Evidence-Based Practice [provide definitions for a) evidence-based practice b) quality improvement and c) research. Please include references using APA format.]Describe how you would use each process (e.g. EBP QI and research) to address the selected quality indicator in Ambulatory Care.A.Description of Clinical Problem/Situation:Nursing Turnover within the Ambulatory Care (ACS) SettingB.PICO QuestionThe following PICO question has been devised to guide this exploration of the scientific literature and other essential forms of evidence.PICO Question Components:P: [patient population or problem]Nurse Retention within the Ambulatory Care SettingI: [intervention or treatment]Factors that may positively influence retention rateC: [comparison with other treatments when warranted]Factors that may negatively influence retention rateO: [outcome] ?Question: What factors may positively (I) or negatively (C) impact nursing retention within the Ambulatory Care Nursing setting (P) (O)?C.Sources of Evidence & References[types of evidence published expert opions patient preferences etc.]Article 1 Article 2 -D.Critical Appraisal of the Evidence[briefly describe how this was done used the Johns Hopkins Nursing EBP criteria provider an evidence rating for each article/evidence source used [e.g. 1A 3C etc.][ex: Each article was critically appraised using the Johns Hopkins Nursing Evidenced-based Practice Research criteria. As an example the article Questions to consider should we implement the practice recommendations? Would this change improve nurse retention outcomes? Would it improve overall unit/pavilion operations e.g. costs workload culture? Can the evidence be translated inn other ways e.g. policy/procedure development?E.Translation[would you put the evidence you appraised into practice? How would that be done? Should we implement the practice recommendations? Would this change improve our nurse retention outcomes? Would it improve overall unit/pavilion operations (e.g. costs workload and culture)? Can the evidence be translated in other ways (e.g. policy/procedure development)?

Choose a contemporary school of nursing, hospital, nursing home,
or other facility in the healthcare arena and research the nursing
theory used there. Describe the changing role of the nurse today
and how they are influenced by the organizational nursing
theory.
Your presentation should include (60 pts.):
How the nursing theory enhances professional nursing practice in
the roles of advocate, provider, teacher, manager, researcher, and
leader. (20 pts.)
How using nursing theory and theory from other disciplines as a
basis for the nursing process helps promote health and healing. (10
pts.)
How we can use nursing theory to challenge professional and
organizational assumptions, explore alternatives, and guide nursing
actions. (30 pts.)
This assignment is a PowerPoint presentation only. (40 pts.) The
presentation should include no more than 20 slides. If you use
graphics be sure they are small in size, so your presentation can
be loaded quickly.
When you have completed this assignments, you will be able to
differentiate the concepts of person, environment, health, and
nursing, as they relate to select nursing theories by: (Competency
1)
identifying and defining the nursing metaparadigms. (10 pts.)
analyzing the philosophical bases of the concepts as they relate to
specific theorists. (10 pts.) differentiating the concepts as they
relate to selected nursing theories. (10 pts.) constructing a
personal nursing philosophy by integr

Week 4 DiscussionLong-Term Care in the U.S.Determine the average daily cost of nursing home care in your state. Discuss the funding options (public and private) that exist to pay for long-term care. What policy and financing recommendations would you make to ensure that long-term care is available for everyone who needs the services in the U.S.? Please justify your answer.Rationing of Healthcare ServicesHealthcare services can be rationed by governmental rationing or by allowing those who can afford the services to purchase the services. If you were the chairperson of a medical ethics committee faced with the decision concerning which of the following patients would receive a heart transplant what decision would you make and what justification would you give to the families of each of the patients for making that decision?Patient 2: A forty-six-year-old unemployed auto worker with a history of alcohol use and smoking suffered a heart attack and will die within one month if he does not receive a heart transplant. The patient does not have health insurance nor does he have the resources to pay for the procedure.

The McGill Model of Nursing is a theory that looks at the patient as a whole person and not just through the eyes of disease and sickness.This theory helps identify the patient with loving family members involved in the care as an individual person and as a person with desires and goals in life (Wright & Gross 2012).A study conducted on the end of life care on patients using the McGill Model focused the study on family members of dying patients and how the transition from palliative to hospice care affected them.Furthermore the study revealed the APNs transition with the family from having hope of saving the patient to finding peace in the dying patient (Wright & Gross 2012). The APN walks through this transition with the patient and family constantly observing the needs of the patient and family while making sure all the medical needs are meant as well.The Gestalt Theory is based on a persons perception of a situation or event.This theory focuses on an event that people experience together but how differently each person can perceive the event (Butts & Rich 2013 p 210).People tend to filter what they see and experience differently from one another much like when a family goes through the death of a loved one.Each family member shows different emotions or has different perspectives for example one person may be angry and resentful of the situation while another might be the one at peace with it (Shaha et el. 2011).Even though these two theories are unrelated they both can be utilized by the APN. The McGill Model looks at the patient and the family members involved in patients care as if they are all the same whereas the Gestalt Theory focuses on individuals perception of the same situation but appreciates the different views of each person.These theories demonstrate a holistic approach on caring for the patient and can provide more meaningful care when combined.(Butts J. B. & Rich K. L. (2013). Philosophies and Theories for Advanced Nursing Practice (2nd ed). Burlington MA: Jones & Bartlett Publishers.Shaha M. Cox C. L. Belcher A. & Cohen M. Z. (2011). Transitoriness: patients’ perception of life after a diagnosis of cancer: Maya Shaha and colleagues discuss the importance of understanding how people come to terms with the finality of life in the context of evidence-based care. Cancer Nursing Practice (4) 24.Wright D. K. & Gros C. P. (2012). Theory inspired practice for end-of-life cancer care: An exploration of the McGill Model of Nursing. Canadian Oncology Nursing Journal 22(3) 175-181.