Adult Health Hypertension Case study Paper

Adult Health Hypertension Case study Paper

ORDER A PLAGIARISM FREE PAPER NOW

Category Points Percentage Description
Pathology:

 

 

 

15 pts

 

 

  ·         Define the patient’s disease process

 

·         Explain the etiology of the disease process.

·         Thoroughly explain signs and symptoms of disease process.

·         State and explain any diagnostic measures utilized with this disease process.

·         Cite sources

Assessment Data 10pt   ·         Clearly explain the difference between subjective and objection data.

·         Identify Subjection and objection data that would be important to understand.

·         Explain the information that would be information to understand from the chart.

·         Identify the information from the chart that would be most helpful

·         Identify what labs would be important to your assessment and why.

Medications

 

 

 

10pt   ·         Understand & explain first line treatment for the disease.

·         Understand & explain second line treatment and why you would use second line treatment.

·         Explain the patient’s medication: minimum of 3-5 medications.

·         Explain the class of medication.

·         Explain alternative therapies.

·         Explain any Black Box warnings, contraindications, and nursing considerations for the medications.

·         Identify 3-5 common side effects.

·         Identify any medication interactions

·         State the common indication for the prescribed medication.

·         Explain 2 challenges that might prevent them from taking medication as prescribed.

·         Cite sources

Diagnosis

 

 

 

 

10pt   ·         Provide 3 nursing diagnosis for the patients (primary physical, psychosocial and education) pertinent to this client’s medical diagnosis.

·         List health assessment priorities for the nursing diagnosis.

·         State 5 or more appropriate interventions with evidence-based practiced rationale for each action stated for each of the 3 primary nursing diagnosis (cite sources).

·         Explain relevant lab work that is required with this medical diagnosis.

·         Cite sources

Plan of care

 

 

15pt   ·         Explain what the patient is at risk for.

·         Articulate safety concerns or issues at home.

·         Explain 2 challenges that might prevent the patient from seeking medical care.

·         Articulate all patient education for the patient and treatment plan.

·         Explain an understanding of the diagnosis and treatment.

·         Identify 2 short-term goals & 2 long-term goals.

·         Identify 2 outcomes for the patients.

·         Cite sources.

Discharge Instructions

 

 

10pt   ·         Articulate appropriate discharge instructions for these patients.

·         Articulate appropriate follow-up care.

·         Cite sources.

SOAPIE Note

 

 

 

 

10pt   The required elements include the following:

·         Clear statement of subjective findings.

·         Clear statement of objective findings.

·         Clear statement of assessment findings.

·         Clear statement of plan.

·         Clear statement of interventions

·         Clear statement of Evaluation

 

APA 20pts   All information taken from another source must be included on a reference listing using the 7th edition APA as per the Stratford University policy as of October 5th, 2020.

 

You are NOT allowed to use your book as a source Reference:  You must use Peer Reviewed Sources/Articles.

Total 100 100  

 

Week 4: APN Professional Development Plan Paper

Week 4: APN Professional Development Plan Paper

Week 4: APN Professional Development Plan Paper

Purpose 

The purpose of this assignment is to provide the student with an opportunity to explore the nurse practitioner (NP) practice requirements in his/her state of practice, NP competencies and leadership skills to develop a plan to support professional development. 

Activity Learning Outcomes 

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

  1. Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care. (CO1)  
  2. Analyze essential skills needed to lead within the context of complex systems. (CO3) 
  3. Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings. (CO4)

    ORDER A PLAGIARISM FREE PAPER NOW

Due Date

Assignment should be submitted to the Week 4 Roles in APN Professional Development Plan dropbox by Sunday 11:59 p.m. MST at the end of Week 4.  

When the assignment is placed in the dropbox, it will automatically be submitted to Turnitin. You may submit the assignment one additional time before the due date to lower the Turnitin score. If you choose to resubmit, the second submission will be considered final and subject to grading.  Once the due date for the assignment passes, you may not resubmit to lower a Turnitin score. 

This assignment will follow the late assignment policy specified in the course syllabus. 

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. 

In the event of a situation that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending. 

 Total Points Possible:  200 

Requirements

A Week 4 Paper Template to be used for your assignment is required for this assignment.

  1. The APN Professional Development Plan paper is worth 200 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 5-8 pages, excluding title page and reference page(s). 
  5. Support ideas with a minimum of 3 scholarly resources. Scholarly resources do not include your textbook. You may need to use more than 3 scholarly resources to fully support your ideas. 
  6. You may use first person voice when discussing information specific to your personal practice or skills.  
  7. Current edition 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): 
    • APN Professional Development Plan (This is the paper introduction. In APA format, a restatement of the paper title, centered and bold serves as the heading of the introduction section) 
    • APN Scope of Practice 
    • Nurse Practitioner (NONPF) Core Competencies  
    • Leadership Skills 
    • Conclusion 

Directions

  1. Introduction: Provide an overview of what will be covered in the paper. Introduction should include general statements on scope of practice, competencies, and leadership, and identification of the purpose of the paper. 
  2. APN Scope of Practice: Research the Nurse Practice Act and APN scope of practice guidelines for the state in which you intend to practice after graduation. (Example: Students who intend to practice in California must research the California Nurse Practice Act and relevant Board of Registered Nursing regulations, such as obtaining a DEA number, and prescriptive requirements).  Describe the educational, licensure, and regulatory requirements for that state in your own words. Identify whether your state allows full, limited, or restricted NP practice. Discuss NP prescriptive authority in your state. Provide support from at least one scholarly source. Source may be the regulatory body that governs nursing practice in your state. (Students who intend to practice in California, include the use of written standard procedures that guide nurse practitioner practice in the state and physician supervision ratios).
  3. Nurse Practitioner (NONPF) Core Competencies: Review the NONPF Core Competencies. Describe two competency areas you believe to be personal strengths and two competency areas in which you have opportunities for growth. Discuss two scholarly activities you could do during the master’s program to help yourself achieve NP competencies. Provide support from at least one scholarly source. Source may be NONPF Core Competencies document provided via the link in the week 2 readings. 
  4. Leadership Skills: Analyze three leadership skills required to lead as an NP within complex systems. Describe two strategies you could use to help you develop NP leadership skills. Provide support from at least one scholarly source. Textbooks are not considered scholarly sources. 
  5. Conclusion: Provide a conclusion, including a brief summary of what you discussed in the paper. 
ASSIGNMENT CONTENT 
Category  Points  %  Description 
Introduction  16  8%  Provides an overview of what will be covered in the paper. Introduction should include:  

  1. general statements on scope of practice. 
  2. general statements on NP competencies. 
  3. general statements on leadership. 
  4. identification of the purpose of the paper. 
APN Scope of Practice  72  36% 
  1. Identify the intended state of practice after graduation.
  2. Describe the educational, licensure, and regulatory requirements for state. 
  3. Identify whether the state allows full, limited, or restricted NP practice. 
  4. Discuss NP prescriptive authority in the state.   

Provides support from at least one scholarly source. Source may be the regulatory body that governs nursing practice in the state. 

 

Nurse Practitioner (NONPF) Core Competencies  38  19% 
  1. Describe two competency areas believed to be student’s personal strengths.  
  2. Describes two competency areas in which student has opportunities for growth. 
  3. Discuss two scholarly activities to do during the master’s program to help student achieve NP competencies. 

Provide support from at least one scholarly source. Source may be NONPF Core Competencies document provided via the link in the week 2 readings. 

Leadership Skills  38  19% 
  1. Analyze three leadership skills required to lead as an NP within complex systems. 
  2. Describe two strategies student could use to help develop NP leadership skills. 

Provide support from at least one scholarly source.  

Conclusion  16  8%  Provide a conclusion, including a brief summary of what was discussed in the paper. 
  180  90%  Total CONTENT Points= 180 points 
ASSIGNMENT FORMAT 
Category  Points  %  Description 
APA Formatting  10  5%  Formatting follows current edition APA Manual guidelines for  

  1. title page 
  2. body of paper (including citations and headings) 
  3. reference page 
Writing Mechanics  10  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 5 pages but no more than 8 pages. 
  20  10%  Total FORMAT Points= 20 points 
  200  100%  ASSIGNMENT TOTAL=200 points 

 

 

Gastroenteritis Essay

Gastroenteritis Essay

 

 

ORDER A PLAGIARISM FREE PAPER NOW

 

 

 

Gastroenteritis

 

Name

United State University

Primary Health of Acute Client/Family Across the Lifespan: xxx

Professor xxxxx

Gastroenteritis in Children

Introduction

The presentation of the 6-months old male patient, brought in by the mother to the clinic is a requirement since the prenatal consent is needed for the best intervention. There was no medical history since when the baby was born healthy and has an exclusive breastfeeding that indicate that there are no previous warning signs. Gastroenteritis Essay

Below are the questions I would ask the mother.

  1. Ask of the mother about the onset of the symptoms, knowing when the symptoms began can assist determine the severity of the dehydration
  2. Ask the mother, when she check the temperature of the baby, what does the thermometer show?
  3. 3. Have you given any over-the counter medication to help with the fever and diarrhea? If so, what medication is it, how often do you give it to the child, and when was the last time you gave it to him?
  4. 4. How many times has the child had diarrhea in a single day, what are the features of the baby’s feces in terms of color, volume, and frequency and how many soiled diapers do you change every day on average?
  5. Apart from your baby, is there anyone in your household that is ill? Is there a recent travel with the baby?

 

The questions directed to the mother of the 6-months old baby is important for the nurse practitioner to get the information that would drive the evaluation and diagnosis of the diseases. The mother sharing about the latest over-the counter medication would guide about the intervention that would be done that would ensure that there is no reaction that might affect the baby in a detrimental manner (Fries, 2020). The nurse practitioner’s questions are critical in guiding about the experiences with the baby since there was no medical history and gives a hint about the differential diagnoses that would be focused on to offer quality evaluation and care.

 

Addition symptoms and Signs that Needs ER

At 100.4 degrees Fahrenheit, a person has a fever. In many cases, doctors advise against treating fevers below 101°F. Due to the body’s natural response to infection, a fever is a common sign of illness. Fever is a sign that your child’s immune system is working properly (Fields, 2016). In case the child temperature is measured and stated temperature above 100.3°F, are sluggish, and aren’t taking in any fluids should be sent to the emergency room immediately.

Continuous Vomiting

A consistent vomiting in the 6-months baby is a serious condition that demands for an immediate intervention and the child must be taken in an emergency room. Vomiting result to an excessive loss of fluids in the body of the baby and this puts the life at high risk (Fields, 2016). Taking the baby to the emergency room makes sure that the lost fluid is restored.

Fast breathing and Breathing Problems

The baby should be taken to an emergency room when fast breathing or difficulty is experienced because it is considered part of pediatric emergency. The issue of breathing challenges is an urgent intervention that a doctor needs to undertake taking the baby to the emergency room.

 

Other additional signs are difficult-to-rouse child with no tears or mucous membranes, blood in the stool, higher or lower respiration, reduced urine output, pale cool complexion with irritation, hollow eyes, and sunken fontanelles would all indicate that the infant should be taken to the ED (Munde, 2019).

Top 3 Differential Diagnoses

The differential diagnosis is an important clinical exercise that makes sure that the nurse practitioners highlight the disease that the patient is suffering from by eliminating those that share some signs and symptoms. Based on the patient’s mother and the medical history that shows that the baby was well all along until the current symptoms of diarrhea and fever, there are three top differential diagnosis that include

Parasitic gastroenteritis: ICD-10-CM B82.9 is a contagious disease or spread by an invading organism.

Rotavirus: ICD-10-CM A08.0 is a viral infection that produces gastrointestinal symptoms such as diarrhea and other gastrointestinal issues.

Acute Gastroenteritis: ICD-10-CM A08.19 is a condition caused by pathogenic bacteria such as Clostridium and Vibrio cholera present in the food or water supply

 

The three diseases are the top because they have related symptoms that can be confused by the nurse practitioners during diagnosis. The highlighted signs that is diarrhea and fever are present in the diseases highlighted and they also have kind of interrelation, and this demands for differential diagnosis to get the right disease for medication (Fries, 2020).

One of the most common causes of death among children in the U.S is gastroenteritis. To put it another way, it is when you get diarrhea for no apparent reason other than dehydration, and it might come on suddenly or gradually. Prevalence is highest amongst children as young age 5. Diarrhea in children is the most common reason for their hospitalization. The bacteria salmonella and shigella also cause severe gastroenteritis in children younger than five years old, but they are not the only cause. Giardia fragilis and Cryptosporidium are two parasites that can cause gastroenteritis in a tiny percentage of the population (Ögren et al., 2020). For children who can take oral hydration but are vomiting, professionally prepared oral hydration might be an option. Start with little amounts of liquid and gradually increase the amount of liquid as the youngster is able to handle. A trip to the emergency room is necessary if a child is critically dehydrated and needs intravenous fluids and hemodynamic monitoring (Malbrain et al., 2020). Proper handwashing is the first step in preventing gastroenteritis. Teaching children, mothers, and their caregivers how to wash their hands properly is critical, as is making sure they are aware of the dangers of food contamination that has been improperly stored.

Conclusion

To conclude, acute diarrhea in children should be treated as quickly as possible in order to avoid dehydration. The initial treatment for mild dehydration is oral rehydration. Children should be taught proper hygiene, for which cleaning hands properly prevent gastroenteritis.

 

 

References

Fields, L. (2016). 7 Serious Symptoms in Babies and Toddlers. WebMD. Retrieved 12 January 2022, from https://www.webmd.com/children/features/serious-symptoms-babies-toddlers

Malbrain, M. L., Langer, T., Annane, D., Gattinoni, L., Elbers, P., Hahn, R. G., … & Van Regenmortel, N. (2020). Intravenous fluid therapy in the perioperative and critical care setting: executive summary of the International Fluid Academy (IFA). Annals of Intensive Care10(1), 1-19.

Munde, C. (2019). Hydriatic Treatment of Scarlet Fever in its Different Forms. Good Press.

Ögren, J., Dienus, O., & Matussek, A. (2020). Optimization of routine microscopic and molecular detection of parasitic protozoa in SAF-fixed faecal samples in Sweden. Infectious Diseases52(2), 87-96.

Findings of a Qualitative Study

Findings of a Qualitative Study

APPENDIX E

Appraisal Guide:

Findings of a Qualitative Study

Citation:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Synopsis

What experience, situation, or subculture does the researcher seek to understand?

Does the researcher want to produce a description of an experience, a social process, or an event, or is the goal to generate a theory?

ORDER A PLAGIARISM FREE PAPER NOW

How was data collected?

How did the researcher control his or her biases and preconceptions?

Are specific pieces of data (e.g., direct quotes) and more generalized statements (themes, theories) included in the report?

What are the main findings of the study?

Credibility

Is the study published in a source
that required peer review?                                                Yes   No   Not clear

Were the methods used appropriate
to the study purpose?                                                       Yes   No   Not clear

Was the sampling of observations or
interviews appropriate and varied
enough to serve the purpose of the  study?                      Yes   No   Not clear

*Were data collection methods
effective in obtaining in-depth data?                               Yes   No   Not clear

Did the data collection methods
avoid the possibility of oversight,
underrepresentation, or
overrepresentation from certain
types of sources?                                                              Yes   No   Not clear

Were data collection and analysis
intermingled in a dynamic way?                                      Yes   No   Not clear

*Is the data presented in ways that
provide a vivid portrayal of what was
experienced or happened and its
context?                                                                            Yes   No   Not clear

*Does the data provided justify
generalized statements, themes,
or theory?                                                                         Yes   No   Not clear

Are the findings credible?                          Yes All   Yes Some   No

Clinical Significance

*Are the findings rich and informative?                          Yes   No   Not clear

*Is the perspective provided
potentially useful in providing
insight, support, or guidance
for assessing patient status
or progress?                                                                      Yes   Some  No  Not clear

Are the findings
clinically significant?                                 Yes All   Yes Some   No

* = Important criteria

Comments

___________________________________________________________________________

___________________________________________________________________________

 

Nursing homework help

Nursing homework help

  • Health Insurance Portability and Accountability (HIPAA) Rules regulate the use and disclosure of personal health information (PHI). The national standards were created to protect our PHI from data theft. The Health Information Technology for Economic and Clinical Health Act (HITECH Act), adopted in 2009, was established to improve health care quality, safety, and efficiency through the promotion of health IT and promote interoperability (CMS, 2021;OCR, 2021).
  • Data sets help with healthcare analytics to evaluate collected data in a meaningful way. The University of Washington (2022) explains that clinical data collected can include “administrative and demographic information, diagnosis, treatment, prescription drugs, laboratory tests, physiologic monitoring data, hospitalization, patient insurance” (para. 4).
  • This information placed in the correct algorithm can look for trends that can guide nurse schedules and the correlation to medication errors and patient safety and outcomes, which relates to the Excel spreadsheet I created (see Appendix). In addition, this information could be used to negotiate nurse contracts between the union and the hospital in the future

    ORDER A PLAGIARISM FREE PAPER NOW

References
Centers for Medicare and Medicaid Services. (2021, December 1). Privacy and Security Information | CMS. CMS. Retrieved May 1, 2022, from https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/HIPAA-ACA/PrivacyandSecurityInformation

Office for Civil Rights (OCR). (2021, June 28). HITECH Act Enforcement Interim Final Rule. HHS.Gov. https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-enforcement-interim-final-rule/index.html#:%7E:text=The%20Health%20Information%20Technology%20for,use%20of%20health%20information%20technology.

University of Washington. (2022, April 19). Library Guides: Data Resources in the Health Sciences: Clinical Data. Retrieved May 1, 2022, from https://guides.lib.uw.edu/hsl/data/findclin

Carolyn Gaeckle 

One focus that I have had lately is that of patients being treated with a second-generation anti-psychotic. Many patients who take these medications experience weight gain, dyslipidemia, and elevated A1C levels, increasing their risk for obesity, cardiac disease, and diabetes (Lieberman, 2004). I think it would be of benefit to monitor patients who are prescribed an anti-psychotic for weight gain, as well monitoring their lipid profiles and A1C. The spreadsheet I have created in Excel can collect these various data points and in the end, can be used to determine things such as average increase in weight, total cholesterol, or A1C. This could be a helpful tool in monitoring patients for things such as metabolic syndrome, dyslipidemia, and diabetes, in which an educated decision could be made (or with the help of a CDSS) to prescribe the patient a statin to help regulate cholesterol or metformin to help lower A1C. Metformin has also been shown to be helpful in reducing weight gain associated with the use of anti-psychotics (de Silva et al., 2016).

de Silva, V.A., Suraweera, C., Ratnatunga, S.S. et al. (2016) Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and meta-analysis. BMC Psychiatry 16, 341. https://doi.org/10.1186/s12888-016-1049-5

Lieberman J. A., 3rd (2004). Metabolic changes associated with antipsychotic use. Primary care companion to the Journal of clinical psychiatry, 6(Suppl 2), 8–13.

 

 

Euridice Nobre 

Week 9 Discussion

Clinical data is the information collected to enable the evolution of new knowledge

to guide the development of best practices and represents the resource most central to healthcare progress (Institute of Medicine, 2010).

I chose to create a spreadsheet in Excel because it is a great way to store, calculate, analyze data, and generate reports. In addition, Excel is relatively cheap and provides flexible data structures (variables can be added and removed as needed) (Bruland & Dugas, 2017). The spreadsheet attached is an example of how fall data related to psychotropic drugs may be stored and monitored to implement fall prevention protocol throughout my organization. Du et al. (2016) found that the use of psychotropic medications, in general, is significantly correlated with higher risks of falls, especially synthetic antidepressants, e.g., SSRIs. The spreadsheet can be used to organize, collected data to implement changes to decrease falls in hospitalized patients by systematically reviewing, tapering, reducing, or discontinuing psychotropic medications periodically.

 

References

Bruland, P., & Dugas, M. (2017). S2O – A software tool for integrating research data from general purpose statistic software into electronic data capture systems. BMC Medical Informatics and Decision Making, 17(1), 3-3. https://doi.org/10.1186/s12911-016-0402-4

Du, Y., Wolf, I., & Knopf, H. (2016). Psychotropic drug use and alcohol consumption among older adults in Germany: Results of the German health interview and examination survey for adults 2008-2011. BMJ Open, 6(10), e012182-e012182. https://doi.org/10.1136/bmjopen-2016-012182

Institute of Medicine (US) Roundtable on Value & Science-Driven Health Care. (2010). Clinical Data as the Basic Staple of Health Learning: Creating and Protecting a Public Good: Workshop Summary. Washington (DC): National Academies Press (US). Summary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK54290/

 

Alicia Michonski 

The National Association of School Nurses (2022), Every Student Counts Initiative was established to create a national school health data set. The primary goal of the data initiative is to create robust health data that will influence local, state, and national student health policy. Additionally, the data initiative is to be leveraged to advocate for the needs of the students, increase evidence-based school nursing practice, and improve student health outcomes (NASN, 2022). Clinical data from my school can be collected and added to the national database to assist with these goals.

One identified data point within this initiative is chronic absenteeism. To develop clinically meaningful use, EHR content must be transformed into readily analyzed data. Keys to successful meaningful use include facilitating data collection at the point of care and generating adequate data sets (Abernathy et al, 2017). For this week’s assignment, I have created a spreadsheet that will help track the number of students who are chronically absent from school. The spreadsheet breaks the data down into reasons why the student has missed class and the duration. This also aligns with my health IT eval project as missed class time is one of my key measures.

Microsoft Excel was used to create the spreadsheet as it is one of the most commonly used software for data visualization and analysis, and it is compatible with the health center’s computer systems. Additionally, Excel has many capabilities to store, organize, and track data within a shared system. Lastly, Excel was most suitable as the health center staff are already familiar with Microsoft Excel and its shared functions. Please see the attached document for the spreadsheet.

References
Abernethy, A. P., Gippetti, J., Parulkar, R., & Revol, C. (2017). Use of electronic health record data for quality reporting. Journal of Oncology Practice, 13(8).

NASN. (2022). National School Health Data Set: Every Student Counts. National Association of School Nurses. Retrieved on May 2, 2022, from https://www.nasn.org/research/everystudentcounts

https://norwich0-my.sharepoint.com/:x:/g/personal/amichons_norwich_edu/EQNJvAESYAdErCh_DyDAlPsBMlOAPXZXQYRRIIIN3adbCg?e=sGmqtJ

 

 

 

PRAC 6635: Psychopathogy and Diagnostic Reasoning Practicum

PRAC 6635: Psychopathogy and Diagnostic Reasoning Practicum

 

 

ORDER A PLAGIARISM FREE PAPER NOW

 

Self-assessment of Clinical Skills

Ariel Cordova Lopez

Walden University

PRAC 6635: Psychopathogy and Diagnostic Reasoning Practicum

Dr. Brandy Benson

March 05, 2022

 

 

Introduction

According to the American Association of Nurse Practitioners, NPs are licensed clinicians with a doctorate or master’s education who provide advanced health care to clients in collaboration with other health care professionals. Clinical training is an educational module that provides psychiatric mental health nurse practitioners an opportunity to assess, diagnose, and treat patients with mental and behavioral disorders. Clinical training offers PMHNP with essential skills to undertake their job functions. The clinical assessment form identifies and discusses my strengths and weaknesses concerning clinical skills. During the practicum experience, goals and objectives are necessary to maintain focus throughout the experience (Kleinpell et al., 2018).

 

Desired Clinical Skills for

Students to Achieve

Confident (Can

complete

independently)

Mostly

confident (Can

complete with

supervision)

Beginning (Have

performed with

supervision or

need

supervision to

feel confident)

New (Have

never

performed or

does not apply)

Comprehensive psychiatric evaluation skills in:        
Recognizing clinical signs and symptoms of psychiatric illness Confident      
Differentiating between

pathophysiological and

psychopathological

conditions

  Mostly confident    
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)   Mostly confident    
Performing and interpreting a

mental status examination

    Beginning  
Performing and interpreting a

psychosocial assessment and

family psychiatric history

  Mostly confident    
Performing and interpreting a

functional assessment

(activities of daily living,

occupational, social, leisure,

educational).

   Mostly confident    
Diagnostic reasoning skill in:        
Demonstrate knowledge of

psychopathology of mental

illnesses through discussion

for different age groups and

mental illnesses

    Beginning  
Developing and prioritizing a

differential diagnoses list

    Beginning  
Formulating diagnoses

according to DSM 5 based on

assessment data

    Beginning  
Differentiating between

normal/abnormal age-related

physiological and

psychological

symptoms/changes

    Beginning  
Psychotherapeutic

Treatment Planning

       
Provide psychoeducation to

individuals and/or any

caregivers

    Beginning  
Promote health and disease

prevention techniques

  Mostly confident    
Self-Assessment skill:        
Develop SMART goals for

practicum experiences

  Mostly confident    
Evaluating outcomes of

practicum goals and modify

plan as necessary

  Mostly confident    
Documenting and reflecting

on learning experiences

  Mostly confident    
Professional skills:        
Maintains professional

boundaries and therapeutic

relationship with clients and

staff

Confident      
Collaborate with multidisciplinary teams to improve

clinical practice in mental health settings

Confident      
Identifies ethical and legal

dilemmas with possible

resolutions

Confident      
Demonstrates nonjudgmental practice

approach and empathy

Confident      
Practices within scope of

practice

Confident      
Selecting and implementing

appropriate screening

instrument(s) and

interpreting results:

       
Demonstrates selecting the

correct screening instrument

appropriate for the clinical

situation

    Beginning  
Implements the screening

instrument efficiently and

effectively with the clients

    Beginning  
Interprets results for

screening instruments

accurately

    Beginning  
Identifies the need to refer to

another specialty provider

when applicable

    Beginning  
Accurately documents

recommendations for

psychiatric consultations

when applicable

  Mostly confident    

 

 

 

Summary of strengths

Patient-centered care is my greatest strength during my daily routines with my patients. my patient-centered approach enables me to obtain relevant historical information and perform a complete physical and mental status exam. My culturally competent communication methods make me aware of patients’ empathic interview techniques. Patient-centered care enables a nurse practitioner to treat clients with respect and dignity. Another strength is delivering personalized and supportive care to my clients (Chambers & Ryder 2018). Over the years, I gained experience maintaining a positive attitude while communicating with patients to avoid annoying them. Empathic interview techniques allow me to perform a comprehensive examination of patients to develop an accurate diagnosis of their condition. To maintain these skills, I practice them daily in community health clinics and medical wards. I can describe the variations in the patient presentation according to age and cultural background.

Another essential skill that is quite beneficial to me is recognizing and making recommendations on the possible use of psychotropic drugs. I usually embrace a warm demeanor during my interactions with my patients, which is essential in obtaining historical data from multiple sources. I have a complete understanding of each component of the mental status exam which enables me to describe common abnormalities and their causes. The principle of communication has allowed me to conduct myself professionally and be more empathetic to accept criticism and learn from my mistakes. Documentation is another notable strength that I utilize to note down clinical findings, diagnoses, and clinical reasoning. At times, laboratory findings may be unavailable; hence, I use my communication skills to obtain information with the patient and other professionals. My multifaceted skill sets have been an immense help, especially in the early identification of psychopathology symptoms.

Opportunities for growth

I need to develop more interview techniques for challenging situations, such as dealing with hostile, potentially assaultive, and cognitively impaired patients. There are many complications when it comes to diagnosing mental and behavioral disorders. Most psychological and pathophysiological disorders are challenging to diagnose because they require extensive knowledge; hence I need to gain a more comprehensive understanding and better my assessment skills. I need to focus on psychopathological differential diagnosis in that it becomes my priority. Another area of improvement is distinguishing between psychopathology and pathophysiology since they are two broad fields that require more profound understanding. The mental diagnosis process is lengthy in that it begins with the conduction of a physical examination of the patient (Phillips, 2020).

A mental status examination is then done, followed by a psychological assessment to do away with differential diagnosis to arrive at an accurate psychosocial diagnosis. Over the years that I have been caring for patients with behavioral disorders, it goes unnoticed that psychopathological diagnosis and treatment require in-depth knowledge and assessment skills. As a result, most diagnostic tests are unreliable during diagnosing psychopathological diseases. I need to widen my knowledge of psychopathological conditions to improve these weaknesses. I have to take advantage of every opportunity during the clinical rotations to apply the acquired knowledge. I also have a liability in the performance and interpretation of mental status examinations. I have to embark on vigorous clinical practice sessions to boost my experience in the interpretation of mental status examinations. Another way to improve my knowledge at the clinical sites is by continuous practice and personal and professional development. The newly acquired skills will encourage the provision of evidence-based and patient-based care as PMHNP (Price & Reichert, 2017).

Possible Goals and objectives

  1. Goal: Incorporate knowledge on clinical reasoning and differential diagnosis
  2. Objective: Identify signs and symptoms predisposing to any psychopathological disorder
  3. Objective: understand basic test outcomes and other professional reports
  4. Objective: Develop differential diagnosis of some clients with psychiatric disorders.
  5. Goal: Independently develop psychiatric diagnosis at the end of the practicum
  6. Objective: demonstrate the practical application of advanced techniques in the assessment process
  7. Objective: Identify differential psychiatric diagnosis by utilizing patient’s concerns and physical assessment
  8. Objective: Apply laboratory and other medical tests to evaluate clients
  9. Goal: Expand mental status examination skills by the end of the period
  10. Objective: monitor patients and perform cognitive assessments
  11. Objective: recognize and differentiate clinical features to make accurate recommendations
  12. Objective: perform mental status exams and interpret its results accurately

 

 

References

Chambers, C., & Ryder, E. (2018). Compassion and caring in nursing. Routledge.

Kleinpell, R., Cook, M. L., & Padden, D. L. (2018). American Association of Nurse Practitioners National Nurse Practitioner sample survey: Update on acute care nurse practitioner practice. Journal of the American Association of Nurse Practitioners, 30(3), 140-149.

Phillips, K. (2020). Mental illness is not anyone’s fault: a review of NAMI, the National Alliance on Mental Illness. Journal of Consumer Health on the Internet, 24(1), 75-81.

Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences, 7(2), 17.

 

 

 

Interdisciplinary Plan Proposal

Interdisciplinary Plan Proposal

Interdisciplinary Plan Proposal

            Write a brief introduction (2 to 3 sentences) to your proposal that outlines the issue you are attempting to solve, the part of the organization in which the plan would be carried out, and the desired outcome. This will set the stage for the sections below.

ORDER A PLAGIARISM FREE PAPER NOW

Objective

Describe what your plan will do and what you hope it will accomplish in one or two succinct sentences. Also, comment on how the objective, if achieved, will improve organizational or patient outcomes. For example:

Test a double-loop feedback model for evaluating new product risk with a small group of project managers with the goal of reducing the number of new products that fail to launch. This objective is aligned to the broader organizational goal of becoming more efficient taking products to market and, if successful, should improve outcomes by reducing waste.

Questions and Predictions

For this section ask yourself 3 to 5 questions about your objective and your overall plan. Make a prediction for each question by answering the question you posed. This helps you to define the important aspects of your plan as well as limit the scope and check its ability to be implemented.

For example:

  1. How much time will using a double-loop feedback model add to a project manager’s workload?
    1. At first, it will likely increase their workloads by 5 to 10 percent. However, as the process is refined and project managers become more familiar and efficient, that percentage will decrease.

Change Theories and Leadership Strategies

For this section, you may wish to draw upon the research you did regarding change theories and leadership for the Interview and Interdisciplinary Issue Identification assessment. The focus of this section is how those best practices will create buy-in for the project from an interdisciplinary team, improve their collaboration, and/or foster the team’s ability to implement the plan. Be sure that you are including at least one change theory and at least one leadership strategy in your explanation. Always remember to cite your sources; direct quotes require quotation marks and a page or paragraph number to be included in the citation.

Another way to approach your explanations in this section is to think through the following:

  • What is the theory or strategy?
  • How will it likely help an interdisciplinary team to collaborate, implement, and/or buy in to the project plan?
    • Make sure to frame this explanation within the organizational context of the proposed plan, that is, your interviewee’s organization.

Team Collaboration Strategy

In this section, begin by further defining the responsibilities and actions that represent the implementation of the plan. One strategy to defining this is to take a “who, what, where, and when” approach for each team member.

For example:

  • Project Manager A will apply the double-loop feedback model on one new product project for a single quarter.
  • Project Manager B will apply the double-loop feedback model on all new product projects for a quarter.

Vice President A will review the workloads of project managers using the double-loop feedback model every Thursday for one quarter.

After you have roughly outlined the roles and responsibilities of team members, you will explain one or more collaborative approaches that will enable the team to work efficiently to achieve the plan’s objective. As with the change theories and leadership strategies, you may draw on the research you conducted for the Interview and Interdisciplinary Issue Identification assessment. However, you are being asked to give a more in-depth explanation of the collaboration approaches and look at how they will help the theoretical interdisciplinary team in your plan proposal.

Another way to approach your explanations in this section is to think through the following:

  • What is the collaboration approach?
  • What types of collaboration and teamwork will best help the interdisciplinary team be successful?
  • How is the collaboration approach relevant to the team’s needs and will it help drive success?
    • Make sure to frame this explanation in terms of the subject of the plan proposal; that is, your interviewee’s organization.

Required Organizational Resources

For this section, you will be making rough estimates of the resources needed for your plan proposal to be successful. This section does not have to be exact but the estimates should be realistic for the chosen organization.

Items you should include or address in this section:

  • What are the staffing needs for your plan proposal?
  • What equipment or supplies are needed for your plan proposal?
    • Does the organization already have these?
      • If so, what is the cost associated with using these resources?
      • If not, what is the cost of acquiring these resources?
    • What access (to patients, departments, and so forth) is needed?
      • Are there any costs associated with these?
    • What is the overall financial budget request for the plan proposal?
      • Staff time, resource use, resource acquisition, and access charged?
        • Remember to include a specific dollar amount in your request.

After you have detailed your budget, make sure that you explain any impacts on organizational resources that could happen if your plan is not undertaken and successful. In other words, if the issue you are try to solve through your plan proposal persists or gets worse, what will be the potential costs to the organization?

 

 

References

CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

 

WK 11 PRAC 6665

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.

ORDER A PLAGIARISM FREE PAPER NOW

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.  CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

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?

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.

 

 

Rubric Detail

 

Select Grid View or List View to change the rubric’s layout.

Name: PRAC_6665_Week11_Assignment_Rubric

  • Grid View
  • List View

 Show Descriptions

Assimilation and Synthesis: Content Reflection–

Excellent 45 (45%) – 50 (50%)

Good 40 (40%) – 44 (44%)

Fair 35 (35%) – 39 (39%)

Poor 0 (0%) – 34 (34%)

Assimilation and Synthesis: Personal Growth–

Excellent 27 (27%) – 30 (30%)

Good 24 (24%) – 26 (26%)

Fair 21 (21%) – 23 (23%)

Poor 0 (0%) – 20 (20%)

Written Expression and Formatting–

Excellent 14 (14%) – 15 (15%)

Good 12 (12%) – 13 (13%)

Fair 11 (11%) – 11 (11%)

Poor 0 (0%) – 10 (10%)

APA–

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3.5 (3.5%) – 3.5 (3.5%)

Poor 0 (0%) – 3 (3%)

Total Points: 100

Name: PRAC_6665_Week11_Assignment_Rubric

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Literature Review

Literature Review

 

ORDER A PLAGIARISM FREE PAPER NOW

 

Literature Review

This literature review will discuss and critique five articles addressing new graduate nurse retention, in relation to my research question of, “For new graduate nursing students hired into INOVA Fairfax ED, does the use of a buddy program for the first year of employment reduce the future risk of turnover compared with no post-orientation intervention?”. Literature Review

Retention of new graduate nurses in all nursing specialties is imperative. Not only is it cost effective to increase the rate of retention of new graduates, the decrease in turnover will improve staffing ratios and patient outcomes. There is a need for research on post-orientation interventions such as a buddy program to decrease turnover of new graduate nurses. Building relationship between new and experienced staff members in crucial, because we are already experiencing a shortage of nurses. Therefore, we need to find a way to stop new nurses form leaving their positions within the first year, and further decrease the likelihood they will leave the profession altogether.

The first study reviewed was a phenomenological study seeking to understand the experiences of graduate nurses and their transition into professional practice (Kelly & McAllister, 2013). A two-year study in which fourteen out of sixty-five senior nursing students from an Australian university participated. The subjects varied in age and background. The preceptors had minimal training received by the hospital that would affect the reliability of this study. Data was collected through semi-structured interviews and journals kept by the participants. The data was collected and inputted into NVivo, an analysis tool, to generate themes throughout the data. There was consistency of data collection and the analysis tools used were appropriate for this study.

The size of this study was limited, which could affect generalizability of the findings. However, the details provided by the participants will aid in the understanding barriers and facilitators of quality learning through clinical preceptors (Kelly & McAllister, 2013). The information obtained through this study expresses a deep need for relationship building between the preceptor and the student to enhance the learning process and build confidence as a new nurse.

The second study, a phenomenological study, followed seven new graduate nurses. All of which varied in age, degrees (i.e. associates or bachelor’s), hospitals, and department. The inclusion criteria consisted of being a new graduate nurse and participation in a new grad residency program. Data collection was obtained through audio recorded interviews performed by the primary researcher. Each interview lasted forty-five to sixty minutes in a setting selected by the participant, which shows consistency in the collection of the data. Great consideration and rigor was taken into account concerning credibility, transferability, dependability, and confirmability of the data (Moore & Cagle, 2012). Two experienced researchers individually collectively analyzed this data to confirm emerging themes. Some limitations to this research was concerning the background and history of the participants had including prior patient care experience.

The third study reviewed was a convergent mixed methods study which was a part of a larger project. The larger project was evaluating the effectiveness of clinical supervision for new graduate nurses that were working in an acute care setting (Hussein, Everett, Ramjan, & Salamonson, 2017). The sample size was one hundred-forty new graduate nurses which were enrolled in a twelve-month long transition program at a Sydney hospital. The Manchester Clinical Supervision Scale (MCSS-26) was used to assess the new graduate nurse’s perception of the quality of clinical supervision. In addition, the Practice Environment Scale -Australia (PES-AUS) was used to assess satisfaction with the clinical environment. These tools allowed for consistency in the collection of the data. Other factors were also taken into consideration such as age, gender, and prior experience in the healthcare profession (Hussein, Everett, Ramjan, & Salamonson, 2017).  The quantitative data was analyzed using a statistical software package (IBM SPSS Statistics Version 22), and “continuous variables were assessed for normality using the Kolmogorov-Smirnov test, and expressed as median and range” (Hussein, Everett, Ramjan, & Salamonson, 2017, p.4). This form of data collection and analysis was appropriate for this study, and tools have been proven to be reliable. Although there are limitations to this study, which include the study being conducted at only one facility. Additionally, the self-repot methods used for the qualitative portion of this survey were not very reliable.

The fourth study reviewed was a retrospective descriptive evaluative design, which looked at retention between two groups of graduate RNs in the critical care units of Cohen Children’s Medical Center (CCMC) before and after the initiation of the Pediatric Fellowship Program (PNFP) (Friedman, Delaney, Schmidt, Quinn, & Macyk, 2013).  A nonprobability convenience sample was used for this study. The sample in this study consists of new graduate RNs hired to begin nursing orientation during March 2005 to August 2007, prior to the initiation of the PNFP, and September 2007 to March 2010, after the initiation of PNFP (Friedman, Delaney, Schmidt, Quinn, & Macyk, 2013). The collection of data regarding retention of both groups was retrieved through the CCMC’s HR department. The data for both groups was measured longitudinally at four different points after the commencement of the new graduate’s program. There was consistency in the collection of data, as well as reliability in the source of the data. The tool used to measure all data was made specifically for this study, appropriate for this data analysis. Limitations in this study are concerned with the retrospective design. Other variables that may have affected new graduate nurse retention are those that the researchers were unable to detect. There was a significant increase in the new graduate nurse retention once the PNFP was implemented (Friedman, Delaney, Schmidt, Quinn, & Macyk, 2013).

The last study which I reviewed was a qualitative study aimed to reveal the experiences and perceptions of nurses regarding turnover to identify strategies to improve retention, job satisfaction, and performance (Dawson, Stasa, Roche, Homer, & Duffield, 2014). The sample consisted of three hundred and sixty-two nurses working on a medical and surgical unit from three of Australia’s states/territories. This study was part of a larger project which examined the relationship between turnover and patient, organizational, and staff outcomes. The study distributed a survey with an open-ended question at the end, which allowed the participants to elaborate on needs and concerns of turnover. Statements were then analyzed using NVivo a qualitative data analysis tool, and themes emerged from this analysis. There was consistency in the collection of the data, and reliability of the instruments used. Out of this data three themes emerged. One which relates to the given research question about the factors that directly affect turnover. Factors listed under this theme include limited career options, poor staff support, poor recognition, and poor staff attitudes, all of which contributes to turnover. This study showed the importance of the relationships between the staff members to reduce the rate of turnover. limitations to this study such as only twenty-two percent of the sample from the larger survey answered the open question. Due to the limited response this may potentially affect the data quality, because this may not be the typical nurse’s perspective.

After reviewing the research that could be found on new graduate nurse retention and mentoring programs I have found there is little research on programs after the orientation phase of the transition from student to being in the workforce. Throughout the research there is a trend of relationship building among staff, bridging the gap between new and experienced nurses. In many of the reviewed literature during interviews, new graduates consistently expressed a lack of support, especially after the orientation phase. Moving forward research needs to be addressed to evaluate if a buddy program for new nurses is effective in increasing retention and decreasing turnover.

 

 

 

 

References

Dawson, A. J., Stasa, H., Roche, M. A., Homer, C. S. E., & Duffield, C. (2014). Nursing churn and turnover in Australian hospitals: Nurses perceptions and suggestions for supportive strategies. BMC Nursing, 13, 11. doi:http://dx.doi.org.prx-stratford.lirn.net/10.1186/1472-6955-13-11

Friedman, M. I., Delaney, M. M., Schmidt, K., Quinn, C., & Macyk, I. (2013). Specialized new graduate RN pediatric orientation: A strategy for nursing retention and its financial impact. Nursing Economics, 31(4), 162.

Hussein, R., Everett, B., Ramjan, L. M., Hu, W., & Salamonson, Y. (2017). New graduate nurses’ experiences in a clinical specialty: a follow up study of newcomer perceptions of transitional support. BMC nursing, 16(1), 42.

Kelly, J., & McAllister, M. (2013). Lessons students and new graduates could teach: a phenomenological study that reveals insights on the essence of building a supportive learning culture through preceptorship. Contemporary nurse, 44(2), 170-177.

Moore, Penny, PhD, R.N., C.N.L., & Cagle, Carolyn Spence, PhD., R.N.C. (2012). The lived experience of new nurses: Importance of the clinical preceptor. The Journal of Continuing Education in Nursing, 43(12), 555-565. doi:http://dx.doi.org.prx-stratford.lirn.net/10.3928/00220124-20120904-29

 

 

 

 

Teaching Plan on Cystic Fibrosis for an adolescent

Teaching Plan on Cystic Fibrosis for an adolescent

Teaching Plan on Cystic Fibrosis for an adolescent, two pages

  1. Purpose: To document and evaluate teaching skills necessary to provide teaching to an individual client with a demonstrated need. With the completion of this assignment the student will be able to achieve the following objectives.

    ORDER A PLAGIARISM FREE PAPER NOW

  1. Demonstrate ability to thoroughly assess the learning styles of an individual or family using given developmental or cultural models.
  2. Demonstrate ability to anticipate learning needs based on developmental or cultural assessments.
  3. Identify and utilize teaching/learning principles to facilitate achievement of learning goals and outcomes.
  4. Select and prioritize learning strategies based on the developmental or cultural assessment to achieve learning goals and outcomes.
  5. Support rationales for teaching plan using teaching and learning theories from required readings with references.
  1. Nursing Competencies:
  1. Assessing and identifying developmental, cultural, and socioeconomic factors affecting a client.
  2. Providing evidence-based health information and teaching based on developmental, cultural, and socioeconomic factors affecting a client or family
  3. Integrating teaching/learning activities into client interactions based on developmental, cultural, and socioeconomic factors affecting a client or family.
  4. Incorporating health promotion and teaching into the plan of care based on developmental, cultural, and socioeconomic factors affecting a family or client.
  1. Plan: submitted to the clinical instructor during the teaching experience. Your clinical instructor must approve the topic.
  1. Develop nursing diagnosis (NANDA)
  2. Develop two (2) learning objectives
  3. State methodology (teaching methods)
  4. Provide and utilize teaching aids
  5. State needed resources
  1. Implementation: Outline (step by step)
  2. Evaluation: Evaluate your project describing the effectiveness of teaching methods and aids, learner’s response, ability to meet objectives, and self-evaluation including what the student learned and what the student would do differently in the future. A copy of the entire teaching plan with the evaluation of patient learning is to be submitted to your clinical instructor during the teaching presentation. This write-up should be 2-3 pages.