Literature Evaluation Table

Literature Evaluation Table

Literature Evaluation Table

Student Name:

Change Topic (2-3 sentences): The aim of the evaluation is to determine the best method for reducing Adverse Drug Events (ADEs) in the older patients. Strategies being compared are educational programs and electronic medication. Literature Evaluation Table

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Criteria Article 1 Article 2 Article 3 Article 4
Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

 

Wang, H., Meng, L., Song, J., Yang, J., Li, J., & Qiu, F. (2018). Electronic medication reconciliation in hospitals: A systematic review and meta-analysis. European Journal of Hospital Pharmacy, 25(5), 245–250. https://doi.org/10.1136/ejhpharm-2017-001441

 

 

Kinlay, M., Ho, L. M., Zheng, W. Y., Burke, R., Juraskova, I., Moles, R., & Baysari, M. (2021). Electronic Medication Management Systems: Analysis of enhancements to reduce errors and improve workflow. Applied Clinical Informatics, 12(05), 1049–1060. https://doi.org/10.1055/s-0041-1739196

 

 

Fuller, A. E. C., Guirguis, L. M., Sadowski, C. A., & Makowsky, M. J. (2018). Electronic Medication Administration records in long‐term Care Facilities: A scoping review. Journal of the American Geriatrics Society, 66(7), 1428–1436. https://doi.org/10.1111/jgs.15384

 

 

Bugnon, B., Geissbuhler, A., Bischoff, T., Bonnabry, P., & von Plessen, C. (2021). Improving primary care medication processes by using shared electronic medication plans in Switzerland: Lessons learned from a participatory action research study. JMIR Formative Research, 5(1). https://doi.org/10.2196/22319
Article Title and Year Published

 

Title- Electronic medication reconciliation in hospitals: A systematic review and meta-analysis.

Year: 2018

Title: Electronic Medication Management Systems: Analysis of enhancements to reduce errors and improve workflow

Year: 2021

Title: Electronic Medication Administration records in long‐term Care Facilities: A scoping review

Year: 2018

Title: Improving primary care medication processes by using shared electronic medication plans in Switzerland: Lessons learned from a participatory action research study

Year: 2021

Research Questions (Qualitative)/Hypothesis (Quantitative)

 

Hypothesis: Medication reconciliation is a multi-professional process for the prevention of medication discrepancies. No research questions/hypothesis Null Null
Purposes/Aim of Study To evaluate the available electronic medication reconciliation (eMedRec) tools and their effect on unintended discrepancies that occur in hospital institutions 1.      Identify system-related medication errors or workflow blocks that were the target of eMM system updates

2.       Describe and classify the system enhancements made to target these risks

To map the extent, range, and nature of research on the effectiveness, level of use, and perceptions about electronic medication administration records (eMARs) in long-term care facilities (LTCFs) Summarize lessons learned from primary care professionals involved in a pioneering pilot project in Switzerland for the system wide implementation of shared electronic medication plans.
Design (Type of Quantitative, or Type of Qualitative)

 

Meta-analysis Retrospective study Scoping review of quantitative and qualitative literature. Formative action research study.
Setting/Sample

 

Meta-analysis, 13 articles included Systematic analysis Literature review Longitudinal study
Methods: Intervention/Instruments

 

Methodological quality was assessed using the nine standard criteria of Cochrane Effective Practice and Organization of Care Review Group (EPOC) 147 individual changes, were made to the eMM system over the 4-year period Systematically searched MEDLINE, CINAHL, Scopus, ProQuest, and the Cochrane Library. Group interviews
Analysis

 

Relative risk and significance difference Descriptive analysis (use of percentages) Level of significance analysis Descriptive analysis
Key Findings

 

Electronic Medical Reconciliation reduces the incidence of medication with unintended discrepancies and improves medication safety. Electronic Medication Management (eMM) reduces medication errors and optimize workflows Evidence linking electronic Medication Administration Records (eMAR) in reducing errors is weak. Participants considered medication plan management, digitalized or not, a core element of good clinical practice
Recommendations

 

Hospitals adopt electronic medication to reduce ADEs Hospital organizations can adopt eMM to enhance patient safety and operational efficiency More research need to be conducted to determine the effectiveness of electronic medication in reducing ADEs Digitalization is a key element of transforming hospital records
Explanation of How the Article Supports EBP/Capstone Project

 

It identifies the best approach that can reduce ADES between educational programs and electronic medication. Shows that electronic Medication Management is the best bet for reducing ADEs The article informs the need for conducting more robust research on the efficacy of electronic medication in reducing ADEs. More research should be done to assess the efficacy of electronic records.

 

 

Criteria Article 5 Article 6 Article 7 Article 8
Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

Gregory, L. R., Lim, R., MacCullagh, L., Riley, T., Tuqiri, K., Heiler, J., & Peters, K. (2021). Intensive Care Nurses’ experiences with the new electronic medication administration record. Nursing Open, 9(3), 1895–1901. https://doi.org/10.1002/nop2.939

 

 

 

Li, R., Zaidi, S. T., Chen, T., & Castelino, R. (2019). Effectiveness of interventions to improve adverse drug reaction reporting by healthcare professionals over the last decade: A systematic review. Pharmacoepidemiology and Drug Safety, 29(1), 1–8. https://doi.org/10.1002/pds.4906 Lau, G., Ho, J., Lin, S., Yeoh, K., Wan, T., & Hodgkinson, M. (2018). Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian Hospital Network. Health Information Management Journal, 48(1), 12–23. https://doi.org/10.1177/1833358317720601

 

 

Martin, P., Tamblyn, R., Benedetti, A., Ahmed, S., & Tannenbaum, C. (2018). Effect of a pharmacist-led educational intervention on inappropriate medication prescriptions in older adults. JAMA, 320(18), 1889. https://doi.org/10.1001/jama.2018.16131
Article Title and Year Published

 

Title: Intensive Care Nurses’ experiences with the new electronic medication administration record

Year: 2021

Title: Effectiveness of interventions to improve adverse drug reaction reporting by healthcare professionals over the last decade: A systematic review

Year: 2019

 

Title: Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian Hospital Network

Year: 2018

 
Research Questions (Qualitative)/Hypothesis (Quantitative)

 

What are intensive care nurses’ experiences with the new electronic medication administration record?

 

No research question and hypothesis Null Can a consumer-targeted, pharmacist-led educational intervention reduce prescriptions for inappropriate medication among community-dwelling older adults?
Purposes/Aim of Study To explore the experiences of Registered Nurses who administered medications to patients using the electronic medication administration record. To assess the impact of various strategies to improve ADR reporting published in the last decade and compare this with the strategies identified in a previous systematic review To explore and compare patient and clinician attitudes towards an integrated e-prescribing and dispensing system o compare the effectiveness of a consumer-targeted, pharmacist-led educational intervention vs usual care on discontinuation of inappropriate medication among community-dwelling older adults.
Design (Type of Quantitative, or Type of Qualitative)

 

Qualitative descriptive exploratory approach Systematic review A cross-sectional survey A cluster randomized clinical trial
Setting/Sample

 

Five participants 10,021 articles selected, 13 articles included Australian metropolitan teaching hospital Quebec, Canada
Methods: Intervention/Instruments

 

Focus group, observation MEDLINE and EMBASE databases  Literature Evaluation Table Survey andomization occurred at the pharmacy level, with 34 pharmacies randomized to the intervention group (248 patients) and 35 to the control group (241 patients)
Analysis

 

Thematic analysis Descriptive analysis Descriptive analysis- percentages Descriptive and inferential statistics
Key Findings

 

eMAR reduced time nurse spent with patients Electronic method was found to be a better approach when reporting adverse drug reactions compared to educational method The majority of patients and clinicians reported a positive impact of e-prescribing on safety and efficiency A pharmacist-led educational intervention compared with usual care resulted in greater discontinuation of prescriptions for inappropriate medication after 6 months
Recommendations

 

More research needed on the effects of using eMAR to patients and healthcare providers. More research needed to find the robustness of each method Hospitals should implement e-prescribing More research needed to establish the effectiveness of educational programs in reducing ADEs
Explanation of How the Article Supports EBP/Capstone

 

Electronic medication has the potential to increase patient safety The article directly compares the effectiveness of educational programs and electronic records which are included in the PICOT question. The study adds to the evidence that electronic medication is the best approach to reduce ADEs The study contributes to the topic because educational program for nurses was found to be effective in dealing with ADEs.

 

 

 

PICOT Question

PICOT Question

 

PICOT Question

Does using electronic medication compared to education and training of nurses reduce adverse drug events over a three-month period?

Problem being investigated

            The existing problem is Adverse Drug Events (ADEs). The problem accounts for significant patient morbidity and mortality and legal, operational, and patient care costs (Mills et al., 2008). Medications that result in most ADEs include narcotics, chemotherapy, and diabetic and cardiovascular medications (Mills et al., 2008). Issues that cause most ADEs include wrong doses, wrong medication, missed medication, prescribing drugs to the wrong patients, and many prescribers for one patient. PICOT Question

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            The patient population under consideration is elders. The elderly population is at an increased risk of experiencing ADEs after medication. Available data shows that 15% or more of the elderly experience ADEs (Pretorius et al., 2013). The ADEs in the elderly population are manifested in various forms, including falls, orthostatic hypotension, heart failure, and delirium. Some ADEs, mainly gastrointestinal or intracranial bleeding and renal failure, result in mortalities. Effects of ADEs in hospitals include increased costs of operation, reduced effectiveness, and increased LOS. Adverse drug outcomes can be mediated using different strategies such as discontinuing medications, prescribing new medications sparingly, reducing the number of prescribers, and frequently reconciling medications.

Evidence-based Interventions for Reducing ADEs

The PICOT question compares two nursing interventions that can be applied to reduce ADEs among the elderly population. They are electronic medication and educational programs and training for nurses. Electronic medication system supports the improved quality, safety, and effectiveness of medication management within hospitals by enabling digital prescription, ordering, checking, reconciling, dispensing, and recording the medication. On the other hand, education and training involve equipping nurses with the requisite skills to reduce ADEs among elderly patients. The training can involve proper prescription and documentation of the drug.

Different scholars in the nursing field have published ample evidence on the efficacy of these interventions. In particular, (Wu et al., 2007) investigated the cost-effectiveness of introducing an electronic medication ordering and administration system and its potential impact on reducing ADEs. Their findings revealed that an electronic medication order entry and administration system could improve care by reducing adverse events (Wu et al., 2007). Thus, electronic medication is an evidence-based intervention.

Another study to assess the efficacy of electronic medication in reducing ADEs was done by Truitt et al., (2016). The authors analyzed the effects of implementing barcode medication administration (BCMA) and electronic medication administration record (eMAR) technology on ADEs. Data were analyzed using descriptive statistics, and findings showed that eMAR and BCMA technology improved patient safety by decreasing the overall rate of ADEs and the rate of transcription errors (Truitt et al., 2016). The two studies by Truitt et al., (2016) and Wu et al., (2007) agree that electronic medication can lower ADEs’ prevalence among the elderly population.

            Scholarly evidence in support of the educational program to reduce ADEs also exists. (Trivalle et al., 2010) analyzed the impact of educational intervention in decreasing ADEs in elderly patients in a hospital setting using a randomized prospective study. Five hundred twenty-six patients included in the study were 65 years and above, while the study period was four weeks. The data collected showed that educational intervention program led to fewer ADEs in the intervention group (n = 38, 22%) than in the control group (n = 63, 36%; p = 0.004) (Trivalle et al., 2010). (Martin et al., 2018) also investigated the effects of a pharmacist-led education intervention on reducing ADEs among patients aged 65 and above. The outcomes indicated that pharmacist-led education reduced ADEs.

Summary

The two interventions for reducing ADEs among the elderly population are electronic medication and educational programs for healthcare providers. Based on the existing evidence, electronic medication is the best intervention because it is more feasible and can have a huge health impact.

 

 

References

Martin, P., Tamblyn, R., Benedetti, A., Ahmed, S., & Tannenbaum, C. (2018). Effect of a pharmacist-led educational intervention on inappropriate medication prescriptions in older adults. JAMA, 320(18), 1889. https://doi.org/10.1001/jama.2018.16131

Mills, P. D., Neily, J., Kinney, L. M., Bagian, J., & Weeks, W. B. (2008). Effective interventions and implementation strategies to reduce adverse drug events in the Veterans Affairs (VA) system. Quality and Safety in Health Care, 17(1), 37–46. https://doi.org/10.1136/qshc.2006.021816

Pretorius, R. W., Gataric, G., Swedlund, S. K., & Miller, J. R. (2013). Reducing the Risk of Adverse Drug Events in Older Adults. American Family Physician, 87(5), 331–336. https://www.aafp.org/afp/2013/0301/p331.html

Trivalle, C., Cartier, T., Verny, C., Mathieu, A.-M., Davrinche, P., Agostini, H., Becquemont, L., & Demolis, P. (2010). Identifying and preventing adverse drug events in elderly hospitalised patients: A randomised trial of a program to reduce adverse drug effects. The Journal of Nutrition, Health & Aging, 14(1), 57–61. https://doi.org/10.1007/s12603-010-0010-4

Truitt, E., Thompson, R., Blazey-Martin, D., Nisai, D., & Salem, D. (2016). Effect of the implementation of Barcode Technology and an electronic medication administration record on Adverse Drug Events. Hospital Pharmacy, 51(6), 474–483. https://doi.org/10.1310/hpj5106-474

Wu, R. C., Laporte, A., & Ungar, W. J. (2007). Cost-effectiveness of an electronic medication ordering and administration system in reducing adverse drug events. Journal of Evaluation in Clinical Practice, 13(3), 440–448. https://doi.org/10.1111/j.1365-2753.2006.00738.x

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Special Considerations Related to Prescribing for Children and Adolescents Assignment

Special Considerations Related to Prescribing for Children and Adolescents Assignment

There is probably no greater responsibility that the psychiatric-mental health nurse practitioner assumes than the responsibility of prescribing medications. While patients can be harmed by psychotherapy, the level and intensity of the harm generally does not approach the same level of harm that can occur from improper prescribing. PMHNPs must understand their responsibility, both at the state and federal levels, when it comes to prescribing medications.

 

This week, you will explore the particular clinical considerations associated with prescribing for children and adolescents.

Learning Objectives

Students will:

  • Recommend psychopharmacological interventions for children and adolescents
  • Recommend nonpharmacological interventions for children and adolescents in mental health settings
  • Analyze clinical decision making related to treatment of children and adolescents in mental health settings
  • Evaluate mastery of nurse practitioner knowledge in preparation for the nurse practitioner national certification examination
  • Create a study plan for the nurse practitioner national certification examination. Special Considerations Related to Prescribing for Children and Adolescents Assignment

Learning Resources

Required Readings (click to expand/reduce)

 

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

 

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

  • Chapter 43, “Pharmacological, Medically-Led and Related Treatments”

Walden University. (n.d.). Developing SMART goals. https://academicguides.waldenu.edu/ld.php?content_id=51901492

 

 

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

  • Chapter 5, “Psychopharmacology”

Required Media (click to expand/reduce)

 

CriticalThinkRx. (2019, June 9). Module 5: Specific drug classes: Focus on adverse effects [Video]. YouTube. https://youtu.be/Gbq6RnOsGKQ

CriticalThinkRx. (2019, June 9). Module 2: Use of psychotropics with youth_prevalence and concerns [Video]. YouTube. https://youtu.be/NRef-g4Ding

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Assignment 1: Prescribing for Children and Adolescents

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

—Agency for Healthcare Research and Quality

Photo Credit: Getty Images/Ingram Publishing

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?  Special Considerations Related to Prescribing for Children and Adolescents Assignment

For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

Reference:

Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know. https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html

To Prepare

  • Your Instructor will assign a specific disorder for you to research for this Assignment.
  • Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.

The Assignment (1–2 pages)

  • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
  • Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
  • Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
  • Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

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By Day 7 of Week 3

Submit your Assignment.

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK3Assgn1+last name+first initial.(extension)” as the name.
  • Click the Week 3 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 3 Assignment 1 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 “WK3Assgn1+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. Special Considerations Related to Prescribing for Children and Adolescents Assignment

Grading Criteria

To access your rubric:

Week 3 Assignment 1 Rubric

 

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 3 Assignment 1 draft and review the originality report.

 

Submit Your Assignment by Day 7 of Week 3

To participate in this Assignment:

Week 3 Assignment 1

 

Assignment 2: Study Plan

Based on your practice exam question results from Week 2, identify strengths and areas of opportunity and create a tailored study plan to use throughout this course to help you prepare for the national certification exam. This will serve as an action plan to help you track your goals, tasks, and progress. You will revisit and update your study plan in NRNP 6675, and you may continue to refine and use it until you take the exam.

Photo Credit: [Jacob Ammentorp Lund]/[iStock / Getty Images Plus]/Getty Images

To Prepare

  • Reflect on your practice exam question results from Week 2. Identify content-area strengths and opportunities for improvement.
  • Also reflect on your overall test taking. Was the length of time allotted comfortable, or did you run out of time? Did a particular question format prove difficult?

The Assignment

  • Based on your practice test question results, and considering the national certification exam, summarize your strengths and opportunities for improvement. Note: Your grade for this Assignment will not be derived from your test results but from your self-reflection and study plan.
  • Create a study plan for this quarter to prepare for the certification exam, including three or four SMART goals and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.
  • Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.

By Day 7 of Week 3

Submit your study plan.

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK3Assgn2+last name+first initial.(extension)” as the name.
  • Click the Week 3 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 3 Assignment 2 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 “WK3Assgn2+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 3 Assignment 2 Rubric

 

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 3 Assignment 2 draft and review the originality report.

 

Submit Your Assignment by Day 7 of Week 3

To participate in this Assignment:

Week 3 Assignment 2

Special Considerations Related to Prescribing for Children and Adolescents. Special Considerations Related to Prescribing for Children and Adolescents Assignment

NUR 335 Practicum Assignment 5.1

NUR 335 Practicum Assignment 5.1

Denver College of Nursing

 

NUR 335 Practicum Assignment 5.1

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Demographics  
Initials: ___L.A_____________

Age:___40________________

Sex: ___male________________

Primary Language Spoken: _Chinese______________

Cultural Background:__chinese__________________

______________________________________

General Health  
How would you rate your general health?

 

The patient reports to the clinic for an evaluation, he reports that he believes that he has a fair general health. NUR 335 Practicum Assignment 5.1
Have you had a wellness checkup with a healthcare provider in the past year? The patient states that for a long time now since the outbreak of the Covid 19, he had not had any meeting with his doctor  physically he however states having virtual meetings on several occasions
Have you ever been told by a health care provider that you have a chronic disease such as hypertension, diabetes, heart disease, stroke, arthritis or kidney disease?

 

This patient states that he has a history of hypertension and pre-diabetes.  L.A has been having this for the past five years but has been able to manage the conditions well.
In the past month, have you had pain on more than three days that impacted your ability to perform your normal daily activities?

If yes:

·         Where was the pain located?

·         What have you tried to relieve the pain?

 

The patient states that he has not had Pain or major changes in his daily activities that might lead to irregularities for the last three days. This is mostly because he has been able to manage these two conditions well.
How would you rate the quality of your sleep?

·         How many hours do you regularly sleep in a night?

·         Do you ever wake up before you wanted to?

·         Do you have problems falling asleep?

L.A states that he has been experiencing sleeping and wake up in the middle of the night. the patient states that he finds himself sleeping at an average of six hours per night and sometimes wake up in the middle of the night and find it difficult getting back to sleep.
Medications  
Are you currently taking medicine for any chronic condition?

·         Do you know what the medication is used to treat?

·         Have you missed doses of your medication in the last week?

 

The patient is currently taking hypertension Acebutolol  medications in order to address his irregular heart beat problem.  L.A states that he is very keen and ensure that he take his medications as indicated by the doctor. He has never missed to take medications since he has set a reminder on his phone.
Women Only:  
Are you pregnant or planning on becoming pregnant in the next year? N/A
A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?

·         If yes, when was your last mammogram?

 

N/A
A Pap test is a test for cancer of the cervix. Have you ever had a Pap test?

·         If yes, when was your last Pap test?

 

N/A
Men Only:  
A PSA test is a test for cancer of the prostate. Have you ever had a PSA test?

·         If yes, when was your last PSA test?

 

He states that he had his last PSA test the last time he visited his doctor three years ago. He had a free PSA reading of 0.12. He did not report pain and no any symptoms and thus he was assured that he had nothing to worry.
Lifestyle  
Do you now smoke cigarettes every day, some days or not at all?

·         If you are currently smoking, have you tried to quit?

·         If yes, what methods have you used to quit smoking?

o   Were the methods successful?

L.A states that in his entire life, he had never smoked. This was because he had witnessed firsthand information about the negative effects of cigarettes as his father died of lung cancer that was largely due to his smoking behavior.
For the questions below consider the past week in your answer:  
How many times did you take part in physical activity of at least 30 minutes during the past week?

·         If yes, what type of physical activity?

·         If no, why?

·         Was the past week representative of your normal level of physical activity?

For the past ten years, the patient states that he has developed a habit of taking early morning jogs and that he does this at least twice per week.  he states that during the last week, he did his usual one hour morning walks on Friday, Saturday and Sunday.
How many hours a day in the past week do you think you spent on sedentary activities where you remained sitting for extended periods of time?

·         What activities were you doing during these times?

The patient states that in the last week, he would spend more than four hours watching movies on Netflix.  He states that finds himself watching movies every time he is not doing anything and is just chilling at home.
To the best of your recollection, what food items have you eaten for breakfast in the past week? The patient states that he does not have a very good appetite but he tries a lot eating a balanced diet. He recalls that in the past week, he included fruits, eggs, milk, bread and vegetables in his breakfast.

 

 

 

To the best of your recollection, what food items have you eaten for lunch in the past week? For his lunch during the last one week, he recalls largely taking bananas, sausages and crackers. He sometimes completely taking his lunch especially when the office schedule was very tight.

 

 

 

To the best of your recollection, what food items have you eaten for dinner in the past week? In the last one week, some of the food items that he took for dinner included mushroom, meat, beans, and sometimes non-fried Chinese food and soup. He however noted that he only took small portions as he largely has an issue with his appetite.

 

 

 

What beverages do you routinely drink?

·         How many times per week did you drink soda or pop?

·         How many glasses of water do you drink in a day?

The patient states that he loves taking coffee and rarely does he take sodas. He states that he drinks approximately six to seven glasses of water every day. This however goes up to 12 during his exercises.
Do you eat snacks throughout the day?

·         If yes, what snacks do you routinely eat?

·         What time in the day do you regularly eat snacks?

The patient states that he does not routinely take snacks throughout the day.
How many times per week have you skipped meals? The patient states that for the last one week, he skipped lunch twice. LA states that he sometimes skips his lunch due to his busy schedule in the office.
For the questions below consider the past 30 days in your answer:  
What is the largest number of alcoholic drinks you had on any occasion in the past 30 days? The patient states that he does not take alcohol at all.
Have you used any drugs or other substances, other than those that are prescribed for medical reasons?

·         If yes, what substance(s) did you take?

·         How many times have you used this substance in the past 30 days?

LA has never taken any drugs apart from the ones prescribed by his doctor. He states that he does not know how most of these drugs look like and has avoided coming into contact with them at all costs.
In the past 30 days, how many times have you eaten a meal outside of the home; at a restaurant or other venue? The patient states that he is not used to eating outside. He recalls only two occasions in the past 30 days when he had to eat outside. One was in a restaurant and the other one in his friend’s house.
For the question below, consider all lifestyle behaviors (combined) in your answer:  
Do you believe you lead a healthy lifestyle?

Please explain your answer?

 

 

 

 LA believes that although he has not been able to completely live a healthy life, he believes that he has tried his best to make sure that his body is healthy and that he is able to manage the two conditions.
Mental Well-Being  
How often do you experience stress that exceeds your ability to cope?

·         What strategies do you use to control stress?

 

 

The patient states that he sometimes feels much stressed especially because of his condition and the medications that he has to take all through. He manages his stress by listening to music, watching movies and doing some exercises.
How often do you get the emotional and social support you need?

·         Who would you describe as your support system?

 

he believes that he gets the required support especially from his wife and his two kids who are always supporting him.
Over the last two weeks, how many days have you felt down, depressed or hopeless?

·         If you have felt these feelings, what actions did you take to make yourself feel better?

 

 

The patient states that he has not felt down in the past two weeks. This is however not always the case as sometimes he is very down.
Access to Preventative Services  
Do you feel you have access to preventative health screenings and education?

·         Do you have health insurance?

·         Have you ever skipped care (Prescriptions, therapy, specialist visits etc.) that was recommended to you because of concerns regarding the cost of the care?

The patient states that he has access to preventative care, insurance and he does not skip appointments apart from the Covid Period where he was forced to talk with his doctor virtually.
Education  
Where do you normally receive health information? Examples could be the internet, health care provider, family or friends, etc.

 

 

The patient states that he looks for information online and in nursing journals. He also contacts his doctor when he feels that he cannot access the information that he needs on these platforms. This has really helped him to keep on tabs regarding what he has to do to keep fit.
What health topic(s) would you like to have more information on, if available?

 

 

 

 

 

He states that he would like to know more about Covid-19 and diabetes so that way he could be better informed about how to live healthier.
Other Assessment Information  
 

 

 

 

 

 

 

 

 

I discovered several health-related issues throughout this evaluation. To start with, this patient is proficient in Chinese, which makes it difficult for me to comprehend this patient when he speaks English. Additionally, there are various times when this patient often misses meals (Othman et al., 2020). This patient has a higher than average risk of developing diabetes as a result of his poor diet as well as the long time that he spends watching movies. When I assessed this patient, he had to rephrase numerous words so that I could understand him well. Despite this, his accent still made it difficult for me to understand him. The patient also expressed concern that he would need an interpreter for his doctor’s appointment because his English isn’t as good as possible. He states that there are times that he has had a hard time with his doctor when he speaks to them, and so he has to write things down to make sure they grasp what he is saying.

 

Diabetes is the primary health issue I’m focusing on for this patient. Because this patient already had a pre-diabetic diagnosis. Because of his limited command of the English language, this patient is unable to comprehend the information being provided to him regarding his health. Diabetes is a concern for the patient, who expresses concern about learning about it.

 

 

References

Othman, E. H., Shatnawi, F., Alrajabi, O., & Alshraideh, J. A. (2020). Reporting nursing interventions classification and nursing outcomes classification in nursing research: A systematic review. International Journal of Nursing Knowledge31(1), 19-36.

 

 

 

 

 

 

Nursing homework help

Nursing homework help

 

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https://tigerconnect.com/blog/5-benefits-of-interprofessional-collaboration-in-healthcare/

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Interdisciplinary communication/collaboration has been researched and used with success to better patient outcomes and satisfaction across all areas of healthcare. Please take a moment to review the articles provided and then be prepared to share your own thoughts in a written APA paper (2-3 pages NOT including your title or reference page) about how you can help facilitate successful interdisciplinary communication and collaboration that will positively impact your patients. Nursing homework help

 

You will develop a realistic scenario that describes how several different healthcare disciplines collaborate to provide safe and effective care to a patient in the hospital, skilled nursing facility, or outpatient setting. Consider some different scenarios that demonstrate how different healthcare professionals must communicate and work together to provide care to a patient.

 

For example, you as the nurse must coordinate the administration of pain medications before physical therapy comes to work with your patient. Think of how many different disciplines may be involved with the simple act of getting the patient to the physical therapy department on time…there are many! You may need to call the doctor to get the order for pain medication, then call the pharmacy to have medication delivered to your unit. The CNA or PCT will have to make sure that the patient has assistance getting cleaned up for the day and is ready to go. Finally, you must communicate with physical therapy to find out when the patient is scheduled so you can administer the pain medication before the patient leaves the unit.

 

Other examples that require interdisciplinary communication/collaboration: getting a patient ready for surgery or discharge, admitting a patient to your unit from the ED, or sending your patient off the unit for a procedure.

 

Please use at least one other source besides the two listed above. Make sure to include your APA formatted references.

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PRAC – 6665 Week 1: Competencies of Advanced Nursing Practice Assignment

PRAC – 6665 Week 1: Competencies of Advanced Nursing Practice Assignment

Practice

PRAC – 6665 Week 1: Competencies of Advanced Nursing Practice

 

 

PRAC – 6665 Psychiatric Mental Health Nurse Practitioner Care Across the Lifespan I Practicum

PRAC – 6665 Week 1: Competencies of Advanced Nursing Practice

What do I have to do? When do I have to do it?
Review your Learning Resources. Days 1–7
Assignment 1: Practicum Site Information Submit Assignment 1 by Day 2.
Assignment 2: Clinical Skills Self-Assessment Submit Assignment 2 by Day 7.
Assignment 3: Clinical Hour and Patient Logs Track your clinical hours and patient encounters in
Meditrek throughout this practicum course. Each week,
your logs must be completed by Day 7. PRAC – 6665 Week 1: Competencies of Advanced Nursing Practice Assignment

 

Introduction

Tell me and I forget, teach me and I may remember, involve me and I learn.
—Xun Kuang, Chinese Confucian philosopher

Welcome to your PMHNP Care Across the Lifespan I Practicum! The practicum experience is an experiential learning opportunity which allows you to gain and refine your clinical advanced nursing skills under the mentorship of a Preceptor. As you engage with patients in the practicum setting, your involvement will extend your learning about a variety of psychiatric and mental health care needs for patients across the lifespan.

Throughout the next 11 weeks, you will evaluate your skill development, reflect on patient encounters, and generate goals related to your growth as an advanced practice nurse. This week, you start by assessing your strengths and opportunities related to psychiatric-mental health nurse practitioner (PMHNP) clinical skills. PRAC – 6665 Week 1: Competencies of Advanced Nursing Practice Assignment

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Learning Objectives

Students will:

  • Complete practicum site form
  • Assess clinical skills related to advanced psychiatric-mental health nursing practice
  • Develop measurable goals and objectives for the practicum experience
  • Describe clinical hours and patient encounters

Learning Resources

Required Readings (click to expand/reduce)

 

American Academy of Child and Adolescent Psychiatry. (2018). CPT code training module. https://www.aacap.org/App_Themes/AACAP/docs/clinical_practice_center/business_of_practice/cpt/2018_CPT_module_revised_March_2018.pdf

 

American Association of Nurse Practitioners. (2019). Discussion paper: Standards of practice for nurse practitioners. https://storage.aanp.org/www/documents/advocacy/position-papers/StandardsOfPractice.pdf

American Psychiatric Association. (2020). Coding and reimbursement. https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement

American Psychiatric Nurses Association. (2013). Population-focused nurse practitioner competencies. https://www.apna.org/files/Councils/Population-Focused-NP-Competencies-2013.pdf

Note: Review the Psychiatric Mental Health Nurse Practitioner Competencies.

International Council of Nurses. (2020). Guidelines on advanced practice nursing 2020. https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf

Meditrek

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

Note: Use this link to log into Meditrek to report your clinical hours and patient encounters.

The National Organization of Nurse Practitioner Faculties

https://www.nonpf.org/

The National Organization of Nurse Practitioner Faculties. (2017). Nurse practitioner core competencies content.

https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/20170516_NPCoreCompsContentF.pdf

 

Walden University Academic Skills Center. (2017). Developing SMART goals.

https://academicguides.waldenu.edu/ld.php?content_id=51901492

Walden University Field Experience. (2020a). Field experience: College of Nursing.

https://academicguides.waldenu.edu/fieldexperience/son/home

Walden University Field Experience. (2020b). MSN nurse practitioner practicum manual.

https://academicguides.waldenu.edu/fieldexperience/son/formsanddocuments

Walden University Field Experience. (2020c). Walden University School of Nursing: Practicum orientation and resource guide for students: MSN—nurse practitioner.

https://academicguides.waldenu.edu/StudentPracticum/NP_StudentOrientation

Document: Practicum Site Information Form (Word document)

Document: PMHNP Clinical Skills List (PDF)

Document: PMHNP Clinical Skills Self-Assessment Form (Word document)

 

Acknowledgment

Practicum Manual Acknowledgment

The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties. PRAC – 6665 Week 1: Competencies of Advanced Nursing Practice Assignment

  • Field Experience: MSN Nurse Practitioner Practicum Manual

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program. PRAC – 6665 Week 1: Competencies of Advanced Nursing Practice Assignment

Nursing homework help

Nursing homework help

Overview

This discussion asks you look at the role of the family health nurse in a genetic counseling scenario. Imagine that you are a family health nurse, and today in your office you will be seeing a married couple who are both carriers for a genetic disorder (for example, sickle cell, cystic fibrosis, or Huntington’s disease). This couple would like to have children, but since they are both carriers for a genetic disorder, they are seeking your advice on what they should do before they attempt to start a family. Nursing homework help

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Your initial post must be posted before you can view and respond to colleagues, must contain minimum of two (2) references, in addition to examples from your personal experiences to augment the topic. The goal is to make your post interesting and engaging so others will want to read/respond to it. Synthesize and summarize from your resources in order to avoid the use of direct quotes, which can often be dry and boring. No direct quotes are allowed in the discussion board posts.

Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.”

Objectives

  • Students will be able to look at the role of the family health nurse in a genetic counseling scenario.

Points: 30

Due Dates:

  • Initial Post: Fri, May 20 by 11:59 p.m. Eastern Standard Time (EST) of the US.
  • Response Post: Sun, May 22 by 11:59 p.m. Eastern Standard Time (EST) of the US – (the response posts cannot be done on the same day as the initial post).

References:

  • Initial Post: Minimum of two (2) total references: one (1) from required course materials and one (1) from peer-reviewed references.
  • Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

  • Initial Post: Minimum 200 words excluding references (approximately one (1) page)
  • Response posts: Minimum 100 words excluding references.

 

Note: Since it is difficult to edit the APA reference in the Blackboard discussion area, you can copy and paste APA references from your Word document to the Blackboard discussion area. Points will not be deducted because of format changes in spacing.

 

Nursing homework help

Nursing homework help

Scenario

You are assigned to discuss your professional identity with your peers on the unit during a meeting and have decided to present the attributes using an infographic. The goal is to encourage all nurses to examine attributes and identify their professional identity to improve professionalism in the healthcare setting. As a nurse leader, you want your infographic to include the attributes that have guided your growth within the profession. As a leader of the unit, you work to grow the nurses on the unit and want to encourage them to identify their professional identity as the leaders to focus on succession planning. Your goal is to develop your infographic and share with other nurses to encourage them to examine the attributes to grow within the profession. Nursing homework help

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Instructions

Create an infographic that includes the attributes you believe support your professional identity. Include the following:

  • Identify 10 attributes that form your professional identity based on professional standards.
  • Reflect on why each of the attributes were selected for your professional identity.
  • Determine the attributes that are important for nurse leaders.
  • Identify how diversity and teamwork plays a role in developing your professional identity.
  • Provide stated ideas with professional language and attribution for credible sources with correct APA citation, spelling, and grammar.

 

 

Managing Quality Across Various Health Care Settings

Managing Quality Across Various Health Care Settings

Assessment 2 Instructions: Managing Quality Across Various Health Care Settings

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  • PRINT
  • Complete a  page assessment template discussing the continuum of patient care, care quality, and communication between physician practices and hospitals. Managing Quality Across Various Health Care Settings

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As a health care administrator, you will likely spend a great deal of your time focused on operations. You may find yourself working in a hospital, clinic, long-term care facility, hospice, urgent care center, home health agency or a number of other types of organizations. Regardless of the type of organization, many of the operational responsibilities are the same.

Health care financing has become quite complex. Because most health care organizations are reimbursed primarily from a third party (insurance company), health care administrators must manage the communication between the patient, the insurance company, and the organization. Consumer-directed health plans (CDHPs) have increased in popularity as a way to reduce insurance premiums; however, the patient has a larger financial responsibility for services compared to managed care plans. This concept is known as cost sharing (Niles, 2021). It is very important to understand the payer mix of your organization, so you understand where and how revenue is coming in.

Information technology is another huge area of focus right now for health care administrators. The health care industry has lagged behind other industries in the area of information technology. The U.S. health care system has seen a large increase in the number of electronic medical records implemented across health care organizations (Niles, 2021). In addition, other technologies such as telehealth, electronic data warehouses (EDWs), and computerized physician order entry (CPOE) are quickly expanding and improving the delivery of health care.

Reference

Niles, N. J. (2021). Basics of the U.S. health care system (4th ed.). Jones & Bartlett Learning.

For this assessment, imagine you have accepted an administrator position at a physicians practice. One of your first tasks is to gather your team to introduce yourself and discuss operational priorities for the practice at a lunch-and-learn.

Instructions

Using course resources along with a minimum of three peer-reviewed articles based on your own research, complete the linked assessment template to address the following:

    • Describe where the physician practice and the hospital fall on the continuum of patient care.
    • Analyze how providers at each location try to return their patients to their highest level of functioning.
    • Explain how a physician practice communicates with the hospital to foster high-quality, efficient, and effective patient care.
    • Analyze three peer-reviewed articles that each discuss one of the topics above.
      • Description or summary presents the what of the article, but analysis will pursue the question of so what?
      • Why do these ideas matter and/or how are these ideas connected?
      • What are the potential gaps or questions that remain?

Please use the Assessment 2 Template [DOCX] to organize your paper with the following headings:

    • Title Page.
    • Agenda.
    • Introduction.
      • Professional introduction (1 paragraph).
        • You have license to be creative as you imagine the background you would bring to a position like this one.
      • Agenda (bullet points).
        • Preview the main goals of the lunch-and-learn.
        • Refer to some of the scholarly sources you will summarize.
    • Continuum of Care.
      • Describe where the physician practice and the hospital fall on the continuum of patient care.
      • Analyze a peer-reviewed article that discusses where the physician practice and the hospital fall on the continuum of patient care.
    • Care Quality.
      • Describe how a physicians practice maximizes patient care quality to return them to the highest level of function, addressing quality standards such as:
        • Maximizing value-based reimbursement.
        • Positive patient experience.
        • Maintaining operational efficiency.
      • Analyze a peer-reviewed article that discusses how a physicians practice maximizes patient care quality to return them to the highest level of function.
    • Operational Approach.
      • Describe how the physicians practice and the hospital system communicate to foster high-quality, efficient, and effective care.
      • Analyze a peer-reviewed article that discusses how a physicians practice and the hospital system communicate to foster high-quality, efficient, and effective care.
    • Conclusion.
      • Recap the main themes of your lunch-and-learn session.
      • Draw conclusions based on information contained in at least two of the articles you summarized.
      • Offer specific examples to demonstrate application of these ideas in everyday practice.
    • References.

Additional Requirements

    • Length: Your paper must be a minimum of 3 double-spaced pages, not including the title page and References section.
    • Font: Times New Roman, 12 point.
    • References: Cite at least three peer-reviewed scholarly journal articles or reliable primary sources from government or professional organization publications.
    • Style: Format your paper according to APA style. Refer to Evidence and APA for guidance.

Note: Please review the Managing Quality Across Various Health Care Settings Scoring Guide before you begin the assessment.

Competencies Measured

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

    • Competency 2: Explain health care management approaches in diverse health care settings.
      • Provide an introduction that identifies the main topics and relevant professional background, and a conclusion that reiterates the key operational indicators included in the session.
      • Describe the main topics of the lunch-and-learn session, including continuum of care, care quality, and operational approach.
      • Summarize peer-reviewed articles that separately discuss the continuum of patient care, care quality, and operational approach.
    • Competency 4: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others.
      • Write with minimal grammar, usage, spelling, and mechanical errors.
      • Apply proper APA formatting and citation style as required.
  • SCORING GUIDE

Use the scoring guide to understand how your assessment will be evaluated.

VIEW SCORING GUIDE

 

HC405 Herzing University HIM 230 Case Study Discussion

HC405 Herzing University HIM 230 Case Study Discussion

After reading Chapter 8, we will use the criteria from the case study on pages 157-1158. Review the criteria set in Table 8.4 (p. 157) and the history and physical report in Figure 8.5 (p. 158), and compare the patient’s history with the admission criteria to determine whether the patient meets criteria for admission to the hospital. To qualify, the patient must meet at least one criterion in the severity of illness and one criterion in the intensity of service. HC405 Herzing University HIM 230 Case Study Discussion

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Instructions

Identify at least one criterion in each of these categories (severity of illness and intensity of service).

Explain why it meets the requirements for admission to the hospital.

Then summarize why the preadmission screening process is an important component of the continuum of care. (NOTE: do not address the customer satisfaction questions in the case

study “Project Application” section – we are only concerned with the admission criteria).

Prepare an APA-style paper that includes the following elements:

Introduction: Why do we need criteria to assess preadmission, care management and discharge processes

Body: Identify the criteria that meet requirements for hospital admission (one from the severity of the illness category and one from the intensity of service category).

Conclusion: Summarize why the preadmission process is so important, what negative outcomes can happen if patients are not appropriately screened? What are the implications for the hospital (financial or otherwise), for the patient?

Minimum length of 2 pages excluding reference page.

List your references in proper APA style, including the textbook. HC405 Herzing University HIM 230 Case Study Discussion