Healthcare Systems And Quality Outcomes

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In this course, you develop a comprehensive Course Project: Promoting Health Care

Quality. To initiate this project, this week you examine the systems and structures of an

organization with which you are familiar.

Organizational Systems and Structures, Part 1

Section 1: Organizational Systems and Structures Evaluation

When a problem related to health care quality and patient safety arises, there can be an

inclination to focus on a specific event rather than to examine the larger context

surrounding it. Analyzing the systems and structures within an organization provides a

foundation for generating a fuller understanding of how and why the event occurred and

for developing strategies to address the underlying issues. Perhaps more importantly,

such an analysis can be used to proactively identify potential challenges and improve

organizational systems and structures in order to promote positive outcomes.

In the first section of your Course Project, you analyze the systems and structures of a

health care organization with which you are familiar.

To prepare:

Identify a health care organization with which you are familiar; one that you will be

able to sufficiently analyze to complete the full scope of the Course Project. (Refer to

the Course Project Overview as needed.)

Select two or more of the following frameworks:

· Learning organizations

· Complex adaptive systems (CAS)

· Clinical microsystems

· Good to great

· The 5 Ps

With these frameworks in mind, analyze the systems and structures of the

organization. Be sure to research and consider:

· Mission, vision, and values

· Strategic plan, goals, and objectives, if possible

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

Week 4: Organizational Systems and Structures, Part 2

Section 1: Organizational Systems and Structures Evaluation

As you continue your evaluation of a health care organization, it is essential to pay

attention to culture. Organizational culture provides the context in which all interactions

and processes occur and is therefore central to any effort to enact change.

To prepare:

Continue to analyze your selected organization, as indicated in Week 3 (Section 1 of

the Course Project).

Continue to analyze essential elements of organizational culture and evaluate the

influence of culture on the ability to achieve goals within your selected organization.

To complete:

Write a 3- to 5-page paper in which you:

· Provide a description of the organization that you selected

· Present your analysis of the organization with attention to:

· Its mission, vision, values

· Strategic plan, goals, and objectives

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

· The essential elements of the organization’s culture

· The influence of culture on meeting organizational goals

Section 2: Quality Improvement Issue

To help you move forward with your Course Project, this week you identify a quality

issue that you would like to address and submit a description of this issue for Instructor

feedback.

Your proposed issue should reflect a genuine need for improvement within your

selected health care organization. Through your Course Project, you will analyze this 

issue and propose strategies to improve outcome(s), including the redesign of a related

process.

To prepare:

· Review the six quality improvement aims from the Institute of Medicine (IOM)

· Safe: Avoiding harm to patients from the care that is intended to help them.

· Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).

· Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.

· Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.

· Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.

· Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

· Conduct a search of the literature to help you identify a specific issue that warrants attention and action to promote quality improvement.

· Consider what you have surmised thus far through your analysis of the organization

that you selected. What have you noticed that could help you identify a quality related need for improvement? For instance:

· What has captured your attention in meetings, reports, and/or daily activities?

· Have you noticed discrepancies between activities in the organization and

recommendations in the research literature, quality standards, and/or the

organization’s stated policies and procedures?

· If so, what do you think could be the reason(s) for variations or gaps between

what you have observed and what is recommended?

Identify a quality improvement issue that you would like to investigate for this project.

Note: Review the Course Project Overview/full instructions, located in the Week 3

Learning Resources, as needed to identify a quality improvement issue that is viable for

completing the full scope of this project. Once you receive a response from your

Instructor on the quality improvement issue that you submit, be sure to integrate his or

her feedback before moving forward with Section 3 of your Course Project.

To complete:

Write a brief description of the quality improvement issue that you would like to address

for your Course Project.

Qualitative Case Study Research Design

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Qualitative Case Study Research Design

This is assignment for my psych NP class. the following must be done, an attached document with an TWO exampleS is available in order to understand the assigment.

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MUST BE APA STYLE

ONE PAGE AT LEAST

ONE PEER REVIEW REFERENCE 5 YEARS OLD NOT OLDER.

  • I must Select one research design/approach
  • descriptive, correlational, semi-experimental, review, meta-analytic, descriptive-longitudinal case study, ethnographic, grounded theory, etc.) that could be used for the chosen topic
  • Elaborate on why the chosen approach is appropriateEXAMPLE ONE

    Select one research design/approach 

    I have selected a qualitative case study research design to allow me to gain concrete, contextual knowledge regarding the correlation between suicide and addiction disorders.  According to Rosenberg et al. (2007), case study designs are essential to the research in nursing and the social sciences.  This type of study typically uses qualitative methods such as interviews, observation, and analysis of primary and secondary sources such as newspapers, articles, and the patient’s medical records for data collection.

    Elaborate on why the chosen approach is appropriate

    A case study design will support me while attempting to analyze the circumstances surrounding the phenomenon of suicide as it relates to individuals with a history of substance use disorder (SUD).  In addition, case study design can allow me to propose practical courses of action to support this population of patients. Using a case study approach will assist me in obtaining descriptive information, trends, and a better understanding of the circumstances surrounding the increased rates of suicide in addiction patients. Finally, case study designs are a viable alternative to more traditional research approaches that allow flexibility if unexpected events occur during data collection (Jones & Lyons, 2004).

     

    Reference

    Jones, C., & Lyons, C. (2004). Case study: Design? Method? Or comprehensive strategy? Nurse Researcher, 11(3), 70-76.

    Rosenberg, J. P., & Yates, P. M. (2007). Schematic representation of case study research designs. Journal of Advanced Nursing, 60(4), 447-452. https://doi.org/10.1111/j.1365-2648.2007.04385.x (Links to an external site.)

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    EXAMPLE 2

     

    Research Design/Approach

    The design or approach that could be used in the development of the chosen topic would be a correlational approach. According to Seeram (2019) “correlational research is a type of non-experimental research that facilitates prediction and explanation of the relationship among variables” (p. 176). In correlational research there is an investigation on the relationship between variables and the person conducting the investigation cannot control or manipulate them. Researchers can use correlational research to uncover variables that interact and the type of interactions that take place, allowing them to make predictions based on the relationships found (Seeram, 2019).

    Why the chosen Design/Approach 

                According to Rumrill (2004) the correlational research approach seeks to investigate how different variables that cannot be manipulated affect outcomes. This approach will provide the most transparent and realistic solution to an issue that has become the norm in many healthcare settings. The variables that will be observed will be increased nurse staffing, and balanced nurse staffing, and the effect they have on healthcare outcomes on day 3 of a hospitalization. Increased nurse staffing refers to a favorable nurse-to-patient ratio, while balanced nurse staffing refers to a favorable ration of experienced and unexperienced nurse through every shift. Through correlational research there will be more clarity gained on how these variables affect the bottom line of healthcare outcomes.

    References

     Rumrill PD  Jr. (2004). Speaking of research. Non-manipulation quantitative designs. Work, 22(3), 255-260.

    Seeram, E. (2019). An overview of correlational research. Radiologic Technology, 91(2), 176-179. 

     

Collaborative Learning Community (CLC)

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This is a Collaborative Learning Community (CLC) assignment.

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10-15 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:

  1. Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.
  2. Explain how the nursing theory incorporates the four metaparadigm concepts.
  3. Provide three evidence-based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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.

Community Teaching Plan: Community Presentation

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The benchmark assesses the following competencies:

3.3 Provide individualized education to diverse patient populations in a variety of health care settings.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Based on the feedback offered by the provider, identify the best approach for teaching. Prepare a presentation based on the Teaching Work Plan and present the information to your community.

Options for Delivery

Select one of the following options for delivery and prepare the applicable presentation:

  1. PowerPoint presentation – no more than 30 minutes
  2. Pamphlet presentation – 1 to 2 pages
  3. Poster presentation

Selection of Community Setting

These are considered appropriate community settings. Choose one of the following:

  1. Public health clinic
  2. Community health center
  3. Long-term care facility
  4. Transitional care facility
  5. Home health center
  6. University/School health center
  7. Church community
  8. Adult/Child care center

Community Teaching Experience Approval Form

Before presenting information to the community, seek approval from an agency administrator or representative using the “Community Teaching Experience Approval Form.” Submit this form as directed in the Community Teaching Experience Approval assignment drop box.

General Requirements

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

Concept Analysis

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Purpose

This assignment provides the opportunity for the student to complete an analysis of a concept supported by a nursing theory using an identified process. The assignment fosters analytical thinking related to the selected concept as well as application within the profession.

Course Outcomes

Through this assignment, the student will demonstrate the ability to:

· (CO#1) Analyze theories from nursing and relevant fields with respect to their components, relationships among the components, logic of the propositions, comprehensiveness, and utility to advanced nursing. (PO1)

· (CO#3) Communicate the analysis of and proposed strategies for the use of a theory in nursing practice. (PO3, 7, 10)

· (CO#4)

· Demonstrate logical and creative thinking in the analysis and application of a theory to nursing practice. (PO4. 7)

Due Date Sunday 11:59 PM MT at the end of Week 3

Total Points Possible: 250 Points

Requirements

Description of the Assignment

This assignment presents a modified method for conducting a concept analysis of ONE concept that is important and useful to nursing. The concept for this assignment must be supported by a published nursing theory. The selected concept is identified and then the elements of the analysis process are applied in order to synthesize knowledge for application as demonstrated through the creation of model, borderline, and contrary cases. Theoretical applications of the concept are also discussed. Non-nursing theories may NOT be used. The paper concludes with a synthesis of the student’s new knowledge about the concept. The scholarly literature is incorporated throughout the analysis.

Only the elements identified in this assignment should be used for this concept analysis.

Criteria for Content

1. Introduction

The introduction substantively presents all the following elements:

· Identifies the role of concept analysis within theory development.

· Identifies the selected nursing concept.

· Identifies the nursing theory that addresses the selected concept.

· Names the sections of the paper.

· Scholarly support is required.

2. Definition/Explanation of the selected nursing concept

This section includes:

· Defines/explains the concept using scholarly literature (a dictionary maybe used for this section ONLY, and additional scholarly nursing references are required).

· A substantive discussion of this section with support from nursing literature is required.

3. Literature review

This section requires:

· A substantive discussion of at least 6 (six) scholarly nursing literature sources on the selected concept.

· Themes, ideas, and/or facts about the concept found in the reviewed sources are presented in an organized fashion.

· Support from nursing literature is required.

Please Note: Primary research articles about the selected nursing concept are the most useful resource for the literature review.

4. Defining attributes

For this section:

· A minimum of THREE (3) attributes are required.

· A substantive discussion of this section with support from nursing literature is required

Explanation: An attribute identifies characteristics of a concept. For this situation, the characteristics of the selected nursing concept are identified and discussed.

5. Antecedent and Consequence

This section requires the identification of:

· 1 antecedent of the selected nursing concept.

· 1 consequence of the selected nursing concept.

· A substantive discussion of the element with support from nursing literature is required.

Explanation: An antecedent is an identifiable occurrence that precedes an event. In this situation, an antecedent precedes a selected nursing concept. A consequence follows or is the result of an event. In this situation a consequence follows or is the result of the selected nursing concept.

6. Empirical Referents

This section requires the identification of:

· 2 (two) empirical referents of the selected nursing concept.

· A substantive discussion of the element with support from nursing literature is required.

Explanation: An empirical referent is an objective ways to measure or determine the presence of the selected nursing concept.

7. Construct Cases

Explanation: hypothetical or real-life situations demonstrating the use or absence of the concept.

This section requires the creation of a model case, borderline case, and contrary case.

· 1 Model Case is created by the student and discussed substantively by demonstrating within the case each of the following areas:

· Definition

· All identified attributes

Explanation: A model case is an example of a hypothetical or real-life situation that demonstrates all of the attributes noted previously in this assignment.

· 1 Borderline Case is created by the student in which one or two of the previously identified attributes are missing.

· 1 Contrary Case is created by the student that demonstrates the opposite of the selected nursing concepts. All identified attributes of the concept are absent in this case.

Explanation: Borderline case is a created case where one or two of the previously identified attributes are missing. Contrary case is a created case that demonstrate the complete opposite of the selected nursing concept – all identified attributes are missing.

8. Theoretical Applications of the Concept

· Discuss the purpose of a concept analysis in relationship to theory.

· Explain how the concept applies to the selected nursing theory.

· A substantive discussion of the element with support from nursing literature is required.

9. Conclusion

This section requires:

· Summarization of key information regarding:

· Selected nursing concept.

· Selected nursing theory.

· Application of concept analysis findings to advanced practice nursing (specific to selected specialty track professional role and/or area of practice).

· The concluding statements include self-reflection on the new knowledge gained from conducting a concept analysis. (Self-reflection may be written in first-person.)

Preparing the Assignment

Criteria for Format and Special Instructions

1. The paper (excluding the title page and reference page) should be at least 6, but no more than 8 pages. Points will be lost for not meeting these length requirements.

1. Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.

1. The source of the concept for this assignment must be a published nursing theory. Non-nursing theories may NOT be used.

1. A minimum of 6 (six) scholarly references must be used. Required textbooks for this course, and Chamberlain College of Nursing lesson information may NOT be used as scholarly references for this assignment. A dictionary maybe used as a reference for the section titled “Definition/Explanation of the selected nursing concept”, but it is NOT counted as one of the 6 required scholarly nursing references. Be aware that information from .com websites may be incorrect and should be avoided.

1. References are current – within a 5-year time frame unless a valid rationale is provided and the instructor has approved them.

1. Ideas and information from scholarly, peer reviewed, nursing sources must be cited and referenced correctly.

1. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.

1. PLEASE note: Do not rely on .com sites to identify the nursing theory as they do not provide accurate information in all cases.

Possible Concepts: The following concepts are not required; students may select one of these concepts or find another concept. Each selected concept must be associated with a nursing theory; the use of non-nursing theories is NOT allowed. If you have any questions regarding your concept or the nursing theory, please consult with your faculty member for assistance. Please note: the concepts of incivility and civility are not allowed for this assignment.

· Adaptation· Burnout· Caring· Comfort· Compassion· Compassion fatigue· Competence· Cultural humility· Empowerment· Engagement· Health· Leadership· Meaningfulness· Modeling· Noise· Pain· Palliative care· Quality of life· Resilience· Self-care· Sensory overload· Situational awareness

Assessing And Treating Patients With Anxiety Disorders

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Assessing And Treating Patients With Anxiety Disorders

Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt patients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, patients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy.

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TO PREPARE

· As you examine the patient case study consider how you might assess and treat patients presenting with anxiety disorders.

  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring anxiolytic therapy. Assessing And Treating Patients With Anxiety Disorders

THE SCENARIO/CASE STUDY: A Middle-Aged Caucasian Man With Anxiety.

THE QUESTION: 5 pages

Make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision-making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Assessing And Treating Patients With Anxiety Disorders

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Assessing And Treating Patients With Anxiety Disorders

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.Bui, E., Pollack, M. H., Kinrys, G., Delong, H., Vasconcelos e Sá, D., & Simon, N. M. (2016). The pharmacotherapy of anxiety disorders. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 61–71). Elsevier.

    American Psychiatric Association. (2010a). Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd.pdf

    American Psychiatric Association. (2010c). Practice guideline for the treatment of patients with panic disorder (2nd ed.). https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/panicdisorder.pdf

    Bendek, D. M., Friedman, M. J., Zatzick, D., & Ursano, R. J. (n.d.). Guideline watch (March 2009): Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd-watch.pdf

    Cohen, J. A. (2010). Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 49(4), 414–430. https://jaacap.org/action/showPdf?pii=S0890-8567%2810%2900082-1

    Davidson, J. (2016). Pharmacotherapy of post-traumatic stress disorder: Going beyond the guidelines. British Journal of Psychiatry, 2(6), e16–e18. 10.1192/bjpo.bp.116.003707. http://bjpo.rcpsych.org/content/2/6/e16

    Hamilton, M. (1959). Hamilton Anxiety Rating Scale (HAM-A). PsycTESTS. https://doi.org/10.1037/t02824-0

     

    Ostacher, M. J., & Cifu, A. S. (2019). Management of posttraumatic stress disorder. JAMA, 321(2), 200–201. https://doi.org/10.1001/jama.2018.19290

    Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski. S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents with generalized anxiety disorder. Depression and Anxiety, 29(4), 328–339. https://doi.org/10.1002/da.21913

     

     

     

     

    MEDICATION RESOURCES

     

    U.S. Food & Drug Administration. (n.d.). Drugs@FDA: FDA-approved drugs. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm

     

    Note: To access the following medications, use the Drugs@FDA resource. Type the name of each medication in the keyword search bar. Select the hyperlink related to the medication name you searched. Review the supplements provided and select the package label resource file associated with the medication you searched. If a label is not available, you may need to conduct a general search outside of this resource provided. Be sure to review the label information for each medication as this information will be helpful for your review in preparation for your Assignments.

     

    Review the following medications:

     

    • benzodiazepines
    • citalopram
    • desvenlafaxine
    • duloxetine
    • escitalopram
    • fluoxetine
    • paroxetine
    • sertraline
    • venlafaxine
    • vilazodone
    • vortioxetine
    • propranolol
    • prazosin

     

     

     

     

Mental Health Essay

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Mental Health Essay

RN326 Mental Health, July 2021 Session

RUA Group PPT Presentation

Each group will prepare a Power Point (PPT) Presentation utilizingScholarly Nursing Research/JournalArticles that have been approved by the Faculty (See Course Calendar for due date and Presentation date)

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Please submit your articles via permalink attachment if the article is from Chamberlain libraryfor approval prior to developing your PowerPoint. Mental Health Essay

If the article is not from Chamberlain Library, download the article and send it via email attachment for approval [DO NOT SUBMIT LINK,COPY AND PASTE IS NOT ACCEPTED].

Note that you will be presenting to a Focus Group that need to learn about the disorder. Each group will utilize information collected fromthe Scholarly Articles to develop the Power Point Presentation. Additional resources may be used.Your Course Textbook must be used as one of your resources/references. Mental Health Essay

Discuss the following in your Presentation/PPT:

  • A brief introduction of your assigned disorders
  • A brief introduction of the scholarly article’s topic and explain why it is important to mental health nursing.
  • Cite statistics to support the significance of the topic.
  • Summarize the article; include key points or findings of the article.
  • Discuss how you could use the information for your practice; give specific examples.
  • Identify strengths and weaknesses of the article.
  • Discuss whether you would recommend the article to other colleagues.
  • Discuss your conclusion.

 

Include an APA title page [include Group #, your group topic, and names of group member] and a reference page; include in‐text citations (use citations whenever paraphrasing, using statistics, or quoting from the article). Please refer to your APA Manual as a guide for in‐text citations and sample references page. Additionally, include speaker notes in each of your slides.

Each member of the group must participate in the presentation to receive the point.

You can use a 3 x 5 index card note for your presentation. Do not read from your notes, PPT, or articles during your presentation, the index card only serve as a reference. Reading to your audience from your note or PPT without expanding on the information will cost the group 3% deduction from your total points.

Each student must submit a copy of his/her group PPT in the grade book.

Dress Code: Semi-Business attire or Your Clinical Uniform (If your group decide to wear Clinical Uniform, every member must wear Clinical Uniform, the same apply if your group decide to wear Semi-business attire – i.e.  all member must wear semi-business attire).

Grading Rubric: Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment.  Please see RUA Guidelines in Canvas. Mental Health Essay

Points for this Assignment: 50

Evaluation of Depression Clinical Practice Guidelines

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Evaluation of Depression Clinical Practice Guidelines

 

 

 

 

 

Abstract

Depression is a mental disorder characterized by chronically depressed mood and by a lack of pleasure in initially pleasurable activities. It may result in a variety of psychological and physical complications and reduce the ability to operate at work and at home. It is highly prevalent in the US. Despite its increased prevalence, its management has been controversial in the US, with the recommendation that its treatment, both pharmacologic and non-pharmacologic, is effective for about 60 percent of the affected individuals. This underscores the possibility of concluding whether the available guideline is trustworthy. Therefore, it needs further revision to direct the delivery of care to depression patients effectively.     Evaluation of Depression Clinical Practice Guidelines

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Healthcare Problem

  1. Description of Depression

Depression (major depressive disorder) is a common and significant clinical condition characterized by impaired mood, thinking, and behavior. Fortunately, it can be treated. Depression leads to feeling of sadness accompanied by a lack of pleasure in initially pleasurable activities. It may result in a variety of psychological and physical complications and reduce the ability to operate at work and at home (Goldman, 2019). Depression is a kind of mood illness characterized by chronic sorrow and lack of interest. It is distinct from the mood swings that individual encounter on a daily basis. Significant life experiences, such as grief or job loss, may trigger depression. However, psychiatrists consider grieving to be a component of depression only when it persists. Depression signs vary in severity from moderate to severe and the manifestations are as follows

  • Depressed mood
  • Loss pleasure in previously appreciated activities
  • increase or reduced appetite
  • increased or reduced sleep
  • Energy loss or excessive weariness
  • feeling of extreme guilt
  • impaired though process, decision making and concentration
  • Suicidal or self-harm ideations

Depression is a chronic condition, not a transitory one. It is composed of series lasting at least two weeks. Depression may endure weeks, months, or even years (Goldman, 2019).

  1. Epidemiology of Depression

Between 2013 and 2016, 8.1percent of American adults aged 20 and older experienced depression over a two-week period. Women (10.4 percent) were nearly twice as likely to suffer depression as males (5.5 percent). Depression was much less prevalent among non-Hispanic Asian people than it was among Hispanic, non-Hispanic black, or non-Hispanic white individuals (CDC, 2019). Depression prevalence reduced as family wealth grew. Around 80% of persons with depression reported experiencing at least some difficulties at work, at home, or in social situations as a result of their depression. Between 2007–2008 and 2015–2016, the proportion of American adults diagnosed with depression remained stable. Additionally, depression has been to affect the Hispanic and African American communities more than the rest of the United States population. Women have been found to suffer from depression more than their male counterparts. according to the Center for Disease Control (2019), depression has high prevalence in individuals whose income is below the poverty line, and that the prevalence for depression decreases as the amount of income increase (NIMH, 2020).

  1. Pathophysiology of depression
  1. Stress

Psychological stress and traumatic life experiences early in life are both significant intermediate indicators of depression’s development. While stress response suggests consistency or preservation of homeostasis, chronic stimulation of the stress response system may have detrimental or even deadly implications by increased risk of overweight, cardiovascular disorders, depression, as well as other illnesses (Ormel, et al., 2019). The hypothalamic–pituitary–adrenal axis (HPA) and its three major components —hypothalamic neurosecretory cells, pituitary gland, and adrenal cortex—function together to ensure successful adaptation to altered environmental circumstances and activation of the organism’s reserves in response to various types of stress. To begin, traumatic situations in one’s life are the most powerful triggers of depression. Second, depressive individuals usually have higher cortisol (the human endogenous glucocorticoid) and corticotropin (ACTH) levels in their plasma, urine, and cerebrospinal fluid (Ormel, et al., 2019). Additionally, depressed people have an enlarged hypophysis and suprarenal glands, as well as impaired corticosteroid receptors activity. Increased HPA axis stimulation is reported in 50percent of depressed individuals, and continued antidepressant treatment tends to reduce this stimulation. Evaluation of Depression Clinical Practice Guidelines

  1. Genetics

Depression is a highly varied condition. Some genetic variability is intrinsic to polygenicity; afflicted people may have diverse configurations of susceptible alleles and healthy persons may also have some of these variations (Ormel, et al., 2019). Depression is a polygenic condition originating from the combined action of multiple genetic variations with separately tiny effect sizes. Defects at particular loci affect strictly defined systems such as conduction of dopamine in the prefrontal brain (Shadrina, et al., 2018). Owing to these mutations, succeeding offspring’s have significant likelihood of experiencing depression.

  • Neurotransmitter Imbalances
  1. Norepinephrine

In individuals with Depression, Norepinephrine deficiency is related with a loss of positive emotional resources, including decreased enjoyment, motivation, pleasure, attention, vigor, and passion, as well as a loss of self-belief. Depression patients showed impaired Norepinephrine function in the lobar NE, which resulted in anhedonia, a lack of vigor and desire, and other associated depressive manifestations (Liu, et al., 2018).

  1. serotonin

5-HT deficit in the brain may exacerbate unpleasant feelings associated with Depressive disorders, such as depression, self-criticism, anger, worry, anxiety, aggressiveness, irritation, and isolation. Previous investigations discovered that blood 5-HT levels were considerably lower in individuals with MDD than in control subjects, implying a 5-HT deficit in people with MDD (Phillips, 2017). Similarly, postmortem investigations revealed decreased 5-HT and 5-HIAA levels in the central nervous system of depressive and suicidal individuals (Liu, et al., 2018). Reduced serotonin production over time may add to the increased vulnerability to MDD. Increasing scientific and clinical data establishes a relationship between antidepressant treatments and brain 5-HT systems, indicating that perturbation of central 5-HT systems plays a critical role in the pathogenesis of MDD. The serotonergic malfunction that contributes to the etiology of MDD is mostly due to decreased neuronal 5-HT production and aberrant 5-HT receptor activity.

  1. dopamine

Dopamine (DA) is a neurotransmitter found in the hypothalamus and pituitary gland that serves as a critical neurobiological substrate for pleasure, focus, desire, psychomotor speed, and the capacity to perceive pleasure, all of which may contribute to human emotion regulation. Depression is characterized by impairments in all of these processes (Liu, et al., 2018). Furthermore, instantaneous bidirectional modulation (suppression or stimulation) of specific midbrain DA neurons modifies several distinct depressed symptoms generated by chronic stress, indicating that mechanisms impacting symptoms of depression modify the limbic DA neuronal programming of action. Additionally, impaired DA neuron activity may result in depressed symptoms such as despair and lack of interest. In individuals with MDD, the amount of DA compounds in the CSF was significantly lower than in control subjects. Inadequate DA receptor activity may culminate to a breakdown of regulation from the prefrontal cortex to the amygdala, leading in amygdala hyperexcitability and the development of stress and abnormal anxiety.

  1. Clinical Practice Guideline

Depression management requires a thorough examination and accurate diagnosis. The evaluation should be depended on a thorough history, physical exam, and investigation of the patient’s mental status. History should be gathered from all possible sources, most notably family. The diagnosis should be made using the most up-to-date diagnostic criteria (Gautam, et al., 2017). The process of developing a therapeutic plan includes agreeing on the therapy environment, drugs, and psychological therapies that will be employed. Patients and carers may be contacted actively throughout the therapy plan’s development. A reasonable, practical, and adaptable therapy plan may be developed to meet the demands of clients and caregivers. Additionally, the treatment plan may be analyzed and updated on a continual basis. A thorough evaluation of the client’s suicide risk must be conducted. During the history taking process, suicidal thoughts and other adverse outcomes for suicide such as manic episodes, extreme anxiety, panic disorder, and alcohol or drug misuse must be assessed (Gautam, et al., 2017). In older individuals, it has been shown that the degree of depressive symptoms is a major predictor of suicide thoughts over time. Additionally, the evaluation covers a history of prior suicide tries, as well as the type of previous attempts. Additionally, patients’ family histories of suicide should be elicited. Apart from inquiring about suicidal ideations, it is critical to inquire about the extent to which the patient wants to act on the suicidal thoughts as well as the extent to which the individual has formed plans or started to commit suicide during mental status tests.

Many patients who suffer from depression recur. As a result, patients and, if necessary, their relatives may be taught about the danger of recurrence. They may be taught to recognize the warning indications and manifestations of recurrent episodes. Additionally, individuals might be urged to seek appropriate therapy as soon as feasible during a new episode to reduce the probability of a complete recurrence or consequence. Electroconvulsive therapy (ECT), psychosocial therapies and antidepressants, and are the primary treatment choices for depression. Other therapies that are less often used or are utilized in individuals with depression that is resistant to treatment include light therapy, repeated transcranial magnetic stimulation (rTMS), ,transcranial direct stimulation, deep brain activation, vagal nerve activation, and sleep deprivation treatment (Gautam, et al., 2017). Benzodiazepines are often used in conjunction with other medications, particularly during the early period of therapy. Additionally, thyroid supplements and lithium may be utilized as adjunctive therapy in rare circumstances when a patient does not react to antidepressants.

The fact that this guideline begins with assessment of the patient and monitoring, I believe it adequately addresses depression, given the diverse methods of treatment and assessment of the client. Involvement of caregivers and family and education to all of them regarding the management of depression is key of key importance. Management of depressive patients based on this guideline has been effective in controlling the disease. However, this management is rarely found in primary care. This means that individuals are not able to access the care until it is too late and the symptoms too adverse. Using this guideline laid by the American Psychological Association, clinicians and other care providers can follow a stepwise methodology for caring and treatment of depression patients, from assessment, through diagnosis and education to treatment and follow ups. This enables complete recovery of the patient as well as preventing relapse.

Management of depression patients is based on trial methods. this means that different antidepressants are prescribed to manage the disease in trial for which works best for the patient. I feel that this is not effective to try patients on several drugs before they are finally given the drug they could tolerate. This is because the drugs could have adverse effects that can be prevented by secure and selective prescription. Additionally, the effectiveness of nonpharmacological intervention of managing depression is highly depended on the psychotherapist, owing much to their character and personality, as well as skills and expertise acquired during practice. Due to this, it can be difficult to ascertain its effectiveness in managing depression. However, it has been found that medications do not work for all depressive patients, and that only 60 percent of the depressive patients can be treated with drugs (Schimelpfening, 2021)

  1. Analysis of the guideline

As mentioned previously that depression medication only account for about 60 percent recovery, it is important to revise the clinical guideline in quest to get a solution that can adequately cure depression. Additionally, non-pharmacologic interventions are not reliable since their effectiveness are dependent on the psychotherapist. There is a need to establish a dependable drug for treatment of depression. This will help to eliminate the try and error practice that is currently being used to manage depression patients. Also, there is need to in cooperate mental health screening in primary care as method of health promotion, in order to identify and treat depression early enough. This calls for a collaborative approach to manage the patient to ensure that the depression is done away with, and that relapses are eliminated. Furthermore, there are several antidepressants used despite the weak evidence for us. it would be important that these drugs are cleared so that only drugs with strong recommendations for use are utilized to manage depressive patients. The new guideline will ensure that there is a standard treatment of depression, and that following this treatment, clinicians are able to manage their patients well, to prevent recurrence of the condition and enhance patient satisfaction

  1. Evaluation

It is critical to examine the efficacy of a new or amended clinical practice guideline to ascertain how it influences patient care, practitioner behavior and knowledge, and the variables that lead to non-compliance, if any. The evaluation findings indicate whether the updated clinical practice guideline achieved the anticipated care outcomes and is helpful in treating and managing depression. The following methodologies are used to assess the updated depression clinical practice guideline’s efficiency:

  • The first stage in determining the amended guideline’s efficacy is to examine potential modifications in care service and practice as a result of the new guideline criteria. This is accomplished by analyzing the conversion of clinical practice and health outcomes in regions with very high levels of guideline promotion to the change in places with low levels of guideline implementation.
  • The next stage is to compare the change of healthcare outcomes in regions with a high rate of guideline adoption to those with a low rate of guideline adoption. This may be accomplished by conducting a focus group to highlight the primary factors that affected the guideline’s adoption.
  1. Learning points
  • Depression is a significant psychological disorder facing a large population in the United States, especially the Hispanic population, African American communities, and those whose income is low.
  • The current guidelines are not sufficiently addressing the problem of depression since it has been discovered that the current therapeutic measures are only helpful to about 60% of the affected individuals.
  • It is important to integrate mental health screening for susceptible individuals in to primary care to facilitate early detection and treatment of depression.

Conclusion

To conclude, depression (major depressive disorder) is a common and significant clinical condition characterized by impaired mood, thinking, behavior and feeling of sadness accompanied by a lack of pleasure in initially pleasurable activities. It may result in a variety of psychological and physical complications and reduce the ability to operate at work and at home. Its pathophysiology ca be explained in terms of neurotransmitter imbalances, genetics and stress. the current guidelines do not adequately address the issue since it is only effective in some people and therefore, they should be revised to ensure that the treatment is effective to all individuals.

 

 

 

 

 

 

 

 

 

 

References

CDC. (2019, June 7). Products – Data briefs – Number 303 – February 2018. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db303.htm

Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical practice guidelines for the management of depression. Indian journal of psychiatry, 59(Suppl 1), S34.

Goldman, L. (2019). Depression: What it is, symptoms, causes, treatment, and more. Medical and health information. https://www.medicalnewstoday.com/articles/8933

Liu, Y., Zhao, J., & Guo, W. (2018). Emotional roles of mono-aminergic neurotransmitters in major depressive disorder and anxiety disorders. Frontiers in psychology, 9, 2201.

NIMH » major depression. (2020). NIMH » Home. https://www.nimh.nih.gov/health/statistics/major-depression

Ormel, J., Hartman, C. A., & Snieder, H. (2019). The genetics of depression: successful genome-wide association studies introduce new challenges. Translational psychiatry, 9(1), 1-10.

Phillips, C. (2017). Physical activity modulates common neuroplasticity substrates in major depressive and bipolar disorder. Neural Plast. 2017, 7014146. doi: 10.1155/2017/7014146 Evaluation of Depression Clinical Practice Guidelines

Schimelpfening, N. (2021). What is the chemistry behind depression? Verywell Mind. https://www.verywellmind.com/the-chemistry-of-depression-1065137

Shadrina, M., Bondarenko, E. A., & Slominsky, P. A. (2018). Genetics Factors in Major Depression Disease. Frontiers in psychiatry, 9, 334. https://doi.org/10.3389/fpsyt.2018.00334

Children And Adolescents’ Health And Transition To Practice

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Children And Adolescents’ Health And Transition To Practice

APA format

1) Minimum 5 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.

ORDER A PLAGIARISM FREE PAPER NOW

           Part 1: minimum  1 page

           Part 2: minimum  3 pages

           Part 3: minimum  1 page

         

   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

         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 Children And Adolescents’ Health And Transition To Practice

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)

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

Part 2: 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: Children and adolescents’ Health

 

Topic: Collaboration in Pediatric Primary Healthcare

1. Describe an experience that you have encountered so far in your pediatric clinical rotation involving collaboration.

2. Describe if in your experience the collaboration resulted in improved patient outcomes.

3. In your experience, what barriers to collaboration have you observed?  Children And Adolescents’ Health And Transition To Practice

4. Why, in your opinion, effective collaboration is essential in providing quality healthcare

Part 2: Children and adolescents’ Health

 

Topic: Collaboration in Pediatric Primary Healthcare

This assignm3nt is specific to a particular pediatric primary care practice and is mostly based upon student observation and experience.

From your observations and experiences in your pediatric clinical rotation:

1. Provide an example of multidisciplinary collaboration (1 paragraph).

2. Provide an example of how multidisciplinary and family collaboration affects patient outcomes (2 paragraphs).

4. Discuss a particular case where collaboration among healthcare professionals and family members affected patient/family satisfaction (2 paragraphs) .

a. Patients

b. Family/caregivers.

4. Discuss a particular case where collaboration among healthcare professionals and family members affected patient/family satisfaction  (2 paragraphs).

5. In your clinical practicum. What are some barriers you have observed to collaboration among health care professionals, patients, and families? (2 paragraphs) Children And Adolescents’ Health And Transition To Practice

Part 3: Transition to practice

 

Topic: Utilizing Evidence Practice Guidelines

One of the ways that the NP can manage risk of being successfully sued for malpractice or negligence is by utilizing evidence practice guidelines.

1. Explain how these guidelines affect the “standard of care”

2. Discuss how utilizing this guideline can be a major strategy to significantly reduce risk to the provider.

Nursing homework help

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Nursing homework help

APA format

1) Minimum 6 pages  (No word count per page)- Follow the 3 x 3 rule: minimum three paragraphs per page

ORDER A PLAGIARISM FREE PAPER NOW

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

           Part 1: minimum  1 page

           Part 2: minimum  3 pages

           Part 3: minimum  1 page

           Part 4: minimum  1 page

   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

         Don’t write in the first person 

Don’t copy and paste the questions. Nursing homework help

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)

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

Part 2: Minimum  5 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

Include in APA format: Nursing homework help

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: Ethics

Check:

Can Rules Define Morality – YouTube

https://www.youtube.com/watch?v=2zPemOvB9sk&t=761s

1. Explain the two formulas inside Kant’s Categorical Imperative.

2. What makes the Categorical Imperative special?

3. Describe how to apply Kant’s moral philosophy to a moment in your life where you behaved wrong/immoral.

4. How can these two formulas make you realize you behaved wrong?

Part 2: Ethics

Topic: Deontology

Catch the films “Gone Baby Gone” and “Sleepers”.

Check:  https://www.youtube.com/watch?v=8rv-4aUbZxQ  (Michael Sandel’s 3 contrasts)

Kant’s Categorical Imperative

1. A person acts morally if his or her conduct would, without condition, be the “right” conduct for any person in similar circumstances (the “First Maxim”).

2. Conduct is “right” if it treats others as ends in themselves and not as means to an end (the “Second Maxim”).

3. A person acts morally when he or she acts as if his or her conduct was establishing a universal law governing others in similar circumstances (the “Third Maxim”).

1. Apply Kant’s moral philosophy to judge Patrick’s final decision (2 paragraphs)

a. “First Maxim”

b. “Second Maxim”

c. “Third Maxim”

2. Apply Kant’s moral philosophy to judge the final decision for “Sleepers” (2 paragraphs)

a. “First Maxim”

b. “Second Maxim”

c. “Third Maxim”

3. Apply Kant’s moral philosophy to judge the priest’s final decision (2 paragraphs).

a. “First Maxim”

b. “Second Maxim”

c. “Third Maxim”

4. Apply Michael Sandel’s 3 contrasts for Patrick’s final decision (1 paragraph)

5. Apply Michael Sandel’s 3 contrasts for the final decision for “Sleepers” (1 paragraph).

5. Apply Michael Sandel’s 3 contrasts for the priest’s final decision (1 paragraph).

Example:

In the case of ” Gone Baby Gone” the philosophical process you will follow in this pap3r should sound as something like this:

1. According to Kant’s first premise Patrick behaved moral because he returned the victim he was hired to find and without condition this is the “right” conduct for any detective in cases of kidnapping (the “First Maxim”). Here Kant speaks of doing the right prior to good.

2. On Kant’s second premise Patrick acted moral because he respected the dignity of Amanda and he treated her as an end in herself and not as means to an end like everyone else was doing in the film (the “Second Maxim”). Here Kant speaks of humans as special creatures and ends in themselves. Humans are ends, not means to an end. Los seres humanos son un fin, no un medio para un fin.

3. The conclusion is that a detective act morally when he reports a kidnapping to the police and this behavior should establish a universal law governing all detectives in cases of kidnapping (the “Third Maxim”). Here Kant asks us to test the universality of our action. Will it be OK if everyone does what I am about to do?

Part 3: Nursing research

1. Describe an issue at your current place of practice.

2. How would you submit a research proposal addressing the issue?

3. Describe a policy/procedure at your workplace that you would like to improve

4. Describe how do you improve this policy/procedure through evidence-based research

Part 4: Nursing theory

Topic: Barrett’s Theory of Power as Knowing Participation in Change

1. Reflect upon the events that are taking place in healthcare today (Covid-19 Pandemic).

2. How do you apply Barrett’s Theory to these events

3. What will be the benefits of applying this nursing theory:

a. Patients

b. Health

c. Nurses