Nursing

Health Resources
Introduction to the Community: Identify the community you will be using for this assignment with the city and state, and provide a brief, one-paragraph description of the community. Your community should be the area where you live or the area surrounding your work setting. The community must include a residential area and be a large enough area to answer the survey questions. Do not include epidemiological or demographic data as this is based on what you observe.
Windshield Survey: Assess your community by doing a windshield survey. Information about the components of a windshield survey is located in your textbook, Nies and McEwen (2019). Drive through the area and report your observations by answering the questions on the form. Be sure to include what you observed related to each of these categories, and also include any significant items that are missing in your community because this may be equally important in identifying a community health problem.
Community vitality
Indicators of social and economic conditions
Health resources
Environmental conditions related to health
Social functioning
Attitude toward healthcare
Note: It is helpful to conduct this assessment at least two different times: during the day or evening, on a weekday, and/or on the weekend. If possible, plan on asking someone to drive during your survey so that you can take notes.
Vulnerable population: Identify the aggregate or vulnerable populations that you observed in your community during your drive through. What did you observe about this population?
Community problem: Based on your assessment in the survey above, identify and discuss one priority community health problem that a community health nurse could positively impact.
Example: If you observed teens who were pregnant or had young children during your survey and felt this was a priority problem in your community, the diagnosis could be
Risk of unintended pregnancy among adolescent girls in XXXX community as evidence by observation of pregnant teens and teens caring for young children during windshield survey.
Healthy People 2020 Objective: Go to the Healthy People topic areas at https://www.healthypeople.gov/2020/topics-objectives. Find a topic area that relates to one of the vulnerable populations you observed. Click on the topic area, and then click on the green Objectives tab. Review the objectives within that topic area to complete the relevant sections of the form. State the Healthy People 2020 objective number (not just a goal) that describes your problem.
Example: The topic area Family Planning would be relevant. You would click on Family Planning, and then click the green Objectives tab, and you might choose
FP-8.1 “Reduce pregnancies among adolescent females aged 15 to 17 years” (U.S. Department of Health and Human Services: Healthy People 2020, 2018, Objectives: Family Planning, para 8).
Summary: Complete the summary of learning section.
References: The purpose of this assignment is to document your observations of your community. Outside sources other than Healthy People 2020 should not be used. We have included this reference on the Windshield Survey form for you.

NR351: Transitions in Professional Nursing
NR351: Transitions in Professional Nursing
[insert session month and year here]
NOTE: No abstract
NOTE: This is a required template and guide and must be used for this assignment.
Delete all yellow highlighted words.
Scholarly Paper Phase 2 (paper title, begins on page 2)
(No heading of Introduction) Introduce the assigned paper topic. Explain that this paper is a summary of the assigned article, followed by explanation of the impact of the article contents on your own future professional nursing practice.
Assigned Article Summary
This section should be a revised and enhanced version of what you wrote in your Scholarly Paper Phase 1 based on Phase 1 feedback from your instructor and feedback on the Week 4 TurnItIn report. Appropriate revisions made from Phase 1 will be crucial to improve your score.
Type statements that summarize the assigned article here. This paper should include a summary of the most important ideas in the assigned article (revised from Phase 1). Most of these facts should be paraphrased (including proper citations). One or two short direct quotations (with appropriate citations) can be used in this section (appropriately revised). There should be no prior knowledge, experience, or opinion in this section. All facts must originate from and be cited to the assigned article. No information should be included from other sources. See rubric for length limitations and other criteria.
Add paragraphs here as needed.
Impact of Assigned Article Content on Future Practice
This section should be a revised and enhanced version of what you wrote in your Scholarly Paper Phase 1 based on Phase 1 feedback from your instructor and feedback on the Week 4 TurnItIn report. Appropriate revisions made from Phase 1 will be crucial to improve your score.
Type statements here about the impact that the content of the assigned article will have on your future professional nursing practice. This portion of this paper should be your own ideas about how your own future practice will be impacted by content of the assigned article (revised based on instructor feedback on Phase 1). Since ideas are your own, use of first person is appropriate and no citations are needed in this section. See rubric for length limitations and other criteria.
Add paragraphs here as needed.
Conclusion
A concise summary of the paper is to be written here. A concluding statement is also to be provided in this section.
References (centered, not bold)
Type your reference here using hanging indent and double line spacing (under “Paragraph” on the Home toolbar ribbon). See your APA Manual and the resources in the APA section of Course Resources under Modules for reference formatting.

Oncology Nursing Forum Assignment
Explicit Assumptions About Knowing
Conceptual Foundations is a new column for Oncology Nursing Forum (ONF) that focuses on the frameworks that underpin research and practice initiatives. The purpose of this inaugural column is to provide an overview of what conceptual frameworks are, related terms, the role of conceptual frameworks in the research process, and why these frameworks matter. The majority of articles published in ONF are research manuscripts. Readers include student nurses, practicing oncology nurses, nurse managers, advanced practice on- cology nurses, nurse scientists, and people in other disciplines who are interested in patients with cancer. In the guidelines for ONF articles, peer reviewers are asked to address the conceptual model/ theory (if needed) that is included in the manuscript. For all who read, apply, and create knowledge, un- derstanding the conceptual frame- work underlying a research study is an essential skill to master. The conceptual framework may be ex- plicitly identified by the author or may be implicit. If not specifically stated, the reader must detect the underlying assumptions that form a conceptual foundation.
Definitions and Related Terms
What is a conceptual framework? Concept is defined as “an abstract or generic idea generalized from
Marie Flannery, PhD, RN, AOCN®, Associate Editor CONCEPTUAL FOUNDATIONS
Flannery is a research assistant professor in the School of Nursing at the University of Rochester Medical Center in New York.
No financial relationships to disclose.
Flannery can be reached at Marie_Flannery@URMC .Rochester.edu, with copy to editor at ONFEditor@ ons.org.
Key words: concept; theory; framework; model; oncology
ONF, 43(2), 245–247.
doi: 10.1188/16.ONF.245-247
particular instances” (“Concept,” n.d., para. 1). Framework is de- fined as “the basic structure of something: a set of ideas or facts that provide support for some- thing” or “a supporting structure” (“Framework,” n.d., para. 1). Taken together, a conceptual framework consists of specified abstract ideas that are joined in an identified structure. Conceptual frameworks identify what is important in un- derstanding a phenomenon and provide guidance for relationships. No universally accepted definition exists for conceptual framework, and the term is sometimes used interchangeably with conceptual model, theoretical framework, and theory (Powers & Knapp, 2011).
Many terms are related to con- ceptual frameworks (see Table 1). Epistemology is a branch of philosophy that studies “how we know” and the justification of knowledge claims. Varying epis- temologic philosophic traditions have emphasized different aspects and views of knowledge, certainty, and truth, and have provided dif- fering interpretations of theory and concepts. Empirical philosophic traditions influence much of the current research and emphasize the systematic observation of real- ity through sensory observation (Powers & Knapp, 2011). Worldview refers to a general orientation or set of beliefs about how the world operates. Paradigm, a term coined by philosopher Thomas Kuhn,
246 VOL. 43, NO. 2, MARCH 2016 • ONCOLOGY NURSING FORUM
also refers to a system of beliefs about knowledge, often specific to a discipline. Theory is a term with many definitions; in the research realm, a scientific theory includes a set of statements or principles that explain phenomena. A theory is one type of a conceptual frame- work that always will include at least two concepts and at least one relational statement. Of note, not all conceptual frameworks will qualify as a theory. A model refers to a graphic representation; it may be a two-dimensional diagram or a three-dimensional mock-up. A con- ceptual model is a diagram or draw- ing of the conceptual framework.
A conceptual framework may be reflected in the worldview, ma- jor paradigm, or general orienting framework of the author. A con- ceptual model may be referenced or drawn in the article. A theory
may be referenced and explained. A conceptual framework may not be explicitly stated but may be discern- ible to the reader by the author’s stated and unstated assumptions. Specifically, the reader may be able to discern the framework used by what is studied, how it is studied, and what is measured. What is not included in the study also may be an indication of the implied framework. A concept that may seem vital to a clinician or researcher but was not included in the study may reflect its relative lack of prominence in the author’s conceptual framework.
Conceptual Frameworks and the Research Process
In the guidelines for manuscripts submitted to ONF, reviewers are asked to critique the use of con- ceptual frameworks in two specific
components of the manuscript. The literature review and discussion section guidelines specifically ask reviewers to consider the concep- tual framework or theory (if need- ed) that is used in the manuscript.
However, the integration of a con- ceptual framework actually threads and weaves through all compo- nents of the research process. The orienting framework or worldview provides a specific lens as to how an area of study is seen and how a clinical problem is identified. The choice of a theory or conceptual framework provides structure for the content that is included in the background and literature review. The framework or theory may be specifically discussed and a figure of the conceptual model included. The conceptual framework influ- ences the choice of method, set- ting, sample, instruments, proce- dures, and analysis strategies. The reviewer (and reader) often looks for a sense of coherence, logical consistency, and logical flow in a research study. The integration of a conceptual framework through all phases of the research process can provide a sense of coherence. For example, if the conceptual frame- work specifies that both patient and caregiver experiences are criti- cal to understanding the clinical issue, one might choose to conduct a descriptive longitudinal study conducted in the home setting; include patients and caregivers in the sample; include open-ended in- terviews, in addition to structured questionnaires, as measurement modalities; and include dyadic eval- uation techniques in the analysis.
The discussion section may in- clude comments on whether the conceptual framework worked or was helpful in the study, if the framework was supported or incon- sistent with study findings, or what revisions to the framework may be needed. Similarly, any practice implications and knowledge trans- lation may be influenced by the
TABLE 1. Terminology and Definitions for Conceptual Frameworks and Related Terms
Term Definition
Oncology Nursing Forum Assignment
Concept Abstract idea; building blocks of theory
Conceptual framework

HCS 533 WEEK 1 Definition of Terms Worksheet
Definition of Terms
The health care environment is constantly changing, new systems arise every day with terminology of their own to reflect the changes. As a health care professional, it is important for you to stay up-to-date with the terminology and its proper use.
Define each term in the table below. Share what you consider the most important aspect of each.
Note: You are encouraged to utilize the Library or professional organizations for assistance with these terms and definitions rather than the general Internet.
Term Definition
Finance/Accounting System (FA)
Human Resource Management System (HRM)
Inventory Control Management System (ICM)
Point of Sale (POS)
Electronic Health Record (EHR)
Electronic Medical Record (EMR)
Systems Development Life Cycle (SDLC)
HL7 Standards
ANSI X12 Standards
XML Interfaces
Project Management
Project Management Life Cycle (PMLC)
LEAN
Six Sigma
Agile
Scrum
Just in Time (JIT)
HITECH
Business Systems Analysis
Database
Relational Database Management System (RDBMS)
Health Care Informatics
Data Interface and Exchange Systems
Disease Registry
Data Mart

NRS 434 Shadow Health: Conversation Concept Lab
Within the Shadow Health platform, complete the Conversation Concept Lab. The estimated average time to complete this assignment is 40 minutes. Please note, this is an average time. Some students may need longer.
This clinical experience is a conversation concept lab. Students have one opportunity to complete this graded assignment. Upon completion, submit the lab pass through the assignment dropbox. Students will receive full points for successful completion of this assignment. A proficiency score is not provided.
Please review the assignment in the Health Assessment Student Handbook in Shadow Health prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Attachments
NRS-434VN-R-HealthScreeningandHisto
NRS 434 Shadow Health: Conversation Concept Lab
Shadow Health is an educational software developer of learning environments termed Digital Clinical Experiences™ (DCEs).
Founded in Gainesville, Florida in 2011, Shadow Health offers web-based clinical learning environments for masters, bachelors, and associate degree students and faculty in the fields of nursing and healthcare. The Shadow Health DCE is used in universities across the United States and Canada. As a learning management system, each DCE provides educators with administration, documentation and tracking functions to measure student clinical competence and clinical reasoning. Students navigate the digital clinical experience gaining confidence, developing clinical skills and learning how to effectively interact with patients within a safe environment.
Through the Shadow Health DCE, students engage with Digital Standardized Patients™ to perform patient exams, practice documentation and develop clinical reasoning skills. Upon completion of each virtual patient examination, students are prompted to reflect on their experiences and compare them against an expert’s notes. Shadow Health’s premier DSP is Tina Jones. According to a health educator at Drexel University, “what truly makes Shadow Health unique, however, is that Tina acts like a real patient by responding to how she is treated, approached or the type of questions she is asked by the student practitioner” [1]
The Shadow Health work environment includes cross-functional teams using agile management. Shadow Health is a graduate of The Innovation Hub, a local incubator hub opened in 2011. “Hub tenants have created more than 760 jobs and drawn more than $50 million in private investment funds” [2] Having been named as one of the 2014 Florida Companies to watch,[3] Shadow Health continues to expand with moves to larger office spaces in both 2012[4] and again December 2015.

Human Experience Across The Health-Illness Continuum
Human Experience Across The Health-Illness Continuum
Human Experience Across The Health-Illness Continuum profile
Human Experience Across The Health-Illness Continuum profile
The benchmark assesses the following competency:
Benchmark: 5.1. Understand the human experience across the health-illness continuum.
Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:
Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).
Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract or thesis is required.
Learning outcome:
LO8:
Name:
1. Instructions and guidelines (Read carefully)
Instructions
Insert your name and surname in the space provided above, as well as in the file name. Save the file as: First name Surname Assignment 4 – e.g. Lilly Smith Assignment 4. NB: Please ensure that you use the name that appears in your student profile on the Online Campus.
2 Write all your answers in this document. There is an instruction that says, “Start writing here” under each question. Please type your answer there.
3 Submit your assignment in Microsoft Word only. No other file types will be accepted.
4 Do not delete the plagiarism declaration or the assignment instructions and guidelines. They must remain on your assignment when you submit.
PLEASE NOTE: Plagiarism cases will be penalised according to the Head Tutor’s and GetSmarter’s discretion.
IMPORTANT NOTICE: Please ensure that you have checked your course calendar for the due date for this assignment.
Guidelines
1 There are eight pages and one question in this assignment.
2 Make sure that you have carefully read and fully understood the questions before answering them. Answer the questions fully but concisely and as directly as possible. Follow all specific instructions for individual questions (e. g. “list”, “in point form”).
3 Answer all questions in your own words. Do not copy any text from the notes, readings or other sources. The assignment must be your own work only.
Plagiarism Declaration:
1. I know that plagiarism is wrong. Plagiarism is to use another’s work and pretend that it is one’s own.
2. This assignment is my own work.
3. I have not allowed, and will not allow, anyone to copy my work with the intention of passing it off as his or her own work.
4. I acknowledge that copying someone else’s assignment (or part of it) is wrong, and declare that my assignments are my own work.
2. Mark allocation
Each question receives a mark allocation. However, you will only receive a final percentage mark and will not be given individual marks for each question. The mark allocation is there to show you the weighting and length of each question.
TOTAL 50
Assignment instructions
Complete Question 1 in this document. Make sure you have read Modules 3 and 4 before completing this assignment.
Note:
Make sure that you show all your workings within the assignment when calculations are required.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
Benchmark – Human Experience Across the Health-Illness Continuum – Rubric
Collapse All Benchmark – Human Experience Across The Health-Illness Continuum – RubricCollapse All
Health-Illness Importance to Health and Patient Care (C5.1)
20 points
Criteria Description
Health-Illness Importance to Health and Patient Care (C5.1)
5. Excellent
20 points
A discussion on the importance of the health-illness continuum in relation to health and the human experience in patient care is presented. The discussion demonstrates that the health-illness continuum is important to patient care. Strong rationale is offered for support.
4. Good
17.8 points
A discussion on the importance of the health-illness in relation to health and the human experience in patient care is presented. The discussion demonstrates that the health-illness continuum is important to patient care. Some rationale is needed for clarity.
3. Satisfactory
15.8 points
A general discussion on the importance of the health-illness in relation to health and the human experience in patient care is presented. The discussion generally establishes that the health-illness continuum is important to patient care. There are some inaccuracies. More information or rationale is needed.
2. Less than Satisfactory
15 points
A partial summary on the importance of the health-illness continuum is presented. The summary does not fully include the relation of the continuum to health and the human experience in patient care. There are significant inaccuracies. More evidence or information is needed.
1. Unsatisfactory
0 points
A discussion on the importance of the health-illness continuum is not presented.
Relation of Human-Illness Continuum to Value, Dignity, and Promotion of Human Flourishing
20 points
Criteria Description
Relation of Human-Illness Continuum to Value, Dignity, and Promotion of Human Flourishing
5. Excellent
20 points
A thorough explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is logically and convincingly presented. The explanation draws clear connections between the role of the health care provider and the promotion of human flourishing. Strong rationale is offered for support.
4. Good
17.8 points
An explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented. The explanation demonstrates that the health care provider does play a role in promoting human flourishing, but some additional rationale is needed for clarity.
3. Satisfactory
15.8 points
A general explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented. There are some inaccuracies, and more information or rationale is needed to support the response.
2. Less than Satisfactory
15 points
A partial explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented, but the connection is tenuous and key elements are omitted, incomplete, or left unexplained.
1. Unsatisfactory
0 points
An explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is not presented.
Refection on Personal State of Health and the Health Illness Continuum
20 points
Criteria Description
Refection on Personal State of Health and the Health Illness Continuum
5. Excellent
20 points
A well-developed discussion of personal state of health is included. The discussion demonstrates strong personal insight into behaviors supporting or detracting from health and well-being. The author clearly establishes where personal health falls on the health-illness continuum.
4. Good
17.8 points
A discussion of personal state of health is included. The discussion demonstrates personal insight into overall behaviors supporting or detracting from health and well-being. The author establishes where personal health falls on the health-illness continuum.
3. Satisfactory
15.8 points
A general discussion of personal overall state of health is included. Overall the discussion demonstrates some insight into some behaviors supporting or detracting from health and well-being. The author does not clearly establish where personal health falls on the health-illness continuum.
2. Less than Satisfactory
15 points
A partial summary of personal overall state of health is included. The summary is not informative. Behaviors supporting or detracting from health and well-being are omitted or incomplete.
1. Unsatisfactory
0 points
Reflection on personal overall state of health is omitted.
Resources Supporting Wellness
20 points
Criteria Description
Resources Supporting Wellness
5. Excellent
20 points
Options and resources available that would be extremely helpful to help the author move toward wellness on the health-illness continuum are presented. The author clearly establishes how these will assist in moving toward wellness. Insight into wellness as it pertains to the health illness continuum is demonstrated.
4. Good
17.8 points
Options and resources available that would reasonably help the author move toward wellness on the health-illness continuum are presented. The author establishes how these resources will assist in moving toward wellness.
3. Satisfactory
15.8 points
General options and resources available that would help the author move toward wellness on the health-illness continuum are presented. More information is needed to establish how this will assist in moving the author toward wellness.
2. Less than Satisfactory
15 points
Partial options and resources available that would help the author move toward wellness on the health-illness continuum are presented. It is unclear how this will assist in moving the author toward wellness.
1. Unsatisfactory
0 points
Options and resources available to help the author move toward wellness on the health-illness continuum are omitted.
Thesis Development and Purpose
5 points
Criteria Description
Thesis Development and Purpose
5. Excellent
5 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
4. Good
4.45 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
3. Satisfactory
3.95 points
Thesis is apparent and appropriate to purpose.
2. Less than Satisfactory
3.75 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Argument Logic and Construction
5 points
Criteria Description
Argument Logic and Construction
5. Excellent
5 points
Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
4. Good
4.45 points
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
3. Satisfactory
3.95 points
Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
2. Less than Satisfactory
3.75 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
1. Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5 points
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. Excellent
5 points
Writer is clearly in command of standard, written, academic English.
4. Good
4.45 points
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
3. Satisfactory
3.95 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
2. Less than Satisfactory
3.75 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Paper Format (use of appropriate style for the major and assignment)
2 points
Criteria Description
Paper Format (use of appropriate style for the major and assignment)
5. Excellent
2 points
All format elements are correct.
4. Good
1.78 points
Template is fully used; There are virtually no errors in formatting style.
3. Satisfactory
1.58 points
Template is used, and formatting is correct, although some minor errors may be present.
2. Less than Satisfactory
1.5 points
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
1. Unsatisfactory
0 points
Template is not used appropriately, or documentation format is rarely followed correctly.
Documentation of Sources
3 points
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. Excellent
3 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
4. Good
2.67 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. Satisfactory
2.37 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
2. Less than Satisfactory
2.25 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
1. Unsatisfactory
0 points
Sources are not documented.
Total 100 points

LDR 615 Topic 3 DQ 2 What is “disruptive change,” and how is this different from “incremental change?”
What is “disruptive change,” and how is this different from “incremental change?” How does disruptive change affect an organization? Provide an example.
Topic 3 Summary
Hello Class,
Our discussions about the role of leaders during change initiatives and the organizational impact of disruptive change were extremely informative! The following quote from Christensen and Overdorf (2000), in my opinion, provides an excellent summary of Topic 3:
Contrary to popular change-management and reengineering programs, processes are not nearly as flexible or adaptable as resources, and values are even less so. So, whether addressing sustaining or disruptive innovations, managers must create a new organizational space where those capabilities can be developed when an organization requires new processes and values (pg. 72).
Christensen and Overdorf (2000) propose solutions such as creating new boundaries for existing organizational structures to facilitate new and improved processes or acquiring a new organization entirely to better facilitate new processes as a result of the change. It is worth noting that their solutions are primarily process-focused rather than people-centered. We also discussed the importance of not losing sight of “people” and employee buy-in during times of change in our discussions.
Unread
Replies
Disruptive change is a non-localized future irreversible and change in the organization that affects a portion of the healthcare
LDR 615 Topic 3 DQ 2 What is disruptive change, and how is this different from incremental change
industry/organization that does not affect a localized area but rather the entire valued network/organization (Smith, 2014). Disruptive change is one that is powerful, abrupt, and can lead to concerns when an organization does not choose to follow suit, and in result they may be left behind (Day, n.d.). The response of how the organization handles the disruptive change will affect the team members involved within the unprepared abrupt changes that are occurring.
Incremental change is when change occurs at a slower pace over time, less drastic and gradually develops changes/plans within the organization (Day, n.d.). Incremental change can improve efficiency, gives understanding, and build stronger rapport and moral within the organization.
Disruptive changes occur every day in our lives; however, the COVID-19 pandemic has caused an increase in disruption. The Covid-19 pandemic placed disruptive change, crisis mode, on many aspects of my organization from available resources, chain supply, staff, visitor policies, technology, and elective surgical cases being canceled, to list a few. With the changes that have occurred within my organization will/has affected the whole organization. An example of disruptive change that is currently occurring at my organization is the need to have to cancel elective surgeries either the night before, morning of, and in some cases when the patient arrives at the hospital due to not having enough hospital beds and/or staff at that very moment. With my hospital needing to cancel elective surgeries and if other hospitals are not needing to, it can cause our organization to lose patients to another organization especially when they are being canceled on the spot of arrival. Another example of disruptive change during the pandemic is technology and the use of telehealth/telemedicine visits. This has been a challenge for many patients since many may not have the technology tools to complete these visits, not educated clearly on how to use the tools and/or financially unable. Abrupt technology has caused patients difficulty in accessing their electronic health record portals and communicating to their provider through them. “A lot of the changes are so gradual that they don’t even qualify as news, or even as interesting: they’re so mundane that we just take them for granted. But history shows that it’s the mundane changes that are more important than the dramatic ‘newsworthy’ events”-Robert D Kaplan (Fingerprint for Success, n.d.).
References
Day, J. (n.d.). Incremental change vs disruptive innovation: What’s the difference?
Fingerprint for Success. (n.d.). Incremental change.
Smith, C. (2014). Meeting the challenge of disruptive change.
Unread
Replies,
Daily, the healthcare upheavals we’re witnessing are evolving and having effects we never could have anticipated. Changing policies and procedures on a weekly, if not daily, basis, depending on the current situation. We’re dealing with challenges with the supply chain, human resources, and the availability of beds, and we’re forced to juggle these concerns on a daily basis. Many people are worried about those who are learning to use the new telemedicine technology and may find themselves cut off from the loved ones they rely on for support as a result. The gradual introduction of telemedicine could help patients learn how it works and help them adapt to it. The epidemic did not allow for a gradual learning curve. We’re seeing patients who’ve been putting off seeking medical attention become more sicker than usual once they finally do, only to be diagnosed with cancer. The pandemic needs to be dealt with at the same time as we seek to bring routine health care back on the table for everyone.

Health Illness Continuum Assignment
Health Illness Continuum Assignment
The benchmark assesses the following competency:
Benchmark: 5.1. Understand the human experience across the health-illness continuum.
Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:
Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).
Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract or thesis is required
Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:
Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).
Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract or thesis is required
Benchmark – Human Experience Across the Health-Illness Continuum – Rubric
Collapse All Benchmark – Human Experience Across The Health-Illness Continuum – RubricCollapse All
Health-Illness Importance to Health and Patient Care (C5.1)
20 points
Criteria Description
Health-Illness Importance to Health and Patient Care (C5.1)
5. Excellent
20 points
A discussion on the importance of the health-illness continuum in relation to health and the human experience in patient care is presented. The discussion demonstrates that the health-illness continuum is important to patient care. Strong rationale is offered for support.
4. Good
17.8 points
A discussion on the importance of the health-illness in relation to health and the human experience in patient care is presented. The discussion demonstrates that the health-illness continuum is important to patient care. Some rationale is needed for clarity.
3. Satisfactory
15.8 points
A general discussion on the importance of the health-illness in relation to health and the human experience in patient care is presented. The discussion generally establishes that the health-illness continuum is important to patient care. There are some inaccuracies. More information or rationale is needed.
2. Less than Satisfactory
15 points
A partial summary on the importance of the health-illness continuum is presented. The summary does not fully include the relation of the continuum to health and the human experience in patient care. There are significant inaccuracies. More evidence or information is needed.
1. Unsatisfactory
0 points
A discussion on the importance of the health-illness continuum is not presented.
Relation of Human-Illness Continuum to Value, Dignity, and Promotion of Human Flourishing
20 points
Criteria Description
Relation of Human-Illness Continuum to Value, Dignity, and Promotion of Human Flourishing
5. Excellent
20 points
A thorough explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is logically and convincingly presented. The explanation draws clear connections between the role of the health care provider and the promotion of human flourishing. Strong rationale is offered for support.
4. Good
17.8 points
An explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented. The explanation demonstrates that the health care provider does play a role in promoting human flourishing, but some additional rationale is needed for clarity.
3. Satisfactory
15.8 points
A general explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented. There are some inaccuracies, and more information or rationale is needed to support the response.
2. Less than Satisfactory
15 points
A partial explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented, but the connection is tenuous and key elements are omitted, incomplete, or left unexplained.
1. Unsatisfactory
0 points
An explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is not presented.
Refection on Personal State of Health and the Health Illness Continuum
20 points
Criteria Description
Refection on Personal State of Health and the Health Illness Continuum
5. Excellent
20 points
A well-developed discussion of personal state of health is included. The discussion demonstrates strong personal insight into behaviors supporting or detracting from health and well-being. The author clearly establishes where personal health falls on the health-illness continuum.
4. Good
17.8 points
A discussion of personal state of health is included. The discussion demonstrates personal insight into overall behaviors supporting or detracting from health and well-being. The author establishes where personal health falls on the health-illness continuum.
3. Satisfactory
15.8 points
A general discussion of personal overall state of health is included. Overall the discussion demonstrates some insight into some behaviors supporting or detracting from health and well-being. The author does not clearly establish where personal health falls on the health-illness continuum.
2. Less than Satisfactory
15 points
A partial summary of personal overall state of health is included. The summary is not informative. Behaviors supporting or detracting from health and well-being are omitted or incomplete.
1. Unsatisfactory
0 points
Reflection on personal overall state of health is omitted.
Resources Supporting Wellness
20 points
Criteria Description
Resources Supporting Wellness
5. Excellent
20 points
Options and resources available that would be extremely helpful to help the author move toward wellness on the health-illness continuum are presented. The author clearly establishes how these will assist in moving toward wellness. Insight into wellness as it pertains to the health illness continuum is demonstrated.
4. Good
17.8 points
Options and resources available that would reasonably help the author move toward wellness on the health-illness continuum are presented. The author establishes how these resources will assist in moving toward wellness.
3. Satisfactory
15.8 points
General options and resources available that would help the author move toward wellness on the health-illness continuum are presented. More information is needed to establish how this will assist in moving the author toward wellness.
2. Less than Satisfactory
15 points
Partial options and resources available that would help the author move toward wellness on the health-illness continuum are presented. It is unclear how this will assist in moving the author toward wellness.
1. Unsatisfactory
0 points
Options and resources available to help the author move toward wellness on the health-illness continuum are omitted.
Thesis Development and Purpose
5 points
Criteria Description
Thesis Development and Purpose
5. Excellent
5 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
4. Good
4.45 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
3. Satisfactory
3.95 points
Thesis is apparent and appropriate to purpose.
2. Less than Satisfactory
3.75 points
Thesis is insufficiently developed or vague. Purpose is not clear.
1. Unsatisfactory
0 points
Paper lacks any discernible overall purpose or organizing claim.
Argument Logic and Construction
5 points
Criteria Description
Argument Logic and Construction
5. Excellent
5 points
Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
4. Good
4.45 points
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
3. Satisfactory
3.95 points
Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
2. Less than Satisfactory
3.75 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
1. Unsatisfactory
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5 points
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. Excellent
5 points
Writer is clearly in command of standard, written, academic English.
4. Good
4.45 points
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
3. Satisfactory
3.95 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
2. Less than Satisfactory
3.75 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.
1. Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Paper Format (use of appropriate style for the major and assignment)
2 points
Criteria Description
Paper Format (use of appropriate style for the major and assignment)
5. Excellent
2 points
All format elements are correct.
4. Good
1.78 points
Template is fully used; There are virtually no errors in formatting style.
3. Satisfactory
1.58 points
Template is used, and formatting is correct, although some minor errors may be present.
2. Less than Satisfactory
1.5 points
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
1. Unsatisfactory
0 points
Template is not used appropriately, or documentation format is rarely followed correctly.
Documentation of Sources
3 points
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. Excellent
3 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
4. Good
2.67 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. Satisfactory
2.37 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
2. Less than Satisfactory
2.25 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
1. Unsatisfactory
0 points
Sources are not documented.
Total 100 points

Lyme Disease Case Study
Lyme Disease Case Study
A 38-year-old male had a 3-week history of fatigue and lethargy with intermittent complaints of headache, fever, chills, myalgia, and arthralgia. According to the history, the patient’s symptoms began shortly after a camping vacation. He recalled a bug bite and rash on his thigh immediately after the trip. The following studies were ordered:
Studies Results
Lyme disease test, Elevated IgM antibody titers against Borrelia burgdorferi (normal: low)
Erythrocyte sedimentation rate (ESR), 30 mm/hour (normal: ?15 mm/hour)
Aspartate aminotransferase (AST), 32 units/L (normal: 8-20 units/L)
Hemoglobin (Hgb), 12 g/dL (normal: 14-18 g/dL)
Hematocrit (Hct), 36% (normal: 42%-52%)
Rheumatoid factor (RF), Negative (normal: negative)
Antinuclear antibodies (ANA), Negative (normal: negative)
Diagnostic Analysis
Based on the patient’s history of camping in the woods and an insect bite and rash on the thigh, Lyme disease was suspected. Early in the course of this disease, testing for specific immunoglobulin (Ig) M antibodies against B. burgdorferi is the most helpful in diagnosing Lyme disease. An elevated ESR, increased AST levels, and mild anemia are frequently seen early in this disease. RF and ANA abnormalities are usually absent.
Critical Thinking Questions
1. What is the cardinal sign of Lyme disease? (always on the boards) 2. At what stages of Lyme disease are the IgG and IgM antibodies elevated?
3. Why was the ESR elevated?
4. What is the Therapeutic goal for Lyme Disease and what is the recommended treatment.
Lyme disease is a multisystem sickness caused by the spirochete “Borrelia burgdorferi” strains, which are transmitted by different species of the tick “Ixodes.”
[1] The erythema chronicum migrans (ECM) eruption at the site of inoculation is a frequent early manifestation, and infection spread can cause disease of the nervous system, heart, and joints, as well as other dermatoses.
[2]
Despite the fact that the disease has been predominantly recorded in temperate regions, the incidence has increased globally as a result of increased travel and changing vector habitats.
Only a few cases had previously been documented from India.
[3]
This case of Lyme borreliosis in a young kid from Himachal Pradesh with both classical and atypical ECM lesions is described in this paper.
Go to: Case Studies
In April 2016, a 10-year-old kid from a hilly town presented with a 3-day history of a painful brownish elevated lesion across the back of his left thigh, accompanied by surrounding redness that was gradually expanding.
There was no fever or other systemic symptoms in the toddler.
He described an excursion to a neighboring forest a few days prior to the onset of the lesion.
On inspection, there was an erythematous annular plaque of approximately 6 5 cm in diameter on the back of the left lower thigh, with a central brownish fluid-filled blister [Figure 1].
Over the lesion, there was induration and discomfort, as well as localized popliteal lymphadenopathy.
A lymphangitic streak was also present on the inner part of the thigh [Figure 2a].
Petechiae over the scapular areas [Figure 2b] were also present, as were a few maculopapular lesions on the dorsum of the hands and ankles.
The results of the systemic assessment were ordinary.
The diagnosis of ECM was made clinically.
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Figure 1 Erythematous annular plaque measuring 6 5 cm in diameter with a central blister on the back of the left leg (IDOJ-8-124-g001.jpg).
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Figure 2 Atypical erythema chronicum migrans (ECM) lesions; (a) ECM lesion on the antero-medial part of the thigh with lymphangitic streak, (b) atypical lesions in the form of petechiae on the right scapular area.
The patient underwent baseline tests, including a full hemogram and a peripheral blood smear, which were both normal.
The enzyme-immunoassay approach was used to test for Borrelia burgoderferi Ospc (23 KDa) antigen.
IgM levels were elevated to 4.4 U/ml (normal 0.90), but IgG levels were normal [0.3 U/ml (normal 0.90)], indicating an acute infection.
Due to funding constraints, a Western blot could not be done.
Biopsy of the active edge of the lesion revealed a considerable perivascular lymphocytic infiltration with a spongiosis center and extravasation of red blood cells in the papillary dermis [Figure 3].
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IDOJ-8-124-g003.jpg (H and E, 100) Figure 3 Perivascular lymphocytic infiltration with red blood cell extravasation into the papillary dermis
Doxycycline 100 mg tablets twice day were started right away, along with additional symptomatic treatments.
The lesion did not grow beyond its initial size after one week of treatment, and the erythema and induration were reduced.
The above-mentioned properties linked with skin exfoliation improved even more after two weeks [Figure 4a].
The drugs were continued for a total of three weeks, and the lesion was clinically resolved [Figure 4b].
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IDOJ-8-124-g004.jpg is the name of the object.
(a) After 2 weeks of treatment, erythema has improved, the advancing margin has vanished, and exfoliation has occurred.
(b) After 3 weeks, the erythema chronicum migrans lesion has resolved and the blister has healed.
Navigate to: Discussion
B. burgdorferi sensu stricto, afzelli, garinii, bavariensis, and speilmanni are pathogenic genospecies of B. burgdorferi sensu lato (comprising at least 20 genospecies, both pathogenic and non-pathogenic), among which B. garinni and B. afzelli have been most regularly implicated as pathogens in Asia (mainly central Asia).
[3]
Though the disease is more usually found in temperate climates, Ixodes ticks are known to be present in the Himalayan region, therefore it could exist in our country.
Ixodes acutitarsus, Ixodes granulatus, Ixodes himalayensis, Ixodes kashmericus, and Ixodes ovatus are some of the Ixodes species found in this area.
[4]
I. persulcatus (reported from Central Asia) is the tick species thought to be responsible for disease transmission in Asia, however it has not been detected in India.
The most usually affected organ is the skin, and the symptoms are known as “dermatoborreliosis.”
Early localized disease, disseminated disease, and chronic disease are the three stages of the disease.
Early localized illness is characterized by ECM, which is commonly regarded as pathognomonic.
It appears as a target lesion at the site of a tick bite and can take one of two forms: growth with varied hues of erythema or centrifugal spread with core clearing and bull’s eye.
Vesicles, erythematous papules, purpura, and lymphangitic streaks have all been recorded as atypical ECM lesions.
Tinea corporis, urticaria, erythema multiforme, erythema annulare centrifugum, and fixed drug eruptions are all differential diagnoses for ECM.
The presence of a perivascular dermal lymphohistiocytic infiltration with few interspersed plasma cells is characteristic of histopathology.
Spirochetes can be seen in 50% of primary ECM lesions using the Warthin-Starry stain.
[3]
ECM is diagnosed mostly through clinical examination, with laboratory evidence serving as a supplement.
In suspected clinically unusual ECM symptoms, detection of B. burgdorferi by culture (expensive and low sensitivity) and/or polymerase chain reaction from skin biopsy is helpful in proving infection.
The most practicable and widely used method for diagnosing Lyme borreliosis is serology, which is required in all instances with clinically suspected Lyme borreliosis except ECM.
It uses a two-step process that starts with an initial screening test (typically an ELISA) and then moves on to a Western blot for reactive and ambiguous samples.
In the future, single-step ELISA using recombinant proteins (such as C6 peptide) may replace the traditional two-tiered method.
[5]
Various antibiotics have been used to treat the condition with success.
In early localized disease, doxycycline (4 mg/kg/day in divided doses; maximum 200 mg/day; after 8 years of age) for two weeks is the treatment of choice.
Alternatives to amoxycillin include cefuroxime axetil and amoxycillin.
Parenteral treatment with ceftriaxone, cefotaxime, or benzyl penicillin is frequently required for disseminated illness.
[6]
Lyme Disease Case Study
In the past, just a few instances of Lyme disease had been documented from India.
Table 1 summarizes an overview of several cases/studies from around the country.
[7,8,9,10,11,12,13]
In this case, the patient had both the typical centrifugally spreading ECM lesion as well as atypical lesions such as lymphangitic streaks, petechiae, and maculopapular lesions.
This case report raises the likelihood of future Lyme disease outbreaks in Himachal Pradesh, and it is important for treating physicians to be informed of the illness’s presence in this region.
Early detection of cutaneous characteristics can aid in the prevention of the progression of severe illness.
Various preventive techniques must be made more widely known to the public.

Pharmacological Methods
Pharmacological Methods
Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.
How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?
Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues.
Her current gestational age is 30 weeks.
She is O+ and all other lab values are normal. No noted STI’s.
1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation.
2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk.
3. What other information would you like to ask her?
4. What nursing intervention will you provide?
5. What screening tests are often obtained to help determine her risk for preterm labor.
6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order?
7. Please also give dose, side effects and possible result of the medication.