Course Work - Nursing Exercises

The severe airflow limitation group included 29 women, which means 59 % of this group was female, and 20 men meaning 41 % of this group was male.

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61% of the total sample were retired while 15% of the total sample were on sick leave.

The total sample size of this research study was N= 91 patients with COPD in the Eckerblad et al. (2014) study. The total number of employed participants severe airflow limitation group and moderate airflow limitation group were 14. The total number (14) is obtained by adding the frequencies of employed in the two groups (7+7). The percentage of the total sample which are still employed = (total percentage- retired) = (100-61) = 39%.

The total percentage of the sample with smoking history is obtained by adding the frequencies of those smoking in the two groups (13+12) and former smokers (28+35) and dividing by the total sample. The total number of smokers and former smokers are 88, that is 13+12+28+35 = 88. When the total number of smokers (88) are divided by the sample (91), the percentage of smokers is 96.7%. The smoking history of the participants is clinically important because it helps to determine pack year smoking.

Pack year of smoking is a value obtained by multiplying the number of packs of cigarettes smoked on a daily basis by the total number of years the individual has smoked. There was no statistically significant difference between the two groups regarding pack years of smoking because the p-value was greater than .05.

The four most common psychological symptoms were difficulty sleeping, worrying, feeling irritable, and feeling sad (Eckerblad et al., 2014). The percentage of subjects who experienced these symptoms were 52%, 33%, 28%, and 22% respectively. There were no statistically significant difference between the two groups regarding psychological symptoms (p> 0.05)

Frequency = 13+32 = 45. Percentage = 45/91= 49%. In this study, 13 of the moderate airflow limitation group and 32 of the severe group used short-acting b2-agonists. Calculations: Frequency = 13 + 32 = 45. Percentage total sample = (45 91) 100% = 0.4945 100% = 49.45% = 49.5%, rounded to the nearest tenth of a percent.

Yes. There is a statistically significant difference between the moderate airflow limitation group and the severe group regarding the use of short-acting b2-agonists because the p-value is less than 0.05. The p-value obtained is .001, which is less than .005 (see Table 1).

In this study, 13 (31%) of the participants with moderate airflow limitation and 32 (65%) of the patients with severe airflow limitation were treated with short-acting b2-agonists.

The knowledge of symptom of moderate as well as severe airflow limitation leads to better symptom management.

Exercise 8

The values provided are 563, 593, 606, 520, 563, 610, and 577 (Winkler et al., 2013). The mean is calculated by adding the total values (563 + 593 + 606 + 520 + 563 +610 + 577) and dividing by the number of values (7). Hence the mean = 4032/7 = 576. The mode is 563 because it appears most. When the values are ranked from the smallest to the largest, the following is obtained: 520, 563, 563, 577, 593, 606, 610. The middle value (median) in this ascending order is 577.

The mode is AMI post-admission for patients admitted with UA. The percentage of participants having this complication was 8%.

The distribution of inpatient complications has a single mode (unimodal). The most reported symptom is AMI post-admission for patients admitted with UA only.

The three most common cardiovascular medical history events include a personal history of CAD (63%), history of unstable angina (45%), and previous acute myocardial infarction (41%). It is important to know the frequency of these events because they are useful in diagnosis and management of patients wth cardiovascular problems.

The mean and median length of stay is 5.37 and 4 respectively.

In this study, the mean (5.37) and median (4) LOS are different. Because the median is smaller than the mode, the distribution is described as negatively skewed (Gravetter, Wallnau, & Forzano, 2016).

The mode for arrhythmias is PVCs (> 50 per hour) with 22% of the participants exhibiting it. The second most common arrhythmia is non-sustained VT (614 consecutive PVCs), with 15% of the participants showing it.

The most common arrhythmia related to the length of stay is PVCs (> 50 per hour). The result was not statistically significant because the p-value obtained is .0005 (see Table 4), which is less than 0.0001.

Age of more than 65 years and a diagnosis of an AMI (p = .0004) were the only independent factors that predicted a patient having more than 50 PVCs per hour.

The race mode for this sample is white with a frequency of 143 (51%). The findings of the study cannot be generalized to the American Indian population in the United States because the American Indian participants were few (23) thus limiting external validity.

Exercise 9

To measure caring practices, the researchers employed three subscales of the Caring Nurse-Patient Interaction Short Scale (CNPISS). The type of measurement method used was a self-report measure because the participants were required to rate their frequency of engagement in various caring practices.

The data collected using CNPISS instrument were at the ordinal level of measurement because the frequency at which the participants engaged in different caring practices are ordered, ranging from almost never (1) to almost always (5).

The sub-scales included in CNPISS included clinical, relational,

and comforting sub-scales (Roch, Dubois, & Clarke, 2014).

Among the subscales for caring practices, relational care had the lowest mean of 2.90. This result indicates that nurses did carry out relational care less frequently compared to clinical and comfort care.

The dispersion results for the Relational subscale included range = 1.675.00 and SD = 0.72. The score for each item on the Relational subscale ranges from 1.005.00 based on the Likert scale used in the CNPISS. Both the range and SD were higher than those of other subscales indicating the dispersion of scores were different from the other subscales.

The Clinical subscale had the lowest dispersion with range = 2.445.00 The SD = 0.57 was also the lowest, showing that the scores for Clinical had the lowest variation among the subscales.

Comforting care subscale had the highest mean. This indicates that comfort care was frequently carried out by the nurses.

The overall rating of organization climate is 3.13 while that of caring practices is 3.62. This indicates that nurses have embraced caring practices more than organizational climate.

A response rate of 45% is a limitation because such a low response rate is not representative of the population. The is negatively affected by nonresponse bias of 55%.

In addition to characteristics of nurses roles influencing the rate of nurses performance of care, other characteristics of organizational climate are also critical. The researchers also concluded that the best organizational climates are those with a lighter workload, maximum teamwork, and where nurses have clearly understood their roles. In my practice, I will ensure that I embrace teamwork with my colleagues so as to realize a good organizational climate.

References

Eckerblad, J., Todt, K., Jakobsson, P., Unosson, M., Skargren, E., Kentsson, M., & Theander, K. (2014). Symptom burden in stable COPD patients with moderate or severe airflow limitation. Heart & Lung: The Journal of Acute and Critical Care, 43(4), 351-357.

Gravetter, F. J., Wallnau, L. B., & Forzano, L.-A. B. (2016). Essentials of Statistics for The Behavioral Sciences. Cengage Learning.Roch, G., Dubois, C. A., & Clarke, S. P. (2014). Organizational Climate and Hospital Nurses' Caring Practices: A MixedMethods Study. Research in nursing & health, 37(3), 229-240.

Winkler, C., Funk, M., Schindler, D. M., Hemsey, J. Z., Lampert, R., & Drew, B. J. (2013). Arrhythmias in patients with acute coronary syndrome in the first 24 hours of hospitalization. Heart & Lung: The Journal of Acute and Critical Care, 42(6), 422-427.