HIS-144 ONL America after World War II Scoring Guid

HIS-144 ONL
America after World War II
Scoring Guide
REQUIREMENTS: Using resources from the Topic 5 Readings,
including your textbook, materials provided by your instructor
through class discussion, and materials from the GCU Library
Guide for HIS-144 US History Themes, complete the
assignment worksheet. Each answer to the questions should be
a minimum of 100-200 words; and, include citations for each
question formatted using the APA Style Guide. The overall
assignment must include three to five relevant scholarly sources
in support of your content. Each response should show good
writing mechanics, grammar, formatting, and proper citations at
the end of each question/response. Wikipedia, Ask.com,
ehow.com and other online information sites, encyclopedias, or
dictionaries are not considered university academic sources and
are NOT TO BE USED.
POSSIBLE
ACTUAL
Explained the G.I. Bill and ways it changed America.
15
Explained why suburbanization occurred after WWII and the
changes suburbia brings to American society.
15
Described why the automobile is so important to post war
America.

15
Explained gendered spheres in American society before WWII
and how they changed after the war.
15
Explained the role of religion in post-WWII American society.
10
Explained the development of youth culture in post war
America.
10
Each section is 100-200 words.
5
A minimum of three - five relevant scholarly resources.
5
TOTAL
90
Instructor Comments:
© 2015. Grand Canyon University. All Rights Reserved.
MSN Capstone Project Proposal FormThis is a building
assignment that you will be completing over Week 1 through
Week 9. This is a stepwise project proposal assignment in which
you will complete one (1) section each week for your MSN

Capstone Project Proposal. By the end of the Week 9, this form
will have been filled in completely and your MSN Capstone
Project Proposal will be completed. It is important that you
keep up with the Weekly Assigned Section. Each section is
graded separately on a weekly basis while the final completed
form will be graded with an overall grade. Each week the
student will receive feedback from the instructor and the student
is expected to incorporate the instructor feedback to edit and
improve the weekly sections. The Week 9 final Capstone Project
Proposal with be based on students incorporating the
instructor’s weekly feedback.How to use this form.· Must use
the same form for all sections. The purpose is to have a
completed the entire form by the end of the course.· Complete
the week’s section with the requested information.· There are
suggested word counts for each weekly section to provide you
with an idea of what is expected. · You are to write in full
sentences, paragraphs, correct grammar, and spelling.· Use APA
formatting with citations and references list.· Refer to the MSN
Capstone Project Proposal Form Example found in Week 1 and
in the Course Resources tab.
· Do not delete or edit the week section instructions.
· Do not lock the form because that will stop you from editing
and revising within the form.
· Leave NO blank sections. All sections are graded separately.
· You may work ahead; however, the instructor will only grade
the week’s section due for the assigned week and the form must
be submitted each week.
· Read the item descriptions carefully. Items request very
specific information. Be sure you understand what is requested.
· Use primary sources for any references. Textbooks are not
acceptable as references.
Late Assignments: Students will receive a 10-point grade
reduction for each day the assignment is submitted past the due
date. After three (3) days past the due date, students will
receive a zero (0) for that weekly section but must complete for

the final Week 9 grading.
MSN Capstone Project Proposal Form
Student Name
Daniela Fernandez
MSN Program
Family Nurse Practitioner
Project Title
Stepwise Management of Asthma.
Week 1
State Your Clinical Question
[100 to 150 words]
· State your clinical question or topic for your capstone project
proposal.
· What issue is the question/topic addressing?
· What are the reasons you selected this question/topic?
The topic proposed for the MSN Capstone project is Stepwise
Management of Asthma. Asthma is one of the conditions that
has raised a lot of concern in primary care due to its exponential
increase. It can be described as a respiratory condition
associated with attacks of spasm in the respiratory surfaces such
as bronchi of the lungs. These attacks often lead to impaired
breathing, affecting the well-being of people living with this
condition. Asthma is a chronic respiratory disease whose
symptoms cause the inflammation of bronchial tubes as well as
narrowing of the airways. If untreated, asthma can be a deadly
health condition. Over 14 million patient visits are recorded
each year, and of these figures, nearly 2.5 million emergency
room admission are recorded annually (Morris, 2020). Even
though asthma does not easily kill, it has been found that the
condition can kill, and most asthmatic patients who die are aged
50 years and above. Nevertheless, young children can also die
out of Asthma.

As provided in the project topic, stepwise management of
asthma will help healthcare professionals working in primary
care to provide personalized patient care for asthmatic patients.
Quality and effective asthma care must also involve treating
other health conditions that may exacerbate asthma symptoms.
Patients need to be enlightened on how a healthy lifestyle
together with stepwise treatment of asthma can help achieve
desired treatment outcomes. Good asthma care help patients
control and manage asthma symptoms and promote their well-
being. What needs to be understood is that with proper asthma
treatment and management strategies, patients can be assisted to
lead a normal active life (Slowiczek, 2019).
The compelling reason that led to the selection of stepwise
management of asthma project is that asthma has been ranked as
the most common chronic condition that affects young children.
It is therefore regarded as a serious condition that affects over
25 million people in the United States only. It also causes an
estimate of 1.6 million emergency room visits annually. Based
on these facts, stepwise management of asthma will be the most
appropriate healthcare approach to help combat the issues
related to asthma. Stepwise management of asthma will also
help provide patient education that will be vital in managing
asthma and risk domains. (Yokoyama, 2018).
Week 2
Background Information
[200 to 250 words]
Address the following questions/bullets in completing this

section:· Start at the starting point - What, Where, When, Why,
and How?
· What is known about this topic or what is the evidence on this
topic (Scoping Search)?
· What is the outcome of interest?
· What are the gaps in our understanding or knowing related to
this topic?
Asthma is a serious illness that has affected 25 million people
across the globe. The disease is more vulnerable to women than
male adults (Cloutier et al., 2018). Stepwise management of
asthma needs serious interventions and cooperation between the
healthcare professionals and the general public. The starting
point to manage asthma is the requirement to provide a
framework through emerging technologies to track the signs and
symptoms and how effective the lungs are working. The second
starting point is to treat asthma based on evidence-based
practice while prioritizing children and the elderly.
There are various evidences about asthma based on scientific
research. The first one is the leading and the most serious
chronic illness among children. The chronic disease is triggered
by allergies, including cockroach waste, mold spores, dust
mites, and pollens. The asthma triggers differ from person to
person. Asthma is closely associated with fungal substances
through the allergic bronchopulmonary aspergillosis test
(Prasad et al. 2020). Therefore, the authors found that
antifungal therapy provides treatment benefits of sixty percent
to patients.
The most interesting outcome is that this proposal will use
evidence-based information from research and developments to
mitigate the risk of asthma in causing death and other health
complications. There are many gaps in achieving mitigation and
eradication of asthma which are contributed by false
misconceptions. For instance, many people believe that
asthmatic people should not exercise. However, healthcare
workers advocate for body exercise through evidence-practice
since it strengthens lungs and control asthma. The second most

interesting outcome is to advise the patients and the healthcare
personnel to use emerging technologies to track and monitor
asthma. For instance, electronic health records enable nurses to
track how effective previous medicines promote quality health
to a patient.
Week 3
Literature Search Strategies
[150 to 200 words]
Provide details of your exhaustive search process. Be certain to
list:
· Databases searched.
· All the keywords or search phrases used.
· How many articles in total that were found?
· List the inclusion/exclusion criteria.
· Provide the number of articles that were retained and a
description on why those articles were retained.
· Consider using a flowchart to outline the search process.
ProQuest Digital Theses, Dissertations, NLM, New York
Academy of Medicine Grey Literature Reviews, SCOPUS, Web
of Science, EMBASE, CINAHL, Cochrane Library, and PubMed
databases from peer-reviewed and grey-literature were used
during the research. The databases were credible since experts
reviewed them before storing them in the database. The
keywords used in the research include asthma, multimorbidity,
chronic, person-centered, and psychological. The researcher
searched for the articles using the framework using preferred
reporting items for systematic reviews and meta-analyze
(PRISMA) (Saberi et al., 2018).
Initially, there were forty-eight topics that had been selected for
the study. However, only thirty-four articles met the study’s
criterion. Some of the articles did not provide information based
on the medical framework, and therefore, some were very
general. Some of the articles were published many decades ago
and seemed not to address asthma disease based on the current

challenges and the emerging technologies. Additionally, some
of the articles were not English-related. Based on the criteria
outlined for the studies, the fourteen articles never fulfilled the
set rules and regulations.
The article's authors only used thirty-four articles to develop
the recommendations and the conclusion. The authors noted no
standard assessment method to identify asthma (Sheehan et al.,
2019). The authors recommended providing the most effective
assessment method in the future to enhance diagnosis,
prevention, and healing of asthma.
Week 4
Literature Review
[500 to 1000 words]
Conduct a review of the literature. Include at least five (5)
research articles and/or evidence-based guidelines. Address the
following questions/bullets in completing this section:
· Conduct a review of the literature.
· Provide the highlights from the research.
· Synthesize the literature on the topic.
· Summarize how the project will contribute to knowledge by
filling in gaps, validating, or testing knowledge.
· Cite references in this section per APA and list the reference
in the References section at the end of the form.
Based on Montalbano et al. (2020), the first literature review
compare determined the quality of life with behaviors problems
among asthmatic people. The article uses the MIMIC model to
provide comprehensive, evidence-based information based on a
quality assessment. The article indicates some behaviors such as
somatic symptoms, depression, and anxiety reduce the quality of
life among asthmatic children. The article based on Gupta et al.
(2020) provided challenges, asthmatic children faced during the
COVID-19 pandemic. The COVID-19 pandemic was less
vulnerable to children than adults, and thus children were less
likely to be admitted to intensive care. Various measures such

as maintaining hygiene to reduce the spread of COVID-19 also
work to the advantage of asthmatic people since there was a
reduction in the number of asthmatic cases across the globe.
Landeo-Gutierrez and Celedón (2020) provided evidence on
stress and psychological stress among asthmatic adults. The
article indicates that exposure to chronic and acute stressors in
the community, family, and individuals leads to severe
complications among asthmatic people. Hufnagl et al. (2020)
indicated that the lung microbiome and dysbiosis of the gut
have a huge role in asthma. The article indicated genus
haemophilus and phylum proteobacteria are more common
among asthmatic patients. The study has shown that many
asthmatic adults are associated with haemophilus
parainfluenzae. Changes in asthma's severity, particularly due
to weather changes, relate to dysbiosis and the growth of
Proteobacteria. Ahmed and Turner (2019) provided various risks
and treatment among asthmatic children. The article indicated
that anti-IgE biologic omalizumab is effective among children
between 6 and 11. Additionally, the mepolizumab medication
has been approved in European countries. The project will
create more awareness on the importance of maintaining
hygiene to reduce factors such as dusts that increases the
complications of asthmatic people. Also, the project has
provided evidenced information on the most effective
medication to asthmatic children.
Week 5
PICOt Question
State your PICOt question here. Use the elements of the PICOt
in separate sections below to describe each component.
· Population – Provide the description of the targeted
population.
· Intervention – Describe your evidence-based intervention.
· Comparison – What is currently happening?

· Outcomes – List at least two (2) measurable outcomes.
· time – What duration of the study for the project? (e.g.,
usually 6 months or 3 months)
Population (P): Asthmatic children below ten years. Many
children cannot achieve their highest academic goal due to
many side effects of asthma, such as depression and anxiety.
Intervention (I): The intervention is conducting qualitative and
quantitative research to provide evidence for asthmatic
management among children below ten years. The most common
intervention for asthma management is bronchodilators (quick-
relief inhalers) (Benka-Cokerc et al., 2020). Since most
asthmatic children are allergic to dust and animal waste,
allergic management is also critical.
Comparison (C): There are various factors to compare the
advanced effects of asthma among children. The first
comparison measure is housing density and income, which
measures the outcome by monitoring the hospital readmission.
There is a relationship between housing density and income. For
instance, there are few cases of asthma in areas where people
are less populated. High-income rates enable a family to access
mediations and early intervention from good hospitals, thus
reducing the effects of asthma among children.
Outcomes (O): Effective asthma management can be measured
through various outcomes. The first one has reduced school
absenteeism. Proper asthma management will make students
increase their quality of life, thus improving self-esteem and
reducing school absenteeism. Additionally, the other outcome is
a reduced rate of hospital readmission and visits to emergencies
departments (Lovinsky-Desir et al., 2020). Therefore, proper
asthmatic management will enable children to improve their
academic performance, enhance self-efficacy and improve their
quality of life. Through various healthcare insurance policy
coverages, all people, including low-income families, have the
same platform to access quality care with reduced cost.
Time (t): 90 days.

Week 6
P (Target Population)
[75 to 100 words]
section:
· Who is your target population?
· Describe your population, i.e., age, ethnicity, gender,
condition/diagnosis, etc.?
· Describe the setting where this project be implemented?
The target population for study is twenty students living with
autism in the United States (Lewis, 2020). Ten children will be
picked from Land Park Academy, California, United States. The
rest of the participants would be students from Jericho National
School which is in Florida (Yu et al., 2020). The population
will involve the equal number of males and females, white and
Hispanic. Children between the age of three to ten will be
considered for the project. The setting of the project will be at
Land Pack Academy. The project will be implemented through
the help of medical personnel.
Week 7
I (Intervention)
[100 to 200 words]
section:
· What are you planning to investigate or implement as a
policy/process or program?
· What are you doing that is different than what is currently
happening?
· List 2-3 potential actions that will be applied in this practice
change.

NOTE: Be very specific in your description.
The implementation of the project is to ascertain the best
medical intervention for the asthmatic children. The project will
involve asthmatic children from Land Park Academy. The
project will develop education programs and treatment plans
that will enhance individualized education and management of
asthma (Paula et al., 2020). Asthmatic children face a lot of
challenges in school particularly when they are exposed to
periods of exacerbation.
The project will provide evidence-based information that will
lead to the collaboration of educators and healthcare workers in
monitoring and promoting the wellbeing of asthmatic children.
The project is different from what is implemented in the United
States. Currently, in the United States the autistic children are
managed differently by healthcare personnel and the educators.
However, the implementation of this project will evaluate the
effectiveness of incorporating various type of therapist in the
education curriculum.
Potential intervention includes:
Provide special education programs for asthmatic children with
high cases of hospital admission to cover the days they are
absent from school.
Introduction of therapeutic nursing intervention in schools for
asthmatic children (Ainsworth, et al., 2020).
Government should set aside resource to support asthmatic
children from humble background since the disease require
regularly healthcare monitoring.
*For purposes of this Proposal Project Form the assumption will
be that the C (Comparison Group) is ‘traditional care or current
care’
Week 8

O (Outcomes to be measured)
[100 to 150 words]
Every project is required to have an evaluation plan. Address
the following questions/bullets in completing this section:
· Which 2-3 outcomes are expected for your project?
· What outcomes will be measured?
· How do you plan to do this?
· What tool will you be using to measure your outcome(s)?
· What data will be used to validate success of the project?
Be sure your outcomes link to the identified problem.
· How will you know if your intervention resulted in change?
The research and development will consider asthmatic children
and the healthcare personnel who are specialist in service
delivery to asthmatic children. The evidence-based information
will be used in the nursing and education field to support the
asthmatic children (Federman, et al., 2019). The following are
expected outcomes.
1. The education sectors will be able to implement school -based
asthmatic management programs to support learning to the
asthmatic children.
2. The healthcare workers will reduce the number of children
visiting the healthcare facilities due to asthmatic complication.
3. Establishment of nursing therapeutic in schools thus
promoting guidance and counseling to asthmatic children thus
enabling students to cope with asthma and achieve their
academic goals.
I would achieve the two outcomes by involving the educators
and the healthcare workers in the planning and implementation
of the project. The first tool I will use to measure the outcome
is the Electronic Health Record (EHR) to determine the rate of
asthmatic children readmission (Dhopeshwarkar, et al., 2019).
The school assessment data will provide critical information
whether the asthmatic children are improving or not.

Week 9 & References
9.1 Conclusion
[200 to 250 words]
· Provide a summary for your MSN Capstone Project.
· Select and provide the rationale for three (3) competencies or
specialty standards that you would expect to use in
implementing this project [List of your specialty competencies
are listed in the Week 9 Reflection Post]
9. 2 References
[Minimal of 5 research articles and references are paged on the
last page.]
· Add your references in APA formats on the last page.
Families with asthmatic children have many challenges to
manage the healthcare condition. Some of the humble families
are not able to adhere to the clinic guidelines due to high out-
of-pocket charges. Sometimes some families are not able to
afford the inhalers to their children. The project will enable the
educators to initiate an education program that incorporates the
nursing therapies in schools to handle challenges that need
immediate intervention from the nursing perspective (Hoch, et
al., 2019). Also, this project will enable educators to create
more time for the asthmatic children to boast their self-esteem
and cover education topics, for example where to go to seek
medications.
The implementation of this will consider three main
competencies which will include leadership, quality, and
technology and information literacy.
Competency 2 – Leadership Competencies – It is very important
to incorporate doctors, teachers, and parents in this project to
collaborate and promote teamwork to enhance the well-being of
asthmatic children in school. This project will require
collaboration of all interdisciplinary teams to improve the

management of asthma in schools.
Competency 3 – Quality Competencies – This project will be
based on the best resources available and evidence-based
practice that involve the views and opinions for both educators
and healthcare workers since they interact with asthmatic
children daily.
Competency 8 – Ethics Competencies – It is fundamental to
incorporate the principle of justice on this project because of
this I think asthmatic children in schools should have the same
opportunities as other children.
References in APA format should begin on the next page.
CONPH MSN Capstone Form vFinal | 11/01//2021
15
References
Ahmed, H., & Turner, S. (2019). Severe asthma in children—a
review of definitions, epidemiology, and treatment options in
2019. Pediatric pulmonology, 54(6), 778-787
Ainsworth, K., Robertson, A. E., Welsh, H., Day, M., Watt, J.,
Barry, F., ... & Melville, C. (2020). Anxiety in adults with

autism: Perspectives from practitioners. Research in Autism
Spectrum Disorders, 69, 101457.
Benka-Coker, W., Hoskovec, L., Severson, R., Balmes, J.,
Wilson, A., & Magzamen, S. (2020). The joint effect of ambient
air pollution and agricultural pesticide exposures on lung
function among children with asthma. Environmental
Research, 190, 109903.
Cloutier, M. M., Salo, P. M., Akinbami, L. J., Cohn, R. D.,
Wilkerson, J. C., Diette, G. B., ... & Zeldin, D. C. (2018).
Clinician agreement, self-efficacy, and adherence with the
guidelines for the diagnosis and management of asthma. The
Journal of Allergy and Clinical Immunology: In practice, 6(3),
886-894.
Dhopeshwarkar, N., Sheikh, A., Doan, R., Topaz, M., Bates, D.
W., Blumenthal, K. G., & Zhou, L. (2019). Drug-induced
anaphylaxis documented in electronic health records. The
Journal of Allergy and Clinical Immunology: In Practice, 7(1),
103-111.
Federman, A. D., O’Conor, R., Mindlis, I., Hoy-Rosas, J.,
Hauser, D., Lurio, J., ... & Wisnivesky, J. P. (2019). Effect of a
self-management support intervention on asthma outcomes in
older adults: the SAMBA study randomized clinical trial. JAMA
internal medicine, 179(8), 1113-1121.
Gupta, A., Bush, A., & Nagakumar, P. (2020). Asthma in
children during the COVID-19 pandemic: lessons from
lockdown and future directions for management. The Lancet
Respiratory Medicine, 8(11), 1070-1071.
Hoch, H. E., Houin, P. R., & Stillwell, P. C. (2019). Asthma in
children: a brief review for primary care providers. Pediatric
annals, 48(3), e103-e109.
Hufnagl, K., Pali-Schöll, I., Roth-Walter, F., & Jensen-Jarolim,
E. (2020, February). Dysbiosis of the gut and lung microbiome
has a role in asthma. In Seminars in immunopathology (Vol. 42,
No. 1, pp. 75-93). Springer.
Landeo-Gutierrez, J., & Celedón, J. C. (2020). Chronic stress

and asthma in adolescents. Annals of Allergy, Asthma &
Immunology, 125(4), 393-398.
Lovinsky-Desir, S., Deshpande, D. R., De, A., Murray, L.,
Stone, J. A., Chan, A., ... & Kattan, M. (2020). Asthma among
hospitalized patients with COVID-19 and related outcomes.
Journal of Allergy and Clinical Immunology, 146(5), 1027-
1034.
Montalbano, L., Ferrante, G., Montella, S., Cilluffo, G., Di
Marco, A., Bozzetto, S., ... & Rusconi, F. (2020). Relationship
between quality of life and behavioural disorders in children
with persistent asthma: a Multiple Indicators Multiple Causes
(MIMIC) model. Scientific reports, 10(1), 1-9.
Morris, M. J. (2020, September 18). What are the features of
each step in a stepwise approach to pharmacotherapy in the
treatment of Asthma according to the guidelines? Retrieved
from https://www.medscape.com/answers/296301-8083/what-
are-the-features-of-each-step-in-a-stepwise-approach-to-
pharmacotherapy-in-the-treatment-of-asthma-according-to-the-
guidelines
Paula, C. S., Cukier, S., Cunha, G. R., Irarrázaval, M., Montiel -
Nava, C., Garcia, R., ... & Rattazzi, A. (2020). Challenges,
priorities, barriers to care, and stigma in families of people with
autism: Similarities and differences among six Latin American
countries. Autism, 24(8), 2228-2242.
Prasad, K. T., Muthu, V., Sehgal, I. S., Dhooria, S., Singh, P.,
Sachdeva, M. U. S., ... & Agarwal, R. (2020). The utility of the
basophil activation test in differentiating asthmatic subjects
with and without allergic bronchopulmonary
aspergillosis. Mycoses, 63(6), 588-595.
Saberi, B., Dadabhai, A. S., Nanavati, J., Wang, L., Shinohara,
R. T., & Mullin, G. E. (2018). Vitamin D levels do not predict
the stage of hepatic fibrosis in patients with non-alcoholic fatty
liver disease: A PRISMA compliant systematic review and
meta-analysis of pooled data. World journal of
hepatology, 10(1), 142.
Sheehan, O. C., Leff, B., Ritchie, C. S., Garrigues, S. K., Li, L.,

Saliba, D., ... & Boyd, C. M. (2019). A systematic literature
review of the assessment of treatment burden experienced by
patients and their caregivers. BMC geriatrics, 19(1), 1-11.
Slowiczek, L. (2019, January 29). Inhaled Steroids: Uses, Side
Effects, Benefits & Cost. Retrieved from
https://www.healthline.com/health/inhaled-steroids.
Yokoyama, A. (2018). Advances in Asthma: Pathophysiology,
Diagnosis and Treatment. Springer.
Yu, L., Stronach, S., & Harrison, A. J. (2020). Public
knowledge and stigma of autism spectrum disorder: Comparing
China with the United States. Autism, 24(6), 1531-1545.
CHART or
PICTURE
CHART or
PICTURE
Type Your Title Here
John Smith, MD1; Jane Doe, DNP2; Frederick Smith, APRN,
PhD1,2
1South University, 2Medical Center of Affiliation
Abstract
In this section provide an abstract of your proposal. This is only
a proposal and is not a project to be implemented. Only Provide
the information you have actually completed with is the MSN
Capstone Project Proposal Form.

In this section provide the background information on the
problem. Why is this project important?
In this section provide a review of the literature. What were the
themes?
Theme
xxxxx
xxxxx
Theme
xxxxx
Literature Review
References

Population (P):
Intervention (I):
Comparison (C):
Outcomes (O):
time (t):
PICOt Question
In this section describe the evidence-based intervention. What
will be done?
Evidence-Based Intervention
© 2021 South University. All rights reserved.
In this section provide your outcome measures and definition
Outcome 1 – Survey – used to measure….
Outcome 2 – Compliance Rate is the percent…
Outcome 3 – Fall rate is the overall falls within the last ….
Outcome Measures
NP Adherence to Practice Protocol:
Management of Persistent Pain in Older Adults
George Peraza-Smith, APRN, DNP, FAANP1; DNP Chair2,
GNP, DNP, FAANP

1South University, 2Case Western Reserve University
Abstract
Even though persistent pain is highest among
older adults, they have been insufficiently
represented in clinical trials and studies on the
management of persistent pain. Agism has had
a negative impact on the adequate assessment
and management of pain in older adults.
Evidence has emerged indicating serious risk for
cardiovascular, gastrointestinal and renal
dysfunction with consistent use of NSAIDs and
COX-2 analgesics. Other evidence supports the
efficacious use of opioid analgesic in the
treatment of moderate-to-severe persistent pain
in older adults. Updated guidelines recommend
more reliance on opioid analgesia.. This
proposal aim is to implement an evidence-based
practice protocol on the pharmacological
management of persistent pain in older adults.
An estimated 25% to 50% of older adults living
in the community and up to 80% of those in
nursing homes experience significant pain at
least some of the time. Undertreated persistent
pain in older adults has been linked to
depression, anxiety, cognitive impairment,
delirium, sleep disturbances, functional decline
and increased healthcare utilization and cost.
This project will implement a best practice so
that each older adult in a clinic will be assessed
and treated more effectively.
Persistent pain is a personal emotional and physical
experience.

Untreated or Inadequate Pain Management
• Persistent pain is under-recognized and under-treated
in older adults in many settings.
• Those with dementia have a greater risk for
inappropriate and inadequate pain treatment.
Pain Assessment with Older Adults
• Many older adults under-report their pain so as not to
be a burden.
• Numeric Rating Scale (1-10) has been shown
ineffective with older adults.
•IPT has high validity and reliability.
Opioid Use with Older Adults
• Guidelines support for persistent pain.
• Prescribing practice of opioids in older adults is mixed.
Literature Review
1.GSA. (2009). Pharmacological management of
persistent pain in older persons. Pain
Medicine, 10(6), 1062-1083.
2. Flaherty, E. (2021). Pain assessment for older
adults. ConsultGeri, 7.
https://hign.org/consultgeri/try-this-series/pain-
assessment-older-adults
References
Population (P): NP providers who make rounds in a 50-
bed skilled nursing facility
Intervention (I): Implementation of an evidenced-Based
Protocol on the management of persistent pain in adults
50 years and older
Comparison (C): Current practice of no protocol

Outcomes (O): 20% improvement in self-report pain
relief, 90% compliance rate of providers with protocol,
50% reduction on the use of NSAID with adults 50 years
and older
time (t): 60-days
PICOt Question
Implementation of a best practice protocol from
the American Geriatrics Society on the
pharmacological management of persistent pain
in older adults.
• Standardized pain assessment tool
• Initial treatment – Acetaminophen
• NSIDs and COX-2 used rarely
• For pain scores at moderate or greater, opioid
therapy is considered.
Evidence-Based Intervention
© 2021 South University. All rights reserved.
Outcome 1 – Iowa Pain Thermometer (IPT) self
report on pain intensity related to a thermometer.
Outcome 2 – NP compliance rate with
implementing protocol.
Outcome 3 – Filled NSAIDs per day compared
to prior to implementation of protocol.
Outcome Measures
https://hign.org/consultgeri/tr y-this-series/pain-assessment-
older-adults

Name:
____________________________________
HIS-144: America after World War II
Directions: Using resources from the Topic 5 Readings,
including your textbook, materials provided by your instructor
through class discussion, and materials from the GCU Library
Guide for HIS-144 US History Themes, respond to the six
prompts below.
Each answer to the questions should be a minimum of 100-200
words
The overall assignment must include three to five relevant
scholarly sources in support of your content.
While APA style is not required for the body of this assignment,
solid academic writing is expected, and documentation of
sources should be presented using APA formatting guidelines,
which can be found in the APA Style Guide, located in the
Student Success Center.
Wikipedia, Ask.com, ehow.com and other online information
sites, encyclopedias, or dictionaries are not considered
university academic sources and are NOT TO BE USED.
1. Explain the G.I. Bill. In what ways does it change America?
2. Why did suburbanization occur after World War II? What
changes does suburbia bring to American society?
3. Why is the automobile so important to post war America?
4. Describe gendered spheres in American society before WWII
and how they changed after the war.

5. What was the role of religion in post-World War II American
society?
6. Explain the development of youth culture in post war
America.
References
2

HIS-144 ONL America after World War II Scoring Guid

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