilizes at least 3 sources and all sources are current within 5 years. Cited following APA format.
Grammar, Spelling, APA, Page Requirement 25% of total result
Excellent Minimal spelling and/or grammar mistakes. The paper is developed using APA-approved headings throughout the paper. Page requirement is met.
NO MORE THAN 10 % PLAGIARISM WILL BE SUBMITTED VIA TURNIN IN
TOPIC: PRENATAL CARE
ICD10- Z34.90
FEMALE: 32 Y/O
CHIEF COMPLAINT: I COMING FOR FOLLOW UP MY PREGNANCY
NO MORE THAN 10% PLAGIARISM THIS ASSIGNMENT WILL BE SUBMITTED VIA TURNIN IN
PLEASE NOTE TEMPLATE AND EXAMPLE ATTACHED TO THIS ORDER
DO YOUR BEST
DUE DATE AUGUST 6, 2025
CONPH NSG6020 Subjective, Objective, Assessment, Plan (SOAP) Notes
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Student Name: |
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Patient Name: B.N. |
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Ethnicity: Caucasian |
Age: 41 |
Sex: Male |
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SUBJECTIVE (must complete this section) |
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CC: “I have a heartburn and acid reflux that keeps waking me up at night” |
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HPI: B.N. is a 45-year-old male patient with a history of gradually worsening gastroesophageal reflux symptoms. He presents with frequent typical episodes of heartburn following spicy or fatty meals and periodic regurgitation of sour-smelling fluid into his mouth. Onset was 3 months ago and have gradually worsened. Located in the epigastric region, with occasional radiation to the throat with a duration typically last 1–2 hours after meals or when lying down at night, with a character: A burning pain or pressure in the chest and upper abdomen. The aggravating factors have been consuming spicy, fatty, or acidic foods, as well as when bending over or lying flat and the relieving factors the use of over-the-counter antacids. Timing have been intermittently throughout the day but are most frequent post-meals and during nighttime, with a Severity of 6/10 on average, with occasional exacerbations to 8/10 during severe episodes. |
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· Medications: Omeprazole 20 mg daily (started 2 weeks ago) |
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· Previous Medical History: Hypertension (diagnosed 4 years ago) and GERD. Allergies: Penicillin , with dizziness and flushing sensation. Medication Intolerances: None reported Chronic Illnesses/Major traumas: Hypertension Hospitalizations/Surgeries: None reported |
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FAMILY HISTORY |
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· M: Alive and healthy · MGM: Late, asthma · MGF: Alive, GERD · F: Alive, obesity · PGM: died of road accident · PGF: Alive, healthy |
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Social History: B.N. is an office employee with a 14-year history of reported cigarette smoking. He smokes a half pack per day and sporadic alcohol use, having two or more beers per week. He denies all illicit drug use. His food intake is fast food and coffee drinking, frequent enough to explain his gastrointestinal complaints. His habits of smoking and eating are addressed as possible aggravating factors in his illness. |
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REVIEW OF SYSTEMS |
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General: B.N is weight loss due to acid reflux during meals. |
Cardiovascular: No chest pain, palpitations, or edema |
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Skin: No rashes, lesions, or itching |
Respiratory: No cough, shortness of breath, or wheezing |
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Eyes: No reported vision changes, denies eye pain. |
Gastrointestinal: Heartburn, regurgitation, denies vomiting, diarrhea, or constipation |
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Ears: No hearing loss, tinnitus, or ear pain |
Genitourinary/Gynecological: |
No urinary symptoms |
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Nose/Mouth/Throat: No nasal congestion, or dental issues, sore throat due to acid reflux. |
Musculoskeletal: No joint pain, no falls. |
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Breast: Denies any change. |
Neurological: No headaches, dizziness, or numbness |
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Heme/Lymph/Endo: Denies anemia or any endocrine disorder. |
Psychiatric: Denies anxiety, or mood changes. |
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OBJECTIVE (Document PERTINENT systems only. Minimum 3) |
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Weight: 180lbs |
Height: 5’9” |
BMI: 25.9 |
BP:138/88mmHg |
Temp: 99.2°F |
Pulse: 78bpm |
Resp:16/min |
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General Appearance: Well-nourished, alert, and oriented x3. Appears comfortable. |
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Skin: Smooth with no rashes, moles, red spots |
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HEENT: Normocephalic, PERRLA, oral mucosa pink and moist, no pharyngeal erythema or tonsillar enlargement. |
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Cardiovascular: Regular rhythm and rate. S1 and S2 present, no gallops or rubs were heard. |
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Respiratory: Lung clear to auscultation bilaterally, no wheezes, crackles or rhonchi sounds |
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Gastrointestinal: Bowel sound presents is 4 quadrants, Abdomen soft upon palpation. |
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Breast: No lumps or tenderness noted. |
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Genitourinary: No tenderness, no CVA pain. |
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Musculoskeletal: Full range of motion in all extremities, no deformities were noted. |
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Neurological: Alert and oriented X 4 , speech appropriated . |
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Psychiatric: Patient calm and answers question appropriately , no anxiety or mood change were noted |
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Lab Tests: CBC, CMP, and H. pylori test. |
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Special Tests: None at this time |
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DIAGNOSIS |
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Differential Diagnoses 1. 1- Diagnosis, (ICD 10 code): “Peptic Ulcer Disease (PUD) – K27.9”. Peptic Ulcer Disease is a disease in which ulcers or open sores occur in the stomach or duodenal lining, usually due to Helicobacter pylori infection or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) (Srivastav, et al., 2023). The symptoms on presentation are epigastric burning pain, nausea, and vomiting at times. ICD-10 code K27.9 is for an unspecified peptic ulcer with hemorrhage or perforation not specified. Although patient symptoms are characteristic of GERD, PUD is not excluded since both can produce upper GI distress and have some of the same symptoms such as epigastric pain. Since there are no alarm symptoms (e.g., weight loss, hematemesis), PUD is unlikely now. 2. 1- Diagnosis, (ICD 10 code): “Esophagitis – K20” Esophagitis is inflammation of the esophagus, usually caused by acid reflux, infection, or drug-induced inflammation (Tageldin, et al.,2021). Symptoms can be chest pain, dysphagia, and heartburn. Code K20 is the ICD-10 code that is specifically used to indicate this condition. Esophagitis is listed as a differential because chronic acid reflux (such as in GERD) will cause inflammation of the esophagus. GERD, if left untreated, can lead to esophagitis and therefore is still a consideration. |
Diagnosis • |
1. 1- Presumptive Primary Diagnosis (ICD 10 code): “Gastroesophageal Reflux Disease (GERD) – K21.9” (Rogers, & Eastland, 2021) GERD happens when stomach acid chronically flows back into the esophagus, irritating and producing symptoms of heartburn, regurgitation, and epigastric pain. GERD is usually associated with lifestyle issues such as diet, smoking, and obesity. The ICD-10 code K21.9 is for GERD without esophagitis. The diagnosis fits the patient's presenting complaint of heartburn, regurgitation, and relief with antacids, and it is the highest presumptive diagnosis (Rogers & Eastland, 2021). The presumptive diagnosis is the most likely diagnosis given the patient's history, physical exam, and preliminary findings. |
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Plan/Therapeutics: 1. Lifestyle Modifications: · stop consuming those meals that cause this problem such as spicy food. · Avoid sleeping after consuming a full meal. Eat a minimum of three hours prior to sleeping in order to allow the stomach time to digest (Jallepalli, et al., 2022) · Refraining from taking large meals. Eating several small meals will assist the patient. · Avoid consuming alcohol or limit the amount and smoking (Jallepalli, et al., 2022). Medications · The patient should Continue taking Omeprazole 20 mg daily before breakfast (Rogers, & Eastland, 2021). · Add Famotidine 20 mg HS PRN breakthrough symptoms. |
1. Follow-Up: RTC in 4 weeks for re-assessment. |
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Diagnostics: · If the symptoms persists, do an upper endoscopy. |
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Education: · Discussed the significance of lifestyle modifications in managing GERD. · Discussed long-term risks of untreated GERD, including Barrett’s esophagus and esophageal cancer. · Provided smoking cessation resources and encouraged follow-through. |
References
Jallepalli, V. R., Thalla, S., Gavini, S. B., Tella, J. D., Kanneganti, S., & Yemineni, G. (2022). Impact of patient education on quality of life in gastroesophageal reflux disease. Int J Pharm Phytopharmacol Res, 12(1), 25-8.
Rogers, J., & Eastland, T. (2021). Understanding the most commonly billed diagnoses in primary care: Gastroesophageal reflux disease. The Nurse Practitioner, 46(4), 50-55.
Srivastav, Y., Kumar, V., Srivastava, Y., & Kumar, M. (2023). Peptic ulcer disease (PUD), diagnosis, and current medication-based management options: schematic overview. Journal of Advances in Medical and Pharmaceutical Sciences, 25(11), 14-27.
Tageldin, O., Shah, V., Kalakota, N., Lee, H., Tadros, M., & Litynski, J. (2021). Esophagus. In Management of Occult GI Bleeding: A Clinical Guide (pp. 65-86). Cham: Springer International Publishing.
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CONPH NSG6020 Subjective, Objective, Assessment, Plan (SOAP) Notes
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Previous Medical History: Allergies: Medication Intolerances: Chronic Illnesses/Major traumas: Hospitalizations/Surgeries: |
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PLEASE SEE ATTACHED DOCUMENT FOR INSTRUCTIONS AND RUBRIC DUE DATE AUGUST 7, 2025 THIS IS THE THIRD PART OF A PREVIOUS ASSIGNMENT, PHASE 1 AND PHASE 2 IS ATTACHED FOR YOU TO GUIDE AND SEE THE TOPIC Phase III-Results Phase 3 is all about results, this part of the paper will be based on the hypothetical analysis. Meaning since we will not be implementing the process, the results described will be based on whatever the students want the research results to be. You will need to provide results for all the statistical tools mentioned and provide descriptive data (demographics of the population, different descriptive data points, etc.). Also include research limitations to improve for future studies. Approximately 5 pages. -NO MORE THAN 10% PLAGIARISM ACCEPTED Please refer to the grading rubric below prior to submitting your assignment. RUBRIC INTEGRATION OF KNOWLEDGE Oustanding The paper demonstrates that the author understands and has applied concepts learned in the course. Concepts are integrated into the writer’s own insights. The writer provides concluding remarks that show analysis and synthesis of ideas. 25POINTS TOPIC FOCUS Oustanding The topic is focused narrowly enough for the scope of this assignment. A thesis statement provides direction for the paper, either by a statement of a position or hypothesis. The topic is consistently well thought out, thorough, offers insight into the topic, and include cited evidence 25 POINTS Depth of Discussion Oustanding In-depth discussion and elaboration in all sections of the paper. 13 POINTS Cohesiveness 13% of total result Oustanding Ties together information from all sources. Paper flows from one issue to the next with no headings. Author’s writing demonstrates an understanding of the relationship among material obtained from all sources Mostly, it ties together information from all sources. Spelling and Grammar 12% of total result Oustanding Fewer than 5 grammatical, spelling, capitalization or punctuation errors Sources 6% of total result Oustanding Over 5 current sources, of which at least 3 are peer-review journal articles or scholarly books. Sources include both general background sources and specialized sources. Special-interest sources and popular literature and acknowledged as such if they are cited. All web sites utilized are authoritative. Citations 6% of total result Oustanding Fewer than 5 incomplete citations and/or quotations, and APA format errors. , 1 Phase I Assignment Student's name: Yulexis Moreda Instructor: Aciel Sagrera-Mulen Course: Nursing Research and Evidence-Based Practice Date: July 6, 2025 Reducing Hospital Readmissions for Heart Failure Patients Introduction to the Problem HF is one of the most common chronic diseases in the United States, especially among older adults. According to Roger (2021), "HF is far more prevalent in older age groups, reaching 4.3% among persons aged 65 to 70 years old in 2012 and projected to increase steadily through year 2030 when the prevalence of HF could reach 8.5%". As Khan et al. (2021) report, "Nearly 1 in 4 heart failure (HF) patients are readmitted within 30 days of discharge and approximately half are readmitted within 6 months". This high readmission rate is a serious issue in healthcare provision, commonly indicating unacceptable transitional care and inadequate post-discharge patient support. Hospital discharge to home is a sensitive period, especially in the case of HF patients who must deal with multiple self-care and follow-up tasks. Studies indicate that readmissions are generally avoidable with proper transitional care measures. Transitional nursing aims to bridge the care gap by implementing systematic interventions, such as patient education, discharge planning, follow-up phone calls, and coordination with outpatient practitioners. When implemented by nurses, these interventions have been found to decrease hospital readmissions and enhance patient outcomes. The goal of this project is to investigate how nurses' transitional care strategies impact the reduction of preventable hospital readmissions for patients with heart failure. Identifying the Problem The most significant problem is the high percentage of 30-day hospital readmissions among patients with heart failure. Transitions are most frequently associated with care fragmentation for hospital-to-home discharge, e.g., poor discharge teaching, medication abuse, failure to follow up on time, and poor patient comprehension of their disease (Sakowitz et al., 2023). Although post-discharge care has been optimized, most hospitals lack the capability to offer uniform, high-quality transitional services for HF patients. There is also a shortage of standard, evidence-based treatments. Patients are commonly discharged from the hospital with minimal information about their drugs, diet, and warning signs of collapse. Interchanges also among hospital groups and community-based carers are frequently poor, resulting in discontinuity of care. That breakdown significantly enhances the risk of avoidable complications and readmission, which consumes healthcare resources and damages patient well-being. Significance of the Issue to Nursing The problem of readmission for heart failure is especially relevant to the field of nursing practice. Nurses are at the forefront of discharge planning and patient education, and their role in transitional care is critical to ensuring that patients are adequately prepared upon hospital discharge. Marques et al. (2022) note that "Outpatient care provided by nurses to patients with HF has been the focus of studies, showing a reduction in hospital readmissions". Advanced practice nurses are also well-suited to facilitate and direct care transition models that encourage communication, track patient progress, and maintain post-discharge adherence to care plans. High rates of readmission are quality markers of care and are associated with financial penalties in value-based reimbursement systems for care. Nurses are dedicated to acting on these quality markers through evidence-based practice. Transitional care is an outgrowth of the nursing process with a focus on assessment, planning, intervention, and evaluation. Nurses can play a highly influential role in reducing readmissions, improving patient satisfaction, and making the healthcare system more sustainable by taking the lead on transitional care initiatives (Marques et al., 2022). In addition, transitional care supports nursing's holistic philosophy because it extends beyond the repair of physical well-being to address the emotional, social, and educational health needs of patients. Nurses reassure, explain physicians' orders, and represent the patient's interests throughout the continuum of care. A readmission reduction not only enhances clinical outcomes but also fosters trust and involvement among patients and healthcare providers. Purpose of the Research The primary objective of this research is to assess the impact of nurses' transitional care interventions on the 30-day readmission rates of heart failure patients to hospitals. The study will quantify the effectiveness of various interventions, including follow-up phone calls, home visits, telemonitoring, and medication reconciliation, in preventing readmissions. Besides clinical outcomes, the study will assess patients' views of the care provided and nurses' experiences with implementing these strategies. Knowing which elements of transitional care yield the most beneficial results can enable institutions to allocate resources effectively and emulate successful methods. By identifying where implementation is likely to be least successful, this research can also inform educational and policy initiatives, enabling nurses to deliver high-quality care during transitions of care. Finally, the results will further establish an evidence base supporting safe, patient-oriented care and facilitating professional development for nurses in extended roles. Research Questions This research will be informed by a set of guiding questions: What are the most effective nurse transitional care programs to minimize 30-day hospital readmission of heart failure? How do patients assess the quality and efficacy of transitional care services from nurses following hospital discharge? What are nurses' challenges in implementing transitional care among heart failure patients? Responding to these questions will help construct a deeper understanding of how transitional care can be maximized to meet the needs of vulnerable populations, most critically those with chronic cardiovascular disease. Master's Essentials that aligned with this topic This project aligns with several of the Essentials of the American Association of Colleges of Nursing (AACN) Essentials for Master's Education. Essential I, which involves the integration of scientific knowledge from both the sciences and humanities, is evident in comprehending the multifaceted pathophysiology and psychosocial dynamics of heart failure care. Essential II, Organizational and Systems Leadership, emphasizes the design and testing of interventions that necessitate strategic planning, interprofessional collaboration, and quality improvement. Core IV, Translating and Integrating Scholarship into Practice, is paramount to this study, as it involves the implementation of existing evidence into the practice of practical nursing interventions. Core VI, Health Policy and Advocacy, is met by confronting systemic barriers and policy dilemmas related to transitional care services. Finally, Core IX, Master ''s-Level Nursing Practice, is confronted by addressing leadership, clinical decision-making, and care coordination, all key elements of advanced nursing practice in transitional care facilities. Conclusion The challenge of high hospital readmission of patients with heart failure is of concern to the healthcare of today, one that nurses can solve. Transitional care nursing is a solution whose time has arrived, providing continuity, safety, and education during the hazardous post-discharge period. This study aims to reiterate the importance of nurse intervention in enhancing patient outcomes and contributing to a more efficient, patient-focused healthcare system. By identifying effective interventions and reviewing implementation barriers, this study contributes to the advancement of nursing practice and the delivery of high-quality care for individuals with chronic illnesses. References Khan, M. S., Sreenivasan, J., Lateef, N., Abougergi, M. S., Greene, S. J., Ahmad, T., … & Butler, J. (2021). Trends in 30-and 90-day readmission rates for heart failure. Circulation: Heart Failure, 14(4), e008335. https://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.121.008335 Marques, C. R. D. G., de Menezes, A. F., Ferrari, Y. A. C., Oliveira, A. S., Tavares, A. C. M., Barreto, A. S., … & Santana-Santos, E. (2022). Educational nursing intervention in reducing hospital readmission and the mortality of patients with heart failure: a systematic review and meta-analysis. Journal of Cardiovascular Development and Disease, 9(12), 420. https://www.mdpi.com/2308-3425/9/12/420 Roger, V. L. (2021). Epidemiology of heart failure: a contemporary perspective. Circulation research, 128(10), 1421–1434. https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.121.318172 Sakowitz, S., Madrigal, J., Williamson, C., Ebrahimian, S., Richardson, S., Ascandar, N., … & Benharash, P. (2023). Care fragmentation after hospitalization for acute myocardial infarction. The American Journal of Cardiology, 187, 131–137. https://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.121.008335 , 1 Phase II Assignment Student's name: Yulexis Moreda Instructor: Aciel Sagrera-Mulen Course: Nursing Research and Evidence-Based Practice Date: July 24, 2025 Reducing Hospital Readmissions in Heart Failure Patients through Structured Discharge Planning and Patient Education Brief Literature Review HF causes a substantial number of hospitalizations and readmissions of older adults, as it is one of the primary causes of both hospitalization and readmission. The transition from Hospital to home is an important opportunity for intervention, especially in terms of successful discharge planning and patient education. This literature consistently advocates for the effectiveness of structured discharge in helping to reduce the rate of hospital readmission among patients with HF. Bradley et al. (2022) conducted an informative review of discharge planning interventions and their impact on patient outcomes. The authors state that “A structured discharge plan that is tailored to the individual patient probably brings about a small reduction in the initial hospital length of stay and readmissions to hospital for older people with a medical condition, may slightly increase patient satisfaction with healthcare received” (Bradley et al., 2022). To support the above-mentioned ideas, the study noted that customized discharge planning may significantly decrease readmission levels and improve patient satisfaction. Key aspects, such as involving the family and patient, early introduction of discharge planning, and follow-up in the post-discharge period, are linked to better outcomes. On the other hand, Browder and Rosamond (2023) specifically addressed socioeconomic factors in HF readmissions. They discovered that the low socioeconomic patients are disproportionately disadvantaged by ineffective discharge planning and the absence of access to post-discharge services. The interventions that overcome these barriers, tailored to the needs of patients, including transportation assistance, medications, and telehealth, showed potential in reducing readmission risks. According to the authors, “there was a reduction in readmissions after the implementation of HRRP” (Browder & Rosamond, 2023). Burse (2024) assessed a discharge planning and education program in the clinical environment of a real-life hospital and found a significant reduction in 30-day readmission. Her results support the significance of properly organized education under nursing leadership that focuses on adherence to medications, monitoring symptoms, and conducting follow-up visits. The involvement of discharge planners in multidisciplinary care teams was also identified as a key strategy for improving patient outcomes. Fatani et al. (2025) examined the effect of discharge planning teams on the length of stay and readmission outcomes in neurological patients. Although this study is not specific to HF, it provides an argument in favor of the generalizability of discharge principles in diagnosis. The existence of a specialized team was associated with a reduced overall length of stay and readmission, supporting the argument that organizational factors had a significant impact on the success of discharges. Similarly, a systematic review carried out by Wu et al. (2024) on nurse-led HF clinics noted a consistent decrease in patient hospitalization and improved self-management. All the clinics provide extensive education, effective drug management, and prompt symptom deterioration management early on. Although the study was not conducted within the Hospital, it confirms the value of nurse-led patient education in preventing readmissions. The body of this research, taken together, provides a solid evidence foundation regarding the value of structured discharge planning and specific educational work as primary tools to prevent HF readmission. Research design and study methods The present study will employ a quasi-experimental pre-post research design to examine the effectiveness of an enhanced discharge planning and education protocol among patients with heart failure. The context in which the intervention will be delivered is a mid-sized urban hospital that accepts a diverse population. The research will consist of two stages: the baseline data collection stage and the intervention stage. In the baseline phase, information on 30-day readmissions, including those of HF patients in the 6 months preceding the intervention, will be obtained retrospectively. During the intervention stage, a standard discharge planning and education program will be implemented for all patients who have been admitted based on their primary diagnosis of heart failure. The intervention will comprise interventional discharge planning initiated at the time of admission, a discharge checklist, medication reconciliation, patient-centered education to learn how to manage heart failure, scheduling of follow-up appointments before discharge, and a post-discharge telephone call made by a nurse within 72 hours. The education part will rely on the teach-back technique to ensure the patient. Written materials, medication calendars, and symptom checking logs will be provided to patients. The significant results will include rates of readmission over 30 days, patient satisfaction, and medication compliance, which will be assessed through pharmacy refill records. Secondary endpoints will include hospitalizations and emergency department visits. The electronic health records of the patients (EHRs), the survey, and the telephone interviews will be used to gather data. “The hospital Institutional Review Board (IRB)” will ethically approve the study, and an informed consent will be signed by all participants. This design ensures internal validity while also facilitating real-world applicability and minimizing disruption to standard care practices. Sampling Methodology In the study, the non-randomized convenience sampling technique, which fits the quasi-experimental design, will be employed. Potential participants will be adult patients (18 years old and beyond) who were admitted to the Hospital with HF as the primary diagnosis in the internal medicine or cardiology departments of the Hospital. Criteria of inclusion will take the form of: (1) proven heart failure as per the ICD-10 coding and through clinical assessment of the patient, (2) has been discharged home or to self-care, and (3) able to provide informed consent. There will be exclusion criteria including: (1) patients who have been transferred to long-term care or hospice, (2) patients with extreme cognitive impairment with no available caregiver who may attend education, and (3) non-English speaking patients without an interpreter. A power analysis will be conducted to determine the sample size required to detect a statistically significant decrease in readmission rates with a power of 80% and an alpha level of 0.05. Using the data from the past, it is projected that an estimated sample size of 200 patients per group (pre-intervention and post-intervention) will be recorded. Although the sampling plan may limit the generalizability of the findings to other populations, it provides viable access to participants in the target demographic. It ensures a reasonable level of integration within the prevailing hospital framework. Mixed methods will be employed to gather both quantitative and qualitative opinions related to readmission rates (admission rates, medication adherence), as well as patient perceptions towards the discharge process. Necessary Tools A series of tools will be utilized in the study for collecting and evaluating data. The tools to be used for collecting primary data will include the electronic health record audit template, validated patient satisfaction surveys, and structured interview guides. The “Morisky Medication Adherence Scale (MMAS-8)” is a rated instrument that will serve as a tool in assessing medication adherence in chronic disease studies, as it is a valid instrument. The checklist for discharge education will become one of the main tools for ensuring the consistency of interventions. Some of the items it will contain include learning about dietary prohibitions, tracking symptoms, understanding the side effects of medications, knowing when to call in, and scheduling follow-up visits. The nurses will record the list of checklist completions in EHR. The teach-back method will be used to assess patient comprehension. To gauge the patients' comprehension, nurses will require them to recall major concepts addressed in the discharge education process. The teach-back assessment rubric will be used to score responses and document them in the patient's medical record. The follow-up calls will be conducted using a structured script that evaluates the patient's symptoms, medication use, follow-up visits, and any impediments to care. Information provided during these calls will be used to measure current compliance and identify initial signs of disengagement. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey will be used to measure patient satisfaction with the discharge process, specifically regarding discharge information and care transition items. Such data will be summed up and analyzed before and after the intervention. SRSP software will be used in data analysis. Demographic and clinical characteristics will be summed up using descriptive statistics. Chi-square tests, along with logistic regression, will be used to evaluate the differences in outcomes between the pre- and post-intervention populations using inferential statistics. Illustrations Morisky Medication Adherence Scale (MMAS-8)
Scoring Items 1–4, 6, 7: Yes = 1, No = 0 Item 5: Yes = 0, No = 1 Item 8: Score based on the option selected Interpretation: Total score 0 = High adherence Score 1–2 = Medium adherence Score ≥3 = Low adherence Conclusion Heart failure readmissions are another ongoing issue that, in many cases, may be addressed with the help of enhanced discharge planning and education. The evidence in the literature is overwhelming regarding the use of structured discharge protocols and nurse-led education as an effective strategy to reduce readmissions and positively impact patient outcomes. This evidence-based quasi-experimental research, employing a rigorous methodology, is proposed to determine the effect of a holistic discharge planning program on 30-day readmission rates, patient satisfaction, and medication adherence. With the use of validated instruments and effective interventions, the study can provide policy and clinical practice guidelines for the transition of care in patients with heart failure. References Bradley, D. C., Lannin, N. A., Clemson, L., Cameron, I. D., & Shepperd, S. (2022). Discharge planning from the Hospital. Cochrane Database of Systematic Reviews, 2022(2). https://doi.org/10.1002/14651858.cd000313.pub6 Browder, S. E., & Rosamond, W. D. (2023). Preventing Heart Failure Readmission in Patients with Low Socioeconomic Position. Current Cardiology Reports, 25(11). https://doi.org/10.1007/s11886-023-01960-0 Burse, C. (2024). Reducing Congestive Heart Failure Readmissions through Discharge Planning and Education. The Aquila Digital Community. https://aquila.usm.edu/cgi/viewcontent.cgi?article=1295&context=dnp_capstone Fatani, A., Alzebaidi, S., Alghaythee, H. K., Alharbi, S., Bogari, M. H., Salamatullah, H. K., Alghamdi, S., & Makkawi, S. (2025). The role of the discharge planning team on the length of hospital stay and readmission in patients with neurological conditions: A single-center retrospective study. Healthcare, 13(2), 143. https://doi.org/10.3390/healthcare13020143 Wu, X., Li, Z., Tian, Q., Ji, S., & Zhang, C. (2024). Effectiveness of nurse-led heart failure clinic: A systematic review. International Journal of Nursing Sciences, 11(3), 315–329. https://doi.org/10.1016/j.ijnss.2024.04.001 Relax & Rejuvenate with the Best Spa in Sohar | Water Spa SoharSearching “relaxing spa near me”? Visit our massage center in Sohar for luxurious massages, spa treatments, and a serene atmosphere. Book your experience today! Nursing NEED ASSIGNMENTEVERYTHING SHOULD ONLY APPLY TO NEW YORK REGULATIONS, RESTRICTIONS, CERTIFICATIONS, AND LICENSURES FOR CERTIFIED NURSE MIDWIVES INSTRUCTION AND TEMPLATE ATTACHED. PLEASE USE ALL RESOURCES WITHIN NEW YORK ONLY ***Blue text should be removed, and your information entered*** Midwifery in State Name: NEW YORK
, Part 2. Complete the Midwifery in My State checklistLinks to an external site. . Please complete the assignment using the provided template. The following guidance will help you complete the assignment: · · Watch or attend the "Preparing for Assignment 5" live session · Read Module 5 · Use primary sources · Go directly to the source of the information you need instead of using third-party sources. For example, if you google "nurse-midwife prescriptive authority in Texas," the first few results are .com addresses. These links take you to less reliable sources, and in this case, they weren't even about nurse-midwives and would have given me the wrong information. By reviewing the list of search results, I was able to find the Texas Board of Nursing (a .gov address), which is a reliable source of information. · Pay attention to the kind of midwife! · In the above example, my search engine couldn't tell the difference between CPM, CNM, LM, CM . . . the list goes on! You'll need to understand the differences between the forms of midwife well enough to be able to understand what you're reading. · This will be important when answering questions about CNM/CM educational programs. Be sure to note the program accrediting body required for graduates to take the AMCB exam. · · Nurse-midwives are sometimes licensed/regulated as APRNs, ARNPs, or mid-level providers. For example, for information on prescription drugs, go to the DEA website for the schedule of controlled drugs for "mid-level providers" listed by state. · · 2024 ACNM State Fact SheetsLinks to an external site. · Links to an external site. ACNM Certified Midwife CredentialLinks to an external site. · ACNM Midwifery Workforce DataLinks to an external site. · Midwife Comparison Chart Download Midwife Comparison Chart Open this document with ReadSpeaker docReader
· Free Standing Birth Center Licensure in your state · Use state regulatory information to answer these questions, the answers will vary by state. · Watch the Birth Center Policy and Regulation live class
· APA and Formatting This assignment does not need to be written in strict APA format, though correct spelling and grammar are expected. Your writing does not need to be double-spaced. Instead of using APA references for all information used, please provide links to the information used in each response. Rubric Part 2. Certification, Licensure, Education and Practice
Total Points: 35
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