THE JOB IS TO REPLY WITH A COMMENT TO EACH POST, POST 1 AND POST 2. WITH 2 COMPLETED (EDUCATIONAL  REFERENCE) includidig retrival or doi, IN APA WITH CITATION ABOVE 2013 PER COMMENT.  POST 1Compreh

THE JOB IS TO REPLY WITH A COMMENT TO EACH POST, POST 1 AND POST 2. WITH 2 COMPLETED (EDUCATIONAL  REFERENCE) includidig retrival or doi, IN APA WITH CITATION ABOVE 2013 PER COMMENT.

  POST 1

Comprehensive Integrated Psychiatric Assessment

Following recent research, the level of mental health problems among children and adolescents has risen dramatically (American Psychiatric Association, 2013). The present-day life and current associations within the society contribute greatly to these adversities. Culture, environmental exposure, social and economic status are frequent predisposing factors to mental and behavioral disorders. For example, domestic violence, sexual assault and the rising prevalence of divorces are the most common causes of mental health problems among the youth (American Psychiatric Association, 2013. Nonetheless, assessing and treating children and adolescents is very challenging. Psychiatric mental health nursing practitioners (PMHNPs) ought to be patient and diligent when practicing mental assessments to this type of clients.

Based on the YMH Boston Vignette 4 Video

What did the practitioner do well?

At the beginning of the session, the nursing practitioner expresses his respect for the nursing code of ethics, conduct and autonomy. This is a good approach since it assures the client of his protection and the nondisclosure of his/her health information. Additionally, the nursing practitioner was keen to establish a sense of rapport between himself and his client. This was necessary to necessitate voluntary and ease of information sharing.

In what areas can the practitioner improve?

The nursing practitioner fails to warm-up the client at the start of the interview. It is advisable to start with a casual conversation before jumping into the main point (Kaplan, 2016). Failure to this (as evident in the Boston Vignette 4 Video) the patient keeps his guard up and even suggest that his mother should answer some of the PMHNP’s question. Also, it is imperative to

apply cognitive testing to help determine the client’s mental status at the time of visit (Kaplan, 2016). Contrary to this aspect, the PMHNP appears more interested in the patient’s history than his current status. Ideally, the PMHNP should improve on the areas noted above.

At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

 The nursing practitioner in the YMH Boston Vignette 4 Video seats causally and speaks rather sparingly. In comparison to the PMHNP in the YMH Boston vignette 1 video the practitioner seats and speaks directly to the client to capture his attention and cognitive status. This makes his client attentive unlike the patient in video 4. As a matter of facts, the practitioner shares a little enthusiasm in the client’s interests (basketball) to help improve the mood of the interview and consequently, derive more information (Merrell, 2013).

What would be your next question and why?

Question: Do you often lose temper on people other than your mum?

This question is necessary to help determine the specific triggers of the client’s anger. If the answer is ‘NO’, then it’s true that the mum triggers his anger through excessive pressure and nagging. However, if the answer is ‘YES’, then the frequent loss of temper would qualify as one of the symptom for mental health conditions such as intermittent explosive disorder (Kulper, Kleiman, McCloskey, Berman & Coccaro 2015).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Kaplan, B. J. (2016). Kaplan and Sadock’s Synopsis of Psychiatry. Behavioral Sciences/Clinical Psychiatry. Tijdschrift voor Psychiatrie, 58(1), 78-79.

Kulper, D. A., Kleiman, E. M., McCloskey, M. S., Berman, M. E., & Coccaro, E. F. (2015). The experience of aggressive outbursts in intermittent explosive disorder. Psychiatry research, 225(3), 710-715.

Merrell, K. (2013). Behavioral, social, and emotional assessment of children and adolescents. Routledge.

POST 2

Comprehensive Integrated Psychiatric Assessment of an adolescent

What did the practitioner do well?

In the YMH Boston Vignette 4 YouTube Video, the therapist was professional by telling the teenager at the beginning of the session of the right of confidentiality and privacy unless he has suicidal or homicidal thoughts. This information built a good rapport and trust with the client which then enabled him to share his feelings. The adolescent may be worried about confidentiality, and clinicians can reassure them that approval will be requested from them before any detailed information is shared with parents, except situations involving danger to self or others (Price, 2017). The practitioner built a good rapport with the client by making good eye contact, trying to focus more on the client and not the parents, as well as asking him about his hobbies. Rapport is built by enabling patients to feel easiness during stressful situations. The practitioner also does a good job as he allows the client to explore his feelings. “When adolescents become able to cope with the controversial and problematic situations, anger affects self-perception because it is displayed in a situation where individuals are restrained or challenged” (Lok & Bademli, 2018). Moreover, the practitioner asked about his school and by asking him about what he liked doing after school.

In what areas can the practitioner improve?

The therapist needs improvement is communication because he did not introduce himself to the patient at the beginning of the video. In addition, the therapist was not firm with his statements as he agreed mostly with the client putting faults oh his mother. The client just wants someone to listen to him which explains why he praised his girlfriend because she listens to him. The practitioner failed to find out why the client thinks his mom is irritating. Moreover, the practitioner needs to improve on listening skills as a lot of time was spent taking notes during the interview which can be distracting for both the therapist and the patients. The practitioner could have politely asked the patient if it is okay for him to take notes during the session and explain the reason for that.

At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

A very important compelling concern is to inquire if the client feels safe at home with his mother. In addition, medications being taken by the client and psychiatric history and, lastly coping skills.

What would be your next question, and why?

I would ask the client about the possibility of having a family session which could be beneficial by making the people involved understand themselves more. It is important for the therapist to remain neutral and validate each family member`s feeling with the goal to improve communication among them and enable the therapist to develop an appropriate care plan for the client (Renee, & Ballas, 2018). Lastly, the next question would have been the practitioner to find out if the client is using drugs or having any suicidal or homicidal thoughts.

References

Lok, N., Bademli, K. (2018). The effects of anger management education on adolescents’ manner of displaying anger and self-esteem: A randomized controlled trial. Archives of Psychiatric Nursing. 32(1), p. 75-81.

Price, B. (2017). Developing patient rapport, trust, and therapeutic relationships. Nursing Standard. 31(50), p. 52-65.

Renee, W., & Ballas, P. (2018). Comprehensive Psychiatric Evaluation for Children. N.p.: University of Rochester Medical Center. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02564

Please see below and contact

Use the practice problem and a quantitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper.

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 Turnitin. Please refer to the directions in the Student Success Center.

QUANTITATIVE RESEARCH GUIDLINES( PLEASE FOLLOW THESE GUIDLINES TO COMPLETE THIS ASSIGNMENT)

Quantitative Study

Background of Study:

·         Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

·         How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem.

·         Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

·         List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

·         Were the purpose and research questions related to the problem?

 Methods of Study

·         Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify?

·         Was informed consent obtained from the subjects or participants?

·         Did it seem that the subjects participated voluntarily in the study?

·         Was institutional review board approval obtained from the agency in which the study was conducted?

·         Are the major variables (independent and dependent variables) identified and defined? What were these variables?

·         How were data collected in this study?

·         What rationale did the author provide for using this data collection method?

·         Identify the time period for data collection of the study.

·         Describe the sequence of data collection events for a participant.

·         Describe the data management and analysis methods used in the study.

·         Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis?

·         What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses?

 Results of Study

·         What is the researcher’s interpretation of findings?

·         Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings?

·         What limitations of the study were identified by researchers?

·         Was there a coherent logic to the presentation of findings?

·         What implications do the findings have for nursing practice? For example, can the findings of the study be applied to general nursing practice, to a specific population, or to a specific area of nursing?

·         What suggestions are made for further studies?

Ethical Considerations

·         Was the study approved by an Institutional Review Board?

·         Was patient privacy protected?

·         Were there ethical considerations regarding the treatment or lack of?

Conclusion

·         Emphasize the importance and congruity of the thesis statement.

·         Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

·         Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

·         Integrate a summary of the knowledge learned.

PLEEASE FOLLOW EACH BULLET POINT OF ABOVE GUIDLINES.

Cultural Diversity in the Health Care Workforce · Review the attached PowerPoint presentation. Attach about chapter of the book.   · Once done, work on the following exercise; ·   I. Write a one-page

Cultural Diversity in the Health Care Workforce

· Review the attached PowerPoint presentation. Attach about chapter of the book.  

· Once done, work on the following exercise;

·  

I. Write a one-page summary of the advantages of having a diverse nursing and health care staff.

a. Include the benefits to both health care providers and patients.

b. What health issues may be better addressed by a diverse health care staff?

· The assignment in an APA format word document, Arial 12 font 

· Will be verified by Turnitin to verify originality 

· A minimum of 700 words is required in the assignment.

·  If the originality exceeds the percentage of plagiarism allow by the University points will be deducted. 

· A minimum of 3 evidence-based references besides the class textbook must be used.

II. In a different page you must post 2 short replies regarding the topics:

· Benefits of having diverse nursing and healthcare staff to both health care providers and patients

· Health issues that may be better addressed by a diverse health care staff.

The replies will be to 2 of your peers sustained with the proper references and make sure that the references that you use in your assignment are properly quoted in it. 

Due date: Friday July 19, 2019.

NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE – Discussion 11 (Grading Rubic and Media Attached)

Discussion: Creating a Culture of Evidence-Based Practice

An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.

In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.

To prepare:

Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.

Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?

Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.

Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?

Reflect on how nurses can disseminate findings from evidence-based practice research.

Post an evaluation of your organization’s use of EBP and how it is furthered or hindered by organizational culture and policies. Describe how you could disseminate the findings. Propose a strategy for strengthening the culture of EBP within the organization. Discuss a nurse’s responsibility to further the use of EBP, providing a rationale supported by specific information from the Learning Resources.

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 30, “Disseminating Evidence: Reporting Research Findings”

In this chapter, the focus is on actually reporting on the research findings and how to determine the best approach for reaching the desired audience. The chapter also includes tips on how to organize the information and describes what is usually included in such reports.

Aitken, L. M., Hackwood, B, Crouch, S., Clayton, S., West, N., Carney, D., & Jack, L. (2011). Creating an environment to implement and sustain evidence based practice: A developmental process. Australian Critical Care, 24(4), 244–254.

Retrieved from the Walden Library databases.

This article describes a multi-dimensional EBP program designed to generate sustainable improvement in patient care and patient outcome. The text details the program’s strategies for implementation along with achievements and lessons learned.

Barnsteiner, J. H., Reeder, V. C., Palma, W. H., Preston, A. M., & Walton, M. K. (2010). Promoting evidence-based practice and translational research. Nursing Administration Quarterly, 34(3), 217–225.

Retrieved from the Walden Library databases.

In this text, the authors highlight established systems and structures designed to supply staff with resources to translate research and deliver EBP. Additionally, the article explicates a multitude of initiatives designed to disseminate evidence to the point of care.

Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230.

Retrieved from the Walden Library databases.

This article provides several models for implementing evidence-based practice within an organization. It introduces four different phases through which an implementation should progress, and provides examples of each.

Estrada, N. (2009). Exploring perceptions of a learning organization by RNs and relationship to EBP beliefs and implementation in the acute care setting. Worldviews on Evidence-Based Nursing, 6(4), 200–209.

Retrieved from the Walden Library databases.

In this article, the authors detail a survey design study conducted to determine the relationship between a learning organization’s characteristics and the beliefs of registered nurses with respect to EBP. In addition, the study examines the impact of EBP beliefs on registered nurses’ implementation of EBP.

Fineout-Overholt, E., Williamson, K. M., Kent, B., & Hutchinson, A. M. (2010). Teaching EBP: Strategies for achieving sustainable organizational change toward evidence-based practice. Worldviews on Evidence-Based Nursing, 7(1), 51–53.

Retrieved from the Walden Library databases.

The authors of this text suggest multiple strategies for integrating the EBP paradigm at the organizational level. The text provides rationale for why educators should also consider change at the individual level as an effective conduit for disseminating the EBP paradigm at the organizational level.

Munten, G. van den Bogaard, J., Cox, K., Garretsen, H., & Bongers, I. (2010). Implementation of evidence-based practice in nursing using action research: A review. Worldviews on Evidence-Based Nursing, 7(3), 135–157.

Retrieved from the Walden Library databases.

This text reviews 21 action research studies to determine what is known about using action research to implement evidence-based practice. The authors explicate the promising features and flaws that were common across the action research studies they used.

Satterfield, J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., & Whitlock, E. P. (2009). Toward a transdisciplinary model of evidence-based practice. The Milbank Quarterly, 87(2), 368–390.

Retrieved from the Walden Library databases.

This article presents the primary issues and challenges in EBP across numerous health disciplines. The authors then posit a transdisciplinary EBP model designed to incorporate the strengths and diminish the flaws of each discipline’s EBP model.

Steurer, L. M.(2010). An evidence-based practice scholars program: One institution’s journey toward excellence. Journal of Continuing Education in Nursing, 41(3), 139–143.

Retrieved from the Walden Library databases.

The author of this article details the efforts of an EBP scholars program that was designed to teach an overview of EBP, along with the skills necessary to improve patient outcomes. In addition to the program’s development and implementation, the article highlights lessons learned. 

Media

Laureate Education (Producer). (2012k). Translating evidence into practice. Baltimore, MD: Author. 

Note: The approximate length of this media piece is 9 minutes.

Dr. Kristen Mauk discusses the outcomes of her DNP project in this video. She explains how nurses in the rehabilitation unit where she conducted her project used the results of her project to improve their practices.

Accessible player  

Laureate Education (Producer). (2012c). Disseminating findings. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.

In this video, Dr. Kristen Mauk offers advice for nursing students and practitioners in disseminating the findings of their research and evidence-based practice projects. She identifies many options for dissemination that are available to nurses.

EXCEPTIONAL GENIUsS ONLY

1.  Have you used any of the treatments described in the Pain Management video series you watched this week on your patients? On yourself? Which of these have you found most effective in pain management? Please describe.

2. Read the following article discussing the connection between childhood trauma, crime, and health. Share your thoughts and opinions on the matter as evidenced in your personal and/or professional life. Have you seen or suspected these correlations? Do you think this is an isolated occurrence? What are your thoughts on the approach to resolution that the doctor and her team have taken? Can you think of other interventions that might be worth pursuing? Share any other articles on the subject that you may have encountered.

http://www.npr.org/blogs/health/2015/03/10/377566905/a-sheriff-and-a-doctor-team-up-to-map-childhood-trauma

3. Change can be a difficult process. However, there are ways that can help reduce the stress caused by a major change. Provide a real-life example of a change that occurred at your work. Was the change effective or ineffective? Why? Utilize a change model to support your response.

4. Outline a plan for developing your professionalism as a nurse. Explain how your plan incorporates characteristics of an innovator? How can these characteristics be used to promote you as a leader?

What is a research proposal?

The purpose of a research proposal is to identify and formulate questions that arise from nursing practice and to design a research project to study the identified problem. The goal of a research proposal is to present and justify a research idea you have and to present the practical ways in which you think this research should be conducted. Research proposals contain extensive literature reviews and must provide persuasive evidence that there is a need for the proposed research study. In addition to providing a rationale for the proposed research, a proposal describes detailed methodology for conducting the research consistent with requirements of the professional or academic field and a statement on anticipated outcomes and/or benefits derived from the study.

Directions

Write a research proposal using your clinical question formulated earlier in the course that was approved by your instructor. This may be either a qualitative or quantitative research proposal. Your proposal must include APA formatting. The proposal should be a 6–10 in length plus appendices cover page, and reference page. The appendices should include your survey instrument created in week 6. You will be presenting your research proposal in a 6–8 minute recorded presentation in week 8.

Introduction 

• Clearly stated problem and purpose of the study
• Independent and dependent variables
• Definition of terms
• Assumptions, hypothesis, or questions (depending on research type)

Theoretical Framework 

• Description of the theoretical framework to be utilized
• Identification of the concepts to be explored
• Rationale for choosing framework

Review of the literature 

• At least four scholarly sources included
• Appropriateness of the review and the proposal focus
• Inclusion of primary or secondary sources

Methodology 

• Description of study type (quantitative or qualitative)
• Description of study design
• Rationale for the use of the selected design
• Inclusion of sample size, type, sampling method, inclusion/exclusion criteria, setting, data collection method (instrument), and data collection process
• Method for Protection of Human Subjects (consent)
• Questionnaire and consent forms must be included as appendices

Data Analysis

• Data analysis method is appropriate for study design.
• Method of data analysis is clearly stated.
• Method for displaying findings is stated.

Applicability to Nursing

• Research focuses on a problem significant to nursing.
• Research would contribute to nursing knowledge.
• Proposal is complete so that another researcher could replicate the study.
• Statement about areas of nursing that would benefit from this study.