Evidence Based Inquiry for Scholarship and Practice-MSN563

/in /by

Evidence Based Inquiry for Scholarship and Practice-MSN563

 

ORDER A PLAGIARISM FREE PAPER NOW

 

 

Project Purpose Statement, Background, Significance, and the PICOT Clinical Formatted Clinical Project Question

                                                                             

 

 

College of Nursing and Health Science

Evidence Based Inquiry for Scholarship and Practice-MSN563

November 30th, 2020

 

 

 

Can hourly rounding reduce falls, injuries and healthcare associated infections?

              Patient safety in healthcare facility is affected by injuries, falls, and healthcare associated infections. These problems interfere with the quality of the healthcare services that are supposed to be received by the patients. Nurses employed in long-term care like the medical-surgical units are always under pressure to provide healthcare services and to improve the safety of the patients. The majority of the patients in medical-surgical units are elderly and most of them are older than 65 years. These populations are therefore exposed to the risk of falls and injuries (Daniels, 2016).

Project purpose Statement

            The purpose of the capstone project is to focus on the effects of the hourly rounding on the safety of the patients. The procedure of the hourly rounding considers positioning area, the proximity of the personal items, bathing, and pottying. Informing the patients about the role of the nurses is important in improving the comfortability that is needed by the patient. Making the patients aware of the work and the intention of the nurses is helping in reducing the level of stress especially when there is no nurse around. It also assists in reducing the patients’ need for ambulance thus reducing the risk of falls (Flynn et al., 2016). 

Background

            In healthcare facilities, elderly patients are exposed to a higher level of stress as a result of the rising healthcare conditions, treatment, nursing care they require. Nurses are also not free from these problems since they are socially and emotionally affected by the increased level of responsibilities. The elderly patients in the medical-surgical units experienced a decrease in their ability to perform the general ADLs. This, therefore, implies that in addition to the provision of nursing care to the patients, nurses help patients to meet their basic needs such as repositioning, eating, and elimination. The lack of information about the routines in the medical-surgical units increases assistance seeking by the patients thus increasing the nursing. This problem, therefore, requires evidence-based interventions to ensure that there is an improvement in the safety of the patients. One of the interventions that are considered effective in dealing with the above issues is hourly nursing rounding (Gormley, et al., 2019).

Significance of the problem

            The process of dealing with the problem presented in this case i.e. safety of the patients is important in revealing some of the pressing issues that patients and the nurses are facing concerning safety. In the healthcare facilities especially medical-surgical units, patients are at higher risks of falls, nosocomial infections, and pressure ulcers. The process of dealing with these issues requires effective strategies which must be implemented fully or the goal of achieving the patients’ safety is realized (Brosey & March 2015).

            Addressing some of the issues that affect the safety of the patients is helping in revealing other forms of challenges that are faced in having effective strategies of addressing the issues such as falls, injuries, and nosocomial infections among others. It reveals some of the barriers that nurse managers are facing when it comes to the provision of the necessary resources and support required for the successful implementation of the intervention (Al Kuwait & Subbarayalu, 2017).

            Usually, healthcare facilities are faced with the problems of a low nurse-to-patient ratio. This makes the implementation process of the intervention such as hourly nursing rounding to be unsuccessful in addressing the problem of the patients’ safety. When nurses are faced with an increased workload, it makes it hard to handle every need of the patients thus exposing patients to danger as a result of lack of emergency attendance. Therefore, this is significant in informing about the need to have an increase in the number of nurses to help in ensuring that the hourly rounding intervention is fully implemented to meet the needs of every patient (Daniels, 2016).

The possible impact of the project on the anticipated outcome of the betterment of health and or health outcomes

            One of the most important effects of the successful implementation of the intervention is the overall reduction in the rates of falls. The reduced rate of falls implies that the safety of the patients is improving. It is also related to the drop in the healthcare cost since there need for the readmission for the fall-related injuries would not be there. It is also expected that the hospital reputation would be improved since the reported rising cases of hospital readmission, morbidity, and mortality associated with injuries, falls, and hospital-acquired infection would no longer be the case or concern. This is likely to benefit healthcare facilities due to the possibility of having an increase and continuous flow of reimbursement from the Centers for Medicaid and Medicare (CMS) (Brosey & March 2015).      

            The intervention is also addressing the patients’ anxiety since it creates a proactive and regular checking of the patients which ensures that nurses are always closer and present near the patients. Usually, patients are emotionally affected in the absence of the nurses and this interferes with the patients’ healing process. The implementation of the intervention, therefore, helps in the promotion of the coping skills that are helping in the successful healing process of the patients (Brosey & March 2015).

            The implementation of the intervention is helping in ensuring that the needs of the patients are met. Some of the important patients’ needs such as bathing, pottying, positioning, control of the pain, and the proximity to the necessary items are addressed by the hourly nursing rounding. The intervention helps in creating a structured format that assists in ensuring that the needs of the patients are met (Gormley, et al., 2019).

PICOT Formatted Clinical Project Questions

            Population: the targeted population is elderly individuals admitted to the medical-surgical units 60 years and older. The patients have a reduced ADLs, therefore, they rely mostly on the help of the patients for their bathing and pottying. These demands expose these patients to stressful situations due to the absence of the nurses in their units. The overdependence on the nurses implies that patients have to rely solely on nurses for their daily needs.

            Intervention: the intervention to be implemented is focused on the hourly nursing rounding to ensure that the needs of the patients are addressed for their safety. The majority of the nurses in these units are exposed to the risk of falls and injuries when they attempt reaching out to their items, pottying, and bathing. Therefore, the intervention would be important in ensuring that the patients are assisted with these needs.

            Comparison: the proposed intervention is compared to the non-scheduled rounding of the nurses.

 Outcome: the anticipated outcome is the reduction in falls, injuries, and nosocomial infection thus assisting in the achievement of patients’ safety.

            Time: the implementation of the program is expected to take at least six months for the implementation with the medical-surgical units.

 

 

References

Al Kuwait, A., & Subbarayalu, A. V. (2017). Reducing patients’ fall rate in an Academic Medical Center (AMC) using Six Sigma “DMAIC” approach. International journal of health care quality assurance. https://doi.org/10.1108/IJHCQA-03-2016-0030

Brosey, L. A., & March, K. S. (2015). Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal of Nursing Care Quality, 30(2), 153-159. http://doi:doi:15505065.

Daniels, J. F. (2016). Purposeful and timely nursing rounds: a best practice implementation project. JBI Evidence Synthesis, 14(1), 248-267. http://doi:10.1097/NNA.0000000000000101

Flynn, F., Evanish, J. Q., Fernald, J., Hutchinson, D. E., & Lefaiver, C. (2016). Progressive care nurses improving patient safety by limiting interruptions during medication administration. Critical Care Nurse, 36(4), 19-35. https://doi.org/10.4037/ccn2016498

Gormley, D. K., Costanzo, A. J., Goetz, J., Israel, J., Hill-Clark, J., Pritchard, T., & Staubach, K. (2019). Impact of nurse-led interprofessional rounding on patient experience. Nursing Clinics, 54(1), 115-126. https://doi.org/10.1016/j.cnur.2018.10.007

 

 

Theoretical Model Framework

/in /by

Theoretical Model Framework

Week-2 capstone project “Theoretical Model Framework.”

This Paper is for Family nurse practitioner class

ORDER A PLAGIARISM FREE PAPER NOW

 

My Paper will be on Use of sertraline versus sertraline with CBT (cognitive behavioral therapy) to treat depression in teenagers age 12-1 8 over a 1-year period of time.

 

 

 

Assignment Prompt

Select the specific theoretical framework that you will use with your project (education, leadership or FNP). Describe how the theory that you chose aligns with your capstone project. Include the following information:

Describe the key features of the selected theoretical framework/model. What are its major components?

  • Identify specific research approaches appropriate for use with the theoretical model or framework and how it fits with your intended project.
    • Does the model lend itself to quantitative or qualitative methods or both?
    • What kind of quantitative/qualitative methods would be most appropriate? (Focus groups, interviews, pre/post-tests, record review, survey, etc.)
  • Describe how the theoretical framework might be used to evaluate the program/project and critique how well the model fits the program or project.
    • What aspects of the model works well and what aspects do not?
    • Why?

Expectations

  • Due: Monday, 11:59 pm PT
  • Length: 3-4 pages not including references
  • Citations: Scholarly reference(s) from within the last 5 years.
  • Format: APA 7th ed.
  • Use the title “Theoretical Model Framework.”

 

 

 

 

 

 

 

 

 

 

 

 

 

RUBRIC

Criteria Superior Above Average Competent Below Standard Far Below Standard Criterion Score
Objective/Health Care Problem 5 points

Objective is precise, knowledgeable, significant, and distinguished from alternate or opposing options.

 4 points

Objective is precise and knowledgeable.

 3 points

Objective is acceptable.

 2 points

Objective may be unclear or irrelevant.

 1 point

Objective is missing.

 Score of Objective/Health Care Problem,

/ 5
Scope/Evidence 5 points

Skillfully arranges evidence to setup premise of the issue.

Persuasively builds the case with supportive evidence.

Elaborates on all key points of the issue.

 4 points

Clearly sets up premise of the issue.

Persuasively builds the case.

Covers key points of the issue.

 3 points

Sets up premise of issue.

Sufficiently persuasive to the case.

Adequate development of key issues.

 2 points

Poorly sets up the premise of the issue

Minimally persuasive to the case.

Poor development of key issues.

 1 point

No premise set up.

Not persuasive to the case.

Absence of key issues.

 Score of Scope/Evidence,

/ 5
Analysis 5 points

Skillful recommendations and/or specific action.  Suggested action is reasonable.

 4 points

Clear recommendations and/or specific action.  Suggested action is reasonable

 3 points

Sufficient recommendations and/or specific action.  Suggested action is reasonable.

 2 points

Vague about specific action.

Action minimally reasonable.

 1 point

Absence of specific action.

Action completely unreasonable.

 Score of Analysis,

/ 5
Conclusion/Evaluation 5 points

Conclusion is precise, knowledgeable, significant, and distinguished from alternate or opposing options. Skillfully implicates impact on nursing practice, patient safety and healthcare quality.

 4 points

Conclusion is precise knowledgeable and significant.

Clearly states impact on nursing practice, patient safety and healthcare quality.

 3 points

Conclusion is appropriate.

Provides a basic explanation of the impact on nursing practice, patient safety and healthcare quality.

 2 points

Conclusion may be unclear or irrelevant.

Vague references regarding impact.

 1 point

Conclusion and/or

impact is missing.

 Score of Conclusion/Evaluation,

/ 5
Integration of Knowledge 5 points

Demonstrates understanding and applies concepts learned in the course at a superior level. Concepts are integrated into insights. Provides concluding remarks that show analysis and synthesis of ideas.

 4 points

Demonstrates understanding and applies concepts learned in the course. Conclusions are supported in reflection.

 3 points

Demonstrates, for the most part, understanding and applies concepts learned in the course. Some of the conclusions, however, are not supported.

 2 points

Demonstrates, to a certain extent, understanding and applies some concepts learned in the course.

 1 point

Does not demonstrates full understanding of concepts learned in the course.

 Score of Integration of Knowledge,

/ 5
Writing Style, Formatting and Conventions 5 points

Appropriate references that support opinions and recommendations. Exceptional writing with no grammar, APA or spelling errors

 4 points

Appropriate references that support opinions and recommendations. Excellent writing with minimal grammar, APA or spelling errors

 3 points

Appropriate references that support opinions and recommendations. Sufficient writing with minor, APA or spelling errors

 2 points

Minimal references and support for opinion on policy and recommendations for changes. Many APA/Grammar and/or spelling errors.

 1 point

Opinions and recommendations not well supported, Poor APA/Grammar and /or spelling

 Score of Writing Style, Formatting and Conventions,

/ 5

 

Diagnosing Patients With Neurocognitive and Neurodevelopmental Disorders

/in /by

Diagnosing Patients With Neurocognitive and Neurodevelopmental Disorders

Assignment: Assessing and Diagnosing Patients With Neurocognitive and Neurodevelopmental Disorders

Photo Credit: Getty Images

ORDER A PLAGIARISM FREE PAPER NOW

Neurodevelopmental disorders begin in the developmental period of childhood and may continue through adulthood. They may range from the very specific to a general or global impairment, and often co-occur (APA, 2013). They include specific learning and language disorders, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, and intellectual disabilities. Neurocognitive disorders, on the other hand, represent a decline in one or more areas of prior mental function that is significant enough to impact independent functioning. They may occur at any time in life and be caused by factors such brain injury; diseases such as Alzheimer’s, Parkinson’s, or Huntington’s; infection; or stroke, among others.

For this Assignment, you will assess a patient in a case study who presents with a neurocognitive or neurodevelopmental disorder.

To Prepare:

  • Review this week’s Learning Resources and consider the insights they provide. Consider how neurocognitive impairments may have similar presentations to other psychological disorders.
  • Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
  • By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
  • Consider what history would be necessary to collect from this patient.
  • Consider what interview questions you would need to ask this patient.
  • Identify at least three possible differential diagnoses for the patient.

By Day 7 of Week 10

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:

  • Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
  • Objective: What observations did you make during the psychiatric assessment?
  • Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

Create documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected.

In the Subjective section, provide:
• Chief complaint
• History of present illness (HPI)
• Past psychiatric history
• Medication trials and current medications
• Psychotherapy or previous psychiatric diagnosis
• Pertinent substance use, family psychiatric/substance use, social, and medical history
• Allergies
• ROS

In the Objective section, provide:
• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.

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

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

Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).

Written Expression and Formatting—Paragraph development and organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

Written Expression and Formatting—English writing standards:
Correct grammar, mechanics, and punctuation

 

Nursing homework help

/in /by

Nursing homework help

DQ1
Melissa Ball

I would say one of my personal strengths regarding professional presentations is I am a people person and would say I have fairly good communication skills. Before I was a nurse I was a waitress/manager for about 16 years so I would say that helped me a little in my communication skills. But one of my weakness is when I get nervous I kind of ramble my words and they don’t make sense. “Presentation skills are crucial to almost every aspect of academic/business life, from meetings, interviews and conferences to trade shows and job fairs” (Dolan, 2017). A method for improvement could be identifying what type of speaker I am for example, an avoider, resister, accepter, or seeker (Dolan, 2017). A method for improvement would be for me to work on my delivery method and to assess my audience. By working on the delivery delivery method and assessing my audience would help me keep from getting nervous and then start to ramble when presenting in the more formal setting.

ORDER A PLAGIARISM FREE PAPER NOW

Reference

Robert Dolan, Effective presentation skills, FEMS Microbiology Letters, Volume 364, Issue 24, December 2017, fnx235, https://doi.org/10.1093/femsle/fnx235

 

 

DQ1

Panna Panchal

 

I did not do many presentations in the state, not because I couldn’t but because of my accent and lack of academic speaking. I usually don’t get easily anxious to speak in public or with peers. However, I will feel a little nervous. According to Wellstead et al., Delivering an oral presentation at conferences and meetings can seem daunting, but, if delivered effectively, it can be an invaluable opportunity to highlight the presentation in front of peers and receive feedback on the project (Wellstead et al., 2017). I am always worried if I mispronounce any words because I have been there before when people laughed and thought it was funny. That is my weakness. My strength is knowledge, years of experience as a nurse taught me so much when I mostly have an answer for every question for skilled related nursing, and if I don’t know something, I always make sure to find out right answer and get back to the person.

I read my PowerPoint repeatedly, and I will present in front of my family and let them ask me questions and discuss how I can improve myself to be more perfect. Having rehearsed a few times, I will be more confident. I will recite words that might have more accent, so I speak out without an accent. I will keep eye contact with my viewers, give pauses, keep my enthusiasm high and be funny to keep my audience engaged during the presentation. I will improve better after repeating before going to the actual presentation.

Reference. 

Wellstead, G., Whitehurst, K., Gundogan, B., & Agha, R. (2017). How to deliver an oral presentation. International journal of surgery. Oncology, 2(6), e25. https://doi.org/10.1097/IJ9.000000000000002

 

DQ1

 

Kayla Machingo

It has been a while since I have stood in front of an audience and presented a PowerPoint Presentation. When I was in my senior year of high school and freshman year of college, I used to complete presentations for the city regarding providing safe travels for students in the evening through an organization called Safe Rides. At this point in time, I felt like I was great at standing in front of a large audience and providing information. Overall, I would say that my personal strength with professional presentations is that I am a people person with a bubbly attitude. Therefore, chatting with the audience and keeping them entertained does not scare me nor do I find it particularly difficult. I think my biggest weakness is being nervous about other people’s thoughts towards to my presentation. To improve this fear, it is important for me to adjust the environment to my liking (get comfortable in my space), get to know the audience more personally by greeting them, working on deep breathing exercises and avoid covering too much information in a short time frame (Kim, 2021). It is important for me to work on these skills as it will make the presentation more smooth, more personable, and more appealing. I will be working on these skills this week prior to my presentation.

 

Reference

 

Kim, L. (2021). 20 Ways to improve your presentation skills. https://www.wordstream.com/blog/ws/2014/11/19/how-to-improve-presentation-skills

 

DQ2

Virginia Gallardo

From past experiences, I can tell that sustaining a change can be difficult. As much as we understand and value all of the benefits of Evidence Based-Practice (EBP), sustaining EBP is not straightforward, and many barriers inhibit individuals from consistently implementing EBP, including inadequate skills and knowledge (Sharplin et al., 2019). A common barrier in sustaining EBP includes insufficient time for teaching new practices to the staff. This is a barrier I have witnessed with previous changes. Project leaders will provide education once and never revisit the topic. This leaves staff with unanswered questions or doubts about the change, leading to staff either not implementing or sustaining the change. Having multimodal communication channels is also essential such as bulletin board flyers, e-mails, and staff meeting discussions (Sharon et al., 2020). Project leaders can use these channels to disseminate information on the change proposal and ensure sustainability over time. 

Other barriers include a lack of resources or organizational support. Some practice changes will require financial support, which can come from various stakeholders like unit directors. Unit leaders not only provide financial support but also reinforce goals, influence change, and monitor clinical outcomes. Over time staff can forget about the change and may revert to previous practice, and thus it is essential to have champions of change who will support the project. Charge nurses were designated champions of change with one of our more recent projects. Their role was to assess whether or not the staff was adopting the change in practice. When they identified that nurses were not adopting the change, they were responsible for providing education on why the practice is necessary. 

 

References

 

Sharplin, G., Adelson, P., Kennedy, K., Williams, N., Hewlett, R., Wood, J., Bonner, R., Dabars, E., & Eckert, M. (2019). Establishing and Sustaining a Culture of Evidence-Based Practice: An Evaluation of Barriers and Facilitators to Implementing the Best Practice Spotlight Organization Program in the Australian Healthcare Context. Healthcare (2227-9032), 7(4), 142. https://doi-org.lopes.idm.oclc.org/10.3390/healthcare7040142

 

Tucker, S. J., Gallagher-Ford, L., & Jang, E. (2020). EBP 2.0: Implementing and Sustaining Change: The Evidence-Based Practice and Research Fellowship Program. American Journal of Nursing, 120(2), 44. https://doi-org.lopes.idm.oclc.org/10.1097/01.NAJ.0000654320.04083.d

 

 

 

 

Using the Pharm Phorm

/in /by

Using the Pharm Phorm

Using the Pharm Phorm

In every classification, certain drugs are picked as prototypes or representative drugs that you will see over and over in your practice. To facilitate your understanding of significant drugs, the Pharm Phorm highlights clinical indications, adverse reactions, and nursing implications. For each prototype drug, you should fill out a Pharm Phorm and use them as study guides, quick clinical reference material and analytical tools. Some students choose to maintain a notebook of 81/2 x 11 sheets while others use the “recipe box” size. In any case, file the phorms by drug class.

ORDER A PLAGIARISM FREE PAPER NOW

Note: All ASN courses that incorporate drugs into the content will use the Pharm Phorm as a basic learning tool. Each subsequent course identifies drugs associated with certain disease entities and asks you to fill out the pharm phorm. Resist the temptation to use commercial, pre-prepared drug cards, as a significant amount of learning occurs by organizing and writing out the drug data.

The master Pharm Phorm is presented on the next page. It is probably best to print copies of the form and then use drug references and the textbook to find the relevant information. The drugs are clearly identified in this course material under the heading PROTOTYPE –followed by drug class as in PROTOTOYPE OPIOIDS. The first Pharm Phorm has been completed for you as an example. Every phorm will request the same type of information. You will need to use both the textbook and your drug reference to complete the pharm phorms.

Read through the completed sample Pharm Phorm again. What did you just learn about morphine? You will see the dose start to take effect quickly. What side effect will you check within 15 minutes after dose? Respiratory rate. Is morphine potentially addictive? Yes. Is it good for pregnant women? No.

Congratulate yourself if you comprehended most of what was written on the sample phorm –you’ve come a long way! Working back and forth between the textbook and drug handbook, complete a phorm for the prototype opioid analgesic meperidine (Demerol).

 

Pharm Phorm

Prototype drug: morphine sulfate (MS Contin, Duramorph)
Class: Opioid Analgesic 
Clinical Indications: (top three)

1.    Severe pain

2.    Pulmonary edema

3.    Heart attack pain
Mechanism of Action: binds to opiate receptors in CNS, alters perception of pain

General CNS depression
Side/Adverse Effects: (adverse in bold)

·         Respiratory depression — hold if respirations less than 10

·         Confusion and sedation

·         Low blood pressure (hypotension)

·         Constipation

·         Shock, cardiac arrest, thrombocytopenia

Route and Dosage: Adults only

·         PO, Rectal 30 mg q 3-4 hr

·         IM, IV, SC 4-8 mg q 3-4hr

·         Continuous infusion 0.8-10 mg/hr
Nursing Implications: (top 3)

1.    Monitor level of consciousness, BR, HR and R routinely.

2.    Assess bowels q 4 hrs, give laxatives if required.

3.    Assess pain level before and after dosing to check effectiveness.
Patient Teaching

·         No alcohol or other CNs depressants

·         May open sustained release caps but do not chew or crush pellets

·         Change position slowly to avoid orthostatic hypotension

·         Long term use may result in phsyical dependency
Other Considerations: (controlled substance; narrow therapeutic window; short half-life; peak and trough; antidote,etc.)

·         Schedule II

·         Rapid onset

·         Antidote to overdose – naloxone (Narcan) IV, O2, IV fluid

 

 

 

 

 

References

Vallerand, A. H., Sanoski, C. A., Deglin, J. H. (2015). Davis’s drug guide for nurses

          (14th ed.). Philadelphia, PA: F.A. Davis.

 

Nursing homework help

/in /by

Nursing homework help

Create a concept map of a chosen condition, disease, or disorder with glucose regulation or metabolic balance considerations. Write a brief narrative (2-3 pages) that explains why the evidence cited in the concept map and narrative are valuable and relevant, as well as how specific interprofessional strategies will help to improve the outcomes presented in the concept map.

ORDER A PLAGIARISM FREE PAPER NOW

Introduction

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

The biopsychosocial (BPS) approach to care is a way to view all aspects of a patient’s life. It encourages medical practitioners to take into account not only the physical and biological health of a patient, but all considerations like mood, personality, and socioeconomic characteristics. This course will also explore aspects of pathophysiology, pharmacology, and physical assessment (the three Ps) as they relate to specific conditions, diseases, or disorders.

The first assessment is one in which you will create a concept map to analyze and organize the treatment of a specific patient with a specific condition, disease, or disorder.

The purpose of a concept map is to visualize connections between ideas, connect new ideas to previous ideas, and to organize ideas logically. Concept maps can be an extremely useful tool to help organize and plan care decisions. This is especially true in the biopsychosocial model of health, which takes into account factors beyond just the biochemical aspects of health. By utilizing a concept map, a nurse can simplify the connection between disease pathways, drug interactions, and symptoms, as well as between emotional, personality, cultural, and socioeconomic considerations that impact health.

Preparation

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

The assessment will be based on the case of a specific patient with a specific condition, disease, or disorder. Think about an experience you have had treating a patient with a condition, disease, or disorder that interests you, or one of the cases presented in the Vila Health: Concept Maps as Diagnostic Tools media simulation.

  • What is the primary condition, disease, or disorder affecting the patient?
    • What types of experience have you had working with patients with this condition, disease, or disorder?
    • How does this condition, disease, or disorder typically present?
    • What are the recommended treatment options?
      • What, if any, characteristics of an individual patient should be kept in mind when determining a course of treatment.
  • How have you used concept maps to help plan and organize care?
    • What are the advantages of concept maps, from your point of view?
    • How could concept maps be more useful?
  • How can interprofessional communication and collaboration strategies assist in driving patient safety, efficiency, and quality outcomes with regard to specific clinical and biopsychosocial considerations?
    • What interprofessional strategies do you recommend health care providers take in order to meet patient-centered safety and outcome goals?

Scenario

You have already learned about evidence-based practice and quality improvement initiatives in previous courses. You will use this information to guide your assessments, while also implementing new concepts introduced in this course. For this assessment, you will develop a concept map and provide supporting evidence and explanations. You may use the case studies presented in the Vila Health: Concept Maps as Diagnostic Tools media, a case study from the literature or your practice that is relevant to the list of conditions below, or another relevant case study you have developed. This case study will provide you with the context for creating your concept map. You may also use the practice context from the case study or extrapolate the case study information and data into your own practice setting. Think carefully when you are selecting the case study for this assessment, as you may choose to build upon it for the second assessment as well.

Some example conditions, diseases and disorders that are relevant to metabolic balance and glucose regulation considerations are:

  • Cancer.
  • Diabetes (type 2).
  • HIV/AIDS.
  • Hyperthyroidism.
  • Hypothyroidism.
  • Metabolic syndrome.
  • Obesity.
  • Polycycstic ovary syndrome.
  • Prediabetes.
  • Pregnancy.

Instructions

Develop a concept map and a short narrative that supports and further explains how the concept map is constructed. You may choose to use the Concept Map Template as a starting point for your concept map, but are not required to do so. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your evidence-based plan addresses all of them. You may also want to read the Concept Map scoring guide and the Guiding Questions: Concept Map document to better understand how each grading criterion will be assessed.

Part 1: Concept Map

  • Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for a condition that has impaired glucose or metabolic imbalance as related aspects.

Concept Map Template [DOCX]. You may choose to use this template for completing this component of the assignment.

Part 2: Additional Evidence (Narrative)

  • Justify the value and relevance of the evidence you used as the basis for your concept map.
  • Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
  • Construct concept map and linkage to additional evidence in a way that facilitates understanding of key information and links.
  • Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

Use the APA Style Paper Tutorial [DOCX] to complete this narrative component.

Example Assessment

You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Additional Requirements

  • Length of submission: Your concept map should be on a single page, if at all possible. You can submit the concept map as a separate file, if you need to. Your additional evidence narrative should be 2-3 double-spaced, typed pages. Your narrative should be succinct yet substantive.
  • Number of references: Cite a minimum of 3-5 sources of scholarly or professional evidence that supports your concept map, decisions made regarding care, and interprofessional strategies. Resources should be no more than five years old.
  • APA formatting:
    • For the concept map portion of this assessment: Resources and citations are formatted according to current APA style. Please include references both in-text and in the reference page that follows your narrative.
    • For the narrative portion of this assessment: use the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your analysis. You do not need to include an abstract for this assessment.

Competencies Measured

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

  • Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.
    • Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for a condition that has impaired glucose or metabolic imbalance as related aspects.
    • Justify the value and relevance of the evidence used as the basis for a concept map.
  • Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.
    • Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
  • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
    • Construct concept map and linkage to additional evidence in a way that facilitates understanding of key information and links.
    • Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

 

MHS504 Scholarly Writing in the Health Sciences

/in /by

MHS504 Scholarly Writing in the Health Sciences

 

 

 

 

 

 

ORDER A PLAGIARISM FREE PAPER NOW

 

 

 

 

 

Infertility

Infertility is a serious public health issue that affects men and women. An infertile person cannot have children; for a man, one cannot have a successful erection and ejaculation, and for women, one is considered infertile if one cannot get pregnant after having unprotected sex for 12 months with a man. Infertility is a relevant public health issue that affects individuals and families. According to the CDC, about 19% of heterosexual women aged 15 to 19 are considered infertile (Sadecki et al., 2022). The report further shows that more than 9% of men in the US are infertile. As a serious healthcare issue, efforts have been made to address it. For example, the National Public Health Action Plan developed a plan that helps detect, manage, and treat infertility. National and local governments have also allocated resources to research and treatment. However, the problem has not been fully resolved, and individuals and families struggle with the challenges associated with infertility.

Causes of Infertility

Several causes have been documented for infertility in men and women. According to Gipson et al. (2020), there are pathogenic variants that cause infertility in females. Studies show that infertile women have two homozygous. All the oocytes carrying PV are surrounded by a thin ZP which does not allow sperm-binding, rendering a female infertile. The loss of PV function leads to an abnormal and structural dysfunction of the ZP, making women unable to conceive.

Researchers have also linked female infertility to problems with the uterus, such as fibroids, polyps, and adhesions inside the uterus cavity. Some females also have a problem with the fallopian tubes, especially those resulting from gonorrhea or chlamydia. Females who also experience problematic ovulations are likely to be infertile, as they cannot release eggs regularly. Ovulation problems may arise from substance abuse, eating disorders, thyroid conditions, or pituitary tumors. Lastly, women may have issues with the quality and number of eggs. When the supply of eggs runs out before menopause, a woman cannot get pregnant. Similarly, some eggs have the wrong number of chromosomes and cannot successfully grow into a healthy fetus.

Many factors increase women’s risk of infertility. Age, lifestyle choices, genetic traits, and health conditions make some women at a higher risk than others of being infertile. Older women, for example, are more vulnerable to infertility than younger women. As women age, the overall number of eggs reduces, there are increased chances of developing healthcare issues, and more eggs have an abnormal number of chromosomes. Other factors such as endometriosis, cysts, tumors, smoking, heavy drinking, structural problems, low body fat count, and being overweight or underweight also increase being infertile.

Surprisingly, the nature of a woman’s work is reportedly significant in increasing the chances of infertility. For example, female surgeons are more likely to be infertile compared to women in other occupations (Rangel et al., 2021). The study argues that the high risk of female surgeons results from delayed training, which makes most of them start a family when they are older. The complex nature of their work also makes them vulnerable to infertility, especially those who work more than 12 hours a week are likely to be infertile. When these women get pregnant, they are likely to develop complications and cannot carry the pregnancy to term. Some lose the baby through miscarriage or give birth to babies with defects. Demographically, infertile women are likely to be educated, using barrier contraception, non-smokers, and married.

These risk factors affect men too. According to research, men may be infertile due to genetic defects and health problems such as diabetes and infections, including chlamydia, mumps, HIV, or gonorrhea. These factors lead to abnormal sperm production, which hinders egg fertilization. A man may also have a low sperm count or reduced quality of sperm which cannot successfully fertilize an egg (Schlegel et al., 2021). Enlarged veins in the testes(varicocele) also affect the quality of sperm, making a man infertile. In some cases, these risk factors cause blockages; hence one will be unable to deliver the sperm.

Effects of Infertility

Infertility is associated with severe health effects for affected individuals. According to research, women who experience infertility at any point in their lives are likely to develop cardiovascular issues later. Growing evidence shows that increased cardiovascular diseases are associated with female infertility that arises from conditions such as obesity, ovarian disease, endometriosis, and thyroid dysfunction (Gleason et al., 2019). Further studies reveal that infertile women have atherogenic lipid profiles and high hs-CRP levels, which increases vulnerability to cardiovascular issues. Based on these findings, infertility goes beyond the daily challenges and has long-term effects.

Other studies also show that the consequences of infertility go beyond the pursuit of family building. Infertile women are at risk of cancer and maternal morbidity and have increased vulnerability to other chronic diseases. A recent study shows that infertile patients are more likely to develop diabetes, renal disease, liver disease, heart disease, cerebrovascular disease, and others (Murugappan et al., 2021). Other studies indicate that infertility is not a disease; instead, it is a symptom of an underlying disease that may be detected later in the life of an infertile man or woman.

Infertile women experience distressing life experiences. According to Alamin et al. (2020), identity crisis is a significant contributor to distress in the lives of infertile men and women. Women and men who feel that society can only accept them if they have children undergo emotional and psychological torture. The challenges get worse when men and women cannot get treated successfully, s they suffer loss and grief. A significant number of women and men have gotten into depression after they find it challenging to live with the fact that they cannot have children.

Infertile men and women experience psychological and social stigma. Infertile women have reportedly experienced higher levels of emotional abuse and stress in the US compared to other developed countries(Ozturk et al., 2021). Infertile women are also less likely to report emotional and physical violence, which increases their vulnerability to stigma. In some cases, infertile men and women are abandoned by their partners, who fail to endure the stigma and abuse from society and close family/friends.

Reports also indicate that infertility is a silent struggle, as infertile men and women often find it hard to share their distress with second or third parties. Despite the high prevalence of infertility, infertile women do not share their stories with family and friends, which increases their psychological vulnerability. The inability to give birth cause feelings of shame, anxiety, and low self-esteem and contributes to poor life quality.

Infertility Treatment

Stakeholders have channeled resources and manpower into treating infertility. Current treatment options include medications and embryo implantation with assisted reproductive technology. Some treatment options are tailored for men, others for women, and both genders can use some. In most cases, however, infertility is treated with conventional therapies, including surgery or medication. In some cases, these options turn out to be unsuccessful, and affected individuals and families resort to sperm donation or surrogacy.

As much as several treatment options are available, research shows that a significant population of men and women do not seek help to address infertility. According to research, only half of US women seek medical services in an attempt to address infertility( Greil et al., 2020). This means that majority of them will live with the problem as they continue to face emotional, physical, and psychological challenges. The same case applies to men; very few men are willing to seek help and treat infertility. According to research, 99% of male infertility cases can be addressed with a combination of medical and lifestyle techniques. However, the barriers to treatment make infertility an unresolved problem.

Studies that seek to understand the barriers to infertility treatment reveal significant issues that, when addressed, can enhance access to treatment. One of the main factors that come ut is the nature of the treatment, which may be scary for the target people. Treatment approaches such as laparoscopy are revealed to be quite painful, and people may fear going for that. Negative thinking and perceptions are also significant barriers to treatment. For example, some individuals believe that there is no treatment for infertility, as most approaches fail. The fear of wasting resources for an uncertain attempt shuns people away. For other couples, associating treatment with increased chances of high-risk pregnancies scare them away.

Men’s experiences are also affected by societal perceptions about infertility, the cost of treatment, and insufficient knowledge about the treatment process. Research shows that most men are unwilling to live with the reality that they have infertility issues, hence lacking the confidence to walk up to a clinic or hospital to seek help. For some, financial constraints become a challenge, and they choose to accept infertility as a natural occurrence that they live with forever. Some men are scared of having conversations with healthcare providers as they reveal important information to aid in the treatment process. Lastly, just like women, some men believe that infertility treatment cannot be successful, hence no need to waste time and resources.

There are safety concerns regarding infertility treatment for men and women. For example, TRIP13 mutant is believed to address fertility issues in women. However, it is associated with human diseases, and the safety of the patient should be considered first (Gipson et al., 2020). Multiple birth defects and Neurological sequelae have also been observed in children conceived by IVF and ICSI. The health concerns associated with infertility treatment challenge the ethical responsibility of the practice of medicine. Therefore, safety factors must be considered before administering any infertility treatment option.

Evidence also shows that partner support directly impacts infertility treatment outcomes. According to research, men and women who get support from their partners alleviate the burden of infertility-related stress. Couples should support each other, and partners should be involved throughout the treatment process to enhance treatment outcomes. Family and social support are also linked to significant treatment outcomes. Health care professionals should explore the social networks available to infertile patients and encourage people to seek positive support from partners and family members. Partner coping patterns must also be assessed to determine the partner’s ability to cope with the treatment processes and infertility experience.

Infertility treatment remains controversial in reproductive medicine, as researchers continue to link infertility treatment with negative outcomes. Research shows that some infertility treatment options lead to serious health effects that require additional help. For example, patients who undergo assisted reproductive treatment are at a high risk of experiencing psychiatric issues. Therefore, it is important to acknowledge and recognize the issues before assisting these patients in coping with the diagnosis and treatment of infertility.

Unsuccessful treatment efforts have also been attributed to a lack of a holistic approach to infertility. According to Gipson et al. (2020), failure to view fertility holistically has hampered the efforts to address infertility. Today, the world is witnessing adverse and novel health challenges and impeded economic development, which may significantly contribute to infertility. The efforts to treat infertility will be more successful if linked to health, economic, and social factors.

Summary and Conclusion

Infertility is a significant health issue that affects a significant population. Infertility is linked to various causes, including genes, age, health conditions, structural factors, ovulation problems, and many others. Men and women who are unable to have children undergo physical, emotional, and psychological distress in society. Health-wise, infertile people are likely to develop chronic diseases later. Researchers indicate that most infertile people have an underlying condition through infertility. Patients battling infertility are vulnerable to heart diseases, diabetes, cancer, and other chronic conditions. Apart from health effects, infertile men and women experience distress, primarily associated with a lack of acceptance. Infertile men and women are emotionally abused, stigmatized, and even abandoned by their loved ones. There are several treatment options, including medications and technology-assisted reproductive processes. However, the treatment options are associated with health and birth effects and a lack of certainty. There are also barriers to treatment, including negative perceptions, social and cultural factors, and the nature of the treatment.

Conclusion and Recommendations

It is clear that as much as there are several treatment options, infertility remains a challenging issue. Several steps must be taken to enhance treatment and avail information to enhance acceptance in society. There is a need to invest more in research to develop safer ways of preventing and treating infertility. It is also important to address barriers to treatment through education and offering social support. The myths associated with infertility treatment, such as risky pregnancies, must be done away with by availing of educative materials that will help people to embrace infertility. Healthcare professionals and other stakeholders should also focus on encouraging social support from partners and extended family members to enhance treatment outcomes by alleviating the stress and burden associated with infertility.

 In general society, access to the correct information is important to ensure people accept and embrace their loved ones who are infertile instead of stigmatizing or abandoning them. It is also important to have clear reporting procedures for verbal or physical abuse among infertile men and women. Relaxation techniques have also been shown to reduce negative emotions, hence recommended to reduce anxiety among infertile men and women.

 

 

 

 

References

Alamin, S., Allahyari, T., Ghorbani, B., Sadeghitabar, A., & Karami, M. T. (2020). Failure in identity building as the main challenge of infertility: a qualitative study. Journal of reproduction & infertility, 21(1), 49.

Gleason, J. L., Shenassa, E. D., & Thomas, M. E. (2019). Self-reported infertility, metabolic dysfunction, and cardiovascular events: a cross-sectional analysis among US women. Fertility and sterility, 111(1), 138-146.

Gipson, J. D., Bornstein, M. J., & Hindin, M. J. (2020). Infertility: a continually neglected component of sexual and reproductive health and rights. Bulletin of the World Health Organization, 98(7), 505.

Gipson, J. D., Bornstein, M. J., & Hindin, M. J. (2020). Infertility: a continually neglected component of sexual and reproductive health and rights. Bulletin of the World Health Organization, 98(7), 505.

Greil, A. L., Slauson-Blevins, K. S., Lowry, M. H., & McQuillan, J. (2020). Concerns about treatment for infertility in a probability-based sample of US women. Journal of reproductive and infant psychology, 38(1), 16-24.

Murugappan, G., Li, S., Alvero, R. J., Luke, B., & Eisenberg, M. L. (2021). Association between infertility and all-cause mortality: analysis of US claims data. American Journal of Obstetrics and Gynecology, 225(1), 57-e1.

Öztürk, R., Bloom, T. L., Li, Y., & Bullock, L. F. (2021). Stress, stigma, violent experiences, and social support of us infertile women. Journal of reproductive and infant psychology, 39(2), 205-217.

Rangel, E. L., Castillo-Angeles, M., Easter, S. R., Atkinson, R. B., Gosain, A., Hu, Y. Y., … & Kim, E. (2021). Incidence of infertility and pregnancy complications in US female surgeons. JAMA Surgery, 156(10), 905-915.

Sadecki, E., Weaver, A., Zhao, Y., Stewart, E. A., & Ainsworth, A. J. (2022). Fertility trends and comparisons in a historical cohort of US women with primary infertility. Reproductive health, 19(1), 1-11.

Schlegel, P. N., Sigman, M., Collura, B., De Jonge, C. J., Eisenberg, M. L., Lamb, D. J., … & Zini, A. (2021). Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. The Journal of Urology, 205(1), 36-43.

 

                                                         

 

 

 

 

Nursing homework help

/in /by

Nursing homework help

Kelly, J. E., & Renner, J. A. (2016). Alcohol-Related disorders. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier.

ORDER A PLAGIARISM FREE PAPER NOW

Renner, J. A., & Ward, N. (2016). Drug addiction. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier.

Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders: Treatment improvement protocol series, no. 32. http://www.ncbi.nlm.nih.gov/books/NBK64350/

  • Chapter 1, “Substance Use Among Adolescents”
  • Chapter 2, “Tailoring Treatment to the Adolescent’s Problem”
  • Chapter 7, “Youths with Distinctive Treatment Needs”

 

University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control. Journal of Psychosocial Nursing & Mental Health Services, 54(4), 15.

 

Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical Pharmacology, 77(2), 375–381. https://doi.org/10.1111/j.1365-2125.2012.04457.x

Hulvershorn, L. A., Schroeder, K. M., Wink, L. K., Erickson, C. A., & McDougle, C. J. (2015). Psychopharmacologic treatment of children prenatally exposed to drugs of abuse. Human Psychopharmacology, 30(3), 164–172. https://doi.org/10.1002/hup.2467

 

Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10–15. https://doi.org/10.3928/00989134-20160314-04

Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual Diagnosis, 8(1), 74–84. https://doi.org/10.1080/15504263.2012.648439

 

Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., Olvera, R., Swann, A. C., & Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive Psychiatry, 55(6), 1337–1341. https://doi.org/10.1016/j.comppsych.2014.04.018

 

 

 

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

 

The Assignment: 5 pages

 

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.

 

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.

 

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.

 

THE CASE STUDY DECISSION LINK

 

https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6630/DT/week_08/index.html

The medications for the decisions are:

  • Vivitrol (naltrexone) injection, 380 mg intramuscularly in the gluteal region every 4 weeks
  • Antabuse (disulfiram) 250 mg orally every morning
  • Campral (acamprosate) 666 mg orally TID

PRAC 6665: PMHNP Week 11: Journal Assignment

/in /by

PRAC 6665: PMHNP Week 11: Journal Assignment

PRAC 6665: PMHNP Week 11: Journal

PRAC 6665: PMHNP Week 11: Journal

What do I have to do? When do I have to do it?
Review your Learning Resources. Days 1–7
Retrieve your Patient Log Log into Meditrek and print out your Patient Log for this quarter.
Assignment: Journal Submit your Journal by Day 7.

 

Introduction

Welcome to the last week of your practicum! As you have proceeded through the practicum experience, you have been regularly challenged to reflect on your growth and development as you made progress on your goals. Additionally, your Preceptor has evaluated your skills and has provided feedback. As you end this practicum, consider what you have gained from the experiences in your practicum setting. Did you meet your goals and objectives? What were the challenges and how did you manage them? What were the successes and what lessons can you take from those experiences and apply to future experiences? Use your reflections to seek opportunities for growth in the areas you found challenging, while simultaneously celebrating your successes.

ORDER   A PLAGIARISM-FREE PAPER   NOW

This week, your complete a reflective journal on your practicum experience. Additionally, you must log in to Meditrek and download and print out your Patient Log. This serves as a record to provide to healthcare organizations when requested. PRAC 6665: PMHNP Week 11: Journal Assignment

Learning Objectives

Students will:

  • Assess clinical skills related to advanced psychiatric-mental health nursing practice
  • Assess achievement of goals and objectives for the practicum experience

Learning Resources

Required Readings (click to expand/reduce)

 

Meditrek

https://edu.meditrek.com/Default.html

 

Reminder: Retrieve Your Clinical Hour and Patient Logs

Photo Credit: auremar / Adobe Stock

This week, your Preceptor must sign off on your clinical hour log in Meditrek. Contact your Preceptor if you do not see this approval.

Additionally, be sure to log in to Meditrek at some point during the week and print out your Patient Log for this quarter. You will need to keep this log and provide it to healthcare organizations when requested to secure privileges. It serves as a record of the patients you have seen.

Assignment: Journal Entry

Photo Credit: Image by Free-Photos from Pixabay

Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes. PRAC 6665: PMHNP Week 11: Journal Assignment

Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum.

To Prepare

  • Refer to the “Population-Focused Nurse Practitioner Competencies” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
  • Refer to your Clinical Skills Self-Assessment Form you submitted in Week 1, and consider your strengths and opportunities for improvement.
  • Refer to your Patient Log in Meditrek, and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.

Journal Entry (450–500 words)

Learning From Experiences

  • Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
  • Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
  • What did you learn from this experience?
  • What resources were available?
  • What evidence-based practice did you use for the patients?
  • What would you do differently?
  • How are you managing patient flow and volume?
  • How can you apply your growing skillset to be a social change agent within your community? PRAC 6665: PMHNP Week 11: Journal Assignment

Communicating and Feedback

  • Reflect on how you might improve your skills and knowledge, and communicate those efforts to your Preceptor.
  • Answer the questions: How am I doing? What is missing?
  • Reflect on the formal and informal feedback you received from your Preceptor.

By Day 7 of Week 11

Submit your Journal.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 11 Assignment Rubric

 

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 11 Assignment draft and review the originality report. PRAC 6665: PMHNP Week 11: Journal Assignment

 

Submit Your Assignment by Day 7 of Week 1

Roles in Advanced Nursing Practice paper

/in /by

Roles in Advanced Nursing Practice paper

Total Points Possible:  150 

Requirements

  1. The Roles in Advanced Nursing Practice paper is worth 150 points and will be graded on the quality of the content, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric. 
  2. Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer and Grammarly tools when creating your assignment. 
  3. Follow the directions below and the grading criteria located in the rubric closely. Any questions about this paper may be posted under the Q & A Forum or emailed to your faculty. 
  4. The length of the paper should be 3-6 pages, excluding title page and reference page(s). 
  5. Support ideas with a minimum of 2 scholarly resources. Scholarly resources do not include your textbook. You may need to use more than 2 scholarly resources to fully support your ideas. 
  6. You may use first person voice when describing your rationale for choosing the CNP role and your plans for clinical practice.  
  7. Current APA format is required with both a title page and reference page(s). Use the following as Level 1 headings to denote the sections of your paper (Level 1 headings use upper- and lower-case letters and are bold and centered):

    ORDER A PLAGIARISM FREE PAPER NOW

    • Roles in Advanced Practice Nursing (This is the paper introduction. In APA format, a restatement of the paper title, centered and bolded serves as the heading of the introduction section) 
    • Four APN Roles 
    • Rationale for Choosing CNP Role 
    • Plans for Clinical Practice 
    • Role Transition 
    • Conclusion 

Directions

  1. Introduction: Provide an overview of what will be covered in the paper. Introduction should include general statements on advanced practice nursing roles, general statements on the role transition from RN to APN, and identification of the purpose of the paper. 
  2. Four APN Roles: Describe the role, educational preparation, and work environment for the four APN roles (CNP, CNS, CRNA & CNM). Provide support from at least one scholarly source. 
  3. Rationale for Choosing CNP Role: Describe your rationale for choosing the CNP advanced practice role versus one of the other roles. 
  4. Plans for Clinical Practice: Discuss your plans for clinical practice after graduation. Explain how your understanding of NP practice has changed after researching the four ANP roles. 
  5. Role Transition: Discuss your transition from the RN role to the NP role. Describe two factors that may impact your transition. Discuss two strategies you will use to support a successful transition from the RN to your NP role. Provide reference support from at least one scholarly source. The textbook is not a scholarly source. 
  6. Conclusion: Provide a conclusion, including a brief summary of what you discussed in the paper. 
ASSIGNMENT CONTENT 
Category  Points  %  Description 
Introduction  12  8%  Provides an overview of what will be covered in the paper. Introduction should include:  

  1. general statements on advanced practice nursing roles 
  2. general statements on the role transition from RN to APN 
  3. identification of the purpose of the paper. 
Four APN Roles  40  27%  Describes the role, educational preparation, and work environment for the four APN roles  

  1. CNP 
  2. CNS 
  3. CRNA 
  4. CNM 

Provides support from at least one scholarly source. 
Rationale for Choosing CNP Role  15  10%  Describes the student’s rationale for choosing the CNP advanced practice role versus one of the other roles. 
Plans for Clinical Practice  15  10%  Discusses the student’s plans for clinical practice after graduation. Explains how student’s understanding of NP practice has changed after researching ANP roles. 

 
Role Transition  40  27%  Discusses the student’s transition from the RN role to the NP role.  

  1. Describes two factors that may impact the transition.  
  2. Discusses two strategies student will use to support a successful transition from the RN to your NP role.  

Provides reference support from at least one scholarly source. The textbook is not a scholarly source. 
Conclusion  12  8%  Provides a conclusion, including a brief summary of what was discussed in the paper. 
  134  90%  Total CONTENT Points= 134 points 
ASSIGNMENT FORMAT 
Category  Points  %  Description 
APA Formatting  8  5%  Formatting follows APA Manual (current edition) guidelines for  

  1. title page 
  2. body of paper (including citations and headings) 
  3. reference page 
Writing Mechanics  8  5%  Writing mechanics Follow the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual. The length of the paper is at least 3 pages but no more than 6 pages. 
  16  10%  Total FORMAT Points= 16 points 
  150  90%  ASSIGNMENT TOTAL=150 points