In your opinion, is it possible to perform a truly and totally pure structured interview? For example, how can you negotiate a participant that tends to add more than the question requires? Explain.
Overview
This module focuses on the implementation phase of research, beginning with an overview of participant recruitment and data collection. Topics covered include recruitment, retention, preparation for collecting data, and interviewing. Structured, semi-structured, and unstructured interviews are also covered. We then focus on Internet sources, secondary analysis, historical research, and intervention.
Recruitment and retention are two tremendous hurdles faced by any researcher. In this module we explored the process of participant recruitment and enrollment, what motivates people to participate in a research study—the incentives, and why they may decline—what barriers to participation exist. We also considered the question of retention, which becomes important if you need to maintain contact and retest or re-interview participants.
The type of data you decide to collect and how you go about collecting it will have a great impact on its value in the analysis, reporting, and application phases of your research study. We began with the initial planning and preparation for data collection, including selection of measures, and then consider procedures for specific data collection modes. Specific approaches to testing and observation were discussed, as well as interviewing, and online, secondary, and archival sources.
In this module we discussed online research, secondary analysis of existing databases, and historical research. Each of these methods of data collection has its advantages but also poses some challenges for the researcher. There is still a lot to be learned about the strengths and weaknesses of Internet-based research and questions to be answered about the ethics of using existing data that are felt
to be private yet are publicly available. Secondary data analysis probably should be done more often than is currently the case. Although there are challenges to using data collected for another purpose, secondary data analyses often generate a rich yield for the effort expended. Historical research addresses entirely different questions and uses different data collection methods. It requires a sense of context and continuity unlike that of the other data collection strategies. As different as they are, each contributes to our understanding of the patients, clients, their families, and the environment in which nurses provide care.
The intervention phase of research requires active involvement of the investigator and members of the research team. A carefully designed intervention based upon previous research and an underlying theoretical framework are the basis for undertaking this phase of the study. Those providing the intervention need to be well trained, the provision of the intervention needs to be monitored and recorded meticulously, and safety of participants needs to be assured throughout the study.
Tappen chapters 13-17
Text: Tappen, R. (2016). Advanced nursing research: From theory to practice (2nd ed.). Sudbury, MA: Jones and Bartlett.  ISBN: 978-1284048308.

American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, D.C.: Author. ISBN: 9781433805615

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Instructions:What are the implications of the American Nurses Association Magnet Status Process in relation to nursing theory-driven research and practice?

Use one peer reviewed resource written within the past five years

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A. Patient Episode
J.R. is an alert and active, 3 month old male brought into the emergency room by his mother for concerns about him not tolerating his feeds.
Source and Reliability: Mother (mom).
B. SOAP
Subjective data.
Patient Age and Gender: 3month ex 32 week old male
Chief Complaint: “he keeps spitting up after he drinks breast milk or formula and even after he has burped”
History Present Illness: The mom explains that the “spitting up” occurs immediately after feeding J.R. and started about a month ago. She made sure to burp him after every two ounces of milk. She pumps the breast milk and then feeds him from a bottle in order to have a better idea of how much milk he is consuming. He has been drinking both formula and breast milk since birth in order to supplement and to help him gain weight. Mom estimates the amount of spit up to be less than half an ounce. The spit up is described as non-bilious non-bloody fluid with no foul smell. The mom denied that J.R. experienced any cough, diarrhea, or fevers with his spitting up. She described that J.R. had seemed more irritable to her during and after feeds because he would become “fussy and start crying”. Mom denied any sick contacts.
Significant Past History:
Pregnancy: Mom had a preterm labor, J.R. was born at 32 weeks and was the first born.
Newborn Period: Born vaginally at 32 weeks, Apgar score of 6. NICU stay: DOL #1 till 4 weeks. Birth weight was 1.8 kg. Extubated DOL# 7
Illnesses: Esophageal atresia. Iron deficiency anemia. Surgeries: repair of esophageal atresia at 1 month of age. Hospitalization: 1 month in NICU.
Accidents: Mom denies any injuries or trauma.
Preventive care: Vaccines UTD. Last PMD visit was last week where some loss of weight was noted. Patient now weighs 3.63 kg. Prior PMD visit was 4 kg. PMD recommended that mom increase amount of formula in order to assure patient consumed appropriate amount of calories.
Significant Family History: Denies significant family history.
Developmental History: J.R. sucks and swallows well during feeds, smiles in response to mom’s voice. Turns his head in the direction of noise. Cries and coos.
Current Medical History: Denies any sick contacts.
-Allergies: Denies any allergies.
-Current Medications: One multivitamin once a day and ferrous sulfate twice a day.
Significant Review of Systems:
General: Mom reports a weight loss of one pound between monthly PMD visits. Mom reports weight loss occurred after the patient began becoming irritable during and after feeds with “spitting up” episodes.
Skin: Denies any noted skin rashes, lesions, masses, or dryness.
HEENT: Head: Denies any trauma. Eyes: Denies any issues with vision. Ears: Denies any issues with hearing.
Nose: Denies any noted difficulty breathing, stuffiness, or runny nose. Mouth: Mom frequently notices J.R. has spit up after his feeds when fluid dribbles down from his mouth.
Respiratory: Denies any noted difficulty breathing or coughing.
Gastrointestinal: Regular bowel movements. Denies any diarrhea or bloody stools. Denies any constipation. Last bowel movement was earlier in the day. J.R. eats 6 ounces of breast milk or formula every 3 to 4 hours. Denies any noted trouble with swallowing. “Spitting up” episodes started about a month ago and occur during and after feeds. Denies any change in formula since birth. Mom consumes dairy twice a week into her diet.
Urinary: Denies any decrease in wet diapers. 8-10 a day is J.R.’s normal. Denies any prior urinary tract infections.
Objective Data.
J.R. is an awake and alert 3 month male who is smiling and cooing at his musical mobile hanging in his crib. He appears calm and comfortable. He occasionally turns his head to his mother’s voice when she is answering questions.
Physical Exam:
Vital Signs: Height: 50.8 cm. Weight: 3.63 kg HC: 24.5 cm. BP 86/54 Right Leg, Heart Rate 140 and normal sinus rhythm, respiratory rate 40, temperature 37.4 degrees Celsius (axillary). No signs of pain.
Skin: Generalized skin is clean, dry and intact. No signs of edema, redness, masses, bruises, scarring or rashes. Generalized skin pink in color, warm to touch, moist mucous membranes.
HEENT: Head: Normocephalic, no lesions or masses palpated. Eyes: PERRLA, symmetric, Pupils 2 to 3 mm constricting. Discs difficult to visualize, no hemorrhage noted. Ears: pinna clear of any drainage, mass, edema, or redness, no external abnormalities; External canals and tympanic membranes without presence of drainage, mass, redness or swelling. Nose: nares clear bilaterally of any mass, drainage, edema; septum midline. Mouth: moist mucous membranes. Tongue symmetric without evidence of edema, mass, or lesions; unable to assess uvula and tonsils.
Neck: Supple, patient turns head side to side as mother moves from one side of crib to the other. Midline trachea, no thyroid palpable.
Lungs: Good expansion. Clear to auscultation, with no audible wheezing, rales, or rhonchi. No apparent dyspnea, tachypnea, or retractions noted. No cough or congestion noted.
Abdomen: distended but soft and no signs of tenderness to palpation. No masses or lesions noted. Bowel sounds heard in all four quadrants. Tympanic to percussion throughout the abdominal cavity. Unable to percuss spleen, liver or kidneys. Spleen, liver, and kidneys not palpable.
Assessment.
1. GERD (Gastroesophageal reflux disease)
The data that supports GERD as the primary diagnosis is the “spitting up” episodes which the mom reports the patient has had for a month with the associated symptom of being colicky and irritable during and after feeds. The patient also has an underlying history of esophageal atresia and being a preemie. Poor weight gain is also noted in the patient. According to Aceti and Corvaglia (2010), typical symptoms are frequency and degree of regurgitation, vomiting, feeding intolerance, crying between feeds, hiccupping, and back arching. GERD includes underlying complications such as esophagitis which causes irritability in many infants. This is what differentiates simple GER and GERD which includes symptoms to developed complications. In addition, Aceti and Corvaglia (p. 405, 2010) report, “incidence of GER in preterm infants is believed to be higher than that in term infants”. In another article regarding GERD, Di Pace, Caruso, Catalano, Casuccio, Cimador, and De Grazia (2011), state that gastroesophageal reflux (GER) and dysmotility are frequently seen in patients treated for esophageal atresia. In this scenario, J.R. was born early at 32 weeks and had a history of esophageal atresia which supports the possible diagnosis of GERD. The patient presented with the majority of these symptoms and was fed by formula in addition to breast milk.
2. MILK PROTEIN ALLERGY:
The “spitting up” episodes reported by mom could be due to an allergic reaction. According to Allen, Davidson, Day, Hill, Kemp, Peake, Prescott, Shugg, Sinn, and Heine (2009), there is increasing evidence of an existing association between GERD and cow’s milk allergy. The reason that milk-protein allergy is presented as the second possible diagnosis is because it is a known differential diagnosis of GERD and it also has the similar symptom of vomiting. The rationale for it not being the primary diagnosis is due to the fact that there were no other evident symptoms supporting that it was a cow’s milk allergy. Some other symptoms related to cow’s milk allergy are diarrhea, eczema, and urticarial which were not reported in this scenario. Allen et. al (2009) validates that breast milk can contain intact cow’s milk antigens which can cause an allergic reaction in the infant. In addition, Allen et. al (2009), explains that Cow’s milk protein-induced gastro-oesophageal reflux disease (GORD) can present with the clinical features of frequent regurgitation and poor feeding.
3. OBSTRUCTION:
Obstruction is listed as a differential diagnosis of GERD in infants which can cause vomiting and irritability.

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1. What is the main Pathology for Eczema? who primarily get it and why?

2. How is this disease diagnosed and what are the necessary laboratory findings specific to this disease? Please include blood work, radiology, and necessary clinical tools for proper diagnosis in the medical community?

3. Are there any significant signs and symptoms common to this disease? *Are there similar disease’s that might get confused with this disease? Compare how you would rule in or out the differences between the different diseases similar to this one?

4. Is there a genetic component to this disease? And what is the like hood that it will be inherited?

5. How is this disease commonly treated in the medical community and what is the prognosis after treatment? Please include if there are any natural therapies accepted amongst the medical community? (natural therapies: massage, exercise, nutrition etc)

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Healthcare in the United States is at a crossroads and faces challenges unparalleled in our nation’s history. This project will be developed throughout the term as you learn more about health economics. The project is a 6-8 page paper (NOT including the title page or the reference page) that could be presented to either boards of directors or legislators to implement your plan.

Select a current health care economic issue such as the ACA, health care spending, prescription drugs, impact of current legislation on health care, medical care for an aging population, or the impact of illegal immigrants on health care economics in the United States or recommend for approval another topic in health economics. Be sure to address:

1. Description of the issue
2. Perform a literature search on the topic. Find at least five articles and provide a summary of the articles. Articles must be less than 5 years old.
3. Research and identify possible economic solutions. The solutions need not be extensive, but should represent possible solutions that have been identified in the research effort.
4. Explain each of your possible solutions that were identified including the pros and cons of each of the possible solutions.
5. Determine and explain which solution appears to be the most effective.
6. Explain your reasoning for choosing the proposed solution.
7. Explain why the solution will work.
8. List the steps that are needed to implement your solution.

This paper is to be formatted in APA style. Please seek out and use the embedded Librarians as well as all links and modules in the course!  Make sure to use APA style, references, and citations: https://apastyle.apa.org/instructional-aids/tutorials-webinars Links to an external site.

NOTE:

• 90 points are assessed/awarded based off this final submission, but the project is worth 100 points.
  • 5 points were already awarded for those who successfully submitted DRAFT – Health Reform Project (Instructor Feedback) on time.
  • 5 points were already awarded for those who successfully submitted Evidence of DRAFT Health Reform Project feedback from Writing Center on time.

Rubric

Some Rubric (1)

General Paper Recommendations:

– Watch your Turn-It-In similarity score.  Should not be higher than 20%.

– Be sure to review the literature, and include no less than five sources that are from 2015 or more recent.

– Best sources are from the library or google scholar. Please reach out to Dr. Soltau with the library if you need help finding some.

– Propose solutions to your issue, including both pros and cons of possible solutions.

– Discuss your best-proposed solution, why, and how you propose to implement it.

– Be sure your final paper is at least six pages of writing (double spaced), not including the title page or reference page. (8 pages total min).

– Take advantage of feedback from the writing center.  (You can submit multiple times.  They can help with APA style, spelling, grammar, etc.)

– The paper should be double spaced (APA writing style).

– All facts must be cited in APA style.

– A reference page with all references listed in APA style should end the paper.

– Try to limit the inclusion of direct quotes.  Better to rephrase in your own words and then properly cite as often as possible.

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Module 12: Using Excel for Data Management and Analysis 1

Module Activities

NOTE: Work for all activities should be on the same Excel file. Post your Excel file addressing activities 1-3 to the module discussion board by midnight on Friday.

Activity 1: Develop an Excel worksheet for data collection and management for your DNP project.

• Clearly state your research question(s) at the top of the
• For each research question, clearly identify the variables needed to answer the question. If there is are Independent and Dependent variables, clearly indicate this next to the variable.
• Clearly identify the source for your

Data Set 1 Headings

Data Set 2 Headings

The nature of the example project requires 2 different working data sets. Data set 1 records HEMS (helicopter EMS units) count by year. Data set 2 records patient level data. In order to keep everything in one place, 3 worksheets are created – Plan, HEMS Count, and Patient Data.

• Create the necessary worksheets for your DNP You will at least need a sheet for your Plan and another for your DNP Data. If other worksheets are needed, create them in your Excel file.
• Your project may not require multiple data sets. If one data set will work, stick with

Activity 2: Fabricate appropriate data to mimic what you expect things to look like for your DNP project.

• Use the sheets in the Excel file to fabricate data that approximates what you anticipate using for your project.
• Create enough entries to complete your
  • If you are using longitudinal data (e.g., weeks, months, or quarters), create at least 12 entries.
  • If you are using individual patient data, create at least 25
  • You can be creative but make the data

Here are what the HEMS example data look like:

Activity 3: Determine your analysis plan to answer your research question.

• What data cleaning or recoding need to be completed?
• What calculations need to be completed?
• What comparisons need to be completed?
• How will you display your data?

NOTE: The purpose of Activity 3 is to get you thinking about the analysis plan. Articulate what you want the data to tell you even if you don’t know the specific statistical test. During the planning phase of your DNP project, you will meet with a data analysist or statistician to determine a detailed data plan (including the analysis).

Here is the HEMS example analysis plan:

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Research Critique Guidelines – Part I
Use this document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples,andreference content from the studiesin your responses.
Qualitative Studies
Background of Study
1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.
How do these two articles support the nurse practice issue you chose?
1. Discuss how these two articles willbe used to answer your PICOT question.
2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.
Method of Study:
1. State the methods of the two articles you are comparing and describe how they are different.
2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.
Results of Study
1. Summarize the key findings of each study in one or two comprehensive paragraphs.
2. What are the implications of the two studies in nursing practice?
Ethical Considerations
1. Discuss two ethical considerationin conducting research.
2. Describe how the researchers in the two articles you choose took these ethical considerations into account while performing their research.

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In patients with stable CAD or CAD risk equivalents who have reduced left ventricular systolic function , what is the comparative effectiveness of ACE inhibitors or ARBs added to standard medical therapy when compared to standard medical therapy alone in

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Using 800-1,000 words, discuss methods to evaluate the effectiveness of your proposed solution and variables to be assessed when evaluating project outcomes.

Example: If you are proposing a new staffing matrix that is intended to reduce nurse turnover, improve nursing staff satisfaction, and positively impact overall delivery of care, you may decide the following methods and variables are necessary to evaluate the effectiveness of your proposed solution:

Methods:

1.Survey of staff attitudes and contributors to job satisfaction and dissatisfaction before and after initiating change.
2.Obtain turnover rates before and after initiating change.
3.Compare patient discharge surveys before change and after initiation of change.

Variables:

1.Staff attitudes and perceptions.
2.Patient attitudes and perceptions.
3.Rate of nursing staff turnover.

Develop the tools necessary to educate project participants and to evaluate project outcomes (surveys, questionnaires, teaching materials, PowerPoint slides, etc.).

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