Develop a 4–6-page proposal for executive leadership that addresses  changes you would like to see within your organization that would  advance the field of nursing.    

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Develop a 4–6-page proposal for executive leadership that addresses  changes you would like to see within your organization that would  advance the field of nursing.

Nursing is in the midst of many changes. In this assessment you  will consider how you can be a driving force to bring about needed  change within the field of nursing.

Collaborative interprofessional groups are at the heart of resolving  contemporary nursing issues. The work of groups and teams is based on  strong decision-making and problem-solving skills, led by effective and  engaged leaders. Nurses leading collaborative teams are critical for  resolving a number of issues such as errors in medications, accidents  involving patients, and unsafe shortcuts.

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Nurses truly are expert problem-solvers. Tucker and Edmondson  (2002) found that nurses utilized problem-solving skills so often that  it had become a routine aspect of a nurse’s day. However, nurses must be  able to maximize their problem-solving skills in order to lead health  care teams in addressing challenges, identifying evidence-based  solutions, and implementing those solutions.

Reference

Tucker, A. L., & Edmondson, A. C. (2002). Managing routine exceptions: A model of nurse problem solving behavior. Advances in Health Care Management, 3, 87–113.

Preparation

To prepare for this assessment, you will need to think about  changes you feel are needed to address a problem either within nursing  as a professional field or within the organization where you work.  Narrow down your options by considering which change would best be  undertaken by an interprofessional team. Some examples for you to  consider might include:

  • The use of mobile and portable technology to support patients.
  • Using evidence-based practice (EBP) to improve patient care.
  • Increasing patient safety and quality of care.
  • The use of medical technology such as genes and stem cells, or robots in the OR.
  • Addressing the nursing shortage now and into the future.
  • Improving the work environment (providing calm, supportive spaces  for nurses; improved dialog between health care professionals).
  • Better safety for nurses at work (violence, spreading diseases, physical injury).
  • Substance abuse by health care professionals.

Or you can narrow the scope to an issue within your own organization:

  • Developing a mobility program for an inpatient unit.
  • Implementing “smart” technology to assist in patient monitoring.
  • Creating a mentoring program to attract and retain nurses.
  • Implementing protocols for infection control and/or treatment of an epidemic.
  • Developing a plan to eliminate physical violence and verbal abuse in the workplace.
  • Other.

Once you have selected an issue to address, look for scholarly and  professional articles that focus on the problem, the needed change, and  how interprofessional teams can work together to drive change.

Requirements

Lately you have noticed the need for changes within your  organization that would advance the field of nursing. You have decided  to develop a proposal and submit it to executive leadership. Format this  assessment as a professional proposal. You may want to look at how  proposals are drafted within your organization and follow that format.  You will still need a references page; follow APA guidelines for in-text  citations and references.

Address the following in your proposal:

  • Briefly describe the problem and how it impacts the organization, patients, and/or the nursing profession.
  • Describe possible evidence-based interventions for the problem.
  • Analyze potential barriers and resistance to change that might come from the organization, patients, and/or colleagues.
  • Describe strategies to overcome barriers and resistance to change.
  • Develop a plan to implement evidence-based interventions. What steps would you take? What resources might you need?
  • Identify other health care professionals to enlist as team members to help drive change in the organization.

Your completed assessment should be 4–6 pages in length, not  including title page and references page. Support your statements and  intervention plan with references to and citations for at least four  scholarly or professional resources.

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Pathophysiology of Diabetes Insipidus     

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Respond  on two different days who selected different factors than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the pathophysiology of diabetes mellitus and diabetes insipidus.

Offer alternative diagnoses and prescription of treatment options for diabetes mellitus and diabetes insipidus.

Validate an idea with your own experience and additional research.

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Pathophysiology of Diabetes Insipidus

Diabetes insipidus is either the loss of antidiuretic hormone (ADH) action or secretion.  ADH is secreted by the posterior pituitary and causes water reabsorption from the collecting ducts.  Increases of ADH increases water reabsorption; this results in concentrated urine and more dilute serum.  Decreases of ADH decreases water reabsorption, this results in an increase and dilute urine output, and the by-product is a more concentrated serum because ADH is lost with DI, urine output increases and leaves behind a more concentrated hypernatremic serum.  There are two categories of DI, central and nephrogenic.  Central DI involves a decrease of ADH in the posterior pituitary; this is usually secondary to head trauma, encephalitis, meningitis, and the like.   Nephrogenic DI consists of a kidney sensitivity to the decrease of ADH; this form is typically hereditary or congenital and originates from the kidneys (Berkowitz, 2007).   Signs and symptoms of DI are much like those of DM and can be, polyuria, polydipsia, and nocturia.  Treatment is based on the type of DI and may involve ADH replacement (Huether & McCance, 2017).

Pathophysiology of Diabetes Mellitus

DM is broken down into type I and type II.  Type I was previously known as insulin-dependent, and type II was formerly known as non-insulin dependent, that is no longer how these two disorders are classified.  Type I is more common in adolescents and associated with the human leukocyte antigen (HLA).  Ketone development commonly occurs in type I, and islet cell antibodies are in 90% of patients within the first year.  Type I is thought to be caused by infectious or toxic environment that insults the B cells of the pancreas in a genetically predisposed person.  Type II DM makes up greater than 90% of the DM cases in the United States.  Type II is an inadequate production of insulin; this can be caused by tissue insensitivity and results in impaired insulin production or resistance.  There is no link to the islet cell antibodies or HLA.  With Type II, there is an association with abnormal lipid profile, obesity, and hypertension.  Signs and symptoms of type I and II resemble DI in regards to polyuria, polydipsia.  Type I involves weight loss, fatigue, and weakness.  Type II includes weight gain, peripheral neuropathy, blurred vision, and chronic skin infections.  Treatment might be insulin, oral antidiabetic choices, diet, and exercise (Barkley, 2018).

Patient Behavior and Ethnic Factors

First degree relatives and infection, infection and illness, are contributing factors to DM type I.  Family history, sedentary lifestyle, obesity, women with polycystic ovary syndrome, gestational diabetes, insulin resistance, and impaired glucose tolerance are all patient and behavior factors that contribute to DMII.  DM is more prevalent with African-Americans, Hispanic/Latino Americans, Asian-Americans, Native-Americans, Alaska Natives, and Pacific Islanders (WedMD, 2019).  For DI there are no apparent contributing patient behaviors or ethnic links.

References

Barkley, T.  (2018).  Adult-gerontology primary care nurse practitioner.  West Hollywood, CA:  Barkley & Associates.Berkowitz, A. (2007).  Clinical pathophysiology made ridiculously simple. Miami, FL:  Medmaster.Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.WebMD.  (2019).  What increases my risk of diabetes?  Retrieved from             https://www.webmd.com/diabetes/guide/risk-factors-for-diabetes#1

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 How has nursing practice evolved over time?

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 How has nursing practice evolved over time? Discuss the key leaders and historical events that have influenced the advancement of nursing, nursing education, and nursing roles that are now part of the contemporary nursing profession.

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Discuss the different types of intelligence, and why this stage in development falls into Erik Erikson’s period of generativity versus stagnation.

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Assignment 5.1: Midlife Transitions

Step 1: Research midlife transitions

In a two page paper write about the following:

  • Discuss the different types of intelligence, and why this stage in development falls into Erik Erikson’s period of generativity versus stagnation.
  • Compare and contrast generativity and stagnation in midlife transitions.
  • Discuss the importance of health and lifestyle during the middle adulthood years.
  • Explain how relationships with both parents and children transition during Middle Adulthood.

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