Describe the background of the problem. Tell the story of the issue and why it deserves attention.

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Write a paper of 500-750 words (not including the title page and reference page) on your proposed problem description for your EBP project. The paper should address the following:

  1. Describe the background of the problem. Tell the story of the issue and why it deserves attention.
  2. Identify the stakeholders/change agents. Who or what organizations are concerned about, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc.
  3. Provide the PICOT question. (PICOT: Population-Intervention-Comparison-Outcome-Timeframe). Make sure that the question fits with your graduate degree specialization.
  4. State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence-based practice is introduced to identify the expected changes.
  5. Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.

Develop an initial reference list to ensure that there is adequate literature to support your evidence-based practice project. Follow the “Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Refer to the “Search Method Example” as the format in which to compile this data.

  1. The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem.
  2. Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence-based project, you must have enough evidence to introduce this as a practice change. If you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required for the individual sections, but is required for the final paper.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Upon receiving feedback from the instructor, refine Section A for your final paper submission.

Display superior content, organization, style, and mechanics; and ·         Use APA 6th Edition format as outlined in the APA Progression Ladder.

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Case Study 9

Disorders of White Blood Cells and Lymphoid Tissues

Max is a 60-year-old living in Iowa. For the 27 years, he has been working in the agricultural industry, particularly in the management of corn production. Recently he began to feel weak during work and tired easily. During the night he woke up sweating, and he often felt unusually warm during the day. Max was also surprised that, in spite of eating regularly, his weight was declining and his work pants were now too large for him. Upon physical examination, his physician noted his inguinal lymph nodes were swollen although Max said they were not sore. Subsequent laboratory tests confirmed follicular, non-Hodgkin lymphoma. Chemotherapy in conjunction with rituximab was immediately initiated.

  1. What are the key cellular differences between non-Hodgkin lymphoma and Hodgkin lymphoma?
  2. The early manifestations of non-Hodgkin lymphoma and Hodgkin lymphoma in lymphatic tissue appear differently. In terms of lymphatic presentation, how would these two diseases appear clinically?
  3. What are the pharmacologic properties of rituximab, and what is its mechanism of action on malignant cells?
  4. Outline the structure of lymph node parenchyma including the areas where B and T lymphocytes reside. Where did Max’s lymphoma arise?

 

Assignment Requirements:

Before finalizing your work, you should:

·

·         Ensure you have written at least four double-spaced pages.

·         Be sure to read the Assignment description carefully (as displayed above);

·         Consult the Grading Rubric (under the Course Home) to make sure you have included everything necessary; and

·         Utilize spelling and grammar check to minimize errors.

·         Follow the conventions of Standard American English (correct grammar, punctuation, etc.);

·         Be well ordered, logical, and unified, as well as original and insightful;

·         Display superior content, organization, style, and mechanics; and

·         Use APA 6th Edition format as outlined in the APA Progression Ladder.

Address the following to help you develop your plan for the Practicum Project:

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Report Issue
  • Reflect on the focus of your proposed Practicum Project, which you identified through discussion with your practicum Faculty Member and Preceptor last week.
  • View the Practicum Project Plan (PPP) Overview document provided in this week’s Learning Resources. Consider the project planning guidelines included in the document as you prepare for this Discussion.
  • Address the following to help you develop your plan for the Practicum Project:
    • Review the scholarly literature, specialization standards, and/or regulatory standards that validate and shed light on your Practicum Project focus. Which professional organizations would you contact in relation to your topic? What regulatory standards would you address? As you proceed, you will continue to gather evidence from a combination of sources for your project as part of your written Practicum Project Plan.
    • Identify the overarching goal for your Practicum Project.
    • Consider how you can achieve your Practicum Project goal through the development and fulfillment of objectives. Based on your Practicum Project goal, develop two or three objectives that are specific, measurable, attainable, results-focused, and time-focused. Incorporate higher-order verbs from Bloom’s taxonomy (i.e., Application-level and above) as you create the objectives. You may wish to review last week’s Learning Resources related to developing objectives.
  • Contemplate any questions or concerns you may have about your Practicum Project or the planning involved. What kind of support could your colleagues offer to help you move forward?

Note: Be mindful of privacy concerns as you engage in this and future Discussions. Do not identify any organizations or individuals by name.

Post on or before Day 3 a description of your proposed Practicum Project. Provide a brief rationale for your selected focus that incorporates references from the literature, specialization standards, regulatory standards, and/or other sources you have used to validate this project. Explain the overarching project goal, and list two or three measurable objectives that will help you meet the goal. Also, share any questions or concerns that your colleagues may be able to help you address as you proceed with planning for your Practicum Project.

 

The Practicum Project Plan is a scholarly proposal for your project. Over the next few weeks, you develop elements of your plan and then integrate these elements in a 4- to 6-page scholarly paper.

Refer to the Practicum Project Plan (PPP) Overview document provided in this week’s Learning Resources, for details about this assignment. Be sure to consider the project planning guidelines included in the document as you proceed with the development of your plan.

 

 

Identify the situation you would like to practice; do you want to plan a new conversation, or replay a past situation but change the outcome?

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In Part 5, you will imagine implementing the new behaviors you identified in 4E. In Part 6, you will practice your new behavior by role-playing with a family member or close friend who is not directly involved in your goal. It is still not time to actually implement your new behaviors, as Parts 5 and 6 will help you to iron out the wrinkles.

Note: Submit both CCC Part 5 and CCC Part 6 in one document, but start a new page for CCC Part 6.

Project Timeline

Part

Description

Due

1

Selecting a communication goal

Week 1

2

Describing communication patterns

Week 2 & 3

3

Establishing behavioral goals: What will it look like when I am doing it well?

Week 3

4

Analyzing the goal

Week 4

5

Covert Rehearsal: Practicing in your imagination

Week 5

6

Behavioral Rehearsal: Practicing your new behavior

Week 5

7

Actual Implementation: Performing your behavior in real-life situations

Week 7

8

Evaluating your progress

Week 8

Instructions: Part 5

5A. Covert Rehearsal
Covert Rehearsal is an effective way of trying out new communication behaviors. Think about a time that you were daydreaming, or dreaming at night. You can use your imagination to think about an experience or situation that is not really happening at that time or in that place. You can do the same type of simulation on purpose to think about a time and place that will allow you to practice your new interpersonal communication skill to meet your goal as outlined in your new behaviors listed in CCC Part 4E.

By covertly rehearsing, you make it much more likely that you will be actually performing the behavior comfortably and effectively in real life situations. This surprising effect of covert rehearsal has been shown in numerous studies. What makes covert rehearsal particularly useful is that you can carry it around and do it anywhere – in the shower, cleaning, cooking, and so forth. The more you vary covertly rehearsing a particular episode, the more likely you will be able to perform well in the actual situation. For example, if you are planning to initiate and maintain a conversation with your neighbor, you should think through a number of possible topics and questions before finally choosing what you perceive to be the best options. In other words, think before you speak. Plan what you will say and do in a particular situation where you can practice your goal.

Covert rehearsal can be used both to prepare for an upcoming communication event, and to evaluate and revise an event that has already occurred – as in instant replay. This is done all the time for sports teams. Each player watches the game again and decides how he or she could do it better next time. Both planning ahead before a conversation and reflecting after a conversation will increase the probability that you will perform your new skill effectively the next time you use it.

Note that some people initially find it difficult to imagine specific conversations with others. Keep with it if you have difficulty. You will eventually succeed with practice, and when you do, you will be amazed at the effect. If you are having a hard time talking to people in your mind, speak to yourself out loud or speak to your reflection in the mirror. Think about the following:

  • Identify the situation you would like to practice; do you want to plan a new conversation, or replay a past situation but change the outcome?
  • Where will you have this conversation – in the kitchen, on the bus, in the cafeteria at lunch, at school in a classroom, in the board room, in your manager’s office, or at a friend’s house?
  • Provide a detailed narrative that identifies your selected communication event.
  • Write a description of your surroundings – date, time, location, specific room, physical surroundings and so forth, and the people who will participate in this communication event.
  • Name the people involved, what you will talk about, where it takes place, when it takes place, how it should occur, and why you need to plan for a better conversation next time.
  • How will your physical surroundings affect your rehearsal?

For this section, you are to select a communication event, related to your goal, for which you will prepare covertly. Choose one or more behaviors to work on that are listed in CCC Part 4E. Choose a communication event that you would like to prepare for privately or secretly – covertly. As you imagine yourself practicing your new skill, focus hard on specific interactions. Actually, think about an interpersonal communication exchange – what you say, and how the other person responds. Don’t just go through the motions. Really see yourself asking specific questions, making specific comments, and hearing the other person replying. As you imagine the sequence, practice precisely what you want to say and how you want to say it. Experiment with what feels to be the most effective and comfortable way for you to implement your new behaviors.

Submit a detailed narrative that identifies your selected communication event and include the following:

  • Description of your surroundings – date, time, location, specific room, physical surroundings and so forth
  • Explanation of how your physical surroundings will affect your rehearsal
  • Description of the people who will participate in this communication event
  • What you will talk about
  • How it should occur
  • Why you need to plan for a better conversation next time

5B. Covert Practice
In a quiet place, begin thinking about the conversation event from Part 5A, as you would like to see it evolve. When you hit rough spots, try a variety of options until you find a response that pleases you. If you are having trouble with this, pretend you are an author planning to write the dialogue for a reality TV episode, or you are composing lines for characters in a play or movie or book. Use the mirror technique and take turns role-playing both people in the conversation. You can also use puppets, stuffed animals, socks on your hands, or different hats or coats to take the parts of two people having a conversation.

What can you see in the background? The scenery department needs to know how to create the setting for the play, movie, or reality TV show. The illustrator needs to know what to draw or paint for the book you are writing. You need to know exactly what type of situation you are dealing with before you can write the dialogue for the characters.

When you are satisfied with your imagined scene, write it out so you can see how it looks and read it aloud so you can hear how it sounds. If you are writing a one-act play, you can plan and add stage directions.

Enter left: The wife enters the kitchen to angrily scream at the dawdling children who won’t eat their supper.

Then, write her exact words down so your actor will know what to do and say. Identify each speaker and use quotation marks for their exact words.

Wife, using a loud and angry voice: “Aren’t you children finished eating your supper yet?”

Plan and write down your nonverbal and verbal behaviors and responses, including your own behaviors and responses and the reactions of the other person in the communication event.

5C. Reflection
Reflect on this experience. Address your observations and reactions to the private covert rehearsal experience. (1-2 paragraphs)

  • How did you feel at first as you prepared for your private covert rehearsal?
  • How did you feel after you finished it?
  • What behaviors or patterns did you use from Part 4E?
  • Did you notice any new behaviors or patterns that you have not noted previously?

Instructions: Part 6
In Part 6, you will take your rehearsal a step further by role-playing with someone who is willing to lend you a hand. Practicing implementation of the new behaviors you identified in 4E will give you insight into how another person might react in a real-life situation, preparing you to respond or adapt when necessary.

6A. Shared Behavior Rehearsal
Shared behavior rehearsal is also known as “role-playing.” Rehearsing communication behavior is useful both before and after an event. Practicing before an event allows you to enter a communication situation in your most prepared state. Rehearsing a disappointing situation after it occurs gives you a chance to discover and remedy aspects of your own behavior that were less than satisfactory.

Like covert rehearsal, practicing the new communication behaviors that you identified in CCC Part 4E through role-play increases the likelihood that you will be successful in Part 7 when you actually implement the changes in real-life situations. Again, it may feel silly at first, but if you take the role-playing seriously, you will be amazed at what you will take away from it. Role-play your imagined scene for your conversation event with a friend or family member who is not directly involved in your communication problem. Say your lines as you planned them. Your practice partner may not really say what you thought he or she would say. Then, show him or her the written script, and have him or her read or act out the scenario. You can practice this a few times both with and without the script.

Write a detailed narrative of what happened in the behavior rehearsal.

  • What did you do?
  • How were your behaviors received?
  • How satisfied were you with your performance of the behaviors in your goal from Part 4E?

6B. Reflection on Observations and Reactions
Address your observations and reactions to the shared behavior rehearsal experience of role-playing with a friend or family member who is not directly involved in your communication problem. (1-2 paragraphs)

  • How did you choose your shared behavior rehearsal partner?
  • Does he or she know about the person or situation being focused on for your CCC goal?
  • Does he or she normally offer guidance and advice in a trustworthy manner already in your established relationship with this person?

6C. Reflection on Planning
Write your observations and reactions to the shared behavior rehearsal experience as far as planning is concerned. (1-2 paragraphs)

  • Did your shared behavioral rehearsal go as planned, or was it totally different than you imagined it would be?
  • How did you feel at first as you prepared for your shared behavioral rehearsal?
  • How did you feel after you finished it? What behaviors or patterns did you use from Part 4E?
  • Did you notice any new behaviors or patterns that you have not noted previously?

Writing Requirements (APA format)

  • Length: 4-5 pages (not including title page or references page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page