Read the case study titled “Missed Opportunities”, attached. 

Write a four to six (4-6) page paper in which you:

1. Examine the pros and cons from the perspective of Crestview Hospital of the placement of its new billboard directly adjacent to Briarwood Medical Center. Interpret the reaction of customers and other community stakeholders to the billboard postings.
2. Use competitive marketing entry strategies to suggest the action that Briarwood Hospital should undertake to counter the messages in the new Crestview Hospital Billboard postings.
3. Recommend the marketing communication strategy or strategies that both Crestview and Briarwood Hospitals should employ. Justify why the Governing Board of both hospitals should take a proactive role in promoting and implementing effective marketing strategies.
4. Assess the value of the various marketing research tool(s) that Briarwood and Crestview hospital could use to promote effective marketing communication strategies. Justify your response.
5. Use at least five (5) quality academic resources. Note: Wikipedia and other Websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

• Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
• Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. 

The specific course learning outcomes associated with this assignment are:

• Evaluate marketing research tools involved in the marketing process.
• Formulate competitive market entry strategies based on analysis of global markets that comply to initiatives in the health care industry.
• Determine the marketing communications strategy used in health care services.
• Use technology and information resources to research issues in health services strategic marketing.
• Write clearly and concisely about health services strategic marketing using proper writing mechanics. 

Overview

Bacteria can talk to each other via molecules they produce themselves. In this way, bacteria can synchronize together and function as one large unit or colony. The phenomenon is called quorum sensing, and is important to bacterial metabolism, growth and virulence. Watch the following video on “How Bacteria Talk”, then read the link below on “Quorum Sensing” to learn more.

Bassler, B.(2009). How Bacteria “talk”. Accessed at http://www.ted.com/talks/bonnie_bassler_on_how_bacteria_communicate#t-1038504 on September 14, 2016.

What is Quorum Sensing? Accessed at https://www.nottingham.ac.uk/quorum/what.htm  on September 14, 2016.

Instructions

Prepare a 2- to 3-page paper in which you address the following questions:

1. How would you define quorum sensing in bacteria?
2. How can quorum sensing improve nutrient delivery to bacteria?
3. Not all bacterial relationships are harmful like the example Dr. Bassler gave for the squid and bacterial bioluminescence. Describe an example of a microbial relationship in the human body that is beneficial. Which body system is involved (intestinal tract, skin, etc.)? Which bacterial species is involved? How is it beneficial for both the bacterium and host?
4. What does the concept of quorum sensing mean for virulence and disease in humans?
5. Based on Dr. Bassler’s research on quorum sensing, what might the “next generation” of antibiotics look like? How might they work? 

SLP Assignment Expectations

Format

TUI encourages all students to comply with APA style and format guidelines for proper citation of references.  Use the formatting in your Background page as a model.

Scholarly Content                   

Your SLP assignment is considered a scholarly work. Your final work should include peer reviewed (scholarly) sources.  Please use the formatting demonstrated in your Background section to cite the tutorials and readings from the Overview.

Please keep in mind that you should not use sources such as “Answers.com” or “Wikipedia” or “Wikianswers.”  None of these are scholarly sources and they can be “modified” by any registered user which makes them unreliable.

Appropriate Headings and Paper Flow

Remember that you are preparing a formal academic paper. Your paper should make use of appropriate headings and subheadings.  You should not cut and paste the questions posed and answer them like a “Question and Answer” session.  Your finished paper should read like an academic paper. Upload your final word document to the SLP assignment dropbox.

Comment1.

In medicine, Levels of evidence (LoE) are arranged in a ranking system used in evidence based practices to describe the strength of the results measured in a clinical trial or research study (Wikipedia, 2018). A method utilized in evidenced based medicine to determine the clinical value of a study (Moore, n.d.). In grading scheme, scientific evidence can range from level 1 that is the most scientifically valid; to level 5 that is the weakest form of evidence (Sharma, n.d)

Different levels of evidence is categorized as follows:

Level 1: Randomized controlled trial (RCT) is a study in which the patients are randomly assigned to the treatment or controlled group and are followed prospectively. It can also be in a form of Meta-analysis of randomized trials with homogenous results (Moore, n.d). Sharma (n.d) states that optic neuritis treatment trial study is a perfect example of this level of evidence.

Level 2: Lesser quality RCT is a prospective comparative study. It is a study in which patient groups are separated non-randomly by exposure or treatment, with exposure occurring after the initiation of the study (Moore, n.d). Example of this study according to Sharma (n.d) is a scatter laser photocoagulation for occult choroid neovascularization.

Level 3: Retrospective cohort study pertains to the study in which groups are separated by the current presence or absence of disease and examined for the prior exposure of interest. A perfect example of this level is thrombolytic therapy for acute retinal arterial occlusion (Sharma, n.d).

Level 4: Moore (n.d) states that a level 4 is a Case Series, which means a report of multiple patients with the same treatment, but no control groups or comparison group. Example is macular translocation surgery for the treatment of Chroidal neovascular membrane (CNVM) and Age-related Macular Degeneration (AMD) (Sharma, n.d).

Level 5: Is a case report, or expert opinion, a mere personal observation. An interventional case reports can be classified as level 5 evidence, example is a removal of choroid neovascular membrane (Sharma, n.d).

Comment2

Meta-analyses –This is a high level of evidence due to the ability of meta-analyses being able to establish statistical significance across studies that may have had contradictory results.  By evaluating multiple studies at one time this increases the statistical significance than with just one study alone. Practice changes in psychology can occur as a result of meta-analyses.  The researcher looks over published studies, and then studies the results for trends.

Experimental studies and Quasi-experimental studies-These types of studies help to determine how effective certain nursing interventions are for patient outcomes.  As a result this could lead to many practice changes in nursing.

Nonexperimental studies-Descriptive and correlational studies are sometimes referred to as nonexperimental and the reason being is that evaluating the study variables is observed naturally and not under any type of control set by the researcher.   

Program Evaluations, RU studies, quality improvement projects, case report.  In our textbook there is an example of a descriptive study design where women were studied with postpartum depression after having pregnancy complications.  The purpose was to describe barriers to treatment, use on internet resources for assistance for postpartum and their inclination for Internet treatment for postpartum depression.

Working in a cancer unit, I have learned that no matter what treatments, or surgeries doctors choose, unfortunately a lot of the time the cancer wins. However, as a nurse I have learned that even though I am unable to make a difference in their overall diagnosis outcome, I can make a difference in their care and well being by using evidence based practice. For example, I found that our unit has the highest CLABSI rate compared to the rest of the entire hospital. So clearly we are doing something wrong, and we need to find that problem and fix it. Our patients are already going through enough and it’s up to us as BSN prepared nurses to implement EBP in the clinical setting to protect our patients from these unnecessary and preventable infections. Making changes over time based on evidence is necessary in order to keep up with our continuously changing health care. BSN prepared nurses understanding of EBP across patient care gives them the unique ability to act as partners with other health professionals and to lead the improvement and redesign of the health care system (IOM, 2010). The first way I will continue to integrate evidence is by staying up to date with the changing health care system. It’s important to be aware of the changes going on outside of our work environment because the can make all the difference in your practice. I feel that nurses tend to get “comfortable” in the way they practice nursing. However, nursing and the health care system will continue to change and we must keep up with those changes. Second, I will make sure that I advocate for the nurses in our workplace by always asking questions, and requesting that our unit receives continuous training in changes occurring out in the nursing world. 

 Reference:

Institute of Medicine (2010). The Future of Nursing: Leading Change and Advancing Health. Retrieved from https://campaignforaction.org/resource/future-nursing-iom-report/

Josphina Chavara 

1 posts

Re:Topic 10 DQ 2

When an EBP is utilized by a nurse, he or she knows that the EBP stems from the result of trials, experiments, tests, routine examinations, and best practices that took a closer examination on the results and the intended results. The BSN-prepare nurse is confident that the EBP utilized is not something that comes from random ideas put together; it is the result of tried and true procedure that improves upon and evolves the nurse’s understanding of what treatment/medication/action works best for the patient currently. Furthermore, the EBP goes through several rigorous sets of eyes to see its role in improving healthcare. According to the Online Journal of Issues in Nursing (2013), for EBP to be successfully adopted and sustained, it needs to be supported and adopted by “individual care providers, microsystem and system leaders, as well as policy makers.” In doing so, the EBP must also be regulated and approved on a federal, state and local level.  The EBP is a testament of stability, reliability, and effectiveness, so BSN-prepared RNs are able to provide a level of care that comes with a form of elevated awareness on best practices and procedure for the patient. This author plans on using the best possible system of care for her patients, and in doing so will provide EBP-supported actions from the moment of patient admittance. I already have a reputation with my patients for having a relatable and comfortable presence, and my work colleagues are aware that I am a strong supporter of using the latest known treatments for my patients.The other plan I have it to ask my fellow nurses to embrace EBP and challenge them to bring their own EBP that they feel passionate about and bring it in to the workplace as considerations for work. The biggest obstacle for something like this would be nurses who would feel like EBP is a waste of time unless they’ve been explicitly directed by the nurse manager or a doctor. In a way, I can understand their hesitance; the safest thing to do in an industry that is rife with mistreatment and clinical error is to simply only act when directed. The other main obstacle is time, as in the time needed to train nurses to be familiar with the EBP. However, EBP’s strength comes from its proven roots and authenticity, and therefore it would only make sense to convince nurses of how it improves their impact as a nurse and changes the lives of patients for the better. Reference: The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. (2013, May). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html

Before you can discuss why EBP is an essential practice of a BSN-prepared RN, you must understand why it is essential to, at a minimum, achieve a BSN level. The role of a nurse is continuously evolving and expanding as the practice of medicine becomes more and more complex (“10 Reasons Why,” 2018). The BSN-prepared nurse is going to have a more in-depth understanding of the complexity of the ever-evolving nursing situation(“10 Reasons Why,” 2018). Understanding that nursing practice is constantly evolving and changing, so should a nurses’ practice. In this nurses’ opinion, as a BSN-prepared nurse, the mindfulness to constantly strive for excellence is in the forefront. Thus, researching and seeking out the best or newest evidence-based practices to keep on with the evolving nursing practice is very imperative.

One of the two ways in which I promised myself I would continue to integrate EBP and integrate it into my work environment is by becoming a member of a professional nurse’s organization once again. Because these memberships generally include medical journals, I will have a greater opportunity to keep up with other peer reviewed research that has been published. These articles can be a step in the right direction towards possible policy change within my organization. Secondly, I am excited to attend more symposiums and conferences. Because of this BSN program, I have a greater appreciation and ability to really understand what lecturers are discussing. Thepvalues and other statistical numbers actually mean something to me now, as they didn’t before.

While I see no obstacles in becoming a member of a professional nursing organization, or attending conferences, I can only speak to my foreseen obstacles with EBP implementation. Two factors that I believe will be an issue are the size of my hospital and the fact that most of the nurses employed at my hospital are not BSN’s. The push for EBP and researching ways to implement it in my place of employment or community are not the focus for AND’s. The only way I can encourage a change in this way is to speak to the benefits of perusing a BSN degree and encouraging as many other nurses who were in my position to go for it.

References

10 reasons why rn’s should pursue their BSN degree. (2018). Retrieved from https://nursejournal.org/nursing-practice/10-reasons-why-rns-should-pursue-their-bsn-degree/

REMEDIOS San Pedro 

3 posts

Re:Topic 10 DQ 2

Before the discovery of Evidence Based Practice (EBP) implementation, the nurses delivered healthcare services without extended focus towards enhancement of patient safety, quality of life, and better outcomes. Overtime, EBP has continued to be viewed as a pivotal component in the growth and development of patient care delivery. It has constantly proven to be an essential element in nursing practice, as it has enabled provision of productive and efficient health care services that extend beyond conventionally simple patient treatment.

According to Boswell, Kraus, Miller, and Lambert (2015), EBP facilitates the nurses to incorporate the ultimate accessible and available research evidence to their clinical expertise and patient preferences, values and attitudes. EBP aids in both nurse’s individual and professional improvement and expands the healthcare practitioner capabilities. Further, Nilsen (2015) states that, nurses who employ EBP in their practice attain optimal decisions in service delivery.

To build EBP driving forces within the healthcare, it is important to maintain interdisciplinary interactions, collaboration and mentorship, and continuous education and training on evidence-based practice. Educative conferences, programs, and training workshops come in handy in helping attain the laid EBP goals. Nevertheless, obstacles like organizational and individual barriers provide a challenge in EBP implementation and sustenance. Organizational obstacles entail poor time management skills, lack of current and up to date information technology, and inadequate EBP implementation, and sustenance resources.

On the other hand, individual obstacles pertain lack of motivation and the expertise to necessary for translating evidence into practice, laziness, and negative attitudes. Providentially, there exist various methodologies for mitigating these obstacles impacts. They include education and training to all stakeholders on the change, ensuring constant interdisciplinary collaboration to ascertain constant sharing of views, ideas, knowledge, skills, and experiences, adequate time allocation to each activity as well as excellent prioritization of the activities and holding motivational conferences for individual and group inspiration (Nilsen, 2015). These steps, when well adhered to, can to a huge extent aid in reducing obstacles to EBP to manageable levels.

References

Boswell, J. F., Kraus, D. R., Miller, S. D., & Lambert, M. J. (2015). Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions. Psychotherapy research, 25(1), 6-19.

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 53.