Category: Nursing

Nursing Leadership Health Policy Paper

Details:

The IOM Future of Nursing report calls for an increase in leadership from nurses at all levels. One way nurses demonstrate their role as a leader, is through public policy change. A leader does not always carry an official title or position, but demonstrates leadership through the work and the stance the leader takes to make a change for the good of others. Nurses have been noted by the Gallop poll year after year as the most trusted professionals.

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This assignment requires thought about a public policy that is needed or needs to be changed that relates to nursing, health care, or the public. Policy changes can occur by working with members of your legislature, and state or national nurses associations, to introduce a new bill and/or change to a current law in your state or federal government Nursing Leadership Health Policy Paper.

Examples of public policy includes any component of the current legislation governing health care, Medicare Part D, Medicaid, nursing regulation, medication technicians, etc.

In 750-1,000 words, propose a health policy change (that is currently a bill, a law, or may not exist at all) at the state or federal level that you believe needs to change and why.

The policy must not be a clinical care policy for individual care. The policy involved may include public or community health, legislative or regulatory, professional organization (nursing-oriented), advanced nursing practice, health plan, or hospital plan Nursing Leadership Health Policy Paper.

Include a specific section for the exact wording for the bill or change in wording of the law.

Include the plan for the implementation of your policy development, to lobbying for passage, to next steps after passage.

Discuss who would be the champion for the bill/law change from your state advocates (legislators, federal legislators, local or national state nursing organizations). Are these individuals also influential in making changes occur? Did you vote for the individual in office that you want to help you make this change? Nursing Leadership Health Policy Paper.

Resources:

Review different pieces of legislation for ideas on wording.

Visit your state’s legislative governmental affairs website site to understand the process your policy change could take if you wanted to introduce to into legislation.

 

Legislative Change

The policy must not be a clinical care policy for individual care. The policy involved may include public or community health, legislative or regulatory, professional organization (nursing-oriented), advanced nursing practice, health plan, or hospital plan. Include a specific section for the exact wording for the bill or change in wording of the law.

The Medicare Prescription Drug, Improvement, and Modernization Act that was passed in 2003 presents a policy for managing Medicare. The legislation added a new section (Part D) to the Medicare Program that allowed private entities to be reimbursed by Medicare for prescription drugs they provide to Medicare beneficiaries. Although the new legislation offers greater benefits for the beneficiaries, it presents an opportunity for fraud. This is particularly true when claims are made for improper rebates, red-lining, enrollment fraud, overcharging, and duplicate billing (False Claims Act, 2018) Nursing Leadership Health Policy Paper. The implication is that the legislation has a glaring loophole that can easily be exploited through fraud.

The loophole in the legislation should be addressed through institutional changes that include greater oversight, inclusion, and control from a body comprised of representatives from all stakeholders, with stricter checks and double verification systems. In fact, there is a need to revise the legislation by calling for mandatory institutional changes. This conceptualized change is best understood by exploring the causes of fraud in health care. Harris (2015) mentions that greater control, inclusion and oversight should minimize the opportunities for fraud in medical care. This assessment is based on the fact that these measures would improve healthcare efficiency and competitiveness while encouraging good governance, values and norms (Harris, 2015).

Emanuel (2014) mentions that although fraud is considered a vice by most stakeholders, there are those who embrace the practice and would be resistant to any change that eliminates fraud. This is especially true for the health care industry where both personnel and facilities readily participate in fraudulent activities in quid pro quo trade that sees benefits flowing both ways. For instance, some medical facilities earn substantial profits from fraudulent Medicare claims that they then share with the personnel who facilitated the earnings. This makes it clear that there is a need to consider the distinguishing features of both personnel and facilities (along with other stakeholders in the medical industry). The consideration helps in defining how the stakeholders would apply their strategic plans. For example, it would show how a facility that benefits from fraud would react to legislative efforts to curb fraud (Emanuel, 2014).

Political economists confirm that fraud is resultant of resource scarcity and limited competition. In fact, a succinct assessment shows that weak governance enables fraud. Case in point, some facilities are pressured by their environment to enable fraud as a salient industry practice. In such cases, the facilities that do not enable fraud may finds that they position becomes insecure within the industry with some of them being targeted (Teitelbaum & Wilensky, 2013) Nursing Leadership Health Policy Paper. In this respect, the proposed change to the legislation would entail including a clause that calls for mandatory institutional changes (greater oversight, inclusion, and control) with stricter checks and double verification systems to reduce the opportunities for fraud. In essence, the proposed legislative change argues that adequate oversight and regulation through the current legislation’s loopholes will allow for greater accountability, oversight and regulation to reduce the opportunities for fraud Nursing Leadership Health Policy Paper.

Include the plan for the implementation of your policy development, to lobbying for passage, to next steps after passage.

The first step in implementing the policy development is to explore the existing problem. In this case, the shortcomings in the current legislation must be identified and explored with the opportunities for fraud well highlighted. Next, a range of solutions are developed through exploring literature and holding discussion. This is followed by identifying the most viable solution with the best chance of succeeding. The solution is then framed as a legislation and further explored for its value in solving the existing problem. The key stakeholders would then be identified, focusing on the persons with the potential to influence legislative activities. Lobbying for the legislative change would ensure whereby these stakeholders are approached to improve their buy in into the proposed legislative change Nursing Leadership Health Policy Paper. Once their stakeholders support is garnered, the proposed legislative change would then be presented to the appropriate legislative assemblies (such as Congress) to discuss the change and pass it based on its merits. The final step would be to implement the legislative change to include monitoring in action.

Discuss who would be the champion for the bill/law change from your state advocates (legislators, federal legislators, local or national state nursing organizations).

The champion for the legislative change would be legislators. That is because their primary responsibility is to ensure that public resources are allocated to areas that are most in need. By eliminating opportunities for fraudulent Medicare claims, legislators are able to save the funds that would then be allocated towards other healthcare needs. Nursing Leadership Health Policy Paper.

Are these individuals also influential in making changes occur?

It is notable that legislators are influential in making the change occur since their official responsibility is to debate legislation, discarding those without public merit and passing those with public merit.

Did you vote for the individual in office that you want to help you make this change?

Although I did not vote for my legislator, this will not influence whether or not I would receive help. That is because the legislator is a publicly elected official who is accountable to the whole electorate and would evaluate the proposed change based on its merits and demerits Nursing Leadership Health Policy Paper.

References

Emanuel, E. (2014).
Reinventing American Health Care: How the Affordable Care Act will improve our terribly complex, blatantly unjust, outrageously expensive, grossly inefficient, error prone system
. New York, NY: Public Affairs Publications.

False Claims Act (2018).
Health Care Fraud and False Claims
. Retrieved from https://www.falseclaimsact.com/common-types-of-fraud/health-care-fraud

Harris, M. (2015).
Handbook of Home Health Care Administration
(6
th
ed.). Burlington, MA: Jones & Bartlett Learning.

Teitelbaum, J. & Wilensky, S. (2013).
Essentials of Health Policy and Law
(2
nd
ed.). Sunbury, MA: Jones & Bartlett Learning Nursing Leadership Health Policy Paper.

Conflict and Collaboration essay

Purpose

This week’s graded discussion topic relates to the following Course Outcomes (COs).

CO 2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO 3)

CO 3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO 7)

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[MUSIC] Thank you for agreeing to talk to me about the discussion we had the other day about assigning patient load. As I started to say in the meeting but got interrupted, it is that I really don’t like the new plan that we have. I like the old one better and I don’t understand why we need to change Conflict and Collaboration essay.

I think that they expressed one concern about visiting patients in Iron Ridge.And that is the key as they were with high crime rate. We all recognize this issue. I do understand, but the new patient assignment scheme is meant to match you with a patient who will most benefit from your specialty and not where you live geographically.

There are many patients in Iron Ridge who have diabetes that need your expertise. [BLANK_AUDIO] Well, I really do love my patients, and I don’t hold it against them that they live in a bad part of town Conflict and Collaboration essay. But frankly, I’m afraid.Every night when I watch the news, there’s somebody that’s been involved in a shooting or a carjacking.

At times the needs of our families conflict with our work responsibilities. Could this possibly be the underlying issue here?

Explain the conflict resolution skills displayed by the leader in the scenario. On a scale of 1-10, how would you rate those of the leader.

How might earlier collaboration have been beneficial? What other leadership skills should be used? Conflict and Collaboration essay.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

Practice Issue Worksheet Directions

A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.

Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..

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Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.

Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions.

Your practice issue will be the same for all three Milestone assignments in this course.

Please type your answers directly into the worksheet. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Evidence Summary Worksheet Directions

Develop an evidence summary by following the grading criteria below.

Document this on the evidence summary portion of the worksheet.

You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.

Please type your answers directly into the worksheet.

Guidelines

Purpose

Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star Model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. The evidence summary will be conducted through the ‘breaking down’ of a systematic review on your topic for your change project.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO4)

CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO8)

Due Dates

Milestone 1 consists of the completion of ONE form with two worksheets. Complete both worksheets and submit the form (Attached)

You are required to use the linked article (
under order 201804) and Worksheets or you will earn a “0” for the assignment. In addition, assignments that do not follow the current guidelines or use the required Worksheet or article will be evaluated for evidence of an academic integrity violation.

Practice Issue Worksheet Directions

Choose the 
ONE
systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List( submitted under order 201804)

Follow the grading criteria below to formulate your practice issue, 
which must be based on the topic of the systematic review you have selected
.

Download the required worksheets (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions. –
Attached

Your practice issue will be the same for all three Milestone assignments in this course.

Please type your answers directly into the worksheet Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Evidence Summary Worksheet Directions

Develop an evidence summary by following the grading criteria below.

Document this on the evidence summary portion of the worksheet.

You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.

Please type your answers directly into the worksheet.

Rubric

NR451_Milestone_1_2

NR451_Milestone_1_2

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomePractice Issue Statement, Scope of Practice, Practice Area

Identifies a practice issue statement that is an independent nursing decision, and is relevant to the systematic review topic chosen from among the approved list provided in the course. Describes the scope of practice issues. Example: The number of falls in your facility has been increasing, especially during shift change. What do you believe may be causing this? Are there any new interventions that could be put into place that would lessen or eliminate the falls? This is where you begin your initial search into the problem or practice issue identified. Identifies the practice area.

20.0 pts

Practice issue is identified based on the approved systematic review topic chosen. Practice issue is an independent nursing decision. Scope of practice issue is fully described. Practice area identified.

18.0 pts

Practice issue is identified but is not clear, however it is based on the approved systematic review topic chosen. Practice issue is an independent nursing decision. Scope of practice issue is described in simple terms. Practice area identified.

16.0 pts

Practice issue is identified but is not clearly related to a nursing practice issue, however it is based on the approved systematic review topic chosen. Practice issue is not an independent nursing decision. Scope of practice issue is described but is not clear. Practice area identified.

8.0 pts

Practice issue is unclear. Practice issue is not based on the approved systematic review topic. Practice Issue is not an independent nursing decision. Scope of practice issue is not described. Practice area identified.

0.0 pts

Practice issue is not identified; practice issue is not an independent nursing decision; scope of practice issue is not described; practice area is not identified.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

20.0 pts

This criterion is linked to a Learning OutcomePractice Issue-Rationale for Selections

Identifies how rationale behind how the practice issue was selected as a practice issue/problem. Documents the practice issue in a logical manner.

35.0 pts

Identifies and documents what types of evidence is needed for review. Thoroughly describes rationale for all checked types of evidence selected.

31.0 pts

Identifies and documents what types of evidence is needed for review. Briefly describes rationale for all checked types of evidence selected.

28.0 pts

Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence.

13.0 pts

Does not document more than one type of evidence that is needed for review and does not include rationale for selected type of evidence.

0.0 pts

Does not document types of evidence or rationale.

35.0 pts

This criterion is linked to a Learning OutcomeTypes of Evidence Gathered-Rationale for Selections

Identifies and documents types of evidence that must be gathered for review of the Practice Issue. Describes rationale for each type of evidence that is selected.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

20.0 pts

Identifies and documents what types of evidence is needed for review. Thoroughly describes rationale for all checked types of evidence selected

18.0 pts

Identifies and documents what types of evidence is needed for review. Briefly describes rationale for all checked types of evidence selected.

16.0 pts

Identifies and documents what types of evidence is needed but includes only a minimum description for rationale for selected evidence.

8.0 pts

Does not document more than one type of evidence that is needed for review and does not include rationale for selected type of evidence.

0.0 pts

Does not document types of evidence or rationale.

20.0 pts

This criterion is linked to a Learning OutcomePractice Problem Description

States practice problem in own words, with reference to the population, setting, and magnitude and in measurable terms. Describes practice setting in measureable terms. Example: Consider the example given in the evidence summary above. The setting is the long term care facility where falls have been increasing and a trend has been identified that it seems to occur mainly during shift change. What do you believe may be causing this? What can be done to lessen or eliminate the falls? How does this number of falls relate to other months that have been tracked?

10.0 pts

-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is identified -Magnitude of problem is discussed. -The practice issue is stated in measurable terms.

9.0 pts

-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is discussed. -The practice issue is stated in measurable terms.

8.0 pts

-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is not discussed. -The practice issue is stated in measurable terms.

4.0 pts

-Practice problem is in own words, with reference to the population of interest. -Setting of the problem is not discussed. -Magnitude of problem is not discussed. -The practice issue is stated but not measurable.

0.0 pts

-Practice problem is not in own words -There are no references to the population of interest. -Setting and magnitude of problem is not discussed -The practice issue is not stated in measurable terms.

10.0 pts

This criterion is linked to a Learning OutcomeSource(s) of Evidence

Identifies a source of evidence that is a nursing topic and is the subject of a systematic review article. Provides a complete reference for the systematic review article that was chosen from the list, as well as any optional scholarly source in support of the project topic.

20.0 pts

Full Marks

-Source is a Systematic Review article chosen from the approved list (plus optional scholarly article of support). Complete APA formatted reference(s) is given for with no errors. The source (s) must be relevant to the practice issue identified.

18.0 pts

-Source is a Systematic Review article chosen from the approved list (plus optional scholarly article of support). -A reference is given, but it has APA formatting errors. -The source must be relevant to the practice issue identified.

16.0 pts

-Source is a Systematic Review article chosen from the approved list. (plus optional scholarly article of support). -No reference is provided. -The source must be relevant to the practice issue identified.

8.0 pts

-Source of evidence is a research article or systematic review not on the approved list. -A reference for the article or systematic review is given. -The source is not relevant to the practice issue identified.

0.0 pts

-Source of evidence is not provided, or is not a research article or systematic review. -Reference is missing.

20.0 pts

This criterion is linked to a Learning OutcomeArticle Objectives/Statement of Questions

Identifies the objectives of the article. Identifies questions being addressed by author/s. Explains relationship to the chosen practice issue

20.0 pts

-Objectives of article are identified. -Questions addressed by author/s are thorough. -Relationship to your practice issue is explained.

18.0 pts

-Objectives of article are identified. -Questions addressed by author/s are explained but not thorough. -Relationship to your practice issue is explained.

16.0 pts

-Objectives of article are identified. -Questions addressed by author/s are not thorough. -Relationship to your practice issue is vague.

8.0 pts

-Objectives of article are identified. -Questions addressed by author/s is missing. -Relationship to your practice issue is not explained.

0.0 pts

-Objectives of article are not identified. -Questions addressed in article and relationship to own practice is not identified.

20.0 pts

This criterion is linked to a Learning OutcomeInterventions/Main Findings Summary

Summarizes, in own words, suggested interventions by the author/s to improve patient outcomes. Summarizes main findings of the author/s including strength of evidence for each main outcome. Describes the relevance to the Milestone 2 paper.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

30.0 pts

-Thoroughly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Thoroughly summarized main findings of the author/s. -Included strength of evidence for each main outcome.

26.0 pts

-Briefly summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Briefly summarized main findings of the author/s. -Included strength of evidence for each main outcome.

24.0 pts

-Vaguely summarized (in their own words) the interventions the author(s) suggest to improve patient outcomes. -Vaguely summarized main findings of the author/s. -Included strength of evidence for most of main outcomes.

11.0 pts

-Summary of interventions is not in own words. -Summarized main findings of the author/s is not apparent. -Did not include strength of evidence for any of the main outcomes.

0.0 pts

-Summary of the interventions the author(s) suggest to improve patient outcomes is missing. -Summary of the main findings of the author is missing. -The strength of the evidence for outcomes are missing.

30.0 pts

This criterion is linked to a Learning OutcomeEvidence-based Solutions and Limitations

Outlines evidence-based solutions to consider for the capstone project. Discusses any limitations to the studies included in the systematic review that he/she believes may impact use of the evidence provided in their project

20.0 pts

-Outline of evidence-based solutions considered for project is documented and clear. Discussed any limitations to the studies performed. Documents limitations believed may impact use in project.

18.0 pts

-Outline of evidence-based solutions being considered for project is documented but not clear. Discussed any limitations to the studies performed. Documents limitations believed may impact use in project.

16.0 pts

-Outline of evidence-based solutions considered for project is documented but not clear. Discussed most limitations to the studies performed. Documents limitations believed may impact use in project.

8.0 pts

-Outline of evidence-based solutions being considered for project is not documented. -Discussed most limitations to the studies performed. Documents limitations believed may impact use in project.

0.0 pts

-Outline of evidence-based solutions, limitations of studies and potential impact to project is missing.

20.0 pts

Total Points: 175.0

NR451_W3_Milestone1_Worksheets

Capstone Project Milestone 1:

Practice Issue and Evidence Summary Worksheets

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

 

Student Name:
                                                        
Date:

Directions

Refer to the guidelines for specific details on how to complete this assignment.

Type your answers directly into the worksheets below.

Submit to the Dropbox by the end of Week 3, Sunday at 11:59 p.m. MT.

Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response.

 

Practice Issue Worksheet

 

List the topic and include the citation for the systematic review you have selected from our approved list (optional: an additional scholarly source of support):

Health-Associated Infection

Cooper, F., Alexander, C., Sinha, S. & Omar, M. (2016). Policies for replacing long-term indwelling urinary catheters in adults.
Cochrane Database of Systematic Reviews
, 2016(7), Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2

What is the nursing practice issue you have identified related to the topic you have chosen?

The nursing practice issue to be addressed is whether or not incorporating antibiotic prophylaxis when using long-term indwelling urinary catheters reduces the incidence of symptomatic bacteruria for adults’ patients with lower urinary tract problems. As a result, it intends to answer the question: In adults with lower urinary tract problems, does the use of long-term indwelling urinary catheters in combination with antibiotic prophylaxis, versus indwelling urinary catheters used in isolation, affect the incidence of symptomatic bacteruria over a period of three months?

Fully describe the scope of the practice issue:

Nurses are typically advised to use antibiotics with caution, particularly when facing the possibility of resistance development. Still, for adult patients suffering from lower urinary tract problems and using long-term indwelling urinary catheters, the catheters present an additional risk of infection. That is because they act as avenues for infection, especially from repeated handling. Despite the warning linked with antibiotics use, analysis shows that reducing the risk of infection is the best outcome for the patient. Antibiotic prophylaxis improves the capacity for preventing infection, thus presenting a good possibility for application by nursing personnel Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

What is the practice area?

_X_
Clinical

___ Education

___ Administration

___ Other (List):

How was the practice issue identified?
(check all that apply)

___ Safety/risk management concerns

_X_
Unsatisfactory patient outcomes

___ Wide variations in practice

___ Significant financial concerns

 

 

___ Difference between hospital and community practice

_X_
Clinical practice issue is a concern

___ Procedure or process is a time waster

___ Clinical practice issue has no scientific base

__ Other:

Describe the rationale for your checked selections:

Using catheters increases the risk of the patients’ acquiring opportunistic infections. As such, the research intends to show that using antibiotic prophylaxis can reduce the risk of acquiring opportunistic infection.

What evidence must be gathered?
(check all that apply)

_X_
Literature search

___ Guidelines

_X_
Expert Opinion

___ Patient Preferences

_X_
Clinical Expertise

___ Financial Analysis

___ Standards (Regulatory, professional, community)

___ Other

 

Describe the rationale for your checked selections:

A literature search will be conducted to understand how past publications view the current topic.

Expert opinion and clinical expertise will be collected to understand how nursing personnel understand the problem. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

 

Evidence Summary Worksheet

Directions
: Please type your answers directly into the worksheet.

 

Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms:

Even when used in clear environments, catheters still present a route for opportunistic infection. This occurs through regular handling by the nursing personnel. The risk for infection is higher among adult patients suffering from lower urinary tract problems since their immune system appears compromised and they can easily be infected. As such, it is prudent to adopt a proactive approach by using antibiotic prophylaxis that effectively prevents the possibility of opportunistic infection.

Type the complete APA reference for the systematic review article you chose from the list provided. It must be relevant to the practice issue you described above. Include the APA reference for any additional
optional
supplemental scholarly source related to the review you wish to use.

Cooper, F., Alexander, C., Sinha, S. & Omar, M. (2016). Policies for replacing long-term indwelling urinary catheters in adults.
Cochrane Database of Systematic Reviews
, 2016(7), Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2

Identify the objectives of the article:

The article intended to determine the effectiveness different policies for replacing long-term indwelling urinary catheters in adults.

Provide a statement of the questions being addressed in the work and how these relate to your practice issue:

The article answer the question of whether there are any differences in the outcomes from the different policies applied in replacing long-term indwelling urinary catheters in adults. This is an acknowledgement that each policy presents a risk of infection although at different levels. This shows that even with the best policy, there is still some risk of infection Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. By including antibiotic prophylaxis, the risk of infection is greatly reduced.

Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.

The article concludes that the best policy for replacing urinary catheters must take into account certain factors that include the patients’ satisfaction, quality of life, type of trauma on the urinary tract, economics, replacement method used, environment-specific performance difference at home and hospital, catheter replacement strategy, and lubrication used.

Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome.  Consider the relevance to your project proposal for the Milestone 2 project paper
.
(If an
optional
supplemental source is also used, include a statement of relevance to it as well.)

The article makes it clear that additional evidence is required before a conclusion can be reached. More information must be collected on the different policies for a complete evaluation.

 

Outline evidence-based solutions that you will consider for your project
.

The project considers the position that antibiotic prophylaxis can play in reducing the possibility of infection so that the differences in policies for handling catheters become of less significance.

Discuss any limitations to the studies that you believe impacts your ability to utilize the research in your project.

The major study limitation will be how to decide from among the many types of antibiotics that are available in the market. In essence, there are many pathogens that can cause infection. Using the many types of antibiotics on a single patient is unrealistic, while using one type means that the prophylaxis does not offer protection against the other types of antibiotics Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

 

Capstone Project Milestone 2: Design for Change Proposal

Purpose

You are to create a Design for Change proposal inclusive of your Practice Issue and Evidence Summary worksheet from your Capstone Project Milestone 1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program.

Course Outcomes

This assignment enables the student to meet the following course outcomes.

CO1: Applies the theories and principles of nursing and related disciplines to individuals, families, aggregates, and communities from entry to the healthcare system through long-term planning. (PO1)

CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO2)

Rubric

Click to view and download the 
NR451 Milestone 2: Design for Change Proposal Rubric (Links to an external site.)Links to an external site.
.

Points

Milestone 2 is worth 
225 points
.

You are required to use one of the required articles from the Week 3 Milestone 1 assignment or you will earn a “0” for the assignment. In addition, assignments that do not follow the current guidelines or use the required article will be evaluated for evidence of an academic integrity violation.

After the due date, there will be no opportunity for revision or resubmission of assignments that have been uploaded to the submission area. It is your responsibility to submit the correct assignment to the correct submission area.

Directions

A tutorial with tips for completing this assignment may be viewed at 
https://atge.webex.com/atge/ldr.php?RCID=b0c912eaf53b4aabb1347a026466c60e(Links to an external site.)Links to an external site.

Review the feedback you received from your instructor for Milestone 1, and use it to develop this milestone.

Create a proposal for your Design for Change Capstone Project. Open the recommended assignment specific 
Milestone 2 Design Proposal Template(Links to an external site.)Links to an external site.
. Use this to write your paper. You will include the information from Milestone 1, your practice issue and evidence summary worksheets, as you compose this proposal. Your plan is to convince your management team of a practice problem you have uncovered that is significant enough to change current practice.

The format for this proposal will be a paper following the 
Publication manual of APA
6 
th

The paper is to be four- to six-pages excluding the Title page and Reference page.

As you organize your information and evidence, include the following topics.

Introduction:
Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the 
Publication manual of the American Psychological Association 
(2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Change Model Overview: 
Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members.

Evidence: 
Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.

Translation: 
develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.

Conclusion: 
Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.

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. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.

Tables and Figures may be added
as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Title

Your Name

Chamberlain College of Nursing

NR451 RN Capstone Course

Term and Year

 

Your title here

This paragraph(s) is to introduce the paper. State the problem and potential solutions backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly APA assignment so
you cannot use first person
. Remember also that you will keep all the bolded headings and just remove the non-bolded content when you start your paper.

Change Model Overview

In this first paragraph, provide an overview of the ACE Star model Evidence-Based Practice Process. Feel free to state why nurses should use this model as a guide to facilitate change. Under each of the second level headers listed below, you now link your identified topic to the ACE Star model EBP Process.

Define the Scope of the EBP

Restate your practice issue. Why is this a problem? Give statistics and information to back the scope of the problem at your facility/work area. How does this problem impact healthcare on a broader scale?

Stakeholders

You will be the leader of the team since this is your project. Who will you also include in your team? Make sure you choose relevant stakeholders. You should have no more than eight members. Do not list your team members by name but instead by position (pharmacists, charge nurse, etc.).

Determine Responsibility of Team Members

Why are the members chosen important to your project? What are their roles?

Evidence

Conduct internal/ external search for evidence. What type of evidence did you find in addition to you Evidence Summary? EBP guidelines? Quality improvement data? Position statements? Clinical Practice Guidelines?  Briefly discuss the strength of this research. This is
not
where you describe the results of your studies. This is done in the following steps.

Summarize the Evidence

In this section, you need to synthesize the information from the systematic review article. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use? Be sure and cite all of your references, in proper APA format, from any and all articles into this one paragraph.

Develop Recommendations for Change Based on Evidence

What is your recommendation based on the research? Ideally, you will have found enough support in your evidence to proceed with implementing your pilot program. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Translation

Action Plan

You have not implemented your project yet, therefore, this section will be hypothetical. Develop your plan for implementation. What are the specific steps you will take to implement your pilot study?  What is the timeline for your plan? Make sure you include a plan for evaluation of outcomes and method to report the results.

Process, Outcomes Evaluation and Reporting

What are the desired outcomes? How will they be measured? How will you report the results to the key stakeholders?

Identify Next Steps

How will you implement the plan on a larger scale? Will this be applicable to other units or the facility as a whole? What will you do to ensure that the implementation becomes permanent?

Disseminate Findings

How will you communicate your findings internally (within your organization) and externally (to others outside of your organization)? Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Conclusion

Provide a clear and concise summary. Review the key aspects of the problem as well as the change model. Be sure to include important aspects of the five points of the ACE Star change model EBP process and ways to maintain the change plan. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

 

References

 

NR451 Milestone2 Rubric

 

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome Introduction

Introduction to the plan is nursing focused, with evidence-based problem identification and potential solutions clearly identified.)

25.0 pts

Introduction to the plan is nursing focused, and evidence-based. Potential interventions clearly identified.

22.0 pts

Introduction to the plan is missing one of the elements listed in the first column.

20.0 pts

Introduction to the plan is missing two elements listed in the first column.

10.0 pts

Introduction lacks evidence to support need for change and/or potential solution is not evidenced-based.

0.0 pts

Introduction is missing.

Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

25 pts

This criterion is linked to a Learning Outcome Change Model Overview

An overview of the ACE Star model as a guide for change is given. Scope of the problem is identified. Stakeholders are identified. Team members and their roles and practice area are identified and discussed. State how nurses should use this model as a guide to facilitate change.

50.0 pts

Overview of the ACE Star model is given. Scope of problem is identified. Rationale for change is present. Stakeholders are identified. Practice area, team members and role are discussed.

44.0 pts

All elements in the first column are included but discussion of one or more items lacks details.

40.0 pts

Overview is missing one of the elements from the first column.

19.0 pts

Overview of the ACE Star model is given. Scope of problem is not identified. Rationale for change is not present. Stakeholders are not identified. Practice area, team members and role are not discussed.

0.0 pts

Change Model Overview is missing all elements of the first column.

50 pts

This criterion is linked to a Learning Outcome Evidence

Evidence is provided thru basic information that indicates a change is needed. For example, there have been 6 urinary tract infections over the last two months and there were none present the last two years at the same time period. What are some of the evidence-based interventions you discovered in your Evidence Summary that do you plan to use?

50.0 pts

Evidence summary is thoroughly provided with information of the current problem in the work setting indicating a change is needed. Interventions discovered in Evidence Summary are used in planning for change.

44.0 pts

Evidence summary contains all elements in the first column, however, one or more items lacks detail.

40.0 pts

Evidence is vaguely provided through information of the current problem in the work setting indicating a change is needed. Some of the interventions discovered in Evidence Summary are used in planning for change.

19.0 pts

Evidence is provided through information of the current problem but is not convincing. Interventions discovered in Evidence Summary are not used in planning for change.

0.0 pts

Evidence summary is not provided.

50 pts

This criterion is linked to a Learning Outcome Translation

Activities to achieve the final steps of change are fully described. What is needed to achieve? How do you translate what information you have gathered into practice? Include measurable outcomes. How do you inform staff? What is your plan of action to pilot the plan? What is the timeline?

50.0 pts

Activities to achieve final steps of change are fully described. Ways to translate evidence into practice are discussed (outcomes). Methods to inform staff, activities planned for plan of action and timeline are discussed.

44.0 pts

Activities to achieve final steps of change are adequately described.

40.0 pts

Activities to achieve final steps of change are briefly described.

19.0 pts

Minimal description of the activities to achieve final steps of change.

0.0 pts

Activities for final change plan are missing. Translation of evidence into practice is missing.

50 pts

This criterion is linked to a Learning Outcome Conclusion

Clear, solid summary of the key points, ACE Star model and steps of the change plan are included; ways to sustain the change plan are described.

25.0 pts

Detailed summary of main points using ACE Star model. Ways to sustain plan are thoroughly described.

22.0 pts

Summary of main points/model is brief. Ways to sustain plan are briefly described.

20.0 pts

Summary of main points/model is vague. Ways to sustain plan are vaguely described.

10.0 pts

Summary of main points/model OR ways to sustain plan are not described.

0.0 pts

Summary is missing. There is no plan to sustain change.

25 pts

This criterion is linked to a Learning Outcome Mechanics

APA format 6th edition. Grammar, sentence structure, punctuation, and spelling correct. References, citations correct. Paper formatted in APA format. 0-1 errors

25.0 pts

APA format 6th edition. Grammar, sentence structure, punctuation, and spelling correct. References, citations correct. Paper formatted in APA format. 0-1 errors

22.0 pts

Two to three errors in elements from the first column.

20.0 pts

Four to five errors in elements from the first column.

10.0 pts

Six to seven errors in elements from the first column.

0.0 pts

More than seven errors.

25 pts

Total Points: 225 Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal

 

Design for Change Proposal

Your Name

Chamberlain College of Nursing

NR451 RN Capstone Course

Term and Year

Design for Change Proposal

Urinary Tract Infect (UTI) is a common medical condition in which the urinary tract is considered infected, to include either the kidneys, bladder or urethra with the result is a persistent pain in the urinary tract. UTI classification occurs based on the specific organ that is infected with infection of the kidneys called pyelonephritis, infection of the bladder called cystitis, and infection of the urethra called urethritis. Medical studies indicate that 50% of women and 5% of men will report a UTI during their lifetime Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. The condition is typically caused by microorganisms (such as
Escherichia coli
) colonizing the tract, in which case antibiotics will be prescribed to combat them and subsequently clear the microorganisms as well as their associated symptoms. Although UTI is a common medical concern, the concern is heightened by the use of a catheter in the bladder and urethra. That is because the catheter is a foreign that presents an opportunity for microorganisms to gain entry when it is being handled (Brooks, 2012). In this respect, a UTI is construed as an infection of the urinary tract and caused by colonization by microorganisms that gain entry through catheters.

Change Model Overview

The most appropriate model for guiding both the evidence-based practice process and change as a strategy for motivating stakeholders is the Stetler Model of Evidence-Based Practice. The selection of this model is directed by the understanding that change is best achieved through use of a conceptual framework that acts as a guide for the different aspects of evidence-based practice to interact. The most important aspect of the model is that it acknowledges sources of information beyond primary research as being capable of influencing evidence-based practice. At its core is the understanding that every assertion or change recommendation must be substantiated with clear, replicable, observable, credible, verifiable and supportable evidence from both internal and external sources (Ellis, 2016) Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. In the present case, the problem (identified as the position that antibiotic prophylaxis can play in reducing the incidence of symptomatic bacteruria for persons using urinary catheters) is recognized as one that requires a solution to improve medical care outcomes. For a solution to garner support, it must be based on acceptable evidence.

Define the Scope of the EBP

The project intends to determine whether or not incorporating antibiotic prophylaxis when using long-term indwelling urinary catheters reduces the incidence of symptomatic bacteruria for adults’ patients with lower urinary tract problems. In fact, it intends to answer the question: In adults with lower urinary tract problems, does the use of long-term indwelling urinary catheters in combination with antibiotic prophylaxis, versus indwelling urinary catheters used in isolation, affect the incidence of symptomatic bacteruria over a period of three months?

Stakeholders

A six-person team that includes the research as team manager, four nurses concerned with catheter management, and a hospital administrator.

Determine Responsibility of Team Members

The team manager is responsible for presenting the project details, assigning responsibilities to the other team members, collecting the outcomes, and presenting the results. The four nurses are responsible for applying the policy of incorporating antibiotic prophylaxis when using long-term indwelling urinary catheters Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal. The hospital administrator is responsible for communicating the hospital management’s outlook and support for the project.

Evidence

Available literature was evaluative through a systematic review that identified one journal that presented supporting evidence to highlight the existing problem and need for a solution.

Summarize the Evidence

Cooper et al. (2016) evaluates the impact of policy changes on outcomes when using long-term indwelling urinary catheters. It notes that each of the available policies for handling catheters presents some element of risk. As such, it recommends that the best policy for handling catheters must at least take into account patients’ satisfaction, quality of life, type of trauma on the urinary tract, economics, replacement method used, environment-specific performance difference at home and hospital, catheter replacement strategy, and lubrication used.

Develop Recommendations for Change Based on Evidence

Based on the results from Cooper et al. (2016) that identify the best features for handling catheters that reduces the risk of infection, there is a possibility that using antibiotic prophylaxis in combination with the catheters would reduce the risk of infection even as it meets the set features.

Translation

Action Plan

The project will first be implemented by the team. Following which results will be collected at the end of the project to note the differences in infection levels between the group that used antibiotics and those that used other policies. The results of the project will then be presented to stakeholders with recommendations for practice change made based on the results. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Process, Outcomes Evaluation and Reporting

The anticipated result is that including antibiotic prophylaxis will reduce the risk of infection. That is because the antibiotics target the pathogens that have gained entry and eliminates them. This results will be verified by comparing the infection incidence for those who use the antibiotic prophylaxis against those who do not use the prophylaxis. Once the results are collected and evaluated, they will be presented to stakeholders who would use them as evidence to implement policy and practice changes.

Identify Next Steps

Should the results show that antibiotic prophylaxis is effective in reducing the risk of infection for catheter users, that support will be sought to conduct a larger scale study that verifies the results. The larger scale study would improve the results generalizability by targeting a larger demographic of subjects. If the results are verified as true, then a recommendation will be made for policy changes to be applied on a larger scale to improve care outcomes. The recommendation would be made to the government and medical organizations that are capable of effecting change at the national level Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

Disseminate Findings

The project results will be published in peer-reviewed journals to facilitate access by other stakeholders who are interested in the same subject.

Conclusion

One must accept that the high risk of infection associated with catheter use is worrying for medical practitioners. That is because the infection has the capacity to reverse medical care gains. The issue is best addressed by introducing a catheter management practice element that eliminates the pathogens that cause infection. Given this awareness, the present project suggests that antibiotics be used in combination with catheters to eliminate the pathogens so that the risk of infection is reduced. Should the project verify that using antibiotic prophylaxis reduces the risk of infection for catheter users, then the results will be availed to health stakeholders with the recommendation that antibiotic prophylaxis be routinely used to reduce the incidence of symptomatic bacteruria for persons using urinary catheters.

References

Brooks, D. (2012).
Urinary Tract Infection
. New York, NY: Springer.

Cooper, F., Alexander, C., Sinha, S. & Omar, M. (2016). Policies for replacing long-term indwelling urinary catheters in adults.
Cochrane Database of Systematic Reviews
, 2016(7), Art. No.: CD011115. doi:10.1002/14651858.CD011115.pub2

Ellis, P. (2016).
Evidence-based Practice in Nursing
(3
rd
ed.). London: Learning Matter/SAGE Publications Ltd. Capstone Project Milestones: Practice Issue and Evidence Summary Worksheet & Design for Change Proposal.

In

Week 1, complete the following human research protection program essay tasks:

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Think about different areas in the field of nursing and identify the importance of research to nursing practice.

Learn about the fundamentals of research and the research process.

Gain insight into the planning of research

Use APA style and citations/references

human research protection program essay

Computed Tomography (CT) essay

Articles in the scientific literature  over the past several years have implied that computed tomography (CT) may cause cancer and that physicians and patients must exercise caution in its use. What is your opinion regarding this subject. Please research and give your input abut the topic.

Minimal 4 paragraphs. ( No introduction is needed )

at least 3 scholarly sources are requested (No older that 5years) .

Examples of scholarly sourses:

-Published journal articles, books and other works (encyclopedias & newspapers)

-Official websites ending in .gov, .org, .edu (CDC,NIH,ADA,WHO, HARVARD, FIU,FNU)

Do not use Sites such Wikipedia, WebMD, Nursingworld, Allnurses they are
NOT
scholarly sources. Computed Tomography (CT) essay.

Week 5 Social Movements Assignment

A grassroots way to facilitate change in society is through a social movement. Often these movements are created after an injustice to change the way a society thinks and acts towards a sect of people.  Your assignment this week focuses on using social psychology concepts to explain the development of a social movement and the change in society that has occurred from the social movement.

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Some examples of social movements you may want to research are:

Black Lives Matter                  Blue Lives Matter                   Pro-Choice

Defend Science                       LGBTQ                                     Human Rights

Environment                           Animal Rights                          Anti-Bullying

 

 

Your assignment for this week is to find two articles that discuss one social movement. Social Movements Assignment. To help guide your analysis, complete the following steps:

 

– Summarize each article, focusing on main ideas and primary examples (2-4 Paragraphs)

– Discuss the relationship between the articles and key terms and ideas in social psychology (2-3 Paragraphs)

– Describe social change that has come about from the movement and utilize social psychology ideas to support your recommendation (1-2 paragraphs)

– Provide APA citations for both articles and additional references.

 

Grading:

50 points – summarizes two articles related to a specific social movement Social Movements Assignment.

20 points – discusses the issues the topics of the articles in relation to social psychology terminology

15 points – conclusion using social psychology ideals on changes that have come about due to the social movement discussed

15 points – for orderly presentation in subsections, freedom from spelling and grammar errors, and use of APA style citations and reference page.

 

Expectation

Points Possible

Summaries

Summaries are included for two articles and provide specific details about main arguments, key claims, and examples.

50

Social Psychology Terminology and Use

The analysis includes a strong use of social psychology terminology and thoughtful applies concepts to current events.

20

Conclusion

Conclusion includes recommendations for social change and provides a specific plan of action to support a culture of change.

15

APA Format and Style

Paper uses APA format and utilizes style and grammar to promote clarity. Social Movements Assignment.

15

Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients

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

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

Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain. Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

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

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

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Please include a brief introduction with the purpose

Conclusion

The references should be most recent (2-3years)

Scenario for Week 7 Case:

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

Voluntary and Involuntary Commitment Regarding Pediatric Psychiatric Patients

Concerning psychiatric patients, voluntary commitment means the patient chooses to be admitted for treatment. On the other hand, involuntary commitment is a legal process through which the patient is ordered to go for treatment by the court (Rayesteijn et al. 2017). In either case, the care is done through an inpatient facility and sometimes through an outpatient basis. For the instance of those who cannot make decisions for themselves like children, the admission to a medical facility will be voluntary when the parents or guardians accept the voluntary (Shields, Borba, & Trinh, 2017). Most entries are often voluntary: involuntary admission is rare. This paper discusses voluntary and involuntary commitment from a scenario where I am a PMHNP.

I strongly oppose voluntary commitment of the client due to the selected reasons herein. First, the patient is overwhelmed by suicidal thoughts hence he cannot voluntarily opt for pediatric psychiatric admission. According to Pfiffner et al., admission to healthcare for suicidal thinking is the last resort and most often treating people in the community is better for such clients (2014). However, the chances of the patient being safe in the community setting are low. Additionally, the client’s parents have conflicts of interest over their son’s assistance. Notably, the mother uses threats to demand that the client be discharged while the father requires that the child be hospitalized because of the suicide. In search of a scenario, the voluntary commitment will fail thus involuntary commitment should be advocated for. Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

However, in the United States, only forty-five states have laws which authorize the use of court-ordered treatment which is in the Mental Health Care Act. In my state, the client is eligible for involuntary commitment. The criteria for one to be involuntarily committed, the client should have a mental illness, the client’s disease and the problem should be requiring instant treatment. Also, the anticipated treatment should be accessible at the accredited mental healthcare institution and that there is a looming risks that the patient may source injury to him or herself (Masood et al. 2017). In my scenario, the patient wants to commit suicide which is the mental illness. Also, his problem needs immediate attention since if left alone, he will continue taking diphenhydramine hydrochloride. Conversely, the client can cause harm since he is overwhelmed by thoughts of suicide. Not to mention, our medical facility is in a position to offer necessary treatment. Having said all these, the client qualifies for involuntary commitment Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

Accordingly, my understanding of the state laws confirms my recommendation about involuntary committing the patient. Following the client’s stunt actions, I was unable to engage voluntarily commit him having a well understanding of the factors seen from the patient. Furthermore, the patient was at imminent risk of taking away his life in which he had already taken Benadryl which suggests that when discharged from the hospital, he will continue taking the tablets. Although the mother is using her clerical staff for the state board of nursing’s position, however, she is not concerned with what the son is capable of doing with her life. Following the nursing policies, ethics and the state laws, I could not bow to pressure to discharge the son before ailment is complete.

Nonetheless, if the client were not eligible for involuntary treatment, I would suggest and take the following course of actions to support voluntary commitment. First, I would recommend a psychotherapist who will be checking on the client’s health progress as well as offering guidance and counseling while at home. When the client-therapist relationship exists, care is provided to the client at the time of the alleged wrongdoing hence reducing chances of harmful actions (Townsend & Morgan, 2017). Also, I will work with the client minimize his risk of feeling shameful and also recommend care which is in line with the principles of cultural safety and competence. Additionally, I will provide hope for the father who thinks that the son will be at risk if discharged as well as encouraging the client that I will take an initiative of talking to the parents of the girlfriend to allow him to date the girl. Doing all these gives the client hope as well as his parents Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

Conversely, my initial actions to begin treatment would be assessing the client’s mental status which includes mood and the effect along with other signs of depression. I will also determine the patient’s feeling of hopelessness as well as obtaining the suicidal behavior history which include threats and ideation, earlier attempts and lethality of these events. For instance, the patient may be experiencing impulsivity symptoms like acting and reacting to situations without putting into account the possible consequences (Davison, Mackay, & McGivern, 2017). Considering all these risk factors will aid me in accurately determining if the patients with romance relationship issues are at risk of suicide thus I can give the right medication.

In conclusion, from the scenario, the client qualifies for involuntary commitment. The client is capable of doing anything to take his life away. However, offering therapy to him is likely to improve the situation. Furthermore, the patient needs to be given hope that his parents or clinicians will take the initiative to talk to the parents of his girlfriend to sort out issues thus he should not commit suicide Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

 

References

Davison, J., Mackay, B., & McGivern, M. J. (2017). The Potential of Simulation to Enhance Nursing Students’ Preparation for Suicide Risk Assessment: A Review. 
Open Journal of Nursing
, 
7
(02), 129.

Masood, B., O’Ceallaigh, S., Thekiso, T., Nichol, M., Kowalska-Beda, P., Murphy, M., … & Kennedy, N. (2017). Clinical predictors of involuntary detention among voluntary inpatients in St Patrick’s University Hospital (SPUH). 
Irish Journal of Psychological Medicine
, 
34
(1), 13-18.

Pfiffner, C., Steinert, T., Kilian, R., Becker, T., Frasch, K., Eschweiler, G., & Jaeger, S. (2015). Rehospitalization risk of former voluntary and involuntary patients with schizophrenia. 
Social psychiatry and psychiatric epidemiology
, 
49
(11), 1719-1727 Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

Ravesteijn, B., Schachar, E. B., Beekman, A. T., Janssen, R. T., & Jeurissen, P. P. (2017). Association of cost sharing with mental health care use, involuntary commitment, and acute care. 
JAMA Psychiatry
, 
74
(9), 932-939.

Shields, M. C., Borba, C. P., & Trinh, N. H. T. (2017). Quality of Inpatient Psychiatric Care and Consumers’ Trust in the Mental Health Care System. 
Psychiatric Services
, 
68
(6), 642-643.

Townsend, M. C., & Morgan, K. I. (2017). 
Psychiatric mental health nursing: Concepts of care in evidence-based practice
. FA Davis Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.

NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay

Course Project: Part 1- Identifying a Researchable Problem

Prescription drug abuse can affect an individual during any stage of their life.  Some of the populations that are most at-risk for prescription drug abuse are adolescents, the elderly, and women.  One population in particular, patients with chronic pain, are at an exceptionally high risk to abuse or misuse prescription medications (Manchikanti, 2006).  NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay. Many times, chronic pain goes unrecognized and untreated in patients of racial and ethnic minorities, women, the elderly, patients with cognitive impairments, and those with cancer and at the end of life (CDC, 2016).  The purpose of this paper is to develop feasible research questions in order to explore the issue pain management poses to nursing practice.

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Area of Interest

Chronic pain is defined as pain that lasts longer than six months.  The American Academy of Pain Medicine (2016) estimates that approximately 100 millions Americans suffer from chronic pain.  There are four common types of chronic pain- back pain, migraine pain, neck pain, and facial pain.  Approximately 26 million Americans between the ages of 20-64 experience back pain (The American Academy of Pain Medicine, 2016) NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

The American Academy of Pain Medicine (2016) believes that prescription painkillers are a major contributor to the total number of drug deaths in America.  Approximately 28,000 Americans died from unintentional drug poisoning in 2007 and nearly 12,000 of these deaths involved prescription pain relievers.  From 1998 to 2008, the proportion of all substance abuse treatment admissions that reported any pain reliever abuse increased more than fourfold (The American Academy of Pain Medicine, 2016).   According to the CDC (2016), 20% of patients presenting to physician offices receive an opioid prescription.  In 2012, health care providers wrote 259 million prescriptions for opioid pain medication (CDC, 2016). NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

Generated Questions and Their Feasibility

For this assignment, we were asked to formulate five research questions based on our topic of interest and then evaluate them to decide which questions are the most feasible.  The following are the five research questions that I have developed:

In patients with chronic pain, what is the effect of utilizing a combination of pharmacological and non-pharmacological methods to manage their pain?

In patients with chronic pain, does pharmacologic use only influence their dependence on narcotics?

In patients with chronic pain, what are the common complaints of pain that these patients seek treatment for? NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

In patients with chronic pain, what are the patient’s expectations regarding pain control and pain management?

In patients with chronic pain, what percentages of physicians are utilizing other methods of pain management besides medications?

Sufficient research questions are utilized to establish a foreground for Evidence-Based Practice, or EBP, inquiry.  Research questions should identify key variables of the study, the relationships among the variables, and the population in which the study is researching.  With these requirements in mind, all of my questions identify key variables of the study I am proposing- pharmacological and non-pharmacological pain management.  The questions also focus on the population the study is examining- patients with chronic pain.  Finally, the questions also aim to explore the relationship between pain management using pharmacological and non-pharmacological methods (Polit & Beck, 2017) NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

PICOT Question

The PICOT question I have developed is as follows:  In patients with chronic pain, what is the effect of a multi-modal pain management system compared to pharmacological use only on pain management over a year? (Walden Student Center for Success, 2012)

In my PICOT question, the population (P) is patients with chronic pain.  The intervention (I) is a multi-modal pain management system.  The comparison (C) is the use of only a pharmacological method of treating pain.  The outcome (O) is pain management, and the time frame (T) is over a year. (Walden Student Center for Success, 2012)

Keyword Searches

According to the Walden Student Center for Success (2012), once you develop your PICOT and research questions, it is time to brainstorm key search terms that will help you to find research relevant to your topic.  The Walden Student Center for Success (2012) gives us three distinct tips for developing key search words: brainstorm synonyms, expand acronyms, and look at subjects.  In order to brainstorm synonyms, you will need to think of other words or phrases that have similar meaning to your research topic.  NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay. Next, to expand out acronyms, you will need to search both the acronym and the actual phrase of the topic.  Finally, you will need to look at subjects.  In order to do this, you will need to search the main topics that the database you are researching through uses to categorize your research topic (Walden Student Center for Success, 2012).

By keeping these guidelines in mind, I developed the following research terms for my topic: “non-pharmacological methods for controlling chronic pain,”  “pain management without narcotics,” “non-pharmacologic pain management,” “chronic pain,” “chronic pain management,” “pain management,” “ending chronic pain,” “long-term pain management,” “narcotic pain management,” and “controlling pain.”

Summary

           
Throughout this paper we have discuss various methods of establishing a research topic, developing research questions, and focusing research terms in order to find the most relevant information for your research topic.  By utilizing feasible research questions, establishing a PICOT question, and creating key research terms, I will now be able to focus my evidence-based practice research on information that is significant to my research topic. NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

References

Centers for Disease Control and Prevention.  (2016).  CDC Guideline for Prescribing Opioids for Chronic Pain.  Retrieved from dhttp://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

Manchikanti, Laxmaiah.  (2006).  Prescription Drug Abuse: What is Being Done to Address this New Drug Epidemic?
Pain Physician. 
Retrieved from https://www.asipp.org/documents/PrescriptiondrugabuseWhatisbeing.pdf

Polit, D. F., & Beck, C. T. (2017).
Nursing research: Generating and assessing evidence for nursing practice
(10th ed.). Philadelphia, PA: Wolters Kluwer. NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

The American Academy of Pain Medicine.  (2016).  AAPM Facts and Figures on Pain.  Retrieved from http://www.painmed.org/patientcenter/facts_on_pain.aspx

Walden Student Center for Success. (2012).
Clinical Question Anatomy
. Retrieved from http://academicguides.waldenu.edu/content.php?pid=183871&sid=2950360 NURS 6052 – Essentials of Evidence-Based Practice – Identifying a Researchable Problem Sample Essay.

Child Abuse Case Study Essay

Introduction on child abuse

What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.

How might exposure to the media and/or social media affect the patient?

What type of mandatory reporting (if any) is required in this case? Why? Child Abuse Case Study Essay.

Conclusion

Please address each sentence separately

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Child Abuse Case Study

NURS 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child

and Adolescent

Morgan, a 19-year-old male comes to your office to discuss his current mood and

symptoms. This is his first visit to a mental health clinic. “I’ve had 26 jobs in the last 2

years; I finally have a job that I like and I want to make it work.” As you begin to get to

know him, he tells you that his mood is down and that he also has times where he has

“more energy and motivation”: “That’s when I am able to get a new job.” He says that he

has difficulty interacting with coworkers. “I feel like I can’t talk to them.” If it wasn’t for

his supportive girlfriend, he wouldn’t be able to function. “She understands me and

accepts me; she knows what I have been through.” Child Abuse Case Study Essay.

As the PMHNP listens to the client and explores what he means by some of his

statements, you try to put together his story. He mentions that he has been having

nightmares and is not sleeping well. He says he startles easily. He becomes withdrawn

when he begins to talk about the reason for the nightmares.

“This all started a few weeks ago when a cousin of mine got out of jail.” He haltingly tells

the story of his parents’ mental illness and how he had to live with various relatives.

“One cousin who I stayed with a lot took advantage of me. He molested me.” They

found out he also molested other children and he went to jail. “It gives me the creeps

that he is out of jail. I have to face what he did to me.”

Morgan asks about his diagnosis. The PMHNP tells him that he has some symptoms

that sound like depression and anxiety, and that when a child has a traumatic

experience, it can reoccur and stay with a person for many years. He acknowledges

that he thought about PTSD but wasn’t sure what the symptoms look like.

As you think about Morgan’s story, consider the following questions: Where did he fall

between the cracks? Are there agencies who advocate for children like him?

There are thousands of children like Morgan. They were in a vulnerable family situation

and the “responsible” adult was not able to care for the child. Sometimes it takes years

for clients to remember and disclose the abuse. Child Abuse Case Study Essay.

Child Abuse Essay

Introduction on child abuse

Child abuse refers to the actual maltreatment of a child or potential for harm through psychological, sexual or physical approaches. It is notable that the agent of the abuse is the child’s parent, caregiver or guardian who is supposed to be responsible for protecting the child but either fails to protect the child or perpetrates the abuse (Gelles & Perlman, 2012). As a result, child abuse refers to a situation where the child is psychologically, sexually or physically harmed Child Abuse Case Study Essay.

What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.

Four strategies are available for assessing a child for abuse. The first strategy collects information from the child at risk of being abused on whether he or she is being abused. The second strategy interviews the parents, guardians and caretakers who are likely to be abusing the child. The third strategy collects information from the child’s environment to include neighbors and friends who may have witnessed the child being abused. The fourth strategy uses clinician-completed assessments. The final strategy entails conducting a physical examination on the child (Gilbert, Parton & Skiveness, 2011).

How might exposure to the media and/or social media affect the patient?

Exposure to the media is likely to have a negative effect on the patient by taking a toll on their development. In fact, it places the child under pressure resulting in an increased risk for emotional behavioral problems that would be exhibited as fear, problems with academics, depression and anxiety. In addition, it could prevent the child from recovery and even forgetting about the abuse by always acting as a reminder of what happened (Pecora et al., 2010). Child Abuse Case Study Essay.

What type of mandatory reporting (if any) is required in this case? Why?

Legal provisions designate a group of persons who are obligated to report all suspected and confirmed cases of child abuse. These groups include law enforcement officers, coroners, medical personnel, child care providers, mental health professionals (such as therapists and counsellors), medical professional (such as nurses and physicians), school personnel, and social workers. These individuals are identified for mandatory reporting because they have regular or frequent contact with children and their professional experiences allow them to identify cases of abuse. As such, they can act as credible sources of information on child abuse (Gilbert, Parton & Skiveness, 2011).

Conclusion

One must accept that child abuse is a worrying since it exposes vulnerable children to indefensible harm or failure to protect from a parent, caregiver or guardian who is supposed to protect the child. Still, there is a need to confirm a case of abuse using assessment strategies. Additionally, the information on an abuse case should not be exposed to the media since it increases the risk for the child experiencing emotional behavioral problems. Besides that, professions that have frequent contact with children should proactively fight child abuse by reporting all suspected cases. In this respect, child abuse refers to a situation where the child is psychologically, sexually or physically harmed. Child Abuse Case Study Essay.

 

References

Gelles, R. & Perlman, S. (2012).
Total Estimated Cost of Child Abuse and Neglect in the United States
. Chicago, IL: Prevent Child Abuse America.

Gilbert, N., Parton, N. & Skiveness, M. (2011).
Child protection systems: international trends and orientations
. New York, NY: Oxford University Press.

Pecora, P., Whittaker, J., Maluccio, A., Barth, R., DePanfilis, D. & Plotnick, R. (2010).
The child welfare challenge: policy, practice, and research
(3
rd
ed.). New Brunswick, NJ: Transaction Publishers. Child Abuse Case Study Essay.

Is Child Obesity a Reflection of Parental Negligence Essay

1. Introduction

Explain the issue you are examining and why it is significant.

2. Review of the Literature

A description of what has already known about this area and short discussion of why the background studies are not sufficient.

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3. Rationale

A description of the questions you are examining and an exploration of the claims.

4. Method and Design

A description of how you would go about collecting data and test the questions your are examining. Method: How would you collect the data and why? Is Child Obesity a Reflection of Parental Negligence Essay

Analysis

• How will you analyze the results?

• What kind of results would confirm your hypothesis?

• What kind of results would disconfirm your hypothesis

5. Significance and Conclusion

Discuss, in general, how your proposed research would lead to a significant improvement over the original studies, and how it would benefit the field. (In other words, why should someone care? If you were applying for money to do this, why would someone fund you? If you wanted to publish your results, why would they be interesting?) Is Child Obesity a Reflection of Parental Negligence Essay

6. References

Include all references in APA style.

 

Is Child Obesity a Reflection of Parental Negligence?

Introduction

Childhood obesity is a growing trend that has become a source of concern since these children may not live as long as their parents (Patel, 2005). That is because obesity is not only a problem for the child’s health, but is also a risk factor for other problems that include suicidal ideation, psychological distress, poor quality of life, low self-esteem, impaired health, and stigmatization. Although incidence of obesity and weight gain have been linked with a range of factors, a distressing aspect is that although some of these factors are outside immediate control (inborn factors that include genetics and hormones), there are those that are within the realm of control to include physical activity and diet. The implication is that although there are some incidence of obesity that cannot be absolutely controlled, there are those that can be controlled by moderating environmental factors in the form of presenting the child with a healthy diet and ensuring that there is adequate physical activity. Given that children are impressionable dependents who are easily influenced by their guardians and careers in whether or not to adopt healthy lifestyles, then it stands to reason that adequate parental supervision with focus on healthy lifestyle (to include a healthy diet and adequate physical activity) will ensure that the child maintains a healthy weight and reduces the incidence of obesity unless inborn factors come into play (Knutson et al., 2009). In this respect, it is hypothesized that sufficient parental supervision with a focus on a healthy diet and adequate physical activity will reduce the incidence of obesity among children. Is Child Obesity a Reflection of Parental Negligence Essay.

Review of the Literature

It is undeniable that there is a correlation between parents’ involvement in children’s life and the learning outcomes. In fact, Knutson et al. (2009) mentions that incidence of obesity among children are either resultant of environment or inborn factors. While little control can be exerted over the inborn factors, the same cannot be said about the environmental factors. That is because children are impressionable dependents who are overly reliant on their parents and guardians to direct their every activity from waking, sleeping, eating, dressing, schoolings and so on. This means that every decision that a child makes is actually one that the parent makes and the child lives with. The implication is that parents can guide their children to adopt healthy lifestyles, or neglect the children and allow them to develop unhealthy diet and physical activity habits that result in obesity (Knutson et al., 2009). Rhee et al. (2015) expresses similar sentiments by noting that there is a relationship between general parenting and childhood obesity. In this case, parents who are investment in the emotional and behavioral dimensions of parenting tended to have children with healthy weight since the parent intentionally guided the child on how to achieve a healthy weight (Rhee et al., 2015). Allen and Fost (2012) are more concise in noting that it is not enough for parent to offer advice and guidance to ensure that the children achieve health weights. Rather, the parent must be assertive in determining what the child can eat and how to exercise to achieve health weights. This means that every food request that the child makes must be evaluated weight gain and loss before being accepted into the diet (Haroldson, Cordell & Halderman, 2015). Patel (2005) similarly acknowledges that obesity among children is best managed by having the parents make healthy environmental decisions for the children, their involvement is limited by the reality that children must attend other social events (such as school) that keep them away from their parents. This means that the parents’ involvement may not be far reaching, and may be limited by the realities of work and school that keep the children and parents apart. Also, the article goes on to adopt a radical approach by suggesting obese children should be withdrawn from their parents since the obesity is an indication that the parents failed in offering the child advice on how to maintain a healthy lifestyle despite having the responsibility of offering care and advice (Parent, 2005). Is Child Obesity a Reflection of Parental Negligence Essay. Based on the discussed literature, it is plausible that parents can be targeted as tools for reducing obesity incidence among children, although their influence could be limited by the modern realities of social engagements that include work and school. As such, there is a need to explore the position that parents can play in reducing the incidence of obesity among children.

Rationale

As earlier indicated, childhood obesity is a source of concern. That is because it predisposes the child to social and health complications. In fact, Patel (2005) observes that children with obesity are unlikely to live for as long as their parents. As such, there is a need to develop an effective strategy for preventing its incidence. Although there are a range of strategies that could offer some relative success in reducing childhood obesity incidence, parents are explored because of their position in the child’s life. The reality is that children are dependent whose dependency only reduces as they advance in age such that they are only able to become independent upon reaching the age of majority (typically 18 years). This means that a child will depend on the parents to make decisions from birth until the child reaches the age of majority. The implication is that the parents can make decisions on how the child lives his or her life, what food is eaten and whether there is adequate physical activity to achieve health weight. Based on this awareness, the present study postulates that parental negligence will allow the child to develop an unhealthy lifestyle and become obese since there will not be any advice on what constitutes health diet and how to achieve healthy weight. Is Child Obesity a Reflection of Parental Negligence Essay. In this respect, the present study intends to answer the question: is child obesity a reflection of parental negligence?, while approving or disapproving the hypothesis: Parental negligence increases the incidence of obesity among children.

Method and Design

This paper proposes the adoption of quantitative research design to conduct the research with the focus being on numerical data. The quantitative research design proposed for this research will involve the use of pre-structured questionnaires as tools for collecting primary data. The questionnaires will evaluate the children’s weight based on body mass index (BMI) criteria and the parenting style applied with focus on whether it is negligent or attentive. The primary data, once collected, will then be subjected to statistical analysis that highlights emerging themes. The results of the statistical analysis will be compared to the literature review. The decision to use a questionnaire is based on the need maintain control over the research process, have flexibility and accuracy, working within the timetable and budget, and collect accurate and definitive data. Questionnaires save on cost and time, have good control and flexibility, but reduce the accuracy and detail of the collected data (Treiman, 2014). A correlation between parental negligence and increased incidence of childhood obesity will answer the research question while confirming the research hypothesis that parental negligence increases the incidence of obesity among children. On the other hand, the absence of a correlation between parental negligence and increased incidence of childhood obesity will answer the research question while disconfirming the research hypothesis that parental negligence increases the incidence of obesity among children. Is Child Obesity a Reflection of Parental Negligence Essay.

Significance and Conclusion 

The significance of the present study is that it evaluates the position that parental supervision and advice can play in reducing the incidence of obesity among children. This considers the fact that childhood obesity is a source of concern since it is a health risk factor. As such, there is a need to preempt childhood obesity incidence. Additionally, children are impressionable dependents who rely on their parents to guide them. Thus, parents are well positioned to influence their children to adopt healthy lifestyles that preempt them from developing obesity. The implication is that engaging parents to actively implement healthy lifestyle changes for their children could reduce the incidence of childhood obesity. In essence, this project anticipates that parental negligence (failing to introduce healthy lifestyle changes to children) will increase the incidence of childhood obesity with the reverse being equally true. Is Child Obesity a Reflection of Parental Negligence Essay.
 

 

References

Allen, D. & Fost, N. (2012). Obesity and neglect; it’s about the child.
The Journal of Pediatrics
, 160(6), 898-899.

Haroldson, A., Cordell, Z. & Halderman, L. (2015). Analysis of child food requests and maternal compliance in low-income Hispanic and non-Hispanic families.
Family and Consumer Sciences Research Journal
, 44(1), 37-50.

Knutson, J. F., Taber, S. M., Murray, A. J., Valles, N. & Koeppl, G. (2009). The role of care neglect and supervisory neglect in childhood obesity in a disadvantaged sample.
Journal of Pediatric Psychology
, 35(5), 523-532.

Patel, D. (2005). Super-sized kids: using the law to combat morbid obesity in children.
Family Court Review
, 43(1), 164-177.

Rhee, K. E., Dickstein, S., Jelalian, E., Boutelle, K., Seifer, R. & Wing, R. (2015). Development of the general parenting observational scale to assess parenting during family meals.
International Journal of Behavioral Nutrition and Physical Activity
, 12(49), 1-15.

Treiman, D. J. (2014). 
Quantitative data analysis: doing social research to test ideas
. Hoboken NJ: John Wiley & Sons. Is Child Obesity a Reflection of Parental Negligence Essay.