NRNP 6531 WK 9 HUMAN Assignment

WK 9 Assignment: i-Human Case Study: Evaluating and Managing Musculoskeletal Conditions Patients frequently present with complaints of pain, such as chronic back pain.

They often seek medical care with the intent of receiving drugs to manage the pain. Typically, for this type of pain, narcotic drugs are often prescribed.

This can pose challenges for you as the advanced practice nurse prescribing the drugs. While there is a process for evaluating back pain, it can be difficult to assess the intensity of a patient’s pain since pain is a subjective experience.

Only the person experiencing the pain truly knows whether there is a need for drug treatments. For this Case Study Assignment, you will analyze an i-Human simulation case study about an adult patient with a musculoskeletal condition. NRNP 6531 WK 9 HUMAN Assignment

Based on the patient’s information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient.

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Photo Credit: SCIEPRO / Science Photo Library / Getty Images

To prepare:

Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with musculoskeletal conditions.
Access i-Human from this week’s Learning Resources and review this week’s i-Human case study. Based on the provided patient information, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.
Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with musculoskeletal conditions. NRNP 6531 WK 9 HUMAN Assignment
Assignment As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform.
By Day 7 Complete your Assignment in i-Human.
Submission and Grading Information To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK9Assgn+last name+first initial.(extension)” as the name.
Click the Week 9 Assignment Rubric to review the Grading Criteria for the Assignment
Click the Week 9 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn+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
– 80 percent of the class don’t write the risk factors down. So there goes two points or three points right there, which you can have. So, make sure you write the HPI in the right place.

– You have to go to EMR button, click on there and posted in there, and then add your risk factors to your usual onset location and information and guaranteed, that you won’t lose points there.

– As far as testing, you have to research it. There’s just no two ways about it. If your expectation is that you can sit down and just work through the eye human, whether knowledge as a nurse, you are mistaken and because you, you need additional information.

– Make sure that you look at the link that she posted and then will discuss briefly what tests to order. Make sure you look at the link that the instructor posted, and she discusses briefly talking about what tests to order. Now, if you and you don’t get graded down for ordering too many tests. However, if you order X-ray, an MRI and CT scan, for sure, you are going to get graded down because you can’t order all three. Insurance doesn’t allow it. Prior authorization doesn’t allow it.

– However, if you order X-ray, an MRI and CT scan, for sure, you are going to get graded down because you can’t order all three. Insurance doesn’t allow it. Prior authorization doesn’t allow it. So, all you are doing is delaying patient care because you have to do authorization. They call you from x-ray, they call you from CT. They say, well, what do you want? So do familiarize yourself with what you are looking for and which test. It shows that the based as far as the BMP and a CMP, remember what’s on it and then ask yourself, how does knowledge about a BMP relate to back pain?

– So do familiarize yourself with what you are looking for and which taste. It shows that the based as far as the the BMP and a CMP, remember what’s on it and then ask yourself, how does knowledge about a BMP relate to back pain?….There really isn’t!

– So the same with a CBC. What are the two main factors for you to order a CBC? Look at a white blood cell to see if there is an infection there. Or look at the hemoglobin and hematocrit to see if there is anemia. Does anemia relate to back pain? And then of course platelets because low platelets may be an indication of bleeding or
something else going on in the bone, which will be important. So think about it when you order tests, approach it in that manner. NRNP 6531 WK 9 HUMAN Assignment

– For instance, with this week well as Sed Rate or is RB valuable? I think so because it’s an indication for acute inflammation.

– It is very true to a real life. So, make sure you ask the appropriate questions or order the appropriate tests. Because it, again, you don’t get graded down, but you will get graded down if you order a CT or MRI or an MRI and back x-ray because it just doesn’t work that way!

So that’s about our testing. Then as far as your differential diagnosis, she still believes that the best way to come up with your differential diagnosis is to look at your symptoms, organize your symptoms in acute and chronic.

So, if a patient arrives with, for instance, let’s lady with back pain and she tells you she’s had back pain for seven years. You really must decide. Does she have chronic back pain or is this an acute event? And for that reason, you then look at what is going on and we’ll walk through it here in a minute specifically.

As far as the Plan, you do not need to write a SOAP NOTE! You write a soap note. I’m not even going to look at it. The score is 0. It is not a soap note. You must follow the outline that is listed below these instructions. You write orders. You don’t have to write in rationale for me, I want to see what your order is.

– Now, some of you still get tripped up with if this is that or if this doesn’t work in that it doesn’t work that way because you write orders for right now patient in front of you. And this is a Case Study not about what needs to be done. It’s orders for RIGHT NOW. You need not list your differential diagnosis or a rationale for your differential diagnosis.

– And then finally, you must have references. And that is you list the references at the bottom. You need three references. But again, no rationale is needed. All right. So, let’s look at back pain, to successfully treat back pain, you have to know that back pain is one of the TOP 5 complaints that patients will present to you in the clinic with it affects more men than women.

– An onset is as early as 40 years of age start coming in with back pain. Now that doesn’t mean that at 21 years of age people are coming in with back pain or an 80 year old can present. This is just the most time they present. Finally, the most common diagnosis itself is herniated discs.

– You should focus your interview on ruling out a herniated disc in my right because that is historically and research shows is the most common complain.

– Knowing that you also need to look at your “Onset”.

– We are going back to physiology. I jumped that. So, let’s look at the spine, the spinal discs that are stacked on top of each other. And in-between is this glutinous gel that kind of space it out as well as the muscles on the side that keeps your spinal cord. The kind of stacked up.

– So when you have pain in your back, you have to consider disc problems as well as muscle because those are the two primary things that can cause back pain. So, muscle strain can cause back pain, but it’s got nothing to do with the disk. Whereas a herniated disc or discitis is trauma to a fracture. Fracture to the back can be excruciating painful, but I have nothing to do with the with the muscle itself. NRNP 6531 WK 9 HUMAN Assignment

– Don’t get tripped up by that. Because osteoarthritis is degeneration of the disc that glutinous it’s area. It’s sort of this integrates. Now that disc is closer on each other. They wrap around each other. They get displaced. They cause inflammation.

– People start having leaning over this way or they walk that way. Now that I have muscle pain from that too because they are compensating for what’s going on in there in the back. So let me just make sure I have everything. So then if it is a herniation or the location is very important because herniation can be both in the cervical spine, the thoracic spine, or the lumbar spine. So, it’s very important to differentiate if it’s lumbar or thoracic when you call it a herniation.

– Most common differentials then for visiting back pain in the office is going to be osteoarthritis. This irradiation, trauma, blunt force because of a motor vehicle accident, this narrowing and spinal stenosis. But remember you can’t diagnose spice spinal stenosis or a herniation or anything for that matter until you have an X-ray.

– So would I make that? I would put it on my list my list of things going on. But I can’t make the diagnosis. It’s back pain until I can figure out what kind of back pain it or lumbar pain or lumbar lumbar curve is another word that we use. . So, you have to look. You’re going to be guided with acute onset or chronic. So, it’s easy to rule out the chronic. First, you watch your patient walking into the room.

– In fact, in my office, I asked my nurse not to put anybody on the exam and table. Doesn’t matter for what your complaint is. They sit in the chair, get their blood pressure in the
WK 9 i-Human Notes: Gloria Jenkins

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chair. And then I ask them to get on there because that is a great way to examine how mobile they are, how uncomfortable they are. So that way you look at them. If they can’t get on the table, you will simply say, “Can you tie a shoe?” Osteoarthritis or the back limits range of motion. So those people can’t bend down to tie their shoe. They can’t move from side to side, reach to the left because they stiff.

– You can quickly figure out if this is an acute problem or a chronic problem. So then we get to the that the list of things that are also back pain. But it’s kind of like the things you want to put in the back of your mind. And I’m going to look at my lips list here. Always. First on my list is history of cancer. If you have been a woman and it can be a 40-year-old that has a history of breast cancer, or it can be a 80 year old that has a history of colon cancer inherit, resected and now they fight. NRNP 6531 WK 9 HUMAN Assignment

– Or a history or undiagnosed cancer. Compression fraction is the first thing that comes into my mind. I always put that there. Then medications. So, people use steroids. A young guy that comes in with terrible back pain, and he has point tenderness of the spine. he’s either using steroids, anabolic steroids, do puffed himself up and don’t forget the 60-year-old man that’s getting into it and getting it on. He looks like he’s 70 up here, but his body looks like is a 40-year-old that guides using steroids. Steroids causes bone problems. So you want to put that in the back of your mind. Then piriformis syndrome is another one of my favorites. People forget about. Piriformis syndrome is the nerve that runs through the kind of from the spine through this little hole pair from hole that sits where the gluteus maximus overlaps the gluteus minimus and the leg muscle comes in little hole that goes through.

– – So if you have any inflammation of your muscle, you’re going to have piriformis syndrome and it is not backed by it. It feels like back pain, and it feels like sciatica, but it’s not. Then the other thing you must consider sciatica. Sciatica is deferred pain. That means it is nerve pain that is radiating down the leg. You must have a back problem for you to have sciatica because it’s I had it somewhere that you have a pinched nerve that’s causing radiation TO leg, that is a problem for you. So bear that in mind.

– Other things is a UTI, make sure that they don’t have any symptoms of a UTI. And remember though, if they are not symptomatic in you do find a UA and you will not treat because the only thing it’s back pain. So, make sure it’s kind of hard to say well, I order a U/A. The lady that comes in now because she has very specific symptoms that tells you exactly what the problem is, and I already gave you most of the diagnosis so you should know where to start. Then. Don’t forget about kidney stones can cause back pain, pyelonephritis can aortic dissection, peripheral vascular disease can
claudication. Backload that is imputed to legs can cause it. Already talked about cancers and steroids. Osteoporosis is another one.

– – There is 2 that you definitely cannot miss. Herpes Zoster (shingles), So you have to lift your patient’s gown. Not just feel for it because I’ve done that. I’ve missed disaster ones because I didn’t actually look at it back. And it was clearly this string of vesicles. Make sure you look, you actually visualize it.

– And then lastly, there are people that are malingering. So, if you are seeing somebody that comes in repeatedly for back pain and you’ve ruled everything out. Both inflammatory disorders, which is your lupus or poly myalgia, rheumatic, as well as your your acute in osteoarthritis and your herniated disc or trauma,

– So if you are seeing somebody that comes in repeatedly for back pain and you’ve ruled everything out. Both inflammatory disorders, which is your lupus or poly myalgia, rheumatic, as well as your acute in osteoarthritis and your herniated disc or trauma, you have to at some stage consider malingering and diplomatically address that.

– So what are the symptoms? So we’re going to just quickly look at symptoms. Usually, it’s pain. It can be chronic or acute onset pain. And again, it can be point tenderness of the spine. If you have point tenderness at the spine, they have a herniated disc, but you cannot miss infectious discitis of the left. But you can only have discitis is if you have somebody that has a fever or chills. So CR my ruling this out.

But herniated disc can be trauma, it can be a exercise. It can be somebody that’s moving, and I keep picked up boxes. All of those things can cause it. So pain, make sure that you rule out according to the symptoms associated with it. It can be numbness and tingling. If you have numbness and tingling, report it is in the upper, then you look at a cervical fold, your CT of the cervical spine.

If it is lower extremity, then you have to look at your MRI. – It’s important to know is your do they have sensation? Do they have numbness or tingling? And do they have problems with with stool or urination? So those are the those are the criteria for ordering an MRI. Okay. Now, the other one is muscle weakness.

When you order, when you consider much muscle weakness, something else you have to put in there is deconditioning. So are they do they look like they have sarcopenia, which is muscle wasting. Do they have Is it potentially a stroke?

– Now remember, if you have a stroke, your upper and lower is affected. So you have to decide yourself, what am I going to scan the brain? But you must have the symptoms to prove that you’re going to scan the brain. And then you have paralysis. If you have paralysis, you have a problem. So P and P paralysis is a problem. You need to do an MRI and you need to scan the brain too, because sudden onset paralysis is a problem. If they had a motor vehicle accident. Very possible that they May be acquired.

But you will not be seeing that patient in the office. And if a patient comes to your office with back pain after they’ve been in a motor vehicle accident, you immediately going to defer them to the emergency room because first of all, there’s usually going to be litigation. So, unless you want to be caught up in that litigation and be accused of missing something or in appropriately managing the patient needs to be seen in the emergency room and a proper scan of the of the spine or whatever the problem will be needs to be done.

– With symptoms if they look at and fevers, chills. If they have fever or chills show your primary diagnosis is going to be either they have discitis or have a urinary tract infection and its deferred pain.

– Do you see any edema that is there an open wound, sacred wound? These old people don’t wipe themselves very well. They’re not very well hygiene they sit on there but the whole day then I know that they have sacred author, but there it is. Now it’s causing pain for them. Then numbness and tingling. You always ask about it but there’s no way to examine them if they have numbness and tingling, be aware of that.

– But you can do a filament test way you evaluate this sensation because they may have diabetic neuropathy or just the neuropathy from some other problem. So, you have to document sensation. Then. We already talked about the muscle. Look at is it muscle is the muscle weakness? Is there is the muscle a good tone? Or is it totally muscle wasted? And then if you are concerned about a neurological problem, there’s two ways to do it. You’re going to check reflexes in any case to see if the reflex is intact. But you can also do the anal wink.

– when you examine this patient, you ask them to take take your pants off and you just take your finger and tap it right on the the anus. If there is a contraction there, you will. You have normal reflexes or normal neural nearby neurological nerve innervation to the lower body because it’s right there. Now. It doesn’t mean that now you’re done. You can leave your neurological exam. That’s a whole different ballgame. If you have a neurological problem or suspected, you have to do a neuro exam which is different from a simple back exam.

– Document gait.

– We kind of talked about BMP and CMP, CBC. If you’re going to do that. Inflammatory markers, you don’t need SED Rate and lactic acid and a CPA CRP. One is, is usually enough. I find a sed rate most effective because all it tells you is this inflammation. You can have elevated sed rate with osteoarthritis. But it’s mostly effective for me with the malingering patient that you’ve done all the scans, nothing shows. You do a Sed Rate if that Sed Rate is elevated, they have something going on there. They have inflammation. So, you do have something to treat.

– Standard is the X-ray, spinal X-ray or a hip x-ray or a x-ray of the upper extremity, the femur. So most insurance companies, mostly Medicare and Medicaid, because we have these back problems mostly when they get older, will not jump to an a CT scan or MRI unless an X-ray has been done because the first thing you have to rule out is a fracture, be that a compression fracture or blunt fracture innovation by avulsion fracture, you have to do that if they have deferred pain. So you palpate the spine, you’re going to do an X-ray if they have a lumbar pain but it’s not on the spine but it’s actually on the sides.

– Don’t forget your frog leg, hip. They especially if they fell because they can have a site grow for the fracture. They can have a hip fracture, or they can have and I’m just thinking that it’s blowing out. I just had somebody with it in yeah. The piriformis syndrome. So you’re going to do your X-ray. The X-ray will not show you or it will just rule out anything in your back. So it’s a diagnosis of exclusion, a piriformis syndrome point tenderness right on the middle of the butt.

Then your next one will be your CT scan. If you have an X-ray that shows a herniated disc with cause that’s what you’ll see on an X-ray, herniated disc for foramina, stenosis for Amnon, a narrowing. Those are the things you’ll see on you on your X-ray or fractures. If you see an X-ray that shows that you have inflammatory changes because you can see it because they will be shadowing around it, then your next step will be a CT scan. So, when you want to rule out this guide us.

When you have somebody with blunt force trauma that has numbness and tingling, anybody that has signs and symptoms of sciatica, you’re going to start with an x-ray and then you proceed to a CT scan. Or if you have both, you can order both, but you probably going to have to do a prior authorization and they’ll do the X-ray first before they will do the CT scan. NRNP 6531 WK 9 HUMAN Assignment

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Simply, good money management for that. And then finally your MRI. The MRI is your soft tissue.

– When you write pain medication, you always have to remember that you’re actually increase this person’s chances of getting worse. First of all, they’re going to sit around because they sedated and they think they don’t have it. You need them to move. So what are you going to do to get them moving? If they are narcotics, they don’t want tomove.

They just sit around and do nothing. If you prescribe non-steroidal. You have to know who is a high-risk candidate for still non-steroidal and who is not a high-risk? Is this person appropriate? So for instance, my 80 year old that comes in with back pain, they don’t get any narcotics, aren’t even look at narcotics. Non-steroidal. Last ditch Either like it because it causes GI bleeding and by the time the 80, what is the risk factor GI bleed? So, groom your critical thinking to always say what is in the patient’s best interests.

– Because part of your treatment plan should be grooming your passion of what they pay in expectation is, if you have a disc herniation and you’re not a candidate for any intervention other than medication and physical therapy, European expectation will never be 0. And you just must be honest with your patient. And that’s we respect comes in if you tell them, hey, our goal is going to be keep your pain in the 45 range. They will appreciate you for that.

They will. So, make sure you’re paying expectation is your treatment plan is safe, it’s appropriate medications for the age and that you it doesn’t nobody can walk away with no pain. Then you don’t have to write the dive diagnosis. Right. Orders. I don’t want to see this. If the Tylenol doesn’t help, we will send him to the orthopedist. What is that? That’s not an order. You are managing this, so you must give it a good shot. And just as an FYI, when you refer somebody to a gastroenterologist or a hematologist, they expect a good baseline workup has been completed.

So, the first time somebody presents with back pain, you must at least make a good effort of diagnosing it in treating it before you refer them to a surgeon. Unless of course, it is something that is that you must have back surgery for. But because your X-ray or CT scan shows that, but you must at least have a good workout before you can send them off to refer. Alrighty. Good luck with it. Make sure you do all effort to attain that tutorial on the 25th. It will be recorded, so it will be available for you to watch.

i-Human outline and EXAMPL for the plan

Posted Monday, November 22, 2021 8:32:21 PM Last Edited:Friday, December 3, 2021 12:28:28 PM You MUST follow this outline.

If you write an essay or a book, or a story you will receive ZERO.

Therapeutic & non-therapeutic modalities (should be written as orders or rx. Not an essay) 5 pts (note there may be 8/9 orders or as little as 3/4, but there will be very specific key things that you cannot miss) Additional labs or diagnostic tests 5 pts (note, there may be 3/4 or nothing) Health Promotion 5 pts Patient Education 5 pts

Consults 5 pts Disposition w/ rational 5 pts EXAMPLE PLAN (30 points) : YOU MUST WRITE ORDERS. NO ESSAYS!

Therapeutic and non-therapeutic modalities: (5 points)

Meloxicam 5mg Po Daily
Vitamin D 1000units Po weekly
Tylenol 1000mg Po TID
Alternate Ice and heat
Knee brace on during the day, off at night Additional labs or diagnostic test
1. Rheumatoid factor and Uric Acid Health Promotion: (5 points) -Schedule osteoporosis screening -Goal weight loss is 5% -Update your flu vaccine and take your COVID booster -AHA rec exercise most days of the week: consider water aerobics – Stop smoking Education: (5 points)

You have OA in your knee that is causing pain. First line tx is tylenol. NSAIDs and PT. Avoid Narcotics for risk of fall
Meloxicam can cause BLE edema/CHF and kidney injury. Take only once a day and complete after 7 days. If you notice blood in your stool or swelling in your legs call the office
Avoid repetitive movements like running /walking long distances
You are at risk for fall . Make sure you work on balance and may use a walker
Notify your job that you should limit weight bearing to 10lbs Consult w/ brief rational (5 points)
Orthopedic surgeon: evaluate steroid knee injection
Physical Therapy: strength training F/U and rational (5 points)
1 month to evaluate effectiveness of brace and progress with strength Screen for SE of Nsaid use and effectiveness of plan
WK 9 i-Human Notes: Gloria Jenkins
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NURS 6521 Advance Health Assessment Fecal Occult Blood Test

NURS 6521 Advance Health Assessment Fecal Occult Blood Test

NURS 6512 Advance Health Assessment Week 3 Assignment (Instructions and Rubric)

Option 1 Diagnostic Tests assigned to students in Groups A 

Assignment Option 1: Adult Assessment Tools or Diagnostic 
Case: Fecal Occult Blood Test

The Assignment

Assignment (3–4 pages, not including title and reference pages):

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:

• A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
  • What is its purpose?
  • How is it conducted?
  • What information does it gather?
• Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting. NURS 6521 Advance Health Assessment Fecal Occult Blood Test

To Prepare

• Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
• By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note:Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
• Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
  

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Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.

Fecal occult blood test

 Student’s name

Institution

Course code

Due date

Fecal occult blood test

Assessment tools play an essential role in ensuring that health care practitioners can recognize any health issue or risk that a patient may be experiencing and design steps to help eradicate the ailment.

There are numerous assessment procedures and tools used in health care facilities for various diseases, ranging from those used for children to those used for adults

This study focuses on the Fecal Occult Blood Test. It examines the purpose of the test, information gathered, and validity, reliability, and sensitivity.

Colorectal cancer

Colorectal cancer is among the most common cancers reported globally (Issa et al., 2017). It affects all populations, regardless of color, ethnicity, gender, or financial position. In the absence of adequate screening, both diagnosis and treatment are delayed. NURS 6521 Advance Health Assessment Fecal Occult Blood Test

Fecal occult blood testing is one of the numerous methods for screening for colon cancer, and it is safe to use in asymptomatic individuals. It assists in the early detection of cancer by directing patient selection for follow-up tests such as colonoscopies (Issa et al., 2017).

FOBT is not required for high-risk or symptomatic patients, who should instantly be referred to a gastroenterologist for further checkups and therapy.

When fecal occult blood testing is misused or performed incorrectly, unnecessary testing, greater healthcare costs, and longer hospitalization. As a result, it should be performed only when considered necessary

The purpose of fecal occult blood test

The fecal occult blood test involves collecting stool samples and determining whether or not they contain occult. The main goal of this test is to detect any blood in stool samples, especially in individuals who have colorectal cancer.

The presence of occult in the feces indicates that the patient has colon cancer (Liles et al., 2017). Given that only a small volume of blood can isolate from the stool, it requires other tests to determine its cause or the bleeding location.

This test is mainly used to assess individuals who have signs and symptoms of colon cancer. But still, this screening is not always reliable, and other procedures, such as a colonoscopy, must be performed to confirm if the patient has colon cancer (Liles et al., 2017).

To produce satisfactory results, patients are advised to avoid eating red meat, using any analgesic, or taking vitamin C supplements that might interfere with the test. In short, the prime purpose of a fecal occult blood test is to detect the presence of blood in stool samples from people suspected to have colon cancer.

How It Is Conducted

This test is often conducted before colonoscopy in individuals suspected to have colon owing to their presenting symptoms. According to Akram et al., 2017, three primary types of fecal occult blood tests vary in collection procedures and analysis.

For instance, the immunochemical fecal occult blood test (iFOBT) is a non-invasive blood test performed at home. Anyone can perform this test following the guideline which healthcare practitioners must supply. iFOBT test has three subtypes which are performed following their guideline.

Among these subtypes, the guaiac smear test requires collecting stool samples from three different bowel movements. These stool samples must be preserved in three separate glass vials. During collection, the patient must guarantee that the sample does not contact water or urine.

Once the sample has been collected, they must be spread in the different test strips, label and sealed as directed by the physician, and then transported to a laboratory.

Another type of fecal blood test, termed fecal immunochemical FOBT test, requires gathering stool samples from two to three bowel movements.

Unlike the iFOBT test, the collection requires a special brush often included in the collection box (Pioche et al., 2018). Fecal immunochemical FOBT test requires that the sample be smeared onto the test card, labeled, packed, and shipped to the laboratory.

A flushable reagent blood test is performed at home using disposable pads. This test requires the patient to place the pad or tissue throughout the bowl and detects blood in the tissue or pad. This test takes around 6 to 10 days, including proper preparation.

To get the most accurate results, certain foods, for instance, red meat, medication like NSAIDs, Colchicine, must be avoided during the test (Akramet al, 2018).

 Information Gathered

The fecal blood test results can either be positive or negative. If no blood is found on the stool samples, the test is deemed negative. If the fecal blood test was intended to test for colorectal cancer, the patient must be advised to wait for a while before repeating the test procedure (Singal et al.,2018).

The presence of blood in the stool can indicate bleeding within the intestine. This is not necessary cancer as there are many health complications, for example, ulcerative colitis, Crohns diseases, hemorrhoids, anal fissures, and polyps which might generate the findings.

And so, an additional test, for instance, colonoscopy, must be conducted to determine the precise size and source of the bleeding. NURS 6521 Advance Health Assessment Fecal Occult Blood Test

Validity and Reliability

Validity

When choosing a test, validity is an essential consideration. It relates to how well the test measures. The value of test scores is provided by validity.

In most cases, it refers to the diagnostic test’s ability to distinguish between persons who have or do not have a particular healthcare issue. In fecal blood tests, it can discriminate between individuals who have and do not have colorectal cancer.

Specificity and sensitivity are two criteria that may be used to assess validity. Specificity entails classifying persons as disease-free. It is connected to negative FOBT findings. Sensitivity classifies people as ill, and it is related to positive FOBT findings, which indicate that the person has colon cancer (Le Pimpec ey al., 2017).

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The predictive value is a parameter used to assess the accuracy of a clinical diagnosis. In essence, predictive value refers to the number of times a positive or negative assessment is typically the actual value.

Screenings utilizing gFOBT in the case of fecal blood tests may be impaired by an increased likelihood of false-positive findings, particularly if the patient does not adhere to food restrictions.

Reliability

Reliability is the consistency with which a test evaluates a feature. The reproducibility and accuracy of test findings determine reliability. It has been linked to improved accuracy and sensitivity in detecting invasive cancer in the context of a fecal blood test (Le Pimpec et al., 2017).

The reliability of fecal blood tests is determined by comparing test results to the eventual accurate diagnosis.

References

Singal, A. G., Corley, D. A., Kamineni, A., Garcia, M., Zheng, Y., Doria-Rose, P. V., … & Halm, E. A. (2018). Patterns and Predictors of Repeat Fecal Occult Blood Test Screening in Four Large Health Systems in the United States. The American journal of gastroenterology, 113(5), 746.

Pioche, M., Ganne, C., Gincul, R., De Leusse, A., Marsot, J., Balique, J., … & Ponchon, T. (2018). Colon capsule versus computed tomography colonography for colorectal cancer screening in patients with positive fecal occult blood test who refuse colonoscopy: a randomized trial. Endoscopy, 50(08), 761-769.

Akram, A., Juang, D., Bustamante, R., Liu, L., Earles, A., Ho, S. B., … & Gupta, S. (2017). Replacing the guaiac fecal occult blood test with the fecal immunochemical test increases proportion of individuals screened in a large healthcare setting. Clinical Gastroenterology and Hepatology, 15(8), 1265-1270.

Liles, E. G., Coronado, G. D., Perrin, N., Harte, A. H., Nungesser, R., Quigley, N., … & deVos, T. (2017). Uptake of a colorectal cancer screening blood test is higher than of a fecal test offered in clinic: a randomized trial. Cancer Treatment and Research Communications, 10, 27-31.

Le Pimpec, F., Moutel, G., Piette, C., Lièvre, A., & Bretagne, J. F. (2017). Fecal immunological blood test is more appealing than the guaiac-based test for colorectal cancer screening. Digestive and Liver Disease, 49(11), 1267-1272.

Issa, I. A., & Noureddine, M. (2017). Colorectal cancer screening: An updated review of the available options. World journal of gastroenterology, 23(28), 5086. NURS 6521 Advance Health Assessment Fecal Occult Blood Test

Assessment Tools and Diagnostic Tests in Adults and Children

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values.

Include the following:

• A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
  • What is its purpose?
  • How is it conducted?
  • What information does it gather?
• Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting. Assessment Tools and Diagnostic Tests in Adults and Children

Include the introduction with the purpose statement and conclusion.

Use a heading for each major part of the assignment:

• • What is its purpose?
  • How is it conducted?
  • What information does it gather?
  • Validity and Reliability
  • Issues with Sensitivity, Reliability, and Predictive values

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Solution

Cancer constitutes various types of illness that may start or affect any body tissue or organ following the uncontrollable growth of abnormal cells and invade adjacent tissues when they grow beyond their normal boundaries. This invasion to adjacent cells, organs, or tissues is termed metastasis and is a major cause of mortality among cancer patients. Cancers may also be regarded as malignant tumors or neoplasms. Cancer is ranked the second leading cause of mortality globally, causing approximately 9.5 million deaths (Ilic et al., 2018). Early and accurate assessment and diagnosis can improve the proposed therapy effectiveness and avoid the disease’s long-term complications to the infected individual (Carroll & Mohler, 2018). Various diagnostic and assessment techniques are available for children and adult patients, including screening programs, radical surgery, chemotherapy, radiation, and imaging. This paper will discuss Prostate-Specific Antigen (PSA) as one of the diagnostic tests in male adults.

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Purpose of the Test

PSA constitutes a protein produced primarily by the prostate gland cells, both malignant and normal. The PSA test is one blood test that measures the PSA’s levels in a man’s circulating blood. The blood sample is withdrawn, and the results are reported following a laboratory analysis. The findings are reported in nanograms of the protein (PSA) per milliliter (ng/ml) (Fenton et al., 2018). prostate cancer is one of the common cancers in men, besides being a frequent cause of demise in the affected males. Early detection and diagnosis of health issues are vital in initiating appropriate and timely treatment, hence better patient prognosis.

Prostate cancer causes an elevation in the body’s PSA levels. However, other non-cancerous or non-malignant conditions contribute to an increase in this protein level in the body, including bacterial prostatitis, ejaculation, or acute urinary retention. The PSA test’s purpose is to detect the levels of the protein PSA in a men’s body but does not solely provide precise and reliable diagnostic information regarding any underlying pathology (Fenton et al., 2018). The test is significantly implicated in most laboratory settings to detect an elevation of these PSA proteins in the blood. This diagnostic technique is used alongside digital rectal examination. Assessment Tools and Diagnostic Tests in Adults and Children

According to Ilic et al. (2018), combining these assessment and diagnostic tests helps diagnose prostate cancer in male adults. During the digital rectal examination, the physician could press, feel, and detect the size of the patient’s prostate gland, any present hard regions, or abnormal lumps. These two tests do not compressively and entirely diagnose prostate cancer in men. However, abnormal findings in the initial assessment may necessitate a prostate biopsy to determine the presence or absence of malignant prostate cells.  The PSA test may also be implicated in patients already diagnosed with prostate cancer to determine the effectiveness of therapy or check the recurrence of the disease.

How PSA Test is Conducted, and the Information Gathered

The PSA test procedure involves a lab technician or a physician withdrawing a small blood sample from the individual’s upper extremities. The sample is thus sent to the lab to test or detect for the presence of PSA, a specific protein marker that significantly determines the individual’s prostate health (Duffy, 2020).

The prostate-specific antigen test could produce false-positive or false-negative findings. As such, the lab results could indicate exceedingly low or high levels of the protein marker, which may often fail to correlate to prostate cancer’s presence. However, coupling with digital rectal examination and prostate biopsy, prostate cancer detection, and appropriate diagnosis may thus be made.

Various variations in prostate-specific antigen tests have been implicated in clinical settings. For instance, the PSA velocity determines the changes in PSA levels in the individual’s body over time (Nordström et al., 2018). Detection in a rapid rise in this protein often indicates an aggressive form of prostate cancer. The percentage of free prostate-specific antigen is another variation in the diagnosis of prostate cancer. The PSA naturally exists in two forms in circulating blood; unattached or attached to specific blood proteins. High prostate-specific antigen levels with a correspondingly low value in its unattached form likely indicate prostate cancer (Nordström et al., 2018).

Validity and Reliability

The concern of wasteful biopsies, on the one hand, and the greater danger of missing a treatable malignancy, on the other, motivate the need for a precise marker. There is no agreement on which PSA adjustments should be used, and none of them has been proved to minimize the number of needless biopsies or enhance clinical results (Carroll & Mohler, 2018). In some instances, PSA may miss the detection of prostate cancer and provide false reassurance to the individual. Besides, the test does not determine the difference between fast-growing and slow-growing malignancies (Ilic et al., 2018).

Issues with Sensitivity and Predictive values

Ongoing research is to find new blood markers with improved predictive value for prostate cancer, especially those that can anticipate aggressive tumors that can be treated to save lives. A PSA threshold of 4.0 ng/mL was shown to have a sensitivity of 21% for identifying asymptomatic prostate cancer and 51% for fully extended tumors. These sensitivities were raised by 32 and 68 percent, respectively, when a 3.0 ng/mL threshold was used (Fenton et al., 2018). The predictive values for a PSA threshold of 4 and 3 ng/mL were 91 percent and 85 percent, respectively.

Conclusion

In combination with other assessment tests, the PSA test constitutes a major clinically relevant diagnostic test for prostate cancer in men. The test is essentially useful when performed early in individuals at higher of developing this type of cancer. Early detection and diagnosis of prostate cancer enhance the individual’s health outcomes when medical interventions are also simultaneously initiated. Regular screening for this type of cancer facilitates this early detection, minimizing the risk of metastasis and other associated health complications. Assessment Tools and Diagnostic Tests in Adults and Children

References

Carroll, P. H., & Mohler, J. L. (2018). NCCN guidelines updates: prostate cancer and prostate cancer early detection. Journal of the National Comprehensive Cancer Network, 16(5S), 620-623.

Duffy, M. J. (2020). Biomarkers for prostate cancer: prostate-specific antigen and beyond. Clinical Chemistry and Laboratory Medicine (CCLM), 58(3), 326-339.

Fenton, J. J., Weyrich, M. S., Durbin, S., Liu, Y., Bang, H., & Melnikow, J. (2018). Prostate-specific antigen-based screening for prostate cancer: evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(18), 1914-1931.

Ilic, D., Djulbegovic, M., Jung, J. H., Hwang, E. C., Zhou, Q., Cleves, A., … & Dahm, P. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. Bmj, 362.

Nordström, T., Akre, O., Aly, M., Grönberg, H., & Eklund, M. (2018). Prostate-specific antigen (PSA) density in the diagnostic algorithm of prostate cancer. Prostate Cancer and Prostatic Diseases, 21(1), 57-63. Assessment Tools and Diagnostic Tests in Adults and Children

Assignment: Workplace Environment Assessment

Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.

In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.

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To Prepare:

• Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
• Review the Work Environment Assessment Template.
• Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
• Select and review one or more of the following articles found in the Resources: I uploaded three of them:
  • Clark, Olender, Cardoni, and Kenski (2011)
  • Clark (2018)
  • Clark (2015)
  • Griffin and Clark (2014)

The Assignment (3-6 pages total):

Part 1: Work Environment Assessment (1-2 pages) Assignment: Workplace Environment Assessment

• Review the Work Environment Assessment Template you completed for this Module’s Discussion. (You will have done this assessment prior to this assignment)
• Describe the results of the Work Environment Assessment you completed on your workplace.
• Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
• Explain what the results of the Assessment suggest about the health and civility of your workplace.

Part 2: Reviewing the Literature (1-2 pages)

• Briefly describe the theory or concept presented in the article(s) you selected.
• Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
• Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.

Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)

• Recommend at least two strategies, supported in the literature,that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
• Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment. Assignment: Workplace Environment Assessment

 

Excellent	Good	Fair	Poor
Part 1: Work Environment Assessment   ·  Complete the Work Environment Assessment Template. ·   Describe the results of the Work Environment Assessment you completed on your workplace. ·   Identify two things that surprised you about the results and one idea that you believed prior to conducting the assessment that was confirmed. ·   Explain what the results of the assessment suggests about the health and civility of your workplace.	45 (45%) – 50 (50%)  An accurate, detailed, and completed Work Environment Assessment Template is provided. The responses accurately and thoroughly describe in detail the results of the Work Environment Assessment completed on a workplace. The responses accurately and clearly identify two surprising things about the results and thoroughly describe in detail at least one idea that was believed prior to conducting the assessment that was confirmed. The responses accurately and thoroughly explain in detail what the results of the assessment suggests about the health and civility of a workplace.	40 (40%) – 44 (44%)  An accurate and completed Work Environment Assessment Template is provided. The responses accurately describe the results of the Work Environment Assessment completed on a workplace. The responses accurately identify two surprising things about the results and describe at least one idea that was believed prior to conducting the assessment that was confirmed. The responses accurately explain what the results of the assessment suggests about the health and civility of a workplace.	35 (35%) – 39 (39%)  A completed Work Environment Assessment Template that is vague or inaccurate is provided. The responses describe the results of the Work Environment Assessment completed on a workplace that is vague or inaccurate. The responses identify two surprising things about the results and describe at least one idea that was believed prior to conducting the assessment that was confirmed that is vague or inaccurate. The responses explain what the results of the assessment suggests about the health and civility of a workplace that is vague or inaccurate.	0 (0%) – 34 (34%)  A vague and inaccurate Work Environment Assessment Template is provided, or is missing. The responses describe the results of the Work Environment Assessment completed on a workplace that is vague and inaccurate, or is missing. The responses identify two surprising things about the results and describe at least one idea that was believed prior to conducting the assessment that was confirmed that is vague and inaccurate, or is missing. The responses explain what the results of the assessment suggest about the health and civility of a workplace that is vague and inaccurate, or is missing.
Part 2: Reviewing the Literature   ·   Briefly describe the theory or concept presented in the article you selected. ·   Explain how the theory or concept presented in the article relates to the results of your Work Environment Assessment. ·   Explain how your organization could apply the theory highlighted in your selected article to improve organizational health and/or stronger work teams. Be specific and provide examples.	14 (14%) – 15 (15%)  The responses accurately and thoroughly describe the theory or concept presented in the article selected. The responses accurately and completely explain in detail how the theory or concept presented in the article relates to the results of the Work Environment Assessment. The responses accurately and thoroughly explain in detail how an organization could apply the theory highlighted in the selected article to improve organizational health and/or stronger work teams. Specific and detailed examples are provided which fully support the responses.	12 (12%) – 13 (13%)  The responses accurately describe the theory or concept presented in the article selected. The responses accurately explain how the theory or concept presented in the article relates to the results of the Work Environment Assessment. The responses accurately explain how an organization could apply the theory highlighted in the selected article to improve organizational health and/or stronger work teams. Specific examples are provided which may support the responses.	11 (11%) – 11 (11%)  The responses describe the theory or concept presented in the article selected that is vague or inaccurate. The responses explain how the theory or concept presented in the article relates to the results of the Work Environment Assessment that is vague or inaccurate. The responses explain how an organization could apply the theory highlighted in the selected article to improve organizational health and/or create stronger work teams that is vague or inaccurate. Vague or inaccurate examples are provided which may support the responses.	0 (0%) – 10 (10%)  The responses describe the theory or concept presented in the article selected that is vague and inaccurate, or is missing. The responses explain how the theory or concept presented in the article relates to the results of the Work Environment Assessment that is vague and inaccurate, or is missing. The responses explain how an organization could apply the theory highlighted in the selected article to improve organizational health and/or create stronger work teams that is vague and inaccurate, or is missing. Specific examples are not provided to support the responses.
Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams   ·   Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment. ·   Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.	18 (18%) – 20 (20%)  The responses clearly and thoroughly recommend in detail at least two strategies that can be implemented to address any shortcomings revealed in the Work Environment Assessment. The responses clearly and thoroughly recommend in detail at least two strategies that can be implemented to bolster successful practices revealed in the Work Environment Assessment.	16 (16%) – 19 (19%)  The responses accurately recommend at least two strategies that can be implemented to address any shortcomings revealed in the Work Environment Assessment. The responses accurately recommend at least two strategies that can be implemented to bolster successful practices revealed in the Work Environment Assessment. Assignment: Workplace Environment Assessment	14 (14%) – 15 (15%)  The responses recommend at least two strategies that can be implemented to address any shortcomings revealed in the Work Environment Assessment that is vague or inaccurate, or only recommends one strategy. The responses recommend at least two strategies that can be implemented to bolster successful practices revealed in the Work Environment Assessment that is vague or inaccurate, or only recommends one strategy.	0 (0%) – 13 (13%)  The responses recommend at least two strategies that can be implemented to address any shortcomings revealed in the Work Environment Assessment that is vague and inaccurate, only recommends one strategy, or is missing. The responses recommend at least two strategies that can be implemented to bolster successful practices revealed in the Work Environment Assessment that is vague and inaccurate, only recommends one strategy, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:   Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.	5 (5%) – 5 (5%)  Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.	4 (4%) – 4 (4%)  Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.	3.5 (3.5%) – 3.5 (3.5%)  Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	0 (0%) – 3 (3%)  Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting – English writing standards:   Correct grammar, mechanics, and proper punctuation	5 (5%) – 5 (5%)  Uses correct grammar, spelling, and punctuation with no errors.	4 (4%) – 4 (4%)  Contains a few (1 or 2) grammar, spelling, and punctuation errors.	3.5 (3.5%) – 3.5 (3.5%)  Contains several (3 or 4) grammar, spelling, and punctuation errors.	0 (0%) – 3 (3%)  Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.	5 (5%) – 5 (5%)  Uses correct APA format with no errors.	4 (4%) – 4 (4%)  Contains a few (1 or 2) APA format errors.	3.5 (3.5%) – 3.5 (3.5%)  Contains several (3 or 4) APA format errors.	0 (0%) – 3 (3%)  Contains many (≥ 5) APA format errors.
Total Points: 100

 

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Solution

 

 

 

Workplace Environment Assessment

Part 1: Work Environment Assessment

Workplace environment is a critical factor which affect employees’ performance, engagement, and productivity in their daily duties and roles. An employee’s loyalty, interaction with colleagues, and role performance is determined by workplace environment. A stressful and unhealthy work environment results in poor productivity, poor patient outcomes and low quality care. This essay examines workplace assessment, presents a review of conversations to inspire and promote a more civil workplace article by Clark (2015), and strategies to promote a healthy work environment/ practices at work.

Description of the results of the Work Environment Assessment completed on workplace

Workplace environment was done using Clark healthy workplace inventory tool where my current workplace scored low indicating an unhealthy work environment. The results reflected that the organization had poor communication and lacked team work and cooperation between staff. Some employees had toxic personalities and the management failed to hold employees responsible for their negative behaviors.

Employees complained of huge workload, dissatisfaction, under appreciation, and frequent burnout resulting into low productivity, lack of interest in duty discharge, and high staff turnover. Additionally, there was a high level of mistrust between the employees and management and there were no opportunities for professional growth. When there is dissatisfaction and lack of teamwork among healthcare workers, patient safety and care become compromised.

Surprises on the results and ideas confirmed after Conducting the Assessment

The surprises from the results is the workplace assessment score reflected the exact issues being experienced and matched the extent of civility in the organization. Based on the results, the organization can improve on its weak areas to create a safe working environment and improve civility. Prior to conducting the environment, I was of the opinion that low remuneration, poor communication, and huge workload on employees decrease the workplace civility and score of workplace assessment.

This was confirmed during assessment as my workplace scored poorly due to poor communication, lack of communication and teamwork, and lack of opportunities for career growth.  Before the assessment, I had not realized what employees feel regarding their workplace. During the assessment, some employees gave suggestions on strategies to improve their working environment. This implied that it would be prudent to engage them in conversations that seek to improve civility at workplace.

Results of Assessment on Workplace Health and Civility

The results from the assessment indicate that the workplace is not civil. Lack of teamwork, high workload, dissatisfaction, and poor communication are some of the areas that need improvement to enhance civility in workplace. Incivility at workplace make employees to experience resentment towards work and clients, distressed, and have low motivation to work which consequently results in poor patient outcomes, low quality of care, unsafe working conditions, and increased medical costs (Walsh & Magley, 2020).  Clark (2015) suggested that civility can be improved through coaching and commending civil behaviors as well as holding people accountable for their actions. Assignment: Workplace Environment Assessment

 Part 2: Reviewing the Literature

Description of Theory Presented in Article Clark, C. M. (2015)

Clark’s (2015) article on conversations to inspire and promote a more civil workplace article asserts that communication and conversations are important in promoting civility at workplace. The article opined that a stressful environment impedes communication and creates unhealthy workplace.

Effective stress coping mechanisms helps to maintain healthy communication, enhance patient safety and care, and proper emotional management (Clark, 2015).  The article postulated that adherence to nursing code of ethics would enhance civility at work since it promotes for treatment of employees with dignity, respect and obligates nurses and organizational management to foster and nurture a healthy and civil workplace.

How Clark (2015) Theory relates to the results of Work Environment Assessment

Clark’s article on conversations to inspire and promote a more civil workplace relates to the workplace assessment results in that it describes how a healthy workplace should be and how organizations can promote civility through conversations and coaching. Clark (2015) noted that a healthy workplace environment promotes safety, productivity, respect, teamwork, and employee retention.

This is reflected in the workplace assessment which indicated an unhealthy workplace that lacked most of the elements that Clark indicated as necessary in promoting civility and positive work environment. The assessment indicated dissatisfaction among staff and compromised patient safety. It is necessary to promote conversations and civility at work to promote work ethics, quality of care, productivity, and nursing practice.

 Application of Clark (2015) in improving Organizational Health and Creating Stronger Work Teams

Clark’s theory on conversations to inspire and promote a more civil workplace can be applied in organizational settings to create stronger work teams. Through conversations, uncivil behavior can be dealt with and help to avoid confrontations. Enhancement of workplace culture and interactions can help to improve teamwork and performance at work (Hossny & Sabra, 2020). Respectful conversations in a relaxed environment can improve communication skills and promote inter-professional collaboration between employees.

Part 3: Evidence-based Strategies to Create High-performance Inter-professional Teams

To create and maintain high performance inter-professional teams, it is prudent to incorporate evidence-based strategies that provide a framework that employees can use to improve productivity, efficiency, and teamwork.

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Strategies to Address Workplace Shortcomings

Shortcomings that were encountered during the workplace assessment include toxic personalities, management not taking action on bad behavior, dissatisfaction among staff, huge workload, high staff turnover, and poor communication. One of the strategies can be adoption of effective communication and conflict resolution skills which will help to call out on bad behavior, deal with issue of toxic personalities, dissatisfaction and huge workload.

Low teamwork, huge workload, and poor communication can be resolved when effective communication skills are applied (Sleem & Seada, 2017). A second strategy would be adoption of policies that promote competitive remuneration and recruitment procedures, fair human resources practices to promote civility, respect, and dignity of all employees. These policies will need strong leadership skills to promote diversity, inclusiveness, and ethical nursing practices through coaching.

Strategies to Bolster Successful Practices Revealed in Work Environment Assessment

To ensure that the successful practices revealed in the workplace assessment are maintained and bolstered in practice, it is necessary to motivate employees and maintenance of civil attributes. Motivation can be done through rewarding nurses who exhibit positive attributes of civility (Sleem & Seada, 2017). This will make the employees more proactive in civil behaviors as well as encourage other employees to improve on civility. Another strategy will be to train employees on practices that increase civility at work. This will create awareness among employees on uncivil behaviors to be shunned. Training helps to instil knowledge of civility and also build a more civil and healthy workplace assessment.

References

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Hossny, E. K., & Sabra, H. E. (2020). Effect of nurses’ perception to workplace civility climate on nurse–physician collaboration. Nursing Open.

Sleem, W. F., & Seada, A. M. (2017). Role of Workplace Civility Climate and Workgroup Norms on Incidence of Incivility Behaviour among Staff Nurses. International Journal Of Nursing Didactics, 7(6), 34-43.

Walsh, B. M., & Magley, V. J. (2020). Workplace civility training: Understanding drivers of motivation to learn. The International Journal of Human Resource Management, 31(17), 2165-2187. Assignment: Workplace Environment Assessment