Triage Assessment Form: Crisis Intervention Assignment

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Triage Assessment Form: Crisis Intervention Assignment 

Triage Assessment Form: Crisis Intervention Assignment

Using the Triage Assessment Form Paper

After reading the case examples in the Myer and Conte (2006) article, you have a better understanding of how to use one type of assessment tool. A Microsoft Word copy of the Triage Assessment Form (TAF) is included in the assignment Resources. The most current version of this form is also shown in your James and Gilliland (2013) text, pages 63–65. Use the form to analyze Jordan, described below. You can save the form as you have completed it as a MS Word document or as a PDF document, and attach the form to your written paper as an appendix. Triage Assessment Form: Crisis Intervention Assignment

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Rate the client in each of the three domains (Affective, Behavioral, and Cognitive) using the Severity Scale included with each domain on the Triage Assessment Form (TAF) and total the scores. Describe, in detail, the rationale for your ratings, including your judgment about how intense and directive the treatment should be based upon the total score. In your discussion of the rationale, summarize diagnostic skills and techniques that can be used to screen for addiction, aggression, and danger to self and others, as you note these risks in your client. Similarly, a possible co-occurring mental disorder (such as substance abuse) may become apparent during a crisis, disaster, or other trauma-causing event that ties in with your assessment during the client’s crisis. Note this as well in your rationale. Triage Assessment Form: Crisis Intervention Assignment

 

Project Objectives

 

To successfully complete this project, you will be expected to:

 

·         Summarize diagnostic skills and techniques used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, disaster, or other trauma-causing events.

 

·         Evaluate key elements of the crisis, disaster, or trauma-causing event including the nature of the crisis and associated risks, including client and counselor safety.

 

·         Discuss developmental and cultural considerations in crisis assessment and intervention.

 

·         Exhibit proficiency in effective, credible academic writing, and critical thinking skills.

 

Note: A template for your APA formatted paper is included in the assignment Resources. Please use the template to present the assignment criteria in an organized way. The headings guide you to the criteria, and the details that are included describe what is necessary to complete the assignment to a Distinguished degree.  Triage Assessment Form: Crisis Intervention Assignment

Case

 

 

 

Jordan

 

Jordan arrives at counseling saying that her husband, Jake, left the house earlier that day in an agitated mood and with his rifle, and tearfully discloses concerns about her safety and his. She states that her friend, who has been worried about her for some time, insisted that she see a counselor. Jordan says she was surprised at Jake’s abrupt departure because she was unaware of any plans he had to go hunting, and if he was not going hunting, why he would take his gun out. She recalls that she and Jake had fought the previous night over his drinking. Jordan reports that she asked Jake to stop drinking so much, and in response, he threatened her and slammed a few doors. She recalls that Jake said he liked being a little drunk and pushed her back against the kitchen counter at one point. When Jake went back into a spare bedroom to sleep that night, Jordan found numerous beer bottles in the den and a large empty whiskey bottle in front of his truck. Triage Assessment Form: Crisis Intervention Assignment. Jordan states that it was not unusual for Jake to put his rifle in his truck when he planned to go hunting, but when he had done so today, he had still been quite angry about her accusation that he was drinking too much. After he left, Jordan reports that she began shaking. She felt fear for her own safety, so she called her friend who insisted that she speak to a counselor. While Jordan was on her way to counseling, her husband called her. He seemed calm, asked about her day, and said nothing about the previous night or his abrupt departure. Jordan states that this switch in mood from extreme aggression to a pleasant tone “seems weird.” Jordan asks for help in dealing with her husband’s odd behaviors. She fears for her own safety and the safety of her husband, but is unwilling to call the police. As she speaks, she is agitated and continually looks over at the doorway, as though expecting it to burst open.

Triage Assessment Form: Crisis Intervention Assignment

Project Requirements

 

·         Content: Prepare a comprehensive paper that includes all elements described.

 

·         Components: The paper must include a title page, abstract, and reference list.

 

·         Written communication: Develop accurate written communication and thoughts that convey the overall goals of the project and do not detract from the overall message. Triage Assessment Form: Crisis Intervention Assignment

 

·         APA formatting: Resources and citations must be formatted according to APA (6th Edition) style and formatting.

 

·         Number of pages: The body of the paper should fall within 3–5 pages of text, plus 3 pages of the Triage Assessment Form, excluding title page and reference list.

Triage Assessment Form: Crisis Intervention Assignment

·         Number of resources: Minimum of 4 current resources, published within the last 12 years, and you may include your text as one.

 

·         Font and font size: Times New Roman, 12-point.

 

Submit the completed paper and form to the assignment area.

Using the Triage Assessment Form

Learner First Name MI. Last Name

Instructor Name

 

 

 

Abstract

There is no indent on an abstract. An abstract is a paragraph that summarizes the most important parts of the entire paper. It briefly allows your reader to quickly obtain an overview of your writing. It is an accurate reflection of the purpose and content of the text written in clear and concise language within the limit of 150 to 250 words.

Triage Assessment Form: Crisis Intervention Assignment

Using the Triage Assessment Form

Include the title of your paper centered at the top of the page, not bolded; it is not considered a heading. *This first section is your paper’s introduction. Note that it does not have a heading; its position at the beginning of the body of the paper implies that it is the introduction. In the body of your paper, indent the first line of each paragraph. As always, use double spaced, 12-point Times New Roman font, and 1.0 margins all around the page layout. Throughout the paper, please support your work by citing at least four current resources (including your textbook).  For the purposes of this assignment, simply replace this text with a brief paragraph in your own words introducing the topic and informing the reader of the organization of the paper.  Triage Assessment Form: Crisis Intervention Assignment

Triage Assessment of the Client

Complete the Triage Assessment Form for the selected case, including all three domains and the total score.  In this section of the paper, summarize the results and provide a logical and articulate rationale for each of the domain ratings with specific descriptions of each, by relating the specifics of the case to the ratings you determine. There is detail about using the TAF in Chapter 3 of your text, as well as the assigned Myer and Conte article. Use appropriate terminology, such as the psychobiological assessment found in Chapter 3 of your text, and language found in the TAF Severity Scales, to guide the course of treatment based upon your total score.  Triage Assessment Form: Crisis Intervention Assignment

Diagnostic Skills and Techniques

Elaborate on diagnostic skills and techniques that can be used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, such as the Hybrid Model and the ABC’s of Assessing Crisis Intervention found in Chapter 3 of your text. Discuss what counseling skills you use in a triage assessment of this client.Triage Assessment Form: Crisis Intervention Assignment

Developmental and Cultural Considerations in Crisis Assessment and Intervention

In this section of the paper, describe how you would differentiate between the characteristics of crisis states versus developmentally appropriate reactions to life obstacles.  Describe crisis assessment and interventions considerations and strategies when working with diverse populations.  Consider any cultural, diversity, or even gender issues that may be involved in assessment or intervention with your chosen scenario. Give examples of what you would include in your assessment and intervention.  Triage Assessment Form: Crisis Intervention Assignment

 

 

References

Cite your textbook and at least three scholastic articles in your paper. The reference below provides an example citation for an article.

Author, A. A., Author, B. B., & Author, C. C. (year). Title of article. Title of Periodical, volume# (issue#), xx–xx.

 

Triage Assessment Form: Crisis Intervention

© by R. A. Myer, R. C. Williams, A. J. Ottens, & A. E. Schmidt

Crisis Event

Identify and describe briefly the crisis situation:

______________________________________________________________________________________________________________________________________________________________________________________________Triage Assessment Form: Crisis Intervention Assignment________________________________

Affective Domain

Identify and describe briefly the affect that is present. (If more than one affect is experienced, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

Anger/Hostility
____________________________________________________________________________________________________________________________________________________

Anxiety/Fear
____________________________________________________________________________________________________________________________________________________

Sadness/Melancholy
____________________________________________________________________________________________________________________________________________________

Affective Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1 2        3 4        5 6        7 8        9 10
No Impairment Minimal Impairment Low Impairment Moderate Impairment Marked Impairment Severe Impairment
Stable mood with normal variation of affect appropriate to daily functioning. Affect appropriate to situation. Brief periods during which negative mood is experienced slightly more intensely than situation warrants. Triage Assessment Form: Crisis Intervention Assignment 

Emotions are substantially under client control.

 Affect appropriate to situation but increasingly longer periods during which negative mood is experienced slightly more intensely than situation warrants. Client perceives emotions as being substantially under control. Affect may be incongruent with situation. Extended periods of intense negative moods. Mood is experienced noticeably more intensely than situation warrants. Liability of affect may be present. Effort required to control emotions. Negative affect experienced at markedly higher level than situation warrants. Affects may be obviously incongruent with situation. Mood swings, if occurring, are pronounced. Onset of negative moods are perceived by client as not being under volitional control.Triage Assessment Form: Crisis Intervention Assignment Decompensation or depersonalization evident.

Behavioral Domain

Identify and describe briefly which behavior is currently being used. (If more than one behavior is used, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

Approach ____________________________________________________________________________________________________________________________________________________

Avoidance ____________________Triage Assessment Form: Crisis Intervention Assignment________________________________________________________________________________________________________________________________

Immobility ____________________________________________________________________________________________________________________________________________________

Behavioral Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1 2        3 4        5 6        7 8        9 10
No Impairment Minimal Impairment Low Impairment Moderate Impairment Marked Impairment Severe Impairment
Coping behavior appropriate to crisis event. Client performs those tasks necessary for daily functioning. Occasional use of ineffective coping behaviors. Client performs those tasks necessary for daily functioning, but does so with noticeable effort. Occasional use of ineffective coping behaviors. Client neglects some tasks necessary for daily functioning.Triage Assessment Form: Crisis Intervention Assignment Client displays coping behaviors that may be ineffective and maladaptive. Ability to perform tasks necessary for daily functioning is noticeably compromised. Client displays coping behaviors that are likely to exacerbate crisis situation. Ability to perform tasks necessary for daily functioning is markedly absent. Behavior is erratic, unpredictable. Client’s behaviors are harmful to self and/or others.

Cognitive Domain

Identify whether a transgression, threat, or loss has occurred in the following areas and describe briefly. (If more than one cognitive response occurs, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

PHYSICAL (food, water, safety, shelter, et cetera):Triage Assessment Form: Crisis Intervention Assignment

Transgression _____  Threat _____   Loss _____

____________________________________________________________________________________________________________________________________________________

PSYCHOLOGICAL (self-concept, emotional well-being, identity):

Transgression _____  Threat _____   Loss _____

____________________________________________________________________________________________________________________________________________________

SOCIAL RELATIONSHIPS (family, friends, coworkers, et cetera):

Transgression _____  Threat _____   Loss _____

____________________________________________________________________________________________________________________________________________________

MORAL/SPIRITUAL (personal integrity, values, beliefs):

Transgression _____  Threat _____   Loss _____

____________________________________________________________________________________________________________________________________________________

Cognitive Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1 2        3 4        5 6        7 8        9 10
No Impairment Minimal Impairment Low Impairment Moderate Impairment Marked Impairment Severe Impairment
Concentration intact. Client displays normal problem-solving and decision-making abilities. Client’s perception and interpretation of crisis event match reality of situation. Client’s thoughts may drift to crisis event but focus of thoughts is under volitional control. Problem-solving and decision-making abilities minimally affected. Client’s perception and interpretation of crisis event substantially match reality of situation.Triage Assessment Form: Crisis Intervention Assignment Occasional disturbance of concentration. Client perceives diminished control over thoughts of crisis event. Client experiences recurrent difficulties with problem-solving and decision-making abilities. Client’s perception and interpretation of crisis event may differ in some respects from reality of situation. Frequent disturbance of concentration. Intrusive thoughts of crisis event with limited control. Problem-solving and decision-making abilities adversely affected by obsessiveness, self-doubt, confusion. Client’s perception and interpretation of crisis event may differ noticeably from reality of situation. Client plagued by intrusiveness of thoughts regarding crisis event. The appropriateness of client’s problem-solving and decision-making abilities likely adversely affected by obsessiveness, self-doubt, confusion. Client’s perception and interpretation of crisis event may differ substantially from reality of situation.Triage Assessment Form: Crisis Intervention Assignment Gross inability to concentrate on anything except crisis event. Client so afflicted by obsessiveness, self-doubt, and confusion that problem-solving and decision-making abilities have “shut down.” Client’s perception and interpretation of crisis event may differ so substantially from reality of situation as to constitute threat to client’s welfare.

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Domain Severity Scale Summary

Affective _____          Cognitive _____          Behavioral _____        =   Total _____

Triage Assessment Form: Crisis Intervention

© by R. A. Myer, R. C. Williams, A. J. Ottens, & A. E. Schmidt

Crisis Event

Identify and describe briefly the crisis situation:

______________________________________________________________________________________________________________________________________________________________________________________________________________________________

Affective Domain

Identify and describe briefly the affect that is present. (If more than one affect is experienced, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

Anger/Hostility
____________________________________________________________________________________________________________________________________________________

Anxiety/Fear
__________________Triage Assessment Form: Crisis Intervention Assignment__________________________________________________________________________________________________________________________________

Sadness/Melancholy
____________________________________________________________________________________________________________________________________________________

Affective Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1 2        3 4        5 6        7 8        9 10
No Impairment Minimal Impairment Low Impairment Moderate Impairment Marked Impairment Severe Impairment
Stable mood with normal variation of affect appropriate to daily functioning. Affect appropriate to situation. Brief periods during which negative mood is experienced slightly more intensely than situation warrants. Emotions are substantially under client control.Triage Assessment Form: Crisis Intervention Assignment Affect appropriate to situation but increasingly longer periods during which negative mood is experienced slightly more intensely than situation warrants. Client perceives emotions as being substantially under control. Affect may be incongruent with situation. Extended periods of intense negative moods. Mood is experienced noticeably more intensely than situation warrants. Liability of affect may be present. Effort required to control emotions. Negative affect experienced at markedly higher level than situation warrants. Affects may be obviously incongruent with situation. Mood swings, if occurring, are pronounced. Onset of negative moods are perceived by client as not being under volitional control.Triage Assessment Form: Crisis Intervention Assignment Decompensation or depersonalization evident.

Behavioral Domain

Identify and describe briefly which behavior is currently being used. (If more than one behavior is used, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

Approach ____________________________________________________________________________________________________________________________________________________

Avoidance __________________________________________________________________________________________________________Triage Assessment Form: Crisis Intervention Assignment__________________________________________

Immobility ____________________________________________________________________________________________________________________________________________________

Behavioral Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1 2        3 4        5 6        7 8        9 10
No Impairment Minimal Impairment Low Impairment Moderate Impairment Marked Impairment Severe Impairment
Coping behavior appropriate to crisis event. Client performs those tasks necessary for daily functioning. Occasional use of ineffective coping behaviors. Client performs those tasks necessary for daily functioning, but does so with noticeable effort.Triage Assessment Form: Crisis Intervention Assignment Occasional use of ineffective coping behaviors. Client neglects some tasks necessary for daily functioning. Client displays coping behaviors that may be ineffective and maladaptive. Ability to perform tasks necessary for daily functioning is noticeably compromised. Client displays coping behaviors that are likely to exacerbate crisis situation. Ability to perform tasks necessary for daily functioning is markedly absent.Triage Assessment Form: Crisis Intervention Assignment Behavior is erratic, unpredictable. Client’s behaviors are harmful to self and/or others.

Cognitive Domain

Identify whether a transgression, threat, or loss has occurred in the following areas and describe briefly. (If more than one cognitive response occurs, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

PHYSICAL (food, water, safety, shelter, et cetera):

Transgression _____  Threat _____   Loss _____

__________________Triage Assessment Form: Crisis Intervention Assignment__________________________________________________________________________________________________________________________________

PSYCHOLOGICAL (self-concept, emotional well-being, identity):

Transgression _____  Threat _____   Loss _____

____________________________________________________________________________________________________________________________________________________

SOCIAL RELATIONSHIPS (family, friends, coworkers, et cetera):

Transgression _____  Threat _____   Loss _____

____________________________________________________________________________________________________________________________________________________

MORAL/SPIRITUAL (personal integrity, values, beliefs):

Transgression _____  Threat _____   Loss _____

____________________________________________________________________________________________________________________________________________________

Cognitive Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1 2        3 4        5 6        7 8        9 10
No Impairment Minimal Impairment Low Impairment Moderate Impairment Marked Impairment Severe Impairment
Concentration intact. Client displays normal problem-solving and decision-making abilities. Client’s perception and interpretation of crisis event match reality of situation. Client’s thoughts may drift to crisis event but focus of thoughts is under volitional control. Problem–solving and decision-making abilities minimally affected. Client’s perception and interpretation of crisis event substantially match reality of situation.Triage Assessment Form: Crisis Intervention Assignment Occasional disturbance of concentration. Client perceives diminished control over thoughts of crisis event. Client experiences recurrent difficulties with problem-solving and decision-making abilities. Client’s perception and interpretation of crisis event may differ in some respects from reality of situation. Frequent disturbance of concentration. Intrusive thoughts of crisis event with limited control. Problem-solving and decision-making abilities adversely affected by obsessiveness, self-doubt, confusion. Client’s perception and interpretation of crisis event may differ noticeably from reality of situation. Client plagued by intrusiveness of thoughts regarding crisis event. The appropriateness of client’s problem-solving and decision-making abilities likely adversely affected by obsessiveness, self-doubt, confusion. Client’s perception and interpretation of crisis event may differ substantially from reality of situation.Triage Assessment Form: Crisis Intervention Assignment Gross inability to concentrate on anything except crisis event. Client so afflicted by obsessiveness, self-doubt, and confusion that problem-solving and decision-making abilities have “shut down.” Client’s perception and interpretation of crisis event may differ so substantially from reality of situation as to constitute threat to client’s welfare.

Domain Severity Scale Summary

Affective _____          Cognitive _____          Behavioral _____        =   Total _____

Using the Triage Assessment Form Paper

Triage Assessment Form: Crisis Intervention Assignment

 

Assignment 2: Comprehensive Well-Woman Exam

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Assignment 2: Comprehensive Well-Woman Exam

For a wide variety of medical conditions, early detection of the problem enables timely and more effective treatment. Annual well-woman exams are among the best tools available for health care professionals to identify potential diseases and medical conditions in women.

Advanced nurse practitioners can play an active role in these important visits. This role can include a physical examination as well as collection of details about such factors as nutrition habits, sexual activity, stress, and more. By participating in comprehensive well-woman exams, advanced nurse practitioners can help patients engage in preventative health.

Photo Credit: Teodor Lazarev / Adobe Stock

For this Assignment, you will complete your well-woman exam using a focused note format in which you will gather patient information, relevant diagnostic and treatment information and reflect on health promotion and disease prevention in light of patient factors, such as age, ethnic group, past medical history (PMH), socio-economic status, cultural background, etc. Assignment 2: Comprehensive Well-Woman Exam

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Note: All Focused Notes must be signed, and each page must be initialed by your preceptor. When you submit your Focused Notes, you should include the complete Focused Note as a Word document and pdf/images of each page that is initialed and signed by your preceptor. You must submit your Focused Notes using SAFE ASSIGN.

Note: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies. Assignment 2: Comprehensive Well-Woman Exam

To prepare:

Reflect on your practicum experience and select a female patient whom you have examined with the support and guidance of your Preceptor.
Think about the details of the patient’s background, medical history, physical exam, labs and diagnostics, diagnosis, and treatment and management plan, and education strategies and follow-up care.
What additional considerations might you think about if your patient was pregnant or just delivered?
Use the “Guidelines for Comprehensive History and Physical SOAP Note” document found in this week’s Learning Resources to guide you as you complete this Assignment.
Assignment:

Write an 8- to 10-page Comprehensive Well-Woman Exam that addresses the following:

Age, race and ethnicity, and partner status of the patient
Current health status, including chief concern or complaint of the patient
Contraception method (if any)
Patient history, including medical history, family medical history, gynecologic history, obstetric history, and personal social history (as appropriate to current problem)
Review of systems
Physical exam
Labs, tests, and other diagnostics
Differential diagnoses
Management plan, including diagnosis, treatment, patient education, and follow-up care
Provide evidence-based guidelines to support treatment plan. Note: Use your Learning Resources and evidence from scholarly sources from your personal search to support your treatment plan of care. Assignment 2: Comprehensive Well-Woman Exam
Reflection

Reflect on some additional factors for your patient:

What are the implications if your patient was pregnant or just delivered?
What are implications if you have observed or know of some domestic violence? Would this change your plan of care? If so, how?
Use your Learning Resources and evidence from scholarly sources from your personal search to support your reflection.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm).

Note: Your Comprehensive Well-Woman Exam Assignment must be signed by Day 7 of Week 10.

By Day 7
Submit your Comprehensive Well-Woman Exam Assignment by Day 7. (Note: You will submit two files, your Comprehensive Well-Woman Exam Assignment, and a Word document of pdf/images of each page that is initialed and signed by your preceptor by Day 7 of Week 10.)Assignment 2: Comprehensive Well-Woman Exam

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

Please save your Assignment using the naming convention “WK10Assgn3+last name+first initial.(extension)” as the name.
Click the Week 10 Assignment 3 Rubric to review the Grading Criteria for the Assignment.
Click the Week 10 Assignment 3 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 “WK10Assgn3+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.
Rubric Detail

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

Content
Name: PRAC_6552_Week10_Assignment3_Rubric
Assignment 2: Comprehensive Well-Woman Exam

Grid View
List View
Excellent Good Fair Poor
Write an 8- to 10-page Comprehensive Well-Woman Exam that addresses the following:
• Age, race and ethnicity, and partner status of the patient
• Current health status, including chief concern or complaint of the patient
• Contraception method (if any)
• Patient history, including medical history, family medical history, gynecologic history, obstetric history, and personal social history (as appropriate to current problem)
• Review of systems
• Physical exam
• Labs, tests, and other diagnostics
• Differential diagnoses
• Management plan, including diagnosis, treatment, patient education, and follow-up care
• Provide evidence-based guidelines to support treatment plan.
Points Range: 40.5 (40.5%) – 45 (45%)
All required points are addressed, with results that are presented fully and clearly
Provides 5 current and credible scholarly sources to support the treatment plan of care. Assignment 2: Comprehensive Well-Woman Exam

Points Range: 36 (36%) – 40 (40%)
At least 8 points are addressed with results that are presented clearly.
Provides at least 4 current and credible scholarly sources to support the treatment plan of care.

Points Range: 31.5 (31.5%) – 35 (35%)
No fewer than 7 points are addressed. One or more results presented in a manner that is vague or incomplete.
Provides at least 3 current and credible scholarly sources to support the treatment plan of care. Assignment 2: Comprehensive Well-Woman Exam

Points Range: 0 (0%) – 34 (34%)
Fewer than 7 points are addressed. One or more results are presented in a manner that is vague, incomplete, or inacurrate.
Provides at least 2 current and credible scholarly sources to support the treatment plan of care.

Reflect on the following:
Reflect on some additional factors for your patient:
• What are the implications if your patient was pregnant or just delivered?
• What are implications if you have observed or know of some domestic violence? Would this change your plan of care? If so, how?

Points Range: 36 (36%) – 40 (40%)
Reflection is clearly presented, with implications that are well-formed, clear, and fully expressed.
Provides at least 3 current and credible scholarly sources to support reflection.

Points Range: 32 (32%) – 39 (39%)
Reflection is clearly presented, with implications that are clearly expressed.
Provides at least 3 current and credible scholarly sources to support reflection.

Points Range: 28 (28%) – 31 (31%)
Reflection is presented in manner that is vague or unclear. Implications are not fully or clearly expressed.
Provides at least 2 current and credible scholarly source to support reflection. Assignment 2: Comprehensive Well-Woman Exam

Points Range: 0 (0%) – 30 (30%)
Reflection is presented in manner that is vague or unclear. Implications are unclear, or one or both implications not expressed.
Provides at least 1 current and credible scholarly source to support reflection.

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.
Points Range: 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.

Points Range: 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.

Points Range: 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. Assignment 2: Comprehensive Well-Woman Exam

Points Range: 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.

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Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
Points Range: 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.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) APA format errors.
Points Range: 0 (0%) – 3 (3%)
Contains many (≥5) APA format errors.
Total Points: 100
Name: PRAC_6552_Week10_Assignment3_Rubric

NURS 6552 PRAC Advanced Nurse Practice in Reproductive Health

Assignment: Comprehensive Well Woman Examination

Walden University

11/03/2021

 

Week 10 Assignment: Well Woman Examination

 

Patient Information:

Name: M.A, Age: 68years,Sex: Female,Race: African American

Subjective data

CC (chief complaint): “I have some irregular vaginal bleeding”

HPI:Ms. Arthuris a 68-year-old African American post-menopausal woman that presents with irregular vaginal bleeding, twice in last 3 months. She describes it as a “heavy menstrual period that lasted for 2 days, each episode”. She denied vaginal irritation but endorsed vaginal dryness.Assignment 2: Comprehensive Well-Woman Exam

Her last menstrual period was at 30 years ago. She lives at home with her husband, in a single-story building with working smoke detectors. She smokes a half a pack of cigarettes per day, since age 20, quit smoking 5 years ago. Denies alcohol or illicit drug use. She has a family history ofHypertension, Prostate Cancer, and hyperlipidemia.

Current Medications: Aspirin 81mg 1 tablet orally daily

: Lisinopril 20mg 1 tablet orally daily

: Rosuvastatin 20mg 1 tablet orally daily

: Januvia 100mg 1 tablet orally daily

: Triamterene-HTCZ 37.5-25mg 1 tablet orally daily

: Allopurinol 100mg 1 capsule orally daily

Allergies: No known drug allergy. No allergy to latex, or animals.

PMHx: Hypertension, Type 2 diabetes Mellitus, Hyperlipidemia, Uterine prolapse, and Gouty arthritis. She had Angioplasty June 2003. I hospitalizations for hypertension management- 2018. Influenza immunization received September 2021.COVID vaccination: completed 2 doses (Pfizer). Hepatitis vaccine: Up to date. Pneumonia vaccine: May 2019.

Soc Hx: Ms. Arthur is a married Mother of 3 living children, 40, 38, and 36. Denied current tobacco and alcohol use. Reports history smoking cigarettes, quit 2016. She enjoys walk around the block with her husband. Volunteers atthe local women’s shelter. She is an active choir member of her local church—1st Baptist church. Uses seat belt and avoids handheld phone call while driving. She maintains a healthy weight, with diet and exercise.

Fam Hx: Both parents are deceased, father had hypertensive and prostate cancer. Mother had type 2 diabetes, uterine, breast cancer, and arthritis. Paternal Grandfather had hypertension and died at age 90. Paternal Grandmother had congestive heart disease and died of stroke at age 83. Maternal grandfather had hypertension, died at age 86, maternal grandmother is deceased with no known medical condition. Three biologic children are alive and healthy. Five grandchildren alive and well. No report of family genetic disorders or mental illnesses.

ROS:

GENERAL: No weight loss, fever, chills, denies lack of sleep.

HEENT: Eyes: Wears eyeglasses, denies visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat: Denies hearing loss, nasalcongestion, or sore throat.

SKIN: No rash or itching.

CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations, edema non heart murmurs.

RESPIRATORY: Denies nasal congestion, denies shortness of breath, cough, or sputum. Chest wall clear on all lobes.

GASTROINTESTINAL: No anorexia, nausea, vomiting, constipation, or diarrhea. No report of abdominal pain or blood in stool.

GENITOURINARY: Denies dysuria, dribbling, urgency, or blood in urine. Reports heavy menstrual bleeding. Use of more than 3 pads a day. Uses pessary for uterine prolapse. Tubal ligation 1985. Denies post coital bleeding. Mammogram: Feb; 2020. Last PAP smear : 10/13/2021 (Negative).

NEUROLOGICAL: No report of headaches. Denies dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL: Denies muscle discomfort, back pain. Reports occasional gouty joint pain, or stiffness from gouty arthritis.

HEMATOLOGIC: Denies anemia, bleeding, or bruising. No history of blood transfusion.

LYMPHATICS: No report of enlarged nodes. No history of splenectomy.

PSYCHIATRIC: No history of depression or anxiety.

ENDOCRINOLOGIC: History of Type 2 diabetes. Deniesunusual sweating, cold or heat intolerance. Denies excess thirst or urination.Assignment 2: Comprehensive Well-Woman Exam

ALLERGIES: Denies history of asthma, hives, or eczema. Report of seasonal allergy.

O.

Vitals: HT: 5’5, WT: 178 lbs.BMI: 29.6, Temp: 98.4, HT: 84, Resp: 14, BP:124/82, O2: 99%

Physical exam: Ms. Arthur is a 68 yr. old African Americanfemale presenting to the clinic for annual well woman examination, and complaint of irregular menstrual bleeding x 2 times in 3 months. Patient is alert and oriented x4, appropriately dressed and groomed. Answers questions without hesitancy and makes good eye contact.

HEENT: WNL

Neck: WNL

Lungs: clear to auscultation in all lung fields

Breast: no masses noted. No discharge from nipples.

GASTROINTESTINAL: normoactive BS. Mild bloating

VVBSU: bloody discharge

Cervix: bloody discharge noted

Uterus: +tenderness

Adnexa: + tenderness

Diagnostics:

– Complete blood count: To assesses for anemia, for report of heavy menstrual bleeding.

– Complete basic panel (BMP): To assess electrolytes, kidneys, and liver function.

– PT/INR: To assess for clotting factors.

– Electrocardiogram: To assess state of the heart muscles, for patient with hypertension

– Uterine and pelvic Ultrasound: Ultrasonography can be helpful in measuring endometrial thickness and in detecting structural abnormalities of the uterus and endometrium, such as polyps, myomas, and fibroids (Holland et al., 2016).Assignment 2: Comprehensive Well-Woman Exam

– Transvaginal ultrasound: Is the first line diagnostic test in postmenopausal women with chief complaint of uterine bleeding (Faizan&Muppidi, 2021).

– Endometrial biopsy: Abnormal findings by TVU, unsuspected abnormalities on EUA and/or suspicious, atypical, or malignant endometrial sampling may require further scanning and tissue diagnosis (Mahdy, Casey, &Crotzer, 2021).

A.

Differential Diagnoses:

White coat hypertension:All hypertensive patients with diabetes should have home blood pressure monitored to identify white-coat hypertension, as majority of these patient’s normal blood pressure are said to be lower at home than at the physician’s office. Patients are at intermediate cardiovascular risk between normotensives and sustained hypertensives. The diagnosis needs confirmation with repeated office and out-of-office BP measurements. If their total cardiovascular risk is low and there is no hypertension-mediated organ damage (HMOD), drug treatment may not be prescribed. However, they should be followed with lifestyle modification, as they may develop sustained hypertension requiring drug treatment (De Boer, Bangalore, Benetos, Davis, Michos, Muntner, Rossing, Zoungas, &Bakris, 2017)
Uterine cancer: The most likely diagnosis for Ms. Arthuris uterine prolapse Since she was a smoker, and is obese, which places her at a higher risk for uterine cancer. Her signs and symptoms of irregularvaginal bleeding, uterine tenderness, and dryness points to that diagnosis. Endometrial cancer is the most common gynecologic malignancy, and the 4th most common cancer in women in the United States, after breast, lung, and colorectal cancer (Schuiling, &Likis, 2022).Assignment 2: Comprehensive Well-Woman Exam

Uterine polyps: Uterine polyps are focal endometrial outgrowths that can occur anywhere within the uterine cavity. They contain a variable number of glands, stroma and blood vessels, the relative amounts of which influence their visual appearance at hysteroscopy (Clark & Stevenson, 2017). Most uterine polyps are diagnosed at imaging by transvaginal pelvic ultrasound (TVUS), or hysteroscopy and confirmation is provided by histological examination of the removed specimen (Clark & Stevenson, 2017).

Endometrial hyperplasia: Endometrial hyperplasia (EH) is a common gynecological endocrine disease, which mainly manifests as irregular vaginal bleeding, infertility, and even malignant transformation. Endometrial dysplasia has certain tendency to become cancerous, and it is recognized as a precancerous lesion of EC with incidence of 23.15–29.08%. Therefore, early detection and intervention of EH is of great significance to improve the prognosis of patients (Zhao, Hu, Zhao, Chen, Fang & Ding, 2021).
Assignment 2: Comprehensive Well-Woman Exam

Treatment and Management

 

Postmenopausal women are questioned about presence of vaginal bleed at every well woman visit, this practicepromotes awareness among women and health care providers of the need for timely evaluation of abnormal vaginal bleeding, patients need education on normal and abnormal vaginal bleeding, while involving them in their careto increase the chance that uterinecancer is detected early and treated promptly and appropriately(Henley, Miller, Dowling, Benard& Richardson, 2018.,Schuiling, &Likis, 2022). Management of hypertension with goal of keeping BP less than 130/80mmHg. Patient might need to be started on statin to prevent organ damage (Scordo, 2017).
Health education:

Patient education on healthy lifestyle choices have been shown to prevent and reduce cardiovascular risk (Scordo, 2017).
Weight reduction through the incorporation of some form of physical activity daily (Schuiling, &Likis, 2022).
Diet modification to include food rich in iron and calcium. Patient to include healthy diet like Mrs. Dash diet, limit sodium, and avoid fried foods.Assignment 2: Comprehensive Well-Woman Exam

Summary

 

Abnormal vaginal bleeding, including bleeding between periods or after sex or any unexpected bleeding after menopause, is most common in female over the 40, history of PCOS, are overweight and a family history of cancer (Schuiling, &Likis, 2022).Cardiovascular risk should be assessed in all hypertensive patients, especially for high-risk patients like Ms. Arthur with type 2 diabetes, history of Smoking and family history of heart disease. Annual medical checkup is advised, especially for persons with risk factors like Ms. Arthur. All high-risk women should adopt a healthy lifestyle that includes exercise, eating well, and aiming for ideal body weight, to lessen risk for cardiovascular diseases and mortality reduction.

 

Reflection

A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks.Certain risk factors and behaviors have a profound negative effect on the health of women and should be addressed during a well-woman visit. Smoking, poor diet, and lack of physical activity are associated with cardiovascular disease, type 2 diabetes, and multiple types of cancer, among other conditions that cause significant morbidity and are the leading causes of mortality in the United States (The American College of Obstetricians and gynecologists. org, 2018).There are significant long-term cardiovascular risks for women with chronic hypertension and those who have had gestational hypertension or preeclampsia or other commodities like type 2 diabetes.

 

Follow up appointment:

Patient to return to clinic in 1 week for review of labs and monitor blood pressure
To keep of log of blood pressure reading, to compare with office records.
Follow up in 6 months for repeat PAP smear
Assignment 2: Comprehensive Well-Woman Exam

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References

Clark, T.J. & Stevenson, H. (2017). Endometrial polyps and abnormal uterine bleeding (AUB-P): What is the relationship, how are they diagnosed and how are they treated? Https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii/

De Boer, I., Bangalore, S., Benetos, A., Davis, A.M., Michos, E.D., Muntner, P., Rossing, P., Zoungas, S. &Bakris, G. (2017). Diabetes and hypertension: A position statement by the American Diabetes Association. Https://care.diabetesjournals.org/content/40/9/1273

Faizan, U., &Muppidi, V. (2021). Uterine Cancer. Https://www.statpearls.com/articlelibrary/viewarticle/30892.

Henley, S.J., Miller, J.W., Dowling, N.F., Benard, V.B. & Richardson, L.C. (2018). Uterine cancer incidence and mortality-United States, 1999-2016. Https://eds-p-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail

Holland, A., Hodges, A., Catron, K., Bevis, K., Berman, N., &Meneses, K. (2016). Endometrial cancer: Using evidence to impact practice and policy. The journal for Nurse practitioners.Https://www.npjournal.org/article/S1555-4155/

Mahdy, H., Casey, M., &Crotzer, D. (2021). Endometrial cancer.Https://www.statpearls.com/articlelibrary/viewarticle/21102

Schuiling, K.D., &Likis, F.E. (2022). Gynecologic health care: With an introduction to prenatal and postpartum care. 4TH ed. Jones & Bartlett learning.

Scordo, K. A. (2017). Hypertension management options:2017 guidelines. Https://oce-ovid-com.ezp.waldenulibrary.org/article/00006205

Seagle, B-L.L., Sobecki-Rausch, J., Strohl, A.E., Shilpi, A., Grace, A., &Shahabi, S. (2017). Prognosis and treatment of uterine leiomyosarcoma: A National cancer Database study.https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii

The American College of Obstetricians and Gynecologists.org (2018). Well-Woman visits. Https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/

Zhao, J., Hu, Y., Zhao, Y., Chen, D., Fang, T., & Ding, M. (2021). Risk factors of endometrial cancer in patients with endometrial hyperplasia: implications for clinical treatments.https://eds-p-ebscohost-com.ezp.waldenulibrary.org/eds/detail/

Assignment 2: Comprehensive Well-Woman Exam

Shadow Health Gastrointestinal SOAP Note Assignment

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Shadow Health Gastrointestinal SOAP Note Assignment

Professional Development

  • Write a 500-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
    • What went well in your assessment?
    • What did not go so well? What will you change for your next assessment?
    • What findings did you uncover?
    • What questions yielded the most information? Why do you think these were effective?
    • What diagnostic tests would you order based on your findings?
    • What differential diagnoses are you currently considering?
    • What patient teaching were you able to complete? What additional patient teaching is needed?
    • Would you prescribe any medications at this point? Why or why not? If so, what?
    • How did your assessment demonstrate sound critical thinking and clinical decision making? Shadow Health Gastrointestinal SOAP Note Assignment

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Documentation / Electronic Health Record

Document: Provider Notes

Student Documentation Model Documentation

Subjective

this 28 you African pleasant female, presents with complaints of stomach pains that started a month ago. “feels like heartburn” Relieved with antacids, but is getting worse. Pain 1-2 right now, but a 5/10 after eating. Eating makes it worse. Sitting up helps. PMH: diabetes: no meds: Asthma: on proventil and albuterol: controlled Social hx: hx of THC use, none now. drinks 3-4 cans of soda in a day. Shadow Health Gastrointestinal SOAP Note Assignment. ROS: heart burn normal form of stools, no diarrhea or constipation : Denies mental health issues: FMK PGF with colon cancer Diet: lots of fried and fast food: Exercise: limited

HPI: Ms. Jones is a pleasant 28-year-old African American woma who presented to the clinic with complaints of upper stomach pa after eating. She noticed the pain about a month ago. She states that she experiences pain daily, but notes it to be worse 3-4 time per week. Pain is a 5/10 and is located in her upper stomach. Sh describes it “kind of like heartburn” but states that it can be shar She notes it to increase with consumption of food and specifical fast food and spicy food make pain worse. She does notice that has increased burping after meals. She states that time generally makes the pain better, but notes that she does treat the pain “ev few days” with an over the counter antacid with some relief. Social History: She denies any specific changes in her diet recen but notes that she has increased her water intake. Breakfast is usually a muffin or pumpkin bread, lunch is a sandwich with chip dinner is a homemade meal of a meat and vegetable, snacks are French fries or pretzels. She denies coffee intake, but does drink cola on a regular basis. She denies use of tobacco and illicit drug She drinks alcohol occasionally, last was 2 weeks ago, and was drink. She does not exercise. Review of Systems: General: Denies changes in weight and gene fatigue. She denies fevers, chills, and night sweats. Shadow Health Gastrointestinal SOAP Note Assignment • Cardiac: De a diagnosis of hypertension, but states that she has been told he blood pressure was high in the past. She denies known history o murmurs, dyspnea on exertion, orthopnea, paroxysmal nocturna dyspnea, or edema. • Respiratory: She denies shortness of breath, wheezing, cough, sputum, hemoptysis, pneumonia, bronchitis, emphysema, tuberculosis. She has a history of asthma, last hospitalization wa age 16, last chest XR was age 16. • Gastrointestinal: States that general her appetite is unchanged, although she does note that s will occasionally experience loss of appetite in anticipation of the pain associated with eating. Denies nausea, vomiting, diarrhea, a constipation. Bowel movements are daily and generally brown in color. Denies any change in stool color, consistency, or frequenc Denies blood in stool, dark stools, or maroon stools. No blood in emesis. No known jaundice, problems with liver or spleen. Shadow Health Gastrointestinal SOAP Note Assignment

Your Results Lab Pass (/assignment_attempts/6541639/lab_pass.pd

Overview

Transcript

Subjective Data Collection

Objective Data Collection

Education & Empathy

Documentation

Document: Provider Notes

 

Shadow Health Gastrointestinal SOAP Note Assignment

Student Documentation Model Documentation

Objective

Skin Turgor : no tenting Lungs; CTA: Heart: Normal S1, S2 sounds. no murmur Abdominal : round, distended, discoloration, striae, no scars noted, symetrical. normal bowel sounds, no organomegly or rebound tenderness Liver palpable 1cm below right costal margin: Liver percussion with 7cm span in the mid-clavicular line. Spleen: not palpable: no tenderness Kidney: No CVA tenderness, not palpable

General: Ms. Jones is a pleasant, obese 28-year-old African American woman in no acute distress. She is alert and oriented. maintains eye contact throughout interview and examination. • Abdominal: Abdomen is soft and protuberant without scars or s lesions; skin is warm and dry, without tenting. Bowel sounds pre and normoactive in all quadrants. No tenderness to light or deep palpation. Tympanic throughout. Liver is 7 cm at the MCL and 1 below the right costal margin. Spleen and bilateral kidneys are no palpable. No CVA tenderness. • Cardiovascular: Regular rate and rhythm, S1 and S2 present, n murmurs, rubs, gallops, clicks, precordial movements. No bruits auscultation over abdominal aorta. No femoral, iliac, or renal bru • Respiratory: Chest is symmetrical with respirations. Lung sound clear to auscultation anteriorly and posteriorly without wheezes, crackles, or cough.Shadow Health Gastrointestinal SOAP Note Assignment

Assessment

Heartburn Possible GERD

Gastroesophageal reflux disease without evidence of esophagitis

Plan

Discuss diet and avoiding fried, spicy, and soda foods. Exercise regimen encouraged Daily activy encouraged Take small frequent meals Consider Zantac if needed F/u in one week with above regimen. consider h-phyloric IGG/IGM if persistent sx Return to clinic if symptoms worsen, bloody stools RT hospital if chest pain

Educate on lifestyle changes including weight loss, engagement daily physical activity, and limitation of foods that may aggravate symptoms including chocolate, citrus, fruits, mints, coffee, alcoh and spicy foods. • Ms. Jones may elevate the head of her bed or sleep on a wedge-shaped bolster for comfort or symptom reduc • Encourage to eat smaller meals and to avoid eating 2-3 hours before bedtime. • Educate on dietary reduction in fat to decrease symptoms. • Trial of ranitidine 150 mg by mouth daily for two we If reduction in symptoms, Ms. Jones may continue therapy. If symptoms persist, consider testing for helicobacter pylori, trial o proton pump inhibitor, or upper endoscopy. • Educate on when t seek emergent care including signs and symptoms of upper and lower gastrointestinal bleed, weight loss, and chest pain. • Retur clinic in two weeks for evaluation and follow up. Shadow Health Gastrointestinal SOAP Note Assignment

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Transcript

Started: Apr 08, 2020 | Total Time: 48 min

Gree 04/08/20 5:29 PM MD

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Empathize 04/08/20 5:29 PM MD

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Your Results Lab Pass (/assignment_attempts/6541639/lab_pass.pd

Overview

Transcript

Subjective Data Collection

Objective Data Collection

Education & Empathy

Documentation

Interview Questions (104) Statements (26) Exam Actions (52)

Hello Miss Jones my name is Doris and I’m here to see you again

Hey.

Maya just verify your name and date of birth (Clarified to What is your name and birthday?.)

My name’s Tina Jones, and my birthday’s February 17th. (Clarified to what is my name and date of birth.)

What brings you in today

I’ve been having this stomach pain for awhile. It keeps coming back, and it really is starting to bother me.

I’m sorry that must be hard for you

I appreciate you saying that.Shadow Health Gastrointestinal SOAP Note Assignment

Let’s see what we can figure out here as I go to your history

Sure, I think I understand what you mean.

Me ask when did the pain start

Probably at least a month ago. Maybe longer. It started out really minor so it took me awhile to realize it was getting bad.

Is it getting worse

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Yeah, it’s getting worse over time. I get these stomach pains every day.

Can I ask how often are you having the pain

It’s every time I eat.Shadow Health Gastrointestinal SOAP Note Assignment

How many episodes in a day (No matching questions found.)

IS THAT 3 TIMES A DAY (No matching questions found.)

Does this happen every day (No matching questions found.)

Is it pain daily

Yeah, I notice it every day. It seems like… 3 or 4 times a week, I’ll have an episode that’s worse.

How long does it pain last

For a few hours after I eat.

What makes it worse

Eating seems to cause it.

What makes it better

Talking to friends or family and going to church always help me feel less stressed–just feeling supported and like someone cares.

How strong is your pain from 1 to 10 (Clarified to How severe is your pain?.)

Right now, I don’t really notice anything, but it can get bad after I eat. (Clarified to how severe my pain is.)

From 1 to 10 10 being the worst what is it (Clarified to Can you rate your current pain level on a scale of 0 to 10?.)

Right now, it’s like a 1 or 2. But after I eat, it’s like a. . . 5? (Clarified to how I would rate my pain on a scale.)

Does it help when you’re sitting up (Clarified to Does the pain improve when you sit up?.)

Usually, yeah. (Clarified to if my pain improves when I sit up.)

Can you describe the pain

Shadow Health Gastrointestinal SOAP Note Assignment

 

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Um, it feels like heartburn. But sometimes, if it’s bad, it’s sharper than that.

Do you have chest pain

No, I’m not having chest pain. The pain I’m feeling is lower, like right in the middle of my torso. . . above my stomach, but below my ribs.

Does it feel cramping

No, it’s not like stomach cramps.

Does it hurt to touch your belly

Yes. Every time I eat it hurts. I’ve been eating less because I don’t like being in pain.

Have you lost weight

No, I don’t think so.Shadow Health Gastrointestinal SOAP Note Assignment

Where’s the location of the pain

It’s like… my upper stomach. Like right below my breastbone, in the middle.

Does it radiate to your back (No matching questions found.)

Does it radiate to your SHOULDER (No matching questions found.)

Does it radiate to your back (No matching questions found.)

DOES THE PAIN RADIATE TO YOUR ARM

No, it’s right in the center of my stomach, like between my belly button and my ribs.

Let’s review your diet

Thanks for telling me.

May I ask what food do you eat (No matching questions found.)

Give me a diary of your food intake (No matching questions found.)

Does the pain get worse with large meals (Clarified to Do large meals make the pain worse?.)

 

 

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Yes, large meals make the pain worse. [AUDIO COMING SOON] (Clarified to if large meals make the pain worse.)

Do you eat spicy food

Well, I used to eat spicy food sometimes, but in the last few weeks I can’t. It makes my stomach pain too bad.

Do you eat a lot of fried foods

Not too much. I mean, I like French fries and stuff, but I try not to eat them too often.

How’s your appetite

I haven’t been wanting to eat lately.Shadow Health Gastrointestinal SOAP Note Assignment

Why don’t you want to eat

It seems like if I eat too much, that’s what makes my stomach pain the worst.

Do you have any burping

Yeah, that’s been happening after I eat.

What food are you eating

I don’t have any food allergies that I know of.

What medication are you taking right now

I have a daily inhaler. And I’ve been taking antacid chews sometimes for my stomach, too.

Are you taking any over-the-counter medication

I’ve been taking antacids lately — chewable ones.

Does it help (Clarified to Does taking the antacids help?.)

Yeah, they help. I try to only take them when the pain seems worse than usual. (Clarified to if the antacids help.)

How often are you taking antacids

I take them every few days. Just if the heartburn gets bad.

Are you taking any ibuprofen

 

Shadow Health Gastrointestinal SOAP Note Assignment

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Yeah, I still take it for cramps.

How often are you taking that (Clarified to How often do you take over the counter medication?.)

I take them every few days. Just if the heartburn gets bad. (Clarified to how often I take over the counter medication.)

Do you have drug allergies

Yeah, I’m allergic to penicillin.

What happens with Penicillin

I don’t remember that well because the last time I had penicillin I was pretty little. . . I think I got a rash, like, hives. The doctor told me not to take it again after that.

I’m glad you know that you’re allergic to penicillin

Alright, thanks for letting me know.

Do you have any gastrointestinal problems

Yeah, I’ve had stomach pain for awhile now.

Have you had ulcers

No.Shadow Health Gastrointestinal SOAP Note Assignment

Have you had any GERD

I’m not really sure what GERD is. I’ve never been diagnosed with it, or anything. [AUDIO COMING SOON]

Have you had any GI surgery

No.

Have you had any appendicitis

No.

Have you had any problems with your gallbladder

No, as far as I know my gallbladder’s never had any problems.

That’s good to hear

 

 

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OK, I understand.

Have you had any stomach cancer (Clarified to Have you had stomach cancer?.)

No. (Clarified to if I have had stomach cancer.)

Do you have family history of stomach cancer

The only cancer that I know of in our family is colon cancer–Grandpa Jones died of that.

Have you any problems with your bladder

No, I never have.Shadow Health Gastrointestinal SOAP Note Assignment

How often do you have a bowel movement

Usually every other day.

Is your stool bloody

Um, no.

Do you have mucus in your stool

Ew. No.

What is the consistency of your stool (Clarified to Can you describe your stool?.)

Uh… usually light or dark brown, I guess? (Clarified to what my stool looks like.)

Do you have trouble peeing

No, I can pee fine.

Do you pee frequently

Yeah, I definitely get up more than once during the night.

Do you have painful urination

No.

Is your urine clear

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Shadow Health Gastrointestinal SOAP Note Assignment

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Um, light yellow or almost clear? The regular color.

Do you have accidentally pee on yourself (Clarified to Have you ever peed yourself?.)

Definitely not. (Clarified to if I have ever had urinary incontinence.)

When was your last menstrual period

I think it was just about a month ago.

Are you sexually active

Um, not right now.Shadow Health Gastrointestinal SOAP Note Assignment

Can you tell me what you have for breakfast (Clarified to What did you eat for breakfast today?.)

This morning, I had toast with butter and honey, and some orange juice. (Clarified to what I ate for breakfast today.)

Can you tell me your diet within the 24 hour period (Clarified to What do you eat in an average day?.)

Let’s see. . . a muffin or pumpkin bread for breakfast, a sandwich for lunch, and some kind of meat with a veggie for dinner. (Clarified to what I typically eat in a day.)

What did you have for lunch yesterday

I had a piece of pizza. It was someone’s birthday at work, so they ordered pizza for all of us.

What did you have for dinner

Last night we had baked potatoes with broccoli and cheese soup on them.

Sounds like you have a lot of carbs in your diet maybe we should talk about that later

That makes sense.Shadow Health Gastrointestinal SOAP Note Assignment

Do you drink alcohol

Not lately, but I do every so often.

How often do you drink alcohol

Very rarely.

How many drinks in a setting

 

 

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Never any more than 2 or 3.

Do you drink soda

Yeah, I drink diet Coke.

How often (Clarified to How often do you drink a soda?.)

I have 3 or 4 diet cokes a day. (Clarified to how often I drink a soda.)

That’s a lot of Coke in a day and it has lots of acid which may cause your heartburn

OK, I understand.Shadow Health Gastrointestinal SOAP Note Assignment

Do you eat fast food

I probably have fast food a few times a week, usually when I’m on campus. Sometimes I don’t bring a lunch, and I get so starving I have to get something from one of the places around campus.

Do you drink caffeine

Like diet Cokes? Yeah, I drink them a lot.

Do you have a fever

No. No fever.

Do you have chills

No, no chills.

Do you smoke cigarette

No, I’ve never smoked a cigarette in my life.

Do you take illicit drugs

Well, I used to smoke pot. . . but I don’t do that anymore.

Do you feel fatigued

No, I don’t feel tired.

Do you get night sweats

 

Shadow Health Gastrointestinal SOAP Note Assignment

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No.

Do you have any mental health issues

No, definitely not.

Anxiety

Not too much — I can get a little anxious and stressed because I’m busy and I work hard. I might have some anxiety lately. Especially since I’d like to get this heartburn fixed.

Do you have nausea

No, I’m fine.

GI vomiting

I don’t have like, diseases. But I’ve had this stomach pain for like, a month.

Do you have diarrhea

No.

Are you gassy

No.

Do you have bloating

No, I don’t feel bloated.

Sore throat

No, my throat doesn’t hurt.

Any cough

No, I haven’t been coughing.Shadow Health Gastrointestinal SOAP Note Assignment

Any difficulty swallowing

No, I can swallow my food and everything.

Do you have difficulty breathing

 

 

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No, my breathing has been fine.

Do you have palpitation

No, not right now.

Has your sense of taste changed

No, I can taste everything fine.

Do you have a family history of GERD

No.

Any family history of irritable bowel syndrome

No, I haven’t heard anything about that.

Any family history of colon cancer

Um, Grandpa Jones died of colon cancer.

Anybody in your family with gallbladder disease

I don’t think so.Shadow Health Gastrointestinal SOAP Note Assignment

Any family history of liver disease

No, nobody’s had anything happen with their liver that I know of.

Any problems with kidney disease (Clarified to Does kidney disease run in your family?.)

No, nobody’s had that. (Clarified to if kidney disease runs in my family.)

Family history of bladder disease

Not that I’ve heard of.

Do you have any medical problems

Yeah. . . I have asthma and diabetes.

What do you take for your diabetes

 

 

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I don’t take medicine for it anymore.

What medication are you on for asthma

I have my Proventil inhaler, and then my daily Flovent inhaler, too.

Is it helpful

My daily inhaler has helped a lot, yeah. I haven’t needed my rescue inhaler since I started it a few months ago.

And you mentioned no drug allergies

Sure, I think I understand what you mean.

It sounds like your diet had a lot of carbs which is not good for diabetes, but also that your food and liquids contain a lot of acid forming foods, and we should review that

Alright, thanks for letting me know.Shadow Health Gastrointestinal SOAP Note Assignment

We’re going to do our exam now

Thanks for telling me.

Do you exercise

I don’t have the energy to go to a gym or anything after work. . . I’m pretty exhausted by the end of the day. But I’m on my feet all the time at work so I feel like that’s a little bit of exercise most days at least.

Tested skin turgor on forearm

Inspected right side of abdomen

Inspected front of abdomen

Inspected left side of abdomen

Inspected front of abdomen

Inspected right side of abdomen

I was looking at your stomach to see if there’s any rashes

That makes sense.

 

 

Educate 04/08/20 5:58 PM MD

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I want to listen to breath sounds

Thanks for telling me.Shadow Health Gastrointestinal SOAP Note Assignment

Please breathe in and out when I move my stethoscope

OK, I understand.

Auscultated breath sounds in anterior right upper lobe

Auscultated breath sounds in anterior right middle lobe

Auscultated breath sounds in anterior right lower lobe

Auscultated breath sounds in anterior left upper lobe

Auscultated breath sounds in anterior left mid-chest (upper lobe)

Auscultated breath sounds in anterior left lower lobe

Listen to your heart now

Alright, thanks for letting me know.

Auscultated aortic area with the bell

Just stay relaxed

That makes sense.

Auscultated pulmonic area with the bell

Auscultated Erb’s point with the bell

Auscultated tricuspid area with the bell

Auscultated tricuspid area with the diaphragm

Auscultated mitral area with the diaphragm

Going to listen to your bowel sounds

 

Shadow Health Gastrointestinal SOAP Note Assignment

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Sure, I think I understand what you mean.

Auscultated right upper quadrant

Auscultated right lower quadrant

Auscultated left lower quadrant

Auscultated left upper quadrant

Listen to your abdominal aorta

Alright, thanks for letting me know.

Auscultated aorta in abdomen

Great I don’t hear abnormal sounds

Thanks for telling me.

I’m going to listen to your arteries that goes to your kidneys

Sure, I think I understand what you mean.

Auscultated right renal artery

Auscultated left renal artery

Auscultated right iliac artery

Auscultated left iliac artery

I’m just listening to all the blood flow of the arteries

That makes sense.Shadow Health Gastrointestinal SOAP Note Assignment

I’m going to listen to your femoral artery

OK, I understand.

Auscultated right femoral artery

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Exam Action 04/08/20 6:02 PM MD

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Auscultated left femoral artery

I’m going to tap around your abdomen

Sure, I think I understand what you mean.

Percussed right upper quadrant

Percussed right lower quadrant

Percussed right upper quadrant

Percussed left upper quadrant

Percussed left lower quadrant

I’m going to tap on your back

OK, I understand.Shadow Health Gastrointestinal SOAP Note Assignment

Percussed left flank for CVA tenderness

Percussed left flank for CVA tenderness

Percussed right flank for CVA tenderness

I’m going to feel for your spleen

Alright, thanks for letting me know.

Percussed spleen

Percussed for liver span: 7 cm in the mid-clavicular line

I’m going to press lightly into your abdomen

That makes sense.

Percussed right lower quadrant

Palpated right lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension

 

 

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Palpated right upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension

Palpated left upper quadrant with light pressure: No tenderness reported; no masses, guarding, or distension

Palpated left lower quadrant with light pressure: No tenderness reported; no masses, guarding, or distension

Palpated right lower quadrant: with deep pressure: No masses

Palpated right upper quadrant with deep pressure: No masses

Palpated left upper quadrant with deep pressure: No masses

Palpated left lower quadrant with deep pressure: No masses

I’m going to feel for your liver

Thanks for telling me.Shadow Health Gastrointestinal SOAP Note Assignment

Palpated liver: Palpable 1 cm below right costal margin

Palpated for spleen: Not palpable

Palpated for right kidney: Not palpable

Palpated for left kidney: Not palpable

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Shadow Health Gastrointestinal SOAP Note Assignment

Shadow Health Gastrointestinal SOAP Note Assignment

Nursing role and scope-Discussion week 9

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Nursing role and scope-Discussion week 9

After reading Chapter 9 and reviewing the lecture power point (located in lectures tab), please answer the following

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questions. Each question must have at least 3 paragraphs and you must use at 3 least references (APA) included in your post.

Additionally, you are expected to reply to two other students and include a reference that justifies your post. Your reply must be at least 3 paragraphs.

1. Describe the link between quality and safety in the healthcare setting.

2. Discuss the role of the nurse in quality improvement.

3. Describe nursing-sensitive measurements and why they are important in Nursing care delivery.

Role of The Nurse in Quality Improvement In the Healthcare Setting Paper

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Role of The Nurse in Quality Improvement In the Healthcare Setting Paper

1. Describe the link between quality and safety in the healthcare setting.

2. Discuss the role of the nurse in quality improvement.

3. Describe nursing-sensitive measurements and why they are important in Nursing care delivery.

Each question must have at least 3 paragraphs and you must use at least 3 references (APA) included in your post.

Tags: APA Quality improvement quality and safety healthcare setting

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Family Health Case Management & Model of Care for Families Discussion

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Family Health Case Management & Model of Care for Families Discussion

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1. In your own word and using the appropriate evidence-based references define family and describe the different types of family.

2. Identify characteristics of the family that have implications for community health nursing practice.

3. Discuss a model of care for families.

4. Describe strategies for moving from intervention at the family level to intervention at the aggregate level.

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached and in Turnitin to verify originality. A minimum of 2 evidence-based references besides the class textbook must be used. A minimum of 700 words is required. Please make sure to follow the instructions as given.

week 9 eddie

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week 9 eddie

Family Health Case Management

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Read chapter 20 of the class textbook and review the attached PowerPoint presentation. Once done answer the following questions;

1. In your own word and using the appropriate evidence-based references define family and describe the different types of family.

2. Identify characteristics of the family that have implications for community health nursing practice.

3. Discuss a model of care for families.

4. Describe strategies for moving from intervention at the family level to intervention at the aggregate level.

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 9 discussion questions” for grading and in Turnitin to verify originality. If you don’t post your assignment in any of the required forums you will not get the points. A minimum of 2 evidence-based references besides the class textbook must be used. You must post two replies to any of your peers sustained with the proper references and make sure the references are properly quoted in your assignment. A minimum of 700 words is required. Please make sure to follow the instructions as given.

NSG456 Phoenix Evidence Based Practice and Clinical Decision Making Paper

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NSG456 Phoenix Evidence Based Practice and Clinical Decision Making Paper

Levels of Research Evidence The strength or validity of the best research evidence in an area depends on the quality

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and quantity of the studies that have been conducted in an area. Quantitative studies, especially experimental studies such as the RCT, provide the strongest research evidence (see Chapter 8). Also, the replication or repeating of studies with similar methodology increases the strength of the research evidence generated. The levels of the research evidence are a continuum, with the highest quality of research evidence at one end and weakest research evidence at the other (Brown, 2014, Craig & Smyth, 2012, Melnyk & Fineout-Overholt, 2011; Figure 1-3). The systematic research reviews and meta-analyses of high-quality experimental studies provide the strongest or best research Fig 1-3 Levels of Research Evidence. evidence for use by expert clinicians in practice. Meta-analyses and integrative reviews of quasiexperimental, experimental, and outcomes studies also provide very strong research evidence for managing practice problems. Mixed-methods systematic reviews and meta-syntheses provide quality syntheses of quantitative, qualitative, and/or mixed-methods studies. Correlational, descriptive, and qualitative studies often provide initial knowledge, which serves as a basis for generating quasi-experimental and outcomes studies (see Figure 1-3). The weakest evidence comes from expert opinions, which can include expert clinicians’ opinions or the opinions expressed in committee reports. When making a decision in your clinical practice, be sure to base that decision on the best research evidence available. The levels of research evidence identified in Figure 1-3 (also included in the front cover of this text) will help you determine the quality of the evidence that is available for practice. The best research evidence generated from systematic reviews, meta-analyses, meta-syntheses, and mixed-methods systematic reviews is used to develop standardized, evidence-based guidelines for use in practice. Introduction to Evidence-Based Guidelines Evidence-based guidelines are rigorous, explicit clinical guidelines that have been developed based on the best research evidence available in that area. These guidelines are usually developed by a team or panel of expert clinicians (nurses, physicians, pharmacists, and other health professionals), researchers, and sometimes consumers, policy makers, and economists. The expert panel works to achieve consensus on the content of the guideline to provide clinicians with the best information for making clinical decisions in practice. There has been a dramatic growth in the production of evidence-based guidelines to assist healthcare providers in building an EBP and improving healthcare outcomes for patients, families, providers, and healthcare agencies. Every year, new guidelines are developed, and some of the existing guidelines are revised based on new research evidence. These guidelines have become the gold standard (or standard of excellence) for patient care, and nurses and other healthcare providers are encouraged to incorporate these standardized guidelines into their practice. Many of these evidence-based guidelines have been made available online by national and international government agencies, professional organizations, and centers of excellence. When selecting a guideline for practice, be sure that the guideline was developed by a credible agency or organization and that the reference list reflects the synthesis of extensive number of studies. An extremely important source for evidence-based guidelines in the United States is the National Guideline Clearinghouse (NGC), initiated in 1998 by the AHRQ. The NGC started with 200 guidelines and has expanded to more than 1400 evidence-based guidelines (see http://www.guideline.gov). Another excellent source of systematic reviews and evidence-based guidelines is the Cochrane Collaboration and Library in the United Kingdom, which can be accessed at http://cochrane.org. Professional nursing organizations, such as the Oncology Nursing Society (http://www.ons.org) and National Association of Neonatal Nurses (http://www.nann.org), have also developed evidence-based guidelines for nursing practice. Their websites will introduce you to some of evidence-based guidelines that exist nationally and internationally. Chapter 13 provides you with direction when critically appraising the quality of an evidence-based guideline and implementing that guideline in your practice. Strongest or best research evidence Systematic review of experimental studies (well designed randomized controlled trials (RCTs]) Meta-analyses of experimental (RCT) and quasi-experimental studies Integrative reviews of experimental (RCT) and quasi-experimental studies Single experimental study (RCT) Single quasi-experimental study Meta-analysis of correlational studies Integrative reviews of correlational and descriptive studies Qualitative research meta-synthesis and meta-summaries Single correlational study Single qualitative or descriptive study Opinions of respected authorities based upon clinical evidence, reports of expert committees Weakest research evidence
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NSG456 Phoenix US Nursing Shortage & Turnover Problem Research Evidence Paper

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NSG456 Phoenix US Nursing Shortage & Turnover Problem Research Evidence Paper

Assignment Content

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Evidence that supports a conclusion is part of the research process. Literature reviews often accompany research papers in the form of a summary and synthesis of the published information about the research topic. Although this week’s assignment is not a literature review, it is designed to familiarize you with the practice of finding appropriate sources and information on a topic.
Find three original research articles that apply to your research topic. The articles must be
peer reviewed,
recent (published within 5 years), and
statistically significant.

Write a 260-word summary of each article in which you identify
participants
independent variable(s),
dependent variable(s),
methods, and
results.

Determine whether these articles are suitable for inclusion in a literature review for your research topic.
If they are not, explain why.
If they are, explain how the information can be used to inform practice.

Compile all summaries in one document.
Include a PDF of and APA citation for each article.
Submit the articles and summaries.

Research dissemination plan

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Research dissemination plan

Advances in Patient Safety Dissemination Planning Tool: Exhibit A from Volume 4. Programs, Tools, and Products

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Previous PageNext Page Table of Contents Advances in Patient Safety: From Research to Implementation This tool was developed to help researchers evaluate their research and develop appropriate dissemination plans, if the research is determined to have “real world” impact. Creation and testing of the tool is described in Development of a Planning Tool to Guide Research Dissemination. ( 157.95 KB ) ( PDF version – Microsoft Word version – 115 KB ). Advances in Patient Safety: From Research to Implementation. Rockville, MD: Agency for Healthcare and Research Quality; 2005. By Deborah Carpenter, Veronica Nieva, Tarek Albaghal, and Joann Sorra (Westat) Contents • • • • • • • • • • Purpose Components of a Dissemination Plan Instructions I. Specifying Research Findings and Products: What You Intend to Disseminate II. Identifying End Users III. Working with Dissemination Partners IV. Communicating Your Message V. Evaluating Success Developing a Summary VI. Dissemination Work Plan Purpose AHRQ is increasingly interested in research that has “real world” impact in the practice of health care. This tool will help you, the Patient Safety Researcher, develop a plan for disseminating your research findings and products to potential users in the health care system. This tool is designed to prompt your thinking about the processes that you would use to disseminate your findings or products, beyond publishing and presenting in peer-reviewed venues. This tool will ask you to identify the aspects of your research that are ready for dissemination, and to think about who could benefit from your findings or products. It will also encourage you to consider various ways to reach these users—establishing direct links as well as working through intermediary organizations, or tapping into existing networks. Return to Contents Components of a Dissemination Plan Developing a dissemination plan will facilitate the translation of your research into practice. Your dissemination plan will include six major elements: I. Research findings and products—What is going to be disseminated? II. End users—Who will apply it in practice? III. Dissemination partners—Individuals, organizations or networks through whom you can reach end users? IV. Communication—How you convey the research outcomes? V. Evaluation—How you determine what worked? VI. Dissemination work plan—Where you start? Go to Figure 1 for graphic illustration. Figure 1. Return to Contents Instructions Select one research finding or product that you expect to be particularly important in improving patient safety, and that is ready for dissemination. You may want to complete the tool separately if you have several findings or products to disseminate. For each component of a dissemination plan, you will answer a few key questions about the selected finding or product. At the end, you will integrate your responses into an overall strategy and workplan. • Don’t be discouraged if at first you cannot answer every question in this planning tool; the questions serve as prompts to consider these elements in the future as your dissemination effort evolves. • • Consider this a working document to help you think through the steps you will need to take to get the word out about your research finding or product. This may take a few iterations! You may want to work back and forth between questions as your thinking develops. You may do a first pass at the tool, and revisit it after a few days. You may also want to ask for input from others. Return to Contents I. Specifying Research Findings and Products: What You Intend to Disseminate Draw the boundary around your research finding or product as broadly or as narrowly as you wish, depending on your dissemination aims. Be specific. The more concrete you can be in defining your finding or product, the easier it will be to complete the tool. For example, • • You may want to disseminate 1) an event reporting system as a large product or 2) separately disseminate the taxonomy, measuring tools, or data analytic methods that you developed as smaller aspects of the reporting system. You may want to disseminate a best practice guideline, a curriculum that you developed around the practice, or research findings on outcomes resulting from adoption of these guidelines. 1. Describe the research finding or product you wish to disseminate. You may want to start by listing your major findings and products, then select one major finding or product for dissemination. For example—A decision support device, an educational curriculum, data collection tool, etc. 2. What problems related to safety in patient care does your research finding or product address? 3. What makes your research finding or product stand out? For example—Is it an innovative way to tackle an existing problem? Does it identify a new problem? Does it support or contradict current practices? Issues to consider in selection what to disseminate: • • • • • Think about the pros and cons of disseminating portions of the research vs. all related products and findings. Different end users (e.g. policymakers and health care providers) may be interested in different aspects of the research. Is your research finding ready for dissemination? How strong is the evidence on your research findings? How generalizable are your findings? How does your research finding/product conform to current procedures? What additional research (for a finding) or testing (for a product) would be needed before launching a dissemination effort? Return to Contents II. Identifying End Users End users are individuals, health care professionals, or delivery organizations that could benefit from and use your research finding or product. These end users are the ultimate target for your dissemination efforts. Specifying your target audience and their needs will provide focus for your dissemination plan and will help you tailor your offering to their needs. 1. List the end users for your research finding or product. Be as specific as possible. You may want to specify health care settings as well as types of clinicians or administrators. For example—ICU nurses, family physicians, hospital administrators, blood bankers, medical schools, doctors’ offices. 2. Describe how your research finding or product is useful to your end users. Why would they want to use your finding or product? For example—does it increase efficiency? Improve quality of care? Provide legal protection? 3. What recent or future events might help or hinder end user interest in your finding or product? 4. Have you involved these end users in your research project? How? How can you involve them at this point? For example—Have nurses evaluate the use of an infusion pump. 5. What barriers might your end users face in trying to implement your finding or product? What suggestions might you have for overcoming these barriers? Return to Contents III. Working with Dissemination Partners You do not have to work alone to reach your end users! Consider working with professionals who are trusted opinion leaders and are influential in their fields. Think about formal and informal networks that you can tap into to spread the word about your research findings or products. Consider also how you might develop working partnerships with organizations to which your end users belong, or that can influence them through their credibility, expertise, or licensing powers. These individuals and organizations can serve as dissemination intermediaries, amplifying your reach into your target audiences. • • • Think about opinion leaders in your professional community who might be interested in spreading the word about your research. Informal networks and colleagues may be useful dissemination partners. Organizational dissemination partners could include quality improvement organizations, professional groups of your target audience, accreditation or licensing boards, or health care delivery associations. 1. List individuals, organizations, and informal networks who might partner with you in translating and communicating your research findings or products to your end users. Note how they are important to reaching particular end users. End users For example: Family Physicians Quality Managers Pharmacists Individual/Organizations/Networks Importance of end users Dr. Sheila Smith, a trusted colleague Professional credibility Institute for Healthcare Improvement Quality improvement expertise United States Pharmacopoeia Established standards for medications 2. How does your research finding or product fit with and advance the mission and goals of these parties? Why would they want to work with you? What recent/future events might help or hinder their willingness to work with you? 3. What characteristics of your finding or product would appeal to each of these potential dissemination partners? 4. How can you develop an ongoing relationship with these potential dissemination partners? How would you work with them so that your research finding or product is included in their communication channels, and/or tailored to their health delivery systems? Issues to consider about dissemination partners: • • • • How will you reach the professional opinion leaders? Do you work with anyone who can link you up with them? How will you work with organizational partners? Do you have a personal contact, have you reviewed their Web sites, their standard publications, and annual reports? What materials might you prepare for their use? Do you need different partners to reach different end users? How can you use partners existing informal networks to reach end users? Return to Contents IV. Communicating Your Message Effective dissemination relies on the use of varied channels—e.g., publications and reports, Web sites and other electronic communications, meetings and conferences, person-to-person communications, formal collaborations or information networks. Consider what methods and channels you might use to bring your research finding or product directly to your end users or partners. Consider also how your dissemination partners communicate regularly with their constituencies—your end users. How you might use their channels to disseminate your finding or product? You should consider all of these channels to ensure that the widest possible audience is exposed to your research finding or product and in ways that are both accessible and easy-to-use. Cost and cost-effectiveness are obviously important considerations in choosing the right medium. Your end users could obtain information about research findings, products, or innovations in health care through various means. Optimally, you will need to use a combination of methods to reach end users. Personal contact Broadcast media • • • • • • • • • • • • • • • • Academic journals Book chapters Technical reports Trade magazines Regular newspapers Special interest newsletters Radio or TV interviews Interest group listservs Web sites Academic detailing Clinical specialty associations Informal professional networks Professional conferences Professional meetings (e.g., grand rounds) Workshops and other CME/CNE training Participating in improvement collaboratives or test beds 1. How do you think your end users obtain information about health care innovations? Which of the methods above would be effective channels to reach them? What combinations of methods could reinforce your message? 2. Which of these methods could you realistically use to reach your end users? 3. Which methods do your potential dissemination partners use to communicate with your end users? Which ones could be used as channels for your research finding or product? 4. What difficulties might end users have with the methods of communication used, and how could you plan to overcome those difficulties? Issues to consider about communicating your message: • • What materials might you provide to potential dissemination partners about your research? How can you frame your research results to make them relevant to your partners’ agenda? How will you tailor your materials and message to adapt to their ways of communicating with your end users? Return to Contents V. Evaluating Success Evaluating the success of your dissemination efforts is an iterative process. Once you have begun to disseminate your research finding or product, consider how you might evaluate the effect that your dissemination strategies have on getting your message to end users. Dissemination is not a one-time activity; rather, it is a long-term relationship with your users that will provide ongoing feedback to help you improve your message. 1. How will you know if you have met your dissemination goals? What are your success criteria? Are there measurable indicators for these criteria? For example—Number of physicians reached, responses to advertisements, number of Web site hits, number of inquiries received. 2. How will you involve end users in evaluating the dissemination activities? For example—Obtaining feedback on how easy the research product was to use, what was needed to translate research findings into practice in their setting. 3. How will you involve end users in evaluating the dissemination activities? Issues to consider in evaluating success of the dissemination effort: • • • What are ways that you can measure the success of your dissemination effort? How will you keep in contact with users and potential users? How will you provide feedback to your users and dissemination partners? How will you incorporate their feedback in your future research, product design, and ongoing development? Return to Contents Developing A Summary After you have considered the components of your dissemination plan, use the last page to write a summary of 100-200 words that outlines your basic plan, based on the structure in this planning tool, by completing the following statements. • • • • • • • • My research finding or product is _________________________________________________ . (Description.) It can be used to _________________________________________________ ______________. (Value statement of advantages over current practice.) My primary end users are _________________________________________________ ______. (Who is in a position to use the information?) I plan to involve users in my dissemination efforts by __________________________________. (How can I make sure my message is clear?) I can use the following individuals, organizations and networks _________________________________________________ _to help. (Who has influence with target users?) The ways that I will communicate the results include: __________________________________________. (Comm unication mechanisms.) Potential obstacles that I face in disseminating my research include _________________________________________________ ____________. (List potential difficulties.) I can mitigate these obstacles by ________________________________________________. (Plan to overcome the difficulties.) • I plan to evaluate the dissemination plan by _________________________________________________ __________________. (Indicators to be used; plans for involving end users and partners.) • I plan to encourage feedback from end users and dissemination partners by _______________________________________________________ and provide feedback to them by _______________________________________________________ (Obtaining and providing feedback.) My Dissemination Strategy—Summary Return to Contents VI. Dissemination Work Plan • Action Items Resources needed: Immediate action items, schedule, and persons responsible: Timeframe Who is Responsible? • Action Items Longer term action items, schedule, and persons responsible: Timeframe Who is Responsible? Resources needed: Page last reviewed October 2014 Page originally created September 2012 Internet Citation: Dissemination Planning Tool: Exhibit A from Volume 4.. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/professionals/quality-patientsafety/patient-safety-resources/resources/advances-in-patient-safety/vol4/planningtool.html Back To Top BACK TO TOP • Accessibility Disclaimers EEO Electronic Policies FOIA HHS Digital Strategy HHS Nondiscrimination Notice Inspector General Plain Writing Act Privacy Policy Viewers & Players • • • • • • • • • • Get Social • • • • Home • About Us • Careers • Contact Us • Sitemap • FAQ Topics Programs Research Data Tools Funding & Grants News & Events About • • • U.S. Department of Health & Human Services The White House USA.gov: The U.S. Government’s Official Web Portal Agency for Healthcare Research and Quality 5600 Fishers Lane Rockville, MD 20857 Telephone: (301) 427-1364
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