Assignment: Off-Label Drug Use in Pediatrics

Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

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To Prepare

Write a 1-page narrative in APA format that addresses the following:

• Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
• Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

• all papers submitted include a title page, introduction, summary, and references.  Assignment: Off-Label Drug Use in Pediatrics

Community teaching Plan proposal Assignment

 

Note:  The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

Select one of the following as the focus for the teaching plan:

1. Primary Prevention/Health Promotion
2. Secondary Prevention/Screenings for a Vulnerable Population
3. Bioterrorism/Disaster
4. Environmental Issues
   

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Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.

1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.
2. Request feedback (strengths and opportunities for improvement) from the provider.
3. Complete the “Community Teaching Experience” form with the provider. You will submit this form in Topic 5.

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance. Community teaching Plan proposal Assignment

 

Community Teaching Work Plan Proposal

Planning and Topic

Directions: Develop an educational series proposal for your community using one of the following four topics:

1. Bioterrorism/Disaster
2. Environmental Issues
3. Primary Prevention/Health Promotion
4. Secondary Prevention/Screenings for a Vulnerable Population

Planning Before Teaching:

Name and Credentials of Teacher:
Estimated Time Teaching Will Last:	Location of Teaching:
Supplies, Material, Equipment Needed:	Estimated Cost:
Community and Target Aggregate:
Topic:

 

Identification of Focus for Community Teaching (Topic Selection):

 

Epidemiological Rationale for Topic (Statistics Related to Topic):

 

 

 

Teaching Plan Criteria

Your teaching plan will be graded based on its effectiveness and relevance to the population selected. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Nursing Diagnosis:

 

 

 

 

 

Readiness for Learning: Identify the factors that would indicate the readiness to learn for the target aggregate. Include emotional and experiential readiness to learn.

 

 

 

 

 

 

 

 

 

 

Goal: Healthy People 2020 (HP2020) objective(s) utilized as the goal for the teaching. Include the appropriate objective number and rationale for using the selected HP2020 objective (use at least one objective from one of the 24 focus areas). If an HP2020 objective does not support your teaching, explain how your teaching applies to one of the two overarching HP2020 goals.

 

 

 

 

 

How Does This HP2020 Objective Relate to Alma Ata’s Health for All Global Initiatives

 

 

 

 

 

Develop Behavioral Objectives (Including Domains), Content, and Strategies/Methods:

Behavioral Objective and Domain Example – Third-grade students will name one healthy food choice in each of the five food groups by the end of the presentation. (Cognitive Domain)	Content (be specific) Example – The Food Pyramid has five food groups which are…. Healthy foods from each group are…. Unhealthy foods containing a lot of sugar or fat are….	Strategies/Methods (label and describe) Example – Interactive poster presentation of the Food  Pyramid. After an explanation of the poster and each food category, allow students to place pictures of foods on the correct spot on the pyramid. Also, have the class analyze what a child had for lunch by putting names of foods on the poster and discussing what food group still needs to be eaten throughout day.
1.	1.	1.
2.	2.	2.
3.	3.	3.
4.	4.	4.

 

 

Creativity: How was creativity applied in the teaching methods/strategies?

 

 

 

 

Planned Evaluation of Objectives (Outcome Evaluation): Describe what you will measure for each objective and how.

 

 

 

 

 

 

 

 

 

 

 

Planned Evaluation of Goal:  Describe how and when you could evaluate the overall effectiveness of your teaching plan.

 

 

 

 

Planned Evaluation of Lesson and Teacher (Process Evaluation):

 

 

 

 

Barriers: What are potential barriers that may arise during teaching and how will those be handled?

 

 

 

 

Therapeutic Communication

4.2 Communicate therapeutically with patients.

 

How will you begin your presentation and capture the interest of your audience? Describe the type of activity will you use with your audience to exhibit active listening? Describe how you applied active listening in tailoring your presentation to your audience? How will you conclude your presentation? What nonverbal communication techniques will you employ? Community teaching Plan proposal Assignment

 

 

Fiona is a 29-year-old woman who works in a medical factory making medical equipment. She lives with her husband and in-laws. Over the last week, she has been more isolative, saying strange things to her husband, and not sleeping due to unidentified fearfulness. The only stressor that her husband can identify is that they started talking about having children. Fiona refuses to do her ADLs, eats very little, and appears intermittently in a trancelike state. The family was becoming more and more concerned and attempted to get Fiona to see their family doctor, but she was refusing. Finally, police were called due to worsening regressed behavior and Fiona was brought to the local emergency department (ED) for evaluation. The ED physician examined her and reported after labs and neuroimaging that she was medically stable. Although the patient reported no history of psychiatric illness, she did report that her maternal grandmother was in a state hospital for most of her life. The physician recommended psychiatric hospitalization for new onset of a psychotic illness. Nursing homework help

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1. Summarize the clinical case.
2. What is the DSM5 diagnosis?  Identify the rationale for your diagnosis using the DSM5 diagnostic criteria.
3. According to the clinical guidelines, which one pharmacological treatment is most appropriate to prescribe? Include the medication name, dose, frequency and rationale for this treatment.
4. According to the clinical guidelines, which one non-pharmacological treatment would you prescribe? (exclude psychotherapy modalities)  Include the risk and benefits of the chosen rationale for this treatment.
5. Include an assessment of medication’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.
6. Use a local pharmacy to research the cost of the medication. Use great detail when answering questions 3-5. Nursing homework help

Reflection of an experience, lesson learned, and/or importance of a role, demonstrates a clear understanding of process, comprehension, and expertise. To reflect requires an ability to consider lessons learned, personal connections, and next steps. As we come to the end of the course, it is important for you to consider what you learned and how to connect these lessons beyond this course.

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For this Discussion, you will reflect on what you learned throughout this course. What is the impact of what you learned? How might you approach engaging in policy advocacy moving forward?

Reference:
Clark, J. (2011). Let’s reflect: What is the point? British Journal of General Practice, 61(593), 747. https://doi.org/10.3399/bjgp11X613232

To prepare:

• Consider what you learned throughout this course and reflect on the impact.
• Consider how you might use what you have learned beyond this course experience.

By Day 3 of Week 11

Post a response detailing the following:

• How has this course impacted your knowledge, attitude, beliefs, perceptions about nurse engagement in policy advocacy and politics?
• What are the takeaways as you move forward as a DNP, in your role as a policy advocate? What resonates with you and how will you use it? Nursing homework help

Standardized Nursing Handoff Sheet For New Graduates Assignment

SUB-HEADINGS

· Introduction of topic: Standardized nursing handoff sheet for new graduates

· Literature review of the topic/issue

· Literature review of the solution/interventions

· Implementation/intervention

Please find instructions and sample attached

CAP Instructions and Rubric

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PAPER SHOULD CONTAIN THE FOLLOWING SUB-HEADINGS

• Introduction of topic
• Literature review of the topic/issue
• Literature review of the solution/interventions
• Implementation/intervention 

Step-by-step directions:

1. Identify a problem, issue, concern, or area for improvement relevant to your clinical setting.
2. Educate yourself about the importance of your topic to nursing and your particular clinical placement. Whenever possible, you will want to include facts, statistics etc. relevant to your
3. Critically analyze the literature related to the area of concern. Standardized Nursing Handoff Sheet For New Graduates Assignment
4. Identify possible solutions to the selected area of concern, based on the evidence in the literature.
5. Review each for its strengths, weaknesses, and feasibility.
6. Select a solution. 

                                                     CAP Instructions and Rubric

Grading criteria for PAPER	Points	Comments
Introduction ·         Introduces topic and provides overview of the issue (2 pts.) ·         Discusses why this issue is pertinent to the particular unit/organization and what led student to choose the topic (2 pts.) ·         Identifies unit, manager, etc. support for the project (1 pt.) ·         Identifies how the project will specifically benefit the unit/organization (2 pts.)	/7
Literature review: topic/issue ·         Includes two recent articles (less than 5-7 years) from professional nursing or health sciences journals (2 pts.) ·         For each article: provides brief summary and discusses how the article is pertinent and relevant to the topic/issue (4 pts./each article=8 total)	/10
Literature review: solution/intervention ·         Includes two recent (less than 5-7 years) articles from professional nursing or health sciences journals (2 pts.) ·         For each article: provides brief summary and discusses how the article is pertinent and relevant to the solution or interventions (4 pts./each article=8 total) ·         Articles support the student’s chosen solution or intervention (2 pts.)	/12
Implementation/intervention ·         Clearly describes final project or intervention (2 pts.) ·         Outlines specific steps to implement final project/solution, including timeline for how the project could be “rolled out” (4 pts.) ·         Discusses how the project will address/improve the clinical issue (2 pts.) ·         Discusses future follow-up, evaluation, and/or measurement of the impact of the project (3 pts.)	/11
Paper mechanics ·         Incorporates required content in a 4-5-page paper (not including title page and reference page) (2 pts.) ·         Follows correct APA: Proper title page (1 pt.) Appropriate text spacing, font size, headings, and in-text citations (2 pts.) Formatted reference page (2 pts.) ·         Writes clearly; uses correct grammar, spelling, and punctuation; avoids first person voice (3 pts.)	/10
Grading criteria for e-POSTER	Points	Comments
Topic/issue ·         Clearly displays the topic or issue (2 pts.) ·         Includes general information about the topic or issue (2 pts.) * ·         Communicates specifics about why it is pertinent to the particular unit or organization (2 pts.) * ·         States institutional support (1 pt.) *If applicable, poster uses appropriate graphic or visual which conveys national or local data, trends, organization or unit statistics, etc.	/7
Literature review of the topic/issue ·         Includes literature support of the topic or issue (1 pt.) ·         Summarizes most important point(s) of each article (4 pts.) ·         Clearly connects authors with literature points (1 pt.)	/6
Solution/intervention ·         Clearly outlines solution and presents as feasible (3 pts.) ·         Includes literature support of chosen solution (2 pt.) ·         Clearly connects authors with solution literature (1 pt.) Standardized Nursing Handoff Sheet For New Graduates Assignment	/6
Implementation ·         Identifies and explains final project and attaches a copy of “work product” (in-service handouts, pamphlet, form, pocket card, for example) (4 pts.) ·         Specifically describes how the final project would be implemented, including timeline for “roll-out” (2 pts.) ·         Describes how the impact of the project could be measured or evaluated (2) ·         Addresses the future implications of the project for the unit and/or nursing in general (2 pts.)	/10
	/6

                                                                                                                                                                                   TOTAL          /85 

Communicating with Ventilated Patients

Introduction

            It may be hard to communicate with patients under mechanical ventilation as a member of an inter-professional team offering care. Ventilated patients are unable to communicate because of the presence of the endotracheal tube (ETT). However, such communication is important to ensure patient safety and comfort since patients under such conditions usually experience panic, anxiety, fear, pain, and dyspnea, among other types of discomfort. Furthermore, despite their conditions, mechanically ventilated patients desire and have the right to be heard and take part in the making of decisions on their health for the attainment of patient-centered care.

This topic is important to contribute to the area of nursing to limit the gap of knowledge regarding relevant methods and strategies of communication for proper communication with ventilated patients. Research reveals that the care process for ventilated patients is undermined when there is a lack of communication between the patient and the caregivers. The presence of a communication barrier coupled with the health issue put the patients in a state of hopelessness. Identifying relevant communication methods for communicating with ventilated patients is important to eliminate feelings of fear, pain, and insecurity over the severity of their conditions.

Additionally, the identification of such communication methods will be useful towards the attainment of positive care outcomes in health care organizations that provide intensive care to critically ill patients. Organizations that consider such communication are bound to stand out as the leading in quality health care providers within their locales. Proper communication with ventilated patients will contribute to the research and study of the experiences of patients under mechanical ventilation and will enhance evidence-based care for such patients.

Literature Review (Topic)

               Over the years, scholars and professionals in the healthcare industry have researched the issue of communicating with ventilated patients. One such research is documented in The Ventilated Patient’s Experience, which seeks to find out if there exists a relationship between the use of effective communication tools with ventilated patients with satisfaction with care among the patient and family (Fink, Makic, Poteet and Oman, 2015). The authors of the article indicate that anxiety, pain, and fear are some of the emotions that patients under mechanical ventilation have to deal with. Standardized Nursing Handoff Sheet For New Graduates Assignment

Furthermore, upon recovery, these patients deal with traumatic memories that may be realistic, delusional, or emotional. Such memories of their time in intensive care place the patients at risk of psychological problems and post-traumatic stress disorder (PTSD) that may linger for as long as they live affecting their quality of life. According to the authors, the emotional pain that was reported most among adult trauma patients’ emotional memories was pain, followed by frustration and anxiety (Fink, Makic, Poteet and Oman, 2015). The loss of ability to communicate leaves ventilated patients feeling powerless and out of control of their situation. There is a need for optimal communication methods and strategies to limit the stress and anxiety of ventilated patients.

Another research is one by Aziza Salem and Muayyad Ahmad, who attempt to find out the issues related to ventilated patient communication (Salem and Ahmad, 2018). The authors aim to contribute to the development of relevant communication strategies and methods for effective communication with patients under mechanical ventilation. A major concern for nurses in inter-professional teams is how to communicate with such patients.

The research reveals that similar to other patients, ventilated patients desire to take part in the process of their care and the communication barrier in form of ETT makes them perceive that they have lost control over their treatment and they end up feeling frustrated (Salem and Ahmad, 2018). Nurses spend limited time when interacting with patients in intensive care and this revealed that there is ineffective communication between such patients and their caregivers. Over 60% of patients indicate that they desired to know about their health progress while under ventilation (Salem and Ahmad, 2018). The article reveals the need for effective communication with these patients as it promotes patient recovery by bringing about a sense of safety and security.

Literature Review (Solution)

Hoom, Elbers, Girbes, and Tuinman (2016) acknowledge the communication issue that arises when caring for patients who are ventilator dependent because of intubation. According to the authors, various assistive communication tools being in place but they are not often used on patients under intensive care (Hoorn, Elbers, Girbes and Tuinman, 2016). The article acknowledges the relationship between ineffective communication with severe emotional reactions among ventilated patients.

This article is relevant to solving the issue of communicating with ventilated patients as it offers an algorithm that standardizes the approach of choosing the relevant augmentative and alternative (AAC) methods. According to the article, AAC represents forms of communication that are not limited to oral speech that express messages (Hoorn, Elbers, Girbes and Tuinman, 2016). One of the communication techniques offered in the article is communication boards made up of icons and pictures to represent basic needs (Hoorn, Elbers, Girbes and Tuinman, 2016). Other communication strategies include; the use of a speaking tracheotomy tube with an inflated cuff, the use of electro larynx, and high-tech communication intervention.

A solution for the ineffective communication between ventilated patients and the nurses offering them care is the use of communication devices (Zaga, Berney and Vogel, 2019). One of the relevant communication devices for these patients is a picture board, which contains pictures of the basic needs the patient might want. According to Zaga, Berney and Vogel (2019), picture boards ease the level of frustration among ventilated patients. To further improve the quality of care for patients under intensive care, nurses should pass on relevant communication techniques in their reports when exchanging shifts.

Research indicates that the use of the Critical care Pain Observation Tool (CPOT) has been shown to improve pain assessment and management for ventilated patients (Zaga, Berney and Vogel, 2019). Furthermore, the use of AAC should be planned rather than unplanned for patient satisfaction with care. Zaga, Berney and Vogel (2019) indicate that the use of communication strategies and methods is important and beneficial towards the improvement of patient care and outcomes overall. As a result, nurses should be educated on the need for communication with ventilated patients and the negative impacts of lack of communication with these patients. Additionally, nurses should be educated on how to make use of AAC to facilitate effective communication with patients who cannot talk because of being mechanically ventilated.

Implementation

               Effective communication with ventilated patients requires sensitivity towards the need for effective communication with these patients and the communication strategies and tools that make it possible. A health care organization can organize a teaching intervention for nurses, which they will attend in their time off work. These interventions will be aimed at teaching nurses the need for communication with patients under intensive care and how to use the tools and strategies in place to enhance communication between them and these patients. The intervention will be done in two segments, where the first will involve sessions that will handle the need for effective communication with ventilated patients while the second will have sessions to handle the use of communication strategies and tools.

This intervention will take approximately two weeks to complete and nurses will be grouped according to the shifts they will be handling in the two weeks. This teaching intervention will be important towards the attainment of effective communication with ventilated patients and will consequently improve the patient care process and outcomes. Teaching nurses to use communication strategies and methods for effective communication with patients will promote the reputation of the health care organization as one that offers quality care regardless of the situation. At the end of the intervention, the nurses will be better equipped to care for patients who are unable to communicate orally because of being mechanically ventilated.

The patients under critical care will be less emotionally stressed and will regain control of the care process for their health. Consequently, the hospital will have attained the universal health care goal of patient-centered goal. In this case, an evaluation will involve analyzing the length of hospital stay for critically ill patients because effective communication with such patients is bound to limit it. Moreover, the evaluation will involve analysis of ventilated patients’ emotional reactions while receiving care. On the other hand, the relevant follow-up will involve research into the improvements and developments made in terms of communication strategies and methods for communicating with ventilated patients and incorporating them into the existing strategies and methods.

 

 

References

Fink, R. M., Makic, M. B. F., Poteet, A. W., & Oman, K. S. (2015). The ventilated patient’s experience. Dimensions of Critical Care Nursing, 34(5), 301-308.

Salem, A., & Ahmad, M. M. (2018). Communication with invasive mechanically ventilated patients and the use of alternative devices: integrative review. Journal of Research in Nursing, 23(7), 614-630.

Ten Hoorn, S., Elbers, P. W., Girbes, A. R., & Tuinman, P. R. (2016). Communicating with conscious and mechanically ventilated critically ill patients: a systematic review. Critical Care, 20(1), 1-14.

Zaga, C. J., Berney, S., & Vogel, A. P. (2019). The feasibility, utility, and safety of communication interventions with mechanically ventilated intensive care unit patients: A systematic review. American journal of speech-language pathology, 28(3), 1335-1355. Standardized Nursing Handoff Sheet For New Graduates Assignment