Differentiate normal and abnormal health history and physical examination findings

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Alternative Writing Assignment

Guidelines and Grading Rubric

Purpose

As a family nurse practitioner, you must possess excellent physical assessment skills. This alternative writing assignment mirrors the discussion content of the debriefing session and will allow the student to expand their knowledge of physical health assessment principles specific to the advanced practice role.

Course Outcomes

This assignment is guided by the following Course Outcomes (COs):

1. Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (PO 1, 2)

2. Differentiate normal and abnormal health history and physical examination findings. (PO 1, 2)

4. Adapt health history and physical examination skills to the developmental, gender-related, age-specific, and special population needs of the individual patient. (PO 1, 2)

The purposes of this assignment are to: (a) identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1), (b) differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2), and (c) adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4).

NOTE: You are to complete this alternative writing assignment ONLY if you had not participated or do not plan to participate in a debriefing session for the given week.

Due Date: This alternative written assignment is due no later than the Sunday of the week in which you did not attend the weekly debriefing session. For example, if you did not attend a debriefing session for Week 3, this written assignment is due the Sunday at 11:59 p.m. MT of Week 4.

The standard MSN Participation Late Assignment policy applies to this assignment (please see the course syllabus)

Total Points Possible: 25 Points

Requirements:

1. This paper will be graded on the quality of the information, inclusion of evidence-based scholarly resources, use of citations, use of Standard English grammar, and organization based on the required components (see the paper headings and content details below).

2. Submit to the appropriate location in Canvas by 11:59 p.m. MT on Sunday of the week due.

3. The length of the paper is to be no less than 1,500 words, excluding title page and reference list.

4. Create this assignment using Microsoft (MS) Word. You can tell that the document is saved as a MS Word document because it will end in “.docx.”

5. APA format (6th edition) is required in this assignment, explicitly for in-text citations and the reference list. Use 12-point Times New Roman font with 1 inch margins and double spacing. See the APA manual for details regarding proper citation. See resources under Course Resources, “Guidelines for Writing Professional Papers” for further clarification.

6. Organize the headings and content of your paper using the outline below:

a. Identify and briefly discuss the body system selected for the topic of this paper

b. Discuss the physiology (structure and function) of the body system including details about the major organ systems (if applicable)

c. Discuss relevant health history questions (subjective data) pertaining to the body system

d. Discuss an overview of the objective data and expected normal physical examination findings for this body system

e. Discuss special physical assessment examination techniques or procedures specific to assessing this body system

f. Discuss how you might adapt your physical assessment skills or techniques to accommodate each of the following specific populations:

i. Infant/pediatric

ii. Pregnancy

iii. Geriatric

g. Identify one major disease or disease process that may significantly impact this body system

h. Discuss the expected abnormal physical examination findings that may be associated with this disease or disease process

i. Summarize the key points

Preparing the Paper:

1. Select a focused body system from the weekly lesson which corresponds with the week of the written assignment.

2. Carefully read and review the selected body system in your course textbooks.

3. Incorporate at least one scholarly peer-reviewed journal article that relates to the body system. It may be useful to identify an article that relates to a disease that impacts the body system.

4. The paper must clearly articulate the relevance of advanced physical assessment skills, techniques, application of advanced practice knowledge, and assessment modification (when necessary) to accommodate for specific patient populations.

5. Provide concluding statements that should summarize key points of the overall assignment content.

6. In-text citations and reference page(s) must be written using proper APA format (6th edition).

CategoryPoints%Description
Application of Knowledge, Analysis, and Clarity1040%Student demonstrates application of course knowledge consistent with the principles of advanced physical assessment; content is specific to the focus topic, organized, and clearly presented.
Adapted Physical Assessment Skills to Special Populations, Disease Process, and Summary1040%Discussed appropriate clinical reasoning and judgment as evidenced by: adaption of physical assessment skills or techniques to accommodate special populations;identified one major disease or disease process and expected examination findings; and summarized key points
Writing Mechanics and Evidence-based Resources520%Paper meets the minimum 1,500 word limit (not including the reference list); Paper is fully supported by evidence from appropriate Evidence-based, peer-reviewed resources published within the last 5 years; In-text citations and full references are provided using proper APA formatting.
Total 25100A quality assignment will meet or exceed all of the above requirements.

Chamberlain College of Nursing NR509 Advanced Physical Assessment

3

Grading Rubric

Assignment CriteriaSatisfactoryUnsatisfactory
10 POINTS0 POINTS
Application of Knowledge, Analysis, and ClarityStudent demonstrates knowledge consistent with the principles of advanced physical assessment; content is specific to the focus topic, organized, and clearly presented.Student did not demonstrate knowledge consistent with the principles of advanced physical assessment; content was missing, unorganized, and unclear.
10 POINTS0 POINTS
Adapted Physical Assessment Skills to Special Populations, Disease Process, and SummaryDiscussed how to adapt physical assessment skills or techniques to accommodate special populations; andidentified one major disease or disease process and expected examination findings; summarized key points.Student did not adapt physical assessment skills or techniques to accommodate special populations; and did notidentify one major disease or disease process and expected examination findings; did not summarize key points.
5 POINTS0 POINTS
Writing Mechanics and Evidence-based ResourcesPaper meets the minimum 1,500 word limit (not including the reference list); Paper is fully supported by evidence from appropriate sources published within the last 5 years; and Evidence-based, peer- reviewed journal article cited; In-text citations and full references are provided.Paper does not meet the minimum 1,500 word limit (not including the reference list)Paper contains no evidence-based practice reference or citation.
Total Possible- Satisfactory = 25 Points25 Points0 Points
NR509 January 20184

Ways in which you could prepare for the interview to make the most positive impression

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The following position is advertised on a career Web site: RN I Surgical Job Travel Involved: None. Job Type: Full-Time. Job Level: Minimum Education Required: Associate Degree Skills: Category: Nursing FTE: 0.9. Position Summary: Description/Purpose of Position: Responsible for providing patient care based upon the nursing process; being effectively involved with maintaining the standard of care for assigned patients through assessment, planning, implementation, and evaluation. Oversees and guides employees who are under your supervision. Requirements Description/Purpose of Position: Responsible for providing patient care based upon the nursing process; being effectively involved with maintaining the standard of care for assigned patients through assessment, planning, implementation, and evaluation. Oversees and guides employees that are under your supervision. Minimum Qualifications: Education: Graduate of an accredited school of Nursing. License/Certification: Current RN license in the state of XXX. Current BCLS Certification. Other: Must be able to demonstrate the knowledge and skills necessary to provide care/service appropriate to the age of the patients served on the assigned unit/department. Note: An RN graduate is a nurse who has completed a course of study at a school of nursing and is eligible for the NCLEX. The RN graduate performs directly under the supervision of the charge nurse or RN designee.

1. List three substantive questions you might expect to be asked in an interview for the job, and summarize your answers.

2. Describe three to five ways in which you could prepare for the interview to make the most positive impression.

3. Be sure to describe what you would wear and what material you would bring with you.

Your best friend, Lindsey, and you are working together in the surgical ICU. Often you cover for her when she goes to lunch or on breaks. You notice that often her clients complain of being in pain, even though she has told you that she medicated them right before she left the unit. You also notice that she appears to be very jumpy and short-tempered and a bit disheveled when she comes to work. You are suspicious that she is using the medications that she says she is giving to her clients.

1. What should you do first?

2. What might be the consequences if you decide to do nothing?

Case Scenario to be completed

–APA Format.-Introduction or abstract page-Summary or Conclusion page-Four pages minimum, no including Introduction or abstract,  summary or conclusion, and Bibliography pages.

It is completely unacceptable to Copy and Paste from the Internet, or other resources-Bibliography has to be in APA Format, minimum 3, no more than 3 years old.

Legal and/or ethical implications related to counseling client that suffers from a disorder related to trauma

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Assignment 3

Select a client whom you observed or counseled that suffers from a disorder related to trauma. Then, address the following in your Practicum Journal:

· Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.

· Using the DSM-5, explain and justify your diagnosis for this client.

· Explain whether any of the therapeutic approaches in this week’s Learning Resources would be effective with this client. Include expected outcomes based on these therapeutic approaches. Support your approach with evidence-based literature.

· Explain any legal and/or ethical implications related to counseling this client.

(Write about an Iraq vet suffering from PTSD)

2nd Assignment

Select a client whom you observed or counseled this week. Then, address the following in your Practicum Journal:

· Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.

· Using the DSM-5, explain and justify your diagnosis for this client.

· Explain whether motivational interviewing would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.

· Explain any legal and/or ethical implications related to counseling this client.

(Example Write about a patient with a mood disorder/depression)

3RD ASSIGNMENT

In a 1- to 2-page paper, address the following:

· Briefly describe how supportive and interpersonal psychotherapies are similar.

· Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor.

· Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.

·

The differing he differing approaches of nursing leaders and managers to issues in practice

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In this assignment, you will be writing a 1,000-1,250-word essay describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

  1. Select an issue from the following list: nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation.
  2. Compare and contrast how you would expect nursing leaders and managers to approach your selected issue. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
  3. Identify the approach that best fits your personal and professional philosophy of nursing and explain why the approach is suited to your personal leadership style.
  4. Identify a possible funding source that addresses your issue. Consider looking at federal, state, and local organizations. For example: There are many grants available through the CDC, HRSA, etc.
  5. Use at least two references other than your text and those provided in the course.

Prepare this assignment according to the APA 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.

Co-morbid Addiction (ETOH and Gambling)

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Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Note:Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Co-morbid Addiction (ETOH and Gambling)  53-year-old Puerto Rican Female

Puerto Rican female

BACKGROUND

Mrs. Maria Perez is a 53 year old Puerto Rican female who presents to your office today due to a rather “embarrassing problem.”

SUBJECTIVE

Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past two years, she has been having more and more difficulty maintaining her sobriety since they opened the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during their grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past two years and she is concerned about the negative effects of the cigarette smoking on her health.

She states that she attempts to abstain from drinking but that she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much” but enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much- she currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight.

Mrs. Perez is quite concerned today because she has borrowed over $50,000 from her retirement account to pay off her gambling debts. She is very concerned because her husband does not know that she has spent this much money.

MENTAL STATUS EXAM

The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.

Diagnosis: Gambling disorder, alcohol use disorder

Co-morbid Addiction (ETOH and Gambling)  53-year-old Puerto Rican Female

Puerto Rican female

Decision Point One

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.png

Naltrexone (Vivitrol) injection, 380 mg intramuscularly in theNaltrexone (Vivitrol) Injection, 380mg intramuscularly in gluteal region every 4 weeks

n every 4 weeks

RESULTS OF DECISION POINT ONE

·  Client returns to clinic in four weeks

·  Mrs. Perez said that she felt “wonderful” as she has not “touched a drop” to drink since receiving the injection

·  Client reports that she has not been going to the casino, as frequently, but when she does go she “drops a bundle” (meaning, spends a lot of money gambling)

·  Client She is also still smoking, which has her concerned. She is also reporting some problems with anxiety, which also have her concerned

Decision Point Two

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.png

Refer to a counselor to address gambling issuesaddress gambling issues

RESULTS OF DECISION POINT TWO

·  Client returns to clinic in four weeks

·  Client reports that the anxiety that she had been experiencing is gone

·  Client reports that she has met with the counselor, but did not really like her. She did start going to a local meeting gamblers anonymous. She stated that last week, for the first time, she spoke during the meeting. She reports feeling supported in this group

Decision Point Three

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.png

Explore the issue that Mrs. Perez is having with her counselor, and encourage her to continue attending the Gambler’s Anonymous meetings

Guidance to Student Although controversy exists in the literature regarding how long to maintain a client on Vivitrol, four weeks is probably too soon to consider discontinuation. The psychiatric mental health nurse practitioner should explore the issues that Mrs. Perez is having with her counselor. As you will learn in future courses, ruptures and the therapeutic alliance can result in clients stopping therapy. Clearly, if the client does not continue with therapy, the likelihood of the gambling problem spontaneously remitting is lower (than had the client continued to receive therapy). Recall that there are no FDA approved treatments for gambling addiction, and the mainstay of treatment for this disorder is counseling. Since Mrs. Perez reports good perceived support from the gamblers anonymous meetings, she should be encouraged to continue her participation with this group.

The PMHNP needs to discuss smoking cessation options with Mrs. Perez in order to address the totality of addictions, and to enhance her overall health.

Academic Success and Professional Development Plan

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Assignment: Academic Success and Professional Development Plan
Part 3: Strategies to Promote Academic Integrity and Professional Ethics

Nurse-scholars have a significant obligation to their community as well. Their work must have academic and professional integrity. Their efforts are designed to add to the body of knowledge, advance the profession, and ultimately help in the care of patients. Work that lacks integrity is subject to quickly erode…or worse.

Fortunately, there are strategies and tools that can help ensure integrity in academic and professional work. This Assignments asks you to consider these and how you might apply them to your own work.

· Reflect on the connection between academic and professional integrity.

The Assignment:

Part 3, Section 1: Writing Sample: The Connection Between Academic and Professional Integrity

Write a 2- 3-paragraph analysis that includes the following:

· Clearly and accurately explains in detail the relationship between academic integrity and writing.

· Clearly and accurately explains in detail the relationship between professional practices and scholarly ethics.

· Accurately cite at least 2 resources that fully support your arguments, being sure to use proper APA formatting.

· Use Grammarly and SafeAssign to improve the productivity

Clearly and accurately describe in detail how Grammarly, SafeAssign, and paraphrasing contributes to academic integrity. Include sufficient evidence that Grammarly and SafeAssign were utilized to improve responses.

Part 3, Section 2: Strategies for Maintaining Integrity of Work

Expand on your thoughts from Section 1 by:

· Clearly identifying and accurately describing strategies you intend to pursue to maintain integrity and ethics of your: 

· 1) a  

Assignment: Academic Success and Professional Development Plan
Part 3: Strategies to Promote Academic Integrity and Professional Ethics

Nurse-scholars have a significant obligation to their community as well. Their work must have academic and professional integrity. Their efforts are designed to add to the body of knowledge, advance the profession, and ultimately help in the care of patients. Work that lacks integrity is subject to quickly erode…or worse.

Fortunately, there are strategies and tools that can help ensure integrity in academic and professional work. This Assignments asks you to consider these and how you might apply them to your own work.

· Reflect on the connection between academic and professional integrity.

Sepsis and Early Prevention

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CAP Instructions and Rubric

 

Description:  The Clinical Application Project (CAP) is an opportunity for the BSN student to identify an issue, topic, or challenge that is relevant to their Role Transition clinical placement. The student will examine the research related to their topic and investigate the literature regarding a potential solution for, or intervention to improve, the issue. The student then creates a final project, intervention, or solution to their identified topic. They will present their work in a professional paper and electronic poster which will be presented via video.

Step-by-step directions:

  1. Identify a problem, issue, concern, or area for improvement relevant to your clinical setting. Consult with your RN preceptor and ResU clinical faculty regarding your topic. Your clinical faculty must approve the topic before work is initiated.
  2. Educate yourself about the importance of your topic to nursing and your particular clinical placement. Whenever possible, you will want to include facts, statistics etc. relevant to your
  3. Critically analyze the literature related to the area of concern.
  4. Identify possible solutions to the selected area of concern, based on the evidence in the literature.
  5. Review each for its strengths, weaknesses, and feasibility. Sepsis and Early Prevention
  6. Select one solution.
  7. Engage in the necessary work for this quality improvement project (e.g., develop a new form and identify approvals required for its use). Although students may not have enough time to actually implement their entire project or quality improvement activity, the final work product should clearly outline the plan for implementation, including a timeline. Students will provide evidence of their work by submitting the product of their (e.g., educational program outline, instructional pamphlet, nursing form, pocket resource, new policy, patient or family focused education, etc.)

    ORDER   A PLAGIARISM FREE PAPER   NOW

The student will create an electronic poster which visually represents the clinical application project. The e-poster displays similar components as the paper, but in a very concise and visually pleasing design. Further guidelines and instructions for the e-poster are included in the document entitled “e-Poster Creation”.

The final paper and electronic poster are graded according to the specifics contained in the following grading rubric. Due to the pandemic, e-poster presentations will not take place on campus. Instead, students will present via video and upload to Brightspace.

 

 

CAP Instructions and Rubric

Grading criteria for PAPER Points Comments
Introduction

·         Introduces topic and provides overview of the issue (2 pts.)

·         Discusses why this issue is pertinent to the particular unit/organization and what led student to choose the topic (2 pts.)

·         Identifies unit, manager, etc. support for the project (1 pt.)

·         Identifies how the project will specifically benefit the unit/organization (2 pts.)

  

 

 

 

/7

  
Literature review: topic/issue

·         Includes two recent articles (less than 5-7 years) from professional nursing or health sciences journals (2 pts.)

·         For each article: provides brief summary and discusses how the article is pertinent and relevant to the topic/issue (4 pts./each article=8 total)

  

 

 

/10

  
Literature review: solution/intervention

·         Includes two recent (less than 5-7 years) articles from professional nursing or health sciences journals (2 pts.)

·         For each article: provides brief summary and discusses how the article is pertinent and relevant to the solution or interventions (4 pts./each article=8 total)

·         Articles support the student’s chosen solution or intervention (2 pts.)

  

 

 

 

/12

 

  
Implementation/intervention

·         Clearly describes final project or intervention (2 pts.)

·         Outlines specific steps to implement final project/solution, including timeline for how the project could be “rolled out” (4 pts.)

·         Discusses how the project will address/improve the clinical issue (2 pts.)

·         Discusses future follow-up, evaluation, and/or measurement of the impact of the project (3 pts.)  Sepsis and Early Prevention

  

 

 

/11

 

 

  
Paper mechanics

·         Incorporates required content in a 4-5-page paper (not including title page and reference page) (2 pts.)

·         Follows correct APA:

    • Proper title page (1 pt.)
    • Appropriate text spacing, font size, headings, and in-text citations (2 pts.)
    • Formatted reference page (2 pts.)

·         Writes clearly; uses correct grammar, spelling, and punctuation; avoids first person voice (3 pts.)

  

 

 

/10

 

  
Grading criteria for e-POSTER Points Comments
Topic/issue

·         Clearly displays the topic or issue (2 pts.)

·         Includes general information about the topic or issue

(2 pts.) *

·         Communicates specifics about why it is pertinent to the particular unit or organization (2 pts.) *

·         States institutional support (1 pt.)

*If applicable, poster uses appropriate graphic or visual which conveys national or local data, trends, organization or unit statistics, etc.

  

 

/7

  
Literature review of the topic/issue

·         Includes literature support of the topic or issue (1 pt.)

·         Summarizes most important point(s) of each article (4 pts.)

·         Clearly connects authors with literature points (1 pt.)

  

 

/6

  
Solution/intervention

·         Clearly outlines solution and presents as feasible (3 pts.)

·         Includes literature support of chosen solution (2 pt.)

·         Clearly connects authors with solution literature (1 pt.)

  

 

/6

  
Implementation

·         Identifies and explains final project and attaches a copy of “work product” (in-service handouts, pamphlet, form, pocket card, for example) (4 pts.)

·         Specifically describes how the final project would be implemented, including timeline for “roll-out” (2 pts.)

·         Describes how the impact of the project could be measured or evaluated (2)

·         Addresses the future implications of the project for the unit and/or nursing in general (2 pts.)

  

 

 

/10

  
e-Poster mechanics

·         Professional looking: follows elements of e-poster construction; organized and clear layout that flows well (2 pts.)

·         Visually appealing: words and graphics are easy to see; appropriate use of color (2 pts.)

·         Student’s name, Resurrection University and project site are clearly identified (1 pt.)

·         Reference page is complete, in proper APA format, and submitted with the e-poster (1 pt.) Sepsis and Early Prevention

  

 

 

 

/6

  

                                                                                                                                                                                   TOTAL          /85

 

                                                                                                                       

 

Proposal and implementation guidelines for an organizational policy that you believe would help lead to an improvement in quality and performance associated with the benchmark metric

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· Draft a written proposal and implementation guidelines for an organizational policy that you believe would help lead to an improvement in quality and performance associated with the benchmark metric for which you advocated action in Assessment 1.

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guidelines change proposals that will enable a team, unit, or the organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care. This assessment offers you an opportunity to take the lead in proposing such changes.

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

· Competency 2: Analyze relevant health care laws and regulations and their applications and effects on processes within a health care team or organization.

1. Propose a succinct policy and guidelines to enable a team, unit, or the organization as a whole to implement recommended strategies to resolve the performance issue related to the relevant local, state, or federal health care policy or law.

. Competency 3: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.

2. Recommend ethical, evidence-based strategies to resolve a performance issue related to health care policy or law.

. Competency 4: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, for health care policies and law for patients, organizations, and populations.

3. Explain the need for creating an organizational policy or practice to address a shortfall in meeting a prescribed metric benchmark.

. Competency 5: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.

4. Analyze the potential effects of environmental factors on recommended strategies.

4. Identify colleagues, individual stakeholders, or stakeholder groups who should be involved in further development and implementation of proposed policy and guidelines and recommended strategies.

. Competency 6: Apply various methods of communicating with policy makers, stakeholders, colleagues, and patients to ensure that communication in a given situation is professional, clear, efficient, and effective.

5. Communicate a proposed policy and guidelines and recommended strategies in a professional and persuasive manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling.

5. Effectively support arguments with relevant sources, correctly formatting citations and references using current APA style.

5.

· As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

Consider the underperforming metric you evaluated in your Dashboard Benchmark Evaluation in Assessment 1 as having the potential to greatly improve the overall quality or performance of a team or the whole organization.

What ethical, evidence-based strategies would you recommend to resolve the performance issue related to the underperforming metric you evaluated?

. What does the literature suggest are potential strategies to improve performance for your targeted benchmark?

. How would these strategies ensure improvement or compliance with the relevant local, state, or federal health care policy or law?

. How would you propose to apply these strategies in the context of Eagle Creek Hospital or your own practice setting?

. How would you ensure that these strategies are ethical and culturally inclusive in their application?

· In this assessment, you will build on the dashboard benchmark evaluation work you completed in Assessment 1.

Preparation

After reviewing your benchmark evaluation, senior leaders in the organization have asked you to draft a policy change proposal and practice guidelines addressing the benchmark metric for which you advocated action.

In their request, senior leaders have asked for a proposal of not more than 2–4 pages that includes a concise policy description (about one paragraph), practice guidelines, and 3–5 credible references to relevant research, case studies, or best practices that support your analysis and recommendations. You are also expected to be precise, professional, and persuasive in justifying the merit of your proposed actions.

When creating your policy and guidelines it may be helpful to utilize the template that your current care setting or organization uses. Your setting’s risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your care setting does not have these resources, there are numerous appropriate templates freely available on the Web.

Proposal Requirements

Note: The tasks outlined below correspond to grading criteria in the scoring guide.

In your proposal, senior leaders have asked that you:

· Explain why a change in organizational policy or practice guidelines is needed to address a shortfall in meeting a performance benchmark prescribed by applicable local, state, or federal health care laws or policies.

1. What is the current benchmark for the organization? What is the numeric score for the underperformance?

1. How might the benchmark underperformance be affecting the quality of care being provided or the operations of the organization?

1. What are the potential repercussions of not making any changes?

. Recommend ethical, evidence-based strategies to resolve the performance issue.

2. What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?

2. How would these strategies ensure improved performance or compliance with applicable local, state, or federal health care laws or policies?

2. How would you propose to apply these strategies in the context of your chosen professional practice setting?

2. How would you ensure that the application of these strategies is ethical and culturally inclusive?

2. Does your policy encompass the key components of your recommendations?

. Analyze the potential effects of environmental factors on your recommended strategies.

3. What regulatory considerations could affect your recommended strategies?

3. What organizational resources could affect your recommended strategies (for example, staffing, finances, logistics, and support services)?

3. Are your policy and guidelines realistic in light of existing environmental factors?

. Propose a succinct policy and guidelines to enable a team, unit, or the organization as a whole to implement recommended strategies to resolve the performance issue related to the relevant local, state, or federal health care policy or law.

. Identify colleagues, individual stakeholders, or stakeholder groups who should be involved in further development and implementation of your proposed policy, guidelines, and recommended strategies.

5. Why is it important to engage these colleagues, individual stakeholders, or stakeholder groups?

5. Do your proposed guidelines help colleagues, individual stakeholders, or stakeholder groups understand how to implement your proposed policy?

5. How might engaging these colleagues, individual stakeholders, or stakeholder groups result in a better organizational policy and smoother implementation?

5. Are your proposal and recommended strategies realistic, given the care team, unit, or organization you are considering?

. Communicate your proposed policy, guidelines, and recommended strategies in a professional and persuasive manner.

6. Write clearly and logically, using correct grammar, punctuation, and mechanics.

. Integrate relevant sources to support your arguments, correctly formatting source citations and references using current APA style.

7. Did you cite an additional 3–5 credible sources to support your analysis and recommendations?

Concepts of Nursing Based on Reed’s Self-Transcendence Theory

/in /by

Self-Transcendence Theory: Pamela G. Reed

Chapter 25

Overview of Self-Transcendence Theory: Three Central Concepts

Self-transcendence: capacity to expand self-boundaries intrapersonally, interpersonally, temporally, and transpersonally

Well-being: feeling whole and healthy, according to one’s own criteria for wholeness and health

Vulnerability: awareness of personal mortality and the likelihood of experiencing difficult life situations

Moderating-mediating factors are personal and contextual variables such as age, gender, life experiences, and social environment that influence the relationships between vulnerability and self-transcendence and between self-transcendence and well-being

Nursing activities that facilitate self-transcendence are points of intervention

Major Concepts of Nursing Based on Reed’s Self-Transcendence Theory

Person: human beings developing over the lifespan in interaction with other persons and within an environment

Environment: composed of family, social networks, physical surroundings, and community resources

Major Concepts of Nursing Based on Reed’s Self-Transcendence Theory

Health: well-being is a sense of feeling whole and healthy, according to one’s own criteria for wholeness and health

Nursing: role of nursing activity is to assist persons through interpersonal processes and therapeutic management of their environment to promote health and well-being

Assumptions of the Self-Transcendence Theory

Focus of the discipline of nursing should be on building and engaging knowledge to promote health processes

Persons are open systems who impose conceptual boundaries upon themselves to define their reality and to provide a sense of wholeness and connectedness within themselves and their environment

Assumptions of the Self-Transcendence Theory

Self-imposed conceptual boundaries fluctuate across the life span and are associated with health and development

Self-transcendence is a developmental imperative that must be expressed for a person to realize a sense of wholeness and connectedness

Propositions of the Self-Transcendence Theory

Self-transcendence is greater in persons facing end-of-own-life issues than in persons not facing these issues

Conceptual boundaries are related to well-being

Increased vulnerability is related to increased self-transcendence

Propositions of the Self-Transcendence Theory

Self-transcendence is positively related to well-being

Personal and contextual factors influence the relationship between vulnerability and self-transcendence

Personal and contextual factors influence the relationship between self-transcendence and well-being

Brief Critique of the Self-Transcendence Theory

Derived using deductive reformulation

Easy to understand with terms used consistently

Number of concepts and relationships is minimal, yet still meaningful and fairly comprehensive

Can be applied to a wide variety of situations

Concepts are broad and abstract but empirical indicators have been identified and scales developed for research and theory development

The Self-Transcendence Theory as a Framework for Nursing Care

Assessment and Planning: nurse assesses indicators of self-transcendence, well-being, vulnerability, and moderating–mediating factors that influence relationships between vulnerability and self-transcendence and between self-transcendence and well-being

The Self-Transcendence Theory as a Framework for Nursing Care

Implementation: actions may focus directly on person’s inner resources for self-transcendence or indirectly on personal and contextual factors that affect relationship between vulnerability and self-transcendence and relationship between self-transcendence and well-being

Evaluation: based on effectiveness of activities to facilitate self-transcendence and well-being

Assumptions of the Theory of Chronic Sorrow

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Theory of Chronic Sorrow: Georgene Gaskill Eakes, Mary Lerman Burke, and Margaret A. Hainsworth

Chapter 26

Overview of the Theory of Chronic Sorrow

Chronic sorrow is the periodic recurrence of permanent, pervasive sadness or other grief-related feelings associated with ongoing disparity resulting from a loss experience

Chronic sorrow is viewed as normal response to a void created by ongoing disparity or loss; normalization of the experience does not diminish the validity or intensity of feelings

Overview of the Theory of Chronic Sorrow

Trigger events are those situations or circumstances that bring the disparity created by the loss into focus and trigger the grief-related feelings associated with chronic sorrow

Management methods within the theory refer to coping strategies used by persons during the chronic sorrow experience and supportive interventions provided by professionals

Major Concepts of Nursing Based on the Theory of Chronic Sorrow

Person: human beings with an idealized perception of life processes and health who compare their experiences both with the ideal and with others around them

Environment: interactions that occur within the social context, including family, social, work, and healthcare environments

Major Concepts of Nursing Based on the Theory of Chronic Sorrow

Health: a normality of functioning, with a person’s health dependent upon adaptation to disparities associated with loss

Nursing: primary roles of nurses include empathetic presence, teacher-expert, and caring and competent caregiver

Assumptions of the Theory of Chronic Sorrow

Chronic sorrow is a normal human response related to ongoing disparity created by a loss situation

Chronic sorrow is cyclic in nature

Predictable internal and external triggers of heightened grief can be categorized and anticipated

Assumptions of the Theory of Chronic Sorrow

A human who experiences either a single loss or an ongoing loss will perceive a disparity between the ideal and reality

Disparity between the real and the ideal leads to feelings of pervasive sadness and grief

Propositions of the Theory of Chronic Sorrow

Humans have inherent and learned coping strategies that may or may not be effective in regaining normal equilibrium when they are experiencing chronic sorrow

Health professionals’ interventions may or may not be effective in assisting the person to regain equilibrium

Brief Critique of the Theory of Chronic Sorrow

Inductively derived and evaluated from review of literature and qualitative research data

Key concepts are consistently defined

Proposed relationships between concepts are clear and logical

Introduced with focus on specific population, but has been shown to be applicable to a wide variety of loss situations

The Theory of Chronic Sorrow as a Framework for Nursing Practice

Assessment: The Chronic Sorrow Questionnaire or interview to identify the indicators of chronic sorrow; should also include assessment for presence and effectiveness of internal management strategies already being used

Planning: matching the internal and external management strategies that should be the most beneficial based on specific loss situation

The Theory of Chronic Sorrow as a Framework for Nursing Practice

Implementation: provide anticipatory guidance regarding the situations and circumstances that are likely to trigger episodes of chronic sorrow; support and strengthen personal coping mechanisms

Evaluation: based on whether the management methods were ineffective or effective in decreasing discomfort