NSG6 420 Week 1 Geriatric Patient Case Study Paper

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NSG6 420 Week 1 Geriatric Patient Case Study Paper

Description

Week 1 Discussion

For this assignment, you will review the case study below and post a discussion for the class, answering the noted questions.

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You are evaluating a 78-year-old white male who comes to your office today with unintentional weight loss of 10 lb in the last year, self-reported exhaustion weakness based on grip strength, and slow walking speed, and low physical activity. Patient notes that he has been feeling worse over the past 6 months and just does not have the strength to do anything anymore. The patient states he is not currently on any medications except a multivitamin. He notes that he lives alone and does not want to leave his house. Answer the following questions with supportive rationale:

  1. What questions should you as the patient/family ask to further assess?
  2. What screening tools would be appropriate in this case?
  3. Do you have concerns with frailty in this patient? If so, why?
  4. What referrals should be made, if any, on this patient? NSG6 420 Week 1 Geriatric Patient Case Study Paper

NSG 6420 South University Online Nursing Discussion

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NSG 6420 South University Online Nursing Discussion

Description

  • . Respond to at least two posts by the end of the week.

POST 1: Dana posted Aug 18, 2022 2:51 AM

 

Question 1: What questions should you ask the patient/ family to further assess?

Older adults are fragile, and hence physician should be sensitive to the kind of questions they ask when assessing them. A thorough geriatric health history is important to compile significant information related to the patient’s chief complaint. This patient’s chief complaint include unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity. In assessing this patient, I would start by asking questions such as how many times does he eat in a day, what do the meals mainly consist of, as well as whether he is able to make his own food or able to feed himself. Also, I would consider asking this patient whether there is any illness or conditions that might change the food he eats, and whether he has enough money to buy food. Besides, asking whether he eats alone or with someone else, as well as asking whether he is having any gastrointestinal issues such as nausea, vomiting, or diarrhea would have been important to lead the correct differential diagnoses. Many things such as lean body mass, slower metabolism and increased body fat are known to cause nutritional changes in older adults (Tilly, 2017). Social factors are significant contributors to unintentional weight loss. NSG 6420 South University Online Nursing Discussion

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Question 2: What screening tools would be appropriate in this case?

Considering this patient’s symptoms of frailty and weakness, one tool that can be used to assess his functionality is the SPICE tool for geriatric syndrome. The SPICE tool is used to assess for patient’s sleep disturbances, problems with eating and feeding, confusion, evidence of falls, and skin breakdown (Fulmer et al., 2019). To further assess his frailty level, a screening tool known as FRAX (Fracture Risk Assessment Tool) can be used to estimate his probability of incurring hip or other major osteoporotic fracture (Whitlock et al., 2019). Also, nutrition screening tools such as the Malnutrition Universal Screening Tool (MUST) and the Malnutrition Screening Tool (MST) would be appropriate to assess his malnutrition risk (Dent et al., 2019). Other screening tools appropriate for this patient include BMP, liver function tests, thyroid function tests and glucose measurement.

Question 3: Do you have concerns with frailty in this patient? If so, why?

My concerns for this patient are mainly related to his frailty symptoms of unintended weight loss, self-reported exhaustion, weakness, slow-walking speed, and low physical activity. Due to these symptoms, my concern is that he may be at high risk for infection and declining health because his immune system does not work that well. Even the simplest type of infection has the potential to cause harm or death of the patient.

Question 4: What referrals should be made, if any, on this patient?

Referrals would be necessary for this patient, even if the laboratory test showed no signs of progressive illness. The first would be referral to dietician to help him with his eating. A dietician would help this patient come up with a plan to regain and maintain his weight, as well as improve his overall nutritional status. Patients who report unintentional weight loss need more calories, proteins and other nutrients. Also, referring this patient to a therapist or a counselor would be appropriate to establish whether the signs of malnutrition are related to depression. Malnutrition and depression have been found to closely link (Wei et al., 2018). Patient who are malnourished due to bad eating habits are likely to end to being depressed. t him at risk for dehydration, falls, mental status changes, metabolic disturbances and muscle wasting (Dunphy, 2017). NSG 6420 South University Online Nursing Discussion

What referrals should be made, if any, on this patient?

A consultation with the dietitian or nutritionist would assist this patient and depending on what diagnostic test, labs and studies show, would determine if any further referrals are needed. Consultation for depression, malignancy, and or physical and or occupational therapy may also assist this patient depending on diagnostic findings.

References

Dunphy, L., Winland-Brown, J., Porter, B., & Thomas, D. (2017). Primary care: The art and science of advanced practice nursing with Davis Edge (5th ed.). F. A. Davis. ISBN: 9780803667181

Kennedy-Malone, L., Fletcher, K. & Martin-Plank, L. (2018). Advanced practice nursing in the care of older adults (2nd ed.). F.A. Davis. ISBN: 9780803666610

POST 2: Daimel posted Aug 18, 2022 4:52 PM

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What questions should you as the patient/family ask to further assess?

The questions I would ask this patient/family are when did these symptoms start, his level of orientation, is he recovering from an illness, any fever chills or malaise, is he depressed, in pain or are there any sentinel events such as a death of a loved one? Is he experiencing any changes in taste, smell or having difficulty swallowing or chewing? What other symptoms has he noticed or is he experiencing any gastrointestinal disturbances such as reflux, nausea, vomiting, diarrhea or constipation. Is he capable of preparing meals, what are his sleep habits, diet, use of alcohol, tobacco, recreational drugs and if he uses herbal remedies? Lastly I would ask if he has been without food due to any financial hardship or situation? NSG 6420 South University Online Nursing Discussion

What screening tools would be appropriate in this case?

The screening tools that would be appropriate in this case would be a head-to-toe assessment- assessing his sense of smell, taste, his ability to swallow and chew, his teeth and tongue should be assessed for caries and lesions and an assessment of his abdomen, GI, GU, and musculoskeletal system would assist in ruling out differential diagnoses. I would use screening tools such as the mini mental status test to assess for dementia, assess for depression and pain, use the functional assessment and FRAIL tool and would order laboratory tests to assess for metabolic or pathologic disease processes (Kennedy-Malone, 2018).

Do you have concerns with frailty in this patient? If so, why?

Yes, I have issues with frailty with this patient because lack of nutritious meals and fluids can lead to muscle wasting, electrolyte imbalances, and nutritional deficits that can put him at risk for dehydration, falls, mental status changes, metabolic disturbances and muscle wasting (Dunphy, 2017).

What referrals should be made, if any, on this patient?

A consultation with the dietitian or nutritionist would assist this patient and depending on what diagnostic test, labs and studies show, would determine if any further referrals are needed. Consultation for depression, malignancy, and or physical and or occupational therapy may also assist this patient depending on diagnostic findings. NSG 6420 South University Online Nursing Discussion

NSG 6420 South University Online Week 2 Aquifer Virtual Case Studies Analysis

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NSG 6420 South University Online Week 2 Aquifer Virtual Case Studies Analysis

Description

For this assignment, you will complete Aquifer virtual case studies based on the course objectives and weekly content. Aquifer virtual cases emphasize core learning objectives for an evidence based primary care curriculum. Throughout the Nurse Practitioner program, you will use Aquifer virtual case studies to promote the development of clinical reasoning through the use of ongoing assessment and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice. NSG 6420 South University Online Week 2 Aquifer Virtual Case Studies Analysis

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The Aquifer virtual case study assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases will be present in the weekly quizzes, and mid-term and final exams. You must have all Aquifer assignments completed in order to successfully pass the course.

Apply information from the Aquifer virtual case studies to answer the following questions:

  • What is the CC in the case studies? What are important questions to ask the patients to formulate the history of present illness and what did the patients tell you?
  • What components of the physical exams are important to review in the cases? What are pertinent positive and negative physical exam findings to help you formulate your diagnosis?
  • Which differential diagnosis is to be considered with each case study? What was your final diagnosis?

Click here for information on how to access and navigate the Aquifer virtual case studies.

This week, complete the cases titled Internal Medicine 08: 55-year-old male with chronic disease management and Internal Medicine 15: 50-year-old male with cough and nasal congestion. NSG 6420 South University Online Week 2 Aquifer Virtual Case Studies Analysis

South University Week 2 Chronic Disease Management Discussions Replies

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South University Week 2 Chronic Disease Management Discussions Replies

Description

respond to two classmates

classmate 1:

Internal Medicine 08: 55-year-old male with chronic disease management

 

What is the CC in the case studies? What are important questions to ask the patients to formulate the history of present illness and what did the patients tell you?

CC: “I had a heart attack about a month ago and had to have open-heart surgery. The heart doctors told me that my heart is weak now. My cardiologist told me that I have to get my blood sugar under control, so I don’t have another heart attack. I am here to get down to work” (Burns, 2021).

In order to create an appropriate HPI it is important to follow the OLDCART pneumonic: onset, location, duration, character, aggravating factors, relieving factors, timing and severity (Goolsby & Grubbs, 2018). Using the OLDCART pneumonic can help assess the patients’ pain, if there is any present, as well as other symptoms the patient is experiencing. Some important questions that should be asked would including inquiring about what medications the patient is currently taking, what kind of food and drinks he typically consumes throughout the day, what his exercise routine consists of and is he able to tolerate such exercise (Bickley & Szilagyi, 2017). It is also important to ask the patient about any visual changes or if they’re experiencing any tingling or numbness in the hands and feet, as well inquiring about their social habits including drug, tobacco, and alcohol use (Bickley & Szilagyi, 2017). South University Week 2 Chronic Disease Management Discussions Replies

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Mr. Morales provided a list of his current medications following his recent heart attack and heart surgery. He provided detailed descriptions of his daily food and beverage intake, which included fast food, soft drinks, hearty meals at home always consisting of meat, gravy, starches and some vegetables, and a large bowl of ice cream in the evening (Burns, 2021). The patient brought a log of his blood sugars he has recorded since leaving the hospital and admits that he will frequently skip his insulin shots because he does not like to give himself shots, and during moments of hypoglycemia instead of taking his blood sugar he skips it and eats a candy bar from the vending machine to avoid the shaky, sweaty, jittery feeling (Burns, 2021). In addition, Mr. Morales informed the provider that he does not have a specific exercise routine other than working on the line and, since his heart surgery, he feels “short of breath just walking to the mailbox at the end of the driveway”, and has also been experiencing numbness in his feet that feel like burning most of the time and his vision is blurry all the time but has not seen an ophthalmologist in some time (Burns, 2021). South University Week 2 Chronic Disease Management Discussions Replies

What components of the physical exams are important to review in the cases? What are pertinent positive and negative physical exam findings to help you formulate your diagnosis?

Prior to beginning Mr. Morales’ physical exam vital signs will be obtained, focusing on blood pressure and fasting blood glucose. During the full physical assessment it is important to including his overall general appearance, HEENT, fundoscopic exam, neurologic, neck, cardiac and respiratory, chest appearance, extremities, and diabetic foot exam (Burns, 2021). Positives on the physical exam include a BMI of 39.6 (obese), bilateral microaneurysms with hard exudates on the left, the PMI diffuse and laterally displaced (Burns, 2021). The important negatives to focus on are the absence of S3 S4 heart sounds or edema that could be indicative of the progression of cardiac disease or the onset of recurring heart failure (Burns, 2021).

Which differential diagnosis is to be considered with each case study? What was your final diagnosis?

One of the differential diagnoses to be considered in this case study includes diabetic retinopathy due to his previous diagnosis of diabetes. The patient reported to the provider that he is suffering from constant blurry vision, and upon examination microaneurysms were found bilaterally and hard exudates on the left that were found on the fundoscopic exam (Burns, 2021). Another potential differential diagnosis is diabetic neuropathy due to the persistent numbness Mr. Morales is experiencing in his feet (Buttaro et. al., 2017). The final diagnosis I would give Mr. Morales is heart failure as he is a diabetic who had a recent MI, complains of dyspnea on exertion, and he has cardiac enlargement assessed by a PMI that is diffuse and laterally displaced (Goolsby & Grubbs, 2018).

Internal Medicine 15: 50-year-old male with cough and nasal congestion

What is the CC in the case studies? What are important questions to ask the patients to formulate the history of present illness and what did the patients tell you?

CC: “I have been sick for the past three or four days. It started with my throat being scratchy and lots of sneezing. Now my nose is all stopped up, and I am blowing it constantly. I’m also coughing a lot.”

In order to piece together a detailed HPI it is important to ask the patient about other symptoms he may have experienced such as fever or chills, does he produce any sputum with his cough and if so what color is it, and whether or not he has experienced this symptoms before (Bickely & Szilagyi, 2017). I would also inquire if the patient has ever experienced allergies or if he has taken any OTC medications for his symptoms and if so, which ones and were they helpful (Bickley & Szilagyi, 2017). Additional questions could include are his symptoms triggered or aggravated by anything specific, and in addition to a fever or chills has he felt fatigued or developed a headache (Goolsby & Grubbs, 2018)?

Mr. Talib informed the provider that he felt warm on the first day but now has occasional chills and feels really tired (Bierman, 2021). He also stated that his children were sick all last week but both himself and his children has tested negative for COVID, and has also admitted to usually being a half-pack/day smoker. The patient denies any shortness of breath or chest pain, but stated that his cough has been dry and will wake him up throughout the night several times and experienced the same symptoms last fall that lasted a couple of weeks (Bierman, 2021). As for OTC medications, the patient has tried Actified Cold and Allergy tablets, Cold-EEZE, vitamin C, and Waltussin DM, none of which has provided any relief of symptoms (Bierman, 2021). South University Week 2 Chronic Disease Management Discussions Replies

What components of the physical exams are important to review in the cases? What are pertinent positive and negative physical exam findings to help you formulate your diagnosis?

Prior to beginning Mr. Talibs’ physical exam vital signs will be obtained, which were all within normal limits, and a BMI of 28.7. During the full physical assessment it is important to include an assessment of his overall general appearance, HEENT, neck, chest/lungs, and cardiovascular system (Bierman, 2021). Positives on the physical exam included a slightly reddened posterior pharynx with no exudate, tonsillar enlargement, or cobblestoning (Bierman, 2021). Upon auscultation, rhonchi was heard throughout all lung fields, but no wheezes or crackles or dullness to percussion (Bierman, 2021). All other systems reviewed presented with normal findings.

Which differential diagnosis is to be considered with each case study? What was your final diagnosis?

One of the potential differential diagnoses would include allergic rhinitis as the cardinal symptoms include sneezing, watery rhinorrhea, nasal congestion, cough, and postnasal drip. Allergic rhinitis can cause sleep-disordered breathing that can lead to generalized tired feeling but does not cause fever, chills, and other signs of systemic illness (Bierman, 2021). Acute bronchitis is another differential diagnosis for Mr. Talib as it presents with a persistent cough, malaise, chills, and rhonchi present on auscultation. The final diagnosis for this patient is ultimately a viral upper respiratory infection, which is supported by the assessment findings of the slightly reddened posterior pharynx and rhonchi present on auscultation (Goolsby & Grubss, 2018).

Classmate 2 Week 2 Discussion Post

Internal Medicine 08: 55-year-old male with chronic disease management

The chief complaint for case 08 is diabetes and cardiovascular maintenance after a heart attack.

A question that could be asked would be do you smoke? How often do you take your medications? Are there any side effects of the medications you don’t like? This would be asked to see if he has the risk factor of smoking, if he is being compliant with his medications, and if there are side effects that would cause him not to take his medications.

A component of the physical exam that is important is the fingerstick blood glucose. The result of 158 which means his sugars are high if he’s fasting and normal if he isn’t.

Another component is his blood pressure which was 150/90. This means he has stage two hypertension. The issue with this reading is he is already on a couple of antihypertensives. If he is regularly having a reading around 150/90, he either needs to be more compliant with his medications, or he needs to have an increased dose of the medications he is currently on or different ones that will be more effective. (Burns, 2020) South University Week 2 Chronic Disease Management Discussions Replies

The fundoscopic exam is important on a diabetic patient because diabetes can affect ocular health. The exam showed several microaneurysms bilaterally as well as the left eye having hard exudates. This would support the concern that patient is noncompliant with his diabetic and cardiovascular management and should be referred to an ophthalmologist. (Inzucchi, 2021)

The neck, specifically the carotid pulses, was important to assess due to the patient’s cardiovascular history. The result of a 2+ carotid pulse bilaterally with normal upstroke could mean the patient has a slightly diminished pulse than what a normal pulse should be. (Burns, 2020; Zimetbaum, 2021)

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The cardiac system is crucial to assess due to his recent myocardial infarction as well as his diabetes. The PMI being diffuse and laterally displaced could be the result of his recent heart failure and stent placement. (Zimetbaum, 2021)

It is important to do a thorough diabetic foot exam due to his distal symmetric polyneuropathy. He does have onychomycosis, but it is unrelated to the diabetes and cardiovascular conditions. (Burns, 2020; Inzucchi, 2021)

Extremities are very important to exam due to his cardiovascular history. There was no edema, cyanosis, or clubbing which could mean his peripheral cardiovascular system is working appropriately. (Burns, 2020)

The blood work was an important part of the physical exam because of his diabetes having many potential complications that should be monitored. The BUN and creatinine were both high mean as well as the albumin to creatinine ratio.(Burns, 2020; Mottl et al., 2020)

Differential diagnoses would include glomerulonephritis, glomerulosclerosis. (Mottl et al., 2020)

The final diagnosis would be diabetic nephropathy.

Internal Medicine 15: 50-year-old male with cough and nasal congestion

The chief complaint is cough and nasal congestion. Questions that would help would be do you have any allergies? Is this something that has happened in the past or regularly? What color is your nasal discharge?

Because an upper respiratory infection is diagnosed based on signs and symptoms, it is important to do a thorough history and physical exam. Vitals are important to assess to determine if the patient’s infection has impacted his oxygen, respiratory rate, blood pressure, or body temperature. (Sexton & McClain, 2021)

The HEENT is an important part of the physical exam based on his symptoms. His posterior pharynx is slightly reddened. This rules out strep throat due to the absence of exudates. His nasal mucosa also slightly erythematous. This would confirm the patient’s complaint of a runny nose. (Bierman, 2022)

The chest is also important to examine based on his symptoms of cough and congestion. His negative chest exam possibly rules out a respiratory component to his illness such as pneumonia and possible acute bronchitis.(Bierman, 2022)

Allergic rhinitis, acute bronchitis, and acute bacterial pharyngitis are all differential diagnoses. The final diagnosis would be a viral upper respiratory infection based on the symptoms of nasal congestion, rhinitis, cough, malaise, pharyngeal erythema, and sore throat. (Bierman, 2022)(Sexton & McClain, 2021) South University Week 2 Chronic Disease Management Discussions Replies

NURS FPX 4060 Capella University Community Service Organizations Discussion

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NURS FPX 4060 Capella University Community Service Organizations Discussion

Description

Assessment 2 Instructions: Community Resources

  • PRINT
  • Research a selected local, national, or global nonprofit organization or government agency to determine how it contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community. Submit your findings in a 3-5 page report.As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment.

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    PROFESSIONAL CONTEXT

    Many organizations work to better local and global communities’ quality of life and promote health and safety in times of crisis. As public health and safety advocates, nurses must be cognizant of how such organizations help certain populations. As change agents, nurses must be aware of factors that impact the organization and the services that it offers. Familiarity with these organizations enables the nurse to offer assistance as a volunteer and source of referral.This assessment provides an opportunity for you gain insight into the mission, vision, and operations of a community services organization. NURS FPX 4060 Capella University Community Service Organizations Discussion

    Demonstration of Proficiency

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

    • Competency 1: Analyze health risks and health care needs among distinct populations.
      • Explain how an organization’s work impacts the health and/or safety needs of a local community.
    • Competency 2: Propose health promotion strategies to improve the health of populations.
      • Explain how an organization’s mission and vision enable it to contribute to public health and safety improvements.
    • Competency 3: Evaluate health policies, based on their ability to achieve desired outcomes.
      • Assess the impact of funding sources, policy, and legislation on an organization’s provision of services.
    • Competency 4: Integrate principles of social justice in community health interventions.
      • Evaluate an organization’s ability to promote equal opportunity and improve the quality of life within a community.
    • Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
      • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
      • Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format. NURS FPX 4060 Capella University Community Service Organizations Discussion

    PREPARATION

    You are interested in expanding your role as a nurse and are considering working in an area where you can help to promote equal opportunity and improve the quality of life within the local or global community. You are aware of several nonprofit organizations and government agencies whose work contributes to this effort in some way. You have particular interest in one of these organizations but would like to know more about its contributions to public health and safety improvements. You would like to report the results of your research in a scholarly paper that you could submit for publication.Research a selected local, national, or global nonprofit organization or government agency from the list provided. Determine how the organization or agency contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community. Submit your findings in a 3–5 page report.As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment.Choose the organization or agency you are most interested in researching:

    Note: Remember that you can submit all, or a portion of, your draft research paper to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

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    INSTRUCTIONS

    Research a selected local, national, or global nonprofit organization or government agency from the list provided. Determine how the organization or agency contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community. Submit your findings in a 3–5 page report.As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment. After completing this activity, choose an organization or agency from the list that you are most interested in researching. NURS FPX 4060 Capella University Community Service Organizations Discussion

    Document Format and Length

    Format your paper using APA style.

    • Refer to the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your paper. Be sure to include:
      • A title page and references page. An abstract is not required.
      • Appropriate section headings.
    • Your paper should comprise 3–5 pages of content plus title and references pages.
    Supporting Evidence

    Cite at least three credible sources from peer-reviewed journals or professional industry publications published within the past 5 years that support your research findings.

    Graded Requirements

    The research requirements, outlined below, correspond to the grading criteria in the assessment scoring guide, so be sure to address each point.

    • Explain how the organization’s mission and vision enable it to contribute to public health and safety improvements.
      • Include examples of ways a local and/or global initiative supports organizational mission and vision and promotes public health and safety.
    • Evaluate an organization’s ability to promote equal opportunity and improve the quality of life in the community.
      • Consider the effects of social, cultural, economic, and physical barriers.
    • Assess the impact of funding sources, policy, and legislation on the organization’s provision of services.
      • Consider the potential implications of funding decisions, policy, and legislation for individuals, families, and aggregates within the community.
    • Explain how an organization’s work impacts the health and/or safety needs of a local community.
      • Consider how nurses might become involved with the organization.
    • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
    • Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
      • Write with a specific purpose and audience in mind.
      • Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

    ADDITIONAL REQUIREMENTS

    Before submitting your paper, proofread it to minimize errors that could distract readers and make it difficult for them to focus on your research findings. NURS FPX 4060 Capella University Community Service Organizations Discussion

NHSFPX 4000 Capella University Analysis of Medication Errors Discussion Paper

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NHSFPX 4000 Capella University Analysis of Medication Errors Discussion Paper

Description

The topic of the work MUST be MEDICAL ERRORS. Please see attached work for reference. “Assignment 2”, which is refered to on the instructions is attatched as a word document. If you are unable to open it please let me know.

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

  • Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
    • Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it.
  • Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.
    • Analyze a health care problem or issue by describing the context, explaining why it is important and identifying populations affected by it.
    • Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution. NHSFPX 4000 Capella University Analysis of Medication Errors Discussion Paper
  • Competency 3: Apply ethical principles and academic standards to the study of health care.
    • Analyze the ethical implications if a potential solution to a health care problem or issue was implemented.
  • Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
    • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
    • Write following APA style for in-text citations, quotes, and references.

INSTRUCTIONS

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

  1. Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas | Transcript media piece) and provide details about it.
    • Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
    • Identify possible causes for the problem or issue.
  2. Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
    • Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
      • You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
      • You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles. NHSFPX 4000 Capella University Analysis of Medication Errors Discussion Paper
      • You may find the applicable Undergraduate Library Research Guide helpful in your search.
    • Review the Think Critically About Source Quality to help you complete the following:
      • Assess the credibility of the information sources.
      • Assess the relevance of the information sources.
  3. Analyze the health care problem or issue.
    • Describe the setting or context for the problems or issues.
    • Describe why the problem or issue is important to you.
    • Identify groups of people affected by the problem or issue.
    • Provide examples that support your analysis of the problem or issue.
  4. Discuss potential solutions for the health care problem or issue.
    • Describe what would be required to implement a solution.
    • Describe potential consequences of ignoring the problem or issue.
    • Provide the pros and cons for one of the solutions you are proposing.
  5. Analyze the ethical implications if the potential solution (the one for which you provide pros and cons) were to be implemented.
    • Provide examples from the literature to support the points you are making.
    • Discuss the pros and cons of implementing the proposed solution from an ethical principle point of view.
    • Describe what would be required to implement the proposed solution.

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

ADDITIONAL REQUIREMENTS

Your assessment should also meet the following requirements:

  • Length: 4–6 typed, double-spaced pages, not including the title page and reference page.
  • Font and font size: Times New Roman, 12 point.
  • APA template: Use the APA Style Paper Template [DOCX] as the paper format and the APA Style Paper Tutorial [DOC] for guidance. NHSFPX 4000 Capella University Analysis of Medication Errors Discussion Paper
  • Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  • Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
  • References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper.
  • APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.

Organize your paper using the following structure and headings:

  • Title page. A separate page.
  • Introduction. A brief one-paragraph statement about the purpose of the paper.
  • Elements of the problem/issue. Identify the elements of the problem or issue or question.
  • Analysis. Analyze, define, and frame the problem or issue.
  • Considering options. Consider solutions, responses, or answers.
  • Solution. Choose a solution, response, or answer.
  • Ethical implications. Ethical implications of implementing the solution.
  • Implementation. Implementation of the potential solution.
  • Conclusion. One paragraph.

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Medication Errors

In the recent times there has been increased concerns about medical errors. The focus has been caused by an increasing cases of incidents where either patients die or get adverse effects due to medication errors. Although, there is a possibility of medical errors, the chances should be slim for healthcare workers because of the fact that they are dealing with human life.

The need to take appropriate action and reduce medication errors is based on studies which show that the common sources of medical errors tiredness, lack of proper training, medical negligence and medication calculations. The positive correlation between tiredness and medication errors is attributed to instances where health workers works for long hours and as a result are likely to commit errors. An instance is where a hospital human resource department creates a schedule for nurses to work on two shifts of 12 hour each. It is practically impossible for the nurses to work for continuous 12 hours with the same level of effectiveness. However, if healthcare workers shift are reduce to say 6 hours a day they are likely to be effective a factor which will lead to a reduction in medication errors.

Identifying Academic Peer-Reviewed Journal Articles

I used Summon, Capella University Library to access healthcare database like ProQuest and PubMed. The Keywords used for the search were medical errors, negligence, medical calculation, tiredness, stress, communication. To ensures my results were limited to reviewed journal articles I limited filtered by including terms like journal articles in nursing and medicine

Assessing Credibility and Relevance of Information Sources

The relevance of the sources was maintaining by limiting my articles to within four years from the time of conducting my research. I checked the credentials to ensure that they are experts or researchers on matters of health a factor which guaranteed the credibility of the sources. The credibility of the sources was   also put in check by ensuring that the content of the study is in line with my research topic.

Annotated Bibliography

Ahmed Z, Saada M, Jones A. M,  & Al-Hamid A. M (2019) Medical errors: Healthcare     professionals’ perspective at a tertiary hospital in Kuwait. PLoS ONE 14(5): e0217023.             https://doi.org/10.1371/journal.pone.0217023

This article is privy to the fact sometimes medical errors can be detrimental to the safety of patients. The fact that medical errors are a result of preventable events means it is possible to take some steps to reduce the errors. The findings of this research are informed from a quantitative study of 203 health professionals. The study found that the frequency of medical errors is as high as 60.3% in Kuwait. The negative effects of medication errors led to 30.9% of the patients staying longer in hospitals, 32.3% developing life threatening conditions and about 20.9% incidents of fatalities. According to Ahmed, Saada , Jones, & Al-Hamid (2019) the common causes of medical errors are incomplete instructions, incorrect dosage, high workload, medical negligence and inadequate training.

Gorgich, E. A., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the Causes   of Medication Errors and Strategies to Prevention of Them from Nurses and Nursing             Student Viewpoint. Global Journal of Health Science, 8(8), 54448.          https://doi.org/10.5539/gjhs.v8n8p220

This article provides information on the major causes of medication errors and then provided some recommendations on what the healthcare sector should do to minimize the errors.  According to findings which were based on a descriptive study of about 327 nursing staff and 62 interns from a hospital in Iran, 97.8 % of medication errors are attributed to nurses being tired due to increased workload.  While 77.4% were caused by wrong drug calculation. Based on the research finding the authors recommended that there is need for the healthcare sector to address the issues of workload by engaging more medical workers. For instance, by employing more nurses there will be less pressure on the workers a factor which will make them to be alert when attending to patients. Besides, there is need to create a special unit of medication calculation a factor that is likely to reduce the cases of medication errors. NHSFPX 4000 Capella University Analysis of Medication Errors Discussion Paper

Salhotra, R., & Tyagi, A. (2019). Medication errors: They continue. Journal of Anaesthesiology,    Clinical Pharmacology, 35(1), 1–2. https://doi.org/10.4103/joacp.JOACP_88_19

According to Salhotra & Tyagi (2019), medication errors are caused by inappropriate administration of drugs or procedure by healthcare workers. Besides, the authors note that despite the advancements in technology medication errors continue to persist. The study was based on a number of literature review and found that one of the leading causes of medication errors is communication. This was linked to lack of clarity during verbal communication or as a result of an illegible handwriting. The effect is wrong administration of drugs a factor which may make the patient to experience adverse reactions. This article also highlighted the use of abbreviations as another cause of medication errors. This is common in the administration of LASA drugs. The suggestions for eliminating the errors entails  putting in place a computerized physician order entry system and discouraging the use of abbreviation or  giving verbal instructions  for LASA drugs.

Zyoud, A &   Abdullah, N. A.  C. (2016). The Effect of Individual Factors on the Medication      Error. Global Journal of Health Science. 8. 197. 10.5539/gjhs.v8n12p197.

This article provides some insight on medication errors by noting that this issues has been a thorn in the fresh in the healthcare industry a factor that has attracted attention.  The focus is reflected in the increased number of studies which seek to determine the common causes of medication errors and possible solutions.  The findings of the article are informed from feedback of about 255 registered nurses. The study highlighted issues like mathematical calculation and lack of proper training to be the major causes of medical errors. It is for this reason that health facilities need to take further steps like retraining the nurses to ensure that they have proper understating of drug calculation. The measure will result in the reduction of medication errors.

Learning from the Research

From the literature reviews I have gained some understanding of medication errors. I found that most medication errors are caused by known issues and this is promising because it can be the basis for instituting appropriate action. Zyoud &   Abdullah (2016) noted that most of the medication errors are caused by human factors like tiredness and wrong medical calculations. Based on this facts and the selection of appropriate research articles I will be able to conduct further research and write a good paper on medical errors.

References

Ahmed Z, Saada M, Jones A. M,  & Al-Hamid A. M (2019) Medical errors: Healthcare     professionals’ perspective at a tertiary hospital in Kuwait. PLoS ONE 14(5): e0217023.             https://doi.org/10.1371/journal.pone.0217023

Gorgich, E. A., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the Causes   of Medication Errors and Strategies to Prevention of Them from Nurses and Nursing             Student Viewpoint. Global Journal of Health Science, 8(8), 54448.          https://doi.org/10.5539/gjhs.v8n8p220

Salhotra, R., & Tyagi, A. (2019). Medication errors: They continue. Journal of Anaesthesiology,    Clinical Pharmacology, 35(1), 1–2. https://doi.org/10.4103/joacp.JOACP_88_19

Zyoud, A &   Abdullah, N. A.  C. (2016). The Effect of Individual Factors on the Medication      Error.             Global Journal of Health Science. 8. 197. 10.5539/gjhs.v8n12p197. NHSFPX 4000 Capella University Analysis of Medication Errors Discussion Paper

 

 

 

 

 

 

 

 

NHS FPX 5004 Assessment 1 Leadership and Group Collaboration

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NHS FPX 5004 Assessment 1 Leadership and Group Collaboration KP

In response to our conversation and subsequent written communications, I would like to inform you of my desire to assume the role of Project Leader.

While the specific needs identified for such a project is disheartening, I’m thankful that the organization is actively seeking to engage the community to ultimately produce impactful and sustainable solutions utilizing organizational capabilities and industry best practices.

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As a healthcare professional, my passion for the well-being of others is of the utmost importance. Upon initiating my academic studies and entering the healthcare field as a trained professional, the Hippocratic Oath was of the utmost importance. While the Oath has been historically taken by physicians, the included principles of medical confidentiality and maleficence have served as my ethical compass throughout my career. If afforded the opportunity to serve, I intend on standing upon this fundamental ethical foundation as it relates to all duties and responsibilities.

My initial understanding is that our target community of Haitians are reluctant to utilize prescribed healthcare services as evidenced by significantly diminished utilization. Also, this apprehension is the result (real or perceived) of cultural values and norms not being understood and thus honored. Furthermore, an internal employee survey has revealed that 75% of employees directly or indirectly serving this target community have expressed “concerns” about not only diversity but also workplace incivility and poor work-life balance.

While I have several questions to include survey methodologies, overall community engagement initiatives and resource allocation, I do feel confident that I have the training, experience and passion to effectively address these most pressing issues. Foremost, it’s imperative that you understand my approach to leadership and collaboration.

From childhood to date, I’ve always desired to be effective in all endeavors. Foremost to me is clearly defining goals and objectives while establishing a clear direction and subsequent means by which goals and objectives will be realized. This approach has served me well throughout my youth, periods of educational pursuit as well as during my entire professional career.  NHS FPX 5004 Assessment 1 Leadership and Group Collaboration

During my time in undergraduate school, I recall studying Maslow’s Hierarchy of Needs. Specifically, it’s been noted that “when a deficit need has been ‘more or less’ satisfied it will go away, and our activities become habitually directed towards meeting the next set of needs that we have yet to satisfy. These then become our salient needs. However, growth needs continue to be felt and may even become stronger once they have been engaged” (McLeod , 2007, p. 2). Applying this concept to business, I believe that continued growth, observation, collaboration and assessment is necessary. Furthermore, successful managers align their vision with that of the larger organization of which they are a part (Davis, Hellervik, Sheard, Skube, Gebelein, 1996,     p. 300).

In today’s workplace, project leadership is critical to success. All of mankind’s greatest accomplishments—from building the great pyramids to discovering a cure for polio to putting a man on the moon—began as a project (Larson, Erik W., Gray, Clifford F., 2018, p.3). While often thought of as a private sector tool used to ensure efficient productivity, project management is very useful (and often critical) to achieving desired societal outcomes. The successful project leader is someone who can achieve desired results by effectively using all available resources (including people).

For our purposes and discussion, the ideal project leader will be someone who values diversity. As an African-American female, I readily relate to the historical and ongoing challenges realized within “communities of color” as well as historically marginalized groups such as women. Someone who clearly reflected a true sense of purpose as it relates to diversity was Martin Luther King Jr (MLK). While I’m certainly not comparing myself (nor anyone else) to MLK, his overall methodology during the Civil Rights Movement reflects those of an outstanding project leader.

NHS FPX 5004 Assessment 1 Leadership and Group Collaboration

As a leader, I possess a number of professional and personal qualities to successfully lead the needed project team. Not unlike MLK, I possess a great deal of love and compassion for the well-being of others. Whether in my professional and personal life, I’m pained by inequity derived from a fundamental disregard or marginalization of others. In respect to the task at hand, the Haitian community is one of diversity within itself as well as in comparison to the larger diaspora found in the United States. The historical significance of the founding of Haiti, international relationships, resource allocation, governance and immigration policy has immensely impacted the typical experience of our Haitian residents. We must first and foremost engage ourselves in both learning this history and aligning ourselves with those capable and desiring to understand.

Another critical requirement of a successful project leader will be to identify someone who can successfully build collaborations. As history teaches, MLK was able to build very powerful collaborations even among groups diametrically opposed politically, socially, religiously, demographically, financially and historically. In my professional capacity as a healthcare leader, I too effectively utilize collaboration to ensure successful healthcare outcomes. To do so, there are matters of personnel, insurance, diagnosis, emotional and legal considerations which must all be managed and appropriately adjudicated. NHS FPX 5004 Assessment 1 Leadership and Group Collaboration

I’ve found that establishing and maintaining effective collaboration is critical to project leadership. Whether identifying project stakeholders, balancing technical and sociocultural needs, appropriately identifying routine operations from those which should be used within a project plan, or successfully identifying and leading throughout all project stages, the importance of effective leadership can’t be underestimated.

The composition of the interdisciplinary group of professionals will be one of the first focuses of my leadership of this project. My understanding is that the projected number of team members will be 4-6 persons. After assuring that we are utilizing an effective means of identifying and ultimately selecting these persons, I would commence with initial communications to those selected so as to schedule our first meeting.

Once the team is together, I would take the time to formally introduce myself while also providing a brief yet revealing insight into myself both as a person and a leader. As a collaborative leader, I value having a range of ideas, opinions and viewpoints expressed within a professional manner. While all viewpoints are valued and likely appropriate for our desired outcomes, it’s also imperative that I maintain the appropriate level of authority in making final decisions while also managing overall execution.

NHS FPX 5004 Assessment 1 Leadership and Group Collaboration KP

Some may resent aspects of their viewpoints not being included within our final decisions and thus a potential for conflict exists. However, it’s incumbent upon me as a leader to demonstrate courage and align varying viewpoints with our project goals. Making sure that the team has input in establishing the actual project goals and designating stakeholders to assure timely execution will further help to avoid project diminishing conflicts. To ensure effective collaboration, my approach is to use all available resources to properly lead and encourage effective communication within the team.

Our communication will take place within a designated project management tool. As an example, I’ve utilized Microsoft Project and found that it’s relatively easy to use and consists of powerful tools to document, communicate, measure, analyze and track resource expenditures at all phases of the project cycle. Those team members lacking previous experience will find the tool to be easy to learn and inclusive of “help” functions that can address most operational questions. As a “one-stop” depository, information is available at any time to all team members.

The practices of accountability, decision making, and delegation are also easily managed with Microsoft Project. From “decision trees” to “accountable party”, each owner of a designated task and/or outcome is identified. A multitude of software operations (reminders, alerts, direct communication, etc) can be made operational to ensure each team member is aware of their respective duties. Interestingly, team members can also see the impact of their respective actions (or lack thereof) as it relates to the larger project goals which serves as a form of accountability. I’m ultimately responsible for assuring that deliverables are satisfied. When necessary, individual guidance, counseling, an/or instruction will be provided.

As a lead, my passion for developing an atmosphere reflecting acceptance of all within the workplace has been a major part of my professional success. Actively engaging others, maintaining a flexible decision-making process reflecting group collaboration, and encouraging both formal and informal engagement amongst employees is highly important.

In closing, I would like to thank you for considering me for this critical leadership position. Upon a more comprehensive review of my candidacy, I believe you’ll find me to be highly professional, motivated and uniquely qualified to assume the role of project leader!

Bibliography

McLeod, Saul (29 December 2021) [2007]. “Maslow’s Hierarchy of Needs”. SimplyPsychology. Retrieved 10 January 2022.

Davis, Brian L., Lowell, Hellervik W., Skube, Carol J., Gebelein, Susan H., Sheard, James L.[1996]. Successful Manager’s Handbook.

Larson, Erik W., Gray, Clifford F., [2018]. Project Management: The Managerial Process

7E.

NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue

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NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue

Analysis of Current Healthcare Issue: Limited Access to Health Care

NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue MS

Disparities in ethnicity, sex, disability, age, race, geographical location, and socioeconomic status, according to the Office of Disease Prevention and Health Promotion [ODPHP] (2021), are the major barriers to people’s access to good healthcare in the United States. Low-income countries have had similar problems. For example, Zegeye et al. (2021) found that money, distance to healthcare facilities, gender, and level of education are the most significant barriers to quality healthcare in Benin. In this way, the problem of healthcare access is vast, requiring a diversified approach to overcome. As a result, policies, initiatives, and strategies aimed primarily at the underserved population are required to improve access to high-quality healthcare.

Elements of the Problem

For many years, the issue of healthcare access has afflicted numerous countries around the world. While the severity of the problem is well understood, given the wealth of study and data on the subject, finding long-term remedies has remained difficult. In the U.S., there are millions of citizens residing in vulnerable urban and rural areas who consider hospitals as the only place they can get healthcare services (Jay & Priya, 2018). This population is likely to increase with the continuously changing healthcare environment. The need to reform hospitals and make them more accessible to Americans has been acknowledged, and efforts are currently underway to develop new healthcare delivery models that will address the most frequently mentioned barriers to healthcare access. Some of the changes include affordability and advancement to all patients regardless of their location. However, to accomplish this, a comprehensive approach that addresses all aspects of inaccessibility is required.

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NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue MS

Age considerations, mental disability, socioeconomic inequities, and educational structure are all major contributions to accessibility issues. There is a shortage of adequate and timely counseling for older adults on where and when to seek medical care. Domestic caregivers are heavily reliant on the mentally disturbed population, who are rarely consulted about their loved ones’ physical health requirements. Low-income families cannot afford vital healthcare services due to a lack of insurance, which contributes to socio-economic inequities. Finally, the structure of some nursing courses should be adjusted to promote awareness about the special needs of vulnerable populations.

Analysis of the Problem

Ensuring that healthcare is available to all populations, in both developed and developing economies, is a challenge. However, the elements that contribute to this widespread issue are very contextual. As a healthcare provider, I can contribute to the resolution of this issue by recommending solutions based on evidence, literature, and personal experience which can be implemented in a variety of settings.  NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue

The Context for Healthcare Access Issue

In the effort to provide complete healthcare services, new obstacles accompany the changing healthcare environment. While measures are being made to encourage equal access to healthcare, socioeconomic disparities render some groups more susceptible since they cannot afford insurance. Others are in inaccessible geographic areas, causing delays or missed healthcare appointments. Similarly, while technological advancements have increased access to healthcare information, the elderly and mentally ill are less capable of using modern technologies to find information. As a result, some vulnerable minorities will be at a greater risk of losing access to important healthcare services as the healthcare system evolves (Jay & Priya, 2018). Therefore, the transition should be diversified and considerate of minority populations.

NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue MS

Populations Vulnerable to Healthcare Access Problems

Age is one factor that cuts across the socioeconomic capabilities of patients when it comes to accessing healthcare. In this sense, it must be considered in the process of devising a solution for healthcare access difficulties. According to Ware et al. (2017), aging populations have different preferences shaped by their experiences while seeking healthcare. Additionally, the authors note that lack of appropriate information is the primary cause of poor health outcomes for the elderly, as they cannot make informed decisions without data. The second element of access to healthcare issues is socioeconomic disparities. Populations living in poor conditions solely depend on hospitals for healthcare. Some people in this population category live too far away from healthcare facilities and cannot afford insurance. Zegeye et al. (2020) argue that women in low-income areas are the most vulnerable. Their problem is worsened by their lack of education as well as their low-educated husbands. The graph below provides a snapshot of the factors prominent in low-income countries. NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue

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Figure 1: Problems in accessing healthcare Source: Zegeye et al. (2020).

The third population that needs special consideration in improving healthcare access to all is the mentally challenged. The services offered to this population are mostly psychological rather than physical. This increases the burden for those responsible for caring for them (the mentally ill). According to Happel et al. (2016), carers are not involved in identifying the physical health needs of the mentally challenged patients they care for. Thus, it is challenging to develop a solution to reduce their physical pain. Finally, the level and kind of education offered to nurses at different professional levels determine their ability to serve the underserved populations satisfactorily. Notably, most people living in rural communities and underdeveloped urban areas are the most vulnerable to accessibility challenges. According to Mixer et al. (2021), the promotion of a community health-tailored education approach can make health practitioners more competent in handling the health needs of underserved populations.

Options for Consideration

To address the issue of accessibility to healthcare, there is a need for extensive research in the mentioned areas to provide real-time data on the factors hindering access to healthcare in different contexts. Existing evidence from other fields should be used as the foundation of national and state research. Actual and latest data can be collected from points of service in vulnerable population areas. Technology-aided services such as electronic health records are important sources of critical information about patient medical history to generate comprehensive databases. Finally, nurses should be at the forefront in identifying problems and potential solutions to improve healthcare access by vulnerable populations.

NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue MS

Solution and Implementation

The challenge of lack of information by older adults can be resolved through patient education and the devising of user-friendly apps for guidance. Evaluation of experiences and frustrations by the older population in their search for healthcare information and services should be used as primary data for designing appropriate technologies that can serve them better (Ware et al., 2017). This can be helpful for those living with chronic conditions. For the mentally ill patient populations, carers should be consulted by healthcare providers to help in identifying the physical health needs of their loved ones. This will facilitate access to all types of services because careers possess essential information about the needs of those they care for. Access to affordable and quality care by the low-income population can be improved through policy. It is through good health policies that economic disparities that hinder access to quality health can be resolved.  Finally, nurses should be prepared for the challenges experienced in rural communities and other low-income areas regarding health matters. Community-based nursing education can significantly contribute to the delivery of tailored services to less privileged families.

Conclusion  

Access to healthcare is every citizen’s right. However, the available resources and their distribution across populations are not sufficient to guarantee quality care for everyone. The healthcare access problem is more pronounced in low-income countries and low-income families within developed countries. The mentally unstable population is at a high risk of missing essential healthcare services unless their carers are considered as pertinent to their care plans. On the other hand, the prevalence of chronic illnesses among older adults contributes to poor healthcare access. Thus, there is a need to create a database that highlights the factors contributing to poor healthcare access and develop evidence-based strategies to solve the issue across different contexts.

References

Happel, B., Wilson, K., Platania-Phung, C., & Stanton, R. (2016). Filling the gaps and finding our way: Family carers navigating the healthcare system to access physical health services for the people they care for. Journal of Clinical Nursing, 26, 1917–1926. DOI: 10.1111/jocn.13505 1917.

Jay, B., & Priya, B. (2018). Ensuring access to quality health care in vulnerable communities. Academic Medicine, 93(9), 1271-1275. DOI: 10.1097/ACM.0000000000002254

Mixer, S., Beebe, L.H., Elliot, L.M., Turley, D., Craig, J., Chelko, M., & McCoig, C. (2021).  Transforming RN roles using an academic-practice partnership to improve healthcare access for underserved populations. Journal of Professional Nursing, 37, 459-466. https://doi.org/10.1016/j.profnurs.2020.06.006.

The Office of Disease Prevention and Health Promotion (2021). Disparities.https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities

Ware, P., Bartlett, S.J., Paré, G., Symeonidis, I., Tannenbaum, C., Bartlett, G., Poissant, L., & Ahmed, S., (2017). Using eHealth technologies: Interests, preferences, and concerns of older adults. Interactive Journal Medical Research, 23, 6(1). DOI: 10.2196/ijmr.4447.Zegeye, B., El-Khatib, Z., Ameyew, E.K., Seidu, A., Ahinkorah, B.O.,  Keetile, M., & Yaya, S. (2020). Breaking barriers to healthcare access: A multilevel analysis of individual- and community-level factors affecting women’s access to healthcare services in Benin. International Journal of Environmental Research and Public Health, 18(750), 1-15. https://doi.org/10.3390/ijerph18020750. NHS FPX 4000 Assignment 3 Analyzing a Current Health Care Problem or Issue

NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

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NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

Introduction 

Registered nurses begin their professional journey with research queries using an evidence-based framework to enhance patient outcomes. PICOT question formulation is an essential function that is used by nurses to create effective patient care plans and practices to meet their specific needs. PICOT stands for population/patient, intervention, comparison, outcome, and time (Seppi, 2019). The PICOT process often starts with analyzing a case study in a clinical practice and formulates a research question that helps to answer a problem or find solution to an issue. This means using PICOT, researchers can create a comprehensive question by searching evidence from the literature (only credible sources) to support their original question. Patient refers to who is the patient or population of patients in a particular hospital or clinical setting; intervention refers to actions or treatment applied to that population; comparison means what other interventions are available; outcomes refers to the desired outcome, and time frame defines how much time taken to reach the desired outcome (Schramm, 2019).  NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

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This report addresses the evaluation of credible resources online to help nurses find the best treatment or diagnosis of anxiety and depression in patients. Several scholarly databases and online journals were researched while looking up for the relevant search terms and synonyms to arrive at the best resources. Moreover, the research has been narrowed down by limiting the work to the pertinent content such as peer-reviewed articles or other websites. The purpose of PICOT process is to find the research results that meet the standards of quality. After careful consideration of research results, the best available evidence is searched to construct the PICOT question (Kappelmann, 2020). Therefore, depending on secondary research mythology, the author of this report defines a practice issue in the hospital settings surrounding patients with depression and anxiety. The key findings from the resources are explained to apply PICOT process and the relevance of those key findings is explained.

Using the PICOT Approach on Depression Patients

In healthcare settings where a majority of adult patients with depression are brought more often than in the past, patients need effective treatments and strategies to have long-term benefits. There are currently 10 patients in the psychiatry ward who suffer from depression and chronic anxiety. Nurses need to have knowledge and research skills to effectively prevent depressive symptoms in patients put under their care; they need to apply interventions and take actions to treat depression patients with positive outcomes. Moreover, they need to compare their effectiveness with other methods and also need to measure the time taken to research, implement, and apply these techniques successfully. Normally, this intervention period is six to eight weeks depending on the severity of the patient’s condition or mental health (Hofmann, 2017). Therefore, the question being explored in this research is: Is psychotherapy approach is more comprehensive and effective compared to medication in managing behavior of patients with depressive symptoms?

NURS FPX 4030 Assessment 3 PICOT Questions and an Evidence-Based Approach JJ

Models for Interventions

The Individualized Intervention Model is a framework that considers of patients’ needs, history, abilities, and preferences in finding the best intervention strategies to eradicate depression (Feller, 2018). In this framework, the patient care tasks and strategies are applied directly by senior nurses and junior subordinates who are responsible for treating ten patients of depression in the current healthcare settings. These nurses have experience in psychotherapy, psychological treatment, and medication approach to reduce and cure depression in patients. Moreover, Care Staff Directed Model is also useful that is different from the Individualized Intervention Model. For instance, in the Care Staff Directed Model, patient care activities are mostly based on staff’s education and training to prove empathetic services to depression patients (Guidi, 2021). This model allows nurses to get proper feedback from their staff to improve their practices.  NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

Findings from Scholarly Resources

While choosing between psychotherapy or medication treatment, psychologists and nurses should consider a few things. Two kinds of psychotherapies are popular to treat depression such as cognitive behavioral therapy and interpersonal therapy. Some practitioners prefer medication treatments to be more helpful than psychotherapy. However, there are several evidences that show using a combination of psychotherapy and medication yields the best outcomes in terms of patient care (Dzevlan, 2019).  NURS FPX 4030 Assessment 3 PICOT Questions and an Evidence-Based Approach JJ

The evidence-based research is performed to help nurses identify the best scholarly resources to improve their patient care outcomes. The first article chosen published in the Cambridge University Press is “The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis” that discusses and compares the effectiveness of psychotherapy and other intervention diseases in treating depression patients (Kamenov, 2017). The researchers focus on Quality of Life (QoL) outcomes in the treatment of depressive symptoms and findings suggest that psychotherapy and pharmacotherapy yielded small to moderate effect sizes in terms of QoL. The results of the study show that the combined treatment of medicines and psychotherapy is more effective than using a single technique. A similar research is selected as the second research articles named “Cognitive Therapy vs. Medications in the Treatment of Moderate to Severe Depression” is explored that addresses the usage of anti-depressive medicines to treat moderate to severe depression patients (DeRubeis, 2005). There is little data on this topic with cognitive therapy; the researchers tested 120 patients with 16 days or medication in the clinical settings of the University of Pennsylvania, Philadelphia. The dosage given was 50mg daily. After 8 weeks, response rates in medications were 50% and in cognitive therapy were 25%. The results of the research show that both cognitive and medication therapies can be equally effective in the initial treatment of patients of moderate to severe depression symptoms. The degree of effectiveness depends on the training and experience level of nurses or therapists (Kamenov, 2016).

Other research by Hollen (2014) states that for anxiety disorders, all methods such as anit-anxiety medications, anti-depressant medicines, and psychotherapy all have been effective in the recent years. However, more researches show that psychotherapy is generally more effective compared to medicines for depression patients. This shows that only treating patients with medicines does not prove to be always beneficial. In case of schizophrenia or bipolar disorder, mood patients receive treatment using mood-changing medications (Djulbegovic, 2017). Therefore, it is vital for medical healthcare professionals to stabilize and personalize their treatment preferences based on patients’ needs and histories and apply evidence-based research to answer their questions to address a particular patient issue. Similarly, another study named “Cognitive therapy vs. medications for depression: Treatment outcomes and neural mechanisms” states that studies show the effectiveness of cognitive therapy as beneficial as medications at treating depressive symptoms. The research states that psychotherapy also helps to reduce the relapse risk; while medications and cognitive therapy results in similar neural mechanisms that are distinctive to each (Marwood, 2018).

Relevance of Findings

The research by Kamenov (2016) was chosen because it compressively discusses how pharmacotherapy can be as effective as psychotherapy in depression patients. The research also discusses with solid evidence how a combination of these two researches can be the best for patients.  The study is it the most relevant for helping nurses make the best decisions based on evidence. The study observed and concluded that combined treatment can be superior for improving function and QoL outcomes. Moreover, the study by Robert and Hollen (2014) also compares the efficacy of anti-depressant medication in depressive patients and apply interventions such as desipramine hydrochloride in addition to cognitive therapy. This research provides comprehensive results to show that cognitive therapy is as effective as medication therapy for treating moderate to severe depression. However, this research states that nurses’ level of skill can also determine the rate of their success using these strategies. This research also proves to be the most authentic and relevant resource because it offers a systematic review of primary data and uses statistical tools to arrive at conclusions. Another relevant research by Nils and Martin (2020) also compares psychotherapy against medication for depressive patients using individual symptom meta-analysis. This research shows that meta-analytic strategy does not reveal any differences in the efficacy of psychotherapy and medication process. The rationale for selecting this research that is provides a systematic review of meta-analysis of many intervention studies and provides findings that help to answer the PICOT question.  NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

NURS FPX 4030 Assessment 3 PICOT Questions and an Evidence-Based Approach JJ

Conclusion

There is a great need for developing evidence-based practices in nursing to help form PICOT questions that aim to find the best treatments related to depression in patients. The PICOT method is applied to see if the interventions nurses are using are effective compared to other methods of treatment. The sources of evidence reveal that both psychotherapy and medication play an equally important role in treating depressive patients; however, their combination can yield even stronger outcomes.

References

Djulbegovic, B., & Guyatt, G. H. (2017). Progress in evidence-based medicine: a quarter century on. The Lancet, 390(10092), 415-423.

Dzevlan, A., Redzepagic, R., Hadzisalihovic, M., Curevac, A., Masic, E., Alisahovic-Gelo, E., & Hadzimuratovic, A. (2019). Quality of life assessment in antidepressant treatment of patients with depression and/or anxiety disorder. Materia socio-medica, 31(1), 14.

Feller, M., Snel, M., Moutzouri, E., Bauer, D. C., de Montmollin, M., Aujesky, D., … & Dekkers, O. M. (2018). Association of thyroid hormone therapy with quality of life and thyroid-related symptoms in patients with subclinical hypothyroidism: a systematic review and meta-analysis. Jama, 320(13), 1349-1359.

Guidi, J., & Fava, G. A. (2021). Sequential combination of pharmacotherapy and psychotherapy in major depressive disorder: a systematic review and meta-analysis. JAMA psychiatry.

Hofmann, S. G., Curtiss, J., Carpenter, J. K., & Kind, S. (2017). Effect of treatments for depression on quality of life: a meta-analysis. Cognitive behaviour therapy, 46(4), 265-286.

Kamenov, K., Twomey, C., Cabello, M., Prina, A. M., & Ayuso-Mateos, J. L. (2017). The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis. Psychological medicine, 47(3), 414-425.

NURS FPX 4030 Assessment 3 PICOT Questions and an Evidence-Based Approach JJ

Kappelmann, N., Rein, M., Fietz, J., Mayberg, H. S., Craighead, W. E., Dunlop, B. W., … & Kopf-Beck, J. (2020). Psychotherapy or medication for depression? Using individual symptom meta-analyses to derive a Symptom-Oriented Therapy (SOrT) metric for a personalised psychiatry. BMC medicine, 18, 1-18.

Schramm, E., Kriston, L., Elsaesser, M., Fangmeier, T., Meister, R., Bausch, P., … & Härter, M. (2019). Two-year follow-up after treatment with the cognitive behavioral analysis system of psychotherapy versus supportive psychotherapy for early-onset chronic depression. Psychotherapy and psychosomatics, 88(3), 154-164.

Seppi, K., Ray Chaudhuri, K., Coelho, M., Fox, S. H., Katzenschlager, R., Perez Lloret, S., … & Djamshidian‐Tehrani, A. (2019). Update on treatments for nonmotor symptoms of Parkinson’s disease—an evidence‐based medicine review. Movement Disorders, 34(2), 180-198.

NURS FPX 4030 Assessment 3 PICOT Questions and an Evidence-Based Approach JJ

DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P. R., Salomon, R. M., … & Gallop, R. (2005). Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of general psychiatry, 62(4), 409-416.

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NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

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NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

PICO (T) Questions and an Evidence-Based Approach

The term PICO(T) stands for Population, Interventions, Comparison, Outcomes, and Time. The implications of PICO(T) work to develop inquiries to help the researchers for evidence. According to evidence-based practice, the significance of PICO(T) leads the nurses to their start-ups. The element of time allows nurses to seek evidence-based on effective searches. The forms of evidence lead nurses to explore meaningful norms of pieces of evidence during the session of research. Efficient nurses are required to start their professional practice under evidence-based practices to improve the quality of health life to implement health care proposals for the improvement of nurses (Driscoll, 2018). PICO(T) procedure leads a particular intimation for inquiries under evidence-based practices to support real questions.  NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach NR

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In the term PICO(T), the patient scenario refers to patients from the population. The term intervention refers to treatments applied to a specific population. The term comparison represents the techniques of particular medications among the residents; the term outcomes refer to the targeted consequences, and the time relates to the access to the specific timeframe to achieve desirable targets. The key to credible online resources is to guide nurses to find out the best techniques for diagnosing anxious treatments in patients (Jahan et al., 2016).

PICOT Approach within the Patients of Anxiety

The ratio of adults or patients visiting health care settings in case of anxiety is much higher than the past data analysis. Patients with pressure also need effective treatments and medications to receive well-being in the future. In the psychiatry ward, the number of patients subjected to anxiety and depression is high in the health care settings, who are 20 in the relevant control of depression in health care settings. It is the daily practice in nursing to acquire nursing skills to eliminate and diminish the harmful symptoms attached to depression and anxiety under their intensive care to achieve desirable results regarding the health maintenance of patients (Perrin et al., 2015). It is critical of the recovery process checked and applied by nurses to monitor the effectiveness of treatment and medication to compute timeframe to evaluate and assess various techniques to use the practical methods on the patients to access desirable results. The intervention span consists of six to eight weeks depending on the severe conditions subjected to patients’ mental and physical needs. Furthermore, the inquiry psychotherapy approach explains the process of medication and treatment thoroughly to deal with patients with the arousal of symptoms of depression and anxiety (Philip et al., 2021).  NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach NR

The selected problem is anxiety and depression and the PICO(T) question formulated is as follows:
“In elder patients, treatment using pharmacotherapy and psychotherapy as compared to standard treatment interventions is more effective?”

Sources of Evidence

The framework is based on individualized interventions working ahead to monitor the requirements of patients, history, capabilities, and inclinations in finding the best interventions-based policies to eliminate depression and anxiety. In the concerning scenario, the guidelines of patients care and quality of the maintenance of life assure the applicability of right and effective strategies by the nurses who take into consideration the accountability about the concerned scenario who are in contact of treatment with the 20 patients in the relevant ward of depression in health care settings. The nurses who deal with patients with anxiety and depression have significant experience of psychotherapy, psychological medications, and appropriate approaches to lower and cure the symptoms of anxiety and depression in patients (Louw et al., 2011). Furthermore, in the Directed Model of Care Staff, the moves and activities of patients are meaningfully compared to the individualized model of interventions. For example, in the Directed Model of Care Staff, the actions of patients are determined by the pieces of training and education of staff to give justifications for the king behavior and services for the available patients of anxiety and depression. The Directed Model of Care Staff permits nurses to receive an efficient response from the staff members to improve the level of efficiency by nursing practices (PMC, n.d.).  NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach NR

Findings from Sources of Evidence

It is a matter of concern for the psychotherapists and nurses to select proper medication approaches for the treatment of patients. In the case of depression and anxiety, two forms of therapy serve as leading and effective remedial strategies: interpersonal therapy and cognitive-based therapy. Most researchers and practitioners like to adopt and recommend proper medications instead of adopting therapies. Moreover, there is a series of emergence in between treatments of medicines and psychotherapies to receive the best results to improve patients’ health care phenomena (Faghy et al., 2021).

The objective of acquiring knowledge through evidence-based techniques is to help the nursing faculty utilize the best sources of evidence to enhance the results from the consequences of care of patients. The first and foremost piece of an article published in the press of Cambridge University is the Efficacy of psychotherapies, pharmacotherapies, and their combinations on functioning and quality of life in depression to have a well-settled communication through the process of medication-related to the patients of anxiety and depression. Practitioners lay stress on maintaining patients’ quality of life to deal with the symptoms of anxiety and depression. The recommendations of results came in front to state that effects of psychotherapy generate medium sizes in terms of betterment in quality of life. The consequences attached to the combination of medication and psychotherapy generate more effective results than a single technique’s applicability. The second research, known as Cognitive Therapies vs. Medication in the Treatments of Moderate to Severe Depressions and Anxiety, is preferably used to get rid of the anxiety and depression to deal with moderate to severe modes of depression and anxiety in health care settings (Noonan et al., 2020). The available data and relevant information on the title of cognitive therapy are few. The experts examined 125 patients with 15 days of medication in the health care settings of the University of Pennsylvania. The daily intake of medicines is about 50 milligrams for up to eight weeks, with the output ratio of results being about 50%, and cognitive therapy was up to 25%. The consequences of research through medication and cognitive therapies to receive the treatments of patients to deal with the symptoms of moderate and severe modes of anxiety and depression. The varied ratio of effectiveness relates to the training and education received by the nurses through health care settings.  NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach NR

By the statements of other experts, it came in the view that in case of disorders through anxiety and depression, the medications related to psychotherapy and anti-anxiety showed effective results in the current years. But many experts state that the effectiveness of psychotherapies is exhibited properly in cases of depression because only dealing and treating patients with medications does not prove to have benefits, especially in the treatments of schizophrenia or disorders of bipolar. The patients need to initiate steps for making possible stabilization in health care settings following the needs and requirements of patients and assuring sessions to conduct with experiments based on evidence-based experiences (Snyder et al., 2011). The most relevant study to the scenario mentioned above is Cognitive therapy vs. medications for depression recommended that yielded results of cognitive theory is most fruitful to attain good results on order to deal with symptoms of anxiety and depression and is also deals with reduction in the risks attached with relapse and the theories of nature of cognitive and medications casts its shadow towards exceptional results.  NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach

Relevance of Findings from Chosen Sources of Evidence

The research based on pharmacotherapy and psychotherapy is more effective in dealing with symptoms of anxiety and depression. It is more effective in orienting and attaining decisive decision-making procedures for nurses. And the combination of treatments of pharmacotherapy and psychotherapy are both best results-oriented for the achievement of patients’ quality of life. According to the research of experts, it is recommended that cognitive theory generates more effective results in the medication treatment of patients up to an intense level of disease and improvement of rising trends in the progress of the strategies adopted by nurses. It is the most authentic approach to dealing with the symptoms of anxiety and depression (Fencl & Matthews, 2017).

Conclusion

Time requires dealing in the nursing field by applying PICO(T) to access the most suitable treatment based on evidence subjected to anxiety and depression in patients. The objective of PICO(T) techniques is to check the effective therapies in the clinical sessions of anxiety and depression with patients. The evidence-based results make it possible to benefit from psychotherapy and medications to deal with patients with anxiety and depression in health care settings.

References

Driscoll, D. (2018). The New RN and Emergency Patient Care Scenarios: How Simulation Can Help. OALib, 05(01), 1–22. https://doi.org/10.4236/oalib.1103904

Faghy, M. A., Arena, R., Stoner, L., Haraf, R. H., Josephson, R., Hills, A. P., Dixit, S., Popovic, D., Smith, A., Myers, J., Bacon, S. L., Niebauer, J., Dourado, V. Z., Babu, A. S., Maden-Wilkinson, T. M., Copeland, R. J., Gough, L. A., Bond, S., Stuart, K., & Bewick, T. (2021). The need for exercise sciences and an integrated response to COVID-19: A position statement from the international HL-PIVOT network. Progress in Cardiovascular Diseases, 67, 2–10. https://doi.org/10.1016/j.pcad.2021.01.004

NURS FPX 4030 Assessment 3 Questions and an Evidence-Based Approach NR

Fencl, J. L., & Matthews, C. (2017). Translating Evidence into Practice: How Advanced Practice RNs Can Guide Nurses in Challenging Established Practice to Arrive at Best Practice. AORN Journal, 106(5), 378–392. https://doi.org/10.1016/j.aorn.2017.09.002

Jahan, N., Naveed, S., Zeshan, M., & Tahir, M. A. (2016). How to Conduct a Systematic Review: A Narrative Literature Review. Cureus, 8(11). https://doi.org/10.7759/cureus.864

Louw, A., Diener, I., Butler, D. S., & Puentedura, E. J. (2011). The Effect of Neuroscience Education on Pain, Disability, Anxiety, and Stress in Chronic Musculoskeletal Pain. Archives of Physical Medicine and Rehabilitation, 92(12), 2041–2056. https://doi.org/10.1016/j.apmr.2011.07.198

Noonan, S., Zaveri, M., Macaninch, E., & Martyn, K. (2020). Food & mood: a review of supplementary prebiotic and probiotic interventions in the treatment of anxiety and depression in adults. BMJ Nutrition, Prevention & Health, bmjnph-2019-000053. https://doi.org/10.1136/bmjnph-2019-000053

Perrin, P. B., Panyavin, I., Morlett Paredes, A., Aguayo, A., Macias, M. A., Rabago, B., Picot, S. J. F., & Arango-Lasprilla, J. C. (2015). A Disproportionate Burden of Care: Gender Differences in Mental Health, Health-Related Quality of Life, and Social Support in Mexican Multiple Sclerosis Caregivers. Behavioural Neurology, 2015, 1–9. https://doi.org/10.1155/2015/283958

Philip, C., Roy, S., Eiden, C., Soler, M., Georgin, F., Müller, A., Picot, M., Donnadieu‐Rigole, H., & Peyriere, H. (2021). Opioid misuse in community pharmacy patients with chronic non‐cancer pain. British Journal of Clinical Pharmacology. https://doi.org/10.1111/bcp.15164

PMC, E. (n.d.). Europe PMC. Europepmc.org. Retrieved February 26, 2022, from https://europepmc.org/books/nbk56834

Snyder, C. H., Facchiano, L., & Brewer, M. (2011). Using Evidence-based Practice to Improve the Recognition of Anxiety in Parkinson’s Disease. The Journal for Nurse Practitioners, 7(2), 136–141. https://doi.org/10.1016/j.nurpra.2010.08.017