Herzing University NU 430 Pico Question and Bill Paper

Herzing University NU 430 Pico Question and Bill Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Herzing University NU 430 Pico Question and Bill Paper STEP I: Topic Selection: PICO Question and bill (if applicable) Each team will select a healthcare problem or current state care bill that impacts patient outcomes The final topic is formatted as a PICO question. Describe the expected patient outcomes you hope to address for this problem (e.g. improved access to health services, decreased risk for infection, and improved communication, more services performed by trained by RNs). Submit on the PICO Development Tool form by Unit 5. pico_development_tool.docx rubrics.docx PICO Development Tool Bill: PICOT P- Patient population (age, illness experience, disease, risk, …) I- Intervention (clinical intervention or approach) Herzing University NU 430 Pico Question and Bill Paper C- Comparison intervention O- Outcomes (improved function) T- Timing: (duration, frequency, …) PICO Question___________________________________________________________________________________________________________________________________________________ Patient Outcomes ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON NU 430: Evidence Based Nursing Research and Practice Assignments and Rubrics Instructor: Course Code: NU 430 Semester: Course Name: Evidence Based Nursing Research and Practice NU 430 EVIDENCE BASED NURSING RESEARCH AND PRACTICE COURSE OUTCOMES CURRICULUM THREADS PROGRAM OUTCOMES CCNE ESSENTIALS OF BSN EDUCATION ANA SCOPE AND STANDARDS NLN OUTCOMES QSEN IOM 1. Develop a proposal for a project that will resolve a problem in a professional work area. Communication, Evidenced Based Practice, Professional Role, Environment 2, 4, 7 Essential III: Scholarship and Evidence Based Practice 7, 9, 13, 14, 15 2, 3, 4 3, 4, 6 4, 5 2. Integrate knowledge from other disciplines when utilizing the research process. Professional Role, Critical Thinking, Evidence Based Practice 3, 6, 7 Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice Essential III: Scholarship and Evidence Based Practice 12, 13, 15 2 2, 6 3 3. Articulate the role of nursing research within clinical practice and explore the components of the research process. Nursing, Professional Role, Safety, Evidence Based Practice, Critical Thinking, Communication 1, 2, 5, 8 Essential II: Basic Organizational and Systems Leadership and Quality Care and Patient Safety Essential III: Scholarship and Evidence Based Practice 9, 13, 14, 15 3, 4 3, 6 4 4. Apply critical thinking when relating nursing research to practice. Critical Thinking, Evidence Based Practice, Professional Role 2, 8 Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice VII. Clinical Prevention and Population Management 13, 14, 15 2 3, 4 4 5. Differentiate between quantitative and qualitative research. Evidence based practice, Professional Role, Critical Thinking 2 Essential III: Scholarship and Evidence Based Practice 13, 15 2, 4 3 3 6. Recognize the value and relevance of research in nursing to the development of one’s own professional practice and to the quality of patient care. Critical Thinking, Evidence Based Practice, Nursing 1, 8 Essential VIII: Professionalism and Professional Values 9, 13, 15 2, 4 3 4 7. Demonstrate ethical practice in nursing research. Professional Role, Culture 1, 8 Essential V: Healthcare Policy, Finance, and Regulatory Environments Essential VIII: Professionalism and Professional Values 7, 8, 15 4 3 3 8. Critically analyze research findings. Critical Thinking, Communication Herzing University NU 430 Pico Question and Bill Paper 2, 7, 8 Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice Essential III: Scholarship and Evidence Based Practice Essential VII: Clinical Prevention and Population Health for Optimizing Health 9, 10 4 3 3 Classroom Behavior Guidelines Please be on time for class: Students who walk into class late or leave early disrupt the learning environment by distracting faculty and other students. Attend every class: You will pass your course if you pay attention and take good notes. Emergencies and illness happen. Contact me as soon as possible. If you miss a class, it is your responsibility to reach out for notes and to arrange for making up assignments. Quizzes given during class cannot be made up. Do not have private conversations: I expect you to pay attention in class and participate in class discussions. Private conversations distract others and are disrespectful to the faculty. Electronics: Turn off cell phones. Computers are only to be used to take notes. Social media or doing work for other classes is unacceptable. While I cannot tell you not to use your computer the way you want to, I would appreciate it if you would not do these things. Be mindful of the P.R.I.C.E model: Read and be prepared for class, you never know what the professor will have in store for you Turn your work in on time. If you need to see me schedule an appointment. This can be done through Outlook Calendar. No gossip about other classes, faculty, or students QUALITATIVE or QUANTITATIVE RESEARCH CRITIQUE CRITERIA Either the qualitative or quantitative critique is due at the beginning of class. Goals for the assignment is to: Use criteria for critiquing a qualitative or a quantitative research report. Evaluate the strengths, weaknesses, and applicability of research. Use research critique methodology to guide evidence-based practice. Directions: Using the criteria in each of the guidelines to assist you, evaluate the study Summarize your findings using substantive information from the article to support the claim you are making about the critique. Submit the following for grading in hard copy Research articles Paper Rating scale (includes comments section) Submit utilizing correct grammar, APA format and citations are expected . Cover sheet, reference page in APA style is required. Qualitative Study Critique Rubric Grading Rubric: each row is worth 10 points It is not enough to indicate that the component is met. Detailed and concise explanations based on the article must be included. Each section in the Research Critique Guide must be included in your critique. Title Abstract Phenomenon of Interest Herzing University NU 430 Pico Question and Bill Paper Purpose Review of Literature Method Sampling Ethical Underpinnings/Theoretical Framework/ Design Data Collection Data Analysis Credibility Auditability Fittingness of the Data Findings Conclusions References APA /Formatting Qualitative Research Critique Guide 1 = unable to determine 2 = not present 3 = marginally present 4 = present Critique Component Rate 1,2,3,4 Comment Elements influencing the believability of the research Title Ø Is the title clear, accurate, and unambiguous Abstract Ø Does the abstract offer a clear overview of the study include the research problem sample, methodology, finding and recommendations? Elements influencing the robustness of the research Phenomenon of interest Ø What is the phenomenon of interest, and is it clearly stated? Ø What is the justification for using a qualitative method? Ø What are the philosophic underpinnings of the research method? Purpose/ Significance of Study Ø What is the purpose of the study? Ø What is the possible significance of the work to nursing? Herzing University NU 430 Pico Question and Bill Paper Review of Literature Ø Has a literature review been undertaken? Ø Does it meet the philosophical underpinnings of the study? Ø Does the review of the literature fulfill its objectives? Ø Were a majority of the sources from primary methods? Method Ø Is the method used to collect data compatible with the purpose of the research? Ø Is the method adequate to address the phenomenon of interest? Ø Was there a particular approach that was used to guide the research? If so, does the researcher complete the study according to the process described? Sample Ø Is the sampling method and sample size identified? Ø Was it convenience or purposive sampling? Ø Is the sampling method appropriate? Ø Are the participants who were chosen appropriate to inform the research? Ø Were the demographics of the participants described? Ethical Considerations Ø Were the participants fully informed about the nature of the research? Ø Was the anonymous/ confidentiality of the participants guaranteed? Ø Were the participants protected from harm? Ø Was ethical permission granted for the study? Data collection Ø Are data focused on human experience? Ø Does the researcher describe data collection strategies (e.g., interview, observation, field notes)? Ø Is protection of participants addressed? Herzing University NU 430 Pico Question and Bill Paper Ø Is saturation of the data described? Data analysis Ø What strategy(ies) are used to analyze data? Ø Are steps described for data analysis followed? Ø If there was a research team, was the data analysis initially conducted independently? Ø Were outside experts consulted in the data analysis process? Ø Were participants consulted on the interpretation of the data? Ø Does the researcher discuss how rigor was assured? Ø Credibility Ø Do the participants recognize the experience as their own? Ø Has adequate time been allowed to understand the phenomenon fully? Ø Auditability Ø Can the reader follow the researcher’s reasoning? Ø Does the researcher document the research process? Ø Fittingness of the data Ø Are the findings applicable outside of the study situation? Ø Are the results meaningful to individuals not involved in the research? Ø Is the strategy used for the analysis compatible with the purpose of the study? Findings Ø Are the findings presented within a context? Ø Is the reader able to comprehend the “essence of the experience” from the report? Ø Are the researcher’s conceptualizations (themes) true to the data? Ø Does the researcher place the report in the context of what is already known? Ø Was the existing literature on the topic related to the findings? Conclusions, implications, and recommendations Ø Do the conclusions, implications, and recommendations give a context to use the findings? Ø Do the conclusions reflect the study findings? Ø What are the recommendations for future study? Ø Do they reflect the findings? Ø How has the researcher made explicit the significance to nursing theory, research, or practice? References Ø Were all the books, journals, and other media alluded to in the study accurately references? These final two sections should not have headings of their own, but the information should be input into your critique in the introduction or the conclusion of your paper. Writing style Ø Is the article well-written, concise, grammatically correct, avoid use of jargon? Ø Is it well laid out and organized? Logical consistency Ø Does the research report follow the steps of the research process in a logical manner? Ø Do these steps naturally flow and are the links clear. Adopted from Yang, Y. (n.d.). Qualitative research article critique guidelines. Retrieve from http://edci6300introresearch.pbworks.com/f/Research+Article+Critique+Guidelines-Qualitative.pdf Introduction is not to be written as it is implied. The bolded words in this guide as level 1 headings The words in red are level 2 headings. Words in blue are level 3 headings. Make sure they are ALL formatted correctly Quantitative Study Critique Rubric Grading Rubric: each area shows point value Title & Abstract (5) Background & Significance with R esearch Question(s) and/or Hypothesis(es) (5) Review of Literature (5) Methods (5), ¨ Internal and External Validity ¨ Research Design ¨ Sampling ¨ Legal-Ethical Issues I/E validity- RD- S- LE I-. Data Collection (5) ü Physiological Measurement ü Observation ü Interview ü Instrumentation ü Data and Records ü Variables PM- O- Int- Instru- DR- V- Data Analysis (5) Conclusions/Implications/ Recommendations (5) Applicability to Nursing Practice (5) References/ APA Formatting and Organization using Rubric (10) R- AO- Total 50 Quantitative Research Critique Guide 1 = unable to determine 2 = not present 3 = marginally present 4 = present Critique Component Rate 1,2,3,4 Comment Elements influencing the believability of the research Title Ø Is the title clear, accurate, and unambiguous Abstract Ø Does the abstract offer a clear overview of the study include the research problem sample, methodology, finding and recommendations? Elements influencing the robustness of the research Background and Significance Ø Appropriately presented in the introduction of the study Ø Does the background or significance section make it clear why the proposed study is being done? Research Question or Hypothesis or Aim/Purpose Ø The hypothesis or research question(s) or aim/purpose express and appropriate relationship between in the independent and dependent variables Ø Appears in the appropriate context of an appropriate theoretical framework Ø Substantiated by adequate experiential and scientific background material. Ø Purpose, aim(s), or goal(s) of the study have been substantiated Ø Each hypothesis of research question is specific and can or cannot be supported with previous studies that have been conducted? Ø Is the purpose of the study/ research problem clearly identified? Ø Given level of evidence suggested by the research question, hypothesis, and design, what is the potential applicability to practice? Ø Logical Consistency (not to be a heading, but to be incorporated into this section or in own paragraph) Ø Does the research report follow the steps of the research process in a logical manner? Ø Do these steps naturally flow and are the links clear? Review of Literature Ø Does the search strategy include an appropriate and adequate number of databases and other resources to identify key published and unpublished research and theoretical resources? Ø Is there an appropriate theoretical/conceptual framework that guides development of the research study and if so, is the framework logically described? Ø Is the literature that is used mostly from primary sources? Ø What gaps or inconsistencies in knowledge or research does the literature uncover so that it builds on earlier studies? Ø Does the review include a summary/critique of each study that includes the strengths and weaknesses or limitations of the study? Ø Is the literature review presented in an organized format that flows logically? Ø Is there a synthesis summary that present the overall strengths and weaknesses and arrives at a logical conclusion that generates hypotheses or research questions? Herzing University NU 430 Pico Question and Bill Paper Methods Ø Internal and External Validity Ø What are the controls for the threats to internal validity? Are they appropriate? Ø What are the controls for the threats to external validity? Are they appropriate? Ø What are the source of bias and are they dealt with right away? Ø How do the threats to internal and external validity contribute to the strength and quality of the evidence? Ø Was the fidelity of the intervention maintained, and if so, how? Ø Research Design Ø What type of design is used in the study? Ø Is the rationale for the design appropriate? Ø Does the design used seem to flow from the proposed research question(s) or hypothesis(es), theoretical framework, and literature review? Ø What types of controls are provided by the design that increase or decrease bias? Ø Sampling Ø What type of sampling strategy is used? Is it appropriate for the design? Ø How was the sample selected? Was the strategy used appropriate for the design? Ø Does the sample reflect the population as identified in the research question or hypothesis? Herzing University NU 430 Pico Question and Bill Paper Ø Is the sample size appropriate? Show is it substantiated? Was a power analysis necessary? Herzing University NU 430 Pico Question and Bill Paper Ø To what population may the findings be generalized? Ø Legal-Ethical Issues Ø How are the rights of subjects been protected? Ø What indications are given that institutional review board (IRB) approval has been obtain? Ø What evidence is given that informed consent of the subjects has been obtained? Data Collection Ø Instrumentation and Procedures (If the instrument or procedure is not applicable to your study, make note of that and move on) Ø Physiological Measurement Ø Is a rationale given for why a particular instrument or method was selected? If so, what is it? Ø What provision is made for maintaining accuracy of the instrument and its use, if any?Herzing University NU 430 Pico Question and Bill Paper Ø Observation Ø Who did the observing? Ø How were the observers trained and supervised to minimize bias? Ø Was there an observation guide? Ø Was interrater reliability calculated? Ø Is there any reason to believe that the presence of observers affected the behavior of the subjects? Ø Interviews Ø Who were the interviewers? How were they trained and supervised to minimize bias?Herzing University NU 430 Pico Question and Bill Paper Ø Is there any evidence of interview bias, and if so, what is it? How does it affect the strength and quality of evidence Ø Instruments Ø What is the type and/or format of the instruments (ex. Likert scale)? Ø Are the operational definitions provided by the instruments consistent with the conceptual definition(s)? Ø Is the format appropriate for use with this population? Ø What type of bias is possible with self-report instruments? Ø Available Data and Records Ø Are the records or data sets used appropriate for the research question(s) or hypothesis(es)? Ø What sources of bias are possible with use of records or existing data sets? Ø Variables Ø Are the variables adequately described? Ø Was a rationale provided for their use? Ø Were the variables chosen appropriate for answering the research question(s)? Ø Overall, how was intervention fidelity maintained? Ø Reliability and Validity Ø Was an appropriate method used to test the reliability of the instrument(s)? Ø Was the reliability of the instrument(s) adequate? Ø Was the appropriate method(s) used to test the validity of the instrument(s)? Ø Have the strengths and weaknesses related to reliability and validity of each instrument been presented? Ø What kinds of threats ton internal and external validity are presented as weaknesses in reliability and/or validity Ø How do the reliability and/or validity after the strength and quality of evidence provided by the student finding Data Analysis Ø Were the descriptive and inferential statistics appropriate to the level of measurement for each variable? Ø Are the inferential statistics appropriate for the type of design, research question(s), or hypothesis? Ø If tables or figures are used, do they meet the following standards? a. They supplement and economize the test b. They have precise titles and headings c. They do not repeat the text Ø Did testing of the research question(s) or hypothesis(es) clearly support or not support each research question or hypothesis Conclusions, Implications, and Recommendations Ø Are the results of each research question or hypothesis presented objectively? Ø Is the information regarding the results concisely and sequentially presented? Ø If the data are supportive of the hypothesis or research questions, does the investigator provide a discussion of how the theoretical framework was supported Ø How does the investigator attempt to identify the study’s weaknesses and limitations (ex. Threats to internal and external validity) and strengths and suggest possible research solutions in future studies? Ø Does the research discuss the study’s relevance to clinical practice? Ø Are any generalizations made and, if so, are they made within the scope of the findings? Ø Are any recommendations for future research stated or implied? Applicability to Nursing Practice Ø What are the risks/benefits involved for patients if the findings are applied in practice? Ø What are the costs/benefits of applying the findings of the study? Ø Do the strengths of the study outweigh the weaknesses? Ø What is the strength, quality, and consistency of evidence provided by the study findings? Ø Are the study findings applicable in terms of feasibility? Ø Are the study findings generalizable? Ø Would it be possible to replicate this study in another clinical setting? References Ø Were all the books, journals, and other medial alluded to in the study accurately referenced? Writing style (This section should not have its own heading, but should be included in the introduction or the conclusion) Ø Is the article well-written, concise, grammatically correct, avoid use of jargon? Ø Is it well laid out and organized? Adopted from LoBiondo-Wood, G., & Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice (8 th ed.). St. Louis, Missouri: Elsevier, Mosby and Coughlin, M., Cronin, P., & Ryan, F. (2007). Step-by-step guide to critiquing research. Part I: Quantitative research. British Journal of Nursing, 16 (11), 658-663. Retrieved from http://web.b.ebscohost.com.ezproxy.lib.uwm.edu/ehost/pdfviewer/pdfviewer?vid=2&sid=a1fb61a6-b368-4e9c-b2c7-bfa64727e8d8%40sessionmgr104 Introduction is not to be written as it is implied. The bolded words in this guide as level 1 headings The words in red are level 2 headings. Words in blue are level 3 headings. Make sure they are ALL formatted correctly Overall EBP Project Description One characteristic of professional nursing practice is to use evidence and research to guide practice. The purpose of this project is to apply the evidence-based practice process to impact health care and patient outcomes. The project utilizes a systematic approach that encompasses the following phases: Topic Selection: PICO Question based on a clinical or healthcare problem or current state health care bill that impacts patient outcomes Review of the Literature for evidence of best practice Development of Best Practice Recommendations/Guidelines Review of Actual Practice Gap Analysis Action Plan: Recommendations for Change Cost Analysis/Economic Implications Conclusions and Recommendations for future research References Poster This project is finalized as a poster and is presented to peers and faculty at a poster session. Composing your Team Students will form teams of 3-4 students. Each team will complete an initial plan for the project, including how the work will be divided equitable, ground rules for working together, and who will assume team leadership for each major section. Submit this document by week 3. Any concerns about a group member’s contribution to the project should be discussed first with that team member by the team at the time the problem is occurring , before involving the course faculty. Try to resolve any conflict within the team with the team. An evaluation of each other’s contribution to the project will be conducted at midterm and at project conclusion, which contributes to the individual grade for the assignment Herzing University NU 430 Pico Question and Bill Paper Online EBP Resources American Nurses Association: http://www.nursingworld.org/EspeciallyForYou/Nurse-Researchers University of Illinois at Chicago (UIC): https://www.uic.edu/research Wisconsin State Legislature: https://docs.legis.wisconsin.gov/2017 Project Components Students are referred to the syllabus for the due dates for each component. Please refer to this document throughout the project for information on where to submit the component and in what format. STEP I : Topic Selection: PICO Question and bill (if applicable): Each team will select a healthcare problem or current state care bill that impacts patient outcomes The final topic is formatted as a PICO question. Describe the expected patient outcomes you hope to address for this problem (e.g. improved access to health services, decreased risk for infection, and improved communication, more services performed by trained by RNs). Submit on the PICO Development Tool form by week 5. STEP II-A: Systematic Review of the Literature There are four parts to this phase: Literature search for relevant research articles Selection of articles for review Review of the articles and completion of the pertinent Evidence Review Form Development of a Review of Literature Table based on the articles reviewed and the template provided Herzing University NU 430 Pico Question and Bill Paper A review of literature for research-based evidence is to be completed for the selected issue. This review of the literature involves: Search the literature for current research/non-research articles using the key words you have identified. (The reference librarian at Herzing University is a helpful resource or course faculty). Select articles based on the research hierarchy; there should be no expert opinion articles. Obtain full-text or pdf copies of the articles that are selected for review. Abstracts are not appropriate for use in this assignment. You will need a hard copy for submission . At least one article per team must address the economic implications. A review of a minimum of 8 evidence-based citations from recent (within the last 5 years is preferable) nursing and health care literature. Each team member must complete one full evidence review (using Evidence Review Form), and one abbreviated reviews. These are due on week 5 : **** Bring a hard copy of the articles to class for the faculty . Articles are to be reviewed according to research/evidence evaluation guidelines provided. STEP II-B As a group, complete the Review of Literature Summary Table , citing: Author(s) of each article in APA format. [Ex: Hunter & Roberts, 2011] Evidence/Hierarchy – clearly indicate what type of evidence the article represents, the level of evidence, and the quality rating Sample size and characteristics if applicable. Succinctly state the evidence in the article relating to the outcomes you chose for your PICO topic. State the evidence from the article in your own words, i.e., paraphrase. DO NOT USE QUOTATIONS. It is permissible to use abbreviations in the Summary Table without spelling out the words first [this saves space]. If there are abbreviations used, include a key to the abbreviations at the bottom of the table. (see example below) DUE on Week 9. Template: Review of Literature Summary Author Use APA format for in-text citation (e.g. author(s), year) Evidence Hierarchy Level [Type of Evidence] Strength: Quality: Sample Size and Characteristics [if appropriate)] Outcome 1 [List the outcome here] Outcome 2 [List the outcome here] Other Outcomes/ Findings [if appropriate] EXAMPLE: of a summary table of articles and the outcomes chosen that represent best practice that would be included on a poster. Example: Review of Literature Summary Author & Date Evidence Hierarchy Level Sample Size and Characteristics Outcome 1 Outcome 2 Other Outcomes/Findings Smith, 2006 Non-experimental Strength: III Quality: Good 50 adult patients during CABG surgery 25% decrease in infection rates Jones, 2007 Meta-analysis Strength: I Quality: Good 5 studies of CABG patients Shortened length of stay Average cost reduction was $… CABG – Coronary Artery Bypass Graft NOTE: Steps III, IV, and V are due week 10 STEP III: Development of Best Practice Recommendations/Guidelines The Best Practice Guidelines will be synthesized from your teams’ review of the literature. Each Best Practice statement is to be supported from the literature review; sources are clearly documented following APA format. Formulate at least 3 best practice statements. Best practice statements are action-oriented. Develop the best practice statement in your own words; through paraphrasing. DO NOT USE QUOTATIONS. STEP IV: Review of Actual Practice Obtain a copy of a policy and procedure concerning the selected issue. Compare the policy with the best practice statements developed. Or observe how the selected nursing issue is actually implemented. Speak with someone about what is actually happening. Use this information in the next step of Analysis/Identification of Gaps. Gap Analysis Table [NO QUOTATIONS] Best Practice Guidelines Herzing University NU 430 Pico Question and Bill Paper What is actually happening: Policy and Procedure, Observation, or interview Gap Statement 1 (include citation(s) supporting best practice) Cite the policy statement if present or indicate not part of policy if appropriate STEP V: Gap Analysis The analysis phase consists of comparing the best practice to what is actually in place through Policy and Procedure, Observation, or Interview. Identify the commonalities and the differences between these three, identifying gaps from best practice. STEP VI: Action Plan Due on Week 11 From the gap analysis identify the key points of the action plan. The action plan consists of the recommendations for change The action plan is presented in a table format [see template and example below]. The action plan for changing practice addresses: Recommendations for changing Rationale for the proposed actions, citing sources in APA format [no quotations] Factors currently present that will facilitate implementation of the recommendations Barriers to implementing recommendations Template: Action Plan for Change to Achieve/Support Best Practice Recommendations Rationale (Cite reference) Facilitators to Implementation Barriers to Implementation (Steps to change to Best Practices) (Summary statement; cite references) (Currently present) (Currently present) STEP VII: Cost Analysis/Economic Implications Due Week 11 An explanation of the cost implications of the project (e.g. cost savings) in a narrative and/or table. Make sure that you cite your sources of the cost information in the body of the cost analysis and on the reference list. Sometimes the “cost” is not an obvious cost related to equipment or supplies. At times the economic implication is less tangible, for example the cost to incur poor patient satisfaction, or unsatisfied nurses. STEP VIII: Conclusions and Recommendations Due Week 11 Conclusions from your findings on this project are to be described. What did you learn? Future recommendations for health care/ nursing practice and research are to be made. What is the logical next step that needs to be taken? For example, often students discover that a limitation of the project is lack of research that supports best practice. The logical next step would be to recommend that more research is needed in this area before practice can be changed. Recommendations to support the bill or not and why. This should be in the form of a narrative. Herzing University NU 430 Pico Question and Bill Paper STEP IX: References- Submit a full list of references- Due Week 12 Submit the f