The purpose of this assignment is to provide you the opportunity to understand the regulatory process as it is followed by the Environmental Protection Agency (EPA). Students should become familiar with regulation and policy language in order to help educate the public about new regulations being enacted by the EPA. Also, being environmental stewards as well as public health professionals, all should be knowledgeable of the major environmental acts and how they have helped to protect the health of U.S. citizens.

First, go to the Federal government regulations website: http://www.regulations.gov (You may have to type the address into your web browser). Click on the “Learn” tab and read through the policy process. Make sure you click on the five tabs that will guide you through the entire regulatory process.

Then, click on the “Search” tab. Search for an environment-related proposal by typing “environmental protection” in the Search box. You will find both state and federal policies in the review process. Select a current policy that is accepting commentary. Provide a summary of the policy, what rules or standards it is proposing, where, and its overall purpose. If the proposal has a series of questions for you to answer for your comments, please provide the responses to those questions. Otherwise, in one or two paragraphs, provide your written comments on why you support the proposal using evidence to support your statements.

Then, write on the National Environmental Policy Act, define it, and explain how it has helped to ensure a safe environment in the U.S.

The paper should be typed and five (5) pages in length, and follow the APA Style which includes using a cover page, one-inch margins, double-spaced, 12-inch font (Times New Roman, Arial or Verdana) with a reference page.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is “running away.”
Reports that she is exhausted and cannot eat or drink by herself.
Objective Data

Height 175 cm; Weight 95.5kg.
Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
Intervention

The following medications administered through drug therapy control her symptoms:

IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Inhaled short-acting bronchodilator (ProAir HFA)
Inhaled corticosteroid (Flovent HFA)
Oxygen delivered at 2L/ NC
Critical Thinking Essay

critically evaluate Mrs. J.’s situation. Include the following:

Describe the clinical manifestations present in Mrs. J.
Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

MOST OF THE WORK IS GOING TO BE BASED OFF OF A ALREADY DONE ANALYSIS

For this assessment, you will develop an 8-14 slide PowerPoint presentation with thorough speaker’s notes designed for a hypothetical in-service session related to the improvement plan you developed in Assessment 2.
As a practicing professional, you are likely to present educational in-services or training to staff pertaining to quality improvement (QI) measures of safety improvement interventions. Such in-services and training sessions should be presented in a creative and innovative manner to hold the audiences attention and promote knowledge acquisition and skill application that changes practice for the better. The teaching sessions may include a presentation, audience participation via simulation or other interactive strategy, audiovisual media, and participant learning evaluation.
The use of in-services and/or training sessions has positive implications for nursing practice by increasing staff confidence when providing care to specific patient populations. It also allows for a safe and nonthreatening environment where staff nurses can practice their skills prior to a real patient event. Participation in learning sessions fosters a team approach, collaboration, patient safety, and greater patient satisfaction rates in the health care environment (Patel & Wright, 2018).
As you prepare to complete the assessment, consider the impact of in-service training on patient outcomes as well as practice outcomes for staff nurses. Be sure to support your thoughts on the effectiveness of educating and training staff to increase the quality of care provided to patients by examining the literature and established best practices.
You are encouraged to explore the AONE Nurse Executive Competencies Review activity before you develop the Improvement Plan In-Service Presentation. This activity will help you review your understanding of the AONE Nurse Executive Competenciesespecially those related to competencies relevant to developing an effective training session and presentation. This is for your own practice and self-assessment, and demonstrates your engagement in the course.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze the elements of a successful quality improvement initiative.
Explain the need for and process to improve safety outcomes related to a specific organizational issue.
Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative.
Competency 4: Explain the nurses role in coordinating care to enhance quality and reduce costs.
List the purpose and goals of an in-service session for nurses.
Explain to the audience their role and importance of making the improvement plan successful.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Communicate with nurses in a respectful and informative way that clearly presents expectations and solicits feedback on communication strategies for future improvement.
Reference
Patel, S., & Wright, M. (2018). Development of interprofessional simulation in nursing education to improve teamwork and collaboration in maternal child nursing. Journal of Obstetric, Gynecologic & Neonatal Nursing, 47(3), s16s17.
Professional Context
As a baccalaureate-prepared nurse, you will often find yourself in a position to lead and educate other nurses. This colleague-to-colleague education can take many forms, from mentoring to informal explanations on best practices to formal in-service training. In-services are an effective way to train a large group. Preparing to run an in-service may be daunting, as the facilitator must develop his or her message around the topic while designing activities to help the target audience learn and practice. By improving understanding and competence around designing and delivering in-service training, a BSN practitioner can demonstrate leadership and prove him- or herself a valuable resource to others.
Scenario
For this assessment it is suggested you take one of two approaches:
Build on the work that you have done in your first two assessments and create an agenda and PowerPoint of an educational in-service session that would help a specific staff audience learn, provide feedback, and understand their roles and practice new skills related to your safety improvement plan, or
Locate a safety improvement plan through an external resource and create an agenda and PowerPoint of an educational in-service session that would help a specific staff audience learn, provide feedback, and understand their roles and practice new skills related to the issues and improvement goals presented in your chosen context.
Instructions
The final deliverable for this assessment will be a PowerPoint presentation with detailed presenter’s notes representing the material you would deliver at an in-service session to raise awareness of your chosen safety improvement initiative and to explain the need for it. Additionally, you must educate the audience as to their role and importance to the success of the initiative. This includes providing examples and practice opportunities to test out new ideas or practices related to the safety improvement initiative.
Be sure that your presentation addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
List the purpose and goals of an in-service session for nurses.
Explain the need for and process to improve safety outcomes related to a specific organizational issue.
Explain to the audience their role and importance of making the improvement plan successful.
Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative.
Communicate with nurses in a respectful and informative way that clearly presents expectations and solicits feedback on communication strategies for future improvement.
There are various ways to structure an in-service session; below is just one example:
Part 1: Agenda and Outcomes.
Explain to your audience what they are going to learn or do, and what they are expected to take away.
Part 2: Safety Improvement Plan.
Give an overview of the current problem, the proposed plan, and what the improvement plan is trying to address.
Explain why it is important for the organization to address the current situation.
Part 3: Audiences Role and Importance.
Discuss how the staff audience will be expected to help implement and drive the improvement plan.
Explain why they are critical to the success of the improvement plan.
Describe how their work could benefit from embracing their role in the plan.
Part 4: New Process and Skills Practice.
Explain new processes or skills.
Develop an activity that allows the staff audience to practice and ask questions about these.
In the notes section of your PowerPoint, brainstorm potential responses to likely questions or concerns.
Part 5: Soliciting Feedback.
Describe how you would solicit feedback from the audience on the improvement plan and the in-service.
Explain how you might integrate this feedback for future improvements.
Remember to account for activity and discussion time.
For tips on developing PowerPoint presentations, refer to:
Capella University Library: PowerPoint Presentations.
Guidelines for Effective PowerPoint Presentations [PPTX].
Additional Requirements
Presentation length: There is no required length; use just enough slides to address all the necessary elements. Remember to use short, concise bullet points on the slides and expand on your points in the presenter’s notes. If you use 2 or 3 slides to address each of the parts in the above example, your presentation would be 1015 slides.
Speaker notes: Speaker notes should reflect what you would actually say if you were delivering the presentation to an audience. Another presenter would be able to use the presentation by following the speaker notes.
APA format: Use APA formatting for in-text citations. Include an APA-formatted reference slide at the end of your presentation.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence to support your assertions. Resources should be no more than 5 years old.
Note: Your instructor may also use the Writing Feedback Tool to provide feedback on your writing. In the tool, click the linked resources for helpful writing information.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.