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  • [Solved] NR week 3 Reply to Peer 2

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    Executive Solution Overview

    Institutional Review Boards (IRBs) assess the ethics and safety of research studies involving human subjects, such as behavioral studies or clinical trials for new drugs or medical devices. Health and Human Services oversees about 2,300 U.S.-based IRBs through routine or for-cause inspections to ass…

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    Institutional Review Boards (IRBs) assess the ethics and safety of research studies involving human subjects, such as behavioral studies or clinical trials for new drugs or medical devices. Health and Human Services oversees about 2,300 U.S.-based IRBs through routine or for-cause inspections to assess if they are following federal laws when reviewing research. But few IRBs are inspected. For example, one HHS agency aims to do just 3-4 routine inspections each year. Also, HHS agencies haven't examined how many inspections are needed or if inspections could be changed to further reduce risks to human subjects (2023). More than 130 countries and international organizations have developed independent committees to approve or deny research that involves human subjects (Capili & Anastasi, 2024).

    For many researchers conducting successful research is the most rewarding thing to do. But what happens when the research does not meet the IRB standards due to being biased, the truth is that many researchers find themselves facing such issues which are easy to occur when proposing a research theory. There are many things that can impact and affect the research, one can be the limited amount of information on the chosen topic, methodology and sample size. Often waiting for the review and approval from the IRB can be challenging. Four challenges identified (1) Community partners not being recognized as research partners (2) Cultural competence, language of consent forms, and literacy level of partners; (3) IRBs apply formulaic approaches to CEnR; & (4) Extensive delays in IRB preparation and approval potentially stifle the relationships with community partners (Onakomaiya et al, 2023).

    In conclusion, getting research published and approved by the IRB is a tedious procedure. It requires understanding and knowledge of possible setbacks that can occur in the process of achieving the sought-out research. While these inefficiencies are an inevitable part of the research process, understanding common pitfalls can limit those hindrances (Shaffer & Huecker, 2025). Recommendations included (1) Training IRBs to understand CEnR principles to streamline and increase the flexibility of the IRB review process; (2) Identifying influential community stakeholders who can provide support for the study; and (3) Disseminating human subjects research training that is accessible to all community investigators to satisfy IRB concerns. The IRBs can benefit from more training in CEnR requirements and methodologies (Onakomaiya et al, 2023).

    References

    (2023, January 17). Institutional Review Boards: Actions Needed to Improve Federal Oversight and Examine Effectiveness. U.S. Government Accountability Office. [**https://www.gao.gov/products/gao-23-104721**](https://www.gao.gov/products/gao-23-104721)

    Capili, B., & Anastasi, J. K. (2024). Ethical Research and the Institutional Review Board: An Introduction. The American journal of nursing, 124(3), 50–54. [**https://doi.org/10.1097/01.NAJ.0001008420.28033.e8**](https://doi.org/10.1097/01.NAJ.0001008420.28033.e8)

    Onakomaiya, D., Pan, J., Roberts, T., Tan, H., Nadkarni, S., Godina, M., Park, J., Fraser, M., Kwon, S. C., Schoenthaler, A., & Islam, N. (2023). Challenges and recommendations to improve institutional review boards' review of community-engaged research proposals: A scoping review. Journal of clinical and translational science, 7(1), e93 **.** [**https://doi.org/10.1017/cts.2023.516**](https://doi.org/10.1017/cts.2023.516)

    Shreffler J, Huecker MR. Common Pitfalls In the Research Process. [Updated 2023 Mar 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: [**https://www.ncbi.nlm.nih.gov/books/NBK568780/**](https://www.ncbi.nlm.nih.gov/books/NBK568780/)

    – 2 years ago

  • [Solved] NR week 3 Reply to Peer 1

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    **The Need for Institutional Review Boards (IRBs) and Their Impact on Research Studies** Institutional Review Boards (IRBs) play a vital role in the modern research landscape, particularly in healthcare settings where studies involve human participants. These ethics committees serve as essential gat…

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    Assignment Prompt & Instructions

    **The Need for Institutional Review Boards (IRBs) and Their Impact on Research Studies**

         Institutional Review Boards (IRBs) play a vital role in the modern research landscape, particularly in healthcare settings where studies involve human participants. These ethics committees serve as essential gatekeepers, ensuring that research maintains high ethical standards while protecting participants from potential harm. My clinical experience working alongside nurse researchers has shown me firsthand how crucial these oversight bodies are to maintaining public trust in the research enterprise. The primary function of IRBs stems from historical ethical failures in research. The infamous Tuskegee Syphilis Study, where researchers withheld treatment from African American men with syphilis without their knowledge, and the horrific Nazi medical experiments during World War II demonstrated the dire consequences of unchecked research. These events led to the development of ethical frameworks like the Nuremberg Code and the Declaration of Helsinki, which eventually evolved into our current IRB system ‌(Barrow et al., 2022). Today, IRBs ensure that researchers obtain proper informed consent, maintain participant privacy, minimize risks, and equitably distribute research benefits.

          IRBs can significantly impact research studies in various ways. One example involves modifying participant recruitment methods. In a study by White et al. (2021), researchers examining pregnancy and birth experiences initially proposed recruiting vulnerable postpartum women through direct solicitation in hospital settings. The IRB identified potential constraint issues and required revisions to the recruitment protocol, mandating that initial contact occur through healthcare providers who had no stake in the research. This modification protected vulnerable participants from feeling pressured to participate but extended the recruitment timeline by several months. Another example of IRB impact relates to risk mitigation strategies. Stokes et al. (2017) conducted a study examining trauma-informed nursing interventions for patients with severe mental illness. The original protocol included detailed questioning about traumatic experiences without adequate psychological support mechanisms. The IRB required substantial revisions, including the addition of on-site mental health professionals during interviews, development of distress protocols, and follow-up mental health resources. While these changes enhanced participant protection, they increased study costs and necessitated additional personnel training.

         IRBs can also shape data collection procedures to protect participant privacy. In my own clinical setting, I observed a nursing quality improvement project examining medication errors that initially proposed collecting identifiable information about staff members involved in errors. The IRB required removing all staff data and implementing stronger data security measures to prevent potential professional repercussions for staff. This modification protected participants but limited some analytical opportunities regarding individual-level factors contributing to errors. The structure and function of IRBs continue to evolve alongside emerging research methodologies and technologies. Modern IRBs must navigate complex issues like genetic data privacy, social media-based recruitment, and international collaborative research (Somia Abdul Same'e & Antony Sheela Anmary, 2024). While sometimes perceived as administrative hurdles, IRBs ultimately strengthen research quality and protect both participants and researchers by ensuring ethical compliance.

    **References**

    Barrow, J. M., Khandhar, P. B., & Brannan, G. D. (2022). _Research Ethics_. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459281/

    Somia Abdul Same'e, & Antony Sheela Anmary. (2024). Navigating the Ethical Complexities. _Advances in Information Quality and Management_, 139–158. https://doi.org/10.4018/978-1-6684-8526-2.ch009

    Stokes, Y., Jacob, J.-D., Gifford, W., Squires, J., & Vandyk, A. (2017). Exploring nurses’ knowledge and experiences related to trauma-informed care. _Global Qualitative Nursing Research_, _4_(4). https://doi.org/10.1177/2333393617734510

    ‌

    White, A., Grady, C., Little, M., Sullivan, K., Clark, K., Ngwu, M., & Lyerly, A. D. (2021). IRB Decision‐Making about Minimal Risk Research with Pregnant Participants. _Ethics & Human Research_, _43_(5), 2–17. https://doi.org/10.1002/eahr.500100

    – 2 years ago

  • [Solved] WK 4 RESP 2 DATA

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – 2 years ago **files (1)** – ## WK4DISCDATA.docx **## WK4DISCDATA.docx** Self-Study: Comparison of Means, Part 1 Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. These Discussions are designed to give you the …

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## WK4DISCDATA.docx

    **## WK4DISCDATA.docx**

    Self-Study: Comparison of Means, Part 1

    Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. These Discussions are designed to give you the opportunity to collaborate with your peers and faculty, test your knowledge, ask questions, practice research analysis, and assist your peers.

    You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    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/157739/modules/items/6373691)

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    · Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021).
    _Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model & guidelines_ (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    · Chapter 6, “Evidence of Appraisal: Research” (pp. 155–158)

    · Appendix E, “Research Evidence Appraisal Tool” (pp. 298–302)

    · Appendix F, “Nonresearch Evidence Appraisal Tool” (pp. 307–314)

    · Appendix G, “Individual Evidence Table” (pp. 315–318)

    · Salkind, N., & Frey, B. (2019).
    _Statistics for people who (think they) hate statistics_ (7th ed.). SAGE Publications.

    · Chapter 12, “t(ea) for Two: Tests Between the Means of Different Groups” (pp. 236–239, 243)

    · Chapter 13, “t(ea) for Two [Again]: Tests Between the Means of Related Groups” (pp. 253–256, 259)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    · Niedz, B. (2024).
    _Comparison of means, part 1_ [Video]. Walden University Canvas. http://waldenu.instructure.com

    [PowerPoint Presentation](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    [Required Resources for Topic: \
    _t_ Test](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    · Cook, H. E., Garris, L. A., Gulum, A. H., & Steber, C. J. (2024).
    [Impact of SMART goals on diabetes management in a pharmacist-led telehealth clinicLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://journals.sagepub.com/doi/10.1177/08971900221125021).
    _Journal of Pharmacy Practice, 37_(1), 54–59.

    [Required Resources for Topic: Paired \
    _t_ Test](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    · DeFusco, C., Lewis, A., & Cohn, T. (2023).
    [Improving critical care nurses perceived self-efficacy in providing palliative care: A quasi-experimental studyLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://journals.sagepub.com/doi/10.1177/10499091221094313).
    _American Journal of Hospice and Palliative Medicine, 40_(2), 117–121.

    · Markiewicz, A., Hickman, R. L., McAndrew, N. S., & Reimer, A. (2023).
    [Enhancing palliative communication in the intensive care unit through simulation: A quality improvement projectLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S1876139923000075).
    _Clinical Simulation in Nursing, 77_, 1–5.

    **To prepare:**

    · Read and view the Learning Resources in Doherty & Skalsky and in Dang et al. (2021) in Required Readings.

    · View the video on comparison of means.

    **Use** this Discussion to collaborate with your peers and faculty as an open office hours/ Q&A forum.

    **Post** answers to the following:

    · Interpret independent sample
    _t_-test results and explain the relevance to the research question (Cook et al., 2024).

    · Compare and contrast Cook et al. (independent samples
    _t_ test) to DeFusco et al. (2023) or Markiewicz et al. (2023) (paired
    _t_ test) results.

    · How did the subjects differ in the two studies?

    · Differentiate between clinical value and statistical significance.

    ·

    For this Self-Study Discussion, you may post throughout Week 4. You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    **Post** answers to any or all of the following:

    · Interpret independent sample t-test results and explain the relevance to the research question (Cook et al., 2024).

    · Compare and contrast Cook et al. (independent samples t-test) to DeFusco et al. (2023) or Markiewicz et al. (2023) (paired t-test) results.

    · How did the subjects differ in the two studies?

    · Differentiate between clinical value and statistical significance.

    Our interactive discussion addresses the following learning objectives:

    · Interpret comparison of mean (
    _t_-test) data in a published study

    · Differentiate between dependent observations and independent observations

    RESPOND TO THIS DISCUSSION POST

    **Aisha**

    **Independent Samples t-Test Results in Cook et al. (2024)**

    Cook et al. (2024) present a research study investigating how specific, measurable, achievable, relevant, and time-bound (SMART) goals affect the management of diabetes in a telehealth clinic. The study applied independent samples t-tests to compare the reduction in the level of A1c in the intervention group that implemented SMART goals and the control group that did not. Based on the presented findings, A1c levels reduced by 1.2% in the intervention group compared to the control group which recorded a 0.85% reduction in A1c levels (Cook et al., 2024) Regarding the relevance to the research question, the results report a p-value of 0.287, indicating that the differences between reduction rates in the two groups was not statistically significant.

    **Independent Sample t-test in Cook et al. (2024) vs Paired t-test in DeFusco et al. (2023)**

    Cook et al. (2024) applied an independent samples t-test in comparing the A1c levels between the intervention and the control group whereas DeFusco et al. (2023) employed a paired t-test in evaluating the self-efficacy of critical care nurses pre-and post-intervention (online palliative care education). The independent samples t-test is useful in the article by Cook et al. (2024) because it compares two groups; the intervention and the control group. The paired t-test is relevant in the study by DeFusco et al. (2023) because it measures the efficacy of the intervention in the same group.

    Although the study by Cook et al. (2024) shows an increased reduction in the levels of A1c in the intervention group compared to the sample group, the difference is not statistically significant. Conversely, the results presented by DeFusco et al. (2023) are statistically significant. The reported p-value is < 0.001. The results have a large effect size. Although the study by Cook et al. (2024) shows the effectiveness of SMART goals in managing diabetes, further research is required. The findings by DeFusco et al. (2023) are viable and can be implemented into practice.

    **Comparing the Study Subjects in the Articles**

    The two studies also show a difference in the subjects under investigation. Cook et al. (2024) investigate the effectiveness of SMART goals in managing diabetes by investigating veterans with type 2 diabetes. The sample size involved 100 patients put in two groups (50 in the intervention group and 50 in the control group). On the other hand, the study by DeFusco et al. (2023) involved 40 critical care nurses in investigating the impact of online palliative education in improving the nurse’s self-efficacy.

    **Statistical Significance vs. Clinical Value**

    The result from a research study is deemed to be statistically significant if the p-value is within the standard threshold, that is, p <0.05. The p-value in the results presented by DeFusco et al. (2023) is 0.001 thus, statistically significant. On the other hand, the p-value in the study by Cook et al. (2024) is 0.287. The p-value is higher than the standard threshold (p <0.05) hence the result is not statistically significant. A study whose result is not statistically significant can still have clinical value if the findings are applicable in the real world. Thus, the result in Cook et al. (2024) has clinical meaning because the SMART goals can be applied to managing diabetes in an actual clinical environment.

    References

    Cook, H. E., Garris, L. A., Gulum, A. H., & Steber, C. J. (2024). Impact of SMART goals on diabetes management in a pharmacist-led telehealth clinic.
    _Journal of Pharmacy Practice_,
    _37_(1), 54-59. DOI: 10.1177/08971900221125021

    DeFusco, C., Lewis, A., & Cohn, T. (2023). Improving critical care nurses perceived self-efficacy in providing palliative care: a quasi-experimental study.
    _American Journal of Hospice and Palliative Medicine®_,
    _40_(2), 117-121. DOI: 10.1177/10499091221094313

    **## WK4DISCDATA.docx**

    Self-Study: Comparison of Means, Part 1

    Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. These Discussions are designed to give you the opportunity to collaborate with your peers and faculty, test your knowledge, ask questions, practice research analysis, and assist your peers.

    You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    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/157739/modules/items/6373691)

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    · Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021).
    _Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model & guidelines_ (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    · Chapter 6, “Evidence of Appraisal: Research” (pp. 155–158)

    · Appendix E, “Research Evidence Appraisal Tool” (pp. 298–302)

    · Appendix F, “Nonresearch Evidence Appraisal Tool” (pp. 307–314)

    · Appendix G, “Individual Evidence Table” (pp. 315–318)

    · Salkind, N., & Frey, B. (2019).
    _Statistics for people who (think they) hate statistics_ (7th ed.). SAGE Publications.

    · Chapter 12, “t(ea) for Two: Tests Between the Means of Different Groups” (pp. 236–239, 243)

    · Chapter 13, “t(ea) for Two [Again]: Tests Between the Means of Related Groups” (pp. 253–256, 259)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    · Niedz, B. (2024).
    _Comparison of means, part 1_ [Video]. Walden University Canvas. http://waldenu.instructure.com

    [PowerPoint Presentation](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    [Required Resources for Topic: \
    _t_ Test](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    · Cook, H. E., Garris, L. A., Gulum, A. H., & Steber, C. J. (2024).
    [Impact of SMART goals on diabetes management in a pharmacist-led telehealth clinicLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://journals.sagepub.com/doi/10.1177/08971900221125021).
    _Journal of Pharmacy Practice, 37_(1), 54–59.

    [Required Resources for Topic: Paired \
    _t_ Test](https://waldenu.instructure.com/courses/157739/pages/week-4-learning-resources?module_item_id=6373691)

    · DeFusco, C., Lewis, A., & Cohn, T. (2023).
    [Improving critical care nurses perceived self-efficacy in providing palliative care: A quasi-experimental studyLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://journals.sagepub.com/doi/10.1177/10499091221094313).
    _American Journal of Hospice and Palliative Medicine, 40_(2), 117–121.

    · Markiewicz, A., Hickman, R. L., McAndrew, N. S., & Reimer, A. (2023).
    [Enhancing palliative communication in the intensive care unit through simulation: A quality improvement projectLinks to an external site.](https://go.openathens.net/redirector/waldenu.edu?url=https://www.sciencedirect.com/science/article/pii/S1876139923000075).
    _Clinical Simulation in Nursing, 77_, 1–5.

    **To prepare:**

    · Read and view the Learning Resources in Doherty & Skalsky and in Dang et al. (2021) in Required Readings.

    · View the video on comparison of means.

    **Use** this Discussion to collaborate with your peers and faculty as an open office hours/ Q&A forum.

    **Post** answers to the following:

    · Interpret independent sample
    _t_-test results and explain the relevance to the research question (Cook et al., 2024).

    · Compare and contrast Cook et al. (independent samples
    _t_ test) to DeFusco et al. (2023) or Markiewicz et al. (2023) (paired
    _t_ test) results.

    · How did the subjects differ in the two studies?

    · Differentiate between clinical value and statistical significance.

    ·

    For this Self-Study Discussion, you may post throughout Week 4. You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    **Post** answers to any or all of the following:

    · Interpret independent sample t-test results and explain the relevance to the research question (Cook et al., 2024).

    · Compare and contrast Cook et al. (independent samples t-test) to DeFusco et al. (2023) or Markiewicz et al. (2023) (paired t-test) results.

    · How did the subjects differ in the two studies?

    · Differentiate between clinical value and statistical significance.

    Our interactive discussion addresses the following learning objectives:

    · Interpret comparison of mean (
    _t_-test) data in a published study

    · Differentiate between dependent observations and independent observations

    RESPOND TO THIS DISCUSSION POST

    **Aisha**

    **Independent Samples t-Test Results in Cook et al. (2024)**

    Cook et al. (2024) present a research study investigating how specific, measurable, achievable, relevant, and time-bound (SMART) goals affect the management of diabetes in a telehealth clinic. The study applied independent samples t-tests to compare the reduction in the level of A1c in the intervention group that implemented SMART goals and the control group that did not. Based on the presented findings, A1c levels reduced by 1.2% in the intervention group compared to the control group which recorded a 0.85% reduction in A1c levels (Cook et al., 2024) Regarding the relevance to the research question, the results report a p-value of 0.287, indicating that the differences between reduction rates in the two groups was not statistically significant.

    **Independent Sample t-test in Cook et al. (2024) vs Paired t-test in DeFusco et al. (2023)**

    Cook et al. (2024) applied an independent samples t-test in comparing the A1c levels between the intervention and the control group whereas DeFusco et al. (2023) employed a paired t-test in evaluating the self-efficacy of critical care nurses pre-and post-intervention (online palliative care education). The independent samples t-test is useful in the article by Cook et al. (2024) because it compares two groups; the intervention and the control group. The paired t-test is relevant in the study by DeFusco et al. (2023) because it measures the efficacy of the intervention in the same group.

    Although the study by Cook et al. (2024) shows an increased reduction in the levels of A1c in the intervention group compared to the sample group, the difference is not statistically significant. Conversely, the results presented by DeFusco et al. (2023) are statistically significant. The reported p-value is < 0.001. The results have a large effect size. Although the study by Cook et al. (2024) shows the effectiveness of SMART goals in managing diabetes, further research is required. The findings by DeFusco et al. (2023) are viable and can be implemented into practice.

    **Comparing the Study Subjects in the Articles**

    The two studies also show a difference in the subjects under investigation. Cook et al. (2024) investigate the effectiveness of SMART goals in managing diabetes by investigating veterans with type 2 diabetes. The sample size involved 100 patients put in two groups (50 in the intervention group and 50 in the control group). On the other hand, the study by DeFusco et al. (2023) involved 40 critical care nurses in investigating the impact of online palliative education in improving the nurse’s self-efficacy.

    **Statistical Significance vs. Clinical Value**

    The result from a research study is deemed to be statistically significant if the p-value is within the standard threshold, that is, p <0.05. The p-value in the results presented by DeFusco et al. (2023) is 0.001 thus, statistically significant. On the other hand, the p-value in the study by Cook et al. (2024) is 0.287. The p-value is higher than the standard threshold (p <0.05) hence the result is not statistically significant. A study whose result is not statistically significant can still have clinical value if the findings are applicable in the real world. Thus, the result in Cook et al. (2024) has clinical meaning because the SMART goals can be applied to managing diabetes in an actual clinical environment.

    References

    Cook, H. E., Garris, L. A., Gulum, A. H., & Steber, C. J. (2024). Impact of SMART goals on diabetes management in a pharmacist-led telehealth clinic.
    _Journal of Pharmacy Practice_,
    _37_(1), 54-59. DOI: 10.1177/08971900221125021

    DeFusco, C., Lewis, A., & Cohn, T. (2023). Improving critical care nurses perceived self-efficacy in providing palliative care: a quasi-experimental study.
    _American Journal of Hospice and Palliative Medicine®_,
    _40_(2), 117-121. DOI: 10.1177/10499091221094313

  • [Solved] WK 4 RES.EPID

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – 2 years ago **files (1)** – ## WK4DISEPID.docx **## WK4DISEPID.docx** Back to Week at a Glance Randomized Trials in Epidemiology ![A blue glove and yellow and white mat AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-4-res-epid) Imagine that researchers are conducti…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## WK4DISEPID.docx

    **## WK4DISEPID.docx**

    Back to Week at a Glance

    Randomized Trials in Epidemiology

    ![A blue glove and yellow and white mat AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-4-res-epid)

    Imagine that researchers are conducting a randomized controlled trial of a high-fiber supplement as a preventive measure in persons at increased risk of type 2 diabetes. People enrolled in the study are disease free at the time they agree to participate in the trial, but they all have a family history of type 2 diabetes and are considered at high risk (80%) to develop the disease during their lifetime. The 10,000 participants who start the trial are healthy individuals who are randomly allocated to receive either high-fiber supplements or placebo for several years. As you can imagine, this study will be quite expensive and will require a large infrastructure of personnel and materials to carry it out successfully.

    Because type 2 diabetes has reached epidemic proportions in the United States, the potential benefits of this research are important at a population level. Unfortunately, high-fiber supplements have also been shown in a few studies to be associated with gastrointestinal blockage (which can be life-threatening) and reduced nutrient absorption, which may lead to anemia, osteoporosis, and other debilitating chronic diseases. The supplements may also reduce absorption of certain medications and cause gastrointestinal distress. The potential side effects of continuous high-fiber supplementation are only partially understood, and long-term effects are unknown.

    For this Discussion, you are asked to identify an example of an experimental study design in the literature and consider the ethical implications of the randomized controlled trial design.

    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/6259801)

    [Required Readings](https://waldenu.instructure.com/courses/155998/pages/week-4-learning-resources?module_item_id=6259801)

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

    · Chapter 2, “Identifying Outcomes in Population-Based Nursing” (pp. 20-38)

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

    · Chapter 8, “Experimental Study Designs”

    · Goldstein, C. E., Weijer, C., Brehaut, J. C., Fergusson, D. A., Grimshaw, J. M., Horn, A. R., & Taljaard, M. (2018).
    [Ethical issues in pragmatic randomized controlled trials: A review of the recent literature identifies gaps in ethical argumentationLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mnh&AN=29482537&site=ehost-live&scope=site&custid=s6527200).
    _BMC Medical Ethics_,
    _19_(1), Article 14. https://doi.org/10.1186/s12910-018-0253-x

    · Walden University Office of Research and Doctoral Services. (n.d.).
    [_Developing researchLinks to an external site._](https://academicguides.waldenu.edu/research-center/student-research/developing-research) _._ https://academicguides.waldenu.edu/research-center/student-research/developing-research

    Examples of Studies Utilizing Experimental and Quasi-experimental Study Designs

    These studies should be used as informative examples. Please locate another article on your own to use for the Discussion.

    · Hooshmand, M., & Foronda, C. (2018).
    [Comparison of telemedicine to traditional face-to-face care for children with special needs: A quasiexperimental study](https://waldenu.instructure.com/courses/155998/files/12410801?wrap=1).
    _Telemedicine Journal and E-health: The Official Journal of the American Telemedicine Association_,
    _24_(6), 433–441. https://doi.org/10.1089/tmj.2017.0116

    · Sawyer, A., Kaim, A., Le, H.-N., McDonald, D., Mittinty, M., Lynch, J., & Sawyer, M. (2019).
    [The effectiveness of an app-based nurse-moderated program for new mothers with depression and parenting problems (eMums Plus): Pragmatic randomized controlled trialLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mnh&AN=31165715&site=ehost-live&scope=site&custid=s6527200).
    _Journal of Medical Internet Research_,
    _21_(6), e13689. https://doi.org/10.2196/13689

    [Optional Resource](https://waldenu.instructure.com/courses/155998/pages/week-4-learning-resources?module_item_id=6259801)

    · Dennis, C. L., Grigoriadis, S., Zupancic, J., Kiss, A., & Ravitz, P. (2020).
    [Telephone-based nurse-delivered interpersonal psychotherapy for postpartum depression: Nationwide randomised controlled trialLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2020-09802-001&site=eds-live&scope=site&custid=s6527200).
    _The British Journal of Psychiatry_,
    _216_(4), 189–196. https://doi.org/10.1192/bjp.2019.275

    To prepare:

    · Search databases in the Walden Library and locate a peer-reviewed article from the last 5 years that uses a randomized controlled trial study design. The subject of the study may be any topic professionally relevant or interesting to your practice. You may not select an article already posted by one of your colleagues for this Discussion. (
    **Tip:** When searching, you may use “randomized trial” as one of your search phrases.)

    · Critically analyze the following aspects of the research study:

    · Purpose

    · Study population

    · Length of the trial

    · Data collection methods

    · Outcome measures

    · Results and conclusions

    · Ethical issues associated with the study

    · Ask yourself: How did this research study benefit from its experimental design? What was achieved by randomization that might not otherwise have been achieved?

    By Day 3 of Week 4

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

    · Summarize the research study addressing the aspects bulleted above.

    · Identify and discuss the ethical issues associated with this study.

    · Be sure to include a link to the article in your post.

    By Day 6 of Week 4

    **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 POST

    ·
    **DENISE**

    ·

    ·
    **Evaluating the PRO-P Trial Design Summarized**

    · I examined the PRO-P study by Al-Monajjed and colleagues (2024), which investigates how electronic symptom tracking might benefit prostate cancer patients after surgery.

    ·
    **Study Summary**

    · The researchers designed this randomized controlled trial to see if electronic patient-reported outcome (ePRO) monitoring improves quality of life for men recovering from prostate surgery. Their hypothesis makes intuitive sense—if doctors can spot complications earlier through digital monitoring, patients should experience better recovery.

    · The study will include 430 men preparing for radical prostatectomy across multiple German hospitals. I appreciate that they've set clear eligibility requirements—participants need to be adults who can provide informed consent, understand German, and use the necessary technology. Each man will be followed for 6 months after surgery, with checkpoints before the procedure, at discharge, and at 1, 3, and 6 months afterward.

    · The data collection approach is straightforward but effective. Both groups complete the same electronic questionnaires about their symptoms and wellbeing, but only the intervention group's responses trigger alerts to healthcare providers when symptoms appear. Their primary goal is measuring quality of life at the 6-month mark using a standardized questionnaire, along with tracking several secondary outcomes like symptom severity and healthcare utilization. Since this is only a protocol paper, we don't have results yet, but the research team expects electronic monitoring to lead to better

    · symptom management and recovery experiences.

    · Ethical Considerations

    · I was astonished by how thoroughly the researchers addressed ethical concerns. As Goldstein et al. (2018) recommend for such trials, they obtained proper ethics committee approval and implemented comprehensive informed consent procedures. Both groups receive standard medical care, maintaining what researchers call "clinical equipoise," with the intervention group receiving additional monitoring. They've also taken steps to protect patient data.

    · I question the potential access disparities. The technology requirements might unintentionally exclude older patients or those less comfortable with digital tools. There's also the question of whether withholding potentially beneficial monitoring from the control group raises ethical concerns, though this is an inherent challenge in many clinical trials.

    · Benefits of Experimental Design

    · What makes this study particularly valuable is its randomized controlled design. As Friis and Sellers (2021) explain, randomization allows researchers to determine if the electronic monitoring causes improvements. By randomly assigning patients to groups, factors like age, disease severity, and technological comfort are distributed evenly.

    · Without this random assignment, the results would be far less reliable—tech-savvy patients might naturally gravitate toward the electronic monitoring option, skewing outcomes. The randomized approach ensures that any improvements in recovery can be credited to the monitoring system itself rather than pre-existing differences between patients.This methodically designed study could provide healthcare providers with evidence they need to implement electronic symptom monitoring as a standard practice in prostate

    · cancer care.

    · The article can be accessed at:
    [https://doi.org/10.1186/s13063-024-08579-8\
    Links to an external site.](https://doi.org/10.1186/s13063-024-08579-8)

    · References

    · Al-Monajjed, R., Albers, P., Droop, J., Fugmann, D., Noldus, J., Palisaar, R.-J., Ritter, M., Ellinger, J., Krausewitz, P., Truß, M., Hadaschik, B., Grünwald, V., Schrader, A.-J., Papavassilis, P., Ernstmann, N., Schellenberger, B., Moritz, A., Kowalski, C., Hellmich, M., & Karger, A. (2024). PRO-P: Evaluating the effect of electronic patient-reported outcome measures monitoring compared with standard care in prostate cancer patients undergoing surgery-study protocol for a randomized controlled trial. Trials, 25(1), Article 754.
    [https://doi.org/10.1186/s13063-024-08579-8\
    Links to an external site.](https://doi.org/10.1186/s13063-024-08579-8)

    · Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th

    · ed.). Jones & Bartlett.

    · Goldstein, C. E., Weijer, C., Brehaut, J. C., Fergusson, D. A., Grimshaw, J. M., Horn, A. R., & Taljaard, M. (2018). Ethical issues in pragmatic randomized controlled trials: A review of the recent literature identifies gaps in ethical argumentation. BMC Medical Ethics, 19(1), Article 14.
    [https://doi.org/10.1186/s12910-018-0253-x\
    Links to an external site.](https://doi.org/10.1186/s12910-018-0253-x)

    ·

    **Reply**

    [Previous](https://waldenu.instructure.com/courses/155998/modules/items/6259788)

    [Next](https://waldenu.instructure.com/courses/155998/modules/items/6259797)

    ## image1.jpeg

    **## WK4DISEPID.docx**

    Back to Week at a Glance

    Randomized Trials in Epidemiology

    ![A blue glove and yellow and white mat AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-4-res-epid)

    Imagine that researchers are conducting a randomized controlled trial of a high-fiber supplement as a preventive measure in persons at increased risk of type 2 diabetes. People enrolled in the study are disease free at the time they agree to participate in the trial, but they all have a family history of type 2 diabetes and are considered at high risk (80%) to develop the disease during their lifetime. The 10,000 participants who start the trial are healthy individuals who are randomly allocated to receive either high-fiber supplements or placebo for several years. As you can imagine, this study will be quite expensive and will require a large infrastructure of personnel and materials to carry it out successfully.

    Because type 2 diabetes has reached epidemic proportions in the United States, the potential benefits of this research are important at a population level. Unfortunately, high-fiber supplements have also been shown in a few studies to be associated with gastrointestinal blockage (which can be life-threatening) and reduced nutrient absorption, which may lead to anemia, osteoporosis, and other debilitating chronic diseases. The supplements may also reduce absorption of certain medications and cause gastrointestinal distress. The potential side effects of continuous high-fiber supplementation are only partially understood, and long-term effects are unknown.

    For this Discussion, you are asked to identify an example of an experimental study design in the literature and consider the ethical implications of the randomized controlled trial design.

    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/6259801)

    [Required Readings](https://waldenu.instructure.com/courses/155998/pages/week-4-learning-resources?module_item_id=6259801)

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

    · Chapter 2, “Identifying Outcomes in Population-Based Nursing” (pp. 20-38)

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

    · Chapter 8, “Experimental Study Designs”

    · Goldstein, C. E., Weijer, C., Brehaut, J. C., Fergusson, D. A., Grimshaw, J. M., Horn, A. R., & Taljaard, M. (2018).
    [Ethical issues in pragmatic randomized controlled trials: A review of the recent literature identifies gaps in ethical argumentationLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mnh&AN=29482537&site=ehost-live&scope=site&custid=s6527200).
    _BMC Medical Ethics_,
    _19_(1), Article 14. https://doi.org/10.1186/s12910-018-0253-x

    · Walden University Office of Research and Doctoral Services. (n.d.).
    [_Developing researchLinks to an external site._](https://academicguides.waldenu.edu/research-center/student-research/developing-research) _._ https://academicguides.waldenu.edu/research-center/student-research/developing-research

    Examples of Studies Utilizing Experimental and Quasi-experimental Study Designs

    These studies should be used as informative examples. Please locate another article on your own to use for the Discussion.

    · Hooshmand, M., & Foronda, C. (2018).
    [Comparison of telemedicine to traditional face-to-face care for children with special needs: A quasiexperimental study](https://waldenu.instructure.com/courses/155998/files/12410801?wrap=1).
    _Telemedicine Journal and E-health: The Official Journal of the American Telemedicine Association_,
    _24_(6), 433–441. https://doi.org/10.1089/tmj.2017.0116

    · Sawyer, A., Kaim, A., Le, H.-N., McDonald, D., Mittinty, M., Lynch, J., & Sawyer, M. (2019).
    [The effectiveness of an app-based nurse-moderated program for new mothers with depression and parenting problems (eMums Plus): Pragmatic randomized controlled trialLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=mnh&AN=31165715&site=ehost-live&scope=site&custid=s6527200).
    _Journal of Medical Internet Research_,
    _21_(6), e13689. https://doi.org/10.2196/13689

    [Optional Resource](https://waldenu.instructure.com/courses/155998/pages/week-4-learning-resources?module_item_id=6259801)

    · Dennis, C. L., Grigoriadis, S., Zupancic, J., Kiss, A., & Ravitz, P. (2020).
    [Telephone-based nurse-delivered interpersonal psychotherapy for postpartum depression: Nationwide randomised controlled trialLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2020-09802-001&site=eds-live&scope=site&custid=s6527200).
    _The British Journal of Psychiatry_,
    _216_(4), 189–196. https://doi.org/10.1192/bjp.2019.275

    To prepare:

    · Search databases in the Walden Library and locate a peer-reviewed article from the last 5 years that uses a randomized controlled trial study design. The subject of the study may be any topic professionally relevant or interesting to your practice. You may not select an article already posted by one of your colleagues for this Discussion. (
    **Tip:** When searching, you may use “randomized trial” as one of your search phrases.)

    · Critically analyze the following aspects of the research study:

    · Purpose

    · Study population

    · Length of the trial

    · Data collection methods

    · Outcome measures

    · Results and conclusions

    · Ethical issues associated with the study

    · Ask yourself: How did this research study benefit from its experimental design? What was achieved by randomization that might not otherwise have been achieved?

    By Day 3 of Week 4

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

    · Summarize the research study addressing the aspects bulleted above.

    · Identify and discuss the ethical issues associated with this study.

    · Be sure to include a link to the article in your post.

    By Day 6 of Week 4

    **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 POST

    ·
    **DENISE**

    ·

    ·
    **Evaluating the PRO-P Trial Design Summarized**

    · I examined the PRO-P study by Al-Monajjed and colleagues (2024), which investigates how electronic symptom tracking might benefit prostate cancer patients after surgery.

    ·
    **Study Summary**

    · The researchers designed this randomized controlled trial to see if electronic patient-reported outcome (ePRO) monitoring improves quality of life for men recovering from prostate surgery. Their hypothesis makes intuitive sense—if doctors can spot complications earlier through digital monitoring, patients should experience better recovery.

    · The study will include 430 men preparing for radical prostatectomy across multiple German hospitals. I appreciate that they've set clear eligibility requirements—participants need to be adults who can provide informed consent, understand German, and use the necessary technology. Each man will be followed for 6 months after surgery, with checkpoints before the procedure, at discharge, and at 1, 3, and 6 months afterward.

    · The data collection approach is straightforward but effective. Both groups complete the same electronic questionnaires about their symptoms and wellbeing, but only the intervention group's responses trigger alerts to healthcare providers when symptoms appear. Their primary goal is measuring quality of life at the 6-month mark using a standardized questionnaire, along with tracking several secondary outcomes like symptom severity and healthcare utilization. Since this is only a protocol paper, we don't have results yet, but the research team expects electronic monitoring to lead to better

    · symptom management and recovery experiences.

    · Ethical Considerations

    · I was astonished by how thoroughly the researchers addressed ethical concerns. As Goldstein et al. (2018) recommend for such trials, they obtained proper ethics committee approval and implemented comprehensive informed consent procedures. Both groups receive standard medical care, maintaining what researchers call "clinical equipoise," with the intervention group receiving additional monitoring. They've also taken steps to protect patient data.

    · I question the potential access disparities. The technology requirements might unintentionally exclude older patients or those less comfortable with digital tools. There's also the question of whether withholding potentially beneficial monitoring from the control group raises ethical concerns, though this is an inherent challenge in many clinical trials.

    · Benefits of Experimental Design

    · What makes this study particularly valuable is its randomized controlled design. As Friis and Sellers (2021) explain, randomization allows researchers to determine if the electronic monitoring causes improvements. By randomly assigning patients to groups, factors like age, disease severity, and technological comfort are distributed evenly.

    · Without this random assignment, the results would be far less reliable—tech-savvy patients might naturally gravitate toward the electronic monitoring option, skewing outcomes. The randomized approach ensures that any improvements in recovery can be credited to the monitoring system itself rather than pre-existing differences between patients.This methodically designed study could provide healthcare providers with evidence they need to implement electronic symptom monitoring as a standard practice in prostate

    · cancer care.

    · The article can be accessed at:
    [https://doi.org/10.1186/s13063-024-08579-8\
    Links to an external site.](https://doi.org/10.1186/s13063-024-08579-8)

    · References

    · Al-Monajjed, R., Albers, P., Droop, J., Fugmann, D., Noldus, J., Palisaar, R.-J., Ritter, M., Ellinger, J., Krausewitz, P., Truß, M., Hadaschik, B., Grünwald, V., Schrader, A.-J., Papavassilis, P., Ernstmann, N., Schellenberger, B., Moritz, A., Kowalski, C., Hellmich, M., & Karger, A. (2024). PRO-P: Evaluating the effect of electronic patient-reported outcome measures monitoring compared with standard care in prostate cancer patients undergoing surgery-study protocol for a randomized controlled trial. Trials, 25(1), Article 754.
    [https://doi.org/10.1186/s13063-024-08579-8\
    Links to an external site.](https://doi.org/10.1186/s13063-024-08579-8)

    · Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th

    · ed.). Jones & Bartlett.

    · Goldstein, C. E., Weijer, C., Brehaut, J. C., Fergusson, D. A., Grimshaw, J. M., Horn, A. R., & Taljaard, M. (2018). Ethical issues in pragmatic randomized controlled trials: A review of the recent literature identifies gaps in ethical argumentation. BMC Medical Ethics, 19(1), Article 14.
    [https://doi.org/10.1186/s12910-018-0253-x\
    Links to an external site.](https://doi.org/10.1186/s12910-018-0253-x)

    ·

    **Reply**

    [Previous](https://waldenu.instructure.com/courses/155998/modules/items/6259788)

    [Next](https://waldenu.instructure.com/courses/155998/modules/items/6259797)

    ## image1.jpeg

  • [Solved] RESPONSE WEEK ONE FOR TRANSITION TO NP

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    RESPON BACK TO THIS POST: you should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. All replies must be constructive and use literature where possible. **Barriers to Advanced Practice Nursing** There are many barriers that slow th…

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    Assignment Prompt & Instructions

    RESPON BACK TO THIS POST: you should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.

    All replies must be constructive and use literature where possible.

    **Barriers to Advanced Practice Nursing**

    There are many barriers that slow the progression of advanced practice nursing in healthcare. In this discussion, I will focus on the affects of the financial burden of affording higher education, restrictions on the scope of practice, and role conflict within interprofessional teams. It will address the impact that these barriers have on the growth of advanced practice nursing, as well as strategies that can be used to help advanced practice nurses (APRNs) navigate and overcome them.

    **Financial Burden of Affording Higher Education**

    While programs like The Affordable Healthcare Act’s Graduate Nurse Education Demonstration aim to offset the costs of clinical training for APRNs, many candidates still face difficulty financing their advanced degrees (Porat-Dahlerbruch et al., 2022). This slows the progress of advanced practice nursing by limiting access from nurses who are financially disadvantaged due to income, number of dependents, or established debt. Possible solutions to overcoming the lack of financial support for education include considering working full-time while completing the advanced degree, seeking scholarships and grants from honor societies and other organizations, applying for financial aid through federal student aid, and exploring military benefits (Khawly & Blore, 2025).

    **Restrictions on the Scope of Practice**

    The roles, responsibilities and autonomy for APRNs vary from state to state.  While 27 US states and territories allow full practice authority, others only allow reduced or restricted practice regulations (Boehning & Punsalan, 2023). This factor causes healthcare disparities within our nation by inhibiting access to high-quality, affordable, and preventative healthcare in many underserved areas (Boehning & Punsalan, 2023). This barrier can be overcome by advocating for state and federal-level policy changes allowing full practice authority for APRNs across the board.

    **Role Conflict within Interprofessional Teams**

    APRNs are trained to provide care by utilizing evidence-based practice and standardizing high-quality and affordable patient care for the American public (Boehning & Punsalan, 2023). The persistent misunderstanding of the APRN role has limited effective collaboration within the interprofessional team establishing role conflict. One distinguishing characteristic of APRNs is their proactivity in patient care. This feature is displayed within the advanced nursing practice via comprehensive patient education and lifestyle counseling, holistic patient care, and disease prevention (NPHub, 2024a). Establishing an advanced practice nursing leadership structure within healthcare organizations could help overcome this barrier within the interprofessional team by evaluating, maintaining, and promoting the APRN role. (Henderson et al., 2024).

    **Conclusion**

               In conclusion, financial constraints, limitations on practice authority, and interprofessional role conflict hinder the progression and advancement of advanced practice nursing. Addressing these inhibitions would require policy reforms, financial support programs, and enhanced collaboration within the interprofessional network. APRNs can continue to evolve and improve patient outcomes with ongoing advocacy and systemic change.

    – 2 years ago

  • [Solved] reply to week 1 discussion

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    RESPON BACK TO THIS POST: you should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. All replies must be constructive and use literature where possible. **Barriers For Advanced Practice Nursing** Advanced practice nursing play an i…

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    Assignment Prompt & Instructions

    RESPON BACK TO THIS POST: you should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.

    All replies must be constructive and use literature where possible.

    **Barriers For Advanced Practice Nursing**

    Advanced practice nursing play an important role in the healthcare system in a vast variety of environments.  Several barriers are noted to hinder the growth and development of the advanced practice nurse.  For this discussion I would like to focus on these three barriers that affect advanced practice nursing, community resistance to advanced practice nursing roles, regulatory restrictions and the lack of full utilization in the advanced practice nursing skill set and scope of practice.  Advanced practice nursing has experienced great growth in their career development in the past years.  There has been acknowledgement nationwide for the need of more advanced practice nursing roles.  Personally, I was hesitant to step into this role and begin my education to further my career as I have seen these various barriers throughout the years in my community and the educational resources available to myself.

    We are all directly affected by our community.  Community resistance in certain areas have affected the growth and dynamics of the advanced practice nurse role.  Viewing advanced practice nursing roles as limited in scope of practice.  There are misconceptions on education required to achieve the role and this affects how the public views the advanced practice nursing role and the ability of individual to care for their community appropriately.  Educating our community and advocating for more of advanced practice nurse role presence can create a better dynamic of trust and acceptance.  This can be done as simply educating our community on one on one basis during visits, promoting healthcare fairs with advanced practice nurse roles present and putting information out that directly reflects the importance and capability of scope that an advanced practice nurse role implies.

    Another barrier that affects this role is regulatory restrictions.  Florida advanced practice nurses have limited scope of practice and are often met with opposition from state and medical groups (Hain et al,).  A total of 21 states allows for full scope practice for the advanced nursing role (Hain et al,).  That leaves greater than half of the states restricting how this role is allowed to practice and affecting how it is seen by the public as well as affecting the rate at which individuals will pursue this role.  Payer policies limit the scope of practice allowed and some policies do not view advanced practice nursing as a primary care role and this affects insurance payments, who is hired to certain facilities and of course limits scope of practice (Flaubert et al,.). Promoting policies that would allow the advanced practice nurse to practice in full scope would decrease this barrier.  Advocating for laws and policies and creating evidence-based practice could help achieve a better role.

    The inability to practice within their full scope is a barrier for the advanced nursing role.  In Florida there are various restrictions to include not being allowed to prescribed controlled substance, the having to practice under the supervision of a physician limits and sometimes this creates an environment that the advanced practice nurse does not want to partake in.  Not only do some payer policies not view the advanced nursing role as a primary care role that can be utilized and billed to insurance studies have shown though a valuable role and positive outcomes physician and patients have shown preference to care directly from a medical doctor (Hain et al,.).  Allowing a full scope of practice while promoting a positive view and work environment can decrease the barrier of stigma against the advanced nursing role and allow it to be viewed similar to physician role in medical practice.

    – 2 years ago

  • [Solved] nursing statistics

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – Reflect on change projects in your setting and describe what elements in the process of the change were effective and what elements were not effective? Has the anticipated outcome been sustained over time? Give specific evidence related to how well the change has been sustained. What would you do …

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    – Reflect on change projects in your setting and describe what elements in the process of the change were effective and what elements were not effective? Has the anticipated outcome been sustained over time? Give specific evidence related to how well the change has been sustained. What would you do differently in planning and implementing a similar project?
    – Using the article by Sharma (2021), cited below, is it possible for research/project findings to have clinical significance even if they do not have statistical significance? Explain your answer.

    Sharma H. (2021). Statistical significance or clinical significance? A researcher's dilemma for appropriate interpretation of research results. _Saudi Journal of Anaesthesia_, _15_(4), 431–434. [https://doi.org/10.4103/sja.sja_158_21Links to an external site.](https://doi.org/10.4103/sja.sja_158_21)

    – 2 years ago

  • [Solved] see below

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

  • [Solved] Soap Note

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    **Directions:** Read over the SOAP note and formulate a primary diagnosis. Based on the diagnosis complete the SOAP note with the details that would be expected for the diagnosis. Use UptoDate and/or Dyna MedPlus to find out what is expected from the history and physical, diagnostic workup and manag…

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    **Directions:** Read over the SOAP note and formulate a primary diagnosis.  Based on the diagnosis complete the SOAP note with the details that would be expected for the diagnosis. Use UptoDate and/or Dyna MedPlus to find out what is expected from the history and physical, diagnostic workup and management for the diagnosis. Include other peer review resources and and journal articles to support the development of your SOAP note. Complete and attach the evaluation & management score sheet to show how you coded the note for billing in each section.

    – Upload a copy of your completed SOAP note.
    – Upload a copy of the evaluation & management score sheet.

    **Case Study:** A 45-year-old white man presents to your office complaining of left knee pain that started last night. He says that the pain started suddenly after dinner and was severe within a span of 3 hours. He denies any trauma, fever, systemic symptoms, or prior similar episodes. He has a history of hypertension for which he takes hydrochlorothiazide (HCTZ). He admits to consuming a great amount of wine last night with dinner .On examination, his temperature is 98°F, his pulse is 90 beats/min, his respirations are 22 breaths/min, and his blood pressure is 129/88 mm Hg. Heart and lung examinations are unremarkable. The patient is reluctant to flex the left knee, wincing in pain at touch, and has passive range of motion. The knee is edematous, hot to touch, and has erythema of the overlying skin. No crepitation or deformity is apparent. No other joints are involved. Inguinal lymph nodes are not enlarged. Complete blood count (CBC) reveals a white blood cell count of 10,900 cells/mm3 and is otherwise normal.

    needs to be EXACTLY like rubric

    – [\
    \
    SOAPTemplateandRubric_Updated.docx](https://www.sweetstudy.com/files/soaptemplateandrubric-updated-docx-10233855 "SOAPTemplateandRubric_Updated.docx")

    – 2 years ago

  • [Solved] Epidemiologic Study Designs

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    – 2 years ago **files (1)** – ## WK4Assignment8310.docx **## WK4Assignment8310.docx** Epidemiologic Study Designs ![A person holding a baby and a doctor AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/epidemiologic-study-designs-20893183) As introduced in the first few w…

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    – 2 years ago

    **files (1)**

    – ## WK4Assignment8310.docx

    **## WK4Assignment8310.docx**

    Epidemiologic Study Designs

    ![A person holding a baby and a doctor AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/epidemiologic-study-designs-20893183)

    As introduced in the first few weeks of this course, investigators use various epidemiological study designs to study health problems and the effects of health interventions. You have examined several study designs, including descriptive designs (in Week 2) and analytic study designs that are observational (in Week 3) or experimental (this week). As an MSN or DNP student, you should be able to determine which study design would be most suitable for addressing a health problem of interest to you, as this is a foundation for evidence-based practice.

    For this Assignment, you will identify an epidemiologic association of interest (e.g., smoking and lung cancer, obesity and heart disease, hormone replacement/modification therapy and breast cancer) and determine an appropriate study design for exploring that association.

    For this Assignment, you will identify an epidemiologic association of interest (e.g., smoking and lung cancer, obesity and heart disease, hormone replacement/modification therapy and breast cancer) and determine an appropriate study design for exploring that association.

    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/161210/modules/items/6261004)

    **To Prepare**

    · Consider an association between a risk factor and a particular health outcome that is of interest to you. Table 2.2, in Curley, has some excellent options. You may use this to guide your selection of topics or select your own population health topic.

    · Then, select an observational OR experimental study design you think would be the most appropriate for exploring this association. You may select from any of the designs covered in this module.

    **The Assignment**

    In a 3- to 4-page paper, not including title page and references, address the following:

    · Briefly identify the population health topic (association between a risk factor and a health outcome) you selected. Present a research question based on this topic that you would like to answer in a proposed study. (Consult the Walden “Developing Research” resource for guidance on crafting a research question.)

    · Explain the epidemiologic study design that would be most appropriate to assess and address your population health problem.

    · Summarize the data collection activities you would use (i.e., how you would collect data—online survey, paper/pen, mailing, etc.).

    · Explain any specific methodologic strategies you would use. For example, if you were conducting a case-control study, how would you select your cases and controls?

    · Consider the methods you would use to make these selections. What are the strengths and limitations of your selected approach?

    · Explain ethical considerations pertaining to your study.

    ## image1.jpeg

    **## WK4Assignment8310.docx**

    Epidemiologic Study Designs

    ![A person holding a baby and a doctor AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/epidemiologic-study-designs-20893183)

    As introduced in the first few weeks of this course, investigators use various epidemiological study designs to study health problems and the effects of health interventions. You have examined several study designs, including descriptive designs (in Week 2) and analytic study designs that are observational (in Week 3) or experimental (this week). As an MSN or DNP student, you should be able to determine which study design would be most suitable for addressing a health problem of interest to you, as this is a foundation for evidence-based practice.

    For this Assignment, you will identify an epidemiologic association of interest (e.g., smoking and lung cancer, obesity and heart disease, hormone replacement/modification therapy and breast cancer) and determine an appropriate study design for exploring that association.

    For this Assignment, you will identify an epidemiologic association of interest (e.g., smoking and lung cancer, obesity and heart disease, hormone replacement/modification therapy and breast cancer) and determine an appropriate study design for exploring that association.

    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/161210/modules/items/6261004)

    **To Prepare**

    · Consider an association between a risk factor and a particular health outcome that is of interest to you. Table 2.2, in Curley, has some excellent options. You may use this to guide your selection of topics or select your own population health topic.

    · Then, select an observational OR experimental study design you think would be the most appropriate for exploring this association. You may select from any of the designs covered in this module.

    **The Assignment**

    In a 3- to 4-page paper, not including title page and references, address the following:

    · Briefly identify the population health topic (association between a risk factor and a health outcome) you selected. Present a research question based on this topic that you would like to answer in a proposed study. (Consult the Walden “Developing Research” resource for guidance on crafting a research question.)

    · Explain the epidemiologic study design that would be most appropriate to assess and address your population health problem.

    · Summarize the data collection activities you would use (i.e., how you would collect data—online survey, paper/pen, mailing, etc.).

    · Explain any specific methodologic strategies you would use. For example, if you were conducting a case-control study, how would you select your cases and controls?

    · Consider the methods you would use to make these selections. What are the strengths and limitations of your selected approach?

    · Explain ethical considerations pertaining to your study.

    ## image1.jpeg