Nursing Essay Writing Service CASP Qualitative Analysis

1. Was there a clear statement of the aims of the research?

Yes,

The study’s objective is to explore the financial burden/stress that families experience from cancer. The researcher’s justification for the study’s aim includes; Most of the research on the implications of cancer on the family addresses emotional distress, coping behavior, the burden on the caregivers, and the quality of life. However, there are no studies on the economic and spiritual implications of cancer on the caregivers. The researchers indicate that the current literature does not address the impact of cancer-related financial issues on the family’s well-being, daily living activities, relationships, and roles. The researchers further indicate that there are limited studies in the UK that mainly focus on cancer and the financial burden. Most of the existing literature is from other countries, such as the United States (US). Thus, it has limited applicability in the UK due to disparities in welfare and healthcare insurance provision. Additionally, most publications on financial issues related to cancer focus on the family cost rather than the patient alone. The publications also focus on the costs incurred during treatment, and there is little emphasis on the expenses incurred during the recovery and the survivorship duration (Amir et al.,2012).

2. Is a qualitative methodology appropriate?

Yes

, The qualitative method is an excellent methodology for the analysis of the topic under investigation. Qualitative methodology is used when the researcher intends to explore people’s experiences as identified in the study. The researchers recruited forty people of age 18 years and above with cancer diagnosis and interviewed the possible carers; This indicates the researchers aim to obtain information from experienced individuals on the phenomenon under investigation. Qualitative methodology answers the “what,” “how,” and the “why” questions rather than seeking the numerical data to answer the question (Hammarberg, Kirkman and de Lacey,2016). For instance. The study intends to answer the “what” question by exploring the implications of cancer-related financial burden or stress on the family’s lifestyle. The qualitative methodology applies interviews as a data collection method to gain in-depth knowledge of the study’s phenomenon. For instance, in the study, the researchers designed one-on-one interviews and freely shared their experiences. Again, the talk was flexible to suit the participants(Amir et al.,2012).

3. Was the research design appropriate to address the aims of the research?

Yes,

The research design caters to the study needs. The researchers explain how they developed the research design. The researchers applied an exploratory qualitative research design based on grounded theory elements, including; using a flexible interview guide and concurrent data analysis through a constant comparative technique and theoretical sampling. The researchers considered the demands of the ethical committee in the research approach. Therefore, the researchers allowed the healthcare providers caring for the participants to identify, approach, and provide them with the study information and only interviewed those who consented. The researchers sampled the participants through a maximum variation approach as the method allows the qualitative researchers to address the variations in experiences and the main research issue. The researchers perceived sampling as more theoretical with the progress made in data collection and analysis(Amir et al.,2012).

4. Was the recruitment strategy appropriate to the aims of the research?

Yes,

Recruitment is an essential consideration for research. In qualitative analysis, the researchers aim to obtain information from a particular group with experiences on the phenomenon under investigation(Anderson,2017). For instance, in the article, the researchers get participants from the regional cancer center. The researchers adhered to the ethical committee requirements, thus involving a health professional or a support group to identify, approach, and provide study information to the participants. The researchers interviewed those who consented. There were no participants who dropped out of the study. The participants hailed from North West England and were under treatment or clinical follow-up in the hospitals within the region. The researchers selected participants with the informed consent age of 18 years and above with cancer diagnosis, and those with cancer were interviewed. The researchers sought specific information from the working participants and individuals who needed financial aid. The researchers also made efforts to increase the ratio of minority participants. The researchers indicate that the approached patients were 16 weeks post-diagnosis to allow them time to accept the situation and be aware of the actual financial difficulties. The researchers excluded patients without knowledge of diagnosis and provided the interviewees with patient consent(Amir et al.,2012).

5. Was the data collected in a way that addressed the research issue?

Yes,

The study setting was a North West England residential area, and data was collected from the individuals under treatment and those under clinical follow-up in the regional hospitals. The researchers sampled the participants purposively through the maximum variation sampling as the method allows them to identify variations of experiences and the main issue under investigation. Upon receiving consent forms, the researchers telephoned the study participants, responded to any concerns, and scheduled the interview date and time. The researchers recorded the interviews digitally upon consent, and the interviewers designed contextual notes. The researchers developed the interviews in a conversational style that allowed them to input the study topic. The researchers used a flexible interview guide and a simultaneous analysis. The interview guide design was as follows; asking the participants to provide information about any financial difficulties/stress experienced due to cancer treatment. The questions and prompts that followed explored all the participants’ financial situations due to cancer diagnosis, including the impact on children and the family. However, the researchers did not discuss data saturation(Amir et al.,2012).

6. Has the relationship between the researcher and participants been adequately considered?

Yes,

The research article mentions that the eligible participants were identified by the health professionals, the support groups, or the helpline contacts. It is difficult to identify any potential bias or influence as while the participants were identified by a different group and interviewed by the research personnel and digitally recorded. However, researchers or healthcare professionals’ relationship between the researcher and the participant may be influenced by reflexivity. Reflexivity is the researcher’s ability to be aware of their contribution to creating the meanings throughout the research process and acknowledging the impossibility of remaining “outside the forty participants’ during the research. The researchers enhanced the credibility of interpretation of the data and the research researcher’s ability amongst themselves and with the project advisory committee to compare and challenge their understanding, thus reducing the risk of potential bias(Amir et al.,2012).

7. Have ethical issues been taken into consideration?

Yes,

The researchers considered the ethical issues by adhering to the ethical committee requirements b involving the healthcare professionals and the support groups to identify, approach, and relay study information to the participants. The researchers indicate that only those who consented were interviewed. The researchers involved the participants with the ability to provide informed consent that is from age 18 years and above. The researchers interviewed the carers upon patient consent. The researchers sent the eligible participants the study information sheet and the consent form and telephoned them upon submitting the informed consent form. Interview recordings were anonymous. The researchers indicate that participation in the study was voluntary. The researchers sought ethical approval from the Salford and Trafford Local Research ethics committee and received ethical approval from the Research Development Committee(Amir et al.,2012).

8. Was the data analysis sufficiently rigorous?

Yes,

The research demonstrates an in-depth description of the analysis process. The researchers transcribed verbatim anonymous interviews and performed a thematic analysis. Thematic analysis is highly inductive as the themes emerge from the data and not influenced by the researchers, thus reducing bias through the NVIVO 7. The researchers read every transcript to understand its meaning, identified the common themes, and organized the relevant data to the themes. The researchers also considered contextual notes in the analysis. The researchers enhanced the credibility of interpretation of the data and the research rigor through discussions amongst themselves and with the project advisory committee to compare and challenge their understanding, thus reducing the risk of potential bias(Amir et al.,2012).

9. Is there a clear statement of findings?

Yes,

It is crystal clear that the researchers generated the following findings from the data analysis; cancer affects the family finances, the implications of cancer on family finances, the impact of financial problems on the families’ lifestyle, and the effects of economic issues on the roles and relationships. The researchers provided sufficient information for each theme to support their arguments. The researchers quote the participants’ narratives in the findings section. The study’s credibility is enhanced by the researcher’s findings on expenses and income loss align with what is identified in the previous publications. The results sufficiently answer the research question. There were no arguments against the research question(Amir et al.,2012).

• How valuable is the research?

The researchers presented sufficient evidence on the impact of financial challenges and stress that cancer inflicts on family life. The research identifies issues that have not been previously addressed, thus generating new knowledge for the topic. The researchers indicate that the qualitative findings are hard to generalize; however, the purposive sampling used in the research produces a vast and rich data on the financial issues related to cancer. The researchers indicate that the findings are transferable as the readers are at liberty of judging if the results suit their needs and are relevant to their experiences. The researchers also indicate that transferability is possible for the findings on extra expenses and income loss. Again, the results boost the literature focus by identifying that cancer’s financial problems significantly affect family lifestyles, roles, and relationships. The researchers recommend further research on the blacks’ economic issues and the minority ethnic groups (Amir et al.,2012).

References

Amir, Z., Wilson, K., Hennings, J., & Young, A. (2012). The meaning of cancer: implications for family finances and the consequent impact on lifestyle, activities, roles, and relationships. Psycho‐Oncology, 21(11), 1167-1174.

Anderson, V. (2017). Criteria for evaluating qualitative research. Human Resource Development Quarterly, 1-9.

Hammarberg, K., Kirkman, M., & de Lacey, S. (2016). Qualitative research methods: when to use them and how to judge them. Human Reproduction, 31(3), 498-501.

 

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When they start their studies as nurses, there are many complex but important topics that they will have to deal with. Every subject they study at university will eventually contribute to the nursing and care of others.

Even though nursing students are skilled in practical nursing elements, some struggle to communicate their ideas and thoughts in writing and cannot show off their talents. Others may not be able to comprehend the essay question they were given, have too many essays to concentrate on or lack the confidence to get the grade they want.

You might have been assigned to discuss health, public health, and health promotion. This includes an understanding of the factors that impact health in a multi-cultural society. You may also be required to research mental and physical health care, problem-solving, and how prioritise your nursing skills. Our clients also asked us for advice on how to transition from student nurse into a qualified professional nurse, and how to continue developing their nursing skills and knowledge throughout their careers. The session covered general nursing concepts, as well as an introduction to medical and surgical nursing. It also included a detailed analysis of cases and how they are delivered. We have qualified nurse researchers available to help you find the right answer for whatever assignment you’ve been given.

1.To what extent is this problem due to a failure to lead? Who has failed to act?

Rosemary’s problem attributes to the fact that she is not getting enough attention from clinical experts as her colleague Jan. Jan works alongside experienced staff; Rosemary works alone during her night shift. I believe Rosemary wishes to work alongside an experienced team to gain the relevant knowledge and experience like her colleague. That way, if a problem arises, she would report to a clinical. She should have expressed her concerns in good time; thus, to some extent, she is to blame.

I feel that the nurse manager failed to act; she should be available to address any problems encountered by Rosemary and guide her through the challenging tasks she may face in her line of work. In this scenario, the manager fails to take her roles seriously. The case illustrates that she lets her assistant assign duty schedules without confirming if the allocation is right. She fails in staff management, scheduling, and educating roles (Espinoza et al. 2009). As a new staff, Rosemary lacked proper orientation and education; thus, it was irresponsible for the nurse manager to schedule her for a nightshift alone. Such acts could have legal implications.

2. What style of leadership was displayed by Rosemary? The nurse manager?

Both Rosemary and the Nurse manager displays a poor leadership approach. Rosemary shows her willingness to express her concerns to the nurse manager; we cannot justify this as good leadership since she fails to see the nurse manager and communicate promptly. The nurse manager demonstrates a Laissez-faire form of leadership. Silvestri & Silvestri (2019). indicate that Laissez-faire entails assigning roles to the employees and entrusting them to work with minimal or no supervision; this form of leadership gives employees a sense of belonging. However, it is essential to note that all employees do not have equal capability and enough potential to achieve organizational objectives. Therefore, before entrusting Rosemary, the nurse manager should ensure that Rosemary has enough potential to deliberate the assigned tasks successfully.

3. How effective was their leadership? What are your suggestions for Rosemary?

The form of leadership displayed in the case scenario is ineffective. The management shows no concern for the employee. Although Rosemary tried to reach the nurse manager on several occasions, she was never available. Favoritism is also evident in this scenario. Jan worked through all the day shifts when the nurse manager and other colleagues are available to guide her in her roles while Rosemary is left to work alone at night. I feel that they should have alternating shifts where sometimes Rosemary would also work during the day. I suggest that Rosemary should be bold enough to walk to the Nurse manager and express her concerns. She should also invoke a safe harbor if she feels that she is not ready for the assigned role. She must take action before things get out of hand or cause any harm to a patient, which she might suffer legal consequences. One cannot defend herself through ignorance on legal matters. Alternatively, Rosemary should always ask for directions from a more experienced colleague in the pediatric unit.

References

Chaudhry, A. Q., & Javed, H. (2012). Impact of transactional and laissez-faire leadership style on motivation. International Journal of Business and Social Science, 3(7).

Silvestri, L. A., & Silvestri, A. E. (2019). Saunders Comprehensive Review for the Nclex-Rn (r) Examination-E-Book. Saunders. Nursing Quarterly, 32(4), 327-334.

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Case Study: Healing and Autonomy

Mike’s Decision and Physician’s Responsibility to James

According to Reach (2014). Autonomy is considered as the patient’s liberty to make personal decisions and where patients lack the capacity the caregivers or family members make decisions on their behalf. Compliance is required of the physician in cases where autonomy rules, however, if the decision made endangers the patient’s wellbeing then the physician’s decision out rules autonomy.

Christian beliefs play a key role in making ethical decisions for believers. Mike and Joanne are active church members and just like any other Christians they believe that God has the power to heal (Hall, 2014), however, their efforts have proved futile since James’ condition is worsening. As a result, there is a need to determine the extent of ethicality alongside the Christian beliefs and values in this particular case. Their decision worsens their son’s condition and is therefore considered an unethical decision due to the wrong outcomes (Beauchamp & Childress, 2001).   The physician acknowledges that James needs a kidney transplant in a year. He/she further knows the negative implications of delayed treatment and therefore should not allow the irrational decisions that Mike is making regarding his son’s health. The physician should let Mike and his wife understand the negative health implications of delaying the treatment process and explain to them that while religion part of human existence, there is need to bridge a gap between the physical and the religious aspect of life.   Mike and Joanne have allowed their Christianity belief to crowd their judgment regarding their son’s well-being. The physician should make them understand the facts about kidney dialysis from a medical perspective.

Christians Views on Health and Sickness

Christians have diverse views regarding health and sickness. However, all Christians must embrace sickness and health as part of human existence. They should shun the belief that sickness is part of suffering due to wrongdoing; the bible demonstrates instances when God used sicknesses on faithful individuals like Job as a test of faith (Testament 2015).

Mike believes that James’ need for a kidney transplant whose donor is his twin brother is a real test of faith and that he requires to uphold that faith more than ever in that particular instance. Other Christians acknowledge that sickness resulted from the fall of man, however, they should shun from believing that they are subjects of pain and suffering due to disease. Amidst these beliefs, God requires them to have good health. It, therefore, their responsibility to take good care of their bodies as the temple of God They should further, maintain high quality of life (Testament 2015)… Medical interventions while sick are therefore inevitable for Christians. God requires Christians to acknowledge and respect the role of physicians in administering treatment. This is because they are giving a service which is a demonstration of God’s love. Opposing medical intervention is against the scripture in Mark 2:17 Jesus acknowledges that” it is not healthy who need a doctor, but the sick”. Therefore Mike’s parents should be bound by the scripture especially when they decided to forego dialysis for their son and seek faith instead and in the case where he refuses the option of a kidney transplant and considering it as a test of faith.

According to Meilaender (2013), the principles of beneficence and non-maleficence are key in provision of medical services. The physician’s interest as guided by the principle is based on the patient’s goodwill and maximum recovery. Non-maleficence, provide for safe handling of the patients and application of ethical guidelines while handling the patient while the beneficence principle is focusing on the needs of the patient in administering treatment. These principles further provide that physicians need to assess the patient’s symptoms which plays a role in diagnosis and administering treatment. The physician adopts immediate treatment measures for James to manage glomerulonephritis thus reducing the pain he is experiencing. James’ physician further upholds these principles of medical interventions by suggesting immediate dialysis for his condition and a consequent kidney transplant for the critical conditions. The physician further embarked on searching for an ideal match.

How a Spiritual Needs Assessment Help Determine Appropriate Intervention

Despite Mike making irrational decisions that prove detrimental to his son, the physician is expected to allow him make the decisions regarding the care services he prefers for his son to others as provided by the principle of autonomy (Hall 2014). Therefore, spirituality and spiritual assessment are key in providing appropriately for Mike to determine an appropriate medical intervention for James’. The physician should be open to determine Mike’s spiritual needs. Mike upholds the view of spiritual healing and therefore the physician’s intervention in swaying him to change his decision about kidney transplants is insignificant. The physician should learn more about his spirituality by asking him open-ended questions about his spiritual beliefs. He/she should further plan a meeting with Mike, his wife Joanne, and his religious leaders to determine the spiritual approach regarding dialysis and kidney transplants and seek spiritual solutions to James’ problem. The physician can further explain the prevailing medical condition and the most appropriate intervention in his/her medical point of view to the religious leader and ask him for intervention in swaying Mike’s decision on waiting for a miracle while his son’s problem requires a kidney transplant. Saguil & Phelps( 2012) indicated that a spiritual need assessment will guide the physician in integrating Mike’s spirituality in managing James’ condition, this will, in turn, build trust and rapport and broaden his relationship with Mike and all individuals involved for James’ well-being when Mike trusts the physician’s decision is in the best interest of his child, he will adhere to the physician’s recommendations and comply with the medical interventions suggested and in this case, he will accept a kidney transplant for his son

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Beauchamp, C. (2001). TL Beauchamp, JF Childress. Principles of Biomedical Ethics.

Hall, H. (2014). Faith Healing: Religious Freedom vs. Child protection. Science and Religion. Retrieved September 9, 2016, from http://www.csicop.org/si/show/faith_healing_religious_freedom_vs._child_protection

Meilaender, G. (2013). Bioethics: A Primer for Christians (3^rd Ed.). Grand Rapids, Michigan / Cambridge, U.K: William B. Eerdmans Publishing Company

Reach, G. (2014). Patient autonomy in chronic care: solving a paradox. Patient preference and adherence, 8, 15.

Saguil, A., & Phelps, K. (2012). The spiritual assessment. American family physician, 86(6), 546-550.

Testament, O. (2015). Holy Bible.

Diabetes is a common health complication resulting from excessive glucose in the blood (Katsarou et al.,2017). According to the American Diabetes Association (2018), about 34.2 million Americans were diabetic in 2018. Out of this, 1.6 million of the population had type 1 diabetes, with about 187,000 children and young adults. The report also indicates that approximately 210,000 young adults have diabetes. According to statistics, diabetes ranked as the seventh leading contributor to mortality rates in the United States (US) as of 2017.

Diabetes occurs due to excessive glucose accumulation in the blood when the body cannot process glucose properly. The factors that impair glucose processing include; failure of the pancreas to produce insulin or insufficient insulin and insulin failure to function correctly. The two types of diabetes include; Type 1 diabetes that occurs due to disintegration of cells that produce insulin and Type 2 diabetes that is associated with insufficient production of insulin or failure of the body cells to react with insulin (Katsarou et al.,2017).

This report is a case study analysis for a 13-year-old adolescent girl admitted and diagnosed with Type 1 diabetes in the pediatric unit. Her mother is her primary caregiver.

Pathophysiology  case study analysis for a 13-year-old adolescent girl admitted and diagnosed with Type 1 diabetes

Type 1 diabetes occurs due to destruction of the cells that generate insulin, thus impairing insulin production. The process is triggered by an abnormal reaction in the cells due to a virus or an infection. The condition occurs at any age and is common in childhood, as identified in the case study—destruction of beta-cells causes insulin deficiency. Loss of the islet cell occurs due to genetic susceptibility, environmental factors, and autoimmunity. Autoimmunity is associated with cell and cytokine injury of the beta cells. The autoantibodies, antibodies, and glutamic acid decarboxylase destroy the islet cells. The environmental factors that stimulate the autoimmune reaction include; medication like pentamidine, streptozocin, and alloxan. High consumption of bovine milk and foods with nitrosamines also trigger autoimmune injury and even viruses. The most commonly affected beta cells include the cytomegalovirus, mumps, and rubella.

Additionally, type 1 diabetes may be stimulated by pancreatitis (Zaccardi et al.,2016). Patients present rapid symptoms when the cells stop producing insulin, including polydipsia, polyphagia, and polyuria. Polydipsia increases blood sugar level, which causes an increase in the body cells’ osmotic pressure, thus resulting in intracellular dehydration and thirst, which is stimulated by the hypothalamus. Polyuria occurs when the blood glucose increase, therefore, acting as an osmotic diuretic. Glucose filtration in the glomeruli is higher than glucose level for reabsorption in the renal tubules thus causing glycosuria. At this point, the patient losses excessive water and electrolytes through urine. Polyphagia occurs due to the cells’ reduced capacity to store proteins, carbohydrates, and fats, resulting in starvation. The patient losses weight and develops fatigue due to loss of body fluids, and they utilize fats and proteins as a source of energy (Katsarou et al.,2017).

Lab abnormalities

Upon assessing the patient’s health history, subjective data include; The patient may have a viral infection like rubella, mumps, coxsackievirus, or any condition—a history of trauma or surgery. The patient might have used medications or regime. Functional health indicates metabolic health patterns like weight loss, thirst, nausea, vomiting, wound healing difficulties, and diet compliance. The patient’s activity and exercise level show fatigue and muscle weakness. The patient may express a blurred vision, abdominal pain, headache, and numbness in the extremities. Objective data include; Kussmaul respiration, confusion, tachycardia, and hypotension. Additionally, the client may have impaired skin integrity, low blood pressure, and increased heartbeat rate. The patient may have a history and risk factors for type 1 diabetes, including insulin resistance, pancreatitis, and infection (American Diabetes Association,2018).

Diagnosis

There are several tests for type 1 diabetes, including a random blood sugar test, a preliminary screening for type 1 diabetes taken at any time. A positive diagnosis for diabetes is indicated by the blood sugar level of 200mg/dL or 11mmol/L and above. Glycated hemoglobin (A1C) test is used to determine the average of the client’s blood sugar level in the previous three months. The presence of diabetes is confirmed if the A1C level is 6.5% and above upon repeating the test. A fasting blood sugar test after fasting overnight. A positive test for type 1 diabetes occurs if the fasting blood sugar level is 126mg/dl or 7,0 mmol/L or higher. Additional tests are also necessary to rule out type 2 diabetes and develop an effective care plan. They include; A blood test to determine the common antibodies present in type 1 diabetes patients. A urine test to determine if ketones are present since they suggest type 1 diabetes (American Diabetes Association,2018).

Implications for Self-Care

Self-care is the patient’s ability to sustain healthy lifestyle behaviors critical to coping with health conditions. Self-care demands that individuals use their resources to promote their health and consider the patients and the caregivers’ actions to maintain good health (Hartweg, 2015). For diabetic patients, as in the case of a 13-year old girl, positive self-care entails; healthy eating habits, physical exercises, regular monitoring of the blood sugar level, adherence to medication, development of healthy coping mechanisms, and refraining from the risk factors for diabetes.

Abraham Maslow’s hierarchy of needs has five levels, which include;(1) physiological conditions, (2) safety, (3) sense of belonging, (4) self-esteem needs, and (5) self-actualization. The hierarchy is critical for prioritizing the needs of the patients. Kenowitz et al. (2020) present the hierarchy needs for type 1 diabetes patients as follows;(1)The survival needs include; insulin, administration of insulin, and control; they also need close monitoring by the healthcare workers, education, and information needs. (2)The patient’s safety needs include; family, peer, community support, and increased knowledge and coping skills. (3)A sense of belonging is rooted in the family and peer support and the patient’s ability to adapt and participate in everyday activities like any other teenager. (4)The 13-year-old patient’s self-esteem needs include; a desire for strength, independence, achievement, and confidence. (5) Lastly is the self-actualization level where a patient would desire to accept themselves for who they are and to continue pursuing her dreams in school, the desire to convince herself that type 1 diabetes is not a death note and she can live with it and continue to pursue her dreams Kenowitz et al. (2020)

 

Orem’s theory of self-care demands that individuals be capable of taking care of their needs (Hartweg, 2015). However, the 13-year old girl described in the case study is a minor; she solely depends on her mother for survival. The case study describes her mother as her caregiver and seats at the bedside during the period the client is in the hospital; thus, it might be difficult for a single mother to raise income to cater to her child’s health needs. Additionally, the mother spends time by the bedside, making it difficult for her to work and make a living.

Patient Education Strategies

Treatment of type 1 diabetes is critical to avoid further complications. The treatment goal for the condition is to keep the blood glucose level in a normal state as much as possible to protect the patient from any difficulties. The interventions focus on keeping the glucose level in the blood between 80 and 130 mg/dl before eating and below 180mg/dl after food consumption. Treatment for type 1 diabetes includes; administering insulin, close monitoring of the patient’s dietary intake and blood sugar level, healthy nutrition intake, and regular exercise to maintain healthy body weight. Insulin is administered through an insulin pump or an injection (Phelan et al., 2018).

Education is critical for the successful management of diabetes. According to Phelan et al. (2018), childhood and adolescent diabetes helps control glycemia and promotes the patient’s psychological well-being. Diabetes education also aims to help the patient develop a self-management attitude against the disease. Education strategies include; informing the patient and the caregiver to remain committed to managing diabetes; this entails adhering to medication, adopting healthy eating practices, participating in physical activity programs, and establishing a healthy relationship with the health care provider. Secondly, inform the patient to identify herself by wearing a tag or bracelets, indicating she has diabetes. The patient should always carry the glucagon kit so that friends and loved ones can help with a low blood sugar emergency. Thirdly, advise the patient to schedule an annual physical and eye exam so the doctor can assess for any complications and any medical issues—the eye specialist checks for any damage to the retina, glaucoma, or cataracts. Fourthly, inform the patient and caregiver to update the vaccination dates; type 1 diabetes weakens the immune system. Therefore, the physician may recommend vaccination against pneumonia. Fifth, inform the patient to care for her feet by washing the feet with lukewarm water and gently drying them, particularly between the toes. The patient should also moisturize the feet with lotion and check for any injuries in the feet. Again, inform the patient to consult the doctor if she has a sore. Sixth, educate the patient and the caregiver to control the blood pressure and cholesterol through healthy dietary intake, regular exercises, and adhering to the recommended medication.

Interdisciplinary Collaboration

Successful management of type 1 diabetes for the 13-year-old patient requires collaboration between health care providers. Upon diagnosis, the patient needs a close medical follow-up to stabilize the blood sugar levels. An endocrinologist, a hormonal disorder specialist, coordinates the diabetes care team. Additionally, the healthcare team includes; a diabetologist, a doctor whose specialty is type 1 diabetes. The patient should visit the diabetologist every three months until the condition is under control. Secondly, a diabetes specialist nurse (DSN) helps in the treatment and management of type 1 diabetes. The nurse supports the patient’s independence and promotes self-management approaches to reduce the risk of complications and extended hospital stays. Thirdly, a general practitioner (GP) monitors the client’s overall well-being and refers the patient to appropriate specialists. Fourthly, a dietician to guide the patient on healthy nutritional choices, food one should take, and planning the meal menu. Fifth, a psychologist to provide patient support as she adjusts to living with diabetes. Sixth, an optometrist manages eye damage, a common problem among diabetic patients (Katsarou et al. 2017).

Conclusion

From the literature, diabetes is a common health complication caused by high blood sugar levels. Type 1 diabetes is most common in childhood, as in the case of a 13-year-old patient. Diabetes is a chronic illness, thus negatively impacting the economy, the healthcare system, the patient, and the caregivers. The paper has explored the pathophysiology of the disease, including the lab abnormalities and the diagnosis. Nursing interventions for type 1 diabetes aim to keep the blood sugar level in check and take insulin a priority for a patient with type 1 diabetes. Additionally, education for type 1 diabetes should aim at enhancing the self-management ability of the patient. Consequently, successful management of the condition requires a multidisciplinary approach and collaboration between healthcare providers.

References

American Diabetes Association. (, 2018). 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2018. Diabetes care, 41(Supplement 1), S13-S27.

Hartweg, D. L. (2015). Dorothea Orem’s self-care deficit nursing theory. Nursing theories and nursing practice, 105-132.

Katsarou, A., Gudbjörnsdottir, S., Rawshani, A., Dabelea, D., Bonifacio, E., Anderson, B. J., … & Lernmark, Å. (2017). Type 1 diabetes mellitus. Nature reviews Disease primers, 3(1), 1-17.

Kenowitz, J. R., Hoogendoorn, C. J., Commissariat, P. V., & Gonzalez, J. S. (2020). Diabetes‐specific self‐esteem, self‐care, and glycaemic control among adolescents with Type 1 diabetes. Diabetic Medicine, 37(5), 760-767.

Phelan, H., Lange, K., Cengiz, E., Gallego, P., Majaliwa, E., Pelicand, J., … & Hofer, S. E. (2018). ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes education in children and adolescents. Pediatric diabetes, 19, 75-83.

Zaccardi, F., Webb, D. R., Yates, T., & Davies, M. J. (2016). Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year perspective. Postgraduate medical journal, 92(1084), 63-69.

 

Capstone Reflective Journal Instructions

Each week, record your experiences, connections to your course goals, and reflections as they relate to the given prompts and/or your course project. You must record one entry each week, but may record more (insert rows as needed). You may find it helpful and rewarding to record one entry at the beginning of the week, think about the prompt during the week, then record another at the end of the week. For privacy, refer to patients, online colleagues, and/or co-workers with initials instead of names.

Save this document to your own computer desktop or storage device after each entry to create a cumulative journal. You will upload the document and submit it each week by 2359 Saturday night.  No Reflective Journal entry is made on Module 7.

Remember that the more thoughtfully and intentionally you record your immediate reflections, the easier it will be for you to pull all your experiences and thoughts together for your Synthesis Paper in Module 7.

Module Journal Entries A separate Journal entry is required for Modules 1-6 by 2359 Saturday of each indicated module.  Provide details of your thinking, including insights, challenges, paradigm shifts, and goals. Identify previous course topics, readings, or research that relate to the prompt.
	Journal Entry
Module 1: Identify 3 key points form this module.  Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area.
Key Point 1	Understanding learning capability and application of strategies Completing the VARK helped me understand that  there are diverse alternatives to tackle challenges and individuals apply different approaches to solve problems like there are multiple learning styles. The assignment instilled me with organization and prioritization skills; This is an aspect of role development identified in the transition to professional nursing course. The lesson also aligns with the “time management” element specified in the Nursing leadership and management course. The study is significant for my practice, enabling me to prioritize patient care and my needs.
Key Point 2	Providing patient with sufficient information regarding safety I gained this insight through the peer-reviewed article I searched from the UTA library for my capstone project. The article emphasized promoting the safety of older patients through fall prevention. The article points out how to identify an unsafe environment that may promote patient falls. Safety information encourages patients to take responsibility. The insights gained from the nursing research article were critical in helping me identify the research article. The impact of this lesson in my work experience is that providing information about patient safety enhances collaboration with the physicians to yield better quality care.
Key Point 3	Identifying and understanding an individual’s personality, as demonstrated by Keirsey’s Temperament Theory. Keirsey’s Temperament Theory demonstrates diversity in the behaviors and personalities of individuals. The theory identifies the primary categories of temperament as; Guardian, rational, idealist and artisans. Understanding human behavior plays a critical role in conflict resolution. I consider myself a guardian. The theory relates to my RN-BSN since I perceive myself capable of creating an enabling environment for the healthcare providers and advancing the nursing profession.
Module 2: Identify 3 key points form this module.  Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area.
Key Point 1	Importance of Goal Setting Setting goals is a critical aspect of an individual’s personal and career life. Goals should be specific and match an individual’s expectations. The SMART acronym guides goal setting and helps one to achieve the set goals. The abbreviation represents Specific, Measurable, Achievable, Realistic, and time-bound. One of the articles suggested that it is critical to write down one’s goals. This activity is crucial for my nursing practice. I will reflect and continually evaluate my professional goals. I will set goals when caring for my patients and ensure that is meet them to achieve positive results.
Key Point 2	Cultural and Religious Awareness This week’s activity helped me understand that culture and spirituality play a critical role in patient safety. I deduced that some cultural factors affect the behavioral response of patients towards health promotion programs. For instance, ethnicity affects individuals’ perceptions of health promotion strategies against patient falls. Older persons have a fatalistic understanding of patient falls, resulting in behavioral changes after participation in health promotion programs. As a nurse practitioner, I should value cultural diversity between my colleagues and the patients and discourage the cultural and spiritual beliefs that undermine the patients’ well-being. Cultural, spiritual, and sexual ideas should not get in the way of a patient’s safety. However, it is critical to respect the patient’s beliefs. This week’s discussion posts were crucial for this lesson. The insights will help me relate well with the patients and colleagues and make clinical decisions while considering the cultural and spiritual implications.
Key Point 3	Finding and summarizing peer-reviewed articles Evidence-based research is a critical aspect of nursing research. This week, I could locate three peer-reviewed articles related to my capstone research project, “prevention of falls in older patients.” I followed the UTA library guide step by step and to locate high-quality articles about the topic. Again, I identified the critical aspects of the peer-reviewed paper that relate to my research topic. The nursing research course was crucial to achieving this week’s objective. I intend to apply the evidence-based practice insights gained from the nursing research course and this activity as a nurse practitioner to make an informed clinical judgment based on the evidence, thus promote patient safety.

 

 

Module 3: Identify 3 key points form this module.  Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area.
Key Point 1	Issues Related to Patient Falls This week I reflected upon the issues related to my capstone project topic. I searched for three peer-reviewed articles regarding patient falls and performed a synopsis on the paper by Smith et al. (2015). I realized that patient falls is a critical healthcare issue that needs to be addressed. I was shocked to learn that patient falls are the leading preventable cause of mortality rates among older patients in the emergency departments. Injuries and deaths related to patient falls cost the United States a large amount of money every year. Unfortunately, the risk continues to rise due to the increase in the aging population across the country. I learned that falls are associated with feelings of embarrassment and affect the patient’s physical and emotional state. The insights gained from the nursing research course helped me identify the most recent (within five years) peer-reviewed article for my capstone project and perform the article synopsis. The insight gained from this activity is critical for my nursing practice as now I understand the severity of the patient falls issue. I will foster to enhance safety for my patient to prevent falls in my work setting. Reference Smith, M. L., Stevens, J. A., Ehrenreich, H., Wilson, A. D., Schuster, R. J., Cherry, C. O. B., & Ory, M. G. (2015). Healthcare providers’ perceptions and self-reported fall prevention practices: findings from a large New York health system. Frontiers in public health, 3, 17. https://doi.org/10.3389/fpubh.2015.00017
Key Point 2	Dissemination of Evidence-Based Research By completing the assignments for this module, I learned about the dissemination of evidence-based research. First, I was able to identify the target audience for my capstone project, including falls patients, their families, and caregivers. Again, I realized that my capstone project’s information would be critical for nurse practitioners to perform a fall risk assessment to identify the patients at risk of falling. Additionally, the data would help create community awareness and healthcare management to establish safety measures against falls within the healthcare facilities. I was intrigued by the numerous strategies; visual, verbal, and demonstration could relay information to the audience. I considered PowerPoint presentations, guided discussions, and brochures as essential tools to relay information to my audience. I believe that the dissemination of information regarding patient falls will significantly impact the audience. Again, I give credit to the insights gained from the nursing research course in completing this activity. The insights gained from the activity are critical for my future BSN role. I will be required to present projects, nurse care plans, and other relevant materials to the nurse leaders, managers, patients, and colleagues. It will help me to confidently identify the most efficient tools for disseminating information for different audiences.
Key Point 3	Preventing Patient Falls One of the activities for this module was to identify the solution to the identified nursing issue. As I read through Smith et al. (2015), I recognized the various solutions to patient falls, including; modifying the risk factors using multifactorial clinical interventions and using a falls-risk assessment to evaluate the likelihood of falls. The article indicated that training is critical to enhancing the use of a falls-risk assessment tool among the clinicians. Again, I learned that patient education is essential to prevent falls. I can relate the insights gained from this activity to the information in the health promotion strategies course. The data is critical for my future BSN role as I will integrate the primary prevention strategies to promote my patients’ safety. I will also provide patient education regarding different conditions to my patients to improve health literacy. Reference Smith, M. L., Stevens, J. A., Ehrenreich, H., Wilson, A. D., Schuster, R. J., Cherry, C. O. B., & Ory, M. G. (2015). Healthcare providers’ perceptions and self-reported fall prevention practices: findings from a large New York health system. Frontiers in public health, 3, 17. https://doi.org/10.3389/fpubh.2015.00017
Module 4: Identify 3 key points form this module.  Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area.
Key Point 1	Importance of Affiliation to a Professional Organization One of the significant lessons learned this week is the importance of being affiliated with a professional organization. I completed acquired the American Nursing Association certification for basic life support. Currently, I do not belong to any professional organization; however, I plan to join the American Psychiatric Association upon completing the BSN program. I learned that being a member of a professional organization demonstrates a commitment to one’s career. It is also a platform to showcase professionalism. Reading through the discussion posts, I learned the significance of being a part of a professional organization. The professional organizations provide members with an opportunity to network, share, and receive information about the nursing profession’s new trends (Escoffery et al.,2015). This week’s discussion also enabled me to understand that being affiliated with a professional organization is an added advantage for the resume. I am eager to join and commit to a professional organization once I am through with this program. I will apply the knowledge gained from professional organizations in my practice to improve the quality of patient care and satisfaction Reference Escoffery, C., Kenzig, M., & Hyden, C. (2015). Getting the most out of professional associations. Health Promotion Practice, 16(3), 309-312
Key Point 2	Spirituality and Culture in Nursing I gained insights into spirituality and religion in the nursing profession. I researched materials to answer the third question in the discussion board, which was “the professional organization’s spiritual/cultural considerations. In most cases, when spirituality is mentioned, most people tend to think about religion. The relationship between spirituality and nursing always amuses nursing professionals. Sometimes spirituality deters nurses from providing a touch of care to the patients when they are affiliated with a nursing organization. Most nursing professionals forget the nursing goal is to provide holistic acute and long-term care that meets the needs of the patient (Bensing, 2013). The lesson was critical in realizing that I should not allow my spiritual beliefs or perceptions to get in the way of care. Meeting the patient’s spiritual needs and considering it is a requirement for accreditation by the Joint Commission of Healthcare. I will apply the knowledge about spirituality in psychiatric care by being empathetic and respecting my patients. I consider the patient’s spiritual needs during treatment and involve the patients in making critical treatment decisions that account for their cultural and spiritual beliefs. Reference (Bensing, 2013). Retrieved from http://nursing.advanceweb.com/Article/Spirituality-in-Nursing-Part-1-Enhancing-the-Journey-2 aspx
Key Point 3	The Importance of a Professional Resume This week’s discussion reminded me of the significance of a resume in one’s professional life. A resume speaks volumes about an individual. It is a marketing tool for a job applicant and the first thing that meets the employer’s eye before considering a candidate. I learned that a resume is my professional statement that tells the reader about my intentions and professional commitment. I learned that a resume should reflect a person’s ability. As I read through my peers’ posts, I realized that a resume should be designed according to the specific needs of the job, and one should avoid using the same resume to apply for jobs that have different demands. A good resume should portray an individual’s qualifications and not be an overstatement. It should be well designed, free of grammatical errors, and possess the responsibilities and accomplishments for each role taken. It should also be updated continuously (Karsh and Pike,2009).  The technical communication skills class was critical in helping me design my current resume. I will create my resume to the specific job requirements while searching for a job upon completing my BSN program and consider the lessons gained from this class and the technical communication skills course. Reference Karsh, B., & Pike, C. (2009). How to Say it on Your Resume: A Top Recruiting Director’s Guide to Writing the Perfect Resume for Every Job. Penguin.
	Module 5: Identify 3 key points form this module.  Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area.
Key Point 1	Developing a Capstone Project This week has been quite challenging. Finalizing the capstone project was involving, but I am glad I handled the challenge. I completed the capstone project on ‘prevention of falls in older patients’ with an appealing PowerPoint presentation using a straightforward and clear language suitable for my audience. I incorporated visual diagrams throughout the presentation to enhance my understanding of my audience. I used a variety of sources, including peer-reviewed articles, to develop the project. The themes that I addressed in my capstone project include; The causes of falls, John Hopkins Fall Risk Assessment, the importance of a fall risk assessment, nursing interventions, prevention of falls in hospitals. Cultural factors affecting prevention of falls, and the spiritual considerations when caring for fall patients. Developing the topic helped me gain significant knowledge about the prevention of falls in older patients. The most capturing theme in the project was a fall risk assessment. I learned about several fall risk assessment tools, including Morse, STRATIFY, and John Hopkins. However, my focus was on the John Hopkins Fall Risk Assessment Tool. A fall risk assessment is critical as it identifies the likelihood of a patient experiencing a fall and helps nurses develop suitable interventions to prevent falls among the patients. The nursing research course was critical in helping me complete the project. The course guided me in finding high-quality research articles for a project. I intend to apply the skills gained in developing this project for my future projects in my nursing career.
Key Point 2	Presentation Skills As I mentioned earlier, the Capstone project has been a challenging but worthwhile task. After developing the Capstone project, I presented it to a small audience of older patients, the shift managers, and the nursing staff in my unit. I designed my project to match the needs of the audience. I used simple and concise language during the presentation. I demonstrated practical presentation skills, such as maintaining eye contact and being audible. I actively engaged the audience throughout the presentation and allowed them to ask questions. Before the presentation, I gathered enough knowledge regarding the topic and was confident enough to answer any questions asked during the presentation. I was time conscious during the presentation and ensured that everyone understood at the end (Sari, 2011). Dissemination of evidence is critical in the nursing profession. The skills gained from the technical communication course enhanced my presentation skills. I will apply the presentation skills in my nursing profession when providing education to patients and creating awareness about critical topics. I will design my presentations to suit the needs of my audience Sari, P. (2011). Creating an Effective Presentation in English for Business Communication Class.
Key Point 3	Evaluating Presentation Projects I used two evaluation tools, the Likert Scale and a post-test survey, to determine the Capstone Project’s effectiveness. I used the Likert scale to obtain feedback about my presentation skills and the materials’ appropriateness. I considered the Likert scale as it is simple and orderly. It allows the audience to provide an objective opinion about the project (Hutchinson, 2019). I was impressed by the positive feedback provided by the audience. In the second section, I used a post-test survey to determine the knowledge gained from the presentation (Hutchinson, 2019). Evaluating outcomes is part of the nursing profession. Sometimes we consider the treatment outcomes to assess the effectiveness of the project. We also assess if the patient understands the discharge instructions and patient education. We also evaluate the effectiveness of the newly implemented system within the facility and the nursing outcomes. Therefore, evaluation is a critical aspect of nursing practice. Moving forward, I will apply the Likert Scale and a survey test to evaluate the appropriateness of projects in the nursing profession and identify improvement areas. Hutchinson, S. (2019). 7 Assessing oral presentations. Innovative Assessment in Higher Education: A Handbook for Academic Practitioners, 88
	Module 6: Identify 3 key points form this module.  Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area.
Key Point 1
Key Point 2
Key Point 3
	Module 7:  NO ENTRY REQUIRED

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