This week, as you explore assessment and diagnosis in psychotherapy, you examine assessment tools, including their psychometric properties and appropriate use. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients. Below you will find your assigned assessment tool for this week’s discussion.

Yale Brown Obsessive Compulsive Scale

1) Post an explanation of the psychometric properties of the assessment tool you were assigned (Yale Brown Obsessive Compulsive Scale).

2)  Explain when it is appropriate to use this assessment tool with clients, including whether the tool can be used to evaluate the efficacy of psychopharmacologic medications. 

3) Support your approach with evidence-based literature. 

4) Also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

• Chapter 3, “Assessment and Diagnosis” (pp. 95–168)
• Chapter      4, “The Initial Contact and Maintaining the Frame” (pp. 169–224)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: It is highly recommended that you use this resource as a reference guide throughout the course. You will access this text from the Walden Library databases. 

American Academy of Child and Adolescent Psychiatry. (1995). Practice parameters for the psychiatric assessment of children and adolescents. Washington, DC: Author. Retrieved from https://www.aacap.org/App_Themes/AACAP/docs/practice_parameters/psychiatric_assessment_practice_parameter.pdf

American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults (3rd ed.). Arlington, VA: Author. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

Walden Library. (2017). NURS 6640 week 2 discussion guide. Retrieved from http://academicguides.waldenu.edu/nurs6640week2discussion

Walden University. (n.d.). Tests & measures: Home. Retrieved February 6, 2017, from http://academicguides.waldenu.edu/library/testsmeasures
Note: This database may be helpful in obtaining assessment tool information for this week’s Discussion.

Required Media

Laureate Education (Producer). (2015a). Counseling competencies—The application of ethical guides and laws to record keeping [Video file]. Baltimore, MD: Author.

Provided courtesy of the Laureate International Network of Universities.

Note: The approximate length of this media piece is 23 minutes. (See Attached Transcript for the Media)

Increasing food supplies are necessary to sustain growing populations around the world and their appetites for great food, quality products, and continuous availability.

A great deal of expensive research is invested in developing technologies to deliver productive agriculture. Horticultural efforts to breed hybrid crops are seen as far back as history can observe, and there have been efforts to domesticate improved animals, as well.

Gene splitting was a 1990s technology to improve the health and productivity of farm crops. With the 21st century have come genetically modified foods (GMF) through the use of nanotechnology to cause changes at the genetic and even molecular levels. These are very expensive technologies, and many new products have been patented and otherwise protected as proprietary products of intellectual property.

Drive out to the country during growing season, and you will see signs identifying that the crop has been grown with a protected seed that cannot be used to produce retained seed for planting in the next growing season.

In terms of this week’s TCOs, what ethical issues are raised by this legal process of patent protection, and how do we see the primary schools of ethics used in these proprietary measures? What, in this deontological week and in our learning to date, informs our understanding of this situation, and what should be done about it?

2  

Kant’s famous First Formulation of the Categorical Imperative reads:

“Act only according to that maxim whereby you can at the same time will that it should become a universal law.” Kant taught morality as a matter of following maxims of living that reflect absolute laws. “Universal” is a term that allows for no exceptions, and what is universal applies always and everywhere. Lying, for any reason, is universally wrong.

Be sure to listen to Kant’s audio lecture before posting this week!

So, consider the famous case of the Crazed Murderer. In your town the Crazed Murderer comes to your door looking for your friend and wanting to kill him. You know that your friend went home to hide. What do you tell the murderer? When he leaves and runs up the street to your friend’s house, what do you do?

3  

Using academic scholarly research, find an article that addresses an ethical dilemma from the past five years and annotate it thoroughly.  What are the key points to the article?  Summarize the dilemma.  What are the key terms of the article?  What conflicts or controversies does it raise?  Where can you offer analysis or an original point of view?  Once you have a handle on the article and your reaction to the issues it raises, use it as a foundation to  

1. Create your own 2-4 paragraph “dilemma.”
2. Apply Kant’s Categorical Imperative to the problem you invent.
3. Apply any other method you have encountered in lecture material and the readings.
4. State which method you prefer and why.

Your paper should be 3 pages.  You MUST provide the source of the foundation dilemma, and thus this paper will require 1 reference using at least 1 correct in-text citation (indicating quoted or paraphrased material from the article and where to locate it).  Use APA format in citing the source.  Refer to course resources for details and help in achieving APA style.

You are required to create an oral presentation.  Consider creating a youtube video, MP3 podcast (if you have those skills) or a video presentation.

Provides an opportunity to deepen your understanding of the conceptual components of a theory. Building on this week’s Discussion, you will build a concept map to express the linkages and interrelationships of the concepts in the middle range theory you have selected.

To prepare:

Explore the various concept maps presented in Chapter 7 of The Practice of Nursing Research, as well as the Cooper and Veo articles.

Using the information presented in the Learning Resources as a guide, consider the linkages and interrelationships of the conceptual concepts for the theory you identified for this week’s Discussion. What relational statements could be articulated?

Theory identified for my discussion this week are: (1)  Pender’s health promotion model from middle range theories and (2) Health belief model from behavioral science theories in my research ( PLS SEE ATTACHED PAPER FOR THE DISCUSSION PAPER)

Create a concept map demonstrating the linkages and interrelationships of the theoretical concepts. Include a clear problem and purpose statement.

 Express relational statements linking the concepts, literally and diagrammatically. You may use Microsoft Word, PowerPoint, or another software application of your choice; however, if you use a product that is not part of the Microsoft Office Suite, you must be able to save it as a PDF or RTF file.

Example OF CONCEPT MAP https://class.waldenu.edu/courses/1/USW1.560.201810/db/_80691160_1/embedded/Kolcaba%27s Conceptual Framework.png

IMPORTANT: Include references from the literature to support your work.

You need heading, you do not need a running head, you should not have a one-sentence paragraph. Similarity index is fine.

REFERENCES

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

Chapter 4, “Theory Development: Structuring Conceptual Relationships in Nursing”

Veo, P. (2010). Concept mapping for applying theory to nursing practice. Journal for Nurses in Staff Development, 26(1), 17–22. doi: 10.1097/NND.0b013e3181cc2d6f

Panniers, T. L., Feuerbach, R. D., & Soeken, K. L. (2003). Methods in informatics: Using data derived from a systematic review of health care texts to develop a concept map for use in the neonatal intensive care setting. Journal of Biomedical Informatics, 36(4–5), 232–239. doi:10.1016/j.jbi.2003.09.010

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Woods, N. F., & Magyary, D. L. (2010). Translational research: Why nursing’s interdisciplinary collaboration is essential. Research & Theory for Nursing Practice, 24(1), 9–24. doi:10.1891/1541-6577.24.1.9

1. A 61-year-old female patient is seen for a complaint of

severe heartburn, lightheadedness, skin reddening, and

shortness of breath. The physician renders a diagnosis of

GERD, sickle cell anemia, lymphangitis, and diaphragmatic

paralysis. What code(s) should be assigned?

ICD-10: __________________________________________

2. A 37-year-old patient comes in complaining of swollen

joints and headaches. The physician’s diagnosis is SLE.

The patient also has rheumatoid arthritis and asthma

with status asthmaticus. What code(s) are assigned?

ICD-10: __________________________________________

3. A 52-year-old patient is seen for mouth pain, knee pain,

and fluid buildup in the chest. The physician renders a

diagnosis of pulp degeneration, old disruption of the posterior

cruciate ligament, and pleural effusion. The

physician also performed a chest tube insertion (draining

the right pleural cavity with a drainage device using a

percutaneous approach) prior to diagnosing the patient’s

pleural effusion. What diagnosis and procedure code(s)

are assigned?

ICD-10: __________________________________________

4. A 30-year-old male is admitted to the hospital with

lymphadenitis, acute lymphoid leukemia in relapse, and

von Willebrand disease. What code(s) are reported?

ICD-10: __________________________________________

5. A 47-year-old male is involved in a motor vehicle accident.

He was driving on the highway when his car

collided with another vehicle. He was brought to the hospital

with a lower arm injury. The physician obtained an

x-ray of the arm and, after careful review and interpretation

of the x-ray, rendered a diagnosis of lower arm

fracture. The physician repaired the arm fracture using

open reduction and internal fixation (reposition of the

right radius with internal fixation using a percutaneous

endoscopic approach). What diagnosis and procedure

code(s) are reported?

ICD-10: __________________________________________

Review each of the following medical coding scenarios. Assign

the CPT code for the services and procedures indicated in

each scenario.

1. A 48-year-old male patient comes to the emergency room

with complaints of GERD. The physician performs a

laparoscopic fundoplasty with a Collis gastroplasty. What

CPT code(s) should be assigned?

CPT: _________________________________________________

2. A 40-year-old female patient is diagnosed with cervical

cancer. She also complains about difficulty breathing.

She is admitted to the hospital, where the physician

begins to perform a bronchoscopy after anesthesia

administration. However, the procedure is discontinued

due to unforeseen complications. Later the same day, a

bilateral cervical lymphadenectomy is performed to

address the patient’s cervical cancer. What CPT code(s)

are assigned?

CPT: _________________________________________________

3. A 50-year-old patient is admitted for a repair of a laceration

to the diaphragm resulting from an accident

involving a bus that ran into a ditch. She also received

eight trigger point injections into the transverse abdominus

muscle due to pain resulting from the accident.

What CPT code(s) are assigned?

CPT: _________________________________________________

4. A 23-year-old patient comes to the emergency room after

being physically assaulted by her boyfriend. She complains

of nasal pain and bleeding from the left nostril.

The physician obtains an x-ray of the nasal cavity, and

the x-ray confirms a nasal septum fracture. The physician

performs an open treatment of the nasal fracture

with a concomitant open treatment of the fractured septum.

What CPT code(s) should be assigned?

CPT: _________________________________________________

5. A 33-year-old patient is seen in the emergency room due

to complaints of headaches and congestion. The final

diagnosis is maxillary sinus infection. The physician performs

a nasal endoscopy with a maxillary antrostomy.

She also removes some tissue from the maxillary sinus.

What CPT code(s) should be assigned?

CPT: _________________________________________________

Review each of the following medical coding scenarios. Assign

the HCPCS code(s) required for each coding scenario.

1. A 49-year-old patient is admitted to the hospital for

repair of an ankle fracture. On the day of discharge, the

physician prescribes a dynamic ankle extension and flexion

device with a soft interface material. The ankle device

is adjustable. What HCPCS code(s) are assigned?

HCPCS: ______________________________________

2. A 26-year-old patient was admitted to the hospital with

acute exacerbation of allergic asthma. During the course

of the hospitalization, the patient received 5 mg of omalizumab

administered subcutaneously. What HCPCS

code(s) are assigned?

HCPCS: ______________________________________

3. A 58-year-old patient is admitted to the hospital due to

severe anemia. He receives six units of fresh frozen

plasma on the first day of admission. What HCPCS

code(s) should be assigned?

HCPCS: ______________________________________

4. A 26-year-old patient comes to the emergency room complaining

of watery diarrhea for five days. She receives 25

mcg of octreotide acetate administered

intravenously. What HCPCS code(s) are assigned?

HCPCS: ______________________________________

5. A patient is brought to the emergency room after ingesting

a bottle of verapamil as a suicide attempt. The

physician ordered 10mg of glucagon HCL to be administered

as an antidote mixed in 100 ml of D5W in an IV

over 2 minutes. What HCPCS code(s) should be

assigned?

HCPCS: ______________________________________

Review the following medical coding scenario. Assign all of

the ICD-10 and CPT codes for the diagnoses and procedures

indicated in the scenario.

After being evaluated by his gastroenterologist, Mr. Jackson

was sent to the hospital for a diagnostic esophagogastroduodenoscopy.

He is having several symptoms that indicate a

potential gastrointestinal condition. As a result, he was admitted

in observation. His symptoms include vomiting, weight

loss, and dysphagia. The esophagogastroduodenoscopy reveals

that the patient has low-grade Barrett’s esophagus, GERD

with reflux esophagitis and a non-obstructing hiatal hernia.

Patient was also incidentally diagnosed with Crest Syndrome

(CRST), which correlates with his complaint of dysphagia.

After the procedure, the patient was noted to have several

PVC’s on his EKG. These resolved shortly after the patient

arrived in the recovery room. Based on the results of the

detailed history, detailed, exam, and straight forward medical

decision making, it was decided that the patient could be discharged

home on the same day with instructions for a follow

up office appointment in 2 days. Code this scenario.

ICD-10: ____________________________________________________

CPT: ____________________________________________________

Throughout history, major events have influenced quality improvement efforts in health care. For example, the Institute of Medicine’s report To Err is Human: Building a Safer Health System revealed statistics about errors in patient safety that result in thousands of deaths annually. Health care providers must be cognizant of the purpose and philosophy of quality improvement efforts as they lead the charge for improving health outcomes and patient safety. This Discussion is intended to help you understand how various developments have shaped contemporary perspectives and approaches to promoting health care quality.

By tomorrow 11/28/17, write a minimum of 550 words essay in APA format with 3 references from the list below which addresses the level one headings as numbered below:

Post a cohesive scholarly response that addresses the following:

When “To Err is Human” was published in 1999, it marked an important milestone in Quality Improvement Science.

1) Analyze how this milestone has influenced the health care delivery system and nursing practice.

2) Provide an example from your own work history and experience as to how the patient safety movement has affected your practice. 

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

• Chapter      1: “Healthcare Quality and the Patient”
• Chapter      2: “Basic Concepts of Healthcare Quality”

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press. 

Executive summary: Released in 1999, this groundbreaking report provides the rationale for implementing comprehensive improvements in patient safety, an important subset of health care quality. Although only the executive summary is required this week, you are strongly encouraged to read additional sections of this report as you proceed through the course.

Institute of Medicine, Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. 

Executive summary: This report was published by the Institute of Medicine in 2001 to highlight the significant gap between the state of health care quality and where it should be. The report draws attention to the need to improve the U.S. health care delivery system as a whole, and identifies six areas for improvement: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Although only the executive summary is required this week, you are strongly encouraged to read additional sections of this report as you proceed through the course.

Wachter, R. M. (2010). Patient safety at ten: Unmistakable progress, troubling gaps. Health Affairs, 29(1), 165–173.

This article presents an analysis of progress in patient safety since the publication of the IOM report, To Err is Human. As you read this article, evaluate the author’s critique, and consider recent developments that continue to shape patient safety efforts in health care.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Concepts of quality and patient safety. Baltimore: Author. 

This video examines the recent history of the quality improvement movement, including two pivotal IOM reports, To Err is Human and Crossing the Quality Chasm. Dr. Donald Berwick introduces six dimensions of quality: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Other topics addressed include transparency, the prevention of adverse events, and the usefulness of international comparisons for quality assessment and improvement.