Importance of health care professionals developing an understanding of CAM, traditional medicine, holistic health, and spirituality

Overview

Prepare a PowerPoint presentation of 8–10 slides that explains why an understanding of complimentary alternative medicine (CAM) and spirituality is important for members of health care teams; examines the ethical, legal, and financial principles related to CAM and spirituality; and describes how these forms of health care can impact plans of action.

Note: The assessments in this course build upon each other, so you are strongly encouraged to complete them in sequence.

As a leader in the field of nursing, it is important for you to identify areas within your organization that may need to improve cultural competence, and to develop educational materials to assist in doing so.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 2: Develop evidence-based health promotion and disease prevention initiatives for diverse and vulnerable populations. 

. Identify topics for an organizational education plan on CAM and spirituality.

. Explain the importance of health care professionals developing an understanding of CAM, traditional medicine, holistic health, and spirituality.

· Competency 3: Apply basic epidemiological concepts, data analysis methods, tools, and databases to determine the effectiveness of health promotion and disease prevention initiatives for diverse and vulnerable populations. 

. Provide a list of resources to include in an organizational education plan on CAM and spirituality.

· Competency 4: Examine the ethical, legal, and economic factors related to health disparities in diverse and vulnerable populations. 

. Examine ethical, legal, and economic principles related to CAM, traditional medicine, holistic health, and spirituality.

· Competency 5: Communicate in a manner that is scholarly, professional, and consistent with expectations for members of the health care professions. 

. Write content clearly and logically, with correct use of grammar, punctuation, APA formatting, and mechanics.

Assessment Instructions

Preparation

Your organization has seen an increase in the number of individuals using complimentary alternative medicine (CAM), traditional medicine, holistic health, and spirituality. In addition to your work on the interdisciplinary team, you have been asked by your organization to prepare and deliver an educational session on CAM, traditional medicine, holistic health, and spirituality that can be used by all health care teams. How will you complete this task?

You should focus on these concepts as they pertain to your population (from the Windshield Survey assessment), but also in a broader sense. Use the Capella library and the Internet to look for recent research articles or information on these topics to use as supporting resources in your assessment.

Requirements

For this assessment, prepare a PowerPoint presentation in which you:

· Identify the topics you will cover in your educational plan.

· Provide a list of resources your audience can use to further their understanding of complimentary alternative medicine (CAM).

· Explain why it is important for nurses and members of other health care teams to develop an understanding of CAM, traditional medicine, holistic health, and spirituality.

· Examine any ethical, legal, and economic principles related to CAM, traditional medicine, holistic health, and spirituality.

· Describe how these forms of health care can affect a plan of action for individuals and populations.

Your presentation should include a slide with the title of your educational session, a slide with the topics that will be covered (your agenda), and a reference slide at the end. Use the notes section of each slide to provide additional information on each topic, along with supporting references. References and in-text citations must adhere to APA guidelines.

Additional Requirements

· Include a title slide and reference slide. The completed assessment should be 8–10 slides in length, not including the title slide and reference slide.

· Reference at least three current scholarly or professional resources.

· Use current APA format for references.

· Be creative!

The relationship between quality patient outcomes, patient safety, and the appropriate use of pharmacology and psychopharmacology

Create a 10–12-slide PowerPoint presentation to identify medications associated with a chosen disease or health condition, explain the actions and side effects of the medications, and discuss any controversies related to the medications. Explain a treatment regime, including pharmacology, for the disease or health condition you selected, along with how the treatment regime may affect a client’s lifestyle.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 1: Apply practice guidelines and standards of evidence-based practice related to pharmacology for safe and effective nursing practice. 

. Identify the pharmacological agents most often used in the treatment of a disease or health condition.

. Describe the treatment regime, including pharmacology, most often prescribed for a disease or health condition.

. Explain the controversies related to a pharmacological agent.

· Competency 2: Explain the relationship between quality patient outcomes, patient safety, and the appropriate use of pharmacology and psychopharmacology. 

. Explain the types of actions, side effects, indications, and contraindications that may be expected from a pharmacological treatment.

. Describe how a treatment regime, including pharmacology, may impact a client’s lifestyle.

. Describe how to monitor a client following a prescribed treatment regime, including pharmacology, in order to obtain a quality patient outcome.

· Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations of a nursing professional. 

. Write content clearly and logically with correct use of grammar, punctuation, and mechanics.

. Correctly format citations and references using current APA style.

Assessment Instructions

Imagine your supervisor has asked you to conduct a lunch and learn session to educate your fellow nursing staff on pharmacological interventions.

Preparation

Select a disease or health condition that requires pharmacological intervention. You may choose any disease or health condition you wish, but the disease or health condition must be relevant to nurses from a variety of settings (for example: ER, pediatrics, public health, et cetera).

Requirements

Once you have selected a disease or health condition, create a PowerPoint presentation you could use in your lunch and learn session, including the following:

· Identify the disease or health condition you have chosen, along with the areas where nurses are likely to see it. (Do this in the agenda slide or next slide after the agenda.)

· Identify the three drugs used most often in the treatment of the disease or health condition.

· Explain the types of actions, side effects, indications, and contraindications that could be expected from the pharmacological treatment.

· Describe the treatment regime most often prescribed for the disease or health condition. This should include pharmacology but not be limited to pharmacology.

· Explain how the treatment regime (including pharmacology) may impact a client’s lifestyle. Consider things such as finances, ease or complexity of administration, instructions (frequency, duration), et cetera.

· Describe how a nurse should monitor a client being treated for the disease or health condition in order to obtain a quality patient outcome.

· Explain any controversies associated with the drugs used in the treatment. For example, is there a black box warning with any of the drugs?

Use the notes section of each slide to expand your points or draft your mock oral presentation (or both) and reference your resources. Use at least 3 peer-reviewed or professional resources to support your work in this assessment. Be sure your PowerPoint includes a title slide, a slide with your agenda or list of topics to be covered, and a reference slide. Follow current APA style and formatting guidelines for your citations and references.

Additional Requirements

· Number of slides: 10–12, not including the title and reference slides.

· Be creative. Consider your intended audience.

Addressing Barriers To Effective Communication

NURS 6053 WK 7 DISCUSSION

Think of a particular day you spent working in a health care environment, and consider three or four distinct points in time. For each point of time, consider the following: With whom did you interact? Which forms of communication did you use? What issues were communicated about—did they seem to be light-hearted or sensitive? Straightforward or complicated? How would you describe the pace of the interactions and your work?

As you consider these questions, it becomes clear that communication can be quite complex, with many layers of meaning that shape the experience for everyone involved. How could this awareness help you to understand instances of ineffective communication when they arise?

To prepare:

· Review the information in Chapter 19 of the course text, as well as the assigned articles.

· Reflect on an incident involving ineffective communication within your organization or another health care setting. Consider this incident through the lens of the communication process outlined in Figure 19.1 of the course text (p. 439).

· What barriers contributed to this incident? What other challenges may have influenced this situation?

· Using the information presented in the other Learning Resources, consider what could have been done to prevent or address the ineffective communication. Why do you think the use of these strategies would have resulted in better outcome(s)?

On the Discussion Board, post 1 page on  a summary of an incident involving ineffective communication. Describe communication barriers and other challenges that contributed to the incident. Propose one or more strategies that could have been employed to promote a better outcome. Be sure to refer to elements of the communication process.

References

· Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Review Chapter 19, “Organizational, Interpersonal, and Group Communication

·  

Gifu, D., Dima, I. C., & Teodorescu, M. (2014). New communication approaches vs. traditional communication. International Letters of Social and Humanistic Sciences, (20), 46-55.  Retrieved from Walden Library Databases.

Johansson, C., Miller, V. D., Hamrin, S. (2014) Conceptualizing communicative leadership: A framework for analyzing and developing leaders’ communication competence, Corporate Communications: An International Journal, 19 (2), 147 – 165.  Retrieved from Walden Library Databases

Manojlovich, M., Harrod, M., Holtz, B., Hofer, T., Kuhn, L., & Krein, S. L. (2015). The Use of Multiple Qualitative Methods to Characterize Communication Events Between Physicians and Nurses. Health communication, 30(1), 61-69.  Retrieved from Walden Library Databases

The social determinates of health (SDOH) contributing to the family's health status

Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-1,000-word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following:

  1. Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family.
  2. Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions. 
  3. Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
  4. Using the model, outline the steps for a family-centered health promotion. Include strategies for communication.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Please Note: Assignment will not be submitted to the faculty member until the “Submit” button under “Final Submission” is clicked.

New AttemptTitleAttached DocumentsCitation ReportSimilarity IndexFinal Submission Click ‘New Attempt’ to start assignment or attach documents

Addressing an unmet need through strategic planning

Week 6: Developing a Strategic Plan to Create Change

Strategic planning implies rethinking priority tasks with available resources to achieve a new business result.

— Michele V. Sare and LeAnn Ogilvie, Strategic Planning for Nurses: Change Management in Health Care

As a nurse leader-manager, you can dynamically impact health care through your involvement in strategic planning. Being able to identify an unmet need is a critical aspect of strategic planning; however, the real value of this process lies in moving a group, unit, or organization through the analysis and actions required to effectively address the unmet need.

This week, you consider how the foundational topics introduced in the first several weeks of this course relate to the creation of a strategic plan. As you move forward, you will be guided through the strategic planning process to develop your Course Project: Developing a Strategic Plan.

Learning Objectives

Students will:

· Analyze historical data and forecasting pertaining to an unmet need in health care or nursing

· Analyze potential stakeholders for a strategic planning effort

· Formulate a vision for addressing an unmet health care-related need at the organizational or systems level

· Evaluate research evidence for addressing an unmet need in health care or nursing* *This Learning Objective assigned this week will be assessed in Week 7

Photo Credit: Hero Images/Hero Images/Getty Images

Learning Resources

Note:  To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Balicer, R. D., Shadmi, E., Lieberman, N., Greenberg-Dotan, S., Goldfracht, M., Jana, L., . . . Jacobson, O. (2011). Reducing health disparities: Strategy planning and implementation in Israel’s largest health care organization. Health Services Research, 46(4), 1281–1299.

Retrieved from the Walden Library databases.

The authors examine the planning, implementation, and evaluation of an organization-wide strategy to address the need to reduce health care inequalities and improve quality in Israel.

Schaffner, J. (2009). Roadmap for success: The 10-step nursing strategic plan. Journal of Nursing Administration, 39(4), 152–155.

Retrieved from the Walden Library databases.

The author outlines a 10-step strategic planning process for nursing.

Strubhar, A. J. (2011). The application of an environmental scanning and strategic planning framework in an academic department of physical therapy. Journal of Physical Therapy Education, 25(3), 53–59.

Retrieved from the Walden Library databases.

The author examines strategic planning, including environmental scanning, within a physical therapy department in an academic institution.

Authenticity Consulting. (n.d.b). Basic description of strategic planning. Retrieved March 13, 2013, from http://managementhelp.org/strategicplanning/basics.htm

This online article provides an overview of the strategic planning.

Authenticity Consulting. (n.d.c). Basic overview of various strategic planning models. Retrieved March 13, 2013, from http://managementhelp.org/strategicplanning/models.htm

This online article describes different models of strategic planning, including issues-based planning.

PlanWare. (n.d.). Business planning papers: Developing a strategic plan. Retrieved March 13, 2013, from http://www.planware.org/strategicplan.htm

View the strategic planning information on this website.

Required Media

Laureate Education (Producer). (2013d). Elements of a strategic plan model [Video file]. Retrieved from https://class.waldenu.edu

Note: The approximate length of this media piece is 6 minutes.

Dr. Carol Huston describes elements common to strategic planning models and discusses ways to approach the development of a strategic plan.

Accessible player 

Optional Resources

Authenticity Consulting. (n.d.a). All about strategic planning. Retrieved March 13, 2013, fromhttp://managementhelp.org/strategicplanning/index.htm

Discussion: Addressing an Unmet Need Through Strategic Planning

Challenges can seem ever present in the health care field. Problems related to the quality of patient care, financial matters, technology, and interdisciplinary collaboration, for example, are often evident in organizations and professional groups.

In your role as a nurse leader-manager, it is important to consider challenges and how these translate into unmet needs. You can then create valuable change by addressing these unmet needs through strategic planning.

Through this Discussion, you may distinguish the focus for your Course Project. Your instructor and colleagues will provide feedback to help you refine your idea as you move forward.

To prepare:

· Consider the information presented by Dr. Carol Huston in this week’s media program. Think about the process of moving from the identification of an unmet need through the development, implementation, and evaluation of a strategic plan.

· Reflect on the initial thinking about trends and unmet needs in nursing and health care that you addressed in Week 5.

· Consider how the information in this week’s Learning Resources deepens and expands your understanding of these trends and unmet needs in relation to the strategic planning process.

· Proceed with planning for your Course Project as follows:

· Select an unmet need that affects a specific group, unit, or organization. 

· Deepen your understanding of this group, unit, or organization by examining the stated mission, vision, and values, if possible.

· Analyze historical data related to the unmet need, and review the evidence in the literature. Use this information to engage in forecasting.

· Consider which stakeholders should be included in the strategic planning process.

· Begin to formulate a vision for addressing this need at the organizational or systems level. (Note: Although not required for this Discussion, you will need to develop a strategic goal for your Course Project.)

Treatment of Psychiatric Emergencies in Children Versus Adults

The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the Psychiatric and Mental Health Nurse Practitioner (PMHNP) must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations.

In this week’s Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.

Learning Objectives

Students will:

· Compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients

· Analyze legal and ethical issues concerning treatment of child or adolescent psychiatric emergency clients

To Prepare:

· Review the Learning Resources concerning emergency psychiatric medicine.

· Consider a case where your adult client had a psychiatric emergency. (Note: If you have not had an adult client with a psychiatric emergency, ask your preceptor to describe one of their clients with a psychiatric emergency to use as an example for this Discussion.)

ASSIGNMENT

· Briefly describe the case you selected.

· Explain how you would treat the client differently if he or she were a child or adolescent.

· Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 23, “Emergency Psychiatric Medicine” (pp. 785–790)

· Chapter 31, “Child Psychiatry” (pp. 1226–1253)

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

· “Bipolar and Related Disorders”

Note: You will access this book from the Walden Library databases.

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

Reversal of benzodiazepine effects

· flumazenil

AggressionBehavioral problemsCataplexy syndrome
clozapine propranolol zuclopenthixolaripiprazole asenapine chlorpromazine haloperidol iloperidone lurasidone olanzapine paliperidone quetiapine risperidone ziprasidoneclomipramine imipramine sodium oxybate
CatatoniaExtrapyramidal side effectsMania
alprazolam chlordiazepoxide clonazepam clorazepate diazepam estazolam flunitrazepam flurazepam loflazepate lorazepam midazolam oxazepam quazepam temazepam triazolambenztropine diphenhydramine trihexyphenidylalprazolam (adjunct) aripiprazole asenapine carbamazepine chlorpromazine clonazepam (adjunct) iloperidone lamotrigine levetiracetam lithium lorazepam (adjunct) lurasidone olanzapine quetiapine risperidone sertindole valproate (divalproex) ziprasidone zotepine

Note:  Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

· Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)

· Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)

Executive Summary of Organizational Diversity

 IT IS IMPORTANT TO COVER THE COMPETENCIES !!!

Write a 3–5 page executive summary that examines an organization’s diversity policies and practices.

Becoming a nursing leader requires a good deal of thought, consideration, and evaluation of the qualities you believe are essential for a nurse to effectively lead in the delivery of health care.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 2: Apply systems theory and systems thinking to facilitate health care delivery and patient outcomes. 

(IMPORTANT) –Analyze the impact of a diverse nursing workforce on patient outcomes.

· Competency 3: Analyze the role of multiculturalism and diversity in organizational and systems structure and leadership. 

(IMPORTANT)-Analyze how a health care organization integrates diversity and multiculturalism into its practices.

(IMPORTANT)-Analyze current recruitment and retention policies to identify gaps between best practices and current policies.

· Competency 4: Evaluate how power relates to health care organizational structure, behavior, and leadership. 

(IMPORTANT) -Recommend evidence-based changes to the organizational structure and systems leadership that empower a diverse workforce.

· Competency 5: Communicate in a manner that is consistent with the expectations of a nursing professional. 

(IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.

Assessment Instructions 

Preparation

To prepare for this assessment, use the Capella library and the Internet to study the impact of health system’s power structure on nursing, leadership, diversity related to empowerment in nursing and patient outcomes, and recruitment of a diverse workforce. You may also wish to look for examples of an executive summary on the Internet.

· Identify a type of health care facility and examine the Web site and available public information to review the organization of the nursing department, nursing recruitment, and any information about the diversity of the system’s workforce and leadership. 

o You may use the health care setting in which you currently work or have worked in the past.

o Describe the type of organization and region. Example: a major Midwestern teaching hospital or a rehabilitation hospital on the East Coast. 

o Do not report the name of the facility.

Deliverable: Executive Summary of Organizational Diversity

Read the following scenario:

Scenario:

The city in which you work has undergone a significant population shift within the last 10 years, due to increased employment, education opportunities, and an influx of immigrants and refugees. To put the population shift in perspective, the local school district enrollment report states that nearly 100 languages are spoken in the schools, up from 32 languages in the last census. Senior leadership has asked you to examine all types of multiculturalism and diversity within your health care organization.

To do this, you will need to use a systems perspective to examine the relationship between a diverse workforce and patient outcomes; identify gaps between best practices and the organization’s diversity policies, and make a recommendation for organizational change.

In the executive summary:

· Analyze the impact of a diverse workforce on patient outcomes. 

o In what ways or situations might multiculturalism and diversity impact health care delivery or patient outcomes?

o How is diversity defined in the organization?

· Analyze how the health care system integrates diversity and multiculturalism into its practices. 

o Is the makeup of the organization’s leadership representative of the patient and employee populations? Is this important? What would you change?

o Explain how multiculturalism and diversity can impact health care delivery or patient outcomes.

· Analyze current recruitment and retention policies to identify gaps between best practices and current policies.

· Assess the level of integration and importance of multiculturalism and diversity in a health care organization. 

o Are all types of diversity recognized and included?

o Provide support for your position by including 2 or 3 examples of the integration of multiculturalism and diversity into the organization.

· Recommend evidence-based changes to the organizational structure and systems leadership that empower a diverse workforce. 

o What changes would you champion as a health care leader to make the system more responsive to patients and the organization’s workforce?

Make your document easy to scan for readers by:

· Using subheadings to organize content.

· Using bullet points and phrases for main points, in addition to short, succinct paragraphs.

· Including a visual, such as a graph, table, or chart.

Additional Requirements

· Written communication: Written communication should be free of errors that distract from the overall message.

· APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.

· Font and font size: Times New Roman, 12 point, double-spaced.

· Length: Summary report should be 3–5 pages.

· Number of resources: Use a minimum of three peer-reviewed resources.

Research the nutrition recommendations for cystic fibrosis

1. The text mentions that CF affects all the exocrine functions in the body as well as lung complications, and can lead to death during the adult years. Using the cystic fibrosis foundation website (www.cff.org (Links to an external site.)Links to an external site.), list the major effects on the digestive alterations in the pancreas, liver and large intestine in those with CF.

2. Read the following case study and write what the dietary regimen Miriam follows.

MIRIAM – A Cystic Fibrosis Case Study

My niece, Miriam, was born in April 1996. At 6 pounds 12 ounces, she had difficulty putting weight on after she was born. In fact at one point it dropped to 6 pounds.

After a spell in hospital in December 1996, when she was suffering from bronchitis, it was thought that she had asthma but my sister-in-law was already beginning to suspect that Miriam had Cystic Fibrosis. There was no other explanation of the symptoms which Miriam had.

Eventually, Miriam was given a “sweat test” and it was confirmed that she had Cystic Fibrosis. Both Tim & Sue are carriers – which is how they unknowingly passed on the faulty CF gene to Miriam.

No sooner had Miriam’s CF been diagnosed, shortly before she was one year old, than the medical support swung into action. The family had meetings with all members of the CF team – a doctor, a nurse, a social worker, a physiotherapist and a dietitian.

Miriam is now approaching five years old. Before she goes to school in the morning, she has around 30 minutes of inhalers and physiotherapy. With every meal she has to eat a number of “Creons”, mixed in with her food, which help her to digest her food. She has to eat a high fat and high calorie diet.

In the evening, she has another 40 minutes of inhalers, physiotherapy and nebulizers. She then has to take a variety of antibiotics, fluoride and vitamins.

Not surprisingly, all these medications have side effects – Miriam can be fairly hyperactive, she is always hot, and it takes her a long time to get to sleep each night.

Every nine weeks, Miriam is taken to the CF clinic. When Miriam has a particularly bad infection, it is necessary for her to go into hospital to receive a course of intra-venous antibiotics. The threat of infection is an ever-constant danger. To counter the risk of cross-infection, there are individual cubicles in the CF clinic and strict hygiene standards apply. Miriam cannot play or mix with other children with CF.

Inevitably all this has a major impact on the family. Every time they go on holiday – however short – all the drugs and equipment need to be taken with them. If they go out for the day, or when they are on holiday, Miriam’s daily routine of physio each morning and evening have to be fitted in – meaning no early starts, and no stopping out late. 

(adapted from http://people.exeter.ac.uk/ajohnson/miriam.htm) (Links to an external site.)Links to an external site.  (Links to an external site.)Links to an external site.

3. Using the information from Chapter 13 and the formula provided below, complete the question a-c.

Table: DRIs for Energy for Children (Available at: http://books.nap.edu/openbook.php?record_id=10490&page=107 (Links to an external site.)Links to an external site.)

EER for Girls 9 Through 18 Years

EER = 135.3 – (30.8 ´ age [y]) + PA ´ (10.0 ´ weight [kg] + 934 ´ height [m]) + 25 kcal

PA = 1.00 if PAL is estimated to be ≥ 1.0 < 1.4 (sedentary)*

PA = 1.13 if PAL is estimated to be ≥ 1.4 < 1.6 (low active)

PA = 1.26 if PAL is estimated to be ≥ 1.6 < 1.9 (active)

PA = 1.42 if PAL is estimated to be ≥ 1.9 < 2.5 (very active)

a. Calculate the estimated nutritional requirements for a 10-year-old female with cystic fibrosis who weighs 62 pounds and is 51 inches tall and is considered low active.

b. The estimated calorie requirement for an individual with cystic fibrosis is two to four times the usual recommendation. How would one know the appropriate calorie level to recommend initially?

c. Research the nutrition recommendations for cystic fibrosis (https://www.cff.org/Living-with-CF/Treatments-and-Therapies/Nutrition (Links to an external site.)Links to an external site. or https://medlineplus.gov/ency/article/002437.htm (Links to an external site.)Links to an external site.) that can assist an individual with meeting her high calorie and protein requirements. What advice could you provide to a patient?

4. What have you learned about treatment for CF?

5. (Optional, one extra credit point) Read the paper, “Caregiver Coping, Mental Health and Child Problem Behaviours in Cystic Fibrosis: A Cross-Sectional Study,”  Jane Sheehan, Int.J. Behav. Med. (2014) 21:211–220. The thesis of the paper is that the caregiver coping strategies is related to the health of the CF child.

a. Complete the table below defining the characteristics noted in the paper of a proactive or adaptive coping strategy and an avoidant or passive coping strategy.

CF behavior issuesProactive/AdaptiveAvoidant/Passive

b. What are the overarching outcomes of the two coping strategies in the health of the child?

Pertinent positive and negative physical exam findings


Patient has to be less than 18 years old

In addition to Journal Entries, SOAP Note submissions are a way to reflect on your Practicum experiences and connect these experiences to your classroom experience. SOAP Notes, such as the ones required in this course, are often used in clinical settings to document patient care. Please refer to this week’s Learning Resources for guidance on writing SOAP Notes.

Select a patient who you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

  • Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent, as well as possible reasons for these discrepancies.
  • Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.
  • Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?
  • Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
  • Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?

Communication and Education to Promote Change

Who provides formal and informal leadership within your practicum setting? What power and/or authority do these individuals hold? How has this influenced planning for and implementing change in the past?

In this Discussion, you analyze the dynamics of your practicum setting with attention toward developing political acumen, which can be highly beneficial in your effort to facilitate evidence-based change. You also consider the need for education and methods that could be used to promote knowledge integration among various stakeholders. As you probe these issues, your goal is to develop strategies for building alliances that would support the successful implementation of the change you are proposing for your practicum experience.

To prepare:

  • How      would you describe the distribution of formal and informal power, as well      as authority, within your practicum setting? Think about the constellation      of professional roles. Which ones are most salient for the change you are      proposing? Who holds each of these roles? Who else within the organization      might have political clout and be able to serve as an ally? What approach      would you take to build productive alliances and generate buy-in for your      proposed change?
  • How      do you anticipate that this change would cascade through the environment?      What strategies would you employ to generate wide-scale interest and      investment in your proposed change, as well as the education necessary for      successful adoption? Evaluate specific structures related to      communication, training, organizational culture, and other factors that      relate to the implementation of sustainable change.
  • What      kinds of issues related to organizational structure and culture or      interpersonal dynamics could pose a challenge for creating buy-in and/or      promoting knowledge integration?
  • In      addition to reviewing this week’s Learning Resources, be sure to speak      with individuals in your practicum setting and conduct additional research      to enrich your thinking for this Discussion.

By tomorrow Wednesday 3/20/19  2 pm write a minimum of 550 words essay in APA format with at least 3 references (see list or required readings below). Include the level one headers as numbered below: 

Post a cohesive response that addresses the following:

1) Based on the specifics of your practicum experience and evidence from the literature, what strategies would you employ to communicate with and educate various stakeholders? 

2) How would you engage the support of those with power and authority? Explain how this would facilitate the successful implementation of your proposed evidence-based change.

3) What are potential challenges for knowledge integration? How might you address those challenges?

Required Readings

White, K. M., & Dudley-Brown, S.(2016). Translation of evidence into nursing and health care practice. (2nd ed.) New York, NY: Springer Publishing Company.

· Review Chapter 7, “Translation of Evidence to Improve Clinical Outcomes”

· Review Chapter 13, “Interprofessional Collaboration and Practice for Translation”

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). Translation of evidence into nursing and health care practice (2nd ed.). New York, NY: Springer.

· Review Chapter 6, “Translation of Evidence for Leadership”

This chapter addresses the pivotal role of leadership in the translation of evidence into practice.

American Association of Colleges of Nursing (AACN). (2006). The essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf

Use the information in this report to guide the formulation of goals for your practicum experience.

Bleich, M. R. (2011). IOM report, The Future of Nursing: Leading Change, Advancing Health: milestones and challenges in expanding nursing science. Research in Nursing & Health, 34(3), 169-170. doi:10.1002/nur.20433

​IOM report, The Future of Nursing: Leading Change, Advancing Health: milestones and challenges in expanding nursing science. Research in Nursing & Health by Bleich, M. R., in Research in Nursing & Health, Vol. 34/Issue 3. Copyright 2011 by John Wiley & Sons – Journals. Reprinted by permission of John Wiley & Sons – Journals via the Copyright Clearance Center.

Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M., & Denis, J. (2016). Nursing unit leaders’ influence on the long-term sustainability of evidence-based practice improvements. Journal of Nursing Management, 24(3), 309-318. doi:10.1111/jonm.12320 

Nursing Unit Leaders’ Influence on the Long-term Sustainability of evidence-based practice improvements by Fleiszer, A.; Semenic, S.; Ritchie, J.; Richer, M.; Denis, J., in Journal of Nursing Management, Vol. 24/Issue 3. Copyright 2016 by John Wiley & Sons – Journals. Reprinted by permission of John Wiley & Sons – Journals via the Copyright Clearance Center.

Greene-Ryan, J. (2016). Creating a community of transformation. Nursing Management, 47(5), 18-21. doi:10.1097/01.NUMA.0000482496.59946.8c

Hauck, S., Winsett, R. P., & Kuric, J. (2013). Leadership facilitation strategies to establish evidence-based practice in an acute care hospital. Journal Of Advanced Nursing, 69(3), 664-674. doi:10.1111/j.1365-2648.2012.06053.x

Kotter, J. P. (2007). Leading change: Why transformation efforts fail. Harvard Business Review, 85(1), 96-103. Retrieved from https://cb.hbsp.harvard.edu/cbmp/pl/57319806/57319860/3d20a24aeeedc7a83d2a918c5013078c

In this foundational reading, Dr. John Kotter discusses errors commonly made as organizations undergo change, and he recommends steps leaders can take to help avoid them.

Nelson-Brantley, H. V., & Ford, D. J. (2017). Leading change: a concept analysis. Journal Of Advanced Nursing, 73(4), 834-846. doi:10.1111/jan.13223

Rose, R., Adams, F., & Johnson, S. (2016). Nurse Led, Nurse Driven Service Lines: How Nurse Leaders Are Navigating Change. Nurse Leader,14195-197.doi:10.1016/j.mnl.2016.03.007

Salmela, S., Eriksson, K., & Fagerström, L. (2012). Leading change: a three-dimensional model of nurse leaders’ main tasks and roles during a change process. Journal of Advanced Nursing, 68(2), 423-433. doi:10.1111/j.1365-2648.2011.05802.x

Sherrod, B., & Goda, T. (2016). DNP-Prepared leaders guide healthcare system change. Nursing Management, (9). 13.