User:Schulrac/sandbox

Article Evaluation: Neonatal Nursing

Is everything in the article relevant to the article topic? Everything in the article was relevant to the Neonatal nursing topic. It focused on what neonatal nurse may do during a normal shift, what they might expect to see treatment wise, and different ways they may assess the infants.

Is there anything that distracted you? No, the article was well organized and easy to follow. It was easy to see what information was important and understand what the reader is supposed to get out of the article.  Is the article neutral? The article seemed mostly neutral. It does rely a little on the author's opinion is on the most common treatments seen in the NICU or the best qualities of a neonatal nurse. There are also parts of the article that are completely neutral, such as when the levels of neonatal care were listed and described.  Are there any claims, or frames, that appear heavily biased toward a particular position? No, there was not really much to base an argument on, other than what the most important facts of neonatal nursing care are.

Are there viewpoints that are overrepresented, or underrepresented? I think they provided enough information to not under or over represent any specific topic or position.

'''Check a few citations. Do the links work?''' 2 of the links did not lead to a working page. The pages must have been deleted. All other 9 links work and lead to pages with lots of information on the topic of neonatal nursing.

Does the source support the claims in the article? Yes, the sources used were good ones for the information presented in the article.

Is each fact referenced with an appropriate, reliable reference? Not every fact is given its due reference. A few were missed. This article does a good job in the reference section listing where they got all of the information, but in the test itself, there are not many citations. This may not give each used reference its due credit.

Are these neutral sources? Many of the used resources were neutral in the information that they provided. There was not a lot of bias in the articles used, which makes them very reliable resource.

If biased, is that bias noted? The only bias I noticed was based solely on the authors opinions and personal views on some of the topics, such at the qualities of a good neonatal nurse.

Is anything missing that could be added? I think they could have talked more extensively about roles of the neonatal nurse. Part of being a neonatal nurse is to be a supporter for not only their patient but their patients parents and family. It can be a stressful time for parents to have to watch their child go through something so tough. The nurse needs to be willing to take on many roles to help her patient along with here family.

'''Check out the Talk page of the article. What kinds of conversations, if any, are going on behind the scenes about how to represent this topic?''' There was only one comment on the paper that read: "I copyedited this article. I've consolidated the references, applying proper templates to them. Some references have been removed: Job site listings are not reliable sources, and as previously used in this article would constitute original research—not to mention they were all dead links. Two references to a conference summary in Proceedings BUMC were removed because they referenced footnotes in that article as if they were full references; the actual articles indirectly referenced were not relevant to this article. However, other information from the Proceedings summary was relevant and I incorporated that information. The last part of the article remains unsourced; I couldn't find anything to back it up in the previously-provided references. It should be sourced or removed. If sourced, it should clearly indicate the countries or localities that establish each listed requirement."

How is the article rated? It is rated as a start-class.

Is it a part of any WikiProjects? I'm not sure whata wiki project is but, this article was a part of the 1013 project.

My article

Exercise Importance for Chronic Heart Failure Rachael Schultz Grand Valley State Universit

Exercise Adherence for Chronic Heart Failure Chronic heart failure (CHF), a condition where the heart is unable to effectively pump blood throughout the body, has become a widespread problem within the United States. Millions of people living within the United States struggle with this perfusion problem and many have a hard time keeping the condition from worsening (Albert, Forney, Slifcak, & Sorrell, 2015). To help maintain the functionality of the heart, patients are advised to participate in moderate intensity exercise. According to the Heart Failure Society of America, the recommended amount of exercise is 30 minutes of exercise five days per week (Pozehl et al., 2014). Unfortunately, that amount of moderate intensity exercise is hard for the majority of the CHF population to engage in, due to lack of motivation and energy along with the presence of physical symptoms (Pozehl et al., 2014). This is such an enormous problem within the United States that nurses today need to be prepared to teach CHF patients the importance of exercise and help them adhere to the recommended exercise schedule. The patients need to be taught in a way that motivates them individually to partake in the recommended amount of exercise, despite the difficulty of the task. The purpose of this paper is to provide direction to nurses on how to use education and activity planning to increase adherence to exercise recommendations in individuals suffering from CHF. Topics that will be discussed in this paper include how adequate education and help with activity planning can increase adherence to the exercise recommendations in the CHF patient along with how nurses today can apply both to their practice. Education of Importance of Exercise It is widely known in the medical community that exercise in CHF patients is important because it helps increase their activity tolerance and quality of life (Williams & Pozehl, 2015). Unfortunately, this is not as widely known in the CHF patient population (Albert et al., 2015). This can be due to multiple different reasons, such as never receiving that information from the care providers or not understanding the information being given to them. In either situation, the patient will not know the importance of exercise to their health. Nurses today should be able to identify when a CHF patient is in need of proper education along with being able to provide that knowledge. Patient Centered Education People with CHF may have similar lifestyles, but when teaching a patient about the importance of exercise, the nurse needs to focus on that particular individual and their perception on exercise. “It is important to learn patients’ perspectives about physical activity and exercise so that interventions can build on patient strengths and overcome issues that may be preventing these effective self-care activities,” (Albert et al., 2015). As a nurse, understanding the certain patient that needs education is vital to effective education. This part of the nurse’s role can be very hard, as it is difficult to get to know a person strengths and limitations in a restricted amount of time. In this case, it is important to know how to assess the patient in a timely manner. The nurse should focus on figuring out how the patient learns best. Patients usually know themselves best, so this can be done simply by asking the patient. There are several ways that patients may answer, examples include hands-on, visual, auditory, and written. Once this is known, the nurse can use whatever tools necessary to teach in that way suggested by the patient such as pamphlets, educational videos, and/or practicing with the patient. It is also important that once the nurse has provided all the information that the nurse reassess the patient’s education. If the patient didn’t learn anything, the nurse should then take time to go back over the information in a different way that they believe will be more effective. Planning Setting Goals An important part of planning is setting goals. The process of setting goals can be a difficult one. Goals need to be strategically set in a way so that they require work, but are still within reach for the individual in question. If the set goals are too easy for the patient to reach, the patient will rapidly progress through the goals but may not see any improvements in their conditions. On the other end of the spectrum, if the goals are too difficult to achieve, the patient could over-exert themselves causing worse damage, or at the very least, discouragement. Some patients will need more directions than others setting achievable goals. With this in mind, the nurse should make sure to take the patient’s preference into consideration when assisting with goal setting, and provide suggestions rather than specific steps. One step that has proven to increase exercise adherence after hospitalization is to start the exercise before discharge, with the nursing staff alongside the patient, encouraging (Lambrinou, Jaarsma, Piotrowicz, Seferovic, & Piepoli, 2014). This helps the patient to “understand that it is feasible to include exercise training in daily life,” as well as making them feel capable of exercise (Lambrinou et al., 2014, p. 200). Starting the exercise while in the hospital makes the transition back home much smoother for the patient. Working on exercise with the nursing staff also provides the patient with many opportunities to ask questions and gain a better understanding of the exercise they should be participating in. Finding Resources Another problem that CHF patients face is the seemingly unavailability of resources. Part of the nurse’s responsibility is to recognize when patients need assistance finding resources to help them begin and continue exercising. There are lots of resources that the nurse can suggest the patient use. There is often a recreational area that the patient can access to use for walking, swimming, and other exercises. Sometimes there is a fee to use the facilities, but it is often very cheap and affordable. Gym memberships are also frequently an option, but one that is not used regularly and can be more on the expensive side. A recent study shown that even playing physically active games on the Wii game system can help CHF patients adhere to exercise recommendations (Jaarsma et al., 2015). A commonly overlooked resource that patients can use are support groups (Duncan, Pozehl, Hertzog, & Norman, 2014). Meeting with other people who are in similar situations can help patients build relationships with others where they keep each other accountable. Merely having support from others who have had a similar experience has shown to increase adherence to exercise. Though it may be hard, members of the support group can encourage each other to continue to exercise. They can even exercise together in pairs or bigger groups. Having support during a tough time truly helps patients, and nurses need to be aware of this. Referring a patient to a support group, though quite a simple action, could greatly help increase adherence to exercise in many CHF patients (Duncan et al., 2014). Application The purpose of this paper was to instruct nurses on how to use education and activity planning to help CHF patients adhere to the exercise recommendations. By being able to recognize when a patient needs more education, providing the education, and assisting with activity planning, nurses can greatly impact the rate of adherence to exercise recommendations. Though many of those steps may be time consuming for many nurses, the end product is worth it. Having more CHF patients participate in exercise and improve their heart’s functional ability leads to an increase in their overall quality of life.

References Albert, N. M., Forney, J., Slifcak, E., & Sorrell, J. (2015). Understanding physical activity and exercise behaviors in patients with heart failure. Heart & Lung: The Journal of Acute and Critical Care, 44(1), 2-8. https://doi.org/10.1016/j.hrtlng.2014.08.006 Duncan, K., Pozehl, B., Hertzog, M., & Norman, J. F. (2014). Psychological responses and adherence to exercise in heart failure. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 39(3), 130–139. http://doi.org/10.1002/rnj.106 Jaarsma, T., Klompstra, L., Ben Gal, T., Boyne, J., Vellone, E., Bäck, M., … Strömberg, A. (2015). Increasing exercise capacity and quality of life of patients with heart failure through Wii gaming: The rationale, design and methodology of the HF‐Wii study; a multicentre randomized controlled trial. European Journal of Heart Failure, 17(7), 743–748. http://doi.org/10.1002/ejhf.305 Lambrinou, E., Jaarsma, T., Piotrowicz, E., Seferovic, P. M., & Piepoli, M. F. (2014). Exercise in heart failure patients: Why and how should nurses care? European Journal of Cariovascular Nursing, 13(3) 198-200. https://doi.org/10.1177/1474515114530049 Pozehl, B. J., Duncan, K., Hertzog, M., McGuire, R., Norman, J. F., Artinian, N. T., & Keteyian, S. J. (2014). Study of adherence to exercise in heart failure: The HEART camp trial protocol. BMC Cardiovascular Disorders, 14, 172. http://doi.org/10.1186/1471-2261-14-17 Williams, M. A., Pozehl, B. (2015). Reasonable expectations: How much aerobic capacity, muscle strength, and quality of life can improve with exercise training in heart failure. Heart Failure Clinics, 11(1), 37-57. https://doi.org/10.1016/j.hfc.2014.08.003