Nursing Theory And Transition To Practice

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Nursing Theory And Transition To Practice

APA format

1) Minimum 7 pages  (No word count per page)- Follow the 3 x 3 rule: minimum three paragraphs per page

You must strictly comply with the number of paragraphs requested per page.

           Part 1: minimum  2 pages

           Part 2: minimum  1 page 

           Part 3: minimum  4 pages

    

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   Submit 1 document per part

2)¨******APA norms

All paragraphs must be narrative and cited in the text- each paragraph

         Bulleted responses are not accepted Nursing Theory And Transition To Practice

         Don’t write in the first person 

Don’t copy and paste the questions.

Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks) Nursing Theory And Transition To Practice

4) Minimum 3 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

Part 1: Minimum  5 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed.

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc

__________________________________________________________________________________

Part 1: Madeleine Leininger’s Theory of Culture Care Diversity (Due 20 hours)

1. Discuss the theory’s core concepts  and their apply in nursing today (2 paragraphs)

2.  Relevance of the theory to healthcare and nursing. Also, (2 paragraphs)

a. Connect the theory to healthcare today

3. Application to research and/or practice provided. Also, (1 paragraph)

a. Connect the theory to current research/practice

b.  How will this theory advance nursing practice?

4.  Summary   (1 paragraph)

a. Describe the benefits of the theory for current nursing

a. Include theory strengths and limitations of theory

Part 2: Transition to practice (Due 20 hours)

 

Topic: Professional Social Networking

One of the best ways to keep informed about what is going on in your profession is social networking. Whether it is a blog or LinkedIn, there are numerous opportunities to make contact with your colleagues and keep informed of what opportunities are available.

1. Discuss various strategies for utilizing social media for your career enhancement.

Part 3: Transition to practice (ONLY Write in the first person) (No references) (It will be verified by Turnitin and SafeAssing) (40 hours)

 

Graduation and certification are the beginning of your career as an NP. Whether you are looking for that dream job or you have decided to open your own practice as an independent NP, you need a plan to get there. Before the Web and social media, job hunting was relatively simple. Job hunters perused the classifieds, made cold calls, and many times just showed up with a resume in hand. There has been a dramatic change in the last decade in how people find and get jobs, and NPs are no exception. For those seeking employment now, there is a wealth of resources available from mega employment websites to specialty blogs. Finding a job as an NP may not be a big challenge, but landing the position that you have passionately prepared for and pursued is going to take some work. A well-crafted cover letter and resume may be necessary items, but it may not be enough to get you exactly where you want to be. With so many opportunities and career trajectories available to NPs today, you need to focus and get serious about what you want to do and where you want to do it.

Purpose: Develop your own strategic career plan for starting your new career as an NP.

1. What is your career vision? (1 paragraph)

2.  Where do you want to work? (pediatric psyquiatry) (1 paragraph)

3. What are your short term and long term goals (give timeline). (1 paragraph)

4. What are the most important things you are looking for? (1 paragraph)

5. Discuss your desires for salary (1 paragraph)

a. Vacation

b. Sick leave

c. CME allowance

d. Medical benefits

e. Retirement

6. Next, describe your ideal work situation, include (1 paragraph)

a. Is it a rural clinic or major trauma center?

b. Who is your target patient population?

c. Do you have a passion for a particular population or specialty? (1 paragraph)

d. What schedule do you want?

7. What are the priorities in your career right now?

a. Where do you see your career in five years?

8. How do you plan on researching opportunities (whether looking for employment or independent practice site)? (1 paragraph)

a.Describe three (3) methods:

i.Job fairs

ii. Web

iii. medical employment agencies.

9. Discuss your networking ideas. (1 paragraph)

a. Networking

b. What Internet resources might you use to network and connect with other healthcare providers?

10. How will you prepare for the interview? (1 paragraph)

a. Describe the specific steps for interview

11. Imagine you are starting your own practice: (2 paragraphs)

a. What population will it serve?

b. How will you market your practice?

c. What personnel will you need to hire?

d. How will you obtain funding?

e. Will you be open extended hours to meet the needs of working patients?

f. Will you be the sole provider, or will you hire other providers?

Nursing homework help

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Nursing homework help

Sarah Kerkla

Posted Date

Mar 31, 2022, 5:10 AM

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AGACNPs have a pivotal role in the healthcare team and are proven assets as members of the surgical team. A literature review conducted of NPs in the orthopedic setting (but can logically be applied to other surgical specialties) discuss the growing concern of physician shortages in surgery specialties and legislation in the early 1990s that limits the hours residents can work (Spence et al., 2019). This left many surgical specialties with less clinicians to severe a large population of patients. NPs have helped fill that void. The AGANP is a skilled clinician that can take accurate medical history, order necessary tests, initiate a plan of can, and consult other services (Spence et al., 2019). There are several modules in which an AGANP can function in the surgical setting; however, they have important role in all aspects of perioperative care. In the postoperative period NPs round on patients, address concerns or issues, provide patient education, coordinate care, lead the interdisciplinary team, perform complex dressing changes/remove drains, and order additional testing as appropriate (Spence et al., 2019). This model allows for surgeons to operate and ensure their post-op patients are being safely managed (Spence et al., 2019).  Nursing homework help

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            In the presented scenario, increased/inadequate chest tube output, change in output color, or increased pain could indicate a potential complication (Columbus et al., 2017, p. 800). The first assessment should always be the patient rather than the device. The patient should be evaluated for respiratory distress and hemodynamic instability. The amount of drainage is highly variable depending on the reason for the chest tube. Occasionally in lobectomy patients, two chest tubes are used; one for lung re-expansion and the other for blood/fluid collection (Shintani et al., 2018). In this instance, it would be expected for one tube to have little to no drainage and the other to have larger amounts. Some lobectomy patients have massive air leaks, pleural effusions, or hemorrhage that require two chest tubes (Shintani et al., 2018). It’s important to note the characteristics of the drainage and if they’ve changed. Large amounts of sanguineous drainage would be cause for concern especially coupled with hemodynamic changes; serous drainage is expected as effusions are common in malignancy; and milky can be consistent with chyle which could be expected or a complication. An abrupt stoppage of drainage in the immediate post-op period is concerning for potential tube occlusion or migration, which can result in pneumothorax.  Nursing homework help

Tubes and drains are commonly placed in surgery as part of postoperative management. A chest tube can be placed in the pleural or mediastinal space for pneumothorax, hemothorax, and cardiac/thoracic surgeries (Columbus et al., 2017, Tables 45-1). GI tubes can be placed for feeding or decompression including: NG tube, gastrostomy tube, jejunostomy tube, or duodenal tube (Columbus et al., 2017, Tables 45-1). A Penrose is a small drain that is open at both ends and is intended to maintain a surgical tract for drainage (Columbus et al., 2017, pp. 45–1). Closed suction drain systems (Jackson-Pratt or Hemovac) are placed in the surgical space to facilitate drainage of blood and other fluids (Columbus et al., 2017, pp. 45–1). AGACNPs should be well versed in different drainage devices and be aware of potential complications. Depending on the specialty of the AGACNP, drains should not be manipulated without discussing it with the placing surgeon and all unexpected changes or concerns should be addressed with the surgeon (Columbus et al., 2017, p. 804).

In the scenario, depending what the assessment demonstrated possible causes of large chest tube output are: hemorrhage, chylothorax, or expected high volume drainage. If the concern of the nurse was no output, possible causes are tube malposition or occlusion. In the scenario of large volume output, I’d expect to see hemodynamic instability with hypotension and tachycardia due to fluid loss or significant fluid shifts. In the case of low/no output, this could cause a pneumothorax or tension pneumothorax and the patient would have respiratory distress along with hypotension and tachycardia.

In the case with sever hemorrhage the patient will likely need transfusion of blood products and taken back to OR for exploration for the source of the bleed. Chylothorax is a rare complication secondary to a thoracic duct injury (Chen et al., 2020). Treatment options are drug therapy with Somatostatin analogs, thoracic duct embolization, or possible surgical intervention (Chen et al., 2020). In some cases, high output may be expected from a large effusion. In this case no intervention is needed if the patient is stable. In the case of decreased output, chest x-ray would be need to verify placement and possible repositioning or clot evacuation may be necessary.

References

Chen, C., Wang, Z., Hao, J., Zhou, J., Chen, N., Lui, L., & Pu, Q. (2020). Chylothorax after lung cancer surgery: A key factor influencing prognosis and quality of life. Annals of Thoracic and Cardiovascular Surgery, 26(6), 303–310. https://doi.org/10.5761%2Fatcs.ra.20-00039

Columbus, A., Havens, J. M., & Peetz, A. B. (2017). Surgical tubes and drains. In Principles and practice of hospital medicine (2nd ed., pp. 798–804). McGraw Hill.

Shintani, Y., Funaki, S., Ose, N., Kanou, T., Kanzaki, R., Minami, M., & Okumura, M. (2018). Chest tube management in patients undergoing lobectomy. Journal of Thoracic Disease, 10(12), 6432–6435. https://doi.org/10.21037%2Fjtd.2018.11.47

Spence, B. G., Ricci, J., & McCuaig, F. (2019). Nurse practitioners in orthopedic surgical settings. Orthopedic Nursing, 38(1), 17–24. https://doi.org/10.1097%2FNOR.0000000000000514

Nursing homework help

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Nursing homework help

 

https://www.jointcommission.org/topics/speak_up_campaigns.aspx

 

 

 

 

  1. Follow these guidelines
  2. Select a Speak Up brochure from The Joint Commission website.
  3. Write a short paper reviewing the brochure. Use the Grading Criteria (below) to structure your critique.
  4. Include current nursing or healthcare journal articles to support your critique. Nursing homework help

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  1. Include the following sections
  2. Introduction of brochure
  3. Includes brochure title
  4. Identifies date published

iii. Describes individuals or groups

  1. Brochure properly cited, included on the reference list, and submitted with assignment
  2. Summary of the article -brochure citation required
  3. Explain the main topics discussed
  4. Communication -brochure citation required
  5. Review information that promotes communication between patients and healthcare providers

 

  1. Personal Reflection
  2. Why did this topic interest you?

 

  1. Evaluation of the brochure (Brochure & nursing article must be cited)
  2. Was the information provided in the brochure beneficial? Could you incorporate it into your patient education?
  3. What was done well, and what could have been improved in the brochure?

iii. Was the information presented clearly?

  1. Did current nursing or healthcare-related research articles support the information presented in the brochure?
  2. What population or individuals does this article apply to (i.e., who will benefit the most from this brochure)?
  3. Who else can use this information?

vii. Will this information increase patient safety?

 

  1. Evidence Review & Application
  2. Evidence was integrated from a recent (5 years) scholarly nursing journal article to support your answers.
  3. Conclusion
  4. Restates main ideas
  5. Includes supporting information from the body of the paper

iii. Summarizes the benefits of following the brochure’s advice to a person at risk

  1. APA style and structure
  2. Adheres to current APA edition formatting guidelines for the title page, margins, in-text citations, and references
  3. Section headers are required
  4. Summary of Brochure b. Patient Communication c. Personal Reflection d. Evaluation of Brochure e. Evidence Review and Application f. Conclusion iii. Paper is no longer than three (3) pages, excluding title page, reference page, and copy of brochure a. Extra pages will not be read or contribute to the assignment grade i. Clarity of writing
  5. Proper use of Standard English ii. Shows original thought iii. No spelling or grammar errors iv. Information is presented in a logical progression

 

 

 

Nursing homework help

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Nursing homework help

For this assignment, you will develop a presentation on a realistic clinical case on a topic that is of interest to you. And then, use Canvas Studio’s Screen Capture feature to record (voice-over) your presentation. Develop your presentation based on a clinical case that was seen during your experience or a topic that is of interest to you. How do I record a Canvas Studio video with a webcam in a course?

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Content Requirements You will create a PowerPoint presentation with a realistic case study and include appropriate and pertinent clinical information that will be covering the following: Nursing homework help

  1. Subjective data: Demographics; Chief Complaint; History of the Present Illness (HPI) that includes the presenting problem and the 8 dimensions of the problem; Medications; Allergies; Past medical history; Family history; Past surgical history; Social history;  Review of Systems (ROS)
  2. Objective data: Vital signs; Physical exam, Labs (reviewed from the patient’s medical records, if no lab/diagnostic tests were done recently to review, you must indicate that to receive credit).
  3. Assessment: Differential diagnosis; Primary Diagnosis
  4. Plan: Laboratory and diagnostic tests; Pharmacologic treatment plan; Non-pharmacologic treatment plan; Anticipatory guidance (primary prevention strategies); Follow up plan.
  5. Other: Incorporation of current clinical guidelines; Integration of research articles; Role of the Nurse practitioner

Submission Instructions:

  • The presentation is original work and logically organized, formatted, and cited in the current APA style, including citation of references.
  • The presentation should consist of 10-15 slides and less than 5 minutes in length.
  • Incorporate a minimum of 4 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).

 

PICOT Question and Literature Research

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PICOT Question and Literature Research

 

Clinic issue: pressure ulcer (pressure injury)

An Ulcer of Pressure is a localized injury to the skin and underlying tissue, usually over a bony prominence, as a result of pressure alone or pressure in conjunction with shear (Dorner et al., 2009). Today, pressure ulcers rank third in terms of cost after cancers and cardiovascular diseases. This disease has a mortality rate of two to six times higher than most other diseases, with 60,000 deaths occurring every year due to this complication(Schindler et al., 2011). Inpatients are more susceptible to pressure ulcers in the tissues of the extremities and in bony extensions such as the sacrum and heel. Pressure ulcers are most often caused by low physical activity, decreased consciousness, urinary and fecal incontinence, malnutrition, and advanced age (Afzali Borojeny et al., 2011). PICOT Question and Literature Research

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In the United States, pressure ulcers are estimated to cause about 2.5 million hospitalizations (Kottner & Dassen, 2010). Pressure ulcers can result in pain, reduced autonomy, increased infection and sepsis risks, more surgical procedures, long hospital stays, and higher costs for patients, families, and health care systems (Stinson et al., 2013). In addition to physical-social and self-care dysfunction, pressure ulcer patients may also experience several complications such as depression, pain, topical infection, osteomyelitis, sepsis, and even death (Senmar et al., 2017). PICOT Question and Literature Research

Despite advances in medicine, pressure ulcers remain one of the most common medical problems. There is currently no consensus on the risk factors of pressure ulcers, so identifying them is the first step in preventing an increase in their incidence (Donnelly et al., 2011). The development of counseling and prevention systems for pressure ulcers in the USA and Europe has become so important because pressure ulcers pose a major concern for patients and healthcare providers(Reddy, Gill, & Rochon, 2006).

PICOT Question

Population: patients who have developed pressure ulcer

The intervention of interest: patients who utilize pressure ulcer prevention strategies

Comparison: patients who are not been used pressure ulcer strategyies

Outcome: better or faster wound healing

Time: in the monitoring phase.

 

Are those pressure ulcer prevention strategies such as use use of specialty beds, turn and re-position, urinary catheter , nutritional consult better or faster for wound healing and prevention Compare patients who not been used pressure ulcer strategies.

 

 

 

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Reddy, M., Gill, S. S., & Rochon, P. A. (2006). Preventing Pressure Ulcers: A Systematic Review. JAMA, 296(8), 974.doi:10.1001/jama.296.8.974 McInnes, E., Jammali-Blasi, A., Bell-Syer, S. E., Dumville, J. C., Middleton, V., & Cullum, N. (2015). Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic Reviews.doi:10.1002/14651858.cd001735 Schindler, C. A., Mikhailov, T. A., Kuhn, E. M., Christopher, J., Conway, P., Ridling, D., … Simpson, V. S. (2010). Protecting Fragile Skin: Nursing Interventions to Decrease Development of Pressure Ulcers in Pediatric Intensive Care. American Journal of Critical Care, 20(1), 26–35.doi:10.4037/ajcc2011754

 

 
How Does the Article Relate to the PICOT Question? This article is relevant to general pressure ulcer prevention strategyies among patients who suffer pressure ulcers The aim of this systematic review is to determine the extent to which pressure-relieving support surfaces reduce the incidence of pressure ulcers compared to standard support surfaces, as well as their comparative effectiveness in ulcer prevention. This article is relevant to determine nursing strategies associated with a lower incidence of pressure ulcers.

 

 

 

 

 
Quantitative, Qualitative (How do you know?)                          methodological quality of randomized control trial                          Randomised controlled trials (RCTs) and quasi-randomised trials

 

  

Randomized clinical trial                                     multivariate logistic regression models

 

 

 

 
Purpose Statement To systematically review the evidence examining interventions to pre- vent pressure ulcers. To review which material of mattress or supportive surface can help relieve pressure ulcer To determine effective interventions associated with low pressure ulcer incident
Research Question Studies assessed three categories of interventions, namely those that addressed impairments of mobility, nutrition, and skin health.

 

 People at high risk of developing pressure ulcers should use higher-specification foam mattresses rather than standard hospital foam mattresses.

 

 

 

 Effective nursing care with targeted interven- tions can reduce the incidence of pressure ulcers.

 

 

 

 

 
Outcome Examed difference approaches: reposition on the special mattress, incontinence care, skin care, nutritional supplement all benefit for decrease or prevention  pressure ulcer

 

 higher-specification foam mattresses show more evidence to prevent pressure injury In this multisite study, we focused on determining the incidence of pressure ulcers among critically ill and injured infants and children, comparing the characteristics of patients with and without pressure ulcers, and identifying prevention strategies associated with fewer pressure ulcers.

 
Setting

(Where did the study take place?)

 Participants  from acute care, long term care,  rehab, and mixed setting

 

 

 Participants who have hight risk of pressure ulcer or some of them have pressure ulcer In PEDs ICU
Sample The 59 selected studies enrolled a total of 13 845 patients: 9397 (67.9%) in acute care, 2367 (17.1%) in LTC, 333 (2.4%) in re- habilitation, and 1748 (12.6%) in mixed settings People receiving health care who were deemed to be at risk of developing pressure ulcers, in any setting, total of included trials to 59 , in comparison 1, participant including

2407

 

 

 

 

 

 

 

 5346 patients in pediatric inten- sive care units in whom pressure ulcers did and did not develop were compared
Method Based on whether the intervention being evaluated addressed mobility, nutrition, or skin health impairments, RCTs were divided into three categories.

 

 Randomised controlled trials (RCTs) and quasi-randomised trials .

Trials that evaluated the following interventions included:

1. “Low-tech” CLP support surfaces

2. “High-tech” support surfaces

3. Other support surfaces

 

 

 The 29 separate preventive measures evaluated in this way were entered into the multivariate logistic regression models described above in order to determine which preventive measures had the greatest influence on pressure ulcer development..

 
Key Findings of the Study  Re-position on the special mattress, skincare, nutritional supple all affectively reduce incident happen High special supportive surface show show more benefit for preventing pressure ulcer Infants and chil- dren sink into low–air loss beds and specialty beds in turning mode, increasing occipital friction and shearing. Pressure ulcers were more likely in children who remained in the pediatric intensive care unit at least 4 days

Some of the pressure ulcers in our patients were related to devices.

Strategies associated with less frequent development of pressure ulcers included use of specialty beds, egg crates, foam overlays, gel pads, dry-weave diapers, urinary catheters, disposable under-pads, body lotion, nutrition consultations, change in body position every 2 to 4 hours, blanket rolls, foam wedges, pillows, and draw sheets
Recommendations of the Researcher The in-complete reporting in the RCTs may have influenced our assessment.  In future studies, the interventions required to prevent pressure ulcers specifically among high-risk populations should be defined. There are several risk factors for pressure ulcers, including being bedridden or chairbound, being unable to reposition without assistance, difficulty ambulating, history of stroke, fecal incontinence (which is highly related to immobility), low body weight, lymphopenia, difficulty feeding independently, impaired nutritional intake, nonblanchable erythema of intact skin (ie, stage 1 pressure ulcer), and dry sacrum. The study also found that people who used sheepskin overlays for their mattresses tended to develop fewer pressure ulcers. In contrast to high-specification constant low-pressure or alternating-pressure support surfaces, there is little evidence that alternating-pressure mattresses can prevent pressure ulcers more effectively than alternating-pressure overlays. These patients may benefit from targeted nursing interventions to reduce pressure ulcers. We plan to conduct a prospective randomized clinical trial to confirm that specific nursing interventions improve outcomes.  During the study, critical care nurses will have access to a set of interventions that can significantly reduce pressure ulcer risk in critically ill children and infants

 

Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink Medical Advisory Secretariat (2009). Community-based care for chronic wound management: an evidence-based analysis. Ontario health technology assessment series, 9(18), 1–24. Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle: A feasibility study. Health & social care in the community, 27(4), e417–e427. https://doi.org/10.1111/hsc.12742 Soban, L. M., Kim, L., Yuan, A. H., & Miltner, R. S. (2017). Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey. Journal of nursing management, 25(6), 457–467. https://doi.org/10.1111/jonm.12416
How Does the Article Relate to the PICOT Question? Managing pressure ulcers with a multidisciplinary wound care team significantly increases wound healing Assessed pressure ulcer prevention strategies in nursing home Programs designed to prevent pressure ulcers include nursing interventions such as risk assessments, as well as organizational strategies such as policies and performance monitoring to embed these interventions into routine care.
Quantitative, Qualitative (How do you know?) Randomized controlled trials and Controlled clinical Trials Quantitative and qualitative data were analyzed using descriptive statistics A cross-sectional survey ,Descriptive statistics
Purpose Statement To determine the effectiveness of a multidisciplinary wound care team for the management of chronic wounds.  To determine, the implementation bundle effective on pressure ulcer To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system.

 

 
Research Question  Multidisciplinary team can help manage Chronic wounds assessed the feasibility of implementing our pressure ulcer prevention care bundle in a nursing home setting.

 

 Assess the presence and operationalization of organizational strategies to support implementation of pressure ulcer
Outcome The percentage of persons and/or wounds completely healed. Reduction in healing time, improved quality of life, and pain management.

 

 

 According to this study, a pressure ulcer prevention bundle is acceptable to nursing home staff and can improve care provision. Participants reported an increase in their motivation to provide more comprehensive care.

 

 Organizational strategies that support pressure ulcer prevention program implementation (policy, oversight committee, wound care specialist, staff education, performance data, and performance improvement activities) were reported at high levels
Setting

(Where did the study take place?)

 Nursing home Nursing home hospitals

 

 
Sample Population includes persons with pressure ulcers (anywhere) and/or leg and foot ulcers

In 2007, control Group 119, experimental  127.

Harrison et al, 2005: before 78, after 180

Vu et al, 2007 : 176 residents (342 wounds)

 

 collected data for 462 resident bed days prior to implementing the bundle; collected data for 1,181 resident bed days during the intervention phase achieved 97% response rate (N=116/120)

 

 
Method Randomized controlled trials and Controlled Clinical Trials (CCT), The intervention includes a multidisciplinary (two or more disciplines) wound care team, The control group does not receive care by a wound care team

 

 

 For 5 weeks before implementing the bundle, we collected quantitative data on nursing home staff pressure ulcer prevention behaviors, as well as pressure ulcer incidence rates. After implementation, we collected data for an additional 9 weeks.

The bundle comprised three evidence-based elements: support surfaces,skininspection,repositioning

 

 A cross-sectional survey of key informants at all VHA acute care hospitals was conducted via email to assess pressure ulcer prevention programs. Surveys were sent to 124 nurse leaders
Key Findings of the Study Using a multidisciplinary wound care team, we’ve been able to reduce the pain and the need for daily wound care. And significantly increases wound healing Before the implementation of this period, five new pressure ulcers were recorded, and repositioning was the only documented way to prevent pressure ulcers.

Following implementation, no new pressure ulcers developed. Documented prevention strategies included repositioning, skin inspection, and checking support surfaces.

 For the year October 1, 2013 to September 31, 2014, the aggregated mean HAPU rate for acute care hospital medical/surgical units was 1.02% (range 0–3.1%)

 

 

 

 
Recommendations of the Researcher Evidence for these outcomes is low to very low, so further research will likely have a big impact on how confident we are in the estimate of effect. Further research is needed to enhance adherence and/or documentation to further investigate a bundle’s potential for preventing pressure ulcers in nursing homes.In spite of low completion rates of the bundle (or the documentation of this), feedback from participants indicates that the bundle was easy to follow, facilitated continuity of care, and resulted in comprehensive pressure ulcer prevention. Nurse leaders and committees and quality improvement teams play important roles in operationalizing patient safety initiatives such as pressure ulcer prevention.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reference

Afzali Borojeny, L., Albatineh, A. N., Hasanpour Dehkordi, A., & Ghanei Gheshlagh, R. (2020). The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A Systematic Review and Meta-Analysis. International journal of preventive medicine, 11, 171. https://doi.org/10.4103/ijpvm.IJPVM_182_19

Dorner BD, Posthauer ME, Thomas D. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Role of Nutrition in Pressure Ulcer Healing Clinical Practice Guideline. 2009

Donnelly, J., Winder, J., Kernohan, W. G., & Stevenson, M. (2011). An RCT to determine the effect of a heel elevation device in pressure ulcer prevention post-hip fracture. Journal of wound care, 20(7), 309–318. https://doi.org/10.12968/jowc.2011.20.7.309

Kottner, J., & Dassen, T. (2010). Pressure ulcer risk assessment in critical care: interrater reliability and validity studies of the Braden and Waterlow scales and subjective ratings in two intensive care units. International journal of nursing studies, 47(6), 671–677. https://doi.org/10.1016/j.ijnurstu.2009.11.005

Reddy, M., Gill, S. S., & Rochon, P. A. (2006). Preventing pressure ulcers: a systematic review. JAMA, 296(8), 974–984. https://doi.org/10.1001/jama.296.8.974

Schindler CA, Mikhailov TA, Kuhn EM, Christopher J, Conway P, Ridling D, Scott AM, Simpson VS Am J Crit Care. 2011 Jan; 20(1):26-34; quiz 35.

Stinson, M., Gillian, C., & Porter-Armstrong, A. (2013). A literature review of pressure ulcer prevention: weight shift activity, cost of pressure care and role of the OT. British Journal of Occupational Therapy, 76(4), 1-10.

 

 

Senmar, M., Azimian, J., Rafiei, H., Habibollahpour, M., & Yousefi, F. (2017). The incidence of pressure ulcer in old patients undergoing open heart surgery and the relevant factors. Journal of Preventive Epidemiology, 2(2), e15-e15.

 

 

 

 

Nursing homework help

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Nursing homework help

Practice Question: In adult patients aged 18 years and older with a diagnosis of depression, will implementing the National Institute for Health and Care Excellence (NICE) Guidelines for exercising impact depression scores over 8-10 weeks? Nursing homework help

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            Information technology is an integral component of quality, safe, and efficient healthcare delivery (Bergey et al., 2019). As the foundation of the future, IT plays an important role in nursing practice (Farokhzadian et al., 2020). Using IT, the DNP student can educate the staff, patients, and families about health-related issues to expand knowledge and improve patient outcomes.

My practicum site is faced with a knowledge-practice gap. To address this practice gap of a non-pharmacological approach to the management of depression affecting patients, the organization as well as the Doctor of Nursing Practice (DNP) student must leverage innovative strategies and the use of information technology (IT) to improve patient care, outcomes, and provide quality care (Role et al., 2021). IT skills are required to identify the extent of the practice gap, its incidence, significance, and cost to the patients as well as the facility and how to provide the solution to the problem. Nursing homework help

The DNP student must use IT skills to capture data that will be used in the planning, implementation, and evaluation of the Project. IT skills are required to map out how the project will be implemented, where and how the participants will document their activities, track the activities as well as evaluate the effectiveness of the project.

How important will IT competencies be to the role/position that you aspire to after completion of your DNP degree? What IT skills do you need to develop? Share your plan for professional development to develop these skills.

IT skills are essential to the role I perform and aspire to perform in the future. My goal is to use evidence-based practice to continue to advocate for patients’ safety and improve patient outcomes. This process requires an extensive literature search using IT. IT will be required to gather and store data needed as well as to educate the patients and staff to expand their knowledge. I will continue to expand on my IT skills, learning how to navigate library searches more efficiently, how to create tables, and embed documents.

Provide your instructor and student colleagues with an update on your implementation plans for your DNP Project. Share any successes, challenges, or barriers you experienced this week

I continue to make corrections to my synthesis of the literature paper as highlighted by the instructor. This will help ensure smoother project implementation.

References

Bergey, Goldsack, J. C., & Robinson, E. J. (2019). Invisible work and changing roles: Health information technology implementation and reorganization of work practices for the inpatient nursing team. Social Science & Medicine (1982), 235, 112387–112387. https://doi.org/10.1016/j.socscimed.2019.112387 (Links to an external site.)

Farokhzadian, Khajouei, R., Hasman, A., &Ahmadian, L. (2020). Nurses’ experiences and viewpoints about the benefits of adopting information technology in health care: a qualitative study in Iran. BMC Medical Informatics and Decision Making, 20(1), 240–240. https://doi.org/10.1186/s12911-020-01260-5

Role, Chao, H., Rosario, C., Ho, P., &Hodgkins, M. (2021). Inpatient Staffing Dashboard: A nursing–information technology collaborative project. Computers, Informatics, Nursing, 39(11), 772–779. https://doi.org/10.1097/CIN.0000000000000778

 

History Of Reimbursement Issues

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History Of Reimbursement Issues

History of Reimbursement Issues

Purpose

The purpose of this discussion is to explore the DNP-prepared nurse’s role, as a member of the interprofessional team, to design systems that optimize reimbursement with a goal to improve the quality of patient care. We will examine the influence of healthcare reimbursement on nursing practice, clinical outcomes, and cost issues. History Of Reimbursement Issues

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Instructions

Reflect upon your readings and professional experience regarding reimbursement issues and address the following.

  1. Analyze how healthcare reimbursement influences your nursing practice.
  2. Examine how the value-based insurance design (VBID) influences clinical outcomes and cost issues.

FROM WEEKEND LECTURE:  With the Affordable Care Act, the reimbursement model is shifting to provide incentives for innovating value-based programs, such as the Medicare Value-Based Insurance Design (V-BID) and Bundled Payment programs. The Value-Based Insurance Design is an approach that drives patients and providers to high value services while discouraging low-value services when the benefits do not justify the cost. The goal of V-BID is to decrease the cost of healthcare while increasing the effectiveness of health services. The V-BID approach structures health insurance in a way that incentivizes and drives patients and providers toward the most valuable services—those most beneficial relative to costs. V-BID has the potential to improve service utilization, quality, and outcomes.

*Know that All responses will be Turnitin checked.

Instructions:

Use an APA 7 style and a minimum of 350 words. Provide support from a minimum of at least (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply. Include the Doi or URL link.

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be use

Nursing homework help

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Nursing homework help

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project. Nursing homework help

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

  1. Title page
  2. Introduction section
  3. A comparison of research questions
  4. A comparison of sample populations
  5. A comparison of the limitations of the study
  6. A conclusion section, incorporating recommendations for further researchPatient falls are a significant problem prevalent in healthcare organizations that negatively impacts patient’s quality of care. Studies show that almost a million ailing individuals fall while receiving medical care in healthcare facilities. The issue is worth investigating because it may precipitate negative outcomes such as internal bleeding and fractures that may increase the duration of patients’ stay in hospitals and inflate the cost of treatment (LeLaurin et al., 2018). Therefore, it is necessary to find evidence-based interventions that will enhance the safety of patients by preventing falls. The PICOT question that will aid in finding an effective intervention is: In geriatric Hispanic patients, how effective is screening patients for risk of falls compared to not screening them in reducing incidences of falls in a period of six months? Evidently, the PICOT question is a significant model that will help determine an evidence-based nursing intervention that will improve patient care and positively portray a healthcare agency and the nursing practice. Nursing homework help

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  1.  

    P: Hispanic population based on this organization’s demographic

    I: Fall risk assessment using right tools and educate patients regarding fall risks

    C: What is other organization’s policy regarding prevention of fall

    O: Fall incidents less than 3

    T: 6 months

    Evidence-Based Solution

    Members of the Hispanic population are vulnerable to chronic conditions such as high blood pressure and diabetes which may lead them highly likely to be hospitalized due to the conditions. Therefore, they are the population that is disproportionately impacted by falls in the healthcare setting and specifically to this organization. Studies show that screening patients for falls are an effective procedure that reduces falls in hospitalized patients (Guirguis-Blake et al., 2019). It helps identify the ailing individuals at a high risk of falling, such as those who has history of frequent falls, syncopal episodes, those with a poor posture, and those with a poor gait secondary to comorbidities. Adequate measures are then put in place to ensure that these vulnerable individuals do not fall, such as activate bed alarms, educate patients to use call lights, educate regarding fall risk and possible prolonged hospitalization secondary to fall.

    Nursing Intervention

    Nursing interventions such as screening patients for falls are effective models for preventing patient falls in the clinical setting. This is because nurses are the primary caregivers of patients; hence their role in ensuring their safety is fundamental (Guirguis-Blake et al., 2018). Therefore, instilling a measure that will place nurses at the forefront of preventing patient falls is guaranteed to elicit positive outcomes in the treatment process. It is important that a nurse utilizes the tool to assess patient’s mobility before ambulating a patient. A nurse can use a tool such as BMAT (Bedside Mobility Assessment Tool) to determine the appropriate patient handling and mobility equipment or device to safely move or mobilize the patient (Perez, n.d). It is also imperative to educate patients regarding fall risks to prevent further damage to patient and follow up with evaluation of education by instructing them to verbalize and demonstrate the teaching. Patients will also benefit from prevention of fall if a nurse orient a patient to the room when they first get admitted. A nurse can activate bed alarm, utilize care view monitor, instruct them on how to use a call light when need help, stay with a patient until their business is done, and be quick to answer call lights to further prevent falls.

    Health Care Agency

    Healthcare agencies are tasked with the critical role of caring for ailing individuals. They are required to ensure that patients elicit positive outcomes during treatment processes. However, aspects such as patient falls reduce the effectiveness of services provided by healthcare agencies. Therefore, it is necessary to use evidence-based protocols such as preventing patients’ falls through interventions such as screening them for susceptibility to falls to prevent the negative occurrences and increasing the quality of care they receive (LeLaurin et al., 2019). The PICOT question will help unveil the evidence that can be applied in the clinical setting.

    Nursing Practice

    Identifying a problem and implementing interventions to advocate for patients is one of the most important tasks in nursing practice. Using the PICOT question to obtain evidence that will be applied in preventing falls in the clinical setting is a significant aspect that will ensure that the nursing practice is identified as a dependable profession that ensures that ailing individuals are cared for well. It will show that the nurses are at the forefront of ensuring that the nation’s health goals are met by using effective nursing interventions to ensure that patients receive quality care that aligns with their dynamic needs (Guirguis-Blake et al., 2018).

     

     

    References

    Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. (2018). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(16), 1705-1716.

    LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in geriatric medicine, 35(2), 273-283.

    Perez, A. (n.d.). BMAT- bedside mobility assessment tool – UCLA health. Retrieved March 13, 2022, from https://www.uclahealth.org/nursing/workfiles/ContinuingEducation2015/TeachBack/UmoveBMAT-TrainingPresentation.pdf

     

     

     

Theory Of Cultural Care Diversity And Universality

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Read Chapter 22 in Alligood (2022).

Describe some difficulties you have experienced with patients you think are related to cultural differences.

What strategies can you use to support cultural sensitivity in your practice?

How has Leininger’s theoretical perspective influenced professional nursing practice?

Reference your posts in APA format and be sure to answer all questions posed in narrative form. Please use Rubic

Reference Theory Of Cultural Care Diversity And Universality

Alligood, M.R. (2022). Nursing theorists and their work (10th ed.).  Elsevier.

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NUR – 600Discussion Forum Rubric

Criteria Ratings
Quality of First Post 50 pts – Full Credit

Information clearly relates to the main topic and adds new concepts, information, it includes several supporting details and/or examples

 25 pts – Partial Credit

Information relates to the main topic, but lacking detail, depth, and/or examples

 0 pts – No Credit

Information has little or nothing to do with the main topic or simply restates the main concept without supporting details/examples
Professional Language and Writing 5 pts – Full Credit

Professional vocabulary, correct grammar, and correct spelling are consistently used throughout the discussion

 2 pts – Partial Credit

Three or less errors in professional vocabulary, grammar and spelling are identified in the discussion post

 0 pts – No Credit

Four of more errors in professional vocabulary, grammar and spelling are identified in the discussion post
APA Format 10 pts – Full Credit

Correct APA format consistently used throughout discussion posts

 5 pts – Partial Credit

No more than two errors in APA format are identified in the discussion posts

 0 pts – No Credit

Three or more errors in APA format are identified within the discussion posts or no reference list is provided
Quality of Second Post 30 pts – Full Credit

Information clearly relates to the main topic (original students post) and adds new concepts, information, and includes several supporting details and/or examples

 15 pts – Partial Credit

Information relates to the main topic (original students post) but lacking detail, depth, and/or examples

 0 pts – No Credit

Information has little or nothing to do with the main topic (original students post) or simply restates the main concept without supporting details/examples
Professional Language and Writing 5 pts – Full Credit

Professional vocabulary, correct grammar, and correct spelling are consistently used when commenting on another student’s response

 2 pts – Partial Credit

Professional vocabulary, correct grammar, and correct spelling are consistently used when commenting on another student’s response

 0 pts – No Credit

Four or more errors in professional vocabulary, grammar and spelling are identified when commenting on another student’s response
Timeliness 0 pts – Full Credit 0 pts – Partial Credit 0 pts – No Credit
Total Points: 100

 

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar

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NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar

INSTRUCTIONS ON HOW TO USE EXEMPLAR AND TEMPLATE—READ CAREFULLY

If you are struggling with the format or remembering what to include, follow the Comprehensive Psychiatric Evaluation Template AND the Rubric as your guide. It is also helpful to review the rubric in detail in order not to lose points unnecessarily because you missed something required. Below highlights by category are taken directly from the grading rubric for the assignment in Weeks 4–10. After reviewing the full details of the rubric, you can use it as a guide. NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar

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In the Subjective section, provide:

  • Chief complaint
  • History of present illness (HPI)
  • Past psychiatric history
  • Medication trials and current medications
  • Psychotherapy or previous psychiatric diagnosis
  • Pertinent substance use, family psychiatric/substance use, social, and medical history
  • Allergies
  • ROS
  • Read rating descriptions to see the grading standards! 

In the Objectivesection, provide:

  • Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
  • Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.
  • Read rating descriptions to see the grading standards! 

In the Assessmentsection, provide:

  • Results of the mental status examination, presented in paragraph form.
  • At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Read rating descriptions to see the grading standards!

Reflecton this case. Include: Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

(The comprehensive evaluation is typically the initial new patient evaluation. You will practice writing this type of note in this course. You will be ruling out other mental illnesses so often you will write up what symptoms are present and what symptoms are not present from illnesses to demonstrate you have indeed assessed for all illnesses which could be impacting your patient. For example, anxiety symptoms, depressive symptoms, bipolar symptoms, psychosis symptoms, substance use, etc.)

EXEMPLAR BEGINS HERE

CC (chief complaint):Abriefstatement identifying why the patient is here. This statement is verbatim of the patient’s own words about why presenting for assessment. For a patient with dementia or other cognitive deficits, this statement can be obtained from a family member.

HPI: Begin this section with patient’s initials, age, race, gender, purpose of evaluation, current medication and referral reason. For example:

N.M. is a 34-year-old Asian male presents for psychiatric evaluation for anxiety. He is currently prescribed sertraline which he finds ineffective. His PCP referred him for evaluation and treatment.

Or

P.H., a 16-year-old Hispanic female, presents for psychiatric evaluation for concentration difficulty. She is not currently prescribed psychotropic medications. She is referred by her therapist for medication evaluation and treatment.

Then, this section continues with the symptom analysis for your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar

Paint a picture of what is wrong with the patient. First what is bringing the patient to your evaluation.  Then, include a PSYCHIATRIC REVIEW OF SYMPTOMS.  The symptoms onset, duration, frequency, severity, and impact. Your description here will guide your differential diagnoses. You are seeking symptoms that may align with many DSM-5 diagnoses, narrowing to what aligns with diagnostic criteria for mental health and substance use disorders.

Past Psychiatric History: This section documents the patient’s past treatments. Use the mnemonic Go Cha MP. 

General Statement: Typically, this is a statement of the patients first treatment experience. For example:The patient entered treatment at the age of 10 with counseling for depression during her parents’ divorce. OR The patient entered treatment for detox at age 26 after abusing alcohol since age 13.

Caregivers are listed if applicable.

Hospitalizations: How many hospitalizations? When and where was last hospitalization? How many detox? How many residential treatments? When and where was last detox/residential treatment? Any history of suicidal or homicidal behaviors? Any history of self-harm behaviors?

Medication trials: What are the previous psychotropic medications the patient has tried and what was their reaction? Effective, Not Effective, Adverse Reaction? Some examples: Haloperidol (dystonic reaction), risperidone (hyperprolactinemia), olanzapine (effective, insurance wouldn’t pay for it)

Psychotherapy or Previous Psychiatric Diagnosis: This section can be completed one of two ways depending on what you want to capture to support the evaluation. First,does the patient know what type? Did they find psychotherapy helpful or not? Why? Second, what are the previous diagnosis for the client noted from previous treatments and other providers. Thirdly, you could document both.

Substance Use History:This section contains any history or current use of caffeine, nicotine, illicit substance (including marijuana), and alcohol. Include the daily amount of use and last known use. Include type of use such as inhales, snorts, IV, etc. Include any histories of withdrawal complications from tremors, Delirium Tremens, or seizures.

Family Psychiatric/Substance Use History: This section contains any family history of psychiatric illness, substance use illnesses, and family suicides. You may choose to use a genogram to depict this information.Be sure to include a reader’s key to your genogram or write up in narrative form.

Social History: This section may be lengthy if completing an evaluation for psychotherapy or shorter if completing an evaluation for psychopharmacology.  However, at a minimum, please include:

Where patient was born, who raised the patient

Number of brothers/sisters (what order is the patient within siblings)

Who the patient currently lives with in a home? Are they single, married, divorced, widowed? How many children?

Educational Level

Hobbies:

Work History: currently working/profession, disabled, unemployed, retired?

Legal history: past hx, any current issues?

Trauma history: Any childhood or adult history of trauma?

Violence Hx:Concern or issues about safety (personal, home, community, sexual (current & historical)

Medical History: This section contains any illnesses, surgeries, include any hx of seizures, head injuries.

 

Current Medications: Include dosage, frequency, length of time used, and reason for use. Also include OTC or homeopathic products.

Allergies:Include medication, food, and environmental allergies separately.Provide a description of what the allergy is (e.g., angioedema, anaphylaxis). This will help determine a true reaction vs. intolerance.

Reproductive Hx:Menstrual history (date of LMP), Pregnant (yes or no), Nursing/lactating (yes or no), contraceptive use (method used), types of intercourse:  oral, anal, vaginal, other, any sexual concerns

ROS: Cover all body systems that may help you include or rule out a differential diagnosis.  Please note: THIS IS DIFFERENT from a physical examination!

You should list each system as follows: General:Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe.

Example of Complete ROS:

GENERAL: No weight loss, fever, chills, weakness, or fatigue.

HEENT: Eyes: No visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.

SKIN: No rash or itching.

CARDIOVASCULAR: No chest pain, chest pressure, or chest discomfort. No palpitations or edema.

RESPIRATORY: No shortness of breath, cough, or sputum.

GASTROINTESTINAL: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain or blood.

GENITOURINARY: Burning on urination, urgency, hesitancy, odor, odd color

NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness, or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL: No muscle, back pain, joint pain, or stiffness.

HEMATOLOGIC: No anemia, bleeding, or bruising.

LYMPHATICS: No enlarged nodes. No history of splenectomy.

ENDOCRINOLOGIC: No reports of sweating, cold, or heat intolerance. No polyuria or polydipsia.

Physical exam (If applicable and if you have opportunity to perform—document if exam is completed by PCP): From headtotoe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head-to-toe format i.e., General: Head: EENT: etc.

Diagnostic results: Include any labs, X-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines).

Assessment

Mental Status Examination: For the purposes of your courses, this section must be presented in paragraph form and not use of a checklist! This section you will describe the patient’s appearance, attitude, behavior, mood and affect, speech, thought processes, thought content, perceptions (hallucinations, pseudohallucinations, illusions, etc.)., cognition, insight, judgment, and SI/HI. See an example below. You will modify to include the specifics for your patient on the above elements—DO NOT just copy the example. You may use a preceptor’s way of organizing the information if the MSE is in paragraph form.

He is an 8-year-old African American male who looks his stated age. He is cooperative with examiner. He is neatly groomed and clean, dressed appropriately. There is no evidence of any abnormal motor activity. His speech is clear, coherent, normal in volume and tone. His thought process is goal directed and logical. There is no evidence of looseness of association or flight of ideas. His mood is euthymic, and his affect appropriate to his mood. He was smiling at times in an appropriate manner. He denies any auditory or visual hallucinations. There is no evidence of any delusional thinking.   He denies any current suicidal or homicidal ideation. Cognitively, he is alert and oriented. His recent and remote memory is intact. His concentration is good. His insight is good.

Differential Diagnoses:You must have at least three differentials with supporting evidence. Explain what rules each differential in or out and justify your primary diagnosis selection. You will use supporting evidence from the literature to support your rationale. Include pertinent positives and pertinent negatives for the specific patient case.

 

Also included in this section is the reflection. Reflect on this case and discuss whether or not you agree with your preceptor’s assessment and diagnostic impression of the patient and why or why not. What did you learn from this case? What would you do differently?

Also include in your reflection a discussion related to legal/ethical considerations (demonstrating critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

References (move to begin on next page)

You are required to include at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines which relate to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.