Category: Nursing

reimbursement rates for mental health treatments sample essays

Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults

NURS 6670

Reimbursement Rate Template

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The American Medical Association (AMA) developed Current Procedural Terminology (CPT) a medical code system that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations. The CPT is a numerical coding methodology that accurately identifies the professional services provided by qualified healthcare professionals and to report those services in a way that can be universally understood by institutions, private and government payers, researchers, and others interested parties. The CPT is the most widely accepted medical nomenclature used to report medical procedures and services for processing claims, conducting research, evaluating healthcare utilization, and developing medical guidelines and other forms of healthcare documentation. (Dotson, 2013). CPT codes are an integral part of the billing process. CPT codes tell the insurance payer what procedures the health care provider would like to be reimbursed for It is used to track important health data and measure performance and efficiency reimbursement rates for mental health treatments sample essays.

CPT code is five characters long and may be numeric or alphanumeric, depending on which category the CPT code is in. (Detorie, Mahesh, Hevezi, 2016).

CPT is divided into three categories of codes which includes Category

I: Procedures that are consistent with contemporary medical practice and are widely performed. Category II: Supplementary tracking codes that can be used for

performance measures.

Categor III: Temporary codes for emerging technology, services, and procedures.

The difference between

CPT codes and ICD codes are that CPT codes are related to procedures and ICD codes are related to diagnoses. ICD codes the ‘category’ refers to the first three characters of the code, which describe the injury or disease documented by the healthcare provider.

 

The relationship between ICD-10 codes and CPT is important because the ICD- 10 codes identifying the diagnosis support the necessity of the procedure completed. This allows the procedure to be covered and the provider to be reimbursed (Thorwarth, 2008)

 

Type of Service eg. -New Office Visit-Established Office Visit-Inpatient hospital-individual psychotherapy-group psychotherapy (see examples below)

CPT code The private insurer reimbursement rate for PMHNP

The private insurer reimbursement rate for physicians Medicare the reimbursement rate for PMHNP Medicare the reimbursement rate for physician Psychiatric

Diagnostic Evaluation

90791

$118.54

$138.26

$119.99

$159.0

Psychiatric Diagnostic Evaluation with Medical Services

90792

$125.13

$159.74

$116.58

$130.0

Psychotherapy, 30 minutes with patient and or family member

90832

$67.22

$96.52

$64.61

$76.10

Psychotherapy, 45 minutes with Patient and/or family member

90834

$89.88

$115.63

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86.16

94.89

Psychotherapy for crisis; first 60 minutes

90839

140.66

$164.28

135.08

143.54

State of Maryland Department of Health and Mental Hygiene (2018) Reimbursement Rates Retrieved from;

https://mmcp.health.maryland.gov/Documents/physicianfeeJCRfinal1

–

14.pdf.

As the PMHNP becomes proficient in diagnosing and treating, it is also important to learn how to bill for your time. The CMS sets up codes to identify the type of service you are providing. You will generally complete this task at the end of the visit as you are documenting the visit with the client. Here are examples of the codes to know: CPT Codes for Psychiatric and Psychological Procedures

HMSA recognizes the following service codes for the reporting of psychiatric and psychological services. (See Code Books for information on how to obtain the books.)

CPT Code

Footnote(s)

Description

90791

1

Psychiatric diagnostic evaluation

90792

1,3

Psychiatric diagnostic evaluation with medical services

90832

2

Psychotherapy, 30 minutes with patient and/or family member

90833

2,3

Psychotherapy, 30 minutes with patient and/or family member when performed with an

evaluation and management service

90834

4

Psychotherapy, 45 minutes with patient and/or family member

90836

3,4

Psychotherapy, 45 minutes with patient and/or family member when performed with an evaluation and management service

90837

6

Psychotherapy, 60 minutes with patient and/or family member

90838

3,6

Psychotherapy, 60 minutes with patient and/or family member when performed with an

evaluation and management service

90839

6

Psychotherapy for crisis; first 60 minutes

90840

2 each additional 30 minutes

90846

4

Family psychotherapy (without the patient present)

90847

4

Family psychotherapy (conjoint psychotherapy) (with patient present)

90849

4

Multiple-family group psychotherapy

90853

4

Group psychotherapy (other than of a multiple-family group)

90870

1, 5

Electroconvulsive therapy (includes necessary monitoring)

96101

1

Psychological testing (includes psych diagnostic assessment of personality, psychopathology,

emotionality, intellectual abilities, e.g., WAIS

–

R, Rorschach, MMPI) with interpretation and report, per hour.

Note:

All hours of psychological testing done on a single day will be counted as one visit (either

inpatient or outpatient as appropriate) toward the patient’s inpatient or outpatient visit maximum.

However, payment will be made to the participating provider on a per-hour basis.

96118

1

Neuropsychological testing battery (e.g., Halstead-Reitan, Luria, WAIS-R) with interpretation and report, per hour

Note:

All hours of psychological testing done on a single day will be counted as one visit (either

inpatient or outpatient as appropriate) toward the patient’s inpatient or outpatient visit maximum.

However, payment will be made to the participating provider on a per-hour basis. Links to websites that discuss this:

https://www.psychiatry.org/psychiatrists/practice/practice

–

management/coding

–

reimbursement

–

medicare

–

and

–

medicaid/coding

–

and

–

reimbursement

http://www.mb

–

guide.org/medical

–

coding

–

guidelines.html

Reference

Dotson, P. (2013). CPT

®

Codes: What Are They, Why Are They Necessary, and How Are They Developed?

Advances in Wound Care

,

2

(10), 583

–

http://doi.org/10.1089/wound.2013.0483

Detorie, N, Mahesh, M, Hevezi, J (2016). CPT®

Code 77370 Journal of American College of Radiology,

5 (8),

937

–

93

Thorwarth, W.T. Jr.(2008). CPT®: An Open System That Describes All That You Do

.

J Am Coll Radiol

.

5:555

–

560.Retrieved from:

https://www.jacr.org/article/S1546

–

1440(08)00226

–

3/references

State of Maryland Department of Health and Mental Hygiene (2018) Reimbursement Rates Retrieved from reimbursement rates for mental health treatments sample essays;

https://mmcp.health.maryland.gov/Documents/physicianfe

eJCRfinal1

–

14.pdf.

9 / 9

Assignment 2-WK6DUWK7- Reimbursement Rates

Week 6 Practicum Journal: Reimbursement Rates

Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses. As a PMHNP, you will be faced with varying rates that may be different than other health care providers you may work with.

In this Practicum Journal Assignment, you will analyze reimbursement rates for mental health treatments you will likely use in your practice and compare those rates to other provider rates.

Learning Objectives reimbursement rates for mental health treatments sample essays

Students will:

• Analyze reimbursement rates for mental health treatments

To prepare for this Practicum Journal:

• Research reimbursement rates for various treatment modalities.

• Compare NP rates to other provider rates.

For this Practicum Journal:

Complete the Reimbursement Rate Template in your Learning Resources using the five types of services you are likely to use in your practice.

 

Practicum Journal: Reimbursement Rates

                                Analyze reimbursement rates for mental health treatments

The Healthcare Common Procedure Coding System (HCPCS), built up in 1978, is an institutionalized framework to portray explicit things and administrations gave in health services conveyance, (IBHP, 2019). This coding framework was produced to guarantee that claims for Medicare, Medicaid, and other medical coverage programs are prepared reliably reimbursement rates for mental health treatments sample essays. At first, utilization of the codes was willful, however with the approach of HIPAA in 1996 (Health Insurance Portability and Accountability Act of 1996), the codes wound up required (IBHP,2019). This paper will break down repayment rates for mental wellness treatment and repayment rates for different treatment modalities and looks at NP rates to other supplier rates.

The outlook of reimbursement rates for various treatment modalities.

The Center for Health Care Solutions has developed Billing and Financial Worksheets for each state that identify current billing opportunities for services in integrated settings. The most frequently used code by the psychiatrists can be found in psychiatry subsection of the medicine section of the CPT manual (codes 90785-90899). In 2005–2006, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA), with guidance from the Centers for Medicare & Medicaid Services (CMS),(2018), jointly sponsored a study to identify the barriers to, and possible solutions for, reimbursement of mental health services provided in primary care settings (Danna et., al 2008). Significant changes to the psychiatry codes were seen in the year 2013 whereby refinement was made between an initial evaluation with medical services carried out by a doctor 90792 and a first assessment done by a non-physician 90791.There’s one major difference between 90791 and 90792: the use of medical services. Whereas both codes are used for psychiatric diagnostic evaluations, 90791 can’t include medical services and 90792 can reimbursement rates for mental health treatments sample essays.

Contrasting NP reimbursement rates to other provider rates.

In contrasting NP repayment rates with other supplier rates, it is perfect to see how to legitimately bill and code for services given by NPPs is basic to running a savvy and effective medical practice. Outlining and documentation necessities must be met. Most importantly, states set their own rates at which they repay suppliers, where you practice is taken cognizance of and my affect the outcome. In a few states, suppliers remain to benefit most by treating patients protected through Medicare reimbursement rates for mental health treatments sample essays. In different states, treating patients guaranteed through Medicaid designs produces the most income, (IBHP,2019).

Directions fluctuate by insurance agencies and states, so both the doctor and the NPP’s must remain current with training rules and progressing changes. Nurse Practitioners and Physician Assistants have progressively turned into a staple in most medical practices. NPs are nurses who hold a graduate degree or Doctor of Nursing Practice (DNP). PAs are affirmed (PA-C), generally holding a graduate degree also. There are a few reasons that therapeutic practices use these mid-level suppliers: reduced Salary expenses (as compared to a physician); lower overhead costs; higher patient volumes; and reduced insurance and liability costs (Tufts Health Plan, 2018) reimbursement rates for mental health treatments sample essays.

 
Psychiatric Business Template

Reimbursement Rate Template

Type of Service

 

CPT code

Private insurer reimbursement rate for PMHNP

Private insurer reimbursement rate for physicians

Medicare

reimbursement rate for PMHNP

Medicare

reimbursement rate for physician

Psychiatric diagnosis evaluation

90791

$135.42

$159.32

$117.76

 $138.54

Psychiatric diagnostic evaluation with medical services

 90792

$135.42

$159.32

$117.76

 $138.54

Electroconvulsive therapy (includes necessary monitoring)

90870

$155.10

$182.47

$97.25

$114.41

Psychological testing, interpretation and reporting per hour by a psychologist

96101

$83.24

$97.93

$72.38

$85.16

Neuropsychological testing, interpretation and reporting by a psychologist

 

96118

$98.15

$115.47

$85.35

$100.41

Various minutes are allotted to each evaluation to attract the stipulated amount of money.

 

 

Reference

Centers for Medicare and Medicaid Services (CMS), (2018). Physician Fee Schedule. Retrieved from                 https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/ reimbursement rates for mental health treatments sample essays

Danna Mauch,D., Kautz, C.,Smith, S. (2008). Reimbursement of Mental Health Services in Primary Care Settings. Retrieved from      https://www.integration.samhsa.gov/Reimbursement_of_Mental_Health_Services_in_Primary_                Care_Settings.pdf

Integrated Behavioral Health Partner IHBP (2019). Billing, Reimbursement and Financing. Retrieved from

Billing, Reimbursement And Financing

Tufts Health Plan. (2018). Nurse Practitioner and Physician Assistant Professional Payment Policy              Retrieved from
https://tuftshealthplan.com/documents/providers/payment-policies/np-pa-
    comm

Quintero-Howard, C. (2019). Child and Adult Psychiatry Business Plan Template. Townson, MD reimbursement rates for mental health treatments sample essays.

NURS 6670

Reimbursement Rate Template

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Type of Service

eg. -New office visit

-Established office visit

-Inpatient hospital

-individual psychotherapy

-group psychotherapy (see examples below)

CPT code

Private insurer reimbursement rate for PMHNP

Private insurer reimbursement rate for physicians

Medicare

reimbursement rate for PMHNP

reimbursement rates for mental health treatments sample essays

Medicare

reimbursement rate for physician

 

Psychiatric diagnostic evaluation

 

90791

 

Psychiatric diagnostic evaluation with medical services

 

90792

 

Electroconvulsive therapy (includes necessary monitoring)

 

90870

 

Psychological testing

 

96101

reimbursement rates for mental health treatments sample essays

 

Neuropsychological testing battery

 

96118

 

As the PMHNP becomes proficient in diagnosing and treating, it is also important to learn how to bill for your time. The CMS sets up codes to identify the type of service you are providing. You will generally complete this task at the end of the visit as you are documenting the visit with the client. Here are examples of the codes to know: reimbursement rates for mental health treatments sample essays.

CPT Codes for Psychiatric and Psychological Procedures

 

HMSA recognizes the following service codes for the reporting of psychiatric and psychological services. (See
Code Books
for information on how to obtain the books.) reimbursement rates for mental health treatments sample essays.

 

CPT Code

Footnote(s)

Description

90791

1

Psychiatric diagnostic evaluation

90792

1,3

Psychiatric diagnostic evaluation with medical services

90832

2

Psychotherapy, 30 minutes with patient and/or family member

90833

2,3

Psychotherapy, 30 minutes with patient and/or family member when performed with an evaluation and management service

90834

4

Psychotherapy, 45 minutes with patient and/or family member

90836

3,4

Psychotherapy, 45 minutes with patient and/or family member when performed with an evaluation and management service

90837

6

Psychotherapy, 60 minutes with patient and/or family member

90838

3,6

Psychotherapy, 60 minutes with patient and/or family member when performed with an evaluation and management service

90839

6

Psychotherapy for crisis; first 60 minutes reimbursement rates for mental health treatments sample essays

90840

2

each additional 30 minutes

90846

4

Family psychotherapy (without the patient present)

90847

4

Family psychotherapy (conjoint psychotherapy) (with patient present)

90849

4

Multiple-family group psychotherapy

90853

4

Group psychotherapy (other than of a multiple-family group)

90870

1, 5

Electroconvulsive therapy (includes necessary monitoring)

96101

1

Psychological testing (includes psychodiagnostic assessment of personality, psychopathology, emotionality, intellectual abilities, e.g., WAIS-R, Rorschach, MMPI) with interpretation and report, per hour. reimbursement rates for mental health treatments sample essays

Note:
All hours of psychological testing done on a single day will be counted as one visit (either inpatient or outpatient as appropriate) toward the patient’s inpatient or outpatient visit maximum. However, payment will be made to the participating provider on a per-hour basis.

96118

1

Neuropsychological testing battery (e.g., Halstead-Reitan, Luria, WAIS-R) with interpretation and report, per hour

 

Note:
All hours of psychological testing done on a single day will be counted as one visit (either inpatient or outpatient as appropriate) toward the patient’s inpatient or outpatient visit maximum. However, payment will be made to the participating provider on a per-hour basis reimbursement rates for mental health treatments sample essays.

Links to websites that discuss this:

https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement

http://www.mb-guide.org/medical-coding-guidelines.html

reimbursement rates for mental health treatments sample essays

Quality of life self care wheel scores sample essay paper

Part 2: How Am I Doing?

Balancing School and Life – My Quality of Life Self-Care Plan. The purpose of developing this Plan is to set a framework and a plan to maintain wellness and to stay motivated and engaged throughout your Program. Doing this will help you achieve success during your coursework and as a professional nurse.

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The goal of the Project is to help you become self-aware and reflective as a means of identifying personal self-care strategies that will increase your energy and help you manage your stress. The Project will give you a chance to learn how this is accomplished as you will be doing similar work with clients during the Program and as a professional nurse to assist them in the same way.

Share in a 2 page paper, the following:

Re-look at your Quality of Life Self-Care Wheel scores. Have they changed? If so, in what ways.

Think about your current levels of tension and stress. On a scale of 1-10 with 10 being the highest level, what is your score? Now think about the strategies you identified. Describe how well you have put them into action. If you have not been able to implement them, identify why and what you can do to overcome this. Quality of life self care wheel scores sample essay paper.

Identify any new strategies that you think will ”fit” better and describe why.

Minimum length 2 pages not including cover or referencing. APA formatting

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.Save your assignment as a Microsoft Word document. (Mac users, please remember to append the ’.docx’ extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below: Quality of life self care wheel scores sample essay paper.

How Am I Doing?

My current scores on the “Quality of life self-care wheel” stand at 7. This is a 2 point change from the last time I evaluated my scores at 5. Although this score is short of my target of 9, I believe that I am moving in the right direction with regards to balancing my school and social life as well as managing my tension and stress levels. In fact, I have now developed a better understanding of myself as an individual, particularly the aspects of who I am that include social, spiritual, emotional, occupational, intellectual, and physical wellness features. Firstly, I have improved my social wellness by respecting my public interactions and relationships, and putting in effort to get along with the people in my environment. Quality of life self care wheel scores sample essay paper Secondly, I have improved my spiritual wellness by setting 15-minutes every morning to reflect on my spirituality and attending a place of worship once every week to get guidance on the meaning and purpose of my life. This actions have allowed me to establish peace and harmony in my life even as I improve my spiritual wellness. Thirdly, I have improved my emotional wellness by keeping in touch with my emotions through expressing them. Previously, I considered expressing negative emotions as a sign of weakness. Currently, I understand the link between emotions and stress, and am keen on expressing all emotions as a strategy for coping with life challenges.

Fourthly, I have improved my occupational wellness by finding fulfillment in my nursing career and understanding that it has meaning since it will improve the lives of other members of the public. Additionally, I have established a better balance between my leisure and school time so that I am able complete all school activities on time. Fifthly, I have improved my intellectual wellness through answering my curiosity, engaging in creative activities, and critically thinking about any problems I face. In fact, I now understand that learning is a lifelong endeavor and no individual is ever truly all-knowing such that every person in my environment can be a source of knowledge. As such, I have been more open to new ideas and experiences with the intention of undergoing intellectual growth. Finally, I have improved my physical wellness through healthy habits, nutritional diets and engaging in regular exercise programs. I have become more critical of my overall health and more proactive in achieving a healthy quality of life. In fact, this is perhaps the aspect I have experienced the most improvement in since I have taken charge of my health and made a conscious decision to be healthy. Quality of life self care wheel scores sample essay paper Overall, I believe that keeping to my current plan will allow me to achieve my target score of 9. Still, I have the capacity to achieve my target at a faster speed by incorporating new strategies that complement my current strategies. Firstly, I should share my plan with my close family and friends with the intention of seeking their support and gaining advice on how best to proceed. This will be more effective if I share my plans with the persons who have achieved my targeted goals. Secondly, I will review my current progress and adjust my plan to improve outcomes. Finally, I will access resources from professional wellness institutions and incorporate the appropriate resources into my plan. In this respect, I am doing well with regards to balancing my wellness, but believe that I can do better and achieve my goals at a faster pace by incorporating the three new strategies that complement my current plan Quality of life self care wheel scores sample essay paper.

This Bipolar Disorder Sample Essay – Captain of the Ship Project assignment discusses the management of a client with bipolar I disorder in terms of psychopharmacology and psychotherapy. It also describes the medical management and primary care needs and how best to coordinate with other providers when managing such clients.

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                                          HPI and Clinical Impression for the Client

                       
EO was a 22year-old African American female client who came to the clinic accompanied by her mother with complaints of insomnia for an entire week and a heightened activity state which she thought was out of control. The client is a college sophomore student. The client’s mother mentioned that most of the client’s behaviors were primarily characterized by ideas which were not only strange but also grandiose as the client thinks she is most important to be recognized by everyone in the entire school irrespective of her poor background. The client had proclaimed to her friends that she owns a business given to her by her father and does not need to go to school Bipolar Disorder Sample Essay – Captain of the Ship Project. However, the client is sometimes noted to be begging for money.  When questioned, EO clearly explained that she was unique in a way that she could still lend her colleagues cash from her business.

EO also had bizarre thinking patterns which had a political dimension. The client strongly believed that her soul had been switched with that of the governor of her state. She also explained how she had developed three governmental theories that only she could use to safeguard the US from destruction with nuclear weapons. The client also reported that she believed that she was best suited for a position in government. The client mother also stated that the client kept explaining her thoughts and theories to everyone at school, family and even wrote them on the dormitory walls, her notebooks and computer with the fear of forgetfulness and also started to campaign for an elected post in government though there were no elections scheduled at this time. Although she was well known by family and friends to be highly organized and tidy, lately, most of them had expressed a lot of worry and disbelief to find that she had started being disorganized and frantic.  The client was very talkative and quickly changing the subject during the interview and in a loud tone of voice without realizing, of which she has to be redirected to speak calmly in a low tone. The client mother also reported that the client was noted not to be sleeping well and will argue and have elevated moods swings and angry at most times, thereby affecting her not to focus on her academic studies.  These behavior patterns especially with the manic episode and others above had be going on for the past two months.

It is imperative to know that the client grew up in an overprotective environment with very demanding parents. Apart from being a passively obedient child, EO never applied makeup as her mother forbade her. The client was also noted to have an angry mood when young at the age of 10 years and will fight with his mother. The client had a positive family history of mood disorders. The client’s paternal grandfather had at once received electroconvulsive therapy for depression and her maternal aunt was once diagnosed with depression when she was going through menopause

Objective: Mental Status Examination

           
The client is a moderately built African American female. Gait is intact and has fair eye contact. Language is intact. Speech is pressured in rate and rhythm, and fast pace. The thought process is logical, slightly goal-directed and tangential. Association is loose, alert and oriented to person, place, time and situation. Concentration is poor. Mood and affect is expansive elation and irritation and anger at times when confronted. Affect is full of a range of expression and talkativeness, euphoria, and intolerance to criticism. Insight and judgment are guarded (American Psychiatric Association. 2013).

Diagnosis

           
The client experience if manic episode lasted for at least one week with the strange mood of persistently elevated, expansive and irritable mood. It was noted above that the manic client behavior and other behavior dysfunction was sufficiently severe to cause extreme impairment in her social functioning.  The client shows grandiosity, with poor concentration, distractibility, psychomotor agitation and lack of sleep.  Based on the DSM –IV criteria, the client behavior symptoms above fall under Bipolar I disorder (Koirala & Anand, 2018).

Recommended Psychopharmacologic Treatments

           
Considering the client’s (EO) Bipolar I diagnosis, the severity of her symptoms and family history, I, as a PMHNP, would strongly recommend the prescription of an antipsychotic and a mood stabilizer. The best two drugs to prescribe for the client, in this case, would be Seroquel and lithium as the mood stabilizer. Lithium is a mood stabilizer which works by altering the sodium transport in nerve and muscles, and it also influences the reuptake of norepinephrine and serotonin. Lithium will, therefore, help to subside the client’s manic symptoms and it might take one to three weeks for a therapeutic effect. The Seroquel will also assist in the psychotic symptoms to calm the patient (Ketter, Miller, Dell’Osso & Wang, 2016).

On the other hand, if the initial planned psychopharmacologic treatment above fails, then an antidepressant will be introduced. A lot of preference would not be given to starting the client on large-scale antidepressants since most scientific studies have demonstrated that for most patients with bipolar I, combining antidepressants to mood stabilizers is very effective as compared to management using only a mood stabilizer. However, practitioners have to be cautious when augmenting lithium with antidepressant as antidepressants can destabilize the client’s mood as well as the induction of rapid cycling or suicidal ideation After four weeks if EO fails to show treatment progress, an antidepressant, preferably SSRI (Prozac) will be added to the prescribed drugs (Stahl, 2014b).

Recommended Psychotherapy Choices

The objective of psychotherapy is to increase the patient’s adherence to medications and to offer social, emotional and psychological support apart from linking up the patient with appropriate resources within the community. The most suggested form of therapy for this patient will be group cognitive behavioral therapy (CBT).  CBT will help the client to change her irrational thoughts and dysfunctional behavioral patterns. Through group interactions, the client will be able to face her fears as compared to practicing avoidance and will develop more effective strategies to maintain calmness and relaxation (Ye et al., 2016).

Medical Management Needs, Primary Care Needs and Community Support Resources

           
It will be necessary to connect with the patient’s primary care physician (PCP) as this will promote effective communication to know about the client’s progress. Baseline laboratory investigations will be needed to ascertain whether the patient can efficiently take the prescribed medications. They include liver profile, complete blood count and a kidney function test.  It is likely that the drugs prescribed will influence some side effects. As recommended by Francisco López-Muñoz et al. (2018), the client needs to be educated about to ensure compliance with medication.  The client will also be connected to community support groups such as those which are supported by Mental Health America, as well as Depression and Bipolar Support Alliance (DBSA) (Behler, Daniels, Scott & Mehl-Madrona, 2017).

Plan for Follow-up and Collaboration with Other Providers

           
The client’s follow-up visit will be scheduled in a week for a start. The purpose of this follow up appointment will be to assess the client’s tolerance to the prescribed medications. The significant issues that will be assessed include compliance to medications and adjustment of the dosages. After that, the next follow-up visits will be scheduled for four weeks. It is essential to note that the client will be instructed to begin psychotherapy the same week with medications and weekly attend to other sessions. It will be necessary to maintain communication with the client’s therapist and PCP for continuous monitoring (Malhi, 2016).

Conclusion

           
The client’s prognosis was unremarkable. The client has managed to regain her social and functional status and to maintain previous relationships that existed with friends and family at this time. In clinical practice, bipolar disorders present a lot of challenges when it comes to diagnosis and management such that, misdiagnosis or mismanagement can easily result in poor prognosis and mental health outcomes. Good treatment outcomes are also associated with a strong and long term therapeutic relationship that is characterized by openness and constant communication (Sadock, Sadock & Ruiz, 2014).

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders (5th ed.). Washin gton, DC: Author

Behler, J., Daniels, A., Scott, J., & Mehl-Madrona, L. (2017). Depression/Bipolar Peer Support Groups: Perceptions of Group Members about Effectiveness and Differences from Other Mental Health Services.
Qualitative Report
,
22
(1), 213. Retrieved from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=120800845&site=eds-live&scope=site

Ketter, T. A., Miller, S., Dell’Osso, B., & Wang, P. W. (2016). Treatment of bipolar disorder: Review of evidence regarding quetiapine and lithium.
Journal Of Affective Disorders
,
191
, 256–273. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jad.2015.11.002Koirala, P., & Anand, A. (2018). Diagnosing and treating bipolar disorder in primary care. 
Cleveland Clinic journal of medicine
, 
85
(8), 601-608.

Francisco López-Muñoz, Winston W. Shen, Pilar D’Ocon, Alejandro Romero, & Cecilio Álamo. (2018). A History of the Pharmacological Treatment of Bipolar Disorder.
International Journal of Molecular Sciences
, (7), 2143. https://doi-org.ezp.waldenulibrary.org/10.3390/ijms19072143.

Malhi, G. S. (2016). Bipolar disorders: key clinical considerations.
The Lancet
, (10027), 1492. https://doi-org.ezp.waldenulibrary.org/10.1016/S0140-6736(15)01045-4.

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

Stahl, S. M. (2014b).
The prescriber’s guide
(5th ed.). New York, NY: Cambridge University

Press

Ye, B. Y., Jiang, Z. Y., Li, X., Cao, B., Cao, L. P., Lin, Y.,  & Miao, G. D. (2016). The effectiveness of cognitive behavioral therapy in treating bipolar disorder: An updated meta‐analysis with randomized controlled trials. 
Psychiatry and clinical neurosciences
, 
70
(8), 351-361.

Assignment 1-WK7

Captain of the Ship Project – Obsessive-Compulsive Disorders

In earlier weeks, you were introduced to the concept of the “captain of the ship.” In this Assignment, you become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with an obsessive-compulsive disorder.

Learning Objectives

Students will:

• Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with obsessive-compulsive disorders

• Recommend psychotherapy based on therapeutic endpoints for clients with obsessive-compulsive disorders

• Identify medical management needs for clients with obsessive-compulsive disorders

• Identify community support resources for clients with obsessive-compulsive disorders

• Recommend follow-up plans for clients with depression disorders

QUESTION

To prepare for this Assignment:

• Select an adult or older adult client with an obsessive-compulsive disorder you have seen in your practicum.

In 3–4 pages, write a treatment plan for your client in which you do the following:

• Describe the HPI and clinical impression for the client.

• Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)

• Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.

• Identify medical management needs, including primary care needs, specific to this client

(NOTE IF IIT IS A FELAEE BEARING CHILD CHECK FOR PREGNANACY TEST BEFORE ORDERING ANY DRUG )

• Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.

• Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

Learning Resources

Required Readings

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

Standard 14 “Professional Practice Evaluation” (pages 80-81)

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 10, “Obsessive-Compulsive and Related Disorders” (pp. 418–436)

Gabbard, G. O. (2014).
Gabbard’s treatment of psychiatric disorders
(5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 21, “Obsessive-Compulsive Disorder”

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

American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author Bipolar Disorder Sample Essay – Captain of the Ship Project.

“Obsessive-Compulsive and Related Disorders”

Note:
You will access this book 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 below. 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. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

 

To access information on specific medications, click on
The Prescriber’s Guide, 5th Ed
. tab on the Stahl Online website and select the appropriate medication.

 

 

Obsessive-compulsive disorder

citalopram

clomipramine

escitalopram

fluoxetine

fluvoxamine

paroxetine

sertraline

venlafaxine

vilazodone

Thompson-Hollands, J., Edson, A., Tompson, M. C., & Comer, J. S. (2014). Family involvement in the psychological treatment of obsessive-compulsive disorder: A meta-analysis.
Journal of Family Psychology, 28
(3), 287–298. doi:10.1037/a0036709

 

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

Required Media

Bruce, T. & Jongsma, A. (Producers). (n.d.)
Evidence-based treatment planning for obsessive compulsive disorder
[Video file]. Mill Valley, CA: Psychotherapy.net.

 

Note:
The approximate length of this media piece is 64 minutes. You will access this video from the Walden Library databases Bipolar Disorder Sample Essay – Captain of the Ship Project.

Optional Resources

Himle, J. A., Chatters, L. M., Taylor, R. J., & Nguyen, A. (2013). The relationship between obsessive-compulsive disorder and religious faith: Clinical characteristics and implications for treatment.
Spirituality in Clinical Practice, 1
(S), 53–70. doi:10.1037/2326-4500.1.S.53

Wheaton, M. G., Rosenfield, D., Foa, E. B., & Simpson, H. B. (2015). Augmenting serotonin reuptake inhibitors in obsessive–compulsive disorder:
What moderates improvement? Journal of Consulting and Clinical Psychology, 83
(5), 926–937. doi:10.1037/ccp0000025

This assignment discusses the management of a client with bipolar I disorder in terms of psychopharmacology and psychotherapy. It also describes the medical management and primary care needs and how best to coordinate with other providers when managing such clients. Bipolar Disorder Sample Essay – Captain of the Ship Project.

                                          HPI and Clinical Impression for the Client

                       
EO was a 22year-old African American female client who came to the clinic accompanied by her mother with complaints of insomnia for an entire week and a heightened activity state which she thought was out of control. The client is a college sophomore student. The client’s mother mentioned that most of the client’s behaviors were primarily characterized by ideas which were not only strange but also grandiose as the client thinks she is most important to be recognized by everyone in the entire school irrespective of her poor background. The client had proclaimed to her friends that she owns a business given to her by her father and does not need to go to school. However, the client is sometimes noted to be begging for money.  When questioned, EO clearly explained that she was unique in a way that she could still lend her colleagues cash from her business.

EO also had bizarre thinking patterns which had a political dimension. The client strongly believed that her soul had been switched with that of the governor of her state. She also explained how she had developed three governmental theories that only she could use to safeguard the US from destruction with nuclear weapons. The client also reported that she believed that she was best suited for a position in government. The client mother also stated that the client kept explaining her thoughts and theories to everyone at school, family and even wrote them on the dormitory walls, her notebooks and computer with the fear of forgetfulness and also started to campaign for an elected post in government though there were no elections scheduled at this time. Although she was well known by family and friends to be highly organized and tidy, lately, most of them had expressed a lot of worry and disbelief to find that she had started being disorganized and frantic.  The client was very talkative and quickly changing the subject during the interview and in a loud tone of voice without realizing, of which she has to be redirected to speak calmly in a low tone. The client mother also reported that the client was noted not to be sleeping well and will argue and have elevated moods swings and angry at most times, thereby affecting her not to focus on her academic studies.  These behavior patterns especially with the manic episode and others above had be going on for the past two months.

It is imperative to know that the client grew up in an overprotective environment with very demanding parents. Apart from being a passively obedient child, EO never applied makeup as her mother forbade her. The client was also noted to have an angry mood when young at the age of 10 years and will fight with his mother. The client had a positive family history of mood disorders. The client’s paternal grandfather had at once received electroconvulsive therapy for depression and her maternal aunt was once diagnosed with depression when she was going through menopause

Objective: Mental Status Examination

           
The client is a moderately built African American female. Gait is intact and has fair eye contact. Language is intact. Speech is pressured in rate and rhythm, and fast pace. The thought process is logical, slightly goal-directed and tangential. Association is loose, alert and oriented to person, place, time and situation. Concentration is poor. Mood and affect is expansive elation and irritation and anger at times when confronted. Affect is full of a range of expression and talkativeness, euphoria, and intolerance to criticism. Insight and judgment are guarded (American Psychiatric Association. 2013) Bipolar Disorder Sample Essay – Captain of the Ship Project.

Diagnosis

           
The client experience if manic episode lasted for at least one week with the strange mood of persistently elevated, expansive and irritable mood. It was noted above that the manic client behavior and other behavior dysfunction was sufficiently severe to cause extreme impairment in her social functioning.  The client shows grandiosity, with poor concentration, distractibility, psychomotor agitation and lack of sleep.  Based on the DSM –IV criteria, the client behavior symptoms above fall under Bipolar I disorder (Koirala & Anand, 2018).

Recommended Psychopharmacologic Treatments

           
Considering the client’s (EO) Bipolar I diagnosis, the severity of her symptoms and family history, I, as a PMHNP, would strongly recommend the prescription of an antipsychotic and a mood stabilizer. The best two drugs to prescribe for the client, in this case, would be Seroquel and lithium as the mood stabilizer. Lithium is a mood stabilizer which works by altering the sodium transport in nerve and muscles, and it also influences the reuptake of norepinephrine and serotonin. Lithium will, therefore, help to subside the client’s manic symptoms and it might take one to three weeks for a therapeutic effect. The Seroquel will also assist in the psychotic symptoms to calm the patient (Ketter, Miller, Dell’Osso & Wang, 2016) Bipolar Disorder Sample Essay – Captain of the Ship Project.

On the other hand, if the initial planned psychopharmacologic treatment above fails, then an antidepressant will be introduced. A lot of preference would not be given to starting the client on large-scale antidepressants since most scientific studies have demonstrated that for most patients with bipolar I, combining antidepressants to mood stabilizers is very effective as compared to management using only a mood stabilizer. However, practitioners have to be cautious when augmenting lithium with antidepressant as antidepressants can destabilize the client’s mood as well as the induction of rapid cycling or suicidal ideation After four weeks if EO fails to show treatment progress, an antidepressant, preferably SSRI (Prozac) will be added to the prescribed drugs (Stahl, 2014b).

Recommended Psychotherapy Choices

The objective of psychotherapy is to increase the patient’s adherence to medications and to offer social, emotional and psychological support apart from linking up the patient with appropriate resources within the community. The most suggested form of therapy for this patient will be group cognitive behavioral therapy (CBT).  CBT will help the client to change her irrational thoughts and dysfunctional behavioral patterns. Through group interactions, the client will be able to face her fears as compared to practicing avoidance and will develop more effective strategies to maintain calmness and relaxation (Ye et al., 2016). Bipolar Disorder Sample Essay – Captain of the Ship Project.

Medical Management Needs, Primary Care Needs and Community Support Resources

           
It will be necessary to connect with the patient’s primary care physician (PCP) as this will promote effective communication to know about the client’s progress. Baseline laboratory investigations will be needed to ascertain whether the patient can efficiently take the prescribed medications. They include liver profile, complete blood count and a kidney function test.  It is likely that the drugs prescribed will influence some side effects. As recommended by Francisco López-Muñoz et al. (2018), the client needs to be educated about to ensure compliance with medication.  The client will also be connected to community support groups such as those which are supported by Mental Health America, as well as Depression and Bipolar Support Alliance (DBSA) (Behler, Daniels, Scott & Mehl-Madrona, 2017). Bipolar Disorder Sample Essay – Captain of the Ship Project.

Plan for Follow-up and Collaboration with Other Providers

           
The client’s follow-up visit will be scheduled in a week for a start. The purpose of this follow up appointment will be to assess the client’s tolerance to the prescribed medications. The significant issues that will be assessed include compliance to medications and adjustment of the dosages. After that, the next follow-up visits will be scheduled for four weeks. It is essential to note that the client will be instructed to begin psychotherapy the same week with medications and weekly attend to other sessions. It will be necessary to maintain communication with the client’s therapist and PCP for continuous monitoring (Malhi, 2016) Bipolar Disorder Sample Essay – Captain of the Ship Project.

Conclusion

           
The client’s prognosis was unremarkable. The client has managed to regain her social and functional status and to maintain previous relationships that existed with friends and family at this time. In clinical practice, bipolar disorders present a lot of challenges when it comes to diagnosis and management such that, misdiagnosis or mismanagement can easily result in poor prognosis and mental health outcomes. Good treatment outcomes are also associated with a strong and long term therapeutic relationship that is characterized by openness and constant communication (Sadock, Sadock & Ruiz, 2014).

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders (5th ed.). Washin gton, DC: Author

Behler, J., Daniels, A., Scott, J., & Mehl-Madrona, L. (2017). Depression/Bipolar Peer Support Groups: Perceptions of Group Members about Effectiveness and Differences from Other Mental Health Services.
Qualitative Report
,
22
(1), 213. Retrieved from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=120800845&site=eds-live&scope=site

Ketter, T. A., Miller, S., Dell’Osso, B., & Wang, P. W. (2016). Treatment of bipolar disorder: Review of evidence regarding quetiapine and lithium.
Journal Of Affective Disorders
,
191
, 256–273. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jad.2015.11.002Koirala, P., & Anand, A. (2018). Diagnosing and treating bipolar disorder in primary care. 
Cleveland Clinic journal of medicine
, 
85
(8), 601-608. Bipolar Disorder Sample Essay – Captain of the Ship Project.

Francisco López-Muñoz, Winston W. Shen, Pilar D’Ocon, Alejandro Romero, & Cecilio Álamo. (2018). A History of the Pharmacological Treatment of Bipolar Disorder.
International Journal of Molecular Sciences
, (7), 2143. https://doi-org.ezp.waldenulibrary.org/10.3390/ijms19072143.

Malhi, G. S. (2016). Bipolar disorders: key clinical considerations.
The Lancet
, (10027), 1492. https://doi-org.ezp.waldenulibrary.org/10.1016/S0140-6736(15)01045-4.

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

Stahl, S. M. (2014b).
The prescriber’s guide
(5th ed.). New York, NY: Cambridge University

Press

Ye, B. Y., Jiang, Z. Y., Li, X., Cao, B., Cao, L. P., Lin, Y.,  & Miao, G. D. (2016). The effectiveness of cognitive behavioral therapy in treating bipolar disorder: An updated meta‐analysis with randomized controlled trials. 
Psychiatry and clinical neurosciences
, 
70
(8), 351-361. Bipolar Disorder Sample Essay – Captain of the Ship Project.

Nursing Care Models Sample essay paper

Read your text, Finkelman (2016), pp- 111-116.

Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability. (I’m an OB nurse)

Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model.

Write a 5 page paper that includes the following:

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Review and summarize two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting.

Review and summarize two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.

Discuss your observations about how the current nursing care model is being implemented. Be specific. Nursing Care Models Sample essay paper.

Recommend a different nursing care model that could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.

Provide a summary/conclusion about this experience/assignment and what you learned about nursing care models.

Write your Nursing Care Models Sample essay paper using APA format using Microsoft Office 2010 or later

 

NR447 Nursing Care Models Paper Rubric

 

Criteria

Ratings

Pts

Nursing Care Model in Practice

(Identifies Nursing Care Model for delivery of nursing care.  Provides specifics.)

After an introduction paragraph, thoroughly identifies Nursing Care Model in practice including all the specifics about who, what when, where, etc.

60.0 pts

After an introduction paragraph, generally identifies Nursing Care Model in practice including most of the specifics about who, what when, where, etc. Nursing Care Models Sample essay paper

53.0 pts

After an introduction paragraph, briefly identifies Nursing Care Model in practice including minimum specifics about who, what when, where, etc.

48.0 pts

After an introduction paragraph, briefly identifies Nursing Care Model in practice, but describes only one or two specifics.

23.0 pts

Does not provide an introduction paragraph. Fails to identify a Nursing Care Model. Does not include any specifics.

0.0 pts

60.0 pts

Scholarly Sources Related to Nursing Care Model

(In addition to Finkelman, locates four scholarly resources related to Nursing Care Models. Summarizes all resources in body of paper.)

Thoroughly reviews and summarizes two scholarly resources (not including the course textbook) related to the nursing care model you observed in the practice setting. Also, thoroughly reviews and summarizes two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed.

40.0 pts

Generally reviews and summarizes two scholarly resources (not including the course textbook) related to the nursing care model you observed in the practice setting. Also, generally reviews and summarizes two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed.

35.0 pts

Briefly reviews only one resource (besides the course textbook) related to nursing care model observed in practice setting. Also, briefly reviews only one resource (besides text) related to a nursing care model that is different from the one you observed.

32.0 pts

Reviews only one resource (besides the course textbook) related to the nursing care model observed in practice, and fails to review a resource (besides the course textbook) related to a nursing care model that is different from the one you observed.

15.0 pts

Fails to provide any resources related to the nursing care model that was observed and that was different.

0.0 pts

40.0 pts

Implementation and Recommendations

(Describe implementation of current Nursing Care Model and recommend a
different
model that could be utilized to improve quality of nursing care, safety and staff satisfaction.)

Thoroughly describes implementation of current Nursing Care Model and recommends a different model that could be utilized to improve quality of nursing care, safety and staff satisfaction

60.0 pts

Generally describes implementation of current Nursing Care Model and recommends a different model that could be utilized but omits quality or safety or staff satisfaction.

53.0 pts

Briefly describes implementation of current Nursing Care Model and recommends a different model that could be utilized but omits two of the following (quality/safety/staff satisfaction).

48.0 pts

Minimally describes implementation of current Nursing Care Model but does NOT recommend a different model that could be utilized. Various elements are missing related to improving quality of nursing care, safety and staff satisfaction.

23.0 pts

Does NOT describe a Nursing Care Model or a different model that could be utilized. Elements are missing related to improving quality of nursing care, safety and staff satisfaction.

0.0 pts

60.0 pts

Conclusion and summary

(Summarize what you learned about this experience including new knowledge about nursing care models.)

Includes conclusion paragraph and thoroughly summarizes what you learned about this experience including new knowledge about nursing care models.

20.0 pts

Includes conclusion paragraph and clearly summarizes what you learned about this experience including new knowledge about nursing care models.

18.0 pts

Includes conclusion paragraph but briefly summarizes what you learned about this experience or includes new knowledge about nursing care models but not both.

16.0 pts

Conclusion/ summary is present but difficult to find in closing paragraphs of paper.

8.0 pts

Does not Include a conclusion paragraph.

0.0 pts

20.0 pts

Clarity of writing

(Content is organized, logical, and with correct grammar, punctuation, spelling, and sentence structure are correct.  APA formatting is apparent and CCN template is utilized. References are properly cited within the paper; reference page includes all citations; proper title page and introduction are present and evidence of spell and grammar check is obvious.)

Content is organized, logical, and grammar, punctuation, spelling, and sentence structure are correct. APA formatting is apparent, utilizing CCN template. References are properly cited within the paper. Reference page includes all citations; proper title page and introduction are present and evidence of spell and grammar check is obvious. Less than three errors are noted.

20.0 pts

Content is mostly organized, logical, and grammar, punctuation, spelling, and sentence structure are correct. APA formatting is apparent, utilizing CCN template. References are properly cited within the paper. Reference page includes all citations; proper title page and introduction are present and evidence of spell check and grammar check is obvious. Four to six errors are noted.

18.0 pts

Content is somewhat organized, logical and grammar, punctuation, spelling, and sentence structure are correct. Minor APA formatting errors exist. References are properly cited within the paper. Reference page includes all citations; proper title page and introduction are present and evidence of spell check and grammar check are not obvious. Seven to 10 errors are noted.

16.0 pts

Content is somewhat organized, but may lack logic. Several errors occur in grammar, punctuation, spelling, and sentence structure. Major APA formatting errors exist. Reference page does not match up with in-text citations, i.e., references may be missing for in-text citations, or references appear with no comparable in-text citation. Eleven to 15 errors are noted.

8.0 pts

Content is disorganized and writing has numerous grammar, spelling, or syntax errors. APA formatting was not used. Spell check and grammar check are not obvious. More than 15 errors are noted.

0.0 pts

20.0 pts

Total Points: 200.0 Nursing Care Models Sample essay paper

Nursing Care Models Sample essay paper

Introduction

Nursing care models are tools that describe and generalize the approaches applied by nurses on offering their professional services. The intention is to improve resource-use efficiency in minimizing costs and ensuring that nurses are assigned to areas where they are most needed and can offer their best. In fact, nursing care models have been around for as long as nursing has existed as a profession with its galvanization occasioned by the reality that nurses are a limited resource and their education must acknowledge this aspect. Still, improvements in medical technologies and development of new nursing professions have refined the existing models even as new models are presented and implement in both practice and education (Finkelman, 2016). Overall, models are tools that guide the provision of nursing care and practice with emphasis on improving efficiency and reducing costs even as they guide practice and education. Nursing Care Models Sample essay paper. The present analysis acknowledges the existence of nursing models by describing a model in action and offering insight into strategies for improving care outcomes by proposing aspects that can be improved to achieve the overall goal of improving efficiency and reducing costs.

Discussion

As an obstetrics (OB) nurse, I am engaged by a clinic specialized in offering gynecology and obstetrics services to females between their puberty and menopause. In fact, the nursing services I offer revolve around addressing problems with the reproductive system as experienced by females to include pregnancy, labor and delivery. As a result, I work in the clinic’s labor and delivery department.

Observed nursing model: Interdisciplinary model of care

As a practicing OB nurse, I have consistently observed the clinic applying the interdisciplinary model of care in my labor and delivery department. In this case, the department has an interdisciplinary committee that is led by representatives from all clinical and non-clinical professions that work in the department to include nurses and physicians. The committee has the primary task of designing and implementing a patient care delivery system that enhances safety, efficiency and effectiveness. The system has been formalized as a ‘structured three-concentric circle chart’ Nursing Care Models Sample essay paper. The chart’s outer circle is comprised of non-clinical and indirect medical personnel whose input is necessary but do not have any direct contact with the patients. An example is the laboratory personnel who receive biological samples from the direct medical personnel, conduct tests on the samples, then present the results to the attending medical personnel by filling in the patients’ sheets. At no time do the laboratory personnel have any direct contact with the patients. Nursing Care Models Sample essay paper The middle circle is comprised of clinical personnel who have direct contact with the patients to include the attending nurses (charge and floor nurses) and physicians. They engage the patients at the personal level, talk to them, collect biological samples, and monitor their condition even as they prescribe medication and observe outcomes. The innermost circle is comprised of the patients and their family members. It is clear that the model incorporates personnel from different medical occupations and professions designed to meet the required patient needs so that each profession completes a unique part that are then combined to present the whole care. Having the concentric circles has facilitated task assignment since each profession is aware of its unique responsibilities. Additionally, it has facilitated accountability since any positives or negatives can easily be traced to a source (Kaakinen et al., 2015; Porter-O’Grady & Malloch, 2016).

I understand that at the core of this model is the need to emphasize on improving quality by identifying the importance of all professions serving in the department and meeting the inter-professional and inter-disciplinary needs with the intention of enhancing integration, communication, collaboration and cooperation for reliable and continuous care. Having observed the model in action, I believe that it has facilitated the development of practice standards that address each profession’s unique roles. For instance, the responsibilities expected of nurses are well differentiated from the responsibilities expected of physicians and laboratory technicians. Additionally, it has ensured that the department makes full use of the available skills and knowledge. That is because each profession and individual is assigned tasks based on competencies and capabilities. For instance, laboratory personnel offer test results based on their observations while physicians present a diagnosis and prescription based on the test results. Besides that, this model has eliminated redundancies since there are no professional overlaps with each profession responsible for a specific aspect of care. In addition, it has it has improved communication links between all persons involved in the care by establishing clear communication lines. For example, the model identifies the charge nurse as the person to be approached for questions when there are suspected problems with the nursing care. Also, the model has promoted interdisciplinary collaboration. Nursing Care Models Sample essay paper. Overall, I understand that with the increasingly complex needs presented by patients, this model offers a good approach for addressing the needs through a combination of knowledge and expertise with the patient as the focus.

Skill mix model

Other than the interdisciplinary model of care, I believe that the skill mix model would achieve good results for my labor and delivery department by presenting complementary benefits. The skill mix model develops an acceptable balance between productivity and quality. It acknowledges although productivity is useful in determining staffing levels, this is a purely commercial outlook that imposes limits on the time assigned to each patient. The model addresses this concern by optimizing the skills available in a department thus allowing the facility to reduce costs. This is achieved by allowing personnel to practice at the apex of their licenses thus ensuring that the patients receive the best possible care even as greater job satisfaction is achieved among the personnel (Porter-O’Grady & Malloch, 2016). Nursing Care Models Sample essay paper The higher job satisfaction is accompanied by lower turnover rates so that the facility does not need to spend more on the hiring process and orientating new personnel. Similarly, the receive benefits since personnel can now spend more time with them thus improving care outcomes. The skill mix model is particularly useful in environments where complex care is required and staff shortages are being experienced. These conditions are true for my department since offering the gynecology and obstetrics services has been limited by staff shortages. In applying the model, the department would pair the more skilled personnel (who demand high salaries such as registered nurses) with their lesser skilled counterparts (who demand lower salaries such as vocational nurses) to work together following a pre-accepted prototypical plan. The key is to delegate tasks to less skilled personnel under the supervision and direction of their more skilled counterparts. The two groups have the same work schedule with the supervisors acting as clinical preceptors (Porter-O’Grady & Malloch, 2016).

The decision to apply the skill mix model should be galvanized by a facility’s objective of offering high quality care. Nursing care provision is largely dependent on the frontline personnel who must be appropriately skilled and engaged to guarantee that they will complete their tasks seamlessly within a team environment. The reality is that there is a shortage of qualified medical personnel. Additionally, patients’ medical needs are becoming increasingly more complex and require new approaches. Also, medical facilities are faced with increasing pressure to protect their commercial margins by mandating productivity and staffing ratio targets that ignore the overall costs and skills mix thus overburdening the personnel who are employed. Besides that, reimbursement pressures are becoming more unbearable. Despite these challenges, the facility is not exempted from providing high quality nursing care Nursing Care Models Sample essay paper. Optimizing nursing skill mix allows the facility to offer high quality nursing care despite the mentioned challenges since less skilled personnel can be engaged to complete relatively easy tasks to maximize the time spent in patients care. This frees up the more skilled personnel the more complex tasks that only they can complete (Bernamn et al., 2014; Finkelman, 2016). For instance, lobotomy does not require a highly skilled registered nurse and can easily be completed by a well-trained and less skilled vocational nurse. In essence, applying the skill mix model allows the medical personnel to spend more time with the patients at a lower cost without compromising the care quality. This means that optimizing the skill mix (around total costs and patients’ needs) for nurses in my department would allow the facility to deliver high quality, effective and safe nursing care in a fiscally responsible way.

Conclusion

It is not enough to offer professional nursing care to improve patients’ outcomes. Rather, it is imperative to model the care delivery so that it is structured around acceptable medical and education goals. Financial reality and skilled personnel limitations demand that nurse staffing decisions be made with cost and patients’ outcomes as considerations. Interdisciplinary model of care and skill mix model describe two nursing care delivery models that are intended to improve patients’ outcomes. The interdisciplinary model of care promotes interdisciplinary collaboration through combining knowledge and expertise with the patient as the focus. The skill mix model offers a complementary perspective by including a cost perspective since it allows the nursing personnel to spend more time with the patients at a lower cost without compromising the care quality. In this respect, nursing care models propose aspects that can be improved to achieve the overall goal of improving efficiency and reducing costs. Nursing Care Models Sample essay paper.

References

Bernamn, A., Snyder, S., Kozier, B., Erb, G., Levett-Jones, T. … & Stanley, D. (2014). Kozier & Erb’s Fundamentals of Nursing: Australian edition (3
rd
ed.). Melbourne: Pearson Australia.

Finkelman, A. (2016).
Leadership and Management for Nurses: Core competencies for quality care
. London: Pearson Education.

Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A. & Hanson, S. (2015).
Family Health Care Nursing: Theory, practice, and research
(5
th
ed.). Philadelphia, PA: F. A. Davis Company.

Porter-O’Grady, T. & Malloch, K. (2016).
Leadership in Nursing Practice: Changing the landscape of healthcare
(2
nd
ed.). Burlington, MA: Jones & Bartlett Learning. Nursing Care Models Sample essay paper.

Research Article Critique Sample Paper Requirements

Through this Research Article Critique Sample Paper assignment, the student will:

Critique a peer-reviewed study, and in your own words, describe the research question, sample, design of study, data collection method, findings, and limitations of each. (CO 1, CO2,)

Summarize the research article and evaluate the significance to nursing. Do not just quote the author’s words. Paraphrase the information. (CO 4, CO5).

Guidelines to writing the Paper

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Tips on how to complete this assignment may be found at http://www.brainshark.com/devry/vu?pi=zFmz5THHgzHr05z0&intk=406182077 (Links to an external site.)Links to an external site.

Download the Research Article Critique List of Articles (Links to an external site.)Links to an external site. and select ONE to analyze Research Article Critique Sample Paper.

Retrieve the full-text version of the article from the library. Read it thoroughly.

Introduction (one paragraph): The introduction should be interesting and capture the reader’s attention.

Provide a brief description of the research article to be discussed.

Discuss the purpose of your paper. The purpose statement of the paper should relate to the research article reviewed and the implications that it has to evidence based nursing practice.

You will need to summarize and analyze the information from the article in your own words

Describe the research question for this study in a paragraph.

Describe the research in greater detail.

Include your observations about this question. Research Article Critique Sample Paper.

Discuss events or trends that could have affected this question.

You will need to summarize and analyze the information from the article in your own words

Describe the research design of this study, and in your own words discuss the design.

Discuss the research design of the study.

Discuss the strengths and weaknesses of the type of design and hypothesize why the author utilized the design as opposed to others.

You will need to summarize the information from the article in your own words

Describe the sample Research Article Critique Sample Paper.

Briefly describe the sample size used for this study

Make a judgment as to whether the sample size was adequate and defend your answer.

Describe the number or participants and determine if the number of participants was adequate compared to the research question and the intent of the study.

Are these numbers adequate? Discuss gaps in that you identified.

You will need to summarize and analyze the information from the article in your own words

Describe the data collection method(s)’

Who collected the data?

What tools were used?

What were the ethical considerations addressed and discuss gaps you identified.

You will need to summarize and analyze the information from the article in your own words

Describe the limitations of the study.

Identify the limitations within the study

Describe how the limitations could be overcome in subsequent studies

Comment on why limitations are important to list and discuss within a study

You will need to summarize and analyze the information from the article in your own words

Describe the findings reported in the study.

Describe the findings reported in the study

Discuss whether the findings of the study answered the research question posed within the study

Discuss the credibility of the findings

If the findings do not support the research question posed within the study, what do you believe is the reason?

You will need to summarize and analyze the information from the article in your own words

Summary

Summarize important points from the body of your paper including the key components of the Research Article Critique Sample Paper.

Include a statement about the research question and the findings.

Discuss the probability of implementation into practice. Based on these findings, is the evidence that you found on your topic strong enough to suggest a change in practice, or an idea for practice?

End with a concluding statement.

Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, ”How do I know this?” and then cite the source.

Reference Page: The Reference Page should start on a new page (insert a page break). All references should be cited within the body of the paper as (Author, year) and the full reference should be included in APA format on the reference page. A url link alone is not an adequate reference. See the APA Guidelines in Course Resources for examples of properly formatted references. Research Article Critique Sample Paper.

Purpose

The purpose of this assignment is for the student to learn to examine, analyze, critique, and summarize an original research article. Student is to select an article from the Research Article Critique List of Articles (Links to an external site.)Links to an external site.. Open the link to find a choice of articles from which you must choose ONE to complete this assignment.

Course Outcomes

Through this assignment, the student will demonstrate the ability to meet the following course outcomes:

CO1: Examine the sources of evidence that contribute to professional nursing practice. (PO7)

CO2: Apply research principles to the interpretation of the content of published research studies. (POs 4 and 8)

CO4: Evaluate published nursing research for credibility and lab significance related to evidence-based practice. (POs 4 and 8)

CO5: Recognize the role of research findings in evidence-based practice. (POs 7 and 8)

Points

The assignment is worth a total of 175 points.

Rubric

Click to view and download the NR439 Research Article Critique Paper Rubric (Links to an external site.)Links to an external site.Research Article Critique Sample Paper.

Due Date

You are to submit your paper by Sunday 11:59 p.m. MT at the end of Week 6.

Requirements

Through this assignment, the student will:

Critique a peer-reviewed study, and in your own words, describe the research question, sample, design of study, data collection method, findings, and limitations of each. (CO 1, CO2,)

Summarize the research article and evaluate the significance to nursing. Do not just quote the author’s words. Paraphrase the information. (CO 4, CO5).

Guidelines to writing the Paper

Tips on how to complete this assignment may be found at http://www.brainshark.com/devry/vu?pi=zFmz5THHgzHr05z0&intk=406182077 (Links to an external site.)Links to an external site.

Download the Research Article Critique List of Articles (Links to an external site.)Links to an external site. and select ONE to analyze.

Retrieve the full-text version of the article from the library. Read it thoroughly.

Introduction (one paragraph):

The introduction should be interesting and capture the reader’s attention.

Provide a brief description of the research article to be discussed.

Discuss the purpose of your paper. The purpose statement of the paper should relate to the research article reviewed and the implications that it has to evidence based nursing practice.

You will need to summarize and analyze the information from the article in your own words

Describe the research question for this study in a paragraph.

Describe the research in greater detail.

Include your observations about this question.

Research Article Critique Sample Paper Discuss events or trends that could have affected this question.

You will need to summarize and analyze the information from the article in your own words

Describe the research design of this study, and in your own words discuss the design.

Discuss the research design of the study.

Discuss the strengths and weaknesses of the type of design and hypothesize why the author utilized the design as opposed to others.

You will need to summarize the information from the article in your own words

Describe the sample.

Briefly describe the sample size used for this study

Make a judgment as to whether the sample size was adequate and defend your answer.

Describe the number or participants and determine if the number of participants was adequate compared to the research question and the intent of the study.

Are these numbers adequate? Discuss gaps in that you identified.

You will need to summarize and analyze the information from the article in your own words

Describe the data collection method(s)’

Who collected the data?

What tools were used? Research Article Critique Sample Paper.

What were the ethical considerations addressed and discuss gaps you identified.

You will need to summarize and analyze the information from the article in your own words

Describe the limitations of the study.

Identify the limitations within the study

Describe how the limitations could be overcome in subsequent studies

Comment on why limitations are important to list and discuss within a study

You will need to summarize and analyze the information from the article in your own words

Describe the findings reported in the study.

Describe the findings reported in the study

Discuss whether the findings of the study answered the research question posed within the study

Discuss the credibility of the findings

If the findings do not support the research question posed within the study, what do you believe is the reason?

You will need to summarize and analyze the information from the article in your own words Research Article Critique Sample Paper.

Summary

Summarize important points from the body of your paper including the key components of the paper.

Include a statement about the research question and the findings.

Discuss the probability of implementation into practice. Based on these findings, is the evidence that you found on your topic strong enough to suggest a change in practice, or an idea for practice?

End with a concluding statement.

Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, ”How do I know this?” and then cite the source.

Reference Page: The Reference Page should start on a new page (insert a page break). All references should be cited within the body of the paper as (Author, year) and the full reference should be included in APA format on the reference page. A url link alone is not an adequate reference. See the APA Guidelines in Course Resources for examples of properly formatted references Research Article Critique Sample Paper.

 

Research Article Critique Paper Rubric

 

Criteria

Ratings

Pts

Research Question

(Describe, analyze, and summarize the research question for this study your own words.) Research Article Critique Sample Paper

Fully describes, analyzes, and summarizes the research question in detail

20.0 pts

Generally, describes, and analyzes the research question.

18.0 pts

Briefly summarizes the research question, but omits some aspects of the question.

16.0 pts

Incorrectly describes the research question.

8.0 pts

Does not describe the research question.

0.0 pts

20.0 pts

Design of Study

(Describe, analyze, and summarize the research design of this study in your own words.)

Fully describes, analyzes, and summarizes the design of the study in detail.

20.0 pts

Generally, describes, and analyzes the design of the study.

18.0 pts

Briefly summarizes the design of the study, but omits some aspects of the design.

16.0 pts

Incorrectly describes the design of the study.

8.0 pts

Does not describe the design of the study.

0.0 pts

20.0 pts

Sample/Population of the Study

(Describe, analyze, and summarize the sample in your own words.)

Fully describes, analyzes, and summarizes the sample used in the study in detail.

25.0 pts

Generally, describes, and analyzes the sample used in the study.

22.0 pts

Briefly summarizes the sample used in the study, but omits some details.

20.0 pts

Incorrectly describes the sample in the study, or omits major details

10.0 pts

Does not describe the sample used in the study.

0.0 pts

25.0 pts

Data Collection Methods

(Describe, analyze, and summarize the data collection method(s)’ in your own words.)

Fully describes, analyzes, and summarizes all of the data collection methods used in the study.

25.0 pts

Generally, describes, and analyzes the majority of data collection methods used in the study.

22.0 pts

Briefly summarizes and describes parts of the data collection method used in the study.

20.0 pts

Incorrectly describes the data collection method used in the study.

10.0 pts

Does not describe the data collection method used in the study.

0.0 pts Research Article Critique Sample Paper

25.0 pts

Limitations

(Describe, analyze, and summarize the limitations of the study in your own words.)

Fully describes, analyzes, and summarizes the limitations found in the study in detail.

20.0 pts

Generally, describes, and analyzes the limitations found in the study.

18.0 pts

Briefly summarizes the limitations found in the study.

16.0 pts

Incorrectly describes the limitations found in the study.

8.0 pts

Does not describe the limitations found in the study.

0.0 pts

20.0 pts

Findings

(Describe, analyze, and summarize the findings reported in the study in your own words)

Fully describes, analyzes, and summarizes the findings of the study in detail.

20.0 pts

Generally, describes, and analyzes the findings of the study.

18.0 pts

Briefly summarizes the findings of the study.

16.0 pts

Incorrectly identifies the findings from the study

8.0 pts

Does not describe the findings of the study.

0.0 pts

20.0 pts

Summary of Article

(Summarize important points from the body of your paper including the key components of the paper and discuss the probability of implementation into practice.)

Summarizes study in detail and states specific rationale for whether a change in practice is warranted.

25.0 pts

Generally, summarizes study. Gives broad rationale for whether a change in practice is warranted.

22.0 pts

Briefly summarizes study and states rationale for whether a change in practice is warranted.

20.0 pts

Minimally summarizes study. Gives poor rationale for whether a change in practice is warranted.

10.0 pts

Does not summarize study and does not give rationale for whether a change in practice is warranted.

0.0 pts

25.0 pts

Grammar, Punctuation, and Spelling/ APA Formatting

(No errors in grammar, punctuation, spelling, and APA formatting.)

No errors in grammar, punctuation, APA, and spelling.

20.0 pts

One to four errors in grammar, spelling.

18.0 pts

Five to eight errors in grammar, spelling, and syntax.

16.0 pts

Nine to twelve errors in grammar, spelling, and syntax.

8.0 pts

Thirteen or more errors to the point where it is difficult to understand the meaning of the student’s writing.

0.0 pts

20.0 pts

Total Points: 175.0 Research Article Critique Sample Paper

 

The Personality Profile and Short‑term Treatment Outcome in Patients with Alcohol Dependence (Case Study of South India)

The Personality Profile and Short‑term Treatment Outcome in Patients with Alcohol Dependence (Case Study of South India)

Introduction

Alcohol misuse and addiction are rampant world over with grave impacts to the affected. Notably, global alcohol abuse contributes to 4% of all deaths and atleast 5% of global toll on disease burden. However, even more alarming is the substance’s growing prevalence in India with the daily use at 9.4% while the weekly intake stands at a high of 26.7%. Besides, at least 17% of the countries neuropsychiatric disorders are attributed to alcohol. Nonetheless, studies on alcohol have extensively focused on the environment related risk factors and the correlation between alcohol abuse and personality. Moreover, Soundararajan, et al. (2017) observes that studies on the correlation between alcohol and personality have centered on other countries without any case study in the Indian context. Further, there are few studies investigating the correlation between treatment outcome and personality.

Intending to fill this research gap, Soundararajan, et al. (2017) conducted a study investigating the correlation between Personality and alcohol dependence, which unveiled illuminating results. The study results highlighted that the extroverts are at a higher risk of alcohol indulgence and relapse. Consequently, the research input is essential to the evidence based nursing practitioners since it points out personality as influencing the treatment outcome in alcohol related cases. In this regard, this paper provides an in depth review of the study, critique and the studies significance to nursing practice. Research Article Critique Sample Paper.

Research question,

The study investigated the role of personality in facilitating alcohol abstinence or contributing to relapse. In this regard, underlining the study’s primary objective, the key research questions can be deduced as; does personality influence alcohol abstinence or relapse? As such, treatment outcome was the study’s dependent variable while personality was the independent variable. For example, the study assumed that in alcohol abuse cases the outcome (either relapse or abstinence) was influenced by an individual’s personality. However, the study could also be said to have intervening variables. Simply defined, intervening variables are other factors likely to influence the dependent variable. Possible intervening variables in this study include the social demographic factors such as age, education level, religion, and economic status, all of which are likely to influence alcohol abstinence or relapse.

Design of study,

The study employed the prospective research design. In prospective design, the researcher selects test subjects and watches them for a set period. Further, in prospective design the level of exposure is investigated at the on set of the study after which consequent development is tracked. In our case, the researcher recruited 99 participants who were assessed for alcohol dependence (exposure) after which they were then followed up after three months. Research Article Critique Sample Paper. Arguably, prospective design is more accurate in data collection compared to the retrospective design, since it hurbors few areas of possible biases. Research Article Critique Sample Paper. In this regard, the researcher was assured of higher accuracy after eliminating or limiting possible selection bias. To this end by enacting a multitude of measures including NEO personality inventory (NEO‑PI‑R), SWL, mini‑international neuropsychiatric interview (MINI), and alcohol use disorders identification test (AUDIT) played a significant role to eliminate possible selection biases.

However, the design is mainly criticized as ineffient due to the long period for follow up before collection of results. Moreover, since the inferences from the results are largely association rather than causian the design is argued to inhibits certainty of the underlying premise. For instance, there is lack of certainty on the possible correlation between personality and treatment outcome in our case since it is not clear to what extent other an assessed factors might have influenced the results Research Article Critique Sample Paper.

Research Sample

In our case, the sample constituted 99 participants who underwent the baseline exposure assessment. The sample was spread across various demographics including age gender, religion, marriage, economic status among others. This sample was adequate for this study since it had incorporated representatives from various demographics. However, the study might have failed to  assess the question under study effectively considering that the relapse as a variable was derived from an assumption that the 17 participants who could not be reached for the three moth followup constituted the relapsers. In this regard, the researcher inference was extensively generalised without consideration that other factors such as relocation may have contributed to the participants unavailability for follow up.

Data collection method

Participants in the study were outsourced from in- patient and outpatients units of a rehabilitation facility in India using prospective design. The primary data collection tool was the questionnaire. However, phone interviews were also conducted in cases where the patients could not avail themselves for the three months follow up. For the purpose of record, the researchers took the respondents socio demographic data on the first visit. Consequently, the participants were followed up for 3 months and administered with questionnaires for feedback. Additionally, alcohol use identification tests were carried out to assess relapsers and abstainers. However, since the participants were outsourced by simply meeting the inclusion criteria, some might have felt coerced into taking part in the study. In this regard, there was need to brief the participants about the study. Research Article Critique Sample Paper Besides, the families of the participants should have been briefed to facilitate the treatment process of the participants.

Limitations of the study

Since not all of the participants availed themselves for follow up, the assumption that the unavailable participants constituted the relapsers was in adequate. As such, the credibility of the research findings cannot be guaranteed to be 100 percent correct. Additionally, the death of three of the participants due to complications resulting from withdrawal also affected the credibility of the research findings. However, in future, researchers need to outsource participants who can be easily accessed and monitored for instance in patients from institutions such as rehabilitation centers. Besides, not only should the participation be voluntary but the participants should also be sensitized and briefed on the importance of progressing with the research. Research Article Critique Sample Paper. Nonetheless, the limitations in any study help future studies to fill gaps experienced by previous researchers. Moreover, recommendations from previous studies go a long way in facilitating and enhancing, and coming up with suggestions of prospective areas of study.

Research Article Critique Sample Paper Findings

In the study, out of the 99 participants with a mean age of age of 37 (±8.36) years, 82 of them were assessed after 3 months. Extraversion traits correlated to alcohol problems, with participants with high activity exhibiting successful treatment outcomes. Additionally, there was a significant variation between abstainers and relapsers with majority of the relapsers being from the lower socio-economic class. However, there was no significant correlation between relapsers and heavy initial drinking. Finally, there was a significant variation between relapsers and abstainers with regard to age at first drinking. Research Article Critique Sample Paper.

In this regard, the findings of the study showed that there was a correlation between personality traits with alcohol misuse and relapse in India. However, the credibility of the findings could be affected by telephonic follow up since their feedback could not be verified  Nonetheless, considering that a big percentage of the participants availed themselves for  follow up, the relevance of the finding is still valid.

Summary

From the study, it is evident that there is a correlation between alcoholism and personality traits primarily extraversion. In this regard, extroverts exhibiting high activity are prone to higher risks of alcohol misuse, which in turn has been argued as inhibiting abstinence. However, other factors such as initial heavy drinking, early drinking, emotional distress, and economic instabilities were at play. For instance, in the study, approximately three fifths of the participants who had experienced suicidal thoughts relapsed Research Article Critique Sample Paper.

The study has a significant impact to the evidence based nursing practitioners. For instance, the study illustrates a possible influence of personality on the treatment outcome. Research Article Critique Sample Paper. As such, nursing practitioners can infer the possibility of success of a selected intervention in alcohol related cases. Notably, the practitioners are most likely to conduct a thorough assessment of a patient’s personality with heightened focus on the patients deemed to be possessing extrovert traits Research Article Critique Sample Paper. Moreover, besides studying personality traits of victims, the study recommends that clinicians should give more focus to patients with anxiety comorbid social disorders to improve treatment outcomes.

 

References

Soundararajan S, Narayanan G, Agrawal A, Murthy P. (2017). Personality profile and short-term treatment outcome in patients with alcohol dependence: A study from South India. Indian J Psychol Med; 39:169-75.Retrieved from, http://www.ijpm.info on Friday, March 31, 2017, IP: 202.177.173.189 Research Article Critique Sample Paper

DECs, Baccalaureate Essentials, QSEN & IOM competencies Case study Essay paper
.

This Discussion Board is designed to assist the RN-BSN integrate the Texas Differentiated Essential Competencies (DECs), Baccalaureate Essentials, QSEN & IOM competencies into their future professional nursing practice. Using the Standards of Professional Performance (ANA’s Nursing: Scope and standards of practice, pages 5-6), the DECs, Baccalaureate Essential IX, and the QSEN & IOM competency; Teamwork and Collaboration/Work in Interdisciplinary Teams, students will read and analyze a case study to determine the differences in care provided by the Associated degree prepared registered nurse and the Baccalaureate degree prepared registered nurse; list 2 safety factors associated with the patient in the case study and measures to be taken to protect both the patient and nurse from harm or injury; and in addition identify key interdisciplinary team members who should be DECs, Baccalaureate Essentials, QSEN & IOM competencies Case study Essay paper

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C
ASE S
TUDY:C
OMPARISON OF ADN
AND BSN P
RACTICE &A
PPLICATION OF T
EXAS

DEC
S,QSEN&IOMC
OMPETENCIES

D
ISCUSSION B
OARD

A 72 year old male (Mr. J) arrives at the emergency department complaining of shortness of breath for the past four days. He states, “My breathing is getting worse, I can’t seem to catch my breath and I get short of breath all the time.”  Mr. J. goes on to state, “It seems to get worse when I lay down or when I have to get up and move about.”  Mr. J. also complains of a night time cough, reports increased swelling in both his legs and states, “My feet are so swollen I can’t wear my shoes so I had to come here in my slippers.” DECs, Baccalaureate Essentials, QSEN & IOM competencies Case study Essay paper. He went on to say, “When I weighed myself this morning I noticed I’ve gained weight, especially around the abdomen.” Even worse he goes on to say, “I can’t seem to button my pants around the waist. When asked how long the swelling has occurred, he reports, “I started to gain weight about three weeks ago after the doctor took me off my Lasix.”

The patient has a history of hypertension, chronic renal insufficiency, and chronic respiratory infections. He has recently completed a round of Rituximab for follicular CD20-positive non-

Hodgkin’s lymphoma.  His vital signs are as follows: BP 210/106, HR 118, RR 26, T 98.2.  The patient presents with rales in both lung bases bilaterally and 2+ pitting edema in the lower extremities bilaterally.  The patient is in no acute respiratory distress but indicates he feels better when he sits up.  His oxygen saturation is 95%. DECs, Baccalaureate Essentials, QSEN & IOM competencies Case study Essay paper.

 

Step 1, Initial posting: 

Using the Standards of Professional Performance (ANA’s Nursing: Scope and standards of practice, pages 5-6), the Texas Differentiated Essential Competencies (DECs), highlight and discuss the differences between how an Associate degree prepared nurse and a Baccalaureate degree prepared nurse would provide care for this patient, support your posting with two professional peer-reviewed journals.

 

AACN Essential IX, Baccalaureate Program Preparation statement number 12 indicates a graduate is prepared to “create a safe care environment that results in high quality outcomes.” Identify 2 safety concerns for this patient and list corresponding measures a Baccalaureate prepared nurse might take to prevent harm or injury to either the patient or himself/herself? DECs, Baccalaureate Essentials, QSEN & IOM competencies Case study Essay paper.

 

Both the QSEN and IOM competencies highlight the importance of teamwork and collaboration/work in interdisciplinary teams. What five members of the interdisciplinary teams would you expect to be part of this patients’ care and why? Support your answer.

 

Comparing ADN and BSN Practices

Part 1.

Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN) present two routes through which individuals can acquire registered nursing (RN) qualification. Still, that is as far as their similarities go. For one, ADN qualification is acquired from a two to three-year program whereas BSN qualification is acquired from a four-year baccalaureate program. This means that BSN graduates are better prepared to address patients’ needs when compared to their ADN counterparts since they are more knowledgeable having attended school for longer with more courses (Williams, 2013). In fact, BSN graduates take on more professional responsibilities since their curriculum allows them to implement solutions as it emphasizes evidence-based practice and leadership as opposed to ADN that does not emphasize the same aspects of nursing care. This means that ADN graduates are unable to take on proactive roles as they would magnify human errors within the context of poorly designed nursing systems. By taking on a proactive nursing leadership role, BSN graduates can identify the circumstances in which preventable errors occur and put measures in place to change workflows to ensure favorable outcomes for the patients (American Sentinel University, 2014). DECs, Baccalaureate Essentials, QSEN & IOM competencies Case study Essay paper.

Part 2. 

Based on the case study, two safety concerns can be identified. Firstly, the patient’s positioning must be corrected to avoid respiratory distress. He reports that he experiences shortness of breath when standing or lying down to imply that sitting upright relieves the distress. As such, the nurse should have the patient sitting upright to avoid continued distress. Secondly, the patient’s legs should be elevated to reduce the fluid pressure on the lower extremities and subsequent edema. Finally, an orderly should be engaged to facilitate the patient’s movement since he appears heavy and has difficulty in moving. Having a nurse move the patient or leaving the patient move on his own could result in additional injury. Addressing the three concerns as mentioned ensures that the patient’s case does not worsen even as diagnosis proceeds before an appropriate treatment is recommended.

Part 3. 

The patient’s interdisciplinary care team would comprise of a doctor, nurse, orderly, laboratory technician, and pharmacist. The doctor conducts the patient’s examination and recommends tests to be conducted before presenting a diagnosis and treatment plan. The nurse receives the patient and implements a care plan that proceeds until the patient is discharged. The orderly manages the patient’s movement and positioning. The laboratory technician conducts the tests as recommended by the doctor DECs, Baccalaureate Essentials, QSEN & IOM competencies Case study Essay paper. The pharmacist dispenses medication based on the doctor’s prescription.

References

American Sentinel University (2014).
How Does Your Nursing Degree Affect Patient Mortality Rates?
Retrieved from http://www.americansentinel.edu/blog/2014/06/04/how-does-your-nursing-degree-affect-patient-mortality-rates/

Williams, I. (2013).
Find the Black Box: Prevent needless hospital deaths
. Bloomington, IN: iUniverse LLC.

This Discussion Board is designed to assist the RN-BSN integrate the Texas Differentiated Essential Competencies (DECs), Baccalaureate Essentials, QSEN & IOM competencies into their future professional nursing practice. Using the Standards of Professional Performance (ANA’s Nursing: Scope and standards of practice, pages 5-6), the DECs, Baccalaureate Essential IX, and the QSEN & IOM competency; Teamwork and Collaboration/Work in Interdisciplinary Teams, students will read and analyze a case study to determine the differences in care provided by the Associated degree prepared registered nurse and the Baccalaureate degree prepared registered nurse; list 2 safety factors associated with the patient in the case study and measures to be taken to protect both the patient and nurse from harm or injury; and in addition identify key interdisciplinary team members who should be DECs, Baccalaureate Essentials, QSEN & IOM competencies Case study Essay paper

Root cause analysis examples in healthcare case study essay

Complete required Root Cause Analysis Chart; and fishbone diagram pertaining to the systems and processes associated with Mr. Jones’s issues and write a 2 page Plan of action addressing the question ” What can be done to prevent a similar incident?” root cause analysis examples in healthcare case study essay.

Personal Philosophy of Helping Essay

A Personal Philosophy of Helping – Midterm Assignment

1.Describe your personal philosophy of helping using your personal and professional life experiences. Integrate your values, beliefs, and ethics

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A. Personal Experiences:

What or whom has been a driving force in formulating your personal helping philosophy?

B. Professional Experiences:

Discuss the impact of nay professional experience (employment, volunteer etc.) that was influential in shaping or creating your philosophy.

2. How do you integrate your beliefs, values and ethics in your personal philosophy of helping? How will or how has your personal values impacted on your role as a professional social worker?

3. Discuss why you have chosen to become a professional social worker.

Note: This ia a self relfective paper. The paper should demonstrate self-awarenesss and also integrate some of the material discussed in class. Personal Philosophy of Helping Essay.

Grading Criteria:

Did the paper include a reflection on the role of personal experiences in shaping the student’s philosophy?

Did the paper include a reflection on the role of professional experiences in shaping the student’s philosophy?

Did the paper dlearly define the student’s actual philosophy of what helping is?

did the paper clearly define how helping is achieved from te students personal perspective?

Did the student explain her personal values/belief system? Personal Philosophy of Helping Essay

Did the student reflect on how these personal values and beliefs may impact thir work with clients?

Did the student discuss how they formed the desire to become a social worker?

Was the paper clearly written and well organized?

Was the paper grammatically and typographically correct?

Does the paper follow APA guidelines Personal Philosophy of Helping Essay

Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) of 2010 provided comprehensive healthcare reform intended to improve healthcare access, contain healthcare costs, and improve healthcare delivery in the United States. In June 2012, the Supreme Court upheld virtually all of the provisions of ACA in a case that questioned its constitutionality. Review the major provisions of the ACA and then respond to the questions below.

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Do you agree with the Supreme Court decision? Support your response.

What do you believe some of the challenges will be in implementing the provisions of the Patient Protection and Affordable Care Act of 2010? Patient Protection and Affordable Care Act.

Nursing and Counseling Theories essay

Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.

Explain why you selected Psychoanalysis/Psychodynamic Theory and Peplau’s nursing theory. Support your approach with evidence-based literature within last five years.

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Develop at least three goals and at least three objectives for the practicum experience in this course.

Create a timeline of practicum activities based on your practicum requirements listed below.

Week 2:You will write about two clients from a family you observed or counseled. (Assignment to be submitted by Day 7 of Week 4)

Week 3: You will complete a comprehensive client family assessment. (Assignment to be submitted by Day 7 of Week 4) Nursing and Counseling Theories essay.

Week 5: You will write about two clients from a family you observed or counseled and explain whether solution-focused or cognitive behavioral therapy would be effective with the family. (Assignment to be submitted by Day 7 of Week 7)

Week 7: You will write a progress note and privileged psychotherapy note for the client family you assessed in Week 3 for the comprehensive client family assessment. (Assignment to be submitted by Day 7 of Week 7.)

Week 8: You will write about two clients you observed or counseled during a group therapy session and explain whether cognitive behavioral therapy would be effective with the group. (Assignment to be submitted by Day 7 of Week 10)

Week 10: You will write about two clients you observed or counseled during a group therapy session for children and adolescents. (Assignment to be submitted by Day 7 of Week 10)

Week 10: You will write a client termination summary for a client who is ready to complete group therapy. (Assignment to be submitted by Day 7 of Week 11) Nursing and Counseling Theories essay.