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Category: Nursing

  • [Solved] nursing

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    In-depth study guidance and analytical solution covering nursing.

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  • [Solved] Response

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    See Attachment – 2 years ago **files (1)** – ## 6ab3RespOUT.pdf **## 6ab3RespOUT.pdf** Quant/Qual Response WHAT : REPLY to the TWO Discussion Posts FORMAT : APA with In-text Citation and Reference List REFERENCES : TWO Peer-Reviewed references minimum within last 5 years INCLUDE : Turnitin Report \…

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    See Attachment

    – 2 years ago

    **files (1)**

    – ## 6ab3RespOUT.pdf

    **## 6ab3RespOUT.pdf**

    Quant/Qual Response

    WHAT : REPLY to the TWO Discussion Posts

    FORMAT : APA with In-text Citation and Reference List

    REFERENCES : TWO Peer-Reviewed references minimum within last 5 years

    INCLUDE : Turnitin Report

    \* Please and THANK YOU *

    \_\_\_____________________

    MaGe

    Discussion Post Reply #1

    When comparing quantitative and qualitative research, it is clear they have different
    approaches to understanding the world. Quantitative research focuses on numbers and
    measurable data. Researchers use surveys, experiments, and statistical analysis to test
    theories and hypotheses. (Creswell & Creswell, 2018), An example of this type of
    research would be a study of the effectiveness of medications. The Quantitative
    method collects numerical data and analyzes it to look for patterns.

    Qualitative research is quite different from quantitative as it researches people’s
    experiences, thoughts, and emotions rather than numerical data. This type of research
    focuses on why things happen using methods such as observations and interviews.
    The goal of qualitative research is to answer more open-ended questions. (Bhandari,
    2023). A good example of a qualitative research method would be exploring how
    behavioral health patients feel about their medical treatment using observations and
    surveys.

    Another type of research is descriptive research, which can often be confused with
    qualitative research but is different. Descriptive research is a specific form of
    quantitative research that aims to outline the characteristics of populations without an
    explanation for cause and effect (Creswell & Creswell, 2018). Descriptive research
    focuses on making a clear picture of a specific phenomenon rather than looking into
    the deeper causes of it.

    Understanding the differences between quantitative, qualitative, and descriptive
    research is important for selecting the correct approach to answer research questions.
    Each of these methods has its strengths and is valuable depending on the specific
    goals of a study.

    JuKi

    Discussion Post Reply #2

    For week three assignment, I used the PICO(T) question: In adults with depression (P),
    does cognitive behavioral therapy (CBT) (I), compared to no CBT (C), reduce
    depressive symptoms (O) over six months (T)?

    The two types of research, quantitative and qualitative, were developed to analyze two
    different research methodologies. Qualitative research usually involves data that are not
    statistically quantifiable. The data are collected in open-ended questions or
    observations to explore experiences, behaviors, and meanings (Dehalwar & Sharma,
    2024). Studies that analyze depressed adult's perceptions of cognitive behavioral
    therapy (CBT) are not quantifiable and require qualitative research methods.
    Quantitative research, on the other hand, measures and analyzes the variables in
    numerical data and statistical significance (Barroga et al., 2023). For example, a study
    that examines whether a depressed patient's CBT affected the Patient Health
    Questionnaire – 9 (PHQ-9) score in a six-month duration would be quantitative
    research.

    Unlike qualitative research design, descriptive research can be quantitative, qualitative,
    or both. The descriptive design focuses on the objective data of 'what is happening,'
    while qualitative research explores 'why' and 'how' something happens. A descriptive
    research example would be observing the types of patients who seek CBT as the
    choice of depression treatment.

    **## 6ab3RespOUT.pdf**

    Quant/Qual Response

    WHAT : REPLY to the TWO Discussion Posts

    FORMAT : APA with In-text Citation and Reference List

    REFERENCES : TWO Peer-Reviewed references minimum within last 5 years

    INCLUDE : Turnitin Report

    \* Please and THANK YOU *

    \_\_\_____________________

    MaGe

    Discussion Post Reply #1

    When comparing quantitative and qualitative research, it is clear they have different
    approaches to understanding the world. Quantitative research focuses on numbers and
    measurable data. Researchers use surveys, experiments, and statistical analysis to test
    theories and hypotheses. (Creswell & Creswell, 2018), An example of this type of
    research would be a study of the effectiveness of medications. The Quantitative
    method collects numerical data and analyzes it to look for patterns.

    Qualitative research is quite different from quantitative as it researches people’s
    experiences, thoughts, and emotions rather than numerical data. This type of research
    focuses on why things happen using methods such as observations and interviews.
    The goal of qualitative research is to answer more open-ended questions. (Bhandari,
    2023). A good example of a qualitative research method would be exploring how
    behavioral health patients feel about their medical treatment using observations and
    surveys.

    Another type of research is descriptive research, which can often be confused with
    qualitative research but is different. Descriptive research is a specific form of
    quantitative research that aims to outline the characteristics of populations without an
    explanation for cause and effect (Creswell & Creswell, 2018). Descriptive research
    focuses on making a clear picture of a specific phenomenon rather than looking into
    the deeper causes of it.

    Understanding the differences between quantitative, qualitative, and descriptive
    research is important for selecting the correct approach to answer research questions.
    Each of these methods has its strengths and is valuable depending on the specific
    goals of a study.

    JuKi

    Discussion Post Reply #2

    For week three assignment, I used the PICO(T) question: In adults with depression (P),
    does cognitive behavioral therapy (CBT) (I), compared to no CBT (C), reduce
    depressive symptoms (O) over six months (T)?

    The two types of research, quantitative and qualitative, were developed to analyze two
    different research methodologies. Qualitative research usually involves data that are not
    statistically quantifiable. The data are collected in open-ended questions or
    observations to explore experiences, behaviors, and meanings (Dehalwar & Sharma,
    2024). Studies that analyze depressed adult's perceptions of cognitive behavioral
    therapy (CBT) are not quantifiable and require qualitative research methods.
    Quantitative research, on the other hand, measures and analyzes the variables in
    numerical data and statistical significance (Barroga et al., 2023). For example, a study
    that examines whether a depressed patient's CBT affected the Patient Health
    Questionnaire – 9 (PHQ-9) score in a six-month duration would be quantitative
    research.

    Unlike qualitative research design, descriptive research can be quantitative, qualitative,
    or both. The descriptive design focuses on the objective data of 'what is happening,'
    while qualitative research explores 'why' and 'how' something happens. A descriptive
    research example would be observing the types of patients who seek CBT as the
    choice of depression treatment.

  • [Solved] Wk5 disc trans ay

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    **Post a description of at least one potential benefit of using big data as part of a clinical system and explain why. Then, describe at least one potential challenge or risk of using big data as part of a clinical system and explain why. Propose at least one strategy you have experienced, observed,…

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    Assignment Prompt & Instructions

    **Post a description of at least one potential benefit of using big data as part of a clinical system and explain why. Then, describe at least one potential challenge or risk of using big data as part of a clinical system and explain why. Propose at least one strategy you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using big data you described. Be specific and provide examples.**

    – 2 years ago

  • [Solved] WK 5 RESP EPID

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    – 2 years ago **files (1)** – ## WK5DISEPID.docx **## WK5DISEPID.docx** Measures Used in Epidemiology ![A group of people sitting at a table AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-epid)One important application of epidemiology is to identify factors th…

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    – 2 years ago

    **files (1)**

    – ## WK5DISEPID.docx

    **## WK5DISEPID.docx**

    Measures Used in Epidemiology

    ![A group of people sitting at a table AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-epid)One important application of epidemiology is to identify factors that could increase the likelihood of a certain health problem occurring within a specific population. Epidemiologists use
    _measures of effect_ to examine the association or linkage in the relationship between risk factors and emergence of disease or ill health. For instance, they may use measures of effect to better understand the relationships between poverty and lead poisoning in children, smoking and heart disease, or low birth weight and future motor skills. The following are some common measures used in epidemiology:

    ·
    **Odds ratio**: The odds ratio quantifies the association between an independent variable (exposure) and a dependent variable (outcome). It is calculated as the odds that an effect will occur given the presence or exposure to a studied variable, compared to the odds when there is no exposure (e.g., lung cancer and smoking)

    ·
    **Risk ratio (also called relative risk)**: Also quantifies the association between an independent variable and a dependent variable. The risk of an effect occurring in one population versus another population (e.g., preeclampsia in women <35 versus >35). Risks greater than one suggest that exposure to a given variable is associated with an increase in the risk of the outcome, and a risk ratio of less than one indicates that the exposure is associated with a decrease in the risk of the outcome.

    ·
    **Mortality**: Measure of deaths in a particular population during a specified time interval. If this is attributed to a specific cause, it is referred to as cause-specific mortality.

    ·
    **Morbidity**: Measure of instances of illness or disability in a population from a given cause (e.g., heart disease) during a specified time interval

    ·
    **Incidence**: The occurrence of new cases of an effect or disease in a population over a defined time period relative to the size of the population at risk (e.g., new cases of COVID-19 in a population over a 7-day period/1000 people)

    ·
    **Prevalence**: The number of all cases of an effect or disease, not just new ones, in a population at a given time relative to the size of the population (e.g., number of people with autism/1000)

    What is the significance of these measures of effect for nursing practice? In this Discussion, you will consider this pivotal question.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/155998/modules/items/6259844)

    [Required Readings](https://waldenu.instructure.com/courses/155998/pages/week-5-learning-resources?module_item_id=6259844)

    · Curley, A. L. C. (Ed.). (2024).
    _Population-based nursing: Concepts and competencies for advanced practice_ (4th ed.). Springer.

    · Chapter 4, “Epidemiological Methods and Measurements in Population-Based Nursing Practice: Part I” (pp. 68-105)

    · Friis, R. H., & Sellers, T. A. (2021).
    _Epidemiology for public health practice_ (6th ed.). Jones & Bartlett.

    · Chapter 3, “Measures of Morbidity and Mortality Used in Epidemiology”

    · Chapter 9, “Measures of Effect”

    To prepare:

    · Select item 1, 2, or 3 to use for this Discussion. Consider the definitions, differences, and utility of the two terms listed under your item selection. Your response will need to include both terms in the item selected.

    1. Odds ratio and risk ratio

    2. Mortality and morbidity

    3. Incidence and prevalence

    · Consider how these epidemiologic measures strengthen and support nursing practice.

    · Assess practice limitations of not using these measures in nursing practice.

    · Conduct additional research in the Walden Library and other credible resources, and then locate two examples in the scholarly literature that support your insights.

    By Day 3 of Week 5

    **Post** a cohesive scholarly response that addresses the following:

    · Explain how your selected measures of effect strengthen and support nursing practice. Provide at least two specific examples from the literature to substantiate your insights.

    · Assess limitations of
    **not** using measures of effect in nursing practice.

    By Day 6 of Week 5

    **Respond** to
    **at least two** colleagues on
    **two different days** in one or more of the following ways:

    · Ask a probing question, substantiated with additional background information, evidence or research.

    · Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    · Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    · Validate an idea with your own experience and additional research.

    · Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    · Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    RESPOND TO THIS DISCUSSION POST

    In nursing and public health, incidence and prevalence are important epidemiological terms that help nurses understand patterns of disease in populations. Although both terms relate to disease occurrence, they measure different aspects. Incidence refers to the number of new cases of a disease or condition that occur in a specific population during a particular time period. It reflects the risk of developing the disease. On the other hand, prevalence measures the total number of cases, both new and existing, in a population at a

    specific point in time or over a period of time. This reflects the overall burden of disease within a population.

    Understanding incidence and prevalence strengthens nursing practice by helping nurses plan patient care, disease prevention, and health education. For example, high incidence rates signal the need for stronger preventive measures and early detection strategies. Prevalence data helps nurses understand how widespread a health issue is, allowing them to allocate resources and plan for long-term care. If nurses did not use these measures, they might underestimate the scale of disease or fail to identify emerging health threats. This could result in inadequate patient education, prevention efforts, or clinical interventions.

    One example from the literature is a study by Dehkordi et al. (2022), which examined the incidence of pressure ulcers in hospitalized patients. The study's findings highlighted the need for continuous monitoring and preventive care by nurses to reduce the occurrence of pressure ulcers. Without measuring incidence, nurses would lack the data needed to advocate for better prevention strategies. Another study by Sanyaolu et al. (2020) focused on the prevalence of comorbidities in COVID-19 patients. Knowing the prevalence of certain conditions in patients allowed nurses and healthcare teams to identify high-risk groups and adjust care plans accordingly.

    In conclusion, incidence and prevalence are critical measures that allow nurses to anticipate health care needs, implement prevention programs, and deliver patient-centered care. Without these measures, nursing practice would lack the data-driven foundation necessary for effective public health and clinical decision-making.

    **References**
    Dehkordi, A. H., Shahinfar, J., & Ganjoo, P. (2022). Incidence and risk factors of

    pressure ulcers in hospitalized patients: A systematic review.
    _International Wound Journal_, 19(3), 624–635. https://doi.org/10.1111/iwj.13640

    Sanyaolu, A., Okorie, C., Marinkovic, A., et al. (2020). Comorbidity and its impact on patients with COVID-19.
    _SN Comprehensive Clinical Medicine_, 2, 1069–1076. https://doi.org/10.1007/s42399-020-00363-4

    ## image1.jpeg

    **## WK5DISEPID.docx**

    Measures Used in Epidemiology

    ![A group of people sitting at a table AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-epid)One important application of epidemiology is to identify factors that could increase the likelihood of a certain health problem occurring within a specific population. Epidemiologists use
    _measures of effect_ to examine the association or linkage in the relationship between risk factors and emergence of disease or ill health. For instance, they may use measures of effect to better understand the relationships between poverty and lead poisoning in children, smoking and heart disease, or low birth weight and future motor skills. The following are some common measures used in epidemiology:

    ·
    **Odds ratio**: The odds ratio quantifies the association between an independent variable (exposure) and a dependent variable (outcome). It is calculated as the odds that an effect will occur given the presence or exposure to a studied variable, compared to the odds when there is no exposure (e.g., lung cancer and smoking)

    ·
    **Risk ratio (also called relative risk)**: Also quantifies the association between an independent variable and a dependent variable. The risk of an effect occurring in one population versus another population (e.g., preeclampsia in women <35 versus >35). Risks greater than one suggest that exposure to a given variable is associated with an increase in the risk of the outcome, and a risk ratio of less than one indicates that the exposure is associated with a decrease in the risk of the outcome.

    ·
    **Mortality**: Measure of deaths in a particular population during a specified time interval. If this is attributed to a specific cause, it is referred to as cause-specific mortality.

    ·
    **Morbidity**: Measure of instances of illness or disability in a population from a given cause (e.g., heart disease) during a specified time interval

    ·
    **Incidence**: The occurrence of new cases of an effect or disease in a population over a defined time period relative to the size of the population at risk (e.g., new cases of COVID-19 in a population over a 7-day period/1000 people)

    ·
    **Prevalence**: The number of all cases of an effect or disease, not just new ones, in a population at a given time relative to the size of the population (e.g., number of people with autism/1000)

    What is the significance of these measures of effect for nursing practice? In this Discussion, you will consider this pivotal question.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/155998/modules/items/6259844)

    [Required Readings](https://waldenu.instructure.com/courses/155998/pages/week-5-learning-resources?module_item_id=6259844)

    · Curley, A. L. C. (Ed.). (2024).
    _Population-based nursing: Concepts and competencies for advanced practice_ (4th ed.). Springer.

    · Chapter 4, “Epidemiological Methods and Measurements in Population-Based Nursing Practice: Part I” (pp. 68-105)

    · Friis, R. H., & Sellers, T. A. (2021).
    _Epidemiology for public health practice_ (6th ed.). Jones & Bartlett.

    · Chapter 3, “Measures of Morbidity and Mortality Used in Epidemiology”

    · Chapter 9, “Measures of Effect”

    To prepare:

    · Select item 1, 2, or 3 to use for this Discussion. Consider the definitions, differences, and utility of the two terms listed under your item selection. Your response will need to include both terms in the item selected.

    1. Odds ratio and risk ratio

    2. Mortality and morbidity

    3. Incidence and prevalence

    · Consider how these epidemiologic measures strengthen and support nursing practice.

    · Assess practice limitations of not using these measures in nursing practice.

    · Conduct additional research in the Walden Library and other credible resources, and then locate two examples in the scholarly literature that support your insights.

    By Day 3 of Week 5

    **Post** a cohesive scholarly response that addresses the following:

    · Explain how your selected measures of effect strengthen and support nursing practice. Provide at least two specific examples from the literature to substantiate your insights.

    · Assess limitations of
    **not** using measures of effect in nursing practice.

    By Day 6 of Week 5

    **Respond** to
    **at least two** colleagues on
    **two different days** in one or more of the following ways:

    · Ask a probing question, substantiated with additional background information, evidence or research.

    · Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    · Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    · Validate an idea with your own experience and additional research.

    · Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    · Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    RESPOND TO THIS DISCUSSION POST

    In nursing and public health, incidence and prevalence are important epidemiological terms that help nurses understand patterns of disease in populations. Although both terms relate to disease occurrence, they measure different aspects. Incidence refers to the number of new cases of a disease or condition that occur in a specific population during a particular time period. It reflects the risk of developing the disease. On the other hand, prevalence measures the total number of cases, both new and existing, in a population at a

    specific point in time or over a period of time. This reflects the overall burden of disease within a population.

    Understanding incidence and prevalence strengthens nursing practice by helping nurses plan patient care, disease prevention, and health education. For example, high incidence rates signal the need for stronger preventive measures and early detection strategies. Prevalence data helps nurses understand how widespread a health issue is, allowing them to allocate resources and plan for long-term care. If nurses did not use these measures, they might underestimate the scale of disease or fail to identify emerging health threats. This could result in inadequate patient education, prevention efforts, or clinical interventions.

    One example from the literature is a study by Dehkordi et al. (2022), which examined the incidence of pressure ulcers in hospitalized patients. The study's findings highlighted the need for continuous monitoring and preventive care by nurses to reduce the occurrence of pressure ulcers. Without measuring incidence, nurses would lack the data needed to advocate for better prevention strategies. Another study by Sanyaolu et al. (2020) focused on the prevalence of comorbidities in COVID-19 patients. Knowing the prevalence of certain conditions in patients allowed nurses and healthcare teams to identify high-risk groups and adjust care plans accordingly.

    In conclusion, incidence and prevalence are critical measures that allow nurses to anticipate health care needs, implement prevention programs, and deliver patient-centered care. Without these measures, nursing practice would lack the data-driven foundation necessary for effective public health and clinical decision-making.

    **References**
    Dehkordi, A. H., Shahinfar, J., & Ganjoo, P. (2022). Incidence and risk factors of

    pressure ulcers in hospitalized patients: A systematic review.
    _International Wound Journal_, 19(3), 624–635. https://doi.org/10.1111/iwj.13640

    Sanyaolu, A., Okorie, C., Marinkovic, A., et al. (2020). Comorbidity and its impact on patients with COVID-19.
    _SN Comprehensive Clinical Medicine_, 2, 1069–1076. https://doi.org/10.1007/s42399-020-00363-4

    ## image1.jpeg

  • [Solved] Weekly Clincal experience in a pediatric clinic

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    Describe your clinical experience this week in the pediatric clinic as a student family nurse practitioner. · Did you face any challenges, any success? If so, what were they? · Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 poss…

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    Assignment Prompt & Instructions

    Describe your clinical experience this week in the pediatric clinic as a student family nurse practitioner.

    ·  Did you face any challenges, any success? If so, what were they?

    ·  Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.

    ·  Mention the health promotion intervention for this patient.

    ·  What did you learn from this week's clinical experience that can beneficial for you as an advanced practice nurse?

    ·  Support your plan of care with the current peer-reviewed research guideline.

    **Submission Instructions:**

    ·  Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

    – 2 years ago

  • [Solved] week 10 Discussion & Reflection

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    In-depth study guidance and analytical solution covering week 10 Discussion & Reflection.

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    Assignment Prompt & Instructions

    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.

  • [Solved] Research Critiques and Evidence-Based Practice Proposal

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    – 2 years ago **files (3)** – ## NRS-445-RS-ResearchCritiquePICOTGuidelines.docx – ## NRS-445-RS-T1-LiteratureEvaluationTable.docx – NRS-445Rubric-RoughDraft-ResearchCritiquesandEvidence-BasedPracticeProposal.pdf **## NRS-445-RS-ResearchCritiquePICOTGuidelines.docx** ![cid:D7D4B297-EEAE-4174-AD01-F8…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (3)**

    – ## NRS-445-RS-ResearchCritiquePICOTGuidelines.docx

    – ## NRS-445-RS-T1-LiteratureEvaluationTable.docx

    – NRS-445Rubric-RoughDraft-ResearchCritiquesandEvidence-BasedPracticeProposal.pdf

    **## NRS-445-RS-ResearchCritiquePICOTGuidelines.docx**

    ![cid:D7D4B297-EEAE-4174-AD01-F87097282051@canyon.com](https://www.sweetstudy.com/questions/research-critiques-and-evidence-based-practice-proposal)

    **NRS-445: Research Critiques and Evidence-Based Practice Change Proposal Guidelines**

    Use this document to synthesize the information from your "Literature Evaluation Table" from Topic 1 into a literature review. Successful completion of this assignment requires that you use your conclusions from your literature review to propose an evidence-based practice change.

    **_Introduction_**

    · Introduce your nursing practice problem and discuss the purpose of your paper.

    · State your updated PICOT question incorporating any feedback that you received from your instructor.

    **_Method of Studies_**

    · State the methods of the four articles you are comparing and describe how each method helps answer the associated research question.

    **_Results of Studies/Key Findings_**

    · Summarize the key findings of the four studies.

    **_Outcomes Comparison_**

    · What are the anticipated outcomes for your PICOT question?

    · How do the outcomes of the four articles you chose compare to your anticipated outcomes?

    **_Proposed Evidence-Based Practice Change_**

    · What is the link between the PICOT question, the research articles, and the nursing practice problem you identified?

    · Based on this information, propose an evidence-based practice change to improve outcomes of patient care for your identified setting.

    · Suggest one way to assess outcomes for the proposed practice change to determine whether or not it is effective.

    **_Conclusion_**

    · Your conclusion should summarize the main points in the essay, including a varied restatement of the thesis.

    © 2023. Grand Canyon University. All Rights Reserved.

    2

    ## image1.jpeg

    **## NRS-445-RS-T1-LiteratureEvaluationTable.docx**

    1

    **NRS-445 Topic 1: Literature Evaluation Table**

    **Student Name:**

    **Faculty Name:**

    **Background of Nursing Practice Problem (one paragraph; no more than 250 words):**

    Despite available pharmacologic and non-pharmacologic interventions, patient symptoms often remain poorly managed, and patient prognosis remains poor throughout the world. As widely known, patients with HF have high rates of readmission, mainly because of episodes of worsening of the disease, thus putting a burden on the healthcare facilities and the patients. Conventional approaches to follow-up and supervision of the heart failure patients entail regular hospital check-ups, which are inconvenient, especially for the elderly patients (Krzesiński, et al 2022). New technologies like telemedicine interventions that may include monitoring of the patient’s vital signs at his/her home can be a solution to the problem by enhancing the patient’s quality of care yet minimizing cases of readmission. All these interventions ensure that patients are closely watched in real-time and more so when a particular patient’s condition worsens. However, future studies are required to support the effectiveness of such interventions for preventing readmissions and enhancing the self-management of heart failure at home (Stergiopoulos, et al 2024). The possible enhancement of the patients’ condition and reduction in the costs of treatment make the telemedicine application an important subject in the management of HF.

    ****References:****

    **Krzesiński, P., Jankowska, E. A., Siebert, J., Galas, A., Piotrowicz, K., Stańczyk, A., Siwołowski, P., Gutknecht, P., Chrom, P., Murawski, P., Walczak, A., Szalewska, D., Banasiak, W., Ponikowski, P., & Gielerak, G. (2022). Effects of an outpatient intervention comprising nurse‐led non‐invasive assessments, telemedicine support and remote cardiologists’ decisions in patients with heart failure (AMULET study): a randomised controlled trial. European Journal of Heart Failure, 24(3), 565–577.**
    **[https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358](https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358)**

    **Georgios M. Stergiopoulos, Anissa N. Elayadi, Edward S. Chen, & Panagis Galiatsatos. (2024). The effect of telemedicine employing telemonitoring instruments on readmissions of patients with heart failure and/or COPD: a systematic review. Frontiers in Digital Health, 6.**
    **[https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334](https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334)**

    ****PICO(T) Question:** _Use the PICOT question developed in Topic 1 Discussion Question (DQ) 2 and refine it as needed._**

    **| | | |**
    **| — | — | — |**
    **| **PICO(T) Question Template** |**
    **| **P** | **Population** | In heart failure patients (P) |**
    **| **I** | **Intervention** | How does home-based telemedicine use remote monitoring (I) |**
    **| **C** | **Comparison** | Compared to standard care (C) |**
    **| **O** | **Outcome** | Affect hospital readmission rates (O) |**
    **| **T** | **Timeline**<br>_(optional)_ | Within 12 months (T) |**
    **| **Intervention** |**
    **| In_<br>heart failure patients_(P), how does _<br>home-based telemedicine using remote monitoring_ (I) compared to <br>standard care (C) affect _<br>hospital readmission rates_ (O) within_<br>12 months_(T)? |**
    **| **Problem Statement** |**
    **| It is not known if the implementation of <br>_home-based telemedicine based on remote monitoring_(I) would impact <br>changes on hospital readmission rates (O) among <br>heart failure patients (P). |**

    **| | | | | |**
    **| — | — | — | — | — |**
    **| **Criteria** | **Article 1** | **Article 2** | **Article 3** | **Article 4** |**
    **| **APA Reference**<br>Include the GCU permalink or working link used to access the article | Krzesiński, P., Jankowska, E. A., Siebert, J., Galas, A., Piotrowicz, K., Stańczyk, A., … & Gielerak, G. (2022). Effects of an outpatient intervention comprising nurse‐led non‐invasive assessments, telemedicine support, and remote cardiologists' decisions in patients with heart failure (AMULET study): A randomized controlled trial. <br>_European Journal of Heart Failure, 24_(3), 565-577.<br> <br>[https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358](https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358) | Georgios M. Stergiopoulos, Anissa N. Elayadi, Edward S. Chen, & Panagis Galiatsatos. (2024). The effect of telemedicine employing telemonitoring instruments on readmissions of patients with heart failure and/or COPD: a systematic review. Frontiers in Digital Health, 6. <br>[https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334](https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334) | Thi Xuan Hanh Vo, Marie-Pascale Pomey, Loyda Jean Charles, Paula A. B. Ribeiro, Stéphanie Béchard, Émilie Rémillard, Shana Grigoletti, John Nguyen, Pascale Lehoux, Emmanuel Marier-Tétrault, & Francois Tournoux. (2024). Patients’ experience using an app for home remote monitoring of heart failure for a university hospital in Quebec, Canada. BMC Digital Health, 2(1), 1–12. <br>[https://doi-org.lopes.idm.oclc.org/10.1186/s44247-024-00126-4](https://doi-org.lopes.idm.oclc.org/10.1186/s44247-024-00126-4) | Jocelyn Carter, Karen Donelan, & Anne N. Thorndike. (2022). Patient Perspectives on Home-Based Care and Remote Monitoring in Heart Failure: A Qualitative Study. Journal of Primary Care & Community Health, 13. <br>[https://doi-org.lopes.idm.oclc.org/10.1177/21501319221133672](https://doi-org.lopes.idm.oclc.org/10.1177/21501319221133672) |**
    **| **Purpose/Aim of Study** | The paper assesses the effectiveness of nurse-led telecare with referral to remote consultation or the cardiologist in relation to hospital readmission as well as mortality in patients with heart failure. | The following paper aims to determine the effectiveness of telemedicine as well as telemonitoring in decreasing the rate of hospital readmissions among heart failure and COPD patients. | The paper aims to assess the positive and negative aspects of the remote telemonitoring mobile application in heart failure patients and its impact on their disease. | The research aims at describing home-based care and remote monitoring experiences of heart failure patients as well as their perceptions and attitude towards the interventions. |**
    **| **Research question(s)** | Is telecare with telemedicine administered by a nurse effective in lowering hospitalization rates and cardiovascular mortality in heart failure patients? | Does telemedicine use the telemonitoring technique attenuate hospital readmissions among heart failure and COPD patients? | What is the experience of heart failure patients in using a mobile app for home remote monitoring for managing their condition? | What is the patient heart failure perception on home based care and remote monitoring? |**
    **| **Design**<br>Is the article qualitative, quantitative, or mixed methods? Explain how you determined the type of research design. | Quantitative, randomized controlled trial. It is done randomly through selection of patients for the study and assessment of indicators such as rates and number of readmissions and number of deaths. | Quantitative, systematic review of studies. This is established based on the integration of several empirical studies that have sought to ascertain the performance of telemedicine. | Qualitative, semi-structured interviews with thematic analysis. | Qualitative, using semi-structured interviews and thematic analysis. |**
    **| **Setting**<br>Where did the study take place? What type of setting: inpatient, outpatient, etc.? | Outpatient setting in multiple centers across Poland. | Various healthcare settings across multiple studies reviewed. | University hospital in Quebec, Canada. | Primary care and community health settings. |**
    **| **Sample**<br>Number and characteristics of participants | It enrolled 605 patients with heart failure and left ventricular ejection fraction ≤49%. | 29 studies on the telemonitoring in heart failure and COPD, 4,326 patients. | 12 heart failure patients using TakeCare™ app for at least 3 months. | 24 heart failure patients. |**
    **| **Methods**<br>Interventions/Instruments | They were given nurse led assessment with support from telemedicine. Based on the findings, hospital readmissions and mortality are two other factors that were established as outcomes of the condition. | Randomized controlled trials and cohort studies were pool for meta-analysis. | Patients should be asked questions aimed at establishing their experiences with the app. | To probe patient perspectives, in depth interviews. |**
    **| **Analysis**<br>How were the collected data analyzed? | Statistical methods were used on data analysis in order to determine the readmission rates between the intervention and control groups. | Meta-analysis of the readmission rates of the considered trials, which resulted in an aggregate odds ratio for telemedicine interventions. | This paper presents thematic analysis of interview data to identify common themes in patients’ experiences. | The interview data selected for thematic analysis for key themes. |**
    **| **Outcomes/key findings** of the study and implications for nursing practice<br> <br>Summary of study results | According to the findings of the study, telecare had a positive impact in doing away with cases of readmission to the hospital and cases of cardio vascular deaths meaning that telemedicine is very important in the management of chronic illnesses. | The telemedicine telemonitoring examination showed that such strategy helps to decrease the level of readmission to the hospital, and thus refutes the idea that remote care should be limited. | It was evidenced, mostly, that the patients benefited from the app interface, and the general facility achieved through the application to be connected to the healthcare team. | The work of the article is that patients were glad to have an opportunity to get more connected with their healthcare providers and manage diseases easier. |**
    **| **Recommendations of the researcher** | Ideally, one should build on the current application of nurse-led telecare interventions in heart failure treatment and enhance its usage in improving more patient results and the outcome of the healthcare industry’s spending. | Integrate telemedicine and telemonitoring services in the day-to-day practice in the treatment of chronic illnesses to minimize cases of readmissions. | Increase the patient experience component and the approaches used in communiqué to thus increase optimism. | Strengthen patient knowledge concerning the application of remote monitoring technologies and adaptation into their daily schedule. |**
    **| **Explain how this article supports your proposed PICO(T) question.** | This study ties into the disease area of heart failure and the effects of telemedicine interventions on readmissions; therefore, it is closely connected to the PICOT question. | This article directly supports the PICOT question by presenting significant evidence that telemedicine has a positive impact on hospital readmissions. | The presented article sheds light on the patients’ readiness to utilize remote monitoring solutions – one of the key aspects using telemedicine in the case of heart failure. | This article supports the PICOT question by providing information on patient handling with remote monitoring technologies as an important factor that determines the effects of such interventions on hospital readmission. |**

    **© 2023. Grand Canyon University. All Rights Reserved.**

    **11**

    **NRS-445Rubric-RoughDraft-ResearchCritiquesandEvidence-BasedPracticeProposal.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nrs-445rubric-roughdraft-researchcritiquesandevidence-basedpracticeproposal-pdf-10237009)

    **NRS-445Rubric-RoughDraft-ResearchCritiquesandEvidence-BasedPracticeProposal.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nrs-445rubric-roughdraft-researchcritiquesandevidence-basedpracticeproposal-pdf-10237009)

    **## NRS-445-RS-ResearchCritiquePICOTGuidelines.docx**

    ![cid:D7D4B297-EEAE-4174-AD01-F87097282051@canyon.com](https://www.sweetstudy.com/questions/research-critiques-and-evidence-based-practice-proposal)

    **NRS-445: Research Critiques and Evidence-Based Practice Change Proposal Guidelines**

    Use this document to synthesize the information from your "Literature Evaluation Table" from Topic 1 into a literature review. Successful completion of this assignment requires that you use your conclusions from your literature review to propose an evidence-based practice change.

    **_Introduction_**

    · Introduce your nursing practice problem and discuss the purpose of your paper.

    · State your updated PICOT question incorporating any feedback that you received from your instructor.

    **_Method of Studies_**

    · State the methods of the four articles you are comparing and describe how each method helps answer the associated research question.

    **_Results of Studies/Key Findings_**

    · Summarize the key findings of the four studies.

    **_Outcomes Comparison_**

    · What are the anticipated outcomes for your PICOT question?

    · How do the outcomes of the four articles you chose compare to your anticipated outcomes?

    **_Proposed Evidence-Based Practice Change_**

    · What is the link between the PICOT question, the research articles, and the nursing practice problem you identified?

    · Based on this information, propose an evidence-based practice change to improve outcomes of patient care for your identified setting.

    · Suggest one way to assess outcomes for the proposed practice change to determine whether or not it is effective.

    **_Conclusion_**

    · Your conclusion should summarize the main points in the essay, including a varied restatement of the thesis.

    © 2023. Grand Canyon University. All Rights Reserved.

    2

    ## image1.jpeg

    **## NRS-445-RS-T1-LiteratureEvaluationTable.docx**

    1

    **NRS-445 Topic 1: Literature Evaluation Table**

    **Student Name:**

    **Faculty Name:**

    **Background of Nursing Practice Problem (one paragraph; no more than 250 words):**

    Despite available pharmacologic and non-pharmacologic interventions, patient symptoms often remain poorly managed, and patient prognosis remains poor throughout the world. As widely known, patients with HF have high rates of readmission, mainly because of episodes of worsening of the disease, thus putting a burden on the healthcare facilities and the patients. Conventional approaches to follow-up and supervision of the heart failure patients entail regular hospital check-ups, which are inconvenient, especially for the elderly patients (Krzesiński, et al 2022). New technologies like telemedicine interventions that may include monitoring of the patient’s vital signs at his/her home can be a solution to the problem by enhancing the patient’s quality of care yet minimizing cases of readmission. All these interventions ensure that patients are closely watched in real-time and more so when a particular patient’s condition worsens. However, future studies are required to support the effectiveness of such interventions for preventing readmissions and enhancing the self-management of heart failure at home (Stergiopoulos, et al 2024). The possible enhancement of the patients’ condition and reduction in the costs of treatment make the telemedicine application an important subject in the management of HF.

    ****References:****

    **Krzesiński, P., Jankowska, E. A., Siebert, J., Galas, A., Piotrowicz, K., Stańczyk, A., Siwołowski, P., Gutknecht, P., Chrom, P., Murawski, P., Walczak, A., Szalewska, D., Banasiak, W., Ponikowski, P., & Gielerak, G. (2022). Effects of an outpatient intervention comprising nurse‐led non‐invasive assessments, telemedicine support and remote cardiologists’ decisions in patients with heart failure (AMULET study): a randomised controlled trial. European Journal of Heart Failure, 24(3), 565–577.**
    **[https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358](https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358)**

    **Georgios M. Stergiopoulos, Anissa N. Elayadi, Edward S. Chen, & Panagis Galiatsatos. (2024). The effect of telemedicine employing telemonitoring instruments on readmissions of patients with heart failure and/or COPD: a systematic review. Frontiers in Digital Health, 6.**
    **[https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334](https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334)**

    ****PICO(T) Question:** _Use the PICOT question developed in Topic 1 Discussion Question (DQ) 2 and refine it as needed._**

    **| | | |**
    **| — | — | — |**
    **| **PICO(T) Question Template** |**
    **| **P** | **Population** | In heart failure patients (P) |**
    **| **I** | **Intervention** | How does home-based telemedicine use remote monitoring (I) |**
    **| **C** | **Comparison** | Compared to standard care (C) |**
    **| **O** | **Outcome** | Affect hospital readmission rates (O) |**
    **| **T** | **Timeline**<br>_(optional)_ | Within 12 months (T) |**
    **| **Intervention** |**
    **| In_<br>heart failure patients_(P), how does _<br>home-based telemedicine using remote monitoring_ (I) compared to <br>standard care (C) affect _<br>hospital readmission rates_ (O) within_<br>12 months_(T)? |**
    **| **Problem Statement** |**
    **| It is not known if the implementation of <br>_home-based telemedicine based on remote monitoring_(I) would impact <br>changes on hospital readmission rates (O) among <br>heart failure patients (P). |**

    **| | | | | |**
    **| — | — | — | — | — |**
    **| **Criteria** | **Article 1** | **Article 2** | **Article 3** | **Article 4** |**
    **| **APA Reference**<br>Include the GCU permalink or working link used to access the article | Krzesiński, P., Jankowska, E. A., Siebert, J., Galas, A., Piotrowicz, K., Stańczyk, A., … & Gielerak, G. (2022). Effects of an outpatient intervention comprising nurse‐led non‐invasive assessments, telemedicine support, and remote cardiologists' decisions in patients with heart failure (AMULET study): A randomized controlled trial. <br>_European Journal of Heart Failure, 24_(3), 565-577.<br> <br>[https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358](https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358) | Georgios M. Stergiopoulos, Anissa N. Elayadi, Edward S. Chen, & Panagis Galiatsatos. (2024). The effect of telemedicine employing telemonitoring instruments on readmissions of patients with heart failure and/or COPD: a systematic review. Frontiers in Digital Health, 6. <br>[https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334](https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334) | Thi Xuan Hanh Vo, Marie-Pascale Pomey, Loyda Jean Charles, Paula A. B. Ribeiro, Stéphanie Béchard, Émilie Rémillard, Shana Grigoletti, John Nguyen, Pascale Lehoux, Emmanuel Marier-Tétrault, & Francois Tournoux. (2024). Patients’ experience using an app for home remote monitoring of heart failure for a university hospital in Quebec, Canada. BMC Digital Health, 2(1), 1–12. <br>[https://doi-org.lopes.idm.oclc.org/10.1186/s44247-024-00126-4](https://doi-org.lopes.idm.oclc.org/10.1186/s44247-024-00126-4) | Jocelyn Carter, Karen Donelan, & Anne N. Thorndike. (2022). Patient Perspectives on Home-Based Care and Remote Monitoring in Heart Failure: A Qualitative Study. Journal of Primary Care & Community Health, 13. <br>[https://doi-org.lopes.idm.oclc.org/10.1177/21501319221133672](https://doi-org.lopes.idm.oclc.org/10.1177/21501319221133672) |**
    **| **Purpose/Aim of Study** | The paper assesses the effectiveness of nurse-led telecare with referral to remote consultation or the cardiologist in relation to hospital readmission as well as mortality in patients with heart failure. | The following paper aims to determine the effectiveness of telemedicine as well as telemonitoring in decreasing the rate of hospital readmissions among heart failure and COPD patients. | The paper aims to assess the positive and negative aspects of the remote telemonitoring mobile application in heart failure patients and its impact on their disease. | The research aims at describing home-based care and remote monitoring experiences of heart failure patients as well as their perceptions and attitude towards the interventions. |**
    **| **Research question(s)** | Is telecare with telemedicine administered by a nurse effective in lowering hospitalization rates and cardiovascular mortality in heart failure patients? | Does telemedicine use the telemonitoring technique attenuate hospital readmissions among heart failure and COPD patients? | What is the experience of heart failure patients in using a mobile app for home remote monitoring for managing their condition? | What is the patient heart failure perception on home based care and remote monitoring? |**
    **| **Design**<br>Is the article qualitative, quantitative, or mixed methods? Explain how you determined the type of research design. | Quantitative, randomized controlled trial. It is done randomly through selection of patients for the study and assessment of indicators such as rates and number of readmissions and number of deaths. | Quantitative, systematic review of studies. This is established based on the integration of several empirical studies that have sought to ascertain the performance of telemedicine. | Qualitative, semi-structured interviews with thematic analysis. | Qualitative, using semi-structured interviews and thematic analysis. |**
    **| **Setting**<br>Where did the study take place? What type of setting: inpatient, outpatient, etc.? | Outpatient setting in multiple centers across Poland. | Various healthcare settings across multiple studies reviewed. | University hospital in Quebec, Canada. | Primary care and community health settings. |**
    **| **Sample**<br>Number and characteristics of participants | It enrolled 605 patients with heart failure and left ventricular ejection fraction ≤49%. | 29 studies on the telemonitoring in heart failure and COPD, 4,326 patients. | 12 heart failure patients using TakeCare™ app for at least 3 months. | 24 heart failure patients. |**
    **| **Methods**<br>Interventions/Instruments | They were given nurse led assessment with support from telemedicine. Based on the findings, hospital readmissions and mortality are two other factors that were established as outcomes of the condition. | Randomized controlled trials and cohort studies were pool for meta-analysis. | Patients should be asked questions aimed at establishing their experiences with the app. | To probe patient perspectives, in depth interviews. |**
    **| **Analysis**<br>How were the collected data analyzed? | Statistical methods were used on data analysis in order to determine the readmission rates between the intervention and control groups. | Meta-analysis of the readmission rates of the considered trials, which resulted in an aggregate odds ratio for telemedicine interventions. | This paper presents thematic analysis of interview data to identify common themes in patients’ experiences. | The interview data selected for thematic analysis for key themes. |**
    **| **Outcomes/key findings** of the study and implications for nursing practice<br> <br>Summary of study results | According to the findings of the study, telecare had a positive impact in doing away with cases of readmission to the hospital and cases of cardio vascular deaths meaning that telemedicine is very important in the management of chronic illnesses. | The telemedicine telemonitoring examination showed that such strategy helps to decrease the level of readmission to the hospital, and thus refutes the idea that remote care should be limited. | It was evidenced, mostly, that the patients benefited from the app interface, and the general facility achieved through the application to be connected to the healthcare team. | The work of the article is that patients were glad to have an opportunity to get more connected with their healthcare providers and manage diseases easier. |**
    **| **Recommendations of the researcher** | Ideally, one should build on the current application of nurse-led telecare interventions in heart failure treatment and enhance its usage in improving more patient results and the outcome of the healthcare industry’s spending. | Integrate telemedicine and telemonitoring services in the day-to-day practice in the treatment of chronic illnesses to minimize cases of readmissions. | Increase the patient experience component and the approaches used in communiqué to thus increase optimism. | Strengthen patient knowledge concerning the application of remote monitoring technologies and adaptation into their daily schedule. |**
    **| **Explain how this article supports your proposed PICO(T) question.** | This study ties into the disease area of heart failure and the effects of telemedicine interventions on readmissions; therefore, it is closely connected to the PICOT question. | This article directly supports the PICOT question by presenting significant evidence that telemedicine has a positive impact on hospital readmissions. | The presented article sheds light on the patients’ readiness to utilize remote monitoring solutions – one of the key aspects using telemedicine in the case of heart failure. | This article supports the PICOT question by providing information on patient handling with remote monitoring technologies as an important factor that determines the effects of such interventions on hospital readmission. |**

    **© 2023. Grand Canyon University. All Rights Reserved.**

    **11**

    **NRS-445Rubric-RoughDraft-ResearchCritiquesandEvidence-BasedPracticeProposal.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nrs-445rubric-roughdraft-researchcritiquesandevidence-basedpracticeproposal-pdf-10237009)

    **## NRS-445-RS-ResearchCritiquePICOTGuidelines.docx**

    ![cid:D7D4B297-EEAE-4174-AD01-F87097282051@canyon.com](https://www.sweetstudy.com/questions/research-critiques-and-evidence-based-practice-proposal)

    **NRS-445: Research Critiques and Evidence-Based Practice Change Proposal Guidelines**

    Use this document to synthesize the information from your "Literature Evaluation Table" from Topic 1 into a literature review. Successful completion of this assignment requires that you use your conclusions from your literature review to propose an evidence-based practice change.

    **_Introduction_**

    · Introduce your nursing practice problem and discuss the purpose of your paper.

    · State your updated PICOT question incorporating any feedback that you received from your instructor.

    **_Method of Studies_**

    · State the methods of the four articles you are comparing and describe how each method helps answer the associated research question.

    **_Results of Studies/Key Findings_**

    · Summarize the key findings of the four studies.

    **_Outcomes Comparison_**

    · What are the anticipated outcomes for your PICOT question?

    · How do the outcomes of the four articles you chose compare to your anticipated outcomes?

    **_Proposed Evidence-Based Practice Change_**

    · What is the link between the PICOT question, the research articles, and the nursing practice problem you identified?

    · Based on this information, propose an evidence-based practice change to improve outcomes of patient care for your identified setting.

    · Suggest one way to assess outcomes for the proposed practice change to determine whether or not it is effective.

    **_Conclusion_**

    · Your conclusion should summarize the main points in the essay, including a varied restatement of the thesis.

    © 2023. Grand Canyon University. All Rights Reserved.

    2

    ## image1.jpeg

    **## NRS-445-RS-T1-LiteratureEvaluationTable.docx**

    1

    **NRS-445 Topic 1: Literature Evaluation Table**

    **Student Name:**

    **Faculty Name:**

    **Background of Nursing Practice Problem (one paragraph; no more than 250 words):**

    Despite available pharmacologic and non-pharmacologic interventions, patient symptoms often remain poorly managed, and patient prognosis remains poor throughout the world. As widely known, patients with HF have high rates of readmission, mainly because of episodes of worsening of the disease, thus putting a burden on the healthcare facilities and the patients. Conventional approaches to follow-up and supervision of the heart failure patients entail regular hospital check-ups, which are inconvenient, especially for the elderly patients (Krzesiński, et al 2022). New technologies like telemedicine interventions that may include monitoring of the patient’s vital signs at his/her home can be a solution to the problem by enhancing the patient’s quality of care yet minimizing cases of readmission. All these interventions ensure that patients are closely watched in real-time and more so when a particular patient’s condition worsens. However, future studies are required to support the effectiveness of such interventions for preventing readmissions and enhancing the self-management of heart failure at home (Stergiopoulos, et al 2024). The possible enhancement of the patients’ condition and reduction in the costs of treatment make the telemedicine application an important subject in the management of HF.

    ****References:****

    **Krzesiński, P., Jankowska, E. A., Siebert, J., Galas, A., Piotrowicz, K., Stańczyk, A., Siwołowski, P., Gutknecht, P., Chrom, P., Murawski, P., Walczak, A., Szalewska, D., Banasiak, W., Ponikowski, P., & Gielerak, G. (2022). Effects of an outpatient intervention comprising nurse‐led non‐invasive assessments, telemedicine support and remote cardiologists’ decisions in patients with heart failure (AMULET study): a randomised controlled trial. European Journal of Heart Failure, 24(3), 565–577.**
    **[https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358](https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358)**

    **Georgios M. Stergiopoulos, Anissa N. Elayadi, Edward S. Chen, & Panagis Galiatsatos. (2024). The effect of telemedicine employing telemonitoring instruments on readmissions of patients with heart failure and/or COPD: a systematic review. Frontiers in Digital Health, 6.**
    **[https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334](https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334)**

    ****PICO(T) Question:** _Use the PICOT question developed in Topic 1 Discussion Question (DQ) 2 and refine it as needed._**

    **| | | |**
    **| — | — | — |**
    **| **PICO(T) Question Template** |**
    **| **P** | **Population** | In heart failure patients (P) |**
    **| **I** | **Intervention** | How does home-based telemedicine use remote monitoring (I) |**
    **| **C** | **Comparison** | Compared to standard care (C) |**
    **| **O** | **Outcome** | Affect hospital readmission rates (O) |**
    **| **T** | **Timeline**<br>_(optional)_ | Within 12 months (T) |**
    **| **Intervention** |**
    **| In_<br>heart failure patients_(P), how does _<br>home-based telemedicine using remote monitoring_ (I) compared to <br>standard care (C) affect _<br>hospital readmission rates_ (O) within_<br>12 months_(T)? |**
    **| **Problem Statement** |**
    **| It is not known if the implementation of <br>_home-based telemedicine based on remote monitoring_(I) would impact <br>changes on hospital readmission rates (O) among <br>heart failure patients (P). |**

    **| | | | | |**
    **| — | — | — | — | — |**
    **| **Criteria** | **Article 1** | **Article 2** | **Article 3** | **Article 4** |**
    **| **APA Reference**<br>Include the GCU permalink or working link used to access the article | Krzesiński, P., Jankowska, E. A., Siebert, J., Galas, A., Piotrowicz, K., Stańczyk, A., … & Gielerak, G. (2022). Effects of an outpatient intervention comprising nurse‐led non‐invasive assessments, telemedicine support, and remote cardiologists' decisions in patients with heart failure (AMULET study): A randomized controlled trial. <br>_European Journal of Heart Failure, 24_(3), 565-577.<br> <br>[https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358](https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2358) | Georgios M. Stergiopoulos, Anissa N. Elayadi, Edward S. Chen, & Panagis Galiatsatos. (2024). The effect of telemedicine employing telemonitoring instruments on readmissions of patients with heart failure and/or COPD: a systematic review. Frontiers in Digital Health, 6. <br>[https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334](https://doi-org.lopes.idm.oclc.org/10.3389/fdgth.2024.1441334) | Thi Xuan Hanh Vo, Marie-Pascale Pomey, Loyda Jean Charles, Paula A. B. Ribeiro, Stéphanie Béchard, Émilie Rémillard, Shana Grigoletti, John Nguyen, Pascale Lehoux, Emmanuel Marier-Tétrault, & Francois Tournoux. (2024). Patients’ experience using an app for home remote monitoring of heart failure for a university hospital in Quebec, Canada. BMC Digital Health, 2(1), 1–12. <br>[https://doi-org.lopes.idm.oclc.org/10.1186/s44247-024-00126-4](https://doi-org.lopes.idm.oclc.org/10.1186/s44247-024-00126-4) | Jocelyn Carter, Karen Donelan, & Anne N. Thorndike. (2022). Patient Perspectives on Home-Based Care and Remote Monitoring in Heart Failure: A Qualitative Study. Journal of Primary Care & Community Health, 13. <br>[https://doi-org.lopes.idm.oclc.org/10.1177/21501319221133672](https://doi-org.lopes.idm.oclc.org/10.1177/21501319221133672) |**
    **| **Purpose/Aim of Study** | The paper assesses the effectiveness of nurse-led telecare with referral to remote consultation or the cardiologist in relation to hospital readmission as well as mortality in patients with heart failure. | The following paper aims to determine the effectiveness of telemedicine as well as telemonitoring in decreasing the rate of hospital readmissions among heart failure and COPD patients. | The paper aims to assess the positive and negative aspects of the remote telemonitoring mobile application in heart failure patients and its impact on their disease. | The research aims at describing home-based care and remote monitoring experiences of heart failure patients as well as their perceptions and attitude towards the interventions. |**
    **| **Research question(s)** | Is telecare with telemedicine administered by a nurse effective in lowering hospitalization rates and cardiovascular mortality in heart failure patients? | Does telemedicine use the telemonitoring technique attenuate hospital readmissions among heart failure and COPD patients? | What is the experience of heart failure patients in using a mobile app for home remote monitoring for managing their condition? | What is the patient heart failure perception on home based care and remote monitoring? |**
    **| **Design**<br>Is the article qualitative, quantitative, or mixed methods? Explain how you determined the type of research design. | Quantitative, randomized controlled trial. It is done randomly through selection of patients for the study and assessment of indicators such as rates and number of readmissions and number of deaths. | Quantitative, systematic review of studies. This is established based on the integration of several empirical studies that have sought to ascertain the performance of telemedicine. | Qualitative, semi-structured interviews with thematic analysis. | Qualitative, using semi-structured interviews and thematic analysis. |**
    **| **Setting**<br>Where did the study take place? What type of setting: inpatient, outpatient, etc.? | Outpatient setting in multiple centers across Poland. | Various healthcare settings across multiple studies reviewed. | University hospital in Quebec, Canada. | Primary care and community health settings. |**
    **| **Sample**<br>Number and characteristics of participants | It enrolled 605 patients with heart failure and left ventricular ejection fraction ≤49%. | 29 studies on the telemonitoring in heart failure and COPD, 4,326 patients. | 12 heart failure patients using TakeCare™ app for at least 3 months. | 24 heart failure patients. |**
    **| **Methods**<br>Interventions/Instruments | They were given nurse led assessment with support from telemedicine. Based on the findings, hospital readmissions and mortality are two other factors that were established as outcomes of the condition. | Randomized controlled trials and cohort studies were pool for meta-analysis. | Patients should be asked questions aimed at establishing their experiences with the app. | To probe patient perspectives, in depth interviews. |**
    **| **Analysis**<br>How were the collected data analyzed? | Statistical methods were used on data analysis in order to determine the readmission rates between the intervention and control groups. | Meta-analysis of the readmission rates of the considered trials, which resulted in an aggregate odds ratio for telemedicine interventions. | This paper presents thematic analysis of interview data to identify common themes in patients’ experiences. | The interview data selected for thematic analysis for key themes. |**
    **| **Outcomes/key findings** of the study and implications for nursing practice<br> <br>Summary of study results | According to the findings of the study, telecare had a positive impact in doing away with cases of readmission to the hospital and cases of cardio vascular deaths meaning that telemedicine is very important in the management of chronic illnesses. | The telemedicine telemonitoring examination showed that such strategy helps to decrease the level of readmission to the hospital, and thus refutes the idea that remote care should be limited. | It was evidenced, mostly, that the patients benefited from the app interface, and the general facility achieved through the application to be connected to the healthcare team. | The work of the article is that patients were glad to have an opportunity to get more connected with their healthcare providers and manage diseases easier. |**
    **| **Recommendations of the researcher** | Ideally, one should build on the current application of nurse-led telecare interventions in heart failure treatment and enhance its usage in improving more patient results and the outcome of the healthcare industry’s spending. | Integrate telemedicine and telemonitoring services in the day-to-day practice in the treatment of chronic illnesses to minimize cases of readmissions. | Increase the patient experience component and the approaches used in communiqué to thus increase optimism. | Strengthen patient knowledge concerning the application of remote monitoring technologies and adaptation into their daily schedule. |**
    **| **Explain how this article supports your proposed PICO(T) question.** | This study ties into the disease area of heart failure and the effects of telemedicine interventions on readmissions; therefore, it is closely connected to the PICOT question. | This article directly supports the PICOT question by presenting significant evidence that telemedicine has a positive impact on hospital readmissions. | The presented article sheds light on the patients’ readiness to utilize remote monitoring solutions – one of the key aspects using telemedicine in the case of heart failure. | This article supports the PICOT question by providing information on patient handling with remote monitoring technologies as an important factor that determines the effects of such interventions on hospital readmission. |**

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  • [Solved] week 5

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  • [Solved] week 4 health promotion

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    Discuss the safety and effectiveness of alternative and complementary medicine for the treatment of specific illnesses such as cancer, diabetes, and hypertension. – 2 years ago

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    Discuss the safety and effectiveness of alternative and complementary medicine for the treatment of specific illnesses such as cancer, diabetes, and hypertension.

    – 2 years ago

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    **Please ensure that the Reply includes more than 200 words with scholarly articles, and the plagiarism level must remain below 20%.** **Discussions on Spirituality in Nursing Practice** Integrating spirituality into nursing care has been widely accepted as a means of providing holistic care that le…

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    **Please ensure that the Reply includes more than 200 words with scholarly articles, and the plagiarism level must remain below 20%.**

    **Discussions on Spirituality in Nursing Practice**

    Integrating spirituality into nursing care has been widely accepted as a means of providing holistic care that leads to better patient outcomes. Spirituality assessment tools allow for data collection regarding integrating spirituality in nursing practice and improving the address of the spiritual requirements in the nursing clinical surroundings. This debate focuses on two prominent tools used to evaluate spirituality in nursing, specifically, the Spiritual Assessment Scale (SAS) and the FICA Spiritual History Tool.

    Few tools specifically exist to evaluate spiritual and religious coping in multicultural clinical settings (Casaleiro, Caldeira, & Esperandio, 2022)—and such instruments can help healthcare providers understand the degree to which prayer and religious considerations influence patient care. The authors assert that spirituality should be evaluated clinically, culturally sensitive, and respectfully. Among the tools they mention is the Spiritual Assessment Scale (SAS), a measure of spiritual well-being and coping across patients of various religious and spiritual traditions. This guide helps nurses evaluate patients' coping skills and how much spirituality contributes to their health. The authors state that SAS is helpful in various clinical environments in which patients' spiritual needs may vary.

    In another instrument that nurses frequently use for spiritual assessment, by Green (2021), the FICA Spiritual History Tool is presented. This tool includes questions related to the patient's Faith or beliefs, the importance of spirituality, Community involvement, and how these factors affect their health (FICA). According to Green (2021), the FICA tool helps nurses have meaningful discussions with patients regarding spirituality, resulting in a holistic understanding of their necessities. The ease of the tool and its comprehensiveness give it excellent efficacy in practice, promoting discussions of patients' spiritual wellness with nurses.

    Both articles underscore the necessity of integrating spiritual assessment as a component of a patient-centered model of care into nursing practice. Green (2021) states that an enforced spiritual health assessment improves therapeutic relationships and makes patients more satisfied; thus, the implementation of this type of tool is successful in practice. Casaleiro et al. (2022) contend that addressing performance, attention, and social danger during patient care is paramount to adequate cultural competence for clinicians to mitigate biases and holistically consider the patient's needs.

    Incorporating tools like the Spiritual Assessment Scale (SAS) and the FICA Spiritual History Tool into nursing practice is vital to addressing the spiritual aspect of patient care. These instruments are essential in providing nurses with practical assessments that enable them to offer patient-centered care that affirms and nurtures spiritual needs and enhances holistic care.

    **References**

    Casaleiro, T., Caldeira, S., & Esperandio, M. R. G. (2022). Instruments for assessing spiritual/religious coping in multicultural clinical settings. _Journal of Christian Nursing, 236–243_. https://doi.org/10.1097/CNJ.0000000000000997

    Green, C. (2021). Nurses and patients' perspectives on spiritual health assessment. _Journal of Religion & Health, 60_(1), 122–133. https://doi.org/10.1007/s10943-020-01113-5

    – 2 years ago