quot;for effective internal control, the billing function should not be performed by the:

“for effective internal control, the billing function should not be performed by the:”

Conceptual and Theoretical Foundations of Advanced Practice Nursing

Conceptual and Theoretical Foundations of Advanced Practice Nursing
Paper instructions:
Answer the following questions providing references and using APA format. No plagiarism, paper will be check using turnitin.

1. Advanced Practice Nursing (50 Points)

a. Provide three definitions of advanced practice nursing (APN).
b. Summarize the education of advanced practice nurses. What are the recommended curriculum requirements?
c. Describe competencies of APN in general, and for FNP advanced practice
nurses; what are the differences?
d. Identify and summarize the four APN specialties.

2. Concept Analysis (50 Points)

a. Provide three theoretical definitions of the concept you have chosen to analyze.
b. Provide two operational definitions of the concept you have chosen to analyze.
c. Develop the definition you will use as the basis for your paper based on your review of the literature (conceptual definitions in ‘a’).
3. Role (50 Points)

a. Describe each of the five levels of proficiency discussed by Benner.
b. Discuss your self- evaluation of your level of proficiency and provide examples to support your evaluation.

4. Certification Requirements (50)

a. List the eligibility requirements to take the certification examination for Family Nurse Practitioners (FNP).
b. Identify areas in the Department of Nursing curriculum that allow students to meet the requirements for the FNP certification examination

The Session Long Project will involve an in-depth study of a governmental role/program in public health

The Session Long Project will involve an in-depth study of a governmental role/program in public health. Your project will involve identifying responsible governmental agencies; describing current challenges and potential impact; proposing a public health policy; researching pertinent laws; and evaluating the ethical principles of laws/policies, financial impact, and sources of funding.

Select a governmental role/responsibility in public health for your SLP. Describe the governmental role/responsibility. Identify the agencies responsible at federal, state, and local government level.
Describe the current challenges and potential impact of these challenges to public health (related to the item you selected in No. 1).
Describe the goal of the proposed policy.
What is the supporting evidence for implementing this policy?
How is this policy to be achieved?
Who is this policy intended to help?
Which agencies will implement this policy?
How cost-effective do you expect this policy to be?
How well do you anticipate this policy will be accepted, given the priorities, culture, values, and political climate?
What are your strategies for overcoming barriers in implementing the policy?
SLP Assignment Expectations
Length: Assignment should be from 3 to 4 pages (750 to 1000 words) in length.

Assessment and Grading: Your paper will be assessed based on the performance assessment grading rubric that is linked within the course. Review it before you begin working on the assignment.

The following guidance appears only in Module 1, but it applies to the assignments throughout the course:

File format: Your work should be prepared using Microsoft Word, PowerPoint, or Excel depending upon the assignment instructions. If an assignment requires video or voice recordings, use media formats that are supported by MyTLC Courses as noted on the Trident Support page.

In-text citations and references: Be sure that all information and ideas in your papers are supported by in-text citations and corresponding references at the end of the paper.

Scholarly sources: At least two references must be included from academic sources (e.g., peer-reviewed journal articles) and include required readings. Online sources must be limited to credible professional and scholarly publications such as peer-reviewed journal articles, e-books, or specific Web pages on websites from a university, government, or nonprofit organization (these have extensions .edu, .gov, or .org). Presenting consumer sources such as e-magazines, newspapers, Wikipedia, WebMD, or other commercial websites (these have extensions .com) as references is not appropriate.

Scholarly writing: Use an academic paper format, not an essay based on your opinions or experience. Avoid using the first person in writing. Synthesize what you learned from the sources you read; write papers in your own words; and cite sources within the text, as well as include a properly formatted reference list. APA format is recommended, but you may use another standardized format.

Use of direct quotes: Use of direct quotes should be avoided, as the focus of the assignments is critical thinking. Only use direct quotes when preserving the exact words of an author is necessary. In the rare instance that directly quoted material is used, it must be properly cited (with quotation marks and page numbers in the in-text citation); quotes should not exceed 5%-10% of the total paper content.

attachment
Publichealthisaprimarygovernmentresponsibilityandinthisregardanumberoflocal.docx

Your firm has an obligation to pay a parts supplier eight equal annual payments of $16,000,000 (the first payment is due 1 year from today). Assume the Treasury yield curve is a flat 4.25%, and today

  • Your firm has an obligation to pay a parts supplier eight equal annual payments of $16,000,000 (the first payment is due 1 year from today). Assume the Treasury yield curve is a flat 4.25%, and today your firm purchases zero-coupon Treasury bonds to fund and immunize the obligation. All bonds that your firm purchases have the same maturity.a. What is the PV and duration of the obligationb. what is the FV of bonds the firm buysC. Immediately after purchasing the bonds the yield curve increase to a flat 4.63% by how much in dollars will the obligation be underfunded or overfunded

It’s due in an hour, PLEASE HELP! THANKS! During January 2018, Pop’s Pizza Company’s records reveal the following events. Use an Excel spreadsheet to…

It’s due in an hour, PLEASE HELP! THANKS!

During January 2018, Pop’s Pizza Company’s records reveal the following events. Use an Excel spreadsheet to record these events using tabular analysis. Show how each event affects the balance sheet equation. If there is no effect on the balance sheet equation, state “No entry needed.”

Timken Inc. made $900,000 in sales during 2016. Twenty-five percent of these were cash sales. During the year, $22,500 of accounts receivable were…

45%

Required: Prepare the adjusting entry required at December 31, 2016.

prepare a network proposal on how to set up a secure network infrastructure in the newly leased building to support university operations.

Assignment Instruction

You have been hired as part of the networking team at UMUC. After completing orientation and training, your manager calls you into a meeting to discuss your first project.

The university has recently leased a single building in Adelphi, Maryland. The building will house faculty and administrative offices, classrooms, a library, and computer labs. Security is important for UMUC, as the university must protect students’ and employees’ data, as well as any intellectual property that UMUC has on its servers and computers. As a result, IT management would like to take the time to review proposals on how best to move forward on security issues. As a junior network engineer, you have been asked to prepare a network proposal on how to set up a secure network infrastructure in the newly leased building to support university operations. The network proposal will require three submissions covering network design, network addressing and security, and network customization and optimization.

Please use the template attached to do the assignment.

As you can see with the template,the assignment has three sections

1)  Network Design

2) Network Addressing and Security

3) Network Customization and Optimization

Consider the information in the additional information provided to bring Trish Flower Shop up-to-date through January 31, 2017.

Consider the information in the additional information provided to bring Trish Flower Shop up-to-date through January 31, 2017. Trish Flowers Shops normal costing system has two direct-cost categories (direct material costs and direct manufacturing labor costs) and one indirect- cost pool ( manufacturing overhead costs, which are allocated using direct manufacturing labor costs).

A. The budgeted manufacturing overhead costs are for 2017 are $700,000 and $400,000 for direct manufacturing labor costs

b. the unfinished Job A as of January 31, 2017 has direct manufacturing labor costs of $ 4,000 (125 direct manufacturing labor-hours) and direct material costs of $10,000. Direct manufacturing labor-hours used for January to 3,500 hours

c. Total direct materials issued to production during January 2017 are 180,000

d Cost of goods completed during January is $360,000

e. Materials inventory as of January 31, 2017 is $40,000. Beginning materials inventory as 1/31/2016 was $ 35,000

f. Finished goods inventory beginning inventory as of January 31, 2016 was $ 10,000 and the ending inventory as of January 31, 2017 is $40,000

  1. Calculate the materials purchased during January 2017
  2. calculate the Cost of Goods Sold during January 2017
  3. Calculate direct manufacturing labor costs incurred during January 2017 (direct manufacturing wage rate) & (direct manufacturing labor costs)
  4. Calculate Manufacturing Overhead Allocated during January 2017 (manufacturing overhead rate) & ( manufacturing overhead allocated costs)

For Essays Guru – Benchmark – Research Critiques And PICOT Statement Final Draft

Details:
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement

Revise the PICOT statement you wrote in the Topic 1 assignment. (See attached)

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions. (Both are attached)

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper. (See attached)

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

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.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. (Rubric attached)
Running head: PICOT AND LITERATURE SEARCH 1

PICOT AND LITERATURE SEARCH 6

Diabetes: PICOT Statement and Literature Search

Grand Canyon University: NRS-433V-0503

Professor: Melissa Petrick Comment by Melissa Petrick: Double check GCU APA paper formatting. Does this need to be included?

April 8, 2018

Diabetes: PICOT Statement and Literature Search

PICOT Statement

PICOT Statement: Adults with Type 1 and Type 2 Diabetes undergoing self-management education compared to not undergoing self-management education can achieve better glycemic control within six months. Comment by Melissa Petrick: All the resources refer to type 2 that I saw in the abstract. Your PICOT question below only has type 2 in it as well.

P: – Population – Adults with Type 1 and Type 2 Diabetes

I: – Intervention – Undergoing self-management education

C: – Comparison – Not undergoing self-management education

O: – Outcome – Can achieve better glycemic control

T: – Time – Six months

Does educating patients on the risk of developing type 2 DM, if lifestyle changes do not occur, reduce the risk for developing DM compared to patients who do not receive education? Comment by Melissa Petrick: From what I saw, your research looked like it aimed to study the effects of self-management on overall health/patient perceptions/a1c levels. However, I didn’t see data that linked self-management/education tools on pre-diabetes and reduction of development of type 2 DM. I might have missed that there’s data embedded in the articles beyond the abstracts, but keep this in mind as you critically think of this topic.

References

Carolan, M., Holman, J., & Ferrari, M. (2015). Experiences of diabetes self‐management: a focus group study among Australians with type 2 diabetes. Journal of clinical nursing, 24(7-8), 1011-1023. Comment by Melissa Petrick: Look at capitalization here in the journal name. Is this an electronic resource? Does it have a doi or URL?

The aim of this study is to explore the experiences and concerns of type 2 diabetes patients in a low socio-economic environment. The researchers performed an exploratory qualitative study with a focus group of 22 people aged between 40 and 70 with type 2 diabetes mellitus. The data collected from this focus group study was analyzed using a thematic analysis approach. The participants of the group described their experiences and they were categorized as physical, emotional, and psychological. The data analysis showed four main themes in the experiences of the patients including personal journey, diabetes the silent disease, access to resources and services, and the work of managing diabetes. The research subjects highlighted that the impact of the diabetes management is not only on the patient but also the support group that assists in the self-management efforts. In conclusion, he members of this study are generally satisfied with their self-management techniques but they are in need of additional information to understand more about their condition.

Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient education and counseling, 99(6), 926-943.

The purpose of this article is to determine the effect of self-management education and the support methods, duration, and contact time or glycemic control for patients of type 2 diabetes. The researchers used online databases such as MEDLINE, ERIC, CINAHL, EMBASE and PsycINFO for article that assess diabetes interventions that involve patients’ participation in self-management activities. The review assessed 118 unique intervention techniques with 61.9% reporting significance. The overall mean reduction in A1C was 0.74 for the study groups and 0.17 for the control groups. A combination of individual and group engagement groups had the largest decreases in A1C with 0.88. Patients with elevated glycemic values reported a statistically significant reduction in their A1C with 83.9%. The data of this study suggests that the mode of self-management education delivery, the hours of engagement, and the baseline glycemic level affect the significant achievement in glycemic control after diabetes self-management.

Milajerdi, A., Shab-Bidar, S., Azizgol, A., & Khosravi-Boroujeni, H. (2015). Provision of nutritional/lifestyle counseling on diabetes self-management: A chance to improve metabolic control in new cases of type 2 diabetes. Journal of Nutritional Sciences and Dietetics, 1(2), 98-106.

The purpose of this study was to evaluate the efficacy of self-management education on metabolic control for type 2 diabetes patients. This was a quasi-experimental study that was done with 300 type 2 diabetes patients as the primary research subjects. The patients participated in 16-week educational program where they were trained on metabolic control by a dietician. At baseline, there was an intervention group attending a 20 minute lifestyle and nutrition educational program. The participants were analyzed at baseline and a 2 to 4 months follow-up for changes in the glycemic status, BMI, and lipid profile were done. Later a pre-education and post education analysis of variance was done to evaluated the differences. This study found that a lifestyle and nutrition education program were effective in helping patients of type 2 diabetes to improve their metabolic control. This study suggested that metabolic control can be done through educational intervention rather that the pharmacological interventions.

Nasab, M. N., Ghavam, A., Yazdanpanah, A., Jahangir, F., & Shokrpour, N. (2017). Effects of self-management education through telephone follow-up in diabetic patients. The health care manager, 36(3), 273-281.

The aim of this study was to investigate the effect of self-management education with a telephone follow-up for diabetic patients living in rural areas of Iran. The study was done using an experimental study design with 64 participants randomly assigned to the intervention and control groups of 32 each. The intervention group included patients who attended four educational sessions lasting 90 minutes each. The control group went through the traditional care routine. The outcome of the experinment was measured using the Diabetes Self-Managemnt Questionnaire (DSMQ) before and after the intervention. The results were analysed using Mann-Whitney U tests. The results found that there was a significant difference in the glycemic control for the intervention and control groups. This study suggests that self-management education facilitates better self-care.

Pereira, K., Phillips, B., Johnson, C., & Vorderstrasse, A. (2015). Internet delivered diabetes self-management education: a review. Diabetes technology & therapeutics, 17(1), 55-63.

The purpose of this article was to investigate the effectiveness of internet-delivered diabetes self-management education on glycemic control. A quantitative analysis was done on literature from various online databases such as PubMed, EBSCO, CINAHL, and Web of Science. The search led to the analysis of 111 relevant articles, but only 14 met the criteria for the review. Nine of the reviewed articles were randomized control trials with study lengths varying between 2 weeks and 24 months. The results of the study showed that internet delivered self-management education is effective in reducing glycemic control among diabetes patients. Additionally, the results showed that self-management education help to increase rates if clinical attendance and change eating habits after the online engagement with patients through the internet. The implications of this study are that education on self-management techniques can be offered through online platforms and help improve self-care among diabetes patients.

Tang, T. S., Funnell, M., Sinco, B., Piatt, G., Palmisano, G., Spencer, M. S., … & Heisler, M. (2014). Comparative effectiveness of peer leaders and community health workers in diabetes self-management support: results of a randomized controlled trial. Diabetes care, 37(6), 1525-1534.

The objective of this article was to compare the differences between the effects of a peer leaders versus community health worker led telephone outreach intervention compared to a six months self-management education program. The study was done using a randomized control trial with 116 Latino adults with type 2 diabetes. The participants were selected from a federally qualified health center and randomly selected for a 6-month self-management education program followed by 12 months of weekly group discussions delivered by peer leaders. Another group was enrolled for the 6-moth education program and later a 12 month outreach program by a community health worker. The results suggested that the group that underwent the peer leadership groups maintained their improvements after the education program for a period of 18 months. Both groups maintained their improvements in waist circumference, diabetes distress, and diabetes support with no significant differences between each of the groups. This study suggests that both low cost peer group interventions and community health worker led outreach programs help diabetes patients to maintain their diabetes management after their education program.
Running head: RESEARCH CRITIQUE 1

RESEARCH CRITIQUE 3

Qualitative Research Critique

Grand Canyon University: NRS-433V-0503

Professor: Melissa Petrick

April 15, 2018

Research Critique

The development of nursing practice is dependent on the advancement of new knowledge, which is facilitated by new research. Evidence-based practice is an important part of nursing as it helps to ensure that the promotion of healthcare is based on valid and applicable information. To determine the validity, credibility, and applicability of research information, it is required that a research critique is conducted to highlight the strengths and weaknesses of the study and how they affect the applicability of the research (LoBiondo-Wood & Haber, 2017). The following is a critique of the article “Experiences of diabetes self‐management: a focus group study among Australians with type 2 diabetes” by Carolan, Holman, and Ferrari (2015). The critique analyses the study’s background, methodology, results, and the ethical considerations made by the researchers. Comment by Melissa Petrick: analyzes

Background of the Study

The study by Carolan, Holman, and Ferrari (2015) was based in Australia where approximately a million people have been diagnosed with diabetes. The rate of diabetes in Australia has more than doubled in the past four decades. Among all the diabetes cases in the country, 85% of them are Type 2 diabetes cases, which are mainly caused by lifestyle decisions. Some of the risk factors for Type 2 diabetes include old age, obesity, sedentary lifestyle, ethnicity, and low socio-economic status. People with more than one risk factor have a higher chance of getting Type 2 diabetes at some point in their life. Diabetes self-management is an important part of proper diabetes care. Patients are expected to understand the strategies that they should take for glycemic control and to change the lifestyle conditions that contribute to diabetes. However, people in the low socio-economic conditions may lack the resources and services to properly manage their condition. Carolan, Holman, and Ferrari (2015) identified the diabetes issue within the Australian population and developed a study that aimed to determine the treatment and care experiences of type 2 diabetes mellitus patients with reference to access to services and resources. The study was based in a low socio-economic rea where the people are likely to have trouble accessing the resources they need to properly care for their illness. The following are the research questions that this study was designed to answer.

· What are the experiences of a diabetes patient in a low socio-economic setting?

· How does diabetes affect a patient and their family?

· What difficulties do diabetes in low socio-economic areas experience?

The purpose and the research questions of this study relate to the study problem because they are focused on the difficulties that the low socio-economic groups in Australia experience. The problem identified that there is a large number of people in Australia with type 2 diabetes and the people in the low-socio economic groups have a higher risk of having diabetes.

Method of Study

The study was conducted using an exploratory qualitative research design. The research data was collected in the form of focus groups made up of a population of 22 people aged between 40 and 70 years, with type 2 diabetes. There was different focus groups ranging from four to eight participants each where the data was recorded, transcribed, and later analyzed using a thematic analysis approach. Although Carolan, Holman, and Ferrari (2015) do not create the exact framework to demonstrate the use of grounded theory, the research process shows that they used a valid process of research.

The qualitative methods that have been used in this study were appropriate in studying the research questions. This was an exploratory study, meaning that there was no definite hypothesis that the researchers were investigating. Therefore, investigating the research problem with a focus group was a good technique of identifying a variety of information, which was later used in the development of the themes.

In developing this study, Carolan, Holman, and Ferrari (2015) cited various qualitative and quantitative research sources to enhance the validity of the claims that have been made in the study. The sources that have been cited tend to include both recent and slightly old studies. The oldest research cited by the authors was published in 1999, while the most recent was published in 2015. However, the older researches used in this study are only focused on developing the methodology. The literature review of the article only focuses on the more recent studies, which are a more accurate representation of developed facts at the time of the development of the article. As for the older citations, it is highly unlikely that research methods have changed too much to affect the validity of the information included by the researcher. In general, the literature review developed in this study builds a valid argument. It shows the gap in understanding the struggles that low income type 2 diabetes patients undergo and the need for new information to develop better care for the poorer diabetes patients in Australia. The research does not list the limitations that were experienced in the research process.

Results of Study

From the data collected from the focus groups, various themes were developed. These themes include the patients’ personal journey, diabetes as a silent disease, the access to services and resources, and the work of managing diabetes. The researchers found that diabetes patients experience emotional, physical, and social challenges. This study highlighted the impact that diabetes has on the individual and their family and the importance of having a family support system to assist in the self-management efforts. The study concluded that the participants were generally satisfied with their current care but there was a clear need for self-management education to provide additional information on the understanding of this condition.

The results of this study have some implications on the development of nursing practice and nursing research. This study has demonstrated that people in the low socio-economic environments have unique challenges that need to be addressed to improve the quality of service and care that they receive. This was an exploratory study; hence, it can be used as a basis for more in-depth studies that investigate the specific themes that have been identified. Possibly, this can help in the development of new information that can improve diabetes self-management.

Ethical Considerations

Carolan, Holman, and Ferrari (2015) took various steps to make sure that their study was ethical. This study was reviewed by an IRB and was approved before its commencement. The ethical consideration that has been made in the study is the protection of the privacy of the participants. The researchers used pseudonyms in place of the real identities of the participants to protect their privacy. Additionally, the researchers obtained a written consent from the participants before they participated in the focus groups. The participants voluntarily left their details and results of the study were mailed to them after the completion of the analysis.

Conclusion

The study by Carolan, Holman, and Ferrari (2015) has utilized some relevant quantitative techniques to ensure that the study is valid and applicable. The study has a clear aim and uses valid qualitative techniques to meet the research objectives. Valid research sources and methodology has been used in performing this research. From this analysis, it is clear that this is a valid study that can be applied in developing new knowledge for nursing practice. Through the study, one can develop new researches that can help to develop self-management care for diabetic patients.

References

Carolan, M., Holman, J., & Ferrari, M. (2015). Experiences of diabetes self‐management: a focus group study among Australians with type 2 diabetes. Journal of clinical nursing, 24(7-8), 1011-1023. Comment by Melissa Petrick: “Clinical Nursing” should be capitalized.

LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.
Running head: RESEARCH CRITIQUE 1

RESEARCH CRITIQUE 4

Quantitative Research Critique

Grand Canyon University: NRS-433V-0503

Professor: Melissa Petrick

April 22, 2018

Introduction

Current estimates indicate that nearly 50 percent of persons suffering from diabetes do not attain and sustain the required target of less than 7 percent for glycated hemoglobin and a mere 14.3 percent are at the target requirements for glycated hemoglobin, low density lipoprotein cholesterol, non-smoking as well as blood pressure. The American Diabetes Association, through its 2015 standards for patient care, recognize the impact of diabetes self-management education as a significant aspect of care for individuals with diabetes. However, recent studies indicate that among new cases of diabetes, 7 percent of persons with private insurance and less than 5 percent of individuals covered by Medicare participate diabetes self-management education (Chrvala, Sherr & Lipman, 2016). It is for this reason that Tang et al. (2014) conducted a study on the impacts of peer leaders as well as community health workers in diabetes self-management support. This paper is a critique of the aforementioned research by Tang et al. (2014) in an article titled “ Comparative effectiveness of peer leaders and community health workers in diabetes self-management support: results of a randomized controlled trial”. Comment by Melissa Petrick: Put the period inside the quotation here.

Article Summary Comment by Melissa Petrick: Within Methods of Study, these questions can be used to guide analysis. You discussed some of these, but make sure you look at these questions to analyze deeper.Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify?Was informed consent obtained from the subjects or participants?Did it seem that the subjects participated voluntarily in the study?Was institutional review board approval obtained from the agency in which the study was conducted?Are the major variables (independent and dependent variables) identified and defined? What were these variables?How were data collected in this study? What rationale did the author provide for using this data collection method? Identify the time period for data collection of the study. Describe the sequence of data collection events for a participant. Describe the data management and analysis methods used in the study. Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis?What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses?

The purpose of this study was to compare peer leader versus community health worker telephone outreach program in sustaining improvements in glycemic control over 1 year after a half a year diabetes self-management education program. The sample was random, including 116 adults suffering from DM type 2 who were recruited via a federally qualified health center. The research participants were randomized to a 6 month diabetes self-management education program followed by a 1 year of weekly group sessions administered by peer leaders with telephone outreach to research participants unable to attend the program. Also, the randomized study of 6 month diabetes self-management education program followed by 1 year of monthly outreach via telephone administered by community health workers. The main outcome was glycemic control with the secondary outcomes being the cardiovascular disease risk factors, diabetes social support as well as diabetes distress. Assessments were performed at three different baselines- 6, 12 as well as 18 months (Tang et al., 2014). Comment by Melissa Petrick: Consider grammar check to resolve this.

The researchers found that, after diabetes self-management support, the group that passed through the peer leadership program maintained glycemic control improvements for up to 18 months after the education program. Only the peer leader group maintained the improvements realized in blood pressure for 18 months. The community health workers’ group, on the other hand, showed a reduction in glycemic control for up to 6 months after the diabetes self-management education program. A follow up, 18 months later, showed that the peer leader group and the community health workers group maintained improvements with no significance difference in three areas-waist circumference, diabetes distress as well as diabetes support. In conclusion, the researchers asserted that low cost maintenance programs-whether peer leader program or community health worker program-maintained improvement in major patient reported diabetes outcomes. Nonetheless, peer leader intervention has additional advantage in sustaining clinical improvement for more than 12 months (Tang et al., 2014).

The Relevance of the Study’s Findings in Nursing Practice

The study’s findings are important for nursing practice since diabetes self-management education has, for many years, been accepted as an essential aspect of care for persons living with diabetes and those at risk for developing diabetes. The Centers for Disease Control and Prevention, in its 2014 data, show that the incidence and prevalence rates for diabetes are high among minority communities. This is attributed to the health care access disparities, which is common among ethnic and minority groups (CDC, 2014). Adoption of community health worker initiative model to reduce health care access disparities to diabetes education is a vital as well as practical approach, with sufficient evidence supporting its efficacy. The National Standards for DM Self-Management Support and Education, fifth standard, acknowledges that case managers, health educators, community health workers as well as peer counselors in diabetes self-management education. In particular, they can contribute effectively as components of DM self-management education team as well as in providing patients with diabetes self-management support. People who serve as community health workers as well as peer counselors can help in providing diabetes education and self-management instructions as well as DM sand support if they acquire enough training in group facilitation, diabetes management, emotional support and self-management skills (AADE, 2015).

From the diabetes perspective, peers are defined as persons suffering from diabetes or individuals affected by diabetes like close family members. Peer support can empower affected individuals to connect with others with similar experiences, which can lead to patient satisfaction as well as motivation. Peer support, from the healthcare point of view is, “the provision of emotional, appraisal and informational assistance by a created social network member who possesses experiential knowledge of specific behavior or stressor and similar characteristics as the target population” (Werfalli et al., 2015, p. 2). The researchers indicate that emotional support is the expression of caring, encouragement, reassurance as well as empathy and it enhances self-esteem. Informational support is the provision of advice, alternative actions, suggestions as well as feedback regarding the issue that a peer is encountering. Appraisal support, on the other hand, includes encouraging optimism as well as persistence for problem resolution. It also relates to affirmation the peer’s feelings and reassurance that he or she can deal with his or her frustrations. Researchers have the responsibility of protecting participants in investigations.

Ethical Considerations

Ethics is a basic foundation for conducting effective as well as meaningful research and, therefore, ethical behavior and conduct of researchers is under scrutiny. All researchers, including psychologists, anthropologists and educators, have four major duties to participants. These include informed consent, privacy and deception as well as protection from harm. With regards to informed consent, a researcher must ensure that research participants have an understanding of the purpose as well as the methods of the study. Also, it is important to risks involved as well as the demands placed on them as participants. The participants must also understand that they have the right to withdraw from a study at any particular time. From a legal perspective, informed consent revolves around three basic aspects: capacity, voluntariness as well as information. These three elements must be present for an effective informed consent (Punch, 2013). Comment by Melissa Petrick: While this is important to understand what ethical considerations are, this critique looks to discuss if the ethical considerations were applied to the study you’re critiquing. Was the study approved by an Institutional Review Board?Was patient privacy protected?Were there ethical considerations regarding the treatment or lack of?

Researchers must take appropriate and reasonable steps to avoid harm to participants and others with whom they operate or work. The basic concern is ensuring that no one is harmed by acting as a participant. Harm includes physical pain and death as well as other factors like psychological stress, humiliation, myriad influences and personal embarrassment that adversely affect participants in significant ways. A research must be planned as well as executed in a way that minimizes harm to research participants. Studies are more ethically justifiable if the probabilities of risks are minimized. Also, researchers must consider the long term effects of the study on participants and other users (Punch, 2013).

The other ethical consideration is attached to participants’ privacy; privacy is a highly treasured right in Western society. The final of deception involves intentional misrepresentation of key facts regarding the purpose, nature and consequences of a study. Researchers collect and analyze data regarding people, either as individuals or groups and this is a source of conflict between a researcher’s goals and the privacy rights. It refers to the omission and commission of information when interacting with participants. Therefore, deception has become concern for researchers (Punch, 2013). Comment by Melissa Petrick: Put a conclusion here tying it altogether.

References

American Association of Diabetes Educators. (2015). Community health workers in diabetes management and prevention. Maryland, MD: Author

Centers for Disease Control and Prevention. (2014). National diabetes statistics report: Estimates of diabetes and its burden in the United States. Atlanta, GA : Author.

Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient education and counseling, 99(6), 926-943.

Punch, K. F. (2013). Introduction to social research: Quantitative and qualitative approaches. Thousand Oaks, C A: sage.

Tang, T. S., Funnell, M., Sinco, B., Piatt, G., Palmisano, G., Spencer, M. S., … & Heisler, M. (2014). Comparative effectiveness of peer leaders and community health workers in diabetes self-management support: results of a randomized controlled trial. Diabetes care, 37(6), 1525-1534.

Werfalli, M., Raubenheimer, P., Engel, M., Peer, N., Kalula, S., Kengne., A. P., &Levitt, N. S. (2015). Effectiveness of community-based peer-led diabetes self-management programmes (COMP-DSMP) for improving clinical outcomes and quality of life of adults with diabetes in primary care settings in low and middle income countries (LMIC): A systematic review and meta analysis. BMJ Open, 5(007635), 1-8.
Research Critique Guidelines

To write a critical appraisal that demonstrates comprehension of the research study conducted, address each component below for qualitative study in the Topic 2 assignment and the quantitative study in the Topic 3 assignment.

Successful completion of this assignment requires that you provide a rationale, include examples, or reference content from the study in your responses.

Qualitative Study

Background of Study:

· Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

· How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem.

· Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

· List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

· Were the purpose and research questions related to the problem?

Method of Study:

· Were qualitative methods appropriate to answer the research questions?

· Did the author identify a specific perspective from which the study was developed? If so, what was it?

· Did the author cite quantitative and qualitative studies relevant to the focus of the study? What other types of literature did the author include?

· Are the references current? For qualitative studies, the author may have included studies older than the 5-year limit typically used for quantitative studies. Findings of older qualitative studies may be relevant to a qualitative study.

· Did the author evaluate or indicate the weaknesses of the available studies?

· Did the literature review include adequate information to build a logical argument?

· When a researcher uses the grounded theory method of qualitative inquiry, the researcher may develop a framework or diagram as part of the findings of the study. Was a framework developed from the study findings?

Results of Study

· What were the study findings?

· What are the implications to nursing?

· Explain how the findings contribute to nursing knowledge/science. Would this impact practice, education, administration, or all areas of nursing?

Ethical Considerations

· Was the study approved by an Institutional Review Board?

· Was patient privacy protected?

· Were there ethical considerations regarding the treatment or lack of?

Conclusion

· Emphasize the importance and congruity of the thesis statement.

· Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

· Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

· Integrate a summary of the knowledge learned.

Quantitative Study

Background of Study:

· Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

· How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem.

· Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

· List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

· Were the purpose and research questions related to the problem?

Methods of Study

· Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify?

· Was informed consent obtained from the subjects or participants?

· Did it seem that the subjects participated voluntarily in the study?

· Was institutional review board approval obtained from the agency in which the study was conducted?

· Are the major variables (independent and dependent variables) identified and defined? What were these variables?

· How were data collected in this study?

· What rationale did the author provide for using this data collection method?

· Identify the time period for data collection of the study.

· Describe the sequence of data collection events for a participant.

· Describe the data management and analysis methods used in the study.

· Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis?

· What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses?

Results of Study

· What is the researcher’s interpretation of findings?

· Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings?

· What limitations of the study were identified by researchers?

· Was there a coherent logic to the presentation of findings?

· What implications do the findings have for nursing practice? For example, can the findings of the study be applied to general nursing practice, to a specific population, or to a specific area of nursing?

· What suggestions are made for further studies?

Ethical Considerations

· Was the study approved by an Institutional Review Board?

· Was patient privacy protected?

· Were there ethical considerations regarding the treatment or lack of?

Conclusion

· Emphasize the importance and congruity of the thesis statement.

· Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

· Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

· Integrate a summary of the knowledge learned.

Reference

Burns, N., & Grove, S. (2011). Understanding nursing research (5th ed.). St. Louis, MO: Elsevier.

© 2016. Grand Canyon University. All Rights Reserved.

4
RUBRIC

1 Unsatisfactory 0.00%

2 Less than Satisfactory 75.00%

3 Satisfactory 83.00%

4 Good 94.00%

5 Excellent 100.00%

60.0 %Content

5.0 %Nursing Practice Problem and PICOT Statement

A nursing practice problem is not clearly described and/or a PICOT statement is not included.

PICOT statement describes a nursing practice problem but lacks reliable sources.

PICOT statement describes a nursing practice problem and includes a few reliable sources.

PICOT statement articulates a nursing practice problem using supporting information from reliable sources.

PICOT statement clearly articulates a nursing practice problem using substantial supporting information from numerous reliable sources.

5.0 %Background of Study

Background of study including problem, significance to nursing, purpose, objective, and research questions is incomplete.

Background of study including problem, significance to nursing, purpose, objective, and research questions is included but lacks relevant details and explanation.

Background of study including problem, significance to nursing, purpose, objective, and research questions is partially complete and includes some relevant details and explanation.

Background of study including problem, significance to nursing, purpose, objective, and research questions is complete and includes relevant details and explanation.

Background of study including problem, significance to nursing, purpose, objective, and research questions is thorough with substantial relevant details and extensive explanation.

5.0 %Method of Study

Discussion of method of study including discussion of conceptual/theoretical framework is incomplete.

Discussion of method of study including discussion of conceptual/theoretical framework is included but lacks relevant details and explanation.

Discussion of method of study including discussion of conceptual/theoretical framework is partially complete and includes some relevant details and explanation.

Discussion of method of study including discussion of conceptual/theoretical framework is complete and includes relevant details and explanation.

Discussion of method of study including discussion of conceptual/theoretical framework is thorough with substantial relevant details and extensive explanation.

5.0 %Results of Study

Discussion of study results including findings and implications for nursing practice is incomplete.

Discussion of study results including findings and implications for nursing practice is included but lacks relevant details and explanation.

Discussion of study results including findings and implications for nursing practice is partially complete and includes some relevant details and explanation.

Discussion of study results including findings and implications for nursing practice is complete and includes relevant details and explanation.

Discussion of study results including findings and implications for nursing practice is thorough with substantial relevant details and extensive explanation.

5.0 %Ethical Considerations

Discussion of ethical considerations associated with the conduct of nursing research is incomplete.

Discussion of ethical considerations associated with the conduct of nursing research is included but lacks relevant details and explanation.

Discussion of ethical considerations associated with the conduct of nursing research is partially complete and includes some relevant details and explanation.

Discussion of ethical considerations associated with the conduct of nursing research is complete and includes relevant details and explanation.

Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation.

5.0 %Conclusion

Conclusion does not summarize a critical appraisal and applicability of findings.

Conclusion is vague and does not discuss importance to nursing.

Conclusion summarizes utility of the research and importance to nursing practice.

Conclusion summarizes utility of the research from the critical appraisal and the findings importance to nursing practice.

Conclusion summarizes utility of the research from the critical appraisal, knowledge learned, and the importance of the findings to nursing practice.

10.0 %Evidence of Revision

Final paper does not demonstrate incorporation of feedback or evidence of revision on research critiques.

Incorporation of research critique feedback or evidence of revision is incomplete.

Incorporation of research critique feedback and evidence of revision are present.

Evidence of incorporation of research critique feedback and revision is clearly provided.

Evidence of incorporation of research critique feedback and revision is comprehensive and thoroughly developed.

10.0 %PICOT Statement, Research Article, and Nursing Practice Problem Link (C. 2.2)

Discussion of the link between the PICOT statement, research articles, and nursing practice problem is not included.

Discussion of the link between the PICOT statement, research articles, and nursing practice problem is incomplete or incorrect.

Discussion of the link between the PICOT statement, research articles, and nursing practice problem is included but lacks relevant details and supporting explanation.

Discussion of the link between the PICOT statement, research articles, and nursing practice problem is complete and includes relevant details and supporting explanation.

Discussion of the link between the PICOT statement, research articles, and nursing practice problem is extremely thorough with substantial relevant details and extensive supporting explanation.

10.0 %Proposed Evidence-Based Practice Change (C. 3.2)

The proposed evidence-based practice change is not included.

The proposed evidence-based practice change is incomplete or incorrect.

Discussion of the link between the PICOT statement, research articles, and nursing practice problem is included but lacks relevant details and supporting explanation. The proposed evidence-based practice change is included but lacks supporting explanation and relevant details.

The proposed evidence-based practice change is complete and includes supporting explanation and relevant details.

The proposed evidence-based practice change is extremely thorough and includes substantial supporting explanation and numerous relevant details.

30.0 %Organization and Effectiveness

10.0 %Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

10.0 %Argument Logic and Construction

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

10.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

10.0 %Format

5.0 %Paper Format (use of appropriate style for the major and assignment)

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

Sources are not documented.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

100 %Total Weightage

Identification of the research study: independent and dependent variables

Write a five to seven page paper. The paper should include basic information about the research article you have chosen to investigate.
2. Format your paper consistent with APA guidelines. Within your paper, please include a minimum of three references (your text may be used as a reference).
1. Identification of the research study: independent and dependent variables
2. Identification of the research study: sample characteristics
3. Identification of the data collection procedures
4. Discuss the results of the study. What was the statistical significance? Were the results meaningful?
5. Identify the study implications. What are the implications of this study for nursing practice, education, or administration? What further questions were raised by this study?
6. Include your own evaluation of the study. In your opinion, was this study done well, and was this an important study for nursing? How could the study have been improved? What are the implications of this study for your practice area?

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