Category: Nursing

  • Ethical Dilemma_Comment 1

    Ethical Dilemma in Practice

    While working on a cardiac unit, I experienced an ethical dilemma that continues to influence how I approach end of life discussions. One of my patients had a rapidly declining condition. As her health worsened, she became confused and eventually lost the capacity to make her own medical decisions. Before this decline, she had expressed that she did not want aggressive life prolonging measures and did not want to continue returning to the hospital as her condition progressed. Once she lost decision making capacity, however, her family insisted that she remain a full code and continue receiving all possible life saving treatments.

    This situation created tension between respect for patient autonomy and the authority of surrogate decision makers. Ethically, patient autonomy requires honoring previously expressed wishes. In practice, once a patient no longer has decision making capacity and formal documentation is limited or unclear, families often assume control over medical decisions. In this case, the family requested continued hospitalization and aggressive interventions even as her condition declined further with each admission.

    The care team attempted to have direct conversations with the family. We reviewed her prior statements and explained the likely progression of her disease. We discussed what aggressive measures would realistically involve and how they might impact her comfort and quality of life. Despite these discussions, the family continued to push for full treatment. The patient was repeatedly brought back to the hospital against what she had previously communicated she wanted.

    This experience highlighted the emotional complexity that often accompanies surrogate decision making. (Childers, 2021) describe how family members may override a patients expressed wishes due to grief, denial, or fear. Their work emphasizes that surrogate decisions are frequently influenced by emotional distress rather than the patients previously stated preferences. That framework helped me better understand what we were seeing in this case. The familys insistence on aggressive care appeared rooted in difficulty accepting her decline rather than intentional disregard for her autonomy.

    At the same time, the situation created moral distress within the team. (Hwu and Pai, 2025) found that nurses often experience ethical strain when they believe care being delivered does not align with what a patient would have chosen. That description matched how many of us felt. We were legally required to follow surrogate decision making authority, yet it felt inconsistent with the patients earlier wishes.

    The situation was eventually managed through interdisciplinary involvement. Ethics consultation and palliative care were brought in to facilitate structured discussions. Eventually the focus shifted more toward comfort oriented measures, but it required repeated conversations rather than a single intervention. The resolution was gradual and emotionally complex for everyone involved.

    This experience reinforced the importance of early advance care planning. As a registered nurse, I recognize that one of my responsibilities is to initiate clear conversations about goals of care before capacity is lost. Encouraging documentation of advance directives and discussing realistic disease trajectories may prevent similar conflicts. It also reminded me that ethical dilemmas in practice are rarely simple. They require balancing autonomy, beneficence, family dynamics, and legal standards while maintaining compassion for everyone involved.

    References

    Childers , J. (2021, June 9). shes not ready to give up yet!: When a family member overrides the patients medical decisions. Journal of pain and symptom management.

    Hwu, L.-J., & Pai, H.-C. (2025, April 24). Exploring ethical dilemmas and coping strategies in nursing: A FOCUS Group Study of nurses and nursing students. Nursing & health sciences.

    Requirements: Make a Comment

  • Week_5_Comment 2_Path

    GI & Endocrine

    Brandy Fields

    St. Thomas University

    NUR 502

    Dr. Morgan

    February 12, 2026

    GI & Endocrine

    Gastroesophageal reflux disease or GERD as it is most referred is the backward flow of gastric contents from the stomach into the esophagus. The gastric contents can go beyond the esophagus extending into the oral cavity, larynx, or lungs causing esophagitis and inflammation of the other affected mucosal surface (Azer & Goosenberg, 2025). Individuals older than fifty years of age, body mass index greater than thirty, alcohol consumption, lack of physical activity, and the consumption of foods high in fat or acidic contribute to the formation of GERD (Azer & Goosenberg, 2025). The underlying pathophysiology to GERD lies in abnormalities in the lower esophageal sphincter. Relaxation of the lower esophageal sphincter, the presence of hiatal hernias, decreased pressure, and obesity contribute to GERD (Dlugasch & Story, 2023).

    Acid clearance can be another contributing factor if there is an impairment of peristalsis and lack of bicarbonates in salvia to neutralize acid. Delayed gastric emptying and increased intra-abdominal due to pressure changes further contribute to the development of GERD. Overtime repeated exposure of the esophageal lining to acidic gastric contents or chyme led to inflammation of the esophagus or esophagitis. Patients may report symptoms of heartburn, regurgitation of food, nausea, dry cough, or the sensation of a lump in the throat (Dlugasch & Story, 2023). Barrett esophagus, strictures, ulcerations, chronic laryngitis, asthma exacerbation, and esophageal cancer can potentially arise due to GERD. (Dlugasch & Story, 2023).

    Evidence-Based Guidelines

    A symptom-based approach is recommended for patients with classic GERD with the absence of major complications. Classic symptoms such as heartburn or regurgitation can be managed with the use of an eight-week trial of a premeal proton-pump inhibitor therapy (Katz et al., 2021). Symptoms such as gastrointestinal bleeding, unexplained weight loss, and persistent vomiting may warrant further diagnostic evaluation. Endoscopy, esophageal pH monitoring, and esophagus manometry are among diagnostic implementations in the treatment and management of GERD. In addition to the pharmacological approach, patients should be educated on lifestyle modifications that can assist in the management of symptoms (Dlugasch & Story, 2023). Maintaining a high fowler position after eating, weight reduction, eating small frequent meals, and the avoidance of late-night meals can assist in the management of GERD (Dlugasch & Story, 2023).

    Advance Nurse Practice and Patient Education

    Symptoms and other contributing factors are the greatest indicator of complicated or uncomplicated GERD. As mentioned above, patients with uncomplicated GERD will be present with the classic symptoms of heartburn and regurgitation. In those cases, where there are no other symptoms or correlations to disorder progression, the NP can render treatment. Patients presenting with more advanced symptoms such as gastrointestinal bleeding, unexplained weight loss, or anemia warrant referral or endoscopic evaluation. Patients should be provided with clear directions on medication administration to include the importance of timing to meals. Patients should also be encouraged to manage weight and make food choices that decrease the risk of symptom flare ups.

    References

    Azer, S. A., & Goosenberg, E. (2025, July 6). Gastroesophageal reflux Disease (GERD). StatPearls – NCBI Bookshelf.

    Dlugasch, L., & Story, L. (2023). Applied Pathophysiology for the advanced practice nurse. Jones & Bartlett Learning.

    Katz, P. O., Dunbar, K. B., Schnoll-Sussman, F. H., Greer, K. B., Yadlapati, R., & Spechler, S. J. (2021). ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. The American Journal of Gastroenterology, 117(1), 2756.

    Requirements: Make a Comment with references

  • Time and stress management skills assessment

    Good evening, I have completed the assessments to use for the paper.

    Attached Files (PDF/DOCX): NUR 531 Time Management Self-Assessment.pdf, NUR 531 Stress Management Self-Assessment.pdf, module 2 journal.pdf

    Note: Content extraction from these files is restricted, please review them manually.

  • Week 5_Comment 1_Path

    GI & Endocrine

    Pathophysiology of Gastroesophageal Reflux Disease (GERD)

    Gastroesophageal reflux disease (GERD) is a chronic disease because of retrograde masses of gastrointestinal fluid discharging to the esophagus, which leads to symptoms or damage to the mucosa. The dysfunction of the lower esophageal sphincter (LES) is the most prevalent pathophysiologic process that can be a temporary lower esophageal sphincter relaxation (TLESR), a reduction in LES tone, or morphologic abnormalities, including a hiatal hernia (Katz et al., 2022), when the process of refluxing of acidic substances of the stomach into the esophagus starts as a result of inadequately high pressure in the LES overcoming the defensive mechanisms against it, such as esophageal peristalsis and salivary buffering.

    Acid exposure causes tissue injury to the esophageal mucosa, which causes inflammation or erosive esophagitis or morbidities, including Barrett’s esophagus. Acid and pepsin affect the integrity of the epithelia and activate esophagus chemoreceptors, which leads to heartburn and regurgitation symptoms (Katz et al., 2022). GERD is a widespread disease globally, and its prevalence is rising among most regions, which is causing a substantial burden and reduced quality of life worldwide (Dirac et al., 2020). Knowledge of these mechanisms aids in the early detection and proper management when dealing with clinical practice

    Evidence-Based Diagnosis and Management (ACG 2022)

    The American College of Gastroenterology (ACG) (2022) guideline claims that uncomplicated GERD can be diagnosed clinically, and patients who show common symptoms, including heartburn and regurgitation, without alarm features (Katz et al., 2022). First-line therapy should include an 8-week trial of a proton pump inhibitor (PPI) and should be taken once daily before meals. Endoscopy is implied in case of alarm symptoms, such as dysphagia, gastrointestinal bleeding, anemia, weight loss, or persistent vomiting.

    Nonpharmacologic measures are highly advised and comprise loss of weight among overweight patients, head of the bed elevation, not taking food 2-3 hours before bedtime, and quitting tobacco (Katz et al., 2022). The change in diet must be made on a case-by-case basis, depending on the triggers of the symptoms. The pharmacologic management is mainly based on PPIs that are of better quality in their acid suppression and healing the mucosa than H 2 receptor antagonists. The minimum dose of therapy should be used, and it needs to be re-evaluated periodically (Katz et al., 2022).

    Implications for Advanced Nursing Practice

    Nurse practitioners (NPs) are important in giving a clear cut between the case of uncomplicated GERD and the one that needs referral. The patients who are sensitive to empiric PPI therapy and not alarming do not need urgent endoscopy. Nevertheless, the alarm symptoms, recurrent symptoms despite the best therapy, or the risk factors of the esophagus of Barrett make it necessary to refer to gastroenterology and potentially perform endoscopy (Katz et al., 2022). Since GERD (Dirac et al., 2020) is a global issue with a high and increasing incidence, advanced practice nurses should implement evidence-based practices to guarantee the prompt detection of complications and prevention of needless operations.

    Patient Education and Adherence Strategies

    Patient education is the key to adherence and outcomes improvement. The patients should be educated that they should take the PPIs 30-60 minutes before eating to reach their peak effect (Katz et al., 2022). Sustainable lifestyles change programs, in particular, weight management, are needed because obesity is a risk factor that can be changed to influence the occurrence and development of GERD (Dirac et al., 2020). Adherence is enhanced through follow-up visits, instructions, and assessments of realistic expectations. Patient-centered counseling and evidence-based management are the only ways in which nurse practitioners can reduce the symptom burden and eradicate the long-term complications.

    References

    Dirac, M. A., et al. (2020). The global, regional, and national burden of gastro-esophageal reflux disease in 195 countries and territories, 19902017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet Gastroenterology & Hepatology, 5(6), 561581.

    Katz, P. O., et al. (2022). ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. American Journal of Gastroenterology, 117(1), 2756.

    Requirements: Make a Comment with references

  • Ethical Dilema

    For this assignment, you will examine an ethical dilemma that exists in pediatric settings. You will examine the ethical dilemma from two opposing positions and consider ethical principles, conflict between the principles and the relationship of the ANA Code of Ethics provisions in relation to both positions

    Requirements: 3-5 pages

  • business management

    complete only topics 4 & 5. Rubric & paper attached. Include references 2018-present.

    Attached Files (PDF/DOCX): PMHNP Outpatient Clinic paper draft-3.docx, Business managment assignment rubric.docx

    Note: Content extraction from these files is restricted, please review them manually.

  • Value of health information technology

    CASE Study: The purpose of this assignment is to evaluate the value of health information technology in the prevention and detection of errors, as well as analysis of unintended consequences and human factors through quality improvement strategies.

    1. Review the following video and documents on the case study. *
    2. RaDonda Vaught speaks out l GMA [Video file]. Retrieved from
    3. . (4:56).
    4. Lusk, C. (2022). Reconsidering the application of systems thinking in healthcare: the RaDonda Vaught case. Available at
    5. State of Tennessee vs. RaDonda Vaught: Discovery request response. Available at
    6. Note pages 5-6, 50-51.
    7. Apply one of the Quality Improvement Models discussed in the course, or choose an approach from the literature, or the one used in your workplace to analyze the case.
    8. Summarize the case in one paragraph, highlighting the role of HIT.
    9. Describe briefly the model chosen for the analysis.
    10. Provide a rationale for using the selected model over other options.
    11. Follow the model steps and processes to identify the quality, safety, security, privacy, and unintended consequences issues in the case.
    12. List interprofessional team members who may be consulted on this process and their expected role.
    13. Design strategies for your workplace to mitigate the issues identified from the case.
    14. Provide at least one visual of the process and proposed changes (i.e., flow chart, process map, data quality, pareto chart, control chart, data visualization).
    15. Identify changes if needed to policies, EHR, equipment, and other HIT applications.
    16. Create a communication/transition plan.
    17. Develop a staff education plan on changes.
    18. What change theory would be best for this program?
    19. What educational deliver method (s) would be most effective?
    20. Compose metrics for evaluating the plan in each of the learning domains:
    21. Cognitive
    22. Psychomotor
    23. Effective
    24. Reflect on the ramifications of criminalizing the nonintentional reporting of mistakes on your own advanced practice, the nursing profession, and Quality Improvement practices.
    25. Submit the written report in APA 7th ed. format, 10-12 pages in length, not including title page, the 1-page reflection and references. Use headers to distinguish the sections of the paper.
  • Incivility in the Workplace

    Incivility in the Workplace Paper Resources & Rubric Review the entire Incivility in the Workplace Rubric criteria here to understand the full assignment. Please make sure your 6-8 page paper includes the following: Write an introduction with a minimum of two detailed paragraphs, and at least five in-depth sentences per paragraph, introducing incivility in the workplace within the healthcare metaparadigm. Ensure that the information demonstrates a strong understanding through clear, logical, and professional organization. All information should be relevant and accurate, based on credible sources. Write a minimum of two detailed paragraphs identifying how incivility impacts an individual nurses ability to use high-level clinical judgment. Each paragraph should contain at least five in-depth sentences. Include a minimum of two specific, in-depth examples of how incivility in the workplace impacts the nurses ability to use high-level clinical judgment, considering emotional factors, stress, and patient care needs. Ensure that the information is presented in a clear, organized, and professional manner. All information should be relevant and accurate, based on credible resources provided. Identify a minimum of two common issues that occur with workplace or clinical site incivility. Provide a minimum of three in-depth sentences for each common issue identified, explaining how and why each common issue negatively affects the workplace or clinical site and how they can be eliminated. Write a minimum of two detailed paragraphs discussing how workplace or clinical site communication is or was affected due to incivility. Consider whether patients suffered or if patient treatments were missed. Each paragraph should contain at least five in-depth sentences, providing a thorough examination of how workplace or clinical site communication is or was affected by incivility. Write a minimum of two detailed paragraphs identifying current health initiatives that organizations are implementing to decrease incivility within the workplace or clinical sites. Review relevant information from the ANA, ONA, and/or Joint Commission, as well as your organizations policies and procedures. Identify a minimum of three current health initiatives that healthcare organizations are implementing to decrease incivility within the workplace or clinical site. Provide a thorough examination, using a minimum of two in-depth sentences for each initiative, with a strong emphasis on how it relates to incivility in the workplace or clinical site. Write a closing or conclusion paragraph that ties the paper together. Provide a minimum of five in-depth sentences as a conclusion paragraph that summarizes all the important key points within the paper. Include two (2) APA Style formatted references and citations. For more information on how to cite and reference in APA Style, visit the APA Resources page at the Hondros Online Library. Use a minimum of two research articles/resources, which should be submitted with the assignment. Ensure that all resources/references are cited and listed using appropriate APA formatting with no errors noted. Evaluate spelling and grammar, make sure the paper is in APA Style format. Use the Sample Hondros College APA Paper as a guide and the APA 7th ed Paper Format Template to write your paper. Accurately use terminology and aim for two or fewer MUGS (Mechanics, Usage, Grammar, Spelling) errors. The Week 6 Incivility in the Workplace Paper is an APA Style-formatted assignment that must be submitted in Microsoft Word (.doc, .docx). Assignments containing handwritten answers will not be accepted. Paper assignments are to be completed by each individual student, not as a group or shared assignment. Assignments submitted in any other format including .pdf or .pages will not be accepted and will receive a zero grade. In the Submit Assignment area below, click the Add File button and click Upload to browse the files on your computer to locate the document you wish to attach. Select the document, and then click Open. Verify your submission is correct, and click the X next to the document if you would like to remove and attach a different file. When you have the correct document, click the Add button. When you are ready to submit the file you must click the Submit button. Turnitin icon Turnitin This assignment will be submitted through Turnitin, which checks the originality of your submission against other sources. Make sure to review your Originality Report to help ensure that you are not plagiarizing. Click the colored icon next to Turnitin Report toward the top of the assignment submission page to review your Turnitin report. It may take 10-15 minutes for your report to process. Remember that you can re-submit your assignment until the deadline passes. Additionally, some of your instructors may provide feedback through Turnitin; to view this feedback, open the Turnitin report, and click on the GradeMark button at the top of the page. For more information, click here for a guide on using Turnitin. Using Turnitin in MyClassroom and Reading Similarity Reports.pdf Assignment due time date icon Assignment Due You must submit your assignment on or before 11:59 pm ET Sunday of this week.
  • Module 5 EBP Assignment Worksheet: Literature Search & Evide…

    Assignment Overview:

    This assignment will guide you in applying evidence-based practice (EBP) skills through a focused literature search to support your approved PICO or PIO question. You’ll use scholarly databases (not Google) to locate and evaluate high-level research evidence relevant to your topic.

    This activity will help you:

    • Identify strong sources of evidence
    • Organize findings using a standardized tool
    • Prepare for your final paper by practicing synthesis and documentation

    Youll complete the Johns Hopkins Evidence-Based Practice (JHEBP) Appendix G: Evidence Summary Table, which youll also use in your Signature Assignment. This is your opportunity to practice using this tool and connect research findings directly to nursing practice.

    What You Will Do:

    • Complete the Module 5 EBP Assignment Worksheet by typing directly into the provided spaces.
    • Use scholarly databases such as CINAHL, PubMed, or the Cochrane Library to locate high-quality research related to your approved PICO/PIO question.
    • Refer to the Directions for Completing the Appendix G Evidence Summary Tool for guidance as you complete the evidence table.
    • Use the Appendix D: Evidence Level and Quality Guide to determine the strength of the evidence you find.
    • Cite all sources in APA 7th edition format.
    • Submit the completed worksheet by the due date.
    • Review the grading rubric provided in the assignment module for evaluation criteria.

    My approved PIO question: In hospitalized adult patients on a medical-surgical floor at high risk for skin breakdown with a Braden score below 18 (P), what is the effect of implementing twice-daily Kamishibai Card (K-Card) audits (I) on the rate of hospital-acquired pressure injuries (O)?

    This assignment is designed to facilitate the achievement of: MOs 1, 2, & 3

    Rubric

    Module 5 EBP Assignment Grading Rubric

    Module 5 EBP Assignment Grading Rubric

    CriteriaRatingsPtsThis criterion is linked to a Learning Outcome

    Section 1: PICO/PIO Question (10 points)

    10 to >7.0 pts

    Meets Expectations

    Clearly written, specific, and appropriate for an EBP focus. Addresses population, issue, and outcomes well.

    7 to >0 pts

    Needs Improvement

    Vague, incomplete, or lacks alignment with EBP. May be missing one or more PICO/PIO components.

    10 pts

    This criterion is linked to a Learning Outcome

    Section 2: Search Strategy (20 points)

    Databases Used (5 points)

    Search Terms/Boolean Operators (5 points)

    Filters Applied (5 points)

    Narrowing & Article Selection (5 points)

    20 to >15.0 pts

    Meets Expectations

    At least 2 scholarly databases used. Logical, relevant terms and operators. Appropriate filters used. Clear explanation of how articles were chosen.

    15 to >0 pts

    Needs Improvement

    Fewer than 2 databases used or includes non-scholarly. Incomplete, irrelevant, or incorrect operators. Inappropriate or missing filters. Vague or missing explanation.

    20 pts

    This criterion is linked to a Learning Outcome

    Section 3: Evidence Summary Table (60 points)

    For each article (x3):

    Author and Date (1 point)

    Evidence Type & Design (3 points)

    Sample Size & Setting (2 points)

    Findings Relevant to EBP (3 points)

    Measures Used (2 points)

    Study Limitations (3 points)

    Evidence Level (3 points)

    Quality Rating (3 points)

    60 to >49.0 pts

    Meets Expectations

    Evidence table includes complete and mostly accurate information for all 3 articles.

    49 to >0 pts

    Needs Improvement

    Evidence table is missing required elements, contains multiple inaccuracies, or lacks clarity.

    60 pts

    This criterion is linked to a Learning Outcome

    APA Format of References (10 points)

    10 to >7.0 pts

    Meets Expectations

    References are properly formatted in APA 7th edition.

    7 to >0 pts

    Needs Improvement

    APA formatting is incomplete or incorrect.

    10 pts

    Total Points: 100

    Attached Files (PDF/DOCX): Johns Hopkins Nursing – Evidence Level and Quality Guide-6.pdf, Directions for Appendix G Evidence Summary Tool-2.pdf, Module 5 EBP Assignment Worksheet – Literature Search Evidence Synthesis-2.docx

    Note: Content extraction from these files is restricted, please review them manually.

  • Literature Review

    Find 5 peer reviewed articles about your capstone project. Write a literature review.

    Please follow the assignment rubric

    • A literature review is not an annotated bibliography in which you summarize briefly each article that you have reviewed.
    • While a summary of what you have read is contained within the literature review, it goes well beyond merely summarizing professional literature.
    • It focuses on a specific topic of interest and includes your critical analysis of the relationship among different works, and relating this research to your work.
    • In this case, your work will be your capstone project.
    • It may be written as a stand-alone paper or to provide a theoretical framework and rationale for a research study (such as a thesis or dissertation).
    • Your literature review will be written as a standalone paper.

    Below is information about the structure of the literature review, finding credible information for research assignments, formulating research questions, search strategies and a literature review template:

    For the title page, follow the guidelines below. Information without brackets should remain as

    written. The learner should replace the information within the brackets with the requested

    information, and all prior information and brackets should be removed.

    Literature Review

    [Remove brackets & insert Your Full Name Here]

    Nightingale College

    [Remove brackets & insert Your Course Number, Section & Course Title]

    [Remove brackets & insert Your instructors name using Professor or Dr. ________]

    [Remove brackets & insert Month, Day, Year this is the date the assignment is due, not the

    date it is submitted]

    Prior to submitting your paper, make sure to remove all

    instructions in brackets on the following pages.

    2

    Literature Review

    [The introduction to the paper must be at least 5 sentences with 1 in-text citation, a

    fully stated purpose statement, and PICOT Question. In this section, introduce the topic to

    the reader. Indicate why the selected topic is important and why it is important to conduct a

    literature review as part of the project. Make sure the PICOT question is written as a quality

    improvement question, not a research question and that it contains all components of PICOT.

    End this section stating, “The purpose of this paper is … “]

    Project Proposal Topic

    [The project proposal section must be at least 1 fully formed paragraph (at least 5

    sentences in length) with in-text citations. In this section, present an overview of the topic

    by discussing the topic in general. Consider providing some background information and

    describing the gap (current practice versus best practice) in nursing practice that was

    identified. Consider using statistics here to reinforce the point.]

    Methods of Searching

    [This section must be at least 1 fully formed paragraph (at least 5 sentences in

    length).This section should describe how the literature search was conducted. For example: A

    literature review was conducted using both electronic and manual resources… Describe how

    the search for literature was conducted by explaining what databases or search engines were

    used to find the peer-reviewed articles. Describe what keywords were used; what date range was

    used to obtain the most current information (remember they must be less than 5 years old); what

    things were excluded (example: blogs, websites with biased information, etc).]

    3

    Review of the Literature

    [There must be at least 5 fully formed paragraphs (at least 5 sentences in length)

    with 5 in-text citations that correlate with the current, peer-reviewed references used. This

    will be the bulk of the review. Organization of the material here is important. In one paragraph

    for each of the 5 current, peer-reviewed articles, elaborate on the relation to the project

    topic/PICOT question, as well as what best practices were identified. Integrate key details of

    each article, demonstrating a clear understanding of the content reviewed. Consider the main

    takeaways after reading each article as they relate to the project project/intervention. This

    section should outline details of each article and also include the learners insight as they relate

    to the project and PICOT. Also include any other pertinent information about the topic that was

    discussed in the articles chosen.]

    Findings

    [This section must be at least 2 fully formed paragraphs (at least 5 sentences in

    length) with in-text citations. In this section, provide a summary of the most significant

    findings found in the Review of the Literature section. Identify strengths and weaknesses of

    the literature (for example, small sample sizes that limit the validity of the findings or

    conclusions that you disagree with as an evaluator); and identify any gaps in the literature found.

    Begin with The literature has shown…]

    Conclusion

    [The section should be at least 1 paragraph (at least 5 sentences in length),

    summarize at least 3 key points, and contain at least 1 in-text citation. Provide a thorough

    summary with at least 3 key points. Although not required, it is suggested learners restate the

    PICOT question in this section, so the reader is drawn to refocus on the topic/question.]

    4

    References

    [There must be at least 5 current (within the last 5 years), peer-reviewed references. Use APA-7

    formatting specific to reference type, including (but not limited to) alphabetical order and

    hanging indent. Specific reference examples have been discussed in the webinars.]

    Rubric :

    CriteriaRatingsPtsThis criterion is linked to a Learning Outcome

    Intentional Learning and Reflection

    15 pts

    Exemplary

    Identifies/addresses a relevant topic and a thesis that provides direction for the content that is engaging and thought provoking. The thesis clearly and concisely states the position, premise, or hypothesis and is consistently the focal point throughout the presentation. Demonstrates a sophisticated understanding and careful, critical analysis of the research topic and thesis (argument). Compares/contrasts perspectives, considers counter arguments or opposing positions, and draws original and thoughtful conclusions with future implications.

    10 pts

    Accomplished

    Identifies/addresses a relevant topic and a thesis that provides adequate direction for the content with some degree of interest for the reader. The thesis states the position, premise, or hypothesis, and is the focal point of the paper for the most part. Demonstrates an understanding and some critical analysis of the research topic and thesis (argument). Adequately compares/contrasts perspectives, counter-arguments, or opposing positions but broader connections and/or implications are not as thoroughly explored

    5 pts

    Developing

    Identifies a research topic but may be too broad in scope and/or the thesis is somewhat unclear and needs to be developed further. Focal point is not consistently maintained throughout the paper. Demonstrates general understanding with limited critical analysis of the research topic and thesis (argument). Summarizes perspectives, counter-arguments, or opposing positions.

    0 pts

    Unsatisfactory Beginning

    Fails to identify a relevant research topic or is not clearly defined and/or the paper lacks focus throughout. Demonstrates a lack of understanding and inadequate analysis of the research topic and thesis. Analysis is superficial based on opinions and preferences rather than critical analysis.

    15 pts

    This criterion is linked to a Learning Outcome

    Decision Making and Clinical Reasoning

    15 pts

    Exemplary

    Provides five current, peer-reviewed sources that present accurate, distinguishing evidence and effectively integrate the main concept into the assignment. Sources are relevant, accurate, current (less than 5 years old) and reliable, reflecting and validating the strength of the content.

    10 pts

    Accomplished

    Provides evidence to support the main concept. There are at least 5 sources, however, there are not at least 5 sources that are peer-reviewed and current (less than 5 years).

    5 pts

    Developing

    Provides evidence to support the main concept with less than 5 adequate and permissible (current/less than 5 years old and peer-reviewed) sources.

    0 pts

    Unsatisfactory Beginning

    There are no sources or the sources in the submission are not aligned with the reference list.

    15 pts

    This criterion is linked to a Learning Outcome

    Organization & Presentation

    15 pts

    Exemplary

    Content is effectively organized. Ideas are arranged logically, flows smoothly, with a strong progression of thought from paragraph to paragraph connecting to the central position. Includes all required components (introduction, body, conclusion, citations, references, etc.). For a slide presentation, the design, font size, style, and spacing are optimal for audience viewing

    10 pts

    Accomplished

    Content is adequately organized. Ideas are arranged reasonably with a progression of thought from paragraph to paragraph connecting to the central position. Includes required components of an introduction, body, and conclusion. For a slide presentation, one or more components of the design, font size, style, and spacing may be less than ideal for audience viewing.

    5 pts

    Developing

    Content is somewhat organized. For a paper, occasionally ideas from paragraph to paragraph may not flow well and/or connect to the central position or be clear as a whole. May be missing a required component and/or components may be less than complete. For a slide presentation, multiple aspects of the design require further development for optimal audience viewing.

    0 pts

    Unsatisfactory Beginning

    Content lacks logical organization and impedes readers comprehension of ideas. For a paper, central position is rarely evident from paragraph to paragraph and/or the paper is missing multiple required components. For a slide presentation, the design lacks clarity for optimal viewing by an audience.

    15 pts

    This criterion is linked to a Learning Outcome

    Writing and APA Formatting

    15 pts

    Exemplary

    Content is well written and uses standard English characterized by elements of a strong writing style. Basically, free from grammar, punctuation, spelling, usage, or formatting errors. APA guidelines for formatting are consistently followed. Includes in-text citations and references that are written correctly.

    10 pts

    Accomplished

    Content shows above average writing style and clarity in writing using standard English. Minor errors in grammar, punctuation, spelling, usage, and/or formatting. APA guidelines for formatting are present. In-text citations are present but may not be complete or correctly formatted. References are written using correct APA format

    5 pts

    Developing

    Content shows an average and/or casual writing style using standard English. Some errors in spelling, grammar, punctuation, and word usage. Use of APA guidelines are generally present, however are incorrectly formatted.

    0 pts

    Unsatisfactory Beginning

    Content shows a below average/poor writing style lacking in elements of appropriate standard English. Frequent errors in spelling, grammar, punctuation, and word usage. Lacks elements required in writing a formal APA paper: title page, references, in-text citations, headers.

    15 pts

    Total Points: 60

    Attached Files (PDF/DOCX): 9788202738792_ch_8.pdf

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