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Essay Instructions: This custom write order requires a writer who can write on a Master's level. The content must be substantive and succinct and not merely repeating the obvious that has already been stated or repeating the instructions in an attempt to add filler to the project or fluff up the project. This is a Capstone Project Professional Paper discussing the benefit of hiring or using a Nurse Practitioner in the emergency department to reduce wait times (overcrowding) in the emergency room. It is important to keep the focus of the writing on the role of the nurse practitioner and not get distracted or off topic.
I wrote a proposal for the paper which is uploaded for your review with citations to give you an idea of what to write. Please read it. The literature articles to cite in the paper are also uploaded for your review. Please feel free to add articles and citations that you feel are relevant and not more than 5 or 6 years old. This is supposed to be a ?publish quality? paper.
I have already conducted most of the literature research and development of the paper with the proposal that I wrote. The paper should consist of but not be limited to the following components:

? Abstract
? Introduction- What is the problem, need, area for study?
? Rationale and significance for advanced practice nursing (nurse practitioners)? (the so what factor)
? Major review of the literature--this should be an integrated review which means that you have analyzed the literature you have selected and then plan your review according to the major components you have uncovered in your search to develop a general outline of the topic. Then within each level of that outline you will write what you have synthesized in each area using your literature to support your synthesis.
For example, your outline for the review of the literature could have several sections:
The first section could be What the problem is ?overcrowding? and how hiring a nurse practitioner is the answer to the problem. Start by defining the problem and talk about crowding in the emergency room and what that means to patients and the hospital and the staff in the emergency room and how hiring a nurse practitioner helped the problem and reference articles that have researched that topic already and what they have said, such as crowding causes poor outcomes- are people waiting so long they die? or get worse so the treatment becomes more expensive and more complicated (cite the articles that have researched this and what they said) and then talk about how using a nurse practitioner in the ED reduces poor outcomes and reference articles that state that fact; talk about how crowding makes unsatisfied patients- are the patients complaining about how long they have to wait and the hospital is getting a bad reputation or losing customers and then talk about how hiring a nurse practitioner will reduce unsatisfied patients and reference articles that state nurse practitioners get good satisfaction scores from patients; problems with patients leaving without being seen (LWOT?s) the initials mean left without treatment- this is a measurement that hospital ED?s keep track of and report to Medicare that serves as a quality marker for how well the hospital ED is moving patients through the emergency room and then talk about how if a nurse practitioner was hired in the ED this helps reduce the number of patients leaving without being treated and site the articles that have researched that fact; if the hospital has long wait times or a lot of LWOT?s then there are costs to hospitals in Medicare payment cuts- hospitals must keep track of quality measures like wait times and LWOT?s and report the data to CMS or face reimbursement cuts, this means meeting quality assurance measures by the Centers for Medicare and Medicaid and reference the article by CMS that is uploaded and quote Medicare guidelines and then talk about how hiring a nurse practitioner in the ED will save the hospital Medicare money and cite the articles that have researched this and what they said; staff morale (overwhelmed ER physician?s become less burdened if the ED physicians group hires a nurse practitioner to help treat patients. Hospitals do not staff physicians or providers like nurse practitioners in the emergency room. The emergency room is considered an ?outpatient? area and therefore hospitals contract with an outside physicians group made up of physicians, nurse practitioners, and physician assistants that are separate from the hospital but work in the hospitals facility so Emergency Room physicians groups are who actually hire nurse practitioners to work in their group and then the Group is then contracted with the hospital); reduced cost to the hospital or ED physicians group because nurse practitioners cost less to hire. Nurse practitioners do not make as much money as an emergency room physician so reference articles that have researched the cost effectiveness of hiring a nurse practitioner to work as opposed to paying for a physician?s salary. Remember to keep the majority of the writing focus on the role of the nurse practitioner.
The next section in the literature review outline could be Hiring a nurse practitioner in the ED reduces wait times (overcrowding) and cite all of the reference that have researched this already and what they said and remember to keep the focus of the writing on the role of the nurse practitioner.
The next section in the outline could be Nurse Practitioners Scope of Practice and how broad it is and how it is ever changing, meaning that as higher education (master?s and doctorate level education) for nurse practitioners advances so does the scope of practice. Reference the Texas State Nursing Board and the National Council of State Boards of Nursing and the American Academy of Nurse Practitioners and talk about nurse practitioners education and scope of practice and how they have primary care education and training and have autonomy (which means they are governed by their own Board. They are not governed by the Medical or Physician?s Board. They are governed by the Board of Nursing in each state.)
The next section could discuss what kinds of nurse practitioners are being hired in the emergency room and list them and their certifications and reference the American Academy of Nurse Practitioners who certifies these specialties such as Family Nurse Practitioners, Emergency Nurse Practitioners and Acute Care Nurse Practitioners. List articles that have researched this and cite them in the paper and what they found.
This should all be an integrated review whereby you have synthesized in each area using your literature to support your synthesis and making an analysis and writing your ?critical thinking? ideas so that the majority of your citations in the literature section therefore, could have multiple authors within a single citation.
Example: (Smith, Brown & Green, 1999; Fox, 2004; Law, 2002; White, 2005) When you have a single piece of literature that deals with only one aspect of your work then of course you will have only one citation for that particular area.
In other words, the literature review needs to demonstrate your analysis and synthesis of ideas. It should NOT be a ?laundry list? that reads like this; Black (1999) said?? ?Green (2004) said?.? ?White (2005) says??, etc. Literature reported in this fashion is just that, a report of what was found and does not reflect your critical thinking about what you read.
? Summary
What did you plan to do with this paper, what did you find in your research. Some English professors would call this the ?tell them what you told them? part of the paper.
? Conclusion and Recommendations
Again here is where you can talk about why this information is important in advanced practice nursing and to others. You could also add some thoughts of your own relative to how this information could/should be used or what needs to be done if there is a gap in the research and literature on a particular subtopic.

Essay Instructions: Please write a 5 page research paper on the problems with over crowding in emergency department. Please address
1. analysis of the problem
2. proposed plan for addressing this problem (focus more on the individual hospital level not on changing the entire health care system
3. discuss possible barriers to implemening your plan
4. recommendations for overcoming these barriers

Essay Instructions: Files for order uploaded to fax/file board.

This paper is masters level research paper on the issues surrounding the provision of pain management in the Emergency Department. It should include mention of issues on defining pain, the pathophysiology & psychology of pain, assessing/evaluating patients pain, choosing treatment modalities (i.e. drugs). I have a rough draft as well as all reference articles which I will supply.

The citation style should be AMA Citation style and in-text citation consists of a superscript that refers to the reference in the bibliography (in order by when referenced in paper). Any reference to a particular journal article throughout the paper will have the same number if it is a repeat occurrence. **if this is confusing, it is the same format used in all of the medical journals that I will send**

Essay Instructions: See uploaded instructions...most important: MUST BE ORIGINAL WORK. No direct quotes...everything should be paraphrased and cited.

10 page paper comparing two middle range nursing theories on improving emergency department nursing staff satisfaction.

Paper must be scholarly...so no Wikipedia. Only research journals!