Assignment: Advocating for The Nursing Role in Program

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Assignment: Advocating for The Nursing Role in Program

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Assignment: Advocating for The Nursing Role in Program Design and Implementation Questions
Assignment: Advocating for The Nursing Role in Program Design and Implementation Questions

Advocating for the Nursing Role in Program Design and Implementation

Interview Transcript of Responses

Question: Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?

Response:  As a utilization management nurse, I am currently tasked with the responsibility of reviewing how health care services are provided with cost efficiency, quality, and within compliance (Healthcare Support, 2020). To ensure the attainment of the job objectives, I comply with the organization’s utilization management program called Milliman guidelines (MCG guidelines). MCG connotes evidence-based protocols that support health care providers in decision making at point of care. The cost of this program can only be determined by the management of the hospital as the details cannot be disclosed to the nurses but, they tend to differ from among the health care settings. The projected outcomes of the utilization management programs include identification of mistakes, enhancement of safety, reduction of waste, lowering health care costs, and reduction of incidences of re-hospitalization and length of hospital stay.

Question: Who is your target population?

Response:  The target population in this program is patients who visit the health care facility to seek health care services and the health care providers who provides the health care services to the patients.

Question: What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

            Response: For a nurse to provide input for the design of this program, the nurse as a role to be familiarize with program. Once the nurse is familiar with the program including its design, the nurse can engage the program’s medical directors to give their perspectives on the design and highlight their concerns about the design of the program (Valaitis et al., 2017). For instance, after reviewing the manner of approving visits in our health care facility, I realized that many visits were pending approval. Consequently, we utilized the MCG protocols in the facility and approved significant amount of visits. However, some visits specifically required endorsement by the medical director based on the appropriateness and necessity.  As a utilization management nurse, I was raised this concern with the medical director at the facility who organized for an urgent meeting with relevant stakeholders. The visits approval issues were addressed at the meeting including the best ways to increase the visit approval efficiency.

Question: What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

Response: Nurses play tends to play critical role as patient advocates (Gerber, 2018). My role as an advocate for my target population in this program is to ensure that patient gets quality, cost effective health care services that is compliant with the established organizational guidelines. I will advocate for this objectives by consistently reviewing and auditing the patient health care files to ensure that patients only get necessary procedures, effective treatment, and reduction in longer hospital stays.  Moreover, I will apply proper utilization of critical thinking skills and knowledge to advocate for improved quality of care and life and prevent patient intricacies during the hospital stay period. Moreover, I will utilize the managed care strategies to enable health insurance providers to manage the health cost by evaluating the suitability prior to adoption of payment through evidence-based protocols or criteria. Currently, I have no input to make in the design decision of the program but I can impact the design by making proposals on the pattern that I observe. The patterns are crucial in assisting the utilization management committee to observe the patterns and determine what can be done to the design to help in informing better patients’ outcomes.

Question: What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?

Response: Nurses play a vital role in the implementation of the health care program (Harris, Roussel & Thomas, 2016). In this program, it is my duty to implement all the changes made in the design of the program or gets acclimatized with any new changes that may be associated with the program implementation. Every patient requires unique health care services that are oriented to the individual needs. Therefore, as a nurses I have a responsibility to advocate for the patients when implementing the facility’s utilization program. This role may differ with between design and implementation since the top management and sales has a lot to do with the program’s design. The department that deals with compliance is equally crucial in guaranteeing adherence to the policy, laws, and regulations of the health care program.

Question: Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

Response: The success of this program requires the involvement of all team members of health care team in the health facility. The hospital administration is crucial in setting a favorable environment for change implementation in the organization. On the other hand, the medical directors are crucial in providing assistance to nurses make decisions regarding the utilization review and health facility. For instance, where the patients require interdisciplinary collaboration to influence positive outcomes, the interdisciplinary collaboration should be facilitated to achieve the desired outcomes. The medical directors and utilization committee also play a vital role in formulating proposals and decisions on the intricate cases involving patient care.

References

Gerber, L. (2018). Understanding the nurse’s role as a patient advocate. Nursing2019, 48(4), 55-58. DOI: 10.1097/01.NURSE.0000531007.02224.65

Harris, J. L., Roussel, L. A., & Thomas, T. (2016). Initiating and sustaining the clinical nurse leader role: A practical guide. Burlington, MA: Jones & Bartlett Learning.

Healthcare Support. (2020). Utilization Management Nurse. Healthcaresupport.com. Retrieved 29 September 2020, from https://www.healthcaresupport.com/utilization-management-nurse/.

Valaitis, R. K., Carter, N., Lam, A., Nicholl, J., Feather, J., & Cleghorn, L. (2017). Implementation and maintenance of patient navigation programs linking primary care with community-based health and social services: a scoping literature review. BMC health services research, 17(1), 116. DOI: 10.1186/s12913-017-2046-1

Assignment: Advocating for The Nursing Role in Program

Question Description
I don’t know how to handle this Nursing question and need guidance.

Assignment: Advocating for the Nursing Role in Program Design and Implementation
As their names imply, the honeyguide bird and the honey badger both share an affinity for honey. Honeyguide birds specialize in finding beehives but struggle to access the honey within. Honey badgers are well-equipped to raid beehives but cannot always find them. However, these two honey-loving species have learned to collaborate on an effective means to meet their objectives. The honeyguide bird guides honey badgers to newly discovered hives. Once the honey badger has ransacked the hive, the honey guide bird safely enters to enjoy the leftover honey.

Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives.

In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.

To Prepare:

Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
Select a healthcare program within your practice and consider the design and implementation of this program.
Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
The Assignment: (2–3 pages)

In a 2- to 3-page paper, create an interview transcript of your responses to the following interview questions:

Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
Who is your target population?
What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

Advocating for the Nursing Role in Program Design and Implementation

Tell us about a healthcare program within your practice. What are the costs and projected outcomes of this program?

Ventilator-associated pneumonia (VAP) emerge as one of the health care-associated infections (HAIs) of significant concern to patients admitted in the intensive care units (ICU). VAP occurs in 10 to 20% of patients most of whom are intubated and receive oxygen supplementation through mechanical ventilation. The incidence rates of VAP are linked to the duration of the use of mechanical ventilators and the extent of oral hygiene among ICU patients. The present health facility is a community teaching and referral hospital with 20 ICU beds. From the facility, patients on mechanical ventilation had 45% mortality rates when compared with 32% of ICU patients on other modes of oxygen supplementation (Boltey, Yakusheva & Costa, 2017). To this effect, the facility initiated a program on oral hygiene care (OHC) to reduce the risk of ventilator-associated pneumonia in these patients.

The focus of the facility is to popularize the use of tooth brush, gel, mouthrinse or a combination of either of the practices in addition to aspiration of oral secretions to reduce the instances of VAP for ICU patients on mechanical ventilation. We will develop a new educational program as well as a prevention protocol that supports the use of agents of oral care among intubated patients. In the initial stage of implementation, the program is anticipated to add to the usual cost of care to patients on mechanical care as they will be required to incur additional expenses on oral cleansing agents. The hospital estimates to spend about US $ 40,000 to develop the oral hygiene protocol in the ICU (Bastable, 2017). The costs include expenses on the purchase of oral cleaning agents, education and training materials for nurses and other health care providers in the facility’s ICU. Through the implementation of the program, the incidences of VAP is projected reduce by 10% in the first three months of adoption. Besides, length of stay and the overall cost on care is anticipated to reduce for ICU patients receiving mechanical ventilation.

Who is your target population?

The program targets ICU patients who require a minimum of 48 hours of endotracheal intubation in the facility. These patients need mechanical ventilation and are at high risk of developing early onset of VAP within the first four days of admission (Koulenti, Tsigou & Rello, 2017).

What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

Nurses as professionals who spend the longest time with patients play crucial roles in the design and development of oral hygiene system for the facility. In this regard, the nurse will utilize the Situation, Background, Assessment and Request (SBAR) approach to evaluate patients in need of oral intervention to reduce the risk of VAP. The nurse will ensure that patients are effectively selected based on the extent of their intubation and therefore priority will be given to those in dire need of oral support (Boltey, Yakusheva & Costa, 2017). Besides, the nurse will work in collaboration with other health care professionals to coordinate oral hygiene practices among at risk ICU patients. For example, the nurse will request physicians to conduct oral swabs for patients and order diagnostic tests on the same to determine the presence of Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae which are common pathogens that cause VAP.

In the design matrix, the nurse will categorize intubated patients and prioritize them based on the length of the use of mechanical ventilators. Besides, the professional assesses patients on daily sedation-vacations and work in conjunction with other health staff in ICU to prevent VAP for these clients (Bastable, 2017). I will act as the control nurse and ensure that all patients are assessed accordingly for them to meet the criteria for oral hygiene support before physicians are notified.

What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?

My role as an advocate for the ICU patients in need of oral hygiene care will be to ensure that all patients prioritized as at risk of VAP receive prompt intervention. I will educate and sensitize critical care nurses on the modalities of oral hygiene practices by providing a written protocol for them in the unit. Besides, as an infection control nurse, I have an essential role in design input decisions (Koulenti, Tsigou & Rello, 2017). Basically, all patient cases at risk of VAP must first be approved by me before a recommendation is made on oral hygiene care. Upon receiving the cases, I will discuss them with critical care nurses before making a decision with other members of the healthcare team. Moreover, as an infection control nurse, I will ensure that the OHC is implemented as per the recommended protocol. I will also monitor and evaluate the outcomes of oral health care to assess its effectiveness to the selected patients.

What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?

The role of the nurse is to ensure excellent oral hygiene care is provided to patients receiving oxygen supplementation through mechanical ventilation. The practice is to minimize bacterial colonization within the oral mucosa during intubation procedures (Koulenti, Tsigou & Rello, 2017). To achieve this, the nurse will follow protocols on oral cleaning agents and frequencies of care during and after intubation procedures for patients at risk of VAP. The role varies between the design and implementation as the nurse will be required to use the SBAR toolkit to select patients for the program (Boltey, Yakusheva & Costa, 2017). For instance, a patient with aspirates that accumulates within the endotracheal tube following mechanical ventilation will be selected as a priority case in need of oral hygiene care. Moreover, the role varies between design and implementation since it will guide nurses to select the frequencies of oral hygiene practices as well as coordinate subglottic suctioning to ensure that undesirable oral secretions are routinely eliminated.

Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

A healthcare program can be readily implemented by critical care nurses as they are the frontline staff during patient care. However, the program on oral hygiene care requires the inputs of physicians, pharmacists and physiotherapists (Bastable, 2017). Physicians serve important role as they provide diagnosis to ascertain the presence of a VAP in a patient. Pharmacists recommend and avail antibiotics to manage pathogens causing the infection in a patient (Boltey, Yakusheva & Costa, 2017). Physiotherapists on the other hand recommend the semi-recumbent position (head elevation between 30 and 45 degrees) for an ICU patient to reduce potential reflux that can cause VAP.

Conclusion

Nurses provide strong leadership in a healthcare team to reduce instances of VAP among ICU patients on mechanical ventilation. The professionals work in partnership with other staff in the unit to identify patients at risk of VAP and recommend optimal practices on oral hygiene care to guarantee quality health services to ICU patients.

References

Bastable, S. B. (2017). Nurse as educator: Principles of teaching and learning for nursing practice. Jones & Bartlett Learning.

Boltey, E., Yakusheva, O., & Costa, D. K. (2017). 5 Nursing strategies to prevent ventilator-associated pneumonia. American nurse today12(6), 42. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5706660/

Koulenti, D., Tsigou, E., & Rello, J. (2017). Nosocomial pneumonia in 27 ICUs in Europe: perspectives from the EU-VAP/CAP study. European journal of clinical microbiology & infectious diseases36(11), 1999-2006. https://link.springer.com/content/pdf/10.1007/s10096-016-2703-z.pdf

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Rubric Detail

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Content
Name: NURS_6050_Module04_Week08_Assignment_Rubric

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Excellent Good Fair Poor
Program Design

In a 2- to 3-page paper, create an interview transcript of your responses to the following interview questions.
· Tell us about a healthcare program within your practice. What are the costs and projected outcomes of this program?

· Who is your target population?

· What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

· What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?

· What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
Points Range: 41 (41%) – 45 (45%)
Response provides a clear and complete summary of the healthcare program, including an accurate and detailed description of the costs and projected outcomes of the program.

Response provides a clear and accurate description that fully describes the target population.

Response provides a clear and accurate explanation of the role of the nurse in providing input for the design of the program, including specific examples.

Response provides an accurate and detailed description of the role of the nurse advocate for the target population for the healthcare program selected.

Response provides an accurate and detailed explanation of how the advocate’s role influences design decisions as well as fully explaining impacts to program design.

Points Range: 36 (36%) – 40 (40%)
Response provides a summary of the healthcare program, including a description of the costs and project outcomes of the program.

Response provides an accurate description of the target population.

Response provides an accurate explanation of the role of the nurse in providing input for the design of the program, including some examples.

Response provides an accurate description of the role of the nurse advocate for the target population for the healthcare program selected.

Response provides an accurate explanation of how the advocate’s role influences design decisions and somewhat explains impacts to program design.

Points Range: 31 (31%) – 35 (35%)
Response provides a summary of the healthcare program that is vague or incomplete or does not include costs or projected outcomes of the program.

Description of the target population is vague or inaccurate.

Explanation of the role of the nurse in providing input for the design of the program is vague, inaccurate, or does not include specific examples.

Description of the role of the nurse advocate for the target population for the healthcare program selected is vague or inaccurate.

Explanation of how the advocate’s role influences design decisions and impacts to program design is vague or inaccurate.

Points Range: 0 (0%) – 30 (30%)
Response provides a summary of the healthcare program that is vague and inaccurate, does not include costs or projected outcomes of the program, or is missing.

Description of the target population is vague and inaccurate, or is missing.

Explanation of the role of the nurse in providing input for the design of the program, and specific examples is vague and inaccurate, or is missing.

Description of the role of the nurse advocate for the target population for the healthcare program selected is vague and inaccurate, or is missing.

Explanation of how the advocate’s role influences design decisions and impacts to program design is vague and inaccurate, or is missing.
Program Implementation
· What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?

· Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why you think this?
Points Range: 36 (36%) – 40 (40%)
Response provides a clear, accurate, and complete explanation of the role of the nurse in healthcare program implementation.

Response provides an accurate and detailed explanation of how the role of the nurse is different between design and implementation of healthcare programs, including specific examples.

Response provides an accurate and detailed description of the members of a healthcare team needed to implement the program selected.

The response fully integrates at least 2 outside resources and 2-3 course specific resources that fully supports the summary provided.

Points Range: 32 (32%) – 35 (35%)
Response provides an accurate explanation of the role of the nurse in healthcare program implementation.

Response provides an accurate explanation of how the role of the nurse is different between design and implementation of healthcare programs, and may include some specific examples.

Response provides and accurate description of the members of a healthcare team needed to implement the program selected.

The response integrates at least 1 outside resource and 2-3 course specific resources that may support the summary provided.

Points Range: 28 (28%) – 31 (31%)
Explanation of the role of the nurse in healthcare program implementation is vague, inaccurate, and/or incomplete.

Explanation of how the role of the nurse is different between design and implementation of healthcare programs is vague or inaccurate and/or does not include specific examples.

Description of the members of a healthcare team needed to implement the program selected is inaccurate or incomplete.

The response minimally integrates resources that may support the summary provided.

Points Range: 0 (0%) – 27 (27%)
Explanation of the role of the nurse in healthcare program implementation is vague and inaccurate, or is missing.

Explanation of how the role of the nurse is different between design and implementation of healthcare programs is vague and inaccurate, or is missing.

Description of the members of a healthcare team needed to implement the program selected is vague and inaccurate, incomplete, or is missing.

The response fails to integrate any resources to support the summary provided.
Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.

Points Range: 4 (4%) – 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.

Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors.

Points Range: 4 (4%) – 4 (4%)
Contains a few (1-2) APA format errors.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) APA format errors.

Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
Total Points: 100
Name: NURS_6050_Module04_Week08_Assignment_Rubric

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