Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

Review the Resources and reflect on the definition and goal of EBP.

Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).

Explore the website to determine where and to what extent EBP is evident.

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

Note:

APA format

3 References within last 5 years

1 page

How might the ways in which we produce, deliver, and pay for care be changed in order to increase access, improve quality, and the cost of healthcare services? This is a VERY BIG question that begs for a simple answer. But we should not be tempted by such simplicity. If the answer was simple, we more than likely would have already implemented it.

Over the weeks of this course we have covered a range of healthcare issues. Now, as we approach the last week of our course, please take a moment, step-back, and think about what we have learned.

It’s been quite a journey through a tremendous amount of material. I hope you have found it of interest and of value.

As you think about all this, your final challenge is to try and bring it all together in response to the following question:

How might the ways in which we produce, deliver, and pay for care be changed in order to increase access, improve quality, and the cost of healthcare services? This is a VERY BIG question that begs for a simple answer. But we should not be tempted by such simplicity. If the answer was simple, we more than likely would have already implemented it.

Rather, we need to dig through the different layers and dimensions of the US healthcare system to be able to see some of the underlying challenges, issues, barriers, and real opportunities that are part of the “big picture.”

So, from that big picture perspective, what would you change about the US healthcare system to make it better? Pick one aspect and support your decision with credible evidence. Provide the decision-making framework you applied to answer this question. Please include your evaluation of the likely unintended consequences of your idea.

Describe the need for Telehealth services. Explain the difference between Synchronous Telehealth and Asynchronous Telehealth. Finally, offer your personal opinions related to this new mechanism for health care (first person narration can be used for this final part).

  • Describe the need for Telehealth services. Explain the difference between Synchronous Telehealth and Asynchronous Telehealth. Finally, offer your personal opinions related to this new mechanism for health care (first person narration can be used for this final part).
  • Find an article that discusses another new or upcoming technology change. Discuss the main points of the article related to the technology (remember to cite the article). Then explain how nursing will be directly impacted by this new technology listing one positive and one possible downside.
    • Title Slide (1 slide)
    • Objective Slide (1 slide)
    • Need for Telehealth services. (2-3 slides)
    • Difference between Synchronous Telehealth and Asynchronous Telehealth. (1-2 slides)
    • Personal opinions of Telehealth. (1-2 slides)
    • Article on new or upcoming technology change, with main points regarding technology. (remember to cite the article) (2-4 slides)
    • How nursing is impacted by this new technology.  (2-3 slides)
    • References (1 slide)

Assignment Expectations:

Length: 11-17 slides

Structure: Include a title slide, objective slide, content slides, reference slide in APA format.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required for this assignment.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

To what extent is this problem due to a failure to lead? Who has failed to act?

Read the case study and comment on the following.

Case Study

Two new associate-degree graduates were hired for the pediatric unit. Both worked three 12-hour shifts a week; Jan worked the day-to-evening shift and Rosemary worked the night shift. Whenever their shifts connected, they would compare notes on their experience. Jan felt she was learning rapidly, gaining clinical skills and beginning to feel at ease with her colleagues.

Rosemary, however, still felt unsure of herself and often isolated. There have been times that she was the only registered nurse on the unit all night. The aides and LPNs were very experienced, but Rosemary feels she is not ready for that kind of responsibility. Rosemary knows she must speak to the nurse manager about this, but she’s called several times, and she’s never available. The shift assignments are left in the staff lounge by an assistant.

Questions

Your discussion post should answer the following questions in a well-constructed commentary. Use references, in APA format, where appropriate.

  1. To what extent is this problem due to a failure to lead? Who has failed to act?
  2. What style of leadership was displayed by Rosemary? The nurse manager?
  3. How effective was their leadership? What are your suggestions for Rosemary?

What is the main focus of information gathering in health care?

Assessment 4

  • Cost Savings Analysis
  • OverviewPrepare a spreadsheet of cost savings data showing efficiency gains attributable to care coordination over the course of one fiscal year, and report your key findings in an executive summary, 4–5 pages in length.
    Information plays a fundamental role in health care. Providers such as physicians and hospitals create and process information as they deliver care to patients. However, managing that information and using it productively poses an ongoing challenge, particularly in light of the complexity of the U.S. health care sector, with its many diverse settings for care and types of providers and services. Health information technology (HIT) has the potential to considerably increase the productivity of the health sector by assisting providers in managing information. Furthermore, HIT can improve the quality of health care and, ultimately, the outcomes of that care for patients.
  • The use of HIT has been upheld as having remarkable promise in improving the efficiency, quality, cost-effectiveness, and safety of medical care delivery in our nation’s health care system. This assessment provides an opportunity for you to examine how utilizing HIT can positively affect the financial health of an organization, improve patient health, and create better health outcomes.
    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

    • Competency 1: Apply care coordination models to improve the patient experience, promote population health, and reduce costs.
      • Describe ways in which care coordination can generate cost savings.
    • Competency 2: Explain the relationship between care coordination and evidence-based data.
      • Describe ways in which care coordination efforts can enhance the collection of evidence-based data and improve quality through the application of an emerging health care model.
    • Competency 3: Use health information technology to guide care coordination and organizational practice.
      • Explain how care coordination can promote improved health consumerism and effect positive health outcomes.
    • Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
      • Present cost savings data and information clearly and accurately.
      • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
    • Competency Map
      CHECK YOUR PROGRESSUse this online tool to track your performance and progress through your course.
    • APA Module.
    • Academic Honesty & APA Style and Formatting.
    • APA Style Paper Tutorial [DOCX].
    • Capella Resources
    • ePortfolio.
    • Research Resources
      You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MSN-FP6612: Emerging Health Care Models and Care Coordination Library Guide can help direct your research. The Supplemental Resources and Research Resources, both linked from the navigation menu in your courseroom, provide additional resources to help support you.
      As you review these resources, you may want to consider the following questions:
    • What is the main focus of information gathering in health care?
    • How can care coordination efforts enhance the collection of evidence-based data and improve quality?
    • What governmental entities are leading care coordination practices?
    • What influence does data analysis have on the development and advancement of health care policy?
  • Asssessment InstructionsPreparation
    As the senior care coordinator in your organization, your manager has asked you to examine and report on how care coordination can generate cost savings, improve outcomes, enhance the collection of evidence-based data, and improve health care quality for the community. She would like you to compile cost savings data in a well-organized spreadsheet and present your key findings in an executive summary.
    Note:Remember that you can submit all or a portion of your draft spreadsheet and executive summary to Smarthinking for feedback before you submit the final version of this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
    Requirements
    Determine how care coordination can reduce costs. Compile your cost savings data in a spreadsheet, using Microsoft Excel or a suitable application of your choice. (If you elect to use an application other than Excel, check with faculty to avoid potential file compatibility issues.) Your spreadsheet should containat least fourcost-saving elements. Identify the cost-saving element, current costs, and anticipated savings.
    Then create an executive summary using theAPA Style Paper Template [DOCX]. Discuss your cost-saving elements and report key findings from your analysis.
    Analyzing Cost Savings
    The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your analysis addresses each point, at a minimum. You may also want to read the Cost Savings Analysis Scoring Guide to better understand how each criterion will be assessed.

    • Describe ways in which care coordination can generate cost savings.
      • What are your primary evidence-based sources of information?
      • Are your conclusions substantiated by the data?
      • What assumptions, if any, underlie your analysis?
    • Explain how care coordination can promote improved health consumerism and effect positive health outcomes.
      • What evidence do you have to substantiate your claims?
    • Describe at least five ways in which care coordination efforts can enhance the collection of evidence-based data and improve quality through the application of an emerging health care model.
      • Choose any emerging health care model.
    • Present cost savings data and information clearly and accurately.
    • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
    • Additional Requirements
      Executive Summary Format and Length
      Format your executive summary using APA style:
    • Use theAPA Style Paper Template [DOCX]provided. Be sure to include:
      • A title page and references page. An abstract is not required.
      • A running head on all pages.
      • Appropriate section headings.
    • See also theAPA Style Paper Tutorial [DOCX]to help you in writing and formatting your executive summary.
    • Your summary should be 4–5 pages in length,not includingthe title page and references page.
    • Supporting Evidence
    • Cite 4–5 sources of relevant and credible scholarly or professional evidence to support your cost savings analysis.
    • Apply APA formatting to all in-text citations and references.
    • Submit both your spreadsheet and your executive summary.
      Portfolio Prompt: You may choose to save your spreadsheet and executive summary to your ePortfolio.
  • attachment

    2665934D-69BA-4482-B71A-6A67C47FA61D.png

Identify and briefly describe your chosen clinical issue of interest.

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Develop a PICO(T) question to address the clinical issue of interest for the Assignment.
  • Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level related to your research question.
  • Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
  • Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
  • Provide APA citations of the four peer-reviewed articles you selected.
  • Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
  • 3 to 5 references within 5 years.

Mr. Smith is an 87 year old male who suffered a stroke 5 years ago. He has been bedridden since the stroke. His wife is no longer able to care for him at home. Because of this, Mr. Smith has been admitted to the long term care facility. He has lost 27 pounds over the last 6 months.

Read the following scenario and complete the Braden Scale worksheet. Discuss why you scored the Braden the way you did and add insights that you gained by completing the activity. Discuss the scoring with your classmates and any differences that you have in the ratings. Make sure to attach your completed Braden to your post.

Mr. Smith is an 87 year old male who suffered a stroke 5 years ago. He has been bedridden since the stroke. His wife is no longer able to care for him at home. Because of this, Mr. Smith has been admitted to the long term care facility. He has lost 27 pounds over the last 6 months.
He requires assistance with feeding and his appetite is poor. He frequently falls asleep during meals making it difficult for him to eat more than half of the food on his plate. He is incontinent of urine and stool. He is able to follow commands, but is unable to communicate verbally.
Physical therapy will begin working with Mr. Smith to increase his muscle strength. The goal is for him to be able to change his position in bed and in the wheel chair.
Current medications are:
4 ounces of ensure after every meal
Metoprolol 100mg every morning
Furosemide 40mg every morning
Colace 100mg every morning
Gemfibrozil 600mg BID

Braden Scale:

  • attachment

    Module_8_Braden_Scale.pdf

Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

MODULE 2: Week 2 Assignment Open Dismiss

MODULE 2: Cardiovascular / Respiratory Systems, Week 2 Assignment

CASE  STUDY 2: Patient HM has a history of atrial fibrillation and a  transient ischemic attack (TIA). The patient has been diagnosed with  type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart  disease.

Drugs currently prescribed include the following:

• Warfarin 5 mg po daily MWF and 2.5 mg daily T, TH, Sat, Sun

• Aspirin 81 mg po daily

• Metformin 1000 mg po bid

• Glyburide 10 mg po bid

• Atenolol 100 mg po daily

• Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

 

o Prepare
  • Review the Resources for this module and consider the impact of  potential pharmacotherapeutics for cardiovascular disorders introduced  in the media piece.
  • Review the case study assigned by your Instructor for this Assignment.
  • Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
  • Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
  • Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
  • Think about how you might improve the patient’s drug therapy plan  based on the pharmacokinetic and pharmacodynamic changes. Reflect on  whether you would modify the current drug treatment or provide an  alternative treatment option for the patient.
By Day 7 of Week 2

Write a 2- to 3-page paper that addresses the following:

  • Explain  how the factor you selected might influence the pharmacokinetic and  pharmacodynamic processes in the patient from the case study you were  assigned.
  • Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

The Assignment: 5 pages

Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

BACKGROUND

This week, we examine a 31-year-old male who presents to the office with a chief complaint of insomnia.

SUBJECTIVE

Patient is a 31-year-old male. He states that his insomnia has gotten progressively worse over the past 6 months. Per the patient, he has never been a “great sleeper” but is now having difficulty both falling asleep and staying asleep at night. The problem began approximately 6 months ago after the sudden loss of his fiancé. The patient states this is affecting his ability to perform his job, which is a forklift operator at a local chemical company. The patient states he has used diphenhydramine in the past to sleep but does not like the way it makes him feel the morning after. He states he has fallen asleep on the job due to lack of sleep from the night before. The patient’s medical record from his previous physician states that he has a history of opiate abuse, which began after he broke his ankle in a skiing accident and was prescribed hydrocodone/apap (acetaminophen) for acute pain management. The patient has not received a prescription for an opiate analgesic in 4 years. The patient states recently he has been using alcohol to help him fall asleep, approximately four beers prior to bed.

MENTAL STATUS EXAM

The patient is alert and oriented to person, place, time, event. He makes good eye contact and is dressed appropriately for time of year. He denies auditory/visual hallucinations. Judgement, insight, and reality contact are all intact. Patient denies suicidal/homicidal ideation, and is future oriented.

Decision Point One

 Trazodone: 50–100 mg daily at bedtime

RESULTS OF DECISION POINT ONE

  • Patient returns to clinic in 2 weeks
  • Patient states medication works well but gives him an unpleasant side effect of a prolonged erection of the penis, approximately 15 minutes after waking
  • Patient states this makes it difficult to get ready for work or go downstairs and have coffee with his girlfriend and daughter in the morning
  • Patient denies auditory/visual hallucinations and is future oriented

Decision Point Two

Explain that priapism is a side effect of trazodone that should diminish over time. Continue dose 

RESULTS OF DECISION POINT TWO

  • Patient returns to clinic in 2 weeks
  • Patient states priapism has diminished over time
  • Patient denies auditory/visual hallucinations and is future oriented
  • Patient states trazodone is effective at 50 mg dose but sometimes wakes up following day with next-day drowsiness
  • Patient denies auditory/visual hallucinations and is future oriented

Decision Point Three

Continue dose. Explain to patient he may split the 50 mg tablet in half. The decreased dose should minimize next-day drowsiness. Follow up in 4 weeks 

Guidance to Student
Trazodone is a selective serotonin reuptake inhibitor that has a low side effect profile. It would not be prudent to prescribe sonata as it carries with it the risk of complex sleep behaviors. Hydroxyzine is an antihistamine with strong sedative properties. However, many patients complain of anticholinergic adverse effects the following morning, such as Xerostomia and Xerophthalmia.
The patient is presenting with excessive somnolence. It would be prudent to reduce the dose of trazodone by 50% and reassess in 4 weeks.

 Unit 4 Discussion [Due Wednesday] Electronic Health Record Systems  It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format. Classroom Participation  Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.  All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation. Discussion Question/Prompt [Due Wednesday]  For healthcare organizations to function at full capacity, all technological and healthcare systems must guarantee protection of patient privacy. Several safeguards are placed into practice to prevent intentional or accidental data breaches of patient information.      What safeguards do you presently have in your professional practice to ensure protection of patient information?     What safeguards are currently utilized at your healthcare organization to ensure privacy?     What types of ethical concerns could an organization incur if a data breach were to occur?  Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.  Please be sure to validate your opinions and ideas with citations and references in APA format.  Please review the rubric to ensure that your response meets the criteria.  Estimated time to complete: 2 hours Discussion Peer/Participation Prompt [Due Sunday]      Respond to at least two other student’s postings with substantive comments.     Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.     References and citations should conform to the APA standards.     Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.     Plagiarism is never acceptable – give credit when credit is due – cite your sources.  Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.  Please review the rubric to ensure that your response meets the criteria. 

Unit 4 Discussion [Due Wednesday] Electronic Health Record Systems  It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format. Classroom Participation  Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.  All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation. Discussion Question/Prompt [Due Wednesday]  For healthcare organizations to function at full capacity, all technological and healthcare systems must guarantee protection of patient privacy. Several safeguards are placed into practice to prevent intentional or accidental data breaches of patient information.      What safeguards do you presently have in your professional practice to ensure protection of patient information?     What safeguards are currently utilized at your healthcare organization to ensure privacy?     What types of ethical concerns could an organization incur if a data breach were to occur?  Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.  Please be sure to validate your opinions and ideas with citations and references in APA format.  Please review the rubric to ensure that your response meets the criteria.  Estimated time to complete: 2 hours Discussion Peer/Participation Prompt [Due Sunday]      Respond to at least two other student’s postings with substantive comments.     Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.     References and citations should conform to the APA standards.     Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.     Plagiarism is never acceptable – give credit when credit is due – cite your sources.  Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.  Please review the rubric to ensure that your response meets the criteria.