Identify the methodology, design, and rationale of the following titles.

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4 pages due in 24 hrs

Discussion Question 1( 2 pages)

Identify the methodology, design, and rationale of the following titles.

  1. Exploring the rate of seasonal-pattern depression in an Inuit community
  2. Democracy in America
  3. The relationship between compassion fatigue and burnout among critical care nurses
  4. Two drugs for Alzheimer’s show promise
  5. Evaluating technology with student success
  6. Factors that influence weight control among women
  7. The meaning of living with brain injury and stroke 10 years after the injury
  8. Exploring the beliefs of healing among Aborigines

Discussion Question 2(2 pages)

Using the South University Online Library, research workforce issues and patient safety.

Based on your research, complete the following tasks:

  • Identify and describe the research problems, purpose, objectives, and hypothesis of the research.
  • Evaluate the credibility and validity of the study.

Suggested References:

Shisana, O., Rice, K., Zungu, N., & Zuma, K. (2010). Gender and poverty in South           Africa in the era of HIV/AIDS: A quantitative study. Journal of Women’s           Health (15409996), 19(1), 39–46.

Ko, E., Nelson-Becker, H., Park, Y., & Shin, M. (2013). End-of-Life decision making           in older Korean adults: Concerns, preferences, and expectations. Educational           Gerontology, 39(2), 71–81.

Witzke, J., Rhone, R., Backhaus, D., & Shaver, N. (2008). How sweet the sound:           Research evidence for the use of music in Alzheimer’s dementia. Journal of           Gerontological Nursing, 34(10), 45–52.

Sandvik, A., Melender, H., Jonsén, E., Jönsson, G., Salmu, M., & Hilli, Y. (2012).           Nursing students’ experiences of the first clinical education: A nordic           quantitative study. Nordic Journal of Nursing Research & Clinical Studies /           Vård I Norden, 32(3), 20–25.

Cooper, C., Taft, L., & Thelen, M. (2004). Examining the role of technology in           learning: An evaluation of online clinical conferencing. Journal of           Professional Nursing, 20(3), 160–166.

Roulston, A., Bickerstaff, D., Haynes, T., Rutherford, L., & Jones, L. (2012). A pilot           study to evaluate an outpatient service for people with advanced lung cancer.           International Journal of Palliative Nursing, 18(5), 225–233.

What were the skills required of nurse

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MSN degree need initial discussion to the assignment below 1-2 pages4 References one from Walden University LibraryDue tonight by 10 pm EST.  Will pay 15.00$What were the skills required of nurse e

 MSN degree need initial discussion to the assignment below 1-2 pages

4 References one from Walden University Library

Due tonight by 10 pm EST.  Will pay 15.00$

What were the skills required of nurse educators yesterday, what are they today, and what will they be tomorrow?

Though nursing has long been a forward-thinking profession, there is much value in looking to the past to better build for the future. Examining societal, political, and global trends allows nurse educators to develop programs that will meet the needs of their future learners. In addition, taking time to consider the volatility of the economic landscape, as well as the swift changes brought on by technology and medical informatics, nurse educators can better prepare themselves to teach students, staff, and patients.

In this Discussion, you creatively and critically explore the evolution of nursing education and thus the evolving role of the nurse educator.

To prepare:

  • Review Chapter 1, “Best-Laid Plans: A Century of Nursing Curricula” in the Keating course text. How has the nursing profession evolved in response to societal, economic, political, and technological factors? How has this evolution directly impacted the role of the nurse educator?
  • Review Chapter 17, “Issues and Challenges for Nurse Educators” also in the Keating text. Consider how the issues and challenges of today’s nurse educators differ from those of past nursing educators. Then, imagine the issues and challenges that might arise for tomorrow’s nurse educators in both clinical and academic settings.
  • Explore the website “Creative Writing Now” to review the parameters for writing a haiku. With this information in mind, write a haiku using the following questions as a guide:
    • If the first line of the haiku represented the roles of past nurse educators, what five-syllable description would you create?
    • If the second line represented the roles of today’s nurse educators, what seven-syllable description would you create?
    • If the third line represented the roles of tomorrow’s nurse educators, what five-syllable description would you create?

DPI Project Proposal Chapter 1 – Introduction to the Project Chapter 1 of the DPI Project is entitled "Introduction to the Project" and includes background and other essential informatio

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DPI Project Proposal Chapter 1 – Introduction to the Project               Chapter 1 of the DPI Project is entitled “Introduction to the Project” and includes background and other essential informatio

DPI Project Proposal Chapter 1 – Introduction to the Project              

Chapter 1 of the DPI Project is entitled “Introduction to the Project” and includes background and other essential information regarding the overall DPI Project design and components.  

General Requirements:  Use the following information to ensure successful completion of the assignment: 

•Locate the “DPI Proposal Template” located in the PI Workspace of the DC Network. 

•Access The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing textbook from DNP-801. The direct link is: http://gcumedia.com/digital-resources/jones-and-bartlett/2013/the-doctor-of-nursing-practice-essentials_ebook_2e.php 

•You may also find it helpful to access the The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing textbook from DNP-801, which you have been using throughout the program. Chapter 10 of this textbook provides an excellent template for a DNP-focused scholarly project. 

•Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is 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.  Directions:  Use the “DPI Proposal Template” to help you develop a draft of the Introduction (Chapter 1) of your DPI Project Proposal. Keep in mind this is an outline and formatting structure; it may be of use to you, but recall that each project will vary in nature and scope, so adaptations to this format may be required.  

Sections in Chapter 1 include: 

1. Introduction 2.Background of the Project 

3. Problem Statement 

4. Purpose of the Project 5.Clinical Question(s) 6.Advancing Scientific Knowledge 

7. Significance of the Project 

8. Rationale for Methodology 

9. Nature of the Project Design 

10. Definition of Terms 

11. Assumptions, Limitations, Delimitations 

12. Summary and Organization of the Remainder of the Project  Much of this information can be gleaned from your DPI Prospectus, but you will find that new as well as expanded content in specific areas will be required, depending on the nature of your proposed DPI Project.

Interviewing A BSN

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Interviewing A BSN

Methodist College

N100: Nursing Seminar

“Interview a BSN”

Purpose:

The purpose of this assignment is to understand the role of a professional nurse and their place within the healthcare team and be inspired to emulate these nurses in a professional manner in one’s own practice.

Instructions:

Interview a practicing BSN and describe their experience or career thus far. Ask them the following questions and then summarize their answers in 3-5 pages. Format the paper according to APA guidelines. Interviewing A BSN

 

Questions:

 

  1. Describe your present position

 

I work in the Emergency Department as an RN at Carle Hospital. In my current role, I triage patients coming in through our waiting room and brought in by ambulance and law enforcement. After triage, I put in orders from a list or given verbally by doctors, place IV and arterial lines, draw and send labs, give medications, suture and wrap wounds, place foley catheters, IO’s (intraosseous access points through drilling into a bone), and NG (nasogastric) and OG (orogastric) tubes, collect and run blood and urine samples, turn patients, clean patients, and chart a TON of information. When a patient is discharged, I go through education, follow up instructions, and often help patients find a ride home.

 

I see everything from common colds and stubbed toes to critical and traumatic injuries. I see newborns, elderly, and everything in between. This is a high impact, high adrenaline, highly stressful, and physically demanding position. In addition to the patients I care for, I also deal with families, coworkers, subordinates, and managers in tense situations daily. Many times, these are the worst days of peoples’ lives. I see people at their weakest, most vulnerable, and most scared moments. Some days, I do CPR on, administer blood for, put lines and tubes into a patient, give them every medication available, and still hold their loved ones’ hands at the end of the day as I sit while the doctors explain what is happening. It is exciting, terrifying, emotionally draining, and invigorating in ways I don’t know how to express. I love what I do. Interviewing A BSN

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In addition to seeing patients, I complete chart audits for other nurses and am continually enrolled in new certification classes to improve patient outcomes. Most recently, I have begun precepting and am involved in a new overdose prevention program. In my current position, there are constant opportunities to learn new things and be involved with my department.

 

  1. Describe your educational journey. Was it important for the position that you presently hold?

 

I started my BSN program at Lakeview College of Nursing in Danville, IL in September 2019. I signed up for an accelerated program, which allowed me to complete my nursing degree in 4 back-to-back semesters. Shortly after the end of my first semester, COVID shut down in person classes, clinicals, and other hands-on educational opportunities. Lakeview worked hard to ensure we were allowed as many options as possible, but a majority of my learning was through a computer. My instructors kept telling me, “It’s okay, you’ll learn on the job as you go!”. I was terrified that my lack of patient interaction would be a huge detriment.

In my last semester, hospitals had begun to open limited access to in-person clinicals. Lakeview offered a course called Concept Synthesis, which allowed us to put down areas we were interested in. These were opportunities for long-term clinicals in a specialized area. I put down pediatrics and oncology as my 2 top choices. Shortly after I turned in my paper indicating areas I was interested in, I was approached by my instructor who told me neither of those areas were available due to COVID restrictions, but they had a spot in “Specialty Surgery” at the Polyclinic. This sounded interesting, and I assumed I might see a variety of patients in this setting. Given no other options, I accepted. Interviewing A BSN

Following my first month, I learned this was a clinical office where patients were seen BEFORE their surgical appointments. At this time, selective surgeries were shut down due to COVID, and most patients who needed surgery were admitted straight through the emergency department. There were 2 weeks where I saw no patients during my clinical time. I told my instructor I needed something different if anything else became available. The following week, she told me there were a few nurses who had chosen emergency medicine as their interest area, and the Emergency Department at OSF had decided to allow a few students in to shadow nurses.

During my final weeks of clinicals, I followed nurses and observed. There were not a lot of opportunities for hands-on interaction, as I was told COVID guidelines limited the number of staff allowed to interact with patients. I placed a total of 3 IVs on patients during my entire tenure of nursing school. I never saw an infant or child as a patient, and I never observed a trauma. None of this was any fault of my school or clinical site, but it left me feeling very unprepared to enter the nursing world.

Nearing graduation, I applied to the pediatrics department at Carle. I got a call 2 days later for an interview, but I was informed that, (again) due to COVID restrictions, pediatrics was not currently accepting any new staff. The recruiter who called me about the interview asked if I would be willing to attend an interview with multiple departments that were currently hiring, and I said yes. Within 2 hours of my online interview with a room full of hiring managers, I got a call from my recruiter. “Given your background of clinicals in the emergency room, you have an employment offer from our emergency department. Would you like to accept?” Emergency medicine had never been on any list of goals or plans in my life… but I knew I wanted a position at Carle, and there was one on the table. I accepted. Interviewing A BSN

Unintentionally, my educational experience at Lakeview is the sole reason I am where I am. My instructors and classroom experiences definitely prepared me for many situations I encounter daily on the job. The fact that my instructor and school worked hard to identify clinical experiences for

us was invaluable. I’m thankful every day that they worked to give me this opportunity.

 

  1. What is your definition of nursing?

 

  1. Which of these statements would you consider your current focus of practice?
    1. Promoting health and wellness
    2. Preventing illness
    3. Restoring health
    4. Caring for the dying

 

My focus of practice is restoring health. While I do all of the above, people come through the emergency department because they have an existing problem that they want to see fixed. During discharge instructions, I try to focus on promoting health and wellness through education, but this is not the primary focus of my practice. I do not typically prevent illness as the people who come to me already have something wrong, and while I do care for the dying, it is a short-lived, very temporary aspect of my job.

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  1. What is the setting that you currently practice in? (hospital, clinic, specialty office, etc.)

I work in a hospital setting. I knew immediately during my first 2 weeks of clinical office experience that a clinic and office setting were NOT for me. I was bored out of my mind… No amount of time off or set schedules could sell me on working in an office setting, but I can see how many people would enjoy this!

 

  1. What stage would you be considered in Benner’s Stages of Nursing Expertise?
    1. Novice: no experience, limited performance and governed by policies and procedures
    2. Advanced Beginner: first two years in practice, recognizes situations and can make judgements, still needs some assistance
    3. Competent: 2-3 years’ experience; good organizational skills; Can prioritize; can multi-task
    4. Proficient: 3-5 years’ experience; holistic understanding of client, improved decision making and focused on long-term goals
    5. Expert: highly proficient, flexible; doesn’t require rules or guidelines to understand situation; intuitive and analytic; has “gut” feelings that help in decision making. Interviewing A BSN

 

I currently fall into the category of “Advanced Beginner” in Benner’s Stages of Nursing Experience as I have less than 2 years of experience. However, Carle does a great job of pushing us to be our best as quickly as possible. We are taught to multi-task, prioritize, and trust our guts very early on.

 

Our team mates and providers who we work with trust us and ask for our input regularly. They are great with constructive criticism that lets us know when we are on the right path and where we can improve. In my department, and in all specialty departments, we spend months one-on-one with a preceptor who oversees all of our patient care and charting until we are deemed ready to practice on our own. There is a whole lot of valuable feedback during this time. In addition, our management puts a huge emphasis on helping us identify and work toward reaching long-term goals.

 

  1. What role(s) would you describe in your present position? (provider of care, educator, manager, researcher, collaborator, patient advocate, counselor, change agent, or case manager)

 

I am, first and foremost, a provider of care. Patients come in with an illness or injury, and it is my job to improve their outcomes. However, I also regularly act as a collaborator with other staff and departments, counselor to patients and families, case manager in arranging rides home for patients, and patient advocate when I might question a treatment plan or diagnosis.

 

In the emergency department, I work with the same doctors, physician assistants, and advanced practice nurses every day. They truly value my input and trust my judgement. Often, they will allow me to help devise a treatment plan I feel will help with a particular patient. One doctor specifically told me within my first month on the job that “You guys (nurses) spend WAY more time talking to the patients than we do. Sometimes, you know best!” Our doctors are amazing at recognizing us as professionals and openly respecting our opinions.

 

I just took on a role as an educator through precepting new nurses. I will have one nurse for 5-6 months depending on progress who will begin by shadowing and then progress to taking on his or her own patients. I oversee their patient care, charting, and interactions with other providers. This allows me to share all that I have learned so far and learn with them along the way. I am thankful for this opportunity as teaching and mentoring has always been a passion of mine!

 

  1. Do you belong to a professional organization? Which one and why? Interviewing A BSN

I do not belong to a professional nursing organization, but I do belong to a pharmacy organization because my employer provides this service, and it allows me to keep my continuing education credits up to date for free. In addition, I get a quarterly newsletter on topics affecting my profession

 

  1. What do you see as the biggest influence on your practice today?
    1. Healthcare reform
    2. Nursing shortage
    3. Consumer demand
    4. Changing technology
    5. Legislation

On a personal level, my practice is most influenced by consumer demand. We have had days where we have had patients in every room, in tents outside, and in hallways surrounding the nurses’ stations. At times, it has truly looked like a scene from some disaster movie. This affects all patient care. My employer had truly done a fantastic job of lessening the blow of staffing shortages, but I frequently hear horror stories from travel nurses in my department. Now that the strain of COVID is lessening, it can be hard to keep a full staff on. Employees are sometimes sent home early or put on standby if the census is too low. Over the past two years, we have had several waves of too many patients and not enough patients. This has led to even more nurses leaving due to burn out, stress, being overworked, OR not having enough work to pay bills at times. This fluid environment increase stress across the board of every part of my profession in the emergency department.

 

  1. What part of this person’s career has inspired you the most? How do you foresee yourself in the future at the same time/point in your career?

 

  1. What have you learned in this course that confirms what you thought about nursing? What have you learned that is new to your understanding of nursing? Give examples.

 

Rubric

Criteria Points Possible Points Earned
Describes the nurse’s present job position and education journey. 5
Identifies the nurse’s personal definition of nursing. 2
Identifies the current focus and setting of nursing practice. 2  
Identifies what stage of Benner’s theory the nurse is considered to be. 2  
Describes the role(s) of the nurse’s current position. 5  
Identifies membership of a professional organization and why it was chosen. 2  
Discusses the biggest influence on current practice. 5  
Explains what has inspired you most and how you foresee yourself in your future career. Interviewing A BSN 10  
Discusses what you have learned, including both new and supporting information for your thoughts and understanding of nursing. 10  
APA Requirements
Required number of references (2) 2  
Title Page, Running head, Margins, Spacing, Font, Page Numbers, Introduction, Conclusion, Headings, Reference Page, Citations 5
Final 50

 

Assignment Week 9 – NRNP 6635 – Case Study

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Assignment Week 9 – NRNP 6635 – Case Study

 

ASSIGNMENT INSTRUCTIONS:

 

  • Select a patient that you examined during the last 2 weeks who presented with a disorder (See attached Case study – Week # 9)

 

  • Conduct a Comprehensive Psychiatric Evaluation on this patient and use the template provided to complete the assignment. There is also a completed exemplar document that you can see an example of the types of information a completed evaluation document should contain. ( see attached documents)

 

  • Include at least five (5) scholarly resources to support your assessment and diagnostic reasoning.

 

  • Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value. Assignment Week 9 – NRNP 6635 – Case Study

 

  • Subjective:What details did the patient provide regarding their personal and medical history? What are their symptoms of concern? How long have they been experiencing them, and what is the severity? How are their symptoms impacting their functioning?

 

  • Objective: What observations did you make during the interview and review of systems?

 

Assessment: What were your differential diagnoses? Provide a minimum of three (3) differentials with supporting evidence. List them from highest to lowest priority. What was your primary diagnosis and why? Explain what rules each differential in or out and justify your primary diagnosis selection. Include pertinent positives and pertinent negatives for the specific patient case.

 

 

Reflection notes: What would you do differently in a similar patient evaluation? 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? Assignment Week 9 – NRNP 6635 – Case Study

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.).

Demographics: Female, 41 years-old Hispanic on disability. The higher level of education High School.
Setting: Private Office, follow up appointed after discharged from inpatient psych admission.
Reason for and Type of Visit: “I was admitted to a mental institution for five days after I tried to kill myself taking an overdose in my medications. They discharged me from the hospital three days ago.”
Diagnosis:
F31.64 – Bipolar disorder, current episode mixed, severe, with psychotic features
Rating Scales: BDRS – The Bipolar Depression Rating Scale: 14
History of Present Illness: 41-year-old female, Hispanic with a previous medical history of Bipolar Disorder, perceptual disturbances, and auditory hallucinations, present to this private office for an initial psychiatric evaluation and follow up after discharge from inpatient hospitalization three days ago. The patient said she complains about her treatment and medications as prescribed by her doctor. The patient said she is not feeling depressed, or having passive death wishes and is not hearing any voices currently. Patient report normal sleep (6-7 hours) and a good appetite. The patient recognized she has a history of poor medication compliance and said she wants a referral to start an outpatient program to help her with her treatment.
Psychiatric History:
The patient was in the hospital for five days after she tried to kill herself by overdose, she was discharged three days ago. The patient state she was hearing voices telling her to kill herself, and she was following the voices. The patient ingests ten pills of clonazepam belongs to her partner. The patient with long psychiatric history with multiple psychiatric admissions. The patient state she has two previous suicidal attempts by overdose and one by jumping in front of a moving car. Patient report PHP 2 years ago. She is not attending any therapy or outpatient program at this time.
Substance Abuse History: The patient report a history of substance abuse, alcohol abuse, cocaine abuse, and cannabis abuse since her 20’s. She participated and completed a voluntary rehabilitation program ten years ago, and the patient denies any substance abuse currently. UDS review form previous hospitalization is negative. Assignment Week 9 – NRNP 6635 – Case Study
Family Psychiatric History:
Patient report that her mother had a history of bipolar disorder and Major Depressive disorder, and she kills herself by overdose when a patient was 12 years old. The patient’s sister has a Depressive Disorder.
Medical/Surgical History: The patient doesn’t have any medical or surgical history.
Medications:
The patient was discharge from impatient hospitalization with the following medications:
Klonopin 0.5mg po bid
Prozac 20mg po qam
Zyprexa 10mg po qhs
1. KLONOPIN
Generic Name: clonazepam
Brand Name: KlonoPIN
Class: Benzodiazepine (anxiolytic, anticonvulsant)
Side Effects: respiratory depression, dependency, abuse, seizures, suicidality, hypotension, orthostatic tachycardia, syncope, blood dyscrasias, hepatomegaly, CNS stimulation.
Patient education: Contact your primary PCP if you feel increased depression, uncommon variations in conduct, or feelings about suicide or hurting yourself; Clonazepam might cause dependence, don’t share your medication with nobody. Keep your medicine in a room or place nobody else can have access; Take the tablet totally, with a full glass of water; do not stop using this medication abruptly, or you might have an unfriendly withdrawal warning sign, as well as seizures (convulsions).
2. PROZAC:
Generic Name: fluoxetine
Brand Names: PROzac, PROzac Weekly, Sarafem
Class: SSRI (Selective serotonin reuptake inhibitor); often classified as an antidepressant.
Side Effects: Nausea, drowsiness, dizziness, anxiety, trouble sleeping, loss of appetite, tiredness, sweating, or yawning may occur.
Patient Education: Share with your PCP all the medications you are taking, including the over the counter medications. Report to your PCP if you have feelings and thoughts of suicide or self-harm. You need to visit your PCP frequently to check your progress. Do not change the dosage or the frequency of this mediation without consulting your doctor.
3. ZYPREXA:
Generic Name: olanzapine
Brand Names: ZyPREXA
Class: Atypical antipsychotic (serotonin-dopamine antagonist; second generation; mood stabilizer)
Mechanism of Action: mechanism of action is unknown; antagonizes dopamine, serotonin 5-HT2, and other receptors (thienobenzodiazepine) Assignment Week 9 – NRNP 6635 – Case Study
Metabolism: liver extensively; CYP450
Side Effects: Drowsiness, dizziness, lightheadedness, stomach upset, dry mouth, constipation, increased appetite, or weight gain may occur.
Patient Education: Avoid doing activities outdoors, including exercise direct under the sun or high humidity, do not use hot tubs. Drink fluids and dress lightly; stand up slowly when you are in a sitting or lying position; this medication can be taken with or without food. Follow your PCP directions.

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Mental Status Exam:
Appearance and behavior: fair hygiene and groomed, cooperative
Eye contact: fair
Level of Alertness: Alert
Mood: euthymic
Affect: congruent
Speech: normal in volume and rate
Thought processes: linear
Thought content: goal-directed
Perceptual disturbances: none report (hx. of Auditory Hallucinations)
Insight/judgment: Good
Suicide ideations/intent/plans: denied
Homicidal ideation/intent/plans: denied.
Points Discussed in Visit: Speaking points with the preceptor
• Medication reconciliation after discharge
• Diagnostic
• Poor medication compliance
• Recommended treatment and therapy
Therapy Recommendations:
The patient is not attending any therapy currently.
The therapy recommended for Bipolar Disorder: Cognitive Behavioral Therapy (CBT) is an individual therapy motivated on the connection between the patient’s mental state, thoughts, and comportments. CBT shows the patient in what way he/she can identify negative thoughts and how to create positive and constructive ways of thinking. Assignment Week 9 – NRNP 6635 – Case Study
Clinical Impression: 41 years old female Hispanic, with PPHx of bipolar disorder, cocaine abuse, cannabis abuse, and alcohol abuse, appears older than her chronological age. The patient appears clean, with fair eye contact. On exam, the patient is in no distress, calm, cooperative, with a linear, organized thought process. No evidence of psychosis or mania/hypomania. The patient mood is euthymic and affect congruent. The patient reports good energy, appetite, sleep (6-7h nightly), denies any suicidal ideation, and denies perceptual disturbances. She denies racing thoughts. The patient denies current issues with anxiety or panic attacks. The patient doesn’t report any other complaints currently.
Diagnosis Code:
F31.64 – Bipolar disorder, current episode mixed, severe, with psychotic features
Treatment Recommendations:
Recommended to the patient to continue with home medications
Patient educated of medication side effects, and benefits of treatment. Patient verbalized understanding. Discussed signs of patient illness and symptom management.
Labs ordered: None at this time – Review of labs results from the previous hospitalization –
Intervention Therapy: The patient recommended to initiate CBT therapy. Practice stress management techniques and incorporate recreational techniques.
The patient referred to the PHP program of Miami Dade County.
The patient instructed to take medication as prescribed. Avoid alcohol. Avoid caffeine and continue with a healthy diet.
The patient instructed to come back for a follow-up consultation in 2 weeks or sooner if needed.

References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. DSM-5, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. (2013)
Stahl, Stephen (2015). Essential Psychopharmacology Prescriber’s Guide. Fifth Edition. New York, NY Cambridge University Press.

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Exemplar

(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.)

CC (chief complaint): A brief statement 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. Assignment Week 9 – NRNP 6635 – Case Study.

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.

Paint a picture of what is wrong with the patient. This section contains the symptoms that is bringing the patient into your office. 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. Assignment Week 9 – NRNP 6635 – Case Study

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. Assignment Week 9 – NRNP 6635 – Case Study

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 head to toe, 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. 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

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. Assignment Week 9 – NRNP 6635 – Case Study

 

 

 

 

project management methodology

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project management methodology

The purpose of this assignment is to contrast common project management methodologies that can be utilized in health care project management. Conduct your own research so you are able to contrast Lean/Six Sigma, Waterfall, PSDA, and Agile methodologies. In addition, select another project management methodology of your choice.

 

Use the Project Management Methodologies template to complete the assignment.

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This assignment requires two to three scholarly resources.

 

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. project management methodology

 

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

 

Project Management Methodologies Template

Directions: Research information about the project management methodologies listed below to complete the table. In addition, conduct your own research on other project management methodologies and include this in the table below. The assignment requires a minimum of two or three scholarly resources. A resource may be used more than once in the last column of the template. project management methodology

 

Lean/Six Sigma

Waterfall

PDSA

Agile

 

Project Management Methodology Description Pros Cons Example of when this methodology would be appropriate Scholarly Resource
Lean /Six Sigma          
Waterfall          
PDSA          
Agile          
Choose an additional project management methodology here          

 

Rubric

The required elements for Lean/Six Sigma are present and thorough.

The required elements for Waterfall are present and thorough. project management methodology

ALL

Identify a nursing informatics role that is of particular interest to you. Conduct further research to find out how this specific role might contribute to patient safety, quality of care, nurse efficiency, the implementation of new informatics initiatives, and/or electronic health records.

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NURS 6401

Discussion: The Roles of Nurse Informaticists

Just as the Internet and other technological innovations have radically changed the world, the constant evolution of informatics continues to transform nursing and health care. The nurse is at the forefront of this transformation, serving as a knowledgeable leader in system development, implementation, and management. As new technologies become integrated into health care settings, the nurse informaticist areas will continue to become more critical.

For this Discussion, you examine the informatics areas that have evolved to facilitate this transformation. You consider different functional areas and responsibilities that nurse informaticists may fulfill and how they contribute to technological progress throughout the health care field.

Note: There are many different terms used to refer to “nurse informaticist,” including informatics nurse, nurse informatician, and informatics specialist. In this specialization, the term “nurse informaticist” is applied, adhering to the American Association of Colleges of Nursing (AACN) terminology.

To prepare:

  • Review this week’s media presentation, The Role of Nurse Informaticists, reflecting on the impact that informaticists have on health care settings.
  • Using the American Medical Informatics Association web resource in this week’s Learning Resources, investigate the various working groups associated with nursing informatics.
  • Identify a nursing informatics role that is of particular interest to you. Conduct further research to find out how this specific role might contribute to patient safety, quality of care, nurse efficiency, the implementation of new informatics initiatives, and/or electronic health records.

By Day 3

Post a description of a nursing informatics role that that is of interest to you and why. In your posting, explain how the nurse informaticist in this role impacts one or more of the following: patient safety, quality of care, nurse efficiency, the implementation of new informatics initiatives, and/or electronic health records. Justify your reasoning by citing authentic examples and references to the research literature.

Read a selection of your colleagues’ responses.

By Day 6

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

  • Ask a probing question, substantiated with additional background information, evidence or research.
  • Validate an idea with your own experience and additional research.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Michael’s Case Study Discussion

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Post with a minimum of 250 words must contain at least (2) professional references, properly cited in the current APA format.

Discussion Topic

Michael is a 22-year-old college student who lives off-campus. Although he has a kitchen in his apartment, he has neither the time nor the interest in making his own food or stocking his own kitchen. All three of his daily meals come from fast-food restaurants. A typical day’s intake is shown below: Michael’s Case Study Discussion

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Breakfast: Two egg and bacon sandwiches on English muffins; large coffee with creamer and sugar

Lunch: Two cheeseburgers with catsup; large French fries; soft drink; cookies

Dinner: A foot-long submarine with cold cuts, cheese, mayonnaise, lettuce, tomato, onion, and pickles; bag of potato chips; soft drink

Snacks: Chocolate bar; chips and salsa; popcorn

  1. What vitamins is Michael probably lacking in his diet? What vitamins is he probably getting enough of?
  2. Are there better choices he could make at fast-food restaurants that would improve his vitamin intake?
  3. What suggestions would you make for keeping “quick” and “easy” food in his apartment that would improve his vitamin intake without being too much “bother”?
  4. How would you respond to this question from Michael: “Can I just take a multivitamin so I don’t have to make changes in my eating habits? Michael’s Case Study Discussion

Describe the selected population in your PICOT/research question and its unique health care needs. (See template for PICOT development below.)

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Type of ResearchType of Service Course WorkUrgency 12 to 18 hours Citation Style APA StyleNo. of Pages/Wordcount 2 page(s)/ 550 WordsNo. of Sources/References 3English: English USDescription Devel

Type of Research

Type of Service 

Course Work

Urgency 12 to 18 hours 

Citation Style APA Style

No. of Pages/Wordcount 

2 page(s)/ 550 Words

No. of Sources/References 

3

English: English US

Description Develop a research question in the PICOT format—population, intervention, comparison, outcome, and time—that relates to your current work environment or to a particular nursing interest. Consider a specific nursing intervention or nursing policy with a specific culture or patient population as the focus. In addition to developing a PICOT question, discuss the role of theory in evidence-based health promotion practice, and address the following:

Describe the selected population in your PICOT/research question and its unique health care needs. (See template for PICOT development below.)

Select a theory, and apply it to your chosen nursing intervention or nursing policy. Why did you choose this theory?

When thinking about how to evaluate (obtain an outcome) its effectiveness, what would you measure? Would you measure lab values, interview participants, or both? Why did you select the method? 

Include at least 2 scholarly articles supporting your post.

Template Examples:

The following templates can be used to develop your PICOT question:

For an Intervention question: 

• In __________ (P), how does __________ (I) compared with __________ (C) affect __________ (O) over __________ (T period of time)? 

For an Etiology question: 

• Are __________ (P) who have __________ (I) compared with those without __________ (C) at __________ risk for __________ (O) over __________ (T period of time)? 

All sources should be cited using APA format. Grammar, spelling, punctuation, and format should be correct and professional.

Note: The question developed here will be the basis for the projects in the course; that is, the literature review in Unit 3 and the project in Unit 4. Include at least 2 references to research sources. When responding to your peers this week, please provide them with constructive feedback on their PICOT question. You may need to revise your PICOT question based on instructor/peer feedback

Which science-based theories do you think are the most useful to advanced practice nurses, and why?

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I need 150 words for each question and individual reference for each. Please, No Plagiarized work. MODULE 1 Q1 Identify a historical change or event that had significant impact on the development of n

I need 150 words for each question and individual reference for each. Please, No Plagiarized work.

MODULE 1

Q1

Identify a historical change or event that had significant impact on the development of nursing theory. Discuss the effect of the change/event on nursing from that point forward, the contribution(s) to nursing that resulted, and how it relates now to successfully preparing the DNP for practice.

Q2

Provide one definition and an outline of the structure of theory. Debate the purpose of theory and your perspective on the role theory or the lack of theory in today’s nursing practice environment. What purpose (if any) does theory contribute to your area of nursing practice?

MODULE 2

Q1

Define the process of theory building. Discuss the differences in approach based on inductive versus deductive reasoning. Describe how you would build and test theory in your practice area.

Q2

Select a nursing model or theory described in your textbook. What are the key concepts and components of the example you selected, and how are they defined? Create an example describing the application to an area of nursing practice.

MODULE 3

Q1

Compare and contrast a minimum of two middle range theories and discuss potential applications in your specific area of nursing practice.

Q2

Conduct a literature search in the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the terms middle range theory, mid-range theory, and nursing. Select one of the articles where the development of the middle range theory is the major focus of the paper. Share the article citation and describe how the theory was developed.

MODULE 4

Q1

Describe a recent or current ethical issue you have faced in nursing practice or which has attained national attention. Discuss the application of ethical theories or principles to the issue. Support the application with sound reasoning.

Q2

Consider yourself in a role in which you are accountable for allocation of scarce health care resources for a given situation. Discuss how ethical principles, virtues, and values affect your decision making. Describe your process for ethical decision making. How might a resolution cause conflicts between personal values and beliefs and the perspective of the community or organization?

MODULE 5

Q1

Learning theories have implications for advanced practice nurses outside the classroom. Share an example describing the application of learning theory or theories to develop a program targeting change to a specific organizational issue, patient lifestyle, or specific unhealthy behaviors.

Q2

Health behavior change theories suggest behavior change as a “process,” not an “event.” How can you put this into action for developing an intervention for practice or research? Discuss how you would apply this in planning your DNP project.

MODULE 6

Q1

Discuss “Envisioning Recovery” as an overarching framework for practice development and focus for all health care treatment.

Q2

How can the knowledge of economic theory be utilized by advanced practice nurses? How can economic theory be applied in analysis of interventions?

MODULE 7

Q1

How can the DNP-prepared nurse apply the concepts of a complex adaptive system to individual patient care? Provide examples.

Q2

Research change theories in scholarly literature and on the Internet. Develop a scenario and describe application of a change theory from the perspective of an advanced practice nurse leader.

MODULE 8

Q1

Which science-based theories do you think are the most useful to advanced practice nurses, and why?

Q2

Explore various science-based theories. Select two theories to describe to your peers. How is each of these theories relevant to application for a DNP-prepared nurse.