DQ-week 1: Health assessment

 Discussion: Building a Health History

 

Effective communication is vital to constructing  an accurate and detailed patient history. A patient’s health or illness  is influenced by many factors, including age, gender, ethnicity, and  environmental setting. As an advanced practice nurse, you must be aware  of these factors and tailor your communication techniques accordingly.  Doing so will not only help you establish rapport with your patients,  but it will also enable you to more effectively gather the information  needed to assess your patients’ health risks.

For this Discussion, you will take on the role  of a clinician who is building a health history for a particular new  patient assigned by your Instructor.

 

                                               To prepare:

By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. (new patient profile):  14-year-old biracial male living with his grandmother in a high-density public housing complex 

 

How would your communication and interview techniques for building a health history differ with each patient?

How might you target your questions for building a health history based on the patient’s social determinants of health?

What  risk assessment instruments would be appropriate to use with each  patient, or what questions would you ask each patient to assess his or  her health risks?

Identify  any potential health-related risks based upon the patient’s age,  gender, ethnicity, or environmental setting that should be taken into  consideration.

Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

Post a summary of the interview and a  description of the communication techniques you would use with your  assigned patient. Explain why you would use these techniques. Identify  the risk assessment instrument you selected, and justify why it would be  applicable to the selected patient. Provide at least five targeted  questions you would ask the patient.

NOTE: THIS IS THE LINK TO DOWNLOAD THE BOOK YOU NEED TO COMPLETE THE DISCUSSION QUESTION

 

https://yadi.sk/i/ 8cLDZzWn8FsUbg

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week 7.1.2

Respond

 

Using references, identity the research result that you could use in your practice setting.

This research I refer to identify key points in my project, my research question is about increasing communication to decrease readmission rates align well with the result of the following article. Ya-huei and Hung-Chang (2019), provide the readers with the type of tool they used to compute the result of their study with an outcome that was closed enough to the right answer. The use of  the  Kaiser-Meyer Olkin test has shown that these researchers have used the right amounts of subjects, in which it was proven that the result was accurate and can be used by healthcare professionals to make necessary improvement in the workplace. The overall reliability for the study was .93, and the retest to make sure that  the result is solid and can be trusted was almost the same. The validity of the study shows a firm association in that positive outcomes can derive from learning how to correctly communicate in the healthcare settings. Per Schaffer, Sandau, and Diedrick, (2012). Evidence-based practice is a paradigm and life-long problem-solving approach to clinical decision-making that involves the conscientious use of the best available evidence (p. 1198)

Determine fit, feasibility, and appropriateness of the result for your practice setting.

I can see that using certain information from the study that show a positive association on the outcome of the problem will surely take precedence in what I need to accomplish by using EBP to make change. The following four factors from the study put together the general idea that  providers can use when they need to increase communication in the practice setting. Knowing these facts will help put the focus on the importance of what matter to patients.  Per Ya-huei and Hung-Chang (2019), these factors are: “1- perception of trust and receptivity, 2- patient-centered information giving, 3- rapport building, and  4- facilitation of patient involvement+ (p. 7, 8). Knowing the focus area will help put into perspective the change process and will have a better chance to succeed. As stated in the result of the study the number of subjects were enough to deduct that the study can be used as evidence to make change in the workplace.

Using Plan-Do-Study-Act (PDSA), outline an action plan.

The PDSA model is a great tool that provider can use to establish a ground rule in order to implement a change that is needed at the workplace. An action plan in this instance is the strategy that  will be used to make the implemented change successful. Per Mennella and Balderrama, (2017), the component of the PDSA in which P: will be the planning phase, which is where the leader put the plan into action by establishing goals, identifying the cause of the problem, what needs to be done in this instance: increase communication, which starts by gather information. D: that is where the leader start doing, so after talking to participants he or she provides ground rules for participants to follow, the idea is to make notes to see if any of these rules were followed. S: is looking back at the information and see is the current situation has improved, or whether the need for improvement is needed, is there any barrier? If so, it will be imperative at this point to break these barriers for a complete success of the change. A: to take action is always an important phase after implementation of a change, because this is where the leader will revise and take action either to continue with the current change or make changes. In any case the need to se that the issue has improved and even resolved is the epitome of the project for change.

Identify the resources (physical, personal, technology) needed to implement your action plan.

Communicate to every participant, share what the leader sees for the future, in addition, establish a way for participants to know what is going on with the proposed change such as encrypted email, or text. Also, establish leadership and make sure participants know that you are in charge. As per Mennella and Balderrama, (2017), “Effective communication occurs through verbalization of the vision and role modeling of desired actions. Role modeling is generally more effective than verbalization” (p. 2).

Determine the criteria that you would use to determine whether the implementation of your project was successful.

Per Brousseau and Pohl,  (2017). In a study in which they were looking at risk of readmission  shows that when you know the risk and correct them, it will lower readmission from 7.4% to 3%.  With that said, regarding this proposed change, when readmission rates decreased and patients were seen by a provider within 48 hours of discharge, only then that we can tentatively say the change is a success. Easter and Tamburri (2018) stated that  the reason leaders should use the PDSA model is the fact that it can authenticate the new change and can show that the enhancement at the practice is underway.

Identify one future research study that would be useful in extending knowledge of your selected project result.

It will be interesting to continue looking  into  research and know that healthcare quality improvement is a complete success due to improve awareness on issues that impede its quality. Per Adair, Quow, Frankel, Mosca, Profit, Hadley, and Sexton. (2018). “To date, no validated scale exists to specifically measure Improvement Readiness (IR), or the ability of a work-setting to effectively participate in continuous learning” (p. 1). In this article quality improvement in healthcare needs work, and providers should always on the look out for research based  on EBP to drive delivery of care and to continue healthcare promotion.

BROUSSEAU, H., & POHL, D. (2017). Quality Improvement Processes in Obesity Surgery Lead to Higher Quality and Value, Lower Costs. Rhode Island Medical Journal, 100(3), 28–30. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=121622898&site=eds-live&scope=site (Links to an external site.)

Easter, K., & Tamburri, L. M. (2018). Understanding Patient Safety and Quality Outcome Data. Critical Care Nurse, 38(6), 58–66. https://doi-org.chamberlainuniversity.idm.oclc.org/10.4037/ccn2018979 (Links to an external site.)

Kathryn C. Adair, Krystina Quow, Allan Frankel, Paul J. Mosca, Jochen Profit, Allison Hadley, … J. Bryan Sexton. (2018). The Improvement Readiness scale of the SCORE survey: a metric to assess capacity for quality improvement in healthcare. BMC Health Services Research, (1), 1. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1186/s12913-018-3743-0

Mennella, H. D. A.-B., & Balderrama, D. R. M. (2017). Leadership: Facilitating Change. CINAHL Nursing Guide. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=nup&AN=T903697&site=eds-live&scope=site (Links to an external site.)

Ya-huei Wang, & Hung-Chang Liao. (2019). Development and validation of the Patient-Healthcare Provider Communication Scale: Chinese version. Social Behavior & Personality: An International Journal, 47(3), 1–10. https://doi-org.chamberlainuniversity.idm.oclc.org/10.2224/sbp.75

 

For Doc Daimler only

Follow up

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Ethical and Legal Implications of Prescribing Drugs ( Georgia ) 3 pages APA

3 pages, APA format, 3-4 references and in-text citations. 

1. Consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.

2. Review the scenario assigned by your Instructor for this Assignment. ( awaiting scenario from my professor. )

3. Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for the state of Georgia, and reflect on these as you review the scenario assigned by your Instructor.

4. Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.

5. Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

 

Evidence-Based Practice Proposal Development Plan 2 (wk 4-DQ2)

Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP project. Why? Has your mentor used either theory, and to what result?

Please use in-text citations, references used must not be older than 5 years.


Factors of Pharmacokinetics and Pharmacodynamics

APA 250-280 words, at least 3 references, in-text citations.

Describe a patient case from your experiences, observations, and/or clinical practice. (ex. patients with kidney failure, liver disease, pancreatitis, opioid addict)

Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified.

Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case.

Be specific and provide examples.

FYI Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas Pharmacodynamics describes what the drug does to the body.

Evidence-Based Practice Proposal Development Plan 2 (wk 4-DQ1)

Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course mentor that you will take into consideration for your own change project.

Please include in-text citations. All references must be no older than 5 years.

 

Pathophysiology of Disorder ( colon cancer & African Americans )

APA Format, 250-280 words, At least 3 references use in-text citations.  

Ethnicity ( African Americans ) and colon cancer

How does being African American impact colon cancer?

What are potential alterations and symptoms?

Identify the pathophysiology of the associated alterations and symptoms, including the normal and altered cellular function.

Consider both intra-and extra- cellular changes that occur?  

Must use at least 3 references use in-text citatio

Review of Current Healthcare Issues

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

  • Review the Resources and select one current national healthcare issue/stressor to focus on.
  • Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

 

Community Assessment and Analysis Presentation

This assignment consists of both an interview and a PowerPoint (PPT) presentation.

Assessment/Interview

Select a community of interest in your region. Perform a physical assessment of the community.

  1. Perform a direct assessment of a community of interest using the “Functional Health Patterns Community Assessment Guide.”
  2. Interview a community health and public health provider regarding that person’s role and experiences within the community.

Interview Guidelines

Interviews can take place in-person, by phone, or by Skype.

Develop interview questions to gather information about the role of the provider in the community and the health issues faced by the chosen community.

Complete the “Provider Interview Acknowledgement Form” prior to conducting the interview. Submit this document separately in its respective drop box.

Compile key findings from the interview, including the interview questions used, and submit these with the presentation.

PowerPoint Presentation

Create a PowerPoint presentation of 15-20 slides (slide count does not include title and references slide) describing the chosen community interest.

Include the following in your presentation:

  1. Description of community and community boundaries: the people and the geographic, geopolitical, financial, educational level; ethnic and phenomenological features of the community, as well as types of social interactions; common goals and interests; and barriers, and challenges, including any identified social determinates of health.
  2. Summary of community assessment: (a) funding sources and (b) partnerships.
  3. Summary of interview with community health/public health provider.
  4. Identification of an issue that is lacking or an opportunity for health promotion.
  5. A conclusion summarizing your key findings and a discussion of your impressions of the general health of the community.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA format ting guidelines.

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