Category: Nursing

  • Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment

    Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment

    NURS 6053 Discussion- Week 4: Critiquing a Change Effort

    NURS 6053 Discussion- Week 4: Critiquing a Change Effort – As a nurse leader, you need to have the skills and knowledge to collaborate and communicate with those who plan for and manage change. This capacity is valuable in any health care setting and for many different types of change. Furthermore, it is essential to be able to evaluate a change effort and determine if it is promoting improved outcomes and making a positive difference within the department or unit, or for the organization as a whole.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    To prepare FOR NURS 6053 Discussion- Week 4: Critiquing a Change Effort:

    Review Chapters 7 and 8 in the course text. Focus on the strategies for planning and implementing change in an organization, as well as the roles of nurses, managers, and other health care professionals throughout this process.

    Reflect on a specific change that has recently occurred in your organization or one in which you have worked previously. What was the catalyst or purpose of the change?

    How did the change affect your job and responsibilities? Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

    Consider the results of the change and whether or not the intended outcomes have been achieved.

    Was the change managed skillfully? Why or why not? How might the process have been improved?

    By Day 3 OF NURS 6053 Discussion- Week 4: Critiquing a Change Effort

    Post a summary of a specific change within an organization and describe the impact of this change on your role and responsibilities. Explain the rationale for the change, and whether or not the intended outcomes have been met. Assess the management of the change, and propose suggestions for how the process could have been improved. Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

    Read a selection of your colleagues’ responses.

    By Day 6 OF NURS 6053 Discussion- Week 4: Critiquing a Change Effort

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence, or research.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research. Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

    Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

    NURS 6053 Week 5 Discussion: Groups

    The dynamic and increasingly complex world of health care often requires nurses to work collaboratively on interprofessional teams. In the group environment, individuals with unique skills and expertise come together to focus on a common goal; however, groups must become cohesive before they can become effective. Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

    Your experiences working with groups—whether you perceive them as positive, negative, or neutral—can be used to facilitate insight and development.Health care, with its focus on interprofessional teamwork and collaboration, offers ample opportunities and an imperative for continuous learning.

    For this Discussion, you focus on strategies for facilitating the group process.

    To prepare:

    Review the information in this week’s Learning Resources regarding the stages of group formation, problematic roles individuals play in groups, and strategies for facilitating and maintaining positive group collaboration. In particular, review Learning Exercise 19.14 of the course text. Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

    Reflect on various groups with which you have been or are currently involved. Select one specific group to analyze for the purposes of this Discussion.Identify the purpose or task that the group is or was meant to perform.

    Consider the four stages of group formation (forming, storming, norming, and performing). How would you describe the progression between stages? Is there a stage in which you believe your group is or was “stuck”?

    Consider the task or group-building role you normally play in a group setting. How could you apply the information from the Learning Resources to improve your group participation and facilitation, as well as the functioning of the group as a whole?

    In addition, think about which individuals within your group (including yourself) may fall into problematic roles such as the Dominator, the Aggressor, or the Blocker. How have you and your group members addressed the enactment of these roles and its impact on interactions? With information from the Learning Resources in mind, what strategies would you apply now or going forward? Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

    By Day 3

    Post a description of a group with which you have been or are currently involved. Assess where the group is in terms of the four stages of group formation.If you are reflecting on a past experience, explain if your group moved through all four stages. Describe the task or group-building role you typically play, or played, in this group. Then, explain what strategies you, as a leader, can apply to better facilitate the group process and address any problematic individual roles in the group.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research. Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

    NURS 6053 Week 8 Discussion: The Distinction Between Leadership and Management

    Think of the managers you have reported to thus far in your career. Now consider the people you have worked with or know of that you would consider leaders. Based on these experiences, what would you surmise about the responsibilities of managers and leaders and about the distinctions between these two categories in health care settings? Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

    This week’s Learning Resources classify management and leadership (which are often confused in everyday discussion) and explain their significance for health care organizations. As you advance professionally, it is critical to understand the distinctions between management and leadership and how you can apply this knowledge for increasing effectiveness in your workplace.

    To prepare:

    Review the information in the Learning Resources.

    Conduct additional research on your own and select at least two current, credible sources that contribute to your understanding of management and leadership.

    Reflect on how the roles of management and leadership differ in supporting the organization to set and achieve goals.

    Drawing upon specific examples from a current or previous practice setting, bring to mind someone who seemed to be a leader but not a manager and someone who seemed to be a manager but not a leader (generally speaking, or within a specific circumstance). Be prepared to support your assessment with specific behavioral descriptions found in the literature.

    By Day 3

    Post an analysis of how management and leadership roles differ in terms of supporting an organization to set and achieve goals. In addition, post descriptions of an individual who demonstrates leadership behaviors but not management behaviors and an individual who demonstrates management behaviors but not leadership behaviors. Provide your rationale, identifying specific characteristics of effective managers and leaders. (Note: Do not identify these individuals by name, position, or location.)

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence, or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Validate an idea with your own experience and additional research.

    Click on the Reply button below to reveal the textbox for entering your Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment message. Then click on the Submit button to post your message.

    NURS 6053 Week 9 Discussion: Leadership Style

    Throughout your career, you will work with many people who display differing leadership styles. As a nurse leader, it is imperative that you communicate well and get along with those whose leadership style does not align with your preferences. It is also important to understand your own leadership style, as this can prompt insight into how others relate to you and what skills you may need to develop as your leadership responsibilities grow.

    To prepare:

    Review the information in the Learning Resources, including the leadership styles identified in Chapter 2 of the course text.

    Bring to mind a leader in your organization or one with which you are familiar. Would you describe his or her style as authoritative, democratic, or laissez-faire? Why?

    Which characteristics or approaches demonstrated by this person would you integrate into your own leadership style? Which ones would you prefer not to integrate?

    Think about how this leader’s style and resulting interactions may impact health care quality and patient outcomes.

    By Day 3

    Post a description of a leader, distinguishing his or her style as authoritative, democratic, or laissez-faire. Describe the characteristics that inform your perception, and explain which ones you would integrate into your own leadership style, as well as which ones you would prefer not to integrate. Explain at least one potential effect of this leadership style on health care quality and patient outcomes.

    Read a selection of your colleagues’ Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence, or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message. Critiquing a Change Effort in nursing essay and Distinction Between Leadership and Management discussion assignment.

  • NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion

    NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion

    NURS 6053 Week 7 Assignment: Application: Leadership

    NURS 6053 Week 7 Assignment 1: Analysis Group Paper

    This week you will begin a group paper that you will develop over the next few weeks. By Day 3 of this week, you will be placed in a collaborative group and provided with a work area for your group (See the Groups area below Week 11 in the left-hand navigation bar. If you do not see your team area by the end of Day 3, contact your Instructor.)

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Before you begin to work with your group, read the information below describing the paper. Then join your group, introduce yourself, and begin work on selecting a topic.

    To prepare FOR NURS 6053 Week 7 Assignment 1 :

    Review the Peer Evaluation Form for important information on how this assignment is graded.

    Identify a group facilitator.

    Within your group, select a topic relevant to interprofessional leadership and the health care field on which to focus your group NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion. The following are some potential topics for your group to consider:

    Matrix organizations

    Accountable care organizations

    Horizontal and vertical organizations

    Role conflict and ambiguity

    Employee recruitment and selection

    Interpersonal relationships in the C-suite of organizations (the relationships between the CEO, CFO, and CNO)

    Resistance to change

    Succession planning

    Whistle blowing

    “Just” culture

    Team Stepps

    When your group has selected a topic, the group facilitator will submit the topic to the Instructor for approval on the Discussion Board in the Week 5 Group Project Topic Forum.

    Conduct research on your topic using the Walden Library and other credible sources. NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion.

    To complete:

    By Day 7 of Week 7 OF NURS 6053 Week 7 Assignment 1

    As a group, write a 3- to 5 (page count does not include title and reference page) page paper that includes the following:

    Section 1: Introduction

    Section 2: Significance of the topic (based on literature that speaks to the relevancy of the concept selected in terms of interprofessional leadership)

    Section 3: Review of the literature related to the concept that the group selects (current best practices, positive or negative impact on leadership or health care organizations, etc.)

    Section 4: Application to nursing (e.g., implications or consequences for nursing leaders)

    Section 5: Conclusion

    All group members are expected to collaborate fully on this project, and your group paper should demonstrate an original and thoughtful application of the ideas presented in the Learning Resources and the research literature. NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion.

    NURS 6053 Week 7 Assignment: Application: Leadership- Concept Analysis Group Paper

    Continue to work on the Leadership Concept Analysis Group Paper, which you began in Week 5, tying in communication. How does the information on communication presented in this week’s Learning Resources relate to your selected concept? What insights have you gained this week that would inform how you communicate about this topic?

    Note: For this project, all group members’ names should appear on the title page, and only the group facilitator should submit the final file. All students who are not the group facilitator will submit only a title page with their group member names on it.

    To complete:

    By Day 7

    As a group, write a 3- to 5-page paper (page count does not include title and reference page) that includes the following:

    Section 1: Introduction

    Section 2:Significance of the topic (based on literature that speaks to the relevancy of the concept selected in terms of interprofessional leadership). NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion.

    Section 3: Review of the literature related to the concept that the group selects (current best practices, positive or negative impact on leadership or health care organizations, etc.)

    Section 4: Application to nursing (e.g., implications or consequences for nursing leaders)

    Section 5: Conclusion

    All group members are expected to collaborate fully on this project, and your group paper should demonstrate an original and thoughtful application of the ideas presented in the Learning Resources and the research literature.

    Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements. All papers submitted must use this formatting.

    Also, complete the evaluation:

    Once you have completed your work on the Leadership Concept Analysis Group Paper this week, evaluate your peers in your group using the Peer Evaluation Form and the results of your efforts. This brief evaluation provides an opportunity for you to assess your teammates’ contribution to the project, as well as your own. NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion.

    Complete this peer evaluation for each member of your team, including yourself. The average score from these evaluations will be used by your instructor to determine your final grade for the assignment worth 100 points. Not all students may receive the same grade. You must be an active participant in the development of the assignment to receive full points. Rate each team member on a scale of 1-100, with 100 being the highest. Include comments explaining why you gave your teammate this score.

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

    Please save your Assignment using the naming convention “WK7Assgn2+last name+first initial.(extension)” as the name.

    Click the Week 7 Assignment 2 Rubric to review the Grading Criteria for the Assignment.

    Click the Week 7 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn2+last name+first initial.(extension)” and click Open. NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion.

    If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

    Click on the Submit button to complete your submission.

    NURS 6053 Week 7 Discussion: Addressing Barriers to Effective Communication

    From moment to moment, a nurse leader’s day involves communication—with patients, families, colleagues, supervisors, and so on.

    Think of a particular day you spent working in a health care environment, and consider three or four distinct points in time. For each point of time, consider the following: With whom did you interact? Which forms of communication did you use? What issues were communicated about—did they seem to be light-hearted or sensitive? Straightforward or complicated? How would you describe the pace of the interactions and your work? NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion.

    As you consider these questions, it becomes clear that communication can be quite complex, with many layers of meaning that shape the experience for everyone involved. How could this awareness help you to understand instances of ineffective communication when they arise?

    To prepare:

    Review the information in Chapter 19 of the course text, as well as the assigned articles.

    Reflect on an incident involving ineffective communication within your organization or another health care setting. Consider this incident through the lens of the communication process outlined in Figure 19.1 of the course text.

    What barriers contributed to this incident? What other challenges may have influenced this situation?

    Using the information presented in the other Learning Resources, consider what could have been done to prevent or address the ineffective communication. Why do you think the use of these strategies would have resulted in better outcome(s)? NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion.

    By Day 3

    Post a summary of an incident involving ineffective communication. Describe communication barriers and other challenges that contributed to the incident.Propose one or more strategies that could have been employed to promote a better outcome. Be sure to refer to elements of the communication process.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond by critiquing at least two of your colleagues’ postings on two different days using elements of the communication process and recommend additional strategies to overcome the barriers. If you think other factors may have contributed to the situation, provide an analysis with the support of literature.

    Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message. NURS 6053 Leadership – Concept Analysis Group Paper and Addressing Barriers to Effective Communication Essay Assignment Discussion.

  • Planned Change in a Department or Unit Essay Assignment Discussion

    Planned Change in a Department or Unit Essay Assignment Discussion

    NURS 6053 Assignment: Application: Planned Change in a Department or Unit

    NURS 6053 Week 4 Assignment – Health care organizations are continuously immersed in change from the emergence of new policies, to promote quality care and improve patient safety to keeping pace with the rapid growth in knowledge and best practices. Establishing a solid framework for planning and implementing change is a wise move, as it provides a foundation for the extensive coordination that will be needed to successfully facilitate the change.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    For this NURS 6053 Week 4 Assignment, you propose a change at the department or unit level and develop a plan for guiding the change effort.

    To prepare:

    Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.

    Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar.Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue. Planned Change in a Department or Unit Essay Assignment Discussion.

    Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.

    Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit.Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.

    Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.

    To complete:

    By Day 7 OF NURS 6053 Week 4 Assignment

    Write a 3- to 5-page Planned Change in a Department or Unit Essay Assignment Discussion paper (page count does not include title and reference page) that addresses the following:

    Identify a problem, inefficiency, or issue within a specific department/unit.

    Describe a specific, realistic change that could be made to address the issue.

    Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.

    Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.

    Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy. Planned Change in a Department or Unit Essay Assignment Discussion.

    Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort.

    Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements. All papers submitted must use this formatting.

    Note: This
    Planned Change in a Department or Unit Essay
    Assignment Discussion will serve as your Portfolio Assignment for this course.

    NURS 6053 Week 4 Assignment Submission and Grading Information

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

    Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.

    Click the NURS 6053 Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.

    Click the NURS 6053 Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.

    If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

    Click on the Submit button to complete your submission. Planned Change in a Department or Unit Essay Assignment Discussion.

    NURS 6053 Discussion – Week 4 Critiquing a Change Effort

    As a nurse leader, you need to have the skills and knowledge to collaborate and communicate with those who plan for and manage change. This capacity is valuable in any health care setting and for many different types of change. Furthermore, it is essential to be able to evaluate a change effort and determine if it is promoting improved outcomes and making a positive difference within the department or unit, or for the organization as a whole.

    To prepare:

    Review Chapters 7 and 8 in the course text. Focus on the strategies for planning and implementing change in an organization, as well as the roles of nurses, managers, and other health care professionals throughout this process.

    Reflect on a specific change that has recently occurred in your organization or one in which you have worked previously. What was the catalyst or purpose of the change? Planned Change in a Department or Unit Essay Assignment Discussion.

    How did the change affect your job and responsibilities?

    Consider the results of the change and whether or not the intended outcomes have been achieved.

    Was the change managed skillfully? Why or why not? How might the process have been improved?

    By Day 3

    Post a summary of a specific change within an organization and describe the impact of this change on your role and responsibilities. Explain the rationale for the change, and whether or not the intended outcomes have been met. Assess the management of the change, and propose suggestions for how the process could have been improved.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence, or research.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

    NURS 6053 Week 5 Discussion: Groups

    The dynamic and increasingly complex world of health care often requires nurses to work collaboratively on interprofessional teams. In the group environment, individuals with unique skills and expertise come together to focus on a common goal; however, groups must become cohesive before they can become effective.

    Your experiences working with groups—whether you perceive them as positive, negative, or neutral—can be used to facilitate insight and development.Health care, with its focus on interprofessional teamwork and collaboration, offers ample opportunities and an imperative for continuous learning.

    For this Discussion, you focus on strategies for facilitating the group process.

    To prepare:

    Review the information in this week’s Learning Resources regarding the stages of group formation, problematic roles individuals play in groups, and strategies for facilitating and maintaining positive group collaboration. In particular, review Learning Exercise 19.14 of the course text.

    Reflect on various groups with which you have been or are currently involved. Select one specific group to analyze for the purposes of this Discussion.Identify the purpose or task that the group is or was meant to perform.

    Consider the four stages of group formation (forming, storming, norming, and performing). How would you describe the progression between stages? Is there a stage in which you believe your group is or was “stuck”?

    Consider the task or group-building role you normally play in a group setting. How could you apply the information from the Learning Resources to improve your group participation and facilitation, as well as the functioning of the group as a whole?

    In addition, think about which individuals within your group (including yourself) may fall into problematic roles such as the Dominator, the Aggressor, or the Blocker. How have you and your group members addressed the enactment of these roles and its impact on interactions? With information from the Learning Resources in mind, what strategies would you apply now or going forward? Planned Change in a Department or Unit Essay Assignment Discussion.

    By Day 3

    Post a description of a group with which you have been or are currently involved. Assess where the group is in terms of the four stages of group formation.If you are reflecting on a past experience, explain if your group moved through all four stages. Describe the task or group-building role you typically play, or played, in this group. Then, explain what strategies you, as a leader, can apply to better facilitate the group process and address any problematic individual roles in the group.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message. Planned Change in a Department or Unit Essay Assignment Discussion.

  • Transitioning From Closed to Open Systems Essay Assignment Discussion

    Transitioning From Closed to Open Systems Essay Assignment Discussion

    NURS 6053 Week 2 Module 2 Discussion: 
    Transitioning From Closed to Open Systems

    NURS 6053 Week 2: How do effective nurse leaders and others approach problem solving and decision making in organizations? As suggested in this week’s Learning Resources, systems theory provides a valuable way to assess situations and prepare to address problems.

    For this week’s Discussion, you identify an issue or process that could be improved and apply knowledge and strategies related to systems theory.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Note: You may find it helpful to view the Assignment instructions and use the same problem for this Discussion.

    To prepare:

    Review the information presented in this week’s Learning Resources on systems theory and the difference between open and closed systems.

    Reflect on the practices and processes with which you are familiar in your organization. Identify one problematic issue or process that could be improved.

    Consider the problem from a closed-system perspective. Then think about how the issue or process you selected could be addressed by viewing it from an open-system perspective. How would the transition from a closed- to an open-system view help you and others to address the problem and improve outcomes?

    By Day 3 OF NURS 6053 Week 2

    Post a description of the problem that you identified in your selected organization. Explain the problem from a closed-system perspective. Then, describe how the problem could be addressed by viewing it from an open-system perspective, and explain how this modification would help you and others improve health care outcomes. Transitioning From Closed to Open Systems Essay Assignment Discussion.

    Read a selection of your colleagues’ responses.

    By Day 6 OF NURS 6053 Week 2

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence, or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Validate an idea with your own experience and additional research.

    Transitioning From Closed to Open Systems Essay Assignment Discussion

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

    NURS 6053 Week 2 Assignment: Application: Systems Theory

    As noted in the Learning Resources, systems theory provides a meaningful and beneficial means of examining challenges in health care organizations. To do this effectively, however, it is essential to assess all system components, as some may be relatively healthy while others are problematic.

    For this Transitioning From Closed to Open Systems Essay Assignment Discussion, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (Note: You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)

    To prepare FOR NURS 6053 Week 2:

    Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).

    Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.

    Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.

    Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.

    Research professional standards that are pertinent to your identified problem. Transitioning From Closed to Open Systems Essay Assignment Discussion.

    Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.)

    To complete:

    By Day 7 OF NURS 6053 Week 2

    Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

    Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.

    Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).

    Based on this information, explain how you would address the problem as follows:

    Formulate a desired outcome.

    Identify goals and objectives that would facilitate that outcome.

    Translate those goals and objectives into policies and procedures for the department or unit.

    Describe relevant professional standards. Transitioning From Closed to Open Systems Essay Assignment Discussion.

    Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

    The Assignment, Systems Theory, is due by Day 7 of Week 2.

    Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements. All papers submitted must use this formatting.

    This Assignment is due by Day 7 of Week 2 (this week) and must be submitted through the Week 2 Assignment Link.

    Submission and Grading Information

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

    Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.

    Click the NURS 6053 Week 2 Assignment Rubric to review the Grading Criteria for the Transitioning From Closed to Open Systems Essay Assignment Discussion.

    Click the NURS 6053 Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.

    If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

    NURS 6053 Week 3 discussion: Organizational Structures and Leadership

    In most health care settings, it is unlikely that you would hear the terms “ad hoc” or “matrix” as you walk down the hallway. Although it is helpful for any organization to delineate pathways of responsibility and authority in an organizational chart, the lived experience of these structures is most apparent through the inquiries and behaviors people share everyday.

    In your own workplace, you may find yourself wondering, who should I turn to when I have a practice dilemma? or Where can I go to learn more about this issue? These questions speak to the intricacies of formal and informal organizational structure and leadership.

    ORDER NOW FOR A CUSTOMIZED ACADEMIC PAPER

    To prepare:

    Review the information presented in Chapter 12 of the course text. Focus on the information about formal versus informal structure as well as the types of organizational structures.

    Consider the overall structure or hierarchy of your organization or one with which you are familiar. Which organizational structure best describes your organization—line (or bureaucratic), ad hoc, matrix, service line, or flat? Note: It is possible to have a combination of structures in one organization. Is decision making centralized or decentralized in this organization?

    What is the role of committees, task forces, and councils in the organization, and who is invited to join? Consider how this relates to formal and informal leadership.

    Reflect on how decisions are made within a specific department or unit. Which stakeholders provide input or influence the decision-making process? Assess this in terms of formal and informal leadership. Transitioning From Closed to Open Systems Essay Assignment Discussion.

    To support your analysis, consider your own experiences and investigate these matters by speaking with others at the organization and reviewing available documents. Be sure to consider how the concepts of formal and informal structure and leadership relate to one another and are demonstrated in the organization and in the particular department or unit.

    By Day 3

    Post a depiction of your organization’s formal structure, indicating whether it is best described as line, ad hoc, matrix, service line, flat, or a combination.Describe how decisions are made within the organization and within one department or unit in particular, noting relevant attributes of centralized/decentralized decision making. Explain the influence of formal and informal leadership on decision making within this department or unit. Transitioning From Closed to Open Systems Essay Assignment Discussion.

    Read a selection of your colleagues’ responses.

    By Day 6

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence, or research.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Validate an idea with your own experience and additional research.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Click on the Reply button below to reveal the textbox for entering your Transitioning From Closed to Open Systems Essay Assignment Discussion message. Then click on the Submit button to post your message.

  • Organizational Foundations Essay Assignment Discussion NURS 6053

    Organizational Foundations Essay Assignment Discussion NURS 6053

    NURS 6053 Week 1 Discussion: As you strive to grow in your leadership skills and abilities, you will find that the context in which you work influences your motivation and areas of focus.In a similar vein, your commitment to developing professionally can contribute toward organizational effectiveness.

    To that end, it is critical to recognize the importance of organizational culture and climate. In particular, through this week’s Learning Resources, you may consider several questions: How do an organization’s mission, vision, and values relate to its culture? What is the difference between culture and climate? Moreover, how are culture and climate manifested within the organization? Organizational Foundations Essay Assignment Discussion NURS 6053.

    For this Discussion, you explore the culture and climate of your current organization or one with which you are familiar. You also consider decisions and day-to-day practices and the way they relate to the organization’s mission, vision, and values.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    To prepare for NURS 6053 Week 1 Discussion :

    Review the information related to planning and decision making in health care organizations presented in the textbook, Leadership Roles and Management Functions in Nursing: Theory and Application. Consider how planning and decision making relate to an organization’s mission, vision, and values, as well as its culture and its climate.

    Familiarize yourself with the mission, vision, and values of your organization or one with which you are familiar. Consider how the statements and actions of leaders and others within the organization support or demonstrate the organizational mission, vision, and values. In addition, note any apparent discrepancies between word and deed. Think about how this translates into expectations for direct service providers. Note any data or artifacts that seem to indicate whether behaviors within the organization are congruent with its mission, vision, and values. Organizational Foundations Essay Assignment Discussion NURS 6053.

    Begin to examine and reflect on the culture and climate of the organization. How do culture and climate differ?

    Why is it important for you, as a master’s-prepared nurse leader, to be cognizant of these matters?

    By Day 3 of NURS 6053 Week 1 Discussion

    Post a description of your selected organization’s mission, vision, and values. Describe relevant data, or artifacts, words, and actions of leaders and others in the organization that support, or perhaps appear to contradict the organization’s mission, vision, and values statement. In addition, discuss the organization’s culture and its climate, differentiating between the two. Explain why examining these matters is significant to your role as a nurse leader.

    Read a selection of your colleagues’ responses.

    By Day 6 of NURS 6053 Week 1 Discussion

    Respond to at least two of your colleagues on two different days using one or more of the following approaches:

    Ask a probing question, substantiated with additional background information, evidence, or research. Organizational Foundations Essay Assignment Discussion NURS 6053.

    Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

    NURS 6053 Week 10 
    Assignment: Application: Taking a Stand

    Effective leaders have a high degree of self-awareness and know how to leverage their strengths in the workplace. Assessments are a valuable tool that professionals can use to learn more about themselves and consider how their temperament and preferences influence their interactions with others.

    As you engage in this learning process, it is important to remember that everyone—regardless of temperament type or related preferences—experiences some challenges with regard to leadership. The key to success is being able to recognize and leverage your own strengths while honoring differences among your colleagues. Organizational Foundations Essay Assignment Discussion NURS 6053.

    At some point in your leadership career, you will encounter an ethical or moral dilemma that requires you to take a stand and defend your position.

    For this Assignment, you evaluate an issue and consider how you could act as a moral agent or advocate, facilitating the resolution of the issue for a positive outcome.

    To prepare:

    Consider the examples of leadership demonstrated in this week’s media presentation and the other Learning Resources.

    To further your self-knowledge, you are required to complete the Kiersey Temperament as indicated in this week’s Learning Resources. Consider your leadership style, including your strengths for leading others and include your results from Kiersey Temperament Sorter to describe potential challenges related to your leadership style. Organizational Foundations Essay Assignment Discussion NURS 6053.

    Mentally survey your work environment, or one with which you are familiar, and identify a timely issue/dilemma that requires you to perform the leadership role of moral agent or advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient, the need for appropriate staffing, a colleague being treated unfairly).

    What ethical, moral, or legal skills, dispositions, and/or strategies would help you resolve this dilemma? Define the differences between ethical, moral, and legal leadership.

    Finally, consider the values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies addressed in this course; and your own values and reasons for entering the profession. What motivation do you see for taking a stand on an important issue even when it is difficult to do so? Organizational Foundations Essay Assignment Discussion NURS 6053.

    To complete:

    By Day 7

    Write a 4 to 5 page Organizational Foundations Essay Assignment Discussion NURS 6053 paper (page count does not include title and reference page) that addresses the following:

    Introduce the conceptual frameworks of the ethical constructs of ethics, moral, or legal standards and the purpose of the paper.

    Consider an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it.

    Analyze the moral, ethical, and legal implications utilized in this situation. Describe your role as a moral agent or advocate for this specific issue.

    Consider your leadership styles identified by your self-assessment and determine if they act as a barrier or facilitation during this dilemma.

    The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements.

    Submission and Grading Information

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

    Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name.

    Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.

    Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.

    If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.

    Click on the Submit button to complete your Organizational Foundations Essay Assignment Discussion NURS 6053 submission.

  • The Buzzard, The Bat & The Bumblebee

    The Buzzard, The Bat & The Bumblebee

    THE BUZZARD:

    If you put a buzzard in a pen that is 6 feet by 8 feet but that is entirely open at the top, the bird, in spite of its ability to fly, will be an absolute prisoner. The reason is that a buzzard always begins a flight from the ground with a run of 10 to 12 feet. Without space to run, as is its habit, it will not even attempt to fly, but will remain a prisoner for life in a small jail with no top.

    THE BAT:

    The ordinary bat that flies around at night, a remarkably nimble creature in the air, cannot take off from a level place. If it is placed on the floor or flat ground, all it can do is shuffle about helplessly and, no doubt, painfully, until it reaches some slight elevation from which it can throw itself into the air. Then, at once, it takes off like a flash. The Buzzard, The Bat & The Bumblebee.

    THE BUMBLEBEE:

    A bumblebee, if dropped into an open tumbler, will be there until it dies, unless it is taken out. It never sees the means of escape at the top, but persists in trying to find some way out through the sides near the bottom. It will seek a way where none exists, until it completely destroys itself.

    PEOPLE:

    In many ways, we are like the buzzard, the bat, and the bumblebee. We struggle about with all our problems and frustrations, never realizing that all we have to do is look up!

    That’s the answer, the escape route and the solution to any problem! Just look up.

    Sorrow looks back, Worry looks around, but faith looks up!

    Live simply, love generously, care deeply, speak kindly. The Buzzard, The Bat & The Bumblebee.

  • Cyclothymic Disorder Decision Tree Case Study Essay Assignment Example

    Cyclothymic Disorder Decision Tree Case Study Essay Assignment Example

    Assignment : Cyclothymic Disorder

    For this Cyclothymic Disorder decision tree case study essay assignment example, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

    Learning Objectives

    Students will:

    Evaluate clients for treatment of mental health disorders

    Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

    THE CASE STUDY

    Cyclothymic Disorder

    BACKGROUND

    SUBJECTIVE

    Stefanie is a 32-year-old female from Puerto Rico who presents to your office today with complaints of difficulty sleeping. You learn that Stefanie can go for a few days with minimal sleep (about 3 hours/night), but does not seem to be fatigued the next day. Stefanie explains that after 3 days with minimal sleep, she “crashes” and has a good night’s sleep. She states that sleep will be “alright” for a few days, even a few weeks, and then she will have a similar issue with sleep.

    You learn throughout the assessment process that Stefanie has had this problem for years. She noticed that it began in college and thought it was just because of the workload and academic demands. However, she found that it persisted after college. She also notices that she has periods where she will engage in increased amounts of goal-directed activity. She states that things will just “pile up” at work and she gets this burst of energy to “make everything right.” She states that these bursts will last most of the day. She states that these periods show up probably every 2 to 3 weeks. Cyclothymic Disorder decision tree case study essay assignment example.

    Stefanie also confesses to problems with being “down in the dumps.” She states that when she has her episodes in which she endeavors to “make everything right,” she feels fantastic and on top of the world. Cyclothymic Disorder decision tree case study essay assignment example. However, when these periods of energy end, she reports that she feels “depressed”—but then states: “well, maybe not depressed, but I definitely feel sad and empty.” She also endorses feelings of fatigue and a decreased ability to concentrate when she is feeling sad. She finally tells you: “I have lived with this for so long, I have to admit that it is finally a relief to tell someone how I feel!”

    OBJECTIVE

    Stefanie is dressed appropriately to the weather. She has no gait abnormalities. Physical assessment is unremarkable. Gross neurological assessment is within normal limits.

    MENTAL STATUS EXAM

    Stefanie is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. Self-reported mood is “sad.” Affect does appear consistent with dysphoria. Eye contact is normal. Speech is clear, coherent, and goal directed. She denies visual or auditory hallucinations. No overt evidence of paranoid or delusional thought processes noted. She denies suicidal or homicidal ideation and is future oriented. Cyclothymic Disorder decision tree case study essay assignment example.

    At this point, please discuss any additional diagnostic tests you would perform on Stefanie.

    1.Decision Point One

    Diagnosis: Cyclothymic disorder

    2.Decision Point Two: Begin Abilify 10mg orally daily

    RESULTS OF DECISION POINT TWO

    – Client returns to clinic in four weeks

    -Stefanie reports that her mood seems a bit more “stable.” She states that she notices that she has not been as “sad” since she started taking the medication. She does report that for the first 2 weeks, she noticed that whenever she went from a lying or sitting to a standing position, she felt “lightheaded.” Cyclothymic Disorder decision tree case study essay assignment example.

    -She does report that the side effect was quite concerning at times. However, she reports that this is no longer happening.

    3.Decision Point Three: Maintain current dose of Abilify

    Guidance to Student

    In order to meet the criteria for a major depressive episode, the client needs to have five or more symptoms (refer to DSM–5 major depressive episode criteria). She only demonstrates criteria # 1: depressed mood most of the day, nearly every day, as indicated by either subjective reports (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful); criteria # 6: “fatigue or loss of energy nearly every day”; and criteria # 8: “diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).” Thus, Stefanie does not meet the criteria for a major depressive episode as she only has three out of the needed five criteria for the diagnosis of a major depressive episode.

    In order to meet criteria for a hypomanic episode, the client needs to have a period of abnormally and persistently elevated, expansive, or irritable mood, and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. Stefanie’s symptoms last 3 days. Additionally, during the period of mood disturbance, the person must have three or more of the qualifying symptoms. Cyclothymic Disorder decision tree case study essay assignment example. Stefanie only has an increase in goal-directed activity and distractibility. Thus, Stefanie does not meet criteria for a hypomanic episode as she only has a decreased need for sleep and an increase in goal-directed activity.

    Since Stefanie has symptoms of both hypomania and depression (but does not meet the criteria for a major depressive or hypomanic episode), and since these behaviors do not occur in the context of a drug/substance or medical condition, Stefanie meets the diagnostic criteria for cyclothymic disorder. Cyclothymic Disorder decision tree case study essay assignment example.

    Some providers will treat cyclothymic disorder with pharmacologic agents used to treat bipolar disorder because individuals with cyclothymic disorder have a higher risk of progression to bipolar disorder. However, there is no consensus in the literature as to the optimal treatment, or if prophylactic psychopharmacologic treatment is beneficial in consideration of the side effects associated with antipsychotics and mood stabilizers.

    Stefanie’s symptoms are most consistent with orthostatic hypotension, which is not uncommon when initiating Abilify. At this point, it sounds as if the side effects have subsided. There is nothing to tell us that we should increase the dose. Similarly, there is nothing in the case to tell us that we should discontinue the Abilify. Instead, routine monitoring should occur.

    The Assignment:

    .

    At each Decision Point, stop to complete the following:

    Decision #1: Cyclothymic disorder

    Which Decision did you select?

    o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

    o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

    o Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?

    Decision #2: Treatment Plan for Psychotherapy

    o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

    o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Cyclothymic Disorder decision tree case study essay assignment example.

    o Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

    Decision #3: Treatment Plan for Psychopharmacology

    o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

    o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

    o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Cyclothymic Disorder decision tree case study essay assignment example.

    Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

     

    Psychiatric Mental Health Nurse Practitioner Role I1: Adult – NURS 6670 – Cyclothymic Disorder decision tree case study essay assignment example

     

                                         Decision #1: Differential Diagnosis

                                                     Cyclothymic disorder

                                                     Reason for this Decision

    Cyclothymic disorder is a mild form of bipolar disorder in which a patient has mood swings throughout two years. The patient has a fluctuating mood swing between depression and hypomania with irritability and a short period of regular activity in between. The patient may sometimes deny that a problem exists. The Cyclothymic disorder starts in adolescence with 15 to 50 percent possibility of developing bipolar type 1 (Tracy, 2012). Patient with this disorder is known to abuse alcohol and other substance abuse. The patient also has a history of multiple religious cults and dilettantism (Saddock, Sadock & Pedro, 2014).   Cyclothymic Disorder decision tree case study essay assignment example.

                What was Hoping to Achieve by Making this Decision

    The patient (Stephanie) is a 32-year-old Hispanic female from Puerto Rican. She is well dressed for the weather. Stephanie is alert oriented x 4. Her speech is clear, spontaneous, goal-directed and coherent. Her gross neurological assessment is within reasonable limits with a steady gait. She denies any homicidal or suicidal ideation. No auditory or visual hallucinations reported (Laureate Education, 2017d).

    Patient Stephanie has been having the following issues for the past two years. She complains of sleeping about 3 hours for few days without being tired and other days have a good night sleep. She experiences period depression now and then, hypomanic phases with enhanced energy, fatigue, sad when unable to concentrate or think good. Cyclothymic Disorder decision tree case study essay assignment example. She had distractibility and enhanced goal-directed activity. Patient symptoms are indicative of cyclothymic disorder (Laureate Education, 2017d).

    Difference between Expected outcome and Achieve outcome with Decision #1

    There is no difference between the expected outcome and the achieve an outcome. The Patient symptoms of mood swings between hypomania and depression, fatigue, high energy, distractibility, decrease the need for sleep and enhanced goal-directed activity are indicative of Cyclothymic disorder
    .

                                     Decision #2: Treatment Plan for Psychotherapy

    Begin Abilify 10mg orally daily

                                                    Reason for this Decision

    Abilify is known to be effective with improving psychotic and manic symptoms within a week but take several weeks for full effect on behavior, cognition and affective stabilization. It increases dopamine output when the concentrations are low, consequently enhancing cognitive, behavioral and affective symptoms. It also reduces dopamine output when the concentrations are high, therefore improving mediating antipsychotic actions and positive symptoms (Stahl, 2014). Cyclothymic Disorder decision tree case study essay assignment example.

    The efficacy of the medication shows between 4–6 weeks for some patient but takes up to 16–20 weeks to show the effect on cognitive symptoms. Educating the patient about the side effect of the medication is crucial. Cyclothymic Disorder decision tree case study essay assignment example. The following baseline of blood pressure, weight, fasting plasma glucose, and fasting lipid profile must be taken and check within three months after starting the medication (Stahl, 2014).The patient is educated about the medication and the side effects (dizziness, hypotension, sedation, nausea, vomiting, headache.

    The patient will be informed to go for psychotherapy because it increased patient awareness of their diagnosis and helped cope with their mood swings. Cyclothymic Disorder decision tree case study essay assignment example. It also helps to prevent full-blown manic attacks from happening (Saddock, Sadock & Ruiz, 2014).

                What was Hoping to Achieve by Making this Decision?

    The aim of giving the patient Abilify is to help stabilize her mood and ability to think well and prevent a full-blown manic attack from happening. When the patient returns for follow up, she will express feeling a little better.

    The Difference between what is Expected and the Achieve outcome with Decision #2

    The expected outcome and achieved outcome are the same. The medication was reduced the symptoms of cyclothymic disorder and the side effect was expected. The patient returned to the clinic for follow-up after four weeks and reported that the medication had helped her not feel sad, but she noted some dizziness which had subsided.

    Decision #3: Treatment Plan for Psychopharmacology

                                                Decision Point Three

                                         Maintain current dose of Abilify

    Reason for Decision

    It is crucial to continue with the same dosage of medication because the patient is doing fine, and the side effect of drugs had disappeared. Increasing the medication or have the patient halting the medication will not able at an advantage to the patient. It is vital to continue to monitor patient progress. Cyclothymic Disorder decision tree case study essay assignment example.

                       What was Hoping to Achieve by Making this Decision?

    The expectation is to achieve significant decreased in patient’s symptoms and to halt relapse of cyclothymic symptoms.

    Expected Result with this Decision.

    The expected result is that the patient will continue to do well with the medication with little or no side effect and prevent relapse. The patient is expected to be doing well with psychotherapy to help with behavioral symptoms.

          Difference between Expected Result and the Achieved Result with Decision

    The expected result and achieved result are the same. Ms. Stephanie returned to the clinic showing decreases symptoms of swing mood and no report of sadness or any issues.

    Ethical Considerations

    It is crucial to consider the following ethical issue while providing care for this patient which beneficence, autonomy, and nonmaleficence. It is significant to assess the patient thoroughly and provided the best treatment without any harm. It is imperative to consider and respect a patient autonomy when providing care. Cyclothymic Disorder decision tree case study essay assignment example.

     

        
                                                  References

    American Psychiatric Association. (2013).
    Diagnostic and statistical manual of mental disorders 
    (5th ed.). Washington, DC: Author.

    Laureate Education (Producer). (2017d).
    A young woman with depression
    [Multimedia file] 
    Baltimore, MD: Author.

    Perugi, G., Hantouche, E., & Vannucchi, G. (2017). Diagnosis and Treatment of Cyclothymia: The “Primacy” of Temperament.
    Current Neuropharmacology
    ,
    15
    (3), 372–379.
     https://doi-
    org.ezp.waldenulibrary.org/10.2174/1570159X14666160616120157

    Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014).
    Kaplan & Sadock’s synopsis of psychiatry:
    Behavioral sciences/clinical psychiatry
    (11th ed.). Philadelphia, PA: Wolters Kluwer. Cyclothymic Disorder decision tree case study essay assignment example.

    Stahl, S. M. (2014).
    Prescriber’s Guide: Stahl’s Essential Psychopharmacology
    (5th ed.).   
    New York, NY: Cambridge University Press.

    Tracy, N. (2012). Bipolar Spectrum Disorders – What is Cyclothymia?.  Retrieved from 

    Bipolar Spectrum Disorders – What is Cyclothymia?

    Van Meter, A., Youngstrom, E., Freeman, A., Feeny, N., Youngstrom, J. K., & Findling, R. L. (2016). Impact of Irritability and Impulsive Aggressive Behavior on Impairment and Social Functioning in Youth with Cyclothymic Disorder.
    Journal Of Child And 
     Adolescent Psychopharmacology
    ,
    26
    (1), 26–37.
    https://doi-rg.ezp.waldenulibrary.org 
     /10.1089/cap.2015.0111. Cyclothymic Disorder decision tree case study essay assignment example.

  • PICO Analysis of Delirium Sample Essay

    PICO Analysis of Delirium Sample Essay

    With the aging of our population, cognitive aging has emerged as a leading public health concern. In a 2014 AARP survey, 93% of respondents identified maintaining brain health as a top priority (Inouye, 2015). Yet a substantial void exists in the fundamental understanding of the cognitive aging process and its distinction from cognitive impairments such as delirium and dementia-related conditions. Nearly one third of the older population in the United States is hospitalized each year in relation to acute illness or surgery, and delirium is the most common complication of hospitalization in older persons, and it occurs in an estimated 2.6 million of older adults each year. Delirium has been identified as a leading contributor to short and long term cognitive decline after hospitalization, and at least 40% of these cases are preventable when identified. PICO Analysis of Delirium Sample Essay. The purpose of this analysis is to ascertain a PICO question related to delirium, identify resources used to find supportive literature, review the supportive information, and create an evidence-based table summarizing the data to determine the best delirium screening options.

    ORDER A PLAGIARISM-FREE PAPER HERE

    PICO Question

    In older adult patients with delirium (P), what are the best delirium screening tools (I) compared to the Diagnostic and Statistical Manual or International Classification of Diseases used in defining the diagnosis of delirium (C) to improve early detection and management in older adult patients with delirium (O)?

    Search Strategy

    To find research to support the chosen PICO question, electronic databases such as CINAHL, Google Scholar, PubMed, PsychInfo, and Medline were used. The Hartford Institute for Geriatric Nursing, the American Geriatrics Society as well as the book
    Evidence-Based Geriatric Medicine
    were also used as resources. PICO Analysis of Delirium Sample Essay. The following keywords and phrases were used to search: delirium screening tools, aging, older adults, geriatric, and primary care setting. Articles that were older than five years old as well as secondary sources were excluded.  Articles that applied to the geriatric population, and analyzed the various delirium screening tools and met the criteria were included. The following Boolean search strings were used: delirium screening tools systematic review, and delirium and aging.

     

    Analysis of Literature

    Evidence Table

    Citation

    Conceptual Framework

    Finding

    Research Method

    Implications of Literature Review

    Level of Evidence

    O’Sullivan, D., O’Regan, N. A., & Timmons, S. (2016). Validity and Reliability of the 6-Item Cognitive Impairment Test for Screening Cognitive Impairment: A Review. 
    Dementia and Geriatric Cognitive Disorders
    , 
    42
    (1-2), 42-49. doi:10.1159/000448241. PICO Analysis of Delirium Sample Essay.

     

    Descriptive Theory

    The
    Six-Item Cognitive Impairment Test (6-CIT)
    has been suggested as a useful dementia screening instrument in primary care. The studies on the 6-CIT in primary care present conflicting results and all 3 have significant variations in their selection of cases/reference standards used.

    Systematic Review of Literature

     Although researchers have investigated its accuracy in diagnosing cognitive impairment in primary and secondary care settings, its validity in primary care use has been questioned and there are limited validation studies on its use in secondary care. In addition, the cut-offs used in 2 of the studies favored specificity over sensitivity, which is not desirable for a screening test. The authors recommend that larger studies, which test the psychometric properties of the 6-CIT in primary and acute care settings, are conducted to establish recommendations for routine screening use.

    Level I

    De, J. & Wand, A. (2015). Delirium Screening: A Systematic Review of Delirium Screening Tools in Hospitalized Patients,
    The Gerontologist
    , 55(6), 1079–1099. Retrieved from https://doi.org/10.1093/geront/gnv100. PICO Analysis of Delirium Sample Essay

    Descriptive Theory

    Thirty-one studies describing 21 delirium screening tools were included in the systematic review. Most studies were conducted across a broad range of inpatient settings internationally in elderly inpatients, including patients with dementia but most excluded nonnative language speakers.

    Systematic Review of Literature

    The Confusion Assessment Method was the most widely used instrument to identify delirium, however, specific training is required to ensure optimum performance. The Delirium Rating Scale and its revised version performed best in the psychogeriatric population but requires an operator with psychiatric training. The Nurses’ Delirium Screening Checklist appears best suited to the surgical and recovery room setting. The Single Question in Delirium shows promise in oncology patients. The Memorial Delirium Assessment Scale, while demonstrating good measures of validity in the surgical and palliative care setting, may be better used a measure of delirium severity. The 4As Test performed well when delirium was superimposed on dementia, but it requires further study.

    Level I

    PICO Analysis of Delirium Sample Essay

    Iatraki, E. et al. (2017). Cognitive screening tools for primary care settings: examining the ‘Test Your Memory’ and ‘General Practitioner assessment of Cognition’ tools in a rural aging population in Greece.
    European Journal of General Practice
    , 23(1), 171-178. Retrieved from http://dx.doi.org/10.1080/13814788.2017.1324845

    Predictive Theory

    The ‘
    Test Your Memory’ (TYM)
    and
    ‘General Practitioner assessment of Cognition’ (GPCog)
    instruments appear to be suitable for routine use in the primary care setting as tools for cognitive impairment risk detection in elderly rural populations.

     

    Randomized Control Trials (RCT)

    PICO Analysis of Delirium Sample Essay

    The clinical validity of TYM/GPCog was assessed through comparison with a screening test that was used to establish risk for cognitive impairment instead of clinical diagnosis of dementia. Although, MMSE is widely used and considered by many as the gold-standard instrument for dementia screening, it has far from perfect sensitivity or specificity. The limited gender and education-level susceptibility of GPCog render it preferable over TYM for routine use in primary care settings in accordance with a growing number of studies in other cultures.

    Level II

    Bellelli, G., Morandi, A., Davis, D. H. J., Mazzola, P., Turco, R., Gentile, S., … MacLullich, A. M. J. (2014). Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age and Ageing, 43(4), 496–502. http://doi.org/10.1093/ageing/afu021. PICO Analysis of Delirium Sample Essay

    Prospective Study

    The
    4AT
    screening tool is a sensitive and specific method of screening for delirium in older people. Its brevity and simplicity support its use in routine clinical practice.

    Cross-Sectional Observation Study

    A strength of this study is the provision of a clear description of exactly how the delirium diagnosis was obtained, detailing the procedure which informed scoring by DSM-IV-TR criteria. Some limitations of this study must be acknowledged. The 4AT assessments were performed by experienced physicians, though no specific training in the 4AT was given. Further research is needed to assess the ease of use of 4AT among other professional groups of varying levels of seniority. The clinical outcomes in relation to ‘possible delirium’ as assessed by the 4AT was not studied.

     

    Level II. PICO Analysis of Delirium Sample Essay

    Fick, D. & Mion, L. (2013). Assessing and Managing Delirium in Older Adults with Dementia. Retrieved from https://consultgeri.org/try-this/dementia/issue-d8.pdf

     

    Geriatric Models of Care

    The Hartford Institute states that the best tools for delirium screening in the older adult population are the
    Confusion Assessment Method (CAM)
    algorithm, which relies on the presence of acute onset of symptoms and a fluctuating course, inattention, and either disorganized thinking or an altered level of consciousness; and the
    Delirium Superimposed on Dementia Algorithm (DSDA)
    is recommended for delirium for people with a pre-existing dementia (Fick and Mion, 2013).

    Evidence-Based Practice Guidelines (systematic reviews, RCTs, Cohorts)

    PICO Analysis of Delirium Sample Essay

    While the CAM is a useful tool, the Delirium Superimposed on Dementia Algorithm recognizes that the patient’s baseline mental status is a critical parameter for assessing and treating delirium. The algorithm presents practical ways for bedside nurses to assess delirium and CAM features such as poor attention and fluctuation. The algorithm can be used with patients with dementia who present to the hospital without previous medical evaluation, and/or family members who cannot describe the patient’s mental status pre-hospitalization, who are at increased risk for undetected delirium. The algorithm helps address ageism, a significant barrier to detecting the presence of delirium, wherein clinicians attribute further cognitive loss or lethargy in a person with dementia as an inevitable fact of life for older adults.

    Level I

     

    Purpose of Research Paper

    Delirium is a common, often underdiagnosed, geriatric syndrome characterized by an acute change in attention and consciousness. The elderly population, especially those who are age 70 and older are particularly vulnerable to delirium than those younger due to changes in brain function, multiple general medical problems, polypharmacy, reduced hepatic metabolism of medications, multisensory declines, and brain disorders such as dementia. Polypharmacy is very common in the elderly, and the possibility of drug-drug interactions must be considered as a cause of agitation. PICO Analysis of Delirium Sample Essay. According to Rosen et al (2015), Delirium is frequently seen in older patients in the emergency department (ED), is under-recognized, and has potentially serious consequences. About 7–17% of older adults who present to the ED suffer from delirium (Rosen, 2015). Delirium is a medical emergency with significant associated morbidity and mortality requiring rapid diagnosis and management. Delirium has been identified as a leading contributor to short and long term cognitive decline after hospitalization, and at least 40% of these cases are preventable. As a neuropsychiatric disorder with an underlying organic cause, delirium is known to occur as both an acute and subacute condition that carries significant morbidity and mortality. Combined with its association with dementia and aging, this makes delirium an important topic for primary care providers to become more familiar with as they are tasked with caring for an aging population (Setters and Solberg, 2017).

    Gaps in Existing Literature

    Presently, there are very few RCTs and studies assessing the effectiveness of delirium screening tools in older adults with delirium in primary care settings. Most of the research focused mostly in acute care/hospital settings. A role for routine delirium screening can be clarified through a well-designed delirium screening trial investigating the benefits of delirium screening, coupled with a multicomponent intervention versus usual care.  PICO Analysis of Delirium Sample Essay. It could be challenging to measure emotions and cognitive improvement in a consistent manner across patients. Studies are needed to rigorously evaluate the benefits and potential harms of screening in relation to multiple outcomes such as medical intervention requirements, preventive strategies, delirium reversibility, care needs and economic burden.

    Conclusion

    Despite the limitations on the available research, most data show that the Confusion Assessment Method is widely used, and can used in any clinical setting. And for the patients with underlying dementia conditions, then, the Delirium Superimposed on Dementia Algorithm is recommended per evidence-based practice guidelines. Poor attention is a key marker in delirium and delirium superimposed on dementia patients. In addition, evaluations of the elderly should include a comprehensive review of all drugs being taken, including those that are prescribed, and those taken OTC and herbals. Delirium is often multifactorial and requires an immediate medical attention. Health practitioners should make it a habit to evaluate elderly patients for signs of delirium in every clinical setting especially in primary care settings as it often overlooked. PICO Analysis of Delirium Sample Essay.

     

    References

    Alaglakrishnan, K. (2017). Delirium. Retrieved from

    http://emedicine.medscape.com/article/288890-overview

    Arcangelo, V. P., & Peterson, A. M. (2013). 
    Pharmacotherapeutics for advanced

    practice: A practical approach
     (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins
    .

    Bellelli, G., Morandi, A., Davis, D. H. J., Mazzola, P., Turco, R., Gentile, S., … MacLullich, A. M. J. (2014). Validation of the 4AT, a

    new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age and Ageing, 43(4), 496–502. http://doi.org/10.1093/ageing/afu021

    De, J. & Wand, A. (2015). Delirium Screening: A Systematic Review of Delirium Screening Tools in Hospitalized Patients,
    The

    Gerontologist
    , 55(6), 1079–1099. Retrieved from https://doi.org/10.1093/geront/gnv100

    Fick, D. & Mion, L. (2013). Assessing and Managing Delirium in Older Adults with Dementia. PICO Analysis of Delirium Sample Essay. Retrieved from https://consultgeri.org/try-this/dementia/issue-d8.pdf

    Fong, T. G., Tulebaev, S. R., & Inouye, S. K. (2009). Delirium in elderly adults: diagnosis,

    prevention and treatment. Nature Reviews. Neurology, 5(4), 210–220. http://doi.org/10.1038/nrneurol.2009.24

    Iatraki, E. et al. (2017). Cognitive screening tools for primary care settings: examining the ‘Test Your Memory’ and ‘General

    Practitioner assessment of Cognition’ tools in a rural aging population in Greece.
    European Journal of General Practice
    , 23(1), 171-178. Retrieved from http://dx.doi.org/10.1080/13814788.2017.1324845. PICO Analysis of Delirium Sample Essay.

    Inouye, S. K. (2015). Enhancing cognitive aging: clinical highlights of a report from the Institute of Medicine. 
    Annals Of Internal

    Medicine
    , 
    163
    (4), 307-310. doi:10.7326/M15-1228

    National Institute on Aging (2013). The Dementias: Hope through Research. Retrieved from https://www.nia.nih.gov/alzheimers/publication/dementias/treatment

    O’Sullivan, D., O’Regan, N. A., & Timmons, S. (2016). Validity and Reliability of the 6-Item Cognitive Impairment Test for Screening

    Cognitive Impairment: A Review. 
    Dementia and Geriatric Cognitive Disorders
    , 
    42
    (1-2), 42-49. doi:10.1159/000448241

    Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., & Flomenbaum, N. PICO Analysis of Delirium Sample Essay.  (2015). Assessment and Management of Delirium in Older Adults in the Emergency Department: Literature Review to Inform Development of a Novel Clinical Protocol. Advanced Emergency Nursing Journal, 37(3), 183–E3. http://doi.org/10.1097/TME.0000000000000066

    Setters, B., & Solberg, L. M. (2017). Delirium. 
    Primary Care
    , 
    44
    (3), 541-559. doi:10.1016/j.pop.2017.04.010. PICO Analysis of Delirium Sample Essay.

  • Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree

    Assignment 1: Practicum: Decision Tree

    For this Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Learning Objectives

    Students will:

    ORDER A PLAGIARISM-FREE PAPER HERE

    Evaluate clients for treatment of mental health disorders

    Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

    The Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree:

    Examine 
    Case 2
    : 
    You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

    At each Decision Point, stop to complete the following:

    Decision #1: Differential Diagnosis

    Which Decision did you select?

    Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different? Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    Decision #2: Treatment Plan for Psychotherapy

    Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

    Decision #3: Treatment Plan for Psychopharmacology

    Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    Also include how ethical considerations might impact your treatment plan and communication with clients and their families.

    Note:
     Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

     

    BACKGROUND

    Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for.

    Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.”

    Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations.

    OBJECTIVE

    During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders.

    When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again.

    MENTAL STATUS EXAM

    Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation.

    Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters.

    Decision Point One

    BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PMHNP GIVE TO TYREL?

    In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

    Generalized Anxiety Disorder (GAD)

    Obsessive Compulsive Disorder

    Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)

    Decision Point One

     
    Generalized Anxiety Disorder (GAD)

    Decision Point Two

    Begin Paxil 10 mg orally daily

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She notices that he is still handwashing frequently, but thinks that the frequency has decreased “a bit.” Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved.

    Decision Point Three

    Increase Paxil to 20 mg orally daily

    Guidance to Student

    While GAD was not the actual diagnosis in this case, the child’s OCD symptoms did decrease with Paxil. Although Paxil is not FDA-approved for treatment of OCD in children, it is an SSRI like Sertraline and Fluvoxamine, which are FDA-approved for the treatment of OCD. So if there are no objectionable side effects and the symptoms appear to be decreasing, there may be no need to change drugs, but optimizing the dose may be a better choice. Augmentation with psychotherapy may also be useful, but the current dose of Paxil is still somewhat low, so augmenting with psychotherapy would be a good idea, but in and of itself would not be sufficient to meet this child’s needs.

    Finally, while the PMHNP could consider changing to Fluvoxamine, the “controlled release” preparation is not FDA-approved for use in children with OCD (see “Special Populations: Children and Adolescents” in the Fluvoxamine monograph of Stahl’s 
    Prescriber’s Guide
     for further details). Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Fluvoxamine 100 mg orally daily may not be tolerated in the morning secondary to the drug’s sigma-1 antagonist properties, which can cause sedation. Dosing of Fluvoxamine should be such that the larger dose is given in the evening to minimize daytime sedation.

    Decision Point Two

     

    Begin Zoloft 50 mg orally daily

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She notices that he is still handwashing frequently, but thinks that the frequency has decreased “a bit.” Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. Tyrel’s mom is concerned about the decrease in Tyrel’s appetite. She reports that he has been having some decreased appetite and has complained of feeling “sick to his stomach.”

    Decision Point Three

    Change to Fluvoxamine controlled release 100 mg orally every morning

    Guidance to Student

    In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this.

    Although the child had OCD and not GAD, Zoloft is FDA-approved to treat OCD in children. The starting dose is 25 mg orally daily. However, it is important to increase from the starting dose to an appropriate therapeutic dose to effectively manage symptoms. Starting at too high a dose can result in unfavorable side effects (gastrointestinal side effects are notable in this drug), and we can see that Tyrel is experiencing nausea and decreased appetite. In this case, it is recommended to wait to see if the side effects dissipate. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Decreasing the dose to 12.5 mg orally daily for about 3 or 4 days, then going back to 25 mg orally daily may help to overcome the unfavorable side effects. If side effects persist, the PMHNP may need to consider switching to a different medication.

    Fluvoxamine controlled release is not FDA-approved for use in children with OCD (see “Special Populations: Children and Adolescents” in the Fluvoxamine monograph of Stahl’s 
    Prescribers Guide
     for further details). Fluvoxamine 100 mg orally daily may not be tolerated in the morning secondary to the drug’s sigma-1 antagonist properties, which can cause sedation. Dosing of Fluvoxamine should be such that the larger dose is given in the evening to minimize daytime sedation. It is also worth noting that nothing in the scenario tells us that the Zoloft will not be effective.

    Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. However, in this case, the PMHNP assumed he/she was working with GAD, which may have delayed some of the work of CBT—that is, the focus of the sessions would have focused on the obsessive thoughts/compulsive behaviors versus a generalized anxiety. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. However, in this case, the diagnostic challenge made it difficult.

    Decision Point One

     
    Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)

    Decision Point Two

    Refer client to a pediatric neurologist

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     You learn that the pediatric neurologist completed a comprehensive assessment on Tyrel, and although symptoms of OCD seem to have occurred after he was sick, and although antistreptolysin O titers were elevated, there is insufficient evidence for the diagnosis of PANDAS.

    Decision Point Three

    Begin Risperdal 0.5 mg orally twice a day

    Guidance to Student

    If the PMHNP believes that PANDAS is the most likely diagnosis, he or she should consider the nature of the disorder and the extent of the management, which may include high doses of steroids, the potential for plasma exchange therapy, and possibly monoclonal antibody therapy. A scope of practice considerations should be undertaken—that is, does the PMHNP have the necessary knowledge, skills, and abilities to undertake the care of this client? The PMHNP should consider working in collaboration with the pediatric neurologist to optimize outcomes for this client and his family. Although antistreptolysin O and other titers indicate recent alpha streptococci infection, it should be noted that these titers can remain elevated for weeks after the infection and do not necessarily represent the development of negative sequelae such as PANDAS.

    In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Notice that nothing in the scenario tells us that the PMHNP has assessed this.

    Zoloft is FDA-approved to treat OCD in children. The starting dose is 25 mg orally daily. However, it is important to increase from the starting dose to an appropriate therapeutic dose to effectively manage symptoms. In this scenario, Fluvoxamine (immediate release) 25 mg orally daily would be the most appropriate agent.

    Week 7: Learning and Motor Disorders in Childhood

    “I had a substitute teacher today, so it was not a good day. She thought I was goofing off, but I could not help myself. As much as I tried to hold back, knowing she would freak out, I felt like a volcano. I erupted with a sound, kinda like a bullfrog that lasted for almost 10 minutes. She kept telling me to quiet down, but I could not help myself. Then the physical stretching and flexing of my neck started. She was really mad. Finally, my friend told her about me. It was embarrassing.”

    Samuel, age 9

    Learning disorders represent a diagnostic challenge in that many of the features of learning disorders overlap with ADHD. Appropriate diagnosis is essential to proper treatment. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Motor disorders can be a source of considerable distress for both the child and their parents. Appropriate diagnosis is required in order to initiate the most appropriate treatment to minimize the impact of these conditions on the child.

    This week, you work with your group again to develop a Parent Guide for an assigned learning or motor disorder. For your practicum, you examine the practice of voluntary and involuntary commitment of children and adolescents with mental health disorders.

    Photo Credit: PT Images

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

    American Nurses Association. (2014).
    Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.)
    . Washington, DC: Author.

    Standard 9 “Evidence-Based Practice and Research” (pages 71-72)

    Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014).
    Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry
    (11th ed.). Philadelphia, PA: Wolters Kluwer.

    Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)

    Chapter 31, “Child Psychiatry” (pp. 1181–1205)

    American Psychiatric Association. (2013).
    Diagnostic and statistical manual of mental disorders
    (5th ed.). Washington, DC: Author.

    “Neurodevelopmental Disorders”

    “Specific Learning Disorder”

    “Motor Disorders”

    Note:
    You will access this book from the Walden Library databases.

    Murphy, T. K., Lewin, A. B., Storch, E. A., Stock, S. (2013). Practice parameter for the assessment and treatment of children and adolescents with tic disorders.
    Journal of the American Academy of Child & Adolescent Psychiatry
    ,
    52
    (12), 1341–1359. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00695-3/pdf

    McGarvey, E. L., Leon-Verdin, M., Wancheck, T. N., & Bonnie, R. J. (2013). Decisions to initiate involuntary commitment: The role of intensive community services and other factors.
    Psychiatric Services
    ,
    64
    (2), 120–126.

    Note:
    You will access this article from the Walden Library databases.

    Kaltiala-Heino, R. (2010). Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree . Involuntary commitment and detainment in adolescent psychiatric inpatient care.
    Social Psychiatry and Psychiatric Epidemiology
    ,
    45
    (8),785–793. doi:10.1007/s00127-009-0116-3

    Note:
    You will access this article from the Walden Library databases.

    Lindsey, M. A., Joe, S., Muroff, J., & Ford, B. E. (2010). Social and clinical factors associated with psychiatric emergency service use and civil commitment among African-American youth.
    General Hospital Psychiatry
    ,
    32
    (3)
    ,
    300–309. doi:10.1016/j.genhosppsych.2010.01.007

    Note:
    You will access this article from the Walden Library databases.

    Stahl, S. M. (2014).
    Prescriber’s Guide: Stahl’s Essential Psychopharmacology
    (5th ed.). New York, NY: Cambridge University Press.

     

    Note:
    All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

     

    To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    Review the following medications:

    Tourette syndrome

    Pervasive developmental disorders

    clonidine

    haloperidol

    pimozide

    guanfacine

    Note:
     Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

    Optional Resources

    Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
    Rutter’s child and adolescent psychiatry
    (6th ed.). Hoboken, NJ: Wiley Blackwell.

    Chapter 47, “Children With Specific Sensory Impairments” (pp. 612–622)

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Discussion: Parent Guide

    Learning disorders and motor disorders can be difficult for parents to understand. They often have many questions that go unanswered and can create considerable misunderstanding. This misunderstanding can damage the child/parent relationship. The PMHNP can answer questions and provide guidance for the family in order to help reduce the uncertainty of the disorders.

    For the Discussion, you will work with your group again to develop a Parent Guide for your assigned disorder.

    Learning Objectives

    Students will:

    Analyze signs and symptoms of learning and motor disorders in childhood

    Analyze pathophysiology of learning and motor disorders in childhood

    Analyze diagnosis and treatment methods for learning and motor disorders in childhood

    Evaluate Parent Guides

    To Prepare for this Discussion:

    Your Instructor will assign you to a group and a disorder by Day 1 of Week 2.

    Review the resources concerning your assigned disorder.

    Use your group’s Discussion Board to design and develop the Parent Guide before posting to the group wiki. For further guidance, refer to the 
    Accessing Group Discussions
     instructions below. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    Using evidence-based research, design and develop a Parent Guide for your assigned disorder including:

    Signs and symptoms

    Pathophysiology

    How the disorder is diagnosed

    Treatment options

    Provide a minimum of three academic references.

    By Day 5

    One designated group member
     should post the completed Parent Guide to the Discussion.

    By Day 7

    Respond
     to at least 
    two
     other groups’ wikis by providing at least two contributions for improving or including in their Parent Guide and at least two things that you like about their guide. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    Submission and Grading Information

    Accessing Group Discussions and Wikis

    To access your group’s discussion
    , click on the 
    Parent Guide Groups
     link. Once you have clicked on the link, select your assigned team (e.g., Team A, Team B, Team C, etc.) to access your team’s home page. Select 
    Group Discussion Board
     under the Group Tools menu to work on your participate in your group’s discussion.

    To access your group’s wiki
    , click on the 
    Parent Guide Groups
     link. Once you have clicked on the link, select your assigned team (e.g., Team A, Team B, Team C, etc.) to access your team’s home page.

    Creating a Wiki Page

    Create the first wiki topic page by entering the group’s wiki area and selecting 
    Create Wiki Page
    . Use the group’s assigned disorder as the name of your wiki. Then add your Parent Guide in the Content text box. You can use the editor functions to format the text and include files, images, web links, multimedia, and mashups. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Select 
    Submit
     when you have completed the wiki page.

    Grading Criteria

    To access your rubric:

    Week 7 Parent Guide Discussion Rubric

    To access your group discussion / wiki:

    Parent Guide Groups

    Post to Discussion by Day 5 and Respond by Day 7

    To participate in this Discussion:

    Parent Guide Groups – Week 7

    Assignment 1: Practicum Journal: Voluntary and Involuntary Commitment

    PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice.

    In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.

    Scenario for Week 7 Case:

    You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Learning Objectives

    Students will:

    Evaluate clients for voluntary commitment

    Evaluate clients for involuntary commitment based on state laws

    Recommend actions for supporting parents of clients not eligible for involuntary commitment

    Recommend actions for treating clients not eligible for involuntary commitment

    To Prepare for this Practicum:

    Review the Learning Resources concerning voluntary and involuntary commitment.

    Read the Week 7 Scenario in your Learning Resources.

    Research your state’s laws concerning voluntary and involuntary commitment.

    The Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree (2–3 pages):

    Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?

    Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.

    Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.

    If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.

    If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

    By Day 7

    Submit 
    your Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Assignment.

    Submission and Grading Information

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

    Please save your Assignment using the naming convention “WK7Assgn1+last name+first initial.(extension)” as the name.

    Click the 
    Week 7 Assignment 1 Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 7 Assignment 1 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK7Assgn1+last name+first initial.(extension)” and click 
    Open
    . Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 7 Assignment 1 Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 7 Assignment 1 draft and review the originality report.

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 7 Assignment 1

    Assignment 2: Practicum: Week 5 Decision Tree

    By Day 7

    Submit 
    your Assignment. Refer to Week 5 for additional guidance.

    Submission and Grading Information

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

    Please save your Assignment using the naming convention “WK7Assgn2+last name+first initial.(extension)” as the name.

    Click the 
    Week 7 Assignment 2 Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 7 Assignment 2 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK7Assgn2+last name+first initial.(extension)” and click 
    Open
    . Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 7 Assignment 2 Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 7 Assignment 2 draft and review the originality report.

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 7 Assignment 2

    Assignment 3: Board Vitals

    This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

    These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

    You can access Board Vitals through the link sent to you in email or by following the link below:

    https://www.boardvitals.com/

    By Day 7

    Complete the Board Vitals questions.

    Practicum Reminder

    Time Logs

    You are required to keep a log of the time you spend related to your practicum experience 
    and enter every patient you see each day
    . You can access your time log from the Welcome Page in your Meditrek account. You track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

    Making Connections

    This week, you worked with your group to develop a Parent Guide for an assigned learning or motor disorder. For your practicum, you examined the practice of voluntary and involuntary commitment of children and adolescents with mental health disorders.

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Next week, you will debate the theory that bipolar depression can or cannot be diagnosed in children and adolescents.

  • Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples

    Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples -1

    Psychotherapy is a proven method in the treatment of various psychiatric disorders in both the individual and group setting. Individual therapy consists of the application of a therapeutic process with an individual and the treating clinician and group therapy applies the same concept but consists of two or more individuals seeking therapeutic intervention. Regardless of the setting, the practicing clinician muse be aware of the legal and ethical implications that come with treating clients in both individual and group psychotherapy sessions. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    ORDER A PLAGIARISM-FREE PAPER HERE

    Legal and Ethical Considerations in Individual and Group Therapy

    According to Wheeler (2014), group therapy offers the ability to increase access to care for clients, to diversify one’s practice by offering services other than individual, couples, or family therapy, while at the same time affording clients a cost-effective and evidence-based intervention for addressing their mental health issues. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. In both individual and group therapy settings there are certain guidelines that must be maintained to prevent consequential ethical or legal implications. in both individual and group therapy, privacy and confidentiality must be maintained unless the clinician has just cause to believe that either the individual client or a member of a group is a danger to themselves or another person. However, in group therapy these rules do not just span between one client and the treating clinician and the therapist must be cognizant of this fact. According to Breeskin (2011), “Anything that is said between any two or more group members at any time is part of the group and is confidential.”  Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    Another ethical implication seen in both individual and group therapy is informed consent. Informed consent allows the client or clients to have enough information regarding the services provided within the therapeutic environment so that they can decide whether they will participate. All clients should be given an orientation to the therapeutic setting including appropriate boundaries, limits, goal setting, and expected behaviors. In group therapy, all legal implications associated with maintaining the privacy of participants protected health information still applies as seen with individual therapy. Participants within the group should be encouraged during the orientation phase and throughout the duration of the group to maintain the confidentiality of all group members. According to McClanahan (2014), confidentiality should become one of the most important group norms, and it should be discussed openly, throughly and often among group members. This implication also applies to group therapy settings involving minors. Guardians must be informed of the application of confidentiality and given disclosure that complete confidentiality cannot be promised as seen in individual therapy settings. According to Ware & Dillman-Taylor (2014), similar to any intervention involving multiple people, therapists cannot promisr complete confidentiality because of one’s lack of control of other members and possible situations of required reporting and must be discussed with parents.

    When providing services to clients in the group or family setting versus those in the individual therapy environment, the therapeutic environment might be impacted if these factors are not taken into account. The therapist must be aware that the therapeutic dynamic is altered when dealing with a group versus a individual therapy session. Client trust and therapeutic alliance will need to established not only with the group facilitator but also with the group participants to meet the goals of the formation of the particular group session. Group members should feel free to interact within the therapeutic environment without fear of intimidation, judgment or unnecessary disclosure of their private thoughts or experiences. The principles of interpersonal learning, group cohesiveness, and catharsis are all impacted by some of these considerations. The competent psychotherapist will also be aware of their abilities in providing effective treatment using the appropriate treatment modalities. According to Wheeler (2014), proficiency in specific theoretical orientations is a necessity for all practicing psychotherapists, but awareness of the nuances, ambiguities, and subtleties of interpersonal interaction, and how to handle them in the immediacy of the clinical encounter to therapeutic effect; are indispensable. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    References

    Breeskin, J. (2011). Procedures and guidelines for group therapy. 
    The Group Psychologist, 21
    (1). Retrieved from http://www.apadivisions.org/division-49/publications/newsletter/group-psychologist/2011/04/group-procedures.aspx

    McClanahan, K.K. (2014). 
    Can confidentiality be maintained in group therapy? 
    Retrieved from http://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-therapy/102566.html

    Ware, J.N., & Dillman-Taylor, D. (2014). Concerns about confidentiality: The application of ethical decision-making within group play therapy. 
    International Journal of Play Therapy, 23
    (3), 172-186. doi:10.1037/a0036667

    Wheeler, K. (Eds.). (2014). 
    Psychotherapy for the advanced practice psychiatric nurse: A how to guide for evidence-based practice. 
    New York, NY: Springer.

     

    Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples – 2

    Group therapy is a form of psychotherapy in which a group of patients meet to describe and discuss their problems together under the supervision of a therapist (Tracy & Wallace, 2016). Family therapy is a form of psychotherapy that works with families and couples in intimate relationships to nurture change and development (Szapoczni, Schwartz, Muir, & Brown, 2012). It tends to view change in terms of the systems of interaction between family members and emphasizes family relationships as an important factor in psychological health (Szapoczni et al., 2012). Individual therapy is a joint process between a therapist and a person in therapy with the common goals of therapy being to inspire change or improve the quality of life for the individual in therapy (Tracy et al., 2016). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    Maintaining confidentiality is the foundation of psychotherapy and without the assurance of confidentiality, the clients in either forms of psychotherapy cannot be expected to reveal embarrassing, sometimes personally damaging information in the selected treatment setting (McClanahan, 2014). It is important to remember that the ethical requirement of confidentiality overlaps with the law so some of the answers to situations the therapist will experience can only occur with an understanding of both ethics and law (McClanahan, 2014). Issues of confidentiality are complex and members of the American Psychological Association (APA) report that the most common dilemma for therapist providing individual therapy involve confidentiality (McClanahan, 2014). Those dilemmas become even more complex when group or family is provided (McClanahan, 2014). Definitive guidelines are provided by associations specifically dedicated to group/family work stating group workers define confidentiality and its limits (for example, legal and ethical exceptions and expectations; waivers implicit with treatment plans; documentation and insurance coverage) (McClanahan, 2014). Group/family therapists have the responsibility to inform all individuals participating of the need for confidentiality, potential consequences of breaching confidentiality and that legal privilege does not apply to group/family discussion, unless provided by state statute (McClanahan, 2014).

    Another important difference is the provider during group/family therapy is no longer dedicated to the individual client nor functions exclusively as the client’s agent (Ezhumalai, Muralidhar, Dhanasekarapandian, & Nikketha, 2018). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. The provider recognizes the responsibility to participate in activities contributing to an overall improved community (Ezhumalia et al., 2018).

    This can be used in clinical practice by maintaining an atmosphere of trust when holding a group or family session, due to all the members potentially speaking openly about their feelings and talking directly to one another about their personal problems (Ezhumalia et al., 2018). It will be important for the therapist to promote that no one will be forced to divulge their deepest secrets and to promote an environment that group/family member to feel free to relate openly and honestly with others in the effort to discover that they are not alone in their issues (Ezhumalia et al., 2014).

    References:

    Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R., & Nikketha, B. S. (2018). Group interventions. 
    Indian Journal of Psychiatry
    , 
    60
    (Suppl 4), S514–S521. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_42_18

    McClanahan, K. (2014). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. Can confidentiality be maintained in group therapy? 
    The National Psychologist. 
    Retrieved from: https://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-therapy/102566.html

    Szapocznik, J., Schwartz, S. J., Muir, J. A., & Brown, C. H. (2012). Brief Strategic Family Therapy: An Intervention to Reduce Adolescent Risk Behavior. 
    Couple & Family Psychology
    , 
    1
    (2), 134–145. http://doi.org/10.1037/a0029002

    Tracy, K., & Wallace, S. P. (2016). Benefits of peer support groups in the treatment of addiction. 
    Substance Abuse and Rehabilitation
    , 
    7
    , 143–154. http://doi.org/10.2147/SAR.S81535

     

    Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples – 3

    Legal and ethics

    Legal and ethical consideration are very important during therapy  to protect patient privacy. And as a practitioner, the code of ethics  requires that I must adhere to the code. Different states have different laws that govern privacy and thus one should familiarize with them and recognize the extent and limits of confidentiality  regulated by law. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. The Health Insurance Portability and Accountability Act (HIPAA) contains a privacy rule that creates national standards to protect individuals’ medical records and personal health information, including information about psychotherapy and mental health.

    Group verses individual therapy confidentiality

    In group therapy and family therapy, confidentiality is not guaranteed, according to McClanahan 2014, the  information revealed to the therapist  is also revealed to other group members, and there is no guarantee that other group members will maintain confidentiality. For individual therapy, at least it’s between the therapist and the client and therefore confidentiality is maintained. According to The APA Ethical Guidelines, there is little specificity regarding confidentiality in group therapy.

    Privileged information

    The difference of group therapy and family therapy from the individual therapy is the privileged information. In most states, privileged communication does not exist in group settings due to the third-party rule, which states that information revealed in front of a third party was not intended to be private and is not privileged, McClanahan (2014). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. Therefore, group members may be called to testify against their peers regarding information obtained in group sessions unless provided by a state statute. On the other hand, individual therapy notes  are confidential and privileged. According to U.S. Department of Health &Human Services. (2014), Privacy Rule requires a covered entity to obtain a patient’s authorization prior to a disclosure of psychotherapy notes for any reason, including a disclosure for treatment purposes to a health care provider other than the originator of the notes [45 CFR 164.508(a)(2)].

    Impact your therapeutic approaches

    The impact of these differences on therapeutic approaches is the consequences of breach these confidentiality and privileges. Remember that a breach of confidentiality can be a malpractice liability (Loewenberg, Dolgoff, & Harrington, 2000). The client competence is also important because impaired cognition may impair the understanding of the consents entered between the client and the practitioner or is obtained under duress. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. Other consideration that may arise is mandatory reporting and mandated  treatments which may impact therapy approaches.

    References

    U.S. Department of Health &Human Services. (2014). HIPAA privacy rule and sharing    Information related to mental health. Retrieved from http://www.hhs.gov/sites/default             /files/ocr/privacy/hipaa/understanding/speail/mhguidencepdf.pdf

    Loewenberg, F. M.; Dolgoff, R. & Harrington, D. (2000). Ethical decisions for social work          practice, 6th edition. Itasca, IL: F. E. Peacock.

    McClanahan, K. K. (2014) Can confidentiality be maintained in group therapy? Retrieved            from http://nationalpsychologist.com/2014/07/can-confidentaility-be-maintained-in-       group-therapy/102566.html

     

    Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples – 4

    During this week’s group and family therapy sessions, I have been able to witness how different these sessions are compared to individuals’ sessions from previous class. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. Some of the differences and challenges, I noted were in relation to different groups and family’s dynamics and issues 

    issues 
    like 
    group
     members 
    privacy and 
    confidentiality.
    It’
    s
     very importance to maintain confidentiality during group or family session to have trust 
    and 
    maintain cohesion failure to which can have major legal and ethical consequences. According to Letitia, Thomas & Emily (2013) as group treatment gains popularity, so does the awareness of the ethical dilemmas that often pose more of a problem in group treatment than in individual therapy. Confidentiality, for one, is an issue warranting much-needed attention in groups. Although therapists are ethically and legally bound, there are no standard rules in place for members of a group engaging in therapeutic dialogue. To reduce the fear surrounding violations of confidentiality, it is speculated that enhancing cohesion and trust among group members will put members at ease. 
    C
    onfidentiality is a cornerstone of healthy therapeutic relationships and effective treatment and is based upon the ethical principles of autonomy and fidelity, and to a lesser degree, beneficence and nonmaleficence. Group members should be encouraged to embrace the concept of confidentiality, making it their own rather than a rule the group therapist has mandated. When new group members join an ongoing group, they may be asked to sign or may have already signed a contract attesting to their commitment to 
    confidentiality
     (
    McClanahan
    , 
    2014
    ).
     

    There are several ethical standards that differential group from individual therapy. 
    According
     Corey et al., (2014) 
    it’s
     
    important
     to scr
    een
     clients in group therapy to ensure that they are in the right group for the topics being discussed and on the same token, screening client ensures that they and their issues are a good fit for the therapist and their level of expertise and experience with those issues is important. 
     Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    One of the issues 
    addressed
     in this 
    week’s 
    video
     
    assignment was how to 
    address 
    client’s 
    confidential
     
    information
     
    in case
     of court 
    subpoena. Each S
    tate and on rare occasional county
     
    addresses
     this issue 
    differently
     and 
    it’s
     on us 
    as therapists
     to stay 
    up to
     date with their jurisdiction mandate. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. As already noted, group and family therapy require a different level of 
    confidentiality
     compared to individual therapy session. These differences have major impact on therapy and how the 
    sessions
     are 
    conducted
     including the rules and group members obligations to each other. Therapists 
    must
     consider the group dynamic and objective while ensuring that each individual client in the 
    group is catered 
    for (
    Cottone
     
    & 
    Tarvydas
    ,
     
    2016)
    . 
     

      

    References

    Corey, G., Schneider-Corey, M., & Haynes, R. (2014). 
    Groups in action: Evolution and 
    challenges 
    (2nd ed.). Belmont, Ca: Brooks/Cole.
     

    Cottone, R. R., & 
    Tarvydas
    , V. (2016). 
    Ethics and decision making in counseling and 
    psychotherapy., 4th ed
    . New York, NY, US: Springer Publishing Co.
     

    Letitia, E., Thomas, W., & Emily, E., (2013) Confidentiality and Cohesion in Groups: 
     
    Collaborative Story Building and Telling as a Means of Improving the Therapeutic 
    Experience.  Eastern Group Psychotherapy Society. Vol. 36, No. 4 (Winter 2013), pp. 
     
    317-331
     . Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    McClanahan, K. K. (2014). 
    Can confidentiality be maintained in group therapy?
     Retrieved from  
    http://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-
     
    therapy/102566.html
     

     

    Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples – 5

    Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior and overcome problems in desired ways. Psychotherapy aims to improve an individual’s well being and mental health to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills (Psychotheraphy, 2018). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    The role of psychotherapy is to facilitate the client’s work in ways which respect the client’s values, personal resources and capacity for self determination. The aim is to empower clients and encourage them to take control of their lives. Only when both therapist and client explicitly agree to enter into a therapy relationship does it become psychotherapy (Stefanazzi, 2018).

    Ethics are important, because they provide a map, a science of morality, which can support us to determine where our duty lies, what is the right course of action to take, that will cause no harm, and is not limited to personal advantage (Stefanazzi, 2018). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

     

    References

    Stefanazzi, M. (2018). Psychotheraphy. 
    IHIAP
     .Retrieved from https://iahip.org/inside-out/issue-58-summer-2009/ethical-issues-in-psychotherapy

    Psychotheraphy. (2018). 
    Wikipedia
     .Retrieved from https://en.wikipedia.org/wiki/Psychotherapy

     

    Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples – 6

    Group therapy is a cost-effective choice for many patients without insurance (Wheeler, 2014). Group therapy provides therapists the opportunity to treat multiple patients at once allow greater access to treatment for clients (Wheeler, 2014).  Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. Approaches for individual psychotherapy offer understanding of the client from an intrapsychic, interpersonal, humanistic-existential, or cognitive behavioral perspective while family therapy strives to understand the client in the context of a system (Wheeler, 2014). IN terms of family therapy, clients have lived most of their lives growing up in a family and starting a new family.

    In group and family therapy, information revealed to the therapist as well as to other group members. Legal and ethical considerations differ from those of individual therapy. Therapists have the responsibility to inform all group participants of the need for confidentiality, potential consequences of breaching confidentiality, and that legal privilege does not apply to group discussions (Mclanahan, 2014).

    Confidentiality should be discussed with group members prior to entering the group therapy session. Potential group members should be informed that therapists may have a legal obligation to break confidentiality in certain circumstances such as a group member verbalizing intent to harm self or others. Therapists can assure confidentiality within the constraints of the law but, are unable to promise that other group members will maintain confidentiality (Mclanahan, 2014). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. In most states, privileged communication does not exist in group settings due to the third-party rule, which states that information revealed in front of a third party was not intended to be private and is not privileged (Mclanahan, 2014). So, group members can testify against other group members regarding information that was revealed in group. In order to help maintain confidentiality, group members must embrace the concept of confidentiality and trust that other members will not reveal information discussed within the constraints of the law. In my own practice in the future, I will educate all members of my psychotherapy groups that is essential to maintain confidentiality to promote trust within the group.

    References:

    Mclanahan, K., (2014). 
    Can confidentiality be maintained n group therapy?
     Retrieved from https://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-therapy/102566.html

    Wheeler, K. (Ed.). (2014). 
    Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice.
     New York, NY: Springer. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

     

    Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples – 7

    Group Therapy Premise

    Group therapy is formulated under several historical assumptions of human behavior and relationship. Fehr & Gaska (2013), explains that psychological basis for group dynamic stems from earlier philosophies regarding the inner circle as in ancient Chinese philosophy, to Rudolph Dreikurs’ group benefit philosophy. The group therapy model harness tribal instincts that may perhaps illicit benefits to the entirety of a tribe, but also reap benefits for the individual.

    Besides the inherent differences, group therapy compared to individual therapy helps the individual’s identity and personality emerge. Individuals may exhibit personalities that are different given the social conditions or environment ( Fehr & Gaska, 2013). For example, in a group setting, there can be social requirements, whether explicit or not, in order to progress a given interaction. The group dynamic helps people understand how they may shape the environment, and the environment could influence them ( Fehr & Gaska, 2013). For the sake of practicality, a group therapy model provides a greater simulation of the real-world. As in individual psychotherapy, there are many modalities that have been described and developed. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.  However, not all are necessarily accepted by professionals.

    Legal and Ethical Implications

    Legal and ethical implications are especially concerning due to an increase in participating parties in group therapy. Unlike individual therapeutic relationships, where the client is reliant of the therapist for confidentiality, group dynamics require all participating members to adhere to ethical conducts. The Health Insurance Portability and Accountability Act (HIPPA), outlines the responsibilities of clients, and providers in order to maintain privacy. Only under the patient’s discretion, or extreme circumstances can health information be shared (U.S. Department of Health & Human Services, 2014). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples. However, confidentiality under the third party rule may not legally bind other participants within the group to the same standards as between the therapist and his or her clients (McClanahan, 2014). Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    Approaches to Group Therapy Implications

    The impact of these requirements require that the therapist take an active role in clearly establishing rules of conduct among group members. It may also be prudent to remove individuals when they are harmful to the standards of therapeutic relationships set forth. If members are known to be discussing the health and care of other members, while not illegal, it could be detrimental a trusting environment. Signed agreements can help hold members accountable, such that participants are given the rules beforehand and agree that they can be removed if they infringed on those prior agreements. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.

    Fehr, S. S., & Gaska, J. M. (2013). 
    Introduction to group therapy : a practical guide
    . New York, New York ; Oxfordshire, England : Routledge, 2013.

    McClanahan, K. K. (2014). 
    Can confidentiality be maintained in group therapy?
     Retrieved from http://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-therapy/102566.html

    U.S. Department of Health & Human Services. (2014). 
    HIPAA privacy rule and sharing information related to mental health.
     Retrieved from http://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/special/mhguidancepdf.pdf. Legal and Ethical Considerations for Group and Family Therapy Discussion Essay Samples.