Category: Nursing

This Nursing theories CLC Assignment – NRS-430V Professional Dynamics is a Collaborative Learning Community (CLC) assignment.

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10-15 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:

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Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.

Explain how the nursing theory incorporates the four metaparadigm concepts.

Provide three evidence-based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. Since you will not actually be presenting to the class, well written, detailed speakers notes that include in-text citations are expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Nursing theories CLC Assignment – NRS-430V Professional Dynamics

Gastrointestinal (GI) and hepatobiliary disorders

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan. Gastrointestinal (GI) and hepatobiliary disorders

CASE STUDY

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

• Synthroid 100 mcg daily

Gastrointestinal (GI) and hepatobiliary disorders

• Nifedipine 30 mg daily

• Prednisone 10 mg daily

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To Prepare

• Review the case study assigned by your Instructor for this Assignment

• Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

• Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder. Gastrointestinal (GI) and hepatobiliary disorders

• Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

By Day 7 of Week 4

Write a 1-page paper that addresses the following:

• Explain your diagnosis for the patient, including your rationale for the diagnosis.

• Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. Gastrointestinal (GI) and hepatobiliary disorders

• Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples. Gastrointestinal (GI) and hepatobiliary disorders.

Natural Disaster And The Role Of Public Health Nurse PowerPoint

Create a power point with the intended audience to be a community health department.

· Focus on a real or fictional disaster that has or could affect your area. For example, if you live on the Florida coast you might choose potential hurricane.

Topic for the assignment is hurricane

· Discuss the role of the Community Health Nurse in each stage of disaster. You should include a few slides on each stage of disaster: preparedness, response, recovery with specific activities and resources that the public health nurse would use in each stage.(Please refer to Chapter 25 for the stages Page 722)

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· Identify other agencies that might be involved.

(Such as the, Police and emergency response team, organizations such the     American Red Cross, Department of Health and Human Services (HHS) ,The HHS National Disaster Medical System (NDMS), HHS Office of Emergency Preparedness (OEP)

Other organization involved may be: salvation army, Community Emergency Response Team (CERT), The Humane Society of the United States, The World Vision)

The assignment should be submitted in Power Point format, with at least 15 content slides (in addition to a title slide and reference slide) and include at least two scholarly sources(less than 5 years old) other than provided materials.

Clark, M. J. (2015). 
Population and community health      nursing
 (6th ed.). Boston, MA: Pearson Chapter 25

http://www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready

Natural Disaster And The Role Of Public Health Nurse PowerPoint

Practicum Decision Tree – young girl with difficulties in school case study

Decision Tree

Introduction

The focus of this assignment is to make decisions regarding the diagnosis and treatment of the 8-year-old with school difficulties. The first decision is about the client’s diagnosis while the other two decisions will be on the client’s treatment. The paper will also discuss ethical issues that may impact the client’s treatment plan. Practicum Decision Tree – young girl with difficulties in school case study

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Decision #1: Differential Diagnosis

The first decision is that the client’s diagnosis is 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation. The reason for selecting this decision is because Katie is manifesting inattention symptoms for ADHD. DSM-5 criteria delineate symptoms of ADHD inattention to include: inattention to details; making mistakes during classwork or at workplace; lack of attention when carrying out duties or during play; inability to actively or directly listen during conversations; not being able o follow instructions; leaving schoolwork or work duties unfinished; inability to organize activities and duties; avoiding activities that require mental concentration; misplacing important things; being forgetful; and being easily distracted (Emser et al, 2018) Similarly, Katie manifests majority of these symptoms and hence the diagnosis of 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation is appropriate (Tong et al, 2016). There are other instruments that can be used to further confirm the client’s ADHD diagnosis and they include the Child Behavior Checklist and Vanderbilt Assessment Scale, ACTeRS.

By selecting this decision, the aim was that the…

Assignment 1: Practicum: Decision Tree

For this Assignment, you examine the client case study in this week’s Learning Resources. Consider how you might assess and treat pediatric clients presenting with symptoms noted in the case.

Note: This Assignment is the first of three assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

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

The Assignment:

Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?

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

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

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

Decision #2: Treatment Plan for Psychotherapy

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

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

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

Decision #3: Treatment Plan for Psychopharmacology

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

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

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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

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

 

Case #1

A young girl with difficulties in school

BACKGROUND

In psychopharmacology you met Katie, an 8-year-old Caucasian female, who was brought to your office by her mother (age 47) and father (age 49). You worked through the case by recommending possible ADHD medications. As you progress in your PMHNP program, the cases will involve more information for you to sort through.

For this case, you see Katie and her parents again. The parents have reported that the medication given to Katie does not seem to be helping. This has prompted you to reconsider the diagnosis of ADHD. You will consider other differential diagnoses and determine what information you need to accurately assess the DSM-5 criteria to make the diagnosis of ADHD or another disorder with similar diagnostic features.

When parents bring their child to your office, they may have read symptoms on the internet or they may have been told by the school “your child has ADHD”. Your diagnosis will either confirm or refute that diagnosis.

Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine a differential diagnosis and to begin medication, if indicated. The PMHNP makes this diagnostic decision based on interviews and observations of the child, her parents, and the assessment of the parents and teacher.

To start, consider what assessment tools you might need to evaluate Katie.

Child Behavior Check List

Conners’ Teacher Rating Scale

The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised” 
(Available at: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000099.1 )
. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, makes careless mistakes in her schoolwork, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. She has difficulty interacting with peers in the classroom and likes to play by herself at recess.

When interviewing Katie’s parents, you ask about pre- and post-natal history and you note that Katie is the first born with parents who were close to 40 years old when she was born. She had a low 5 minute Apgar score. The parents say that she met normal developmental milestones and possibly had some difficulty with sleep during the pre-school years. They notice that Katie has difficulty socializing with peers, she is quiet at home and spends a lot of time watching TV.

SUBJECTIVE

You observe Katie in the office and she is not able to sit still during the interview. She is constantly interrupting both you and her parents. Katie reports that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds some subjects boring or too difficult, and sometimes hard because she feels “lost”. She admits that her mind does wander during class. “Sometimes” Katie reports “I will just be thinking about something else and not looking at the teacher or other students in the class.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. She offers no other concerns at this time.

Katie’s parents appear somewhat anxious about their daughter’s problems. You notice the mother is fidgeting with her rings and watch while you are talking. The father is tapping his foot. Other than that, they seem attentive and straight forward in the interview process.

MENTAL STATUS EXAM

The client is an 8-year-old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is neutral. Katie says that she doesn’t hear any ‘voices’ in her head but does admit to having an imaginary friend, ‘Audrey’. No reports of delusional or paranoid thought processes. Attention and concentration are somewhat limited based on Katie’s short answers to your questions.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHAT IS YOUR DIAGNOSIS FOR KATIE?

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

299.00 Autism Spectrum Disorder (ASD), mild and co-occurring; 300.23 Social Anxiety Disorder

315.0 Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics

314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/03/mm/decision_tree/index.html

 

Decision Tree

Introduction

The focus of this assignment is to make decisions regarding the diagnosis and treatment of the 8-year-old with school difficulties. The first decision is about the client’s diagnosis while the other two decisions will be on the client’s treatment. The paper will also discuss ethical issues that may impact the client’s treatment plan.

Decision #1: Differential Diagnosis

The first decision is that the client’s diagnosis is 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation. The reason for selecting this decision is because Katie is manifesting inattention symptoms for ADHD. DSM-5 criteria delineate symptoms of ADHD inattention to include: inattention to details; making mistakes during classwork or at workplace; lack of attention when carrying out duties or during play; inability to actively or directly listen during conversations; not being able o follow instructions; leaving schoolwork or work duties unfinished; inability to organize activities and duties; avoiding activities that require mental concentration; misplacing important things; being forgetful; and being easily distracted (Emser et al, 2018) Similarly, Katie manifests majority of these symptoms and hence the diagnosis of 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation is appropriate (Tong et al, 2016). There are other instruments that can be used to further confirm the client’s ADHD diagnosis and they include the Child Behavior Checklist and
Vanderbilt
Assessment Scale, ACTeRS. Practicum Decision Tree – young girl with difficulties in school case study

By selecting this decision, the aim was that the correct diagnosis for this client would be made in order to ensure the client received the appropriate treatment.

 

Decision #2: Treatment Plan for Psychotherapy

The second decision is for Katie to start Adderall XR 10 mg orally daily. The reason behind selection of this decision is due to the fact that Adderall XR is approved by FDA to treat ADHD. The medication has been demonstrated to be effective to treat symptoms of ADHD. According to Brown et al (2018) Adderall has been demonstrated to have efficacy in improving attention span and focus, as well as in improving memory and concentration. Another reason for choosing the drug is because it has few side effects and its effect wears-off gradually.

By selecting Adderall for this client, the expectation was the symptoms of ADHD would improve since the medication’s efficacy has been shown in regard to improving ADHD symptoms (Brown et al, 2018). It was expected that the client will maintain attention and focus in the classroom and that she will have minimal or no side effects after taking the medication. Practicum Decision Tree – young girl with difficulties in school case study

As it was expected, the ADHD symptoms improved as depicted by the client’s attention in class improving where she maintained attention in the class during morning hours. Nonetheless, there are some notable variations from the expected outcome. One, the client was only able to maintain concentration during morning hours as indicated by her day-dreaming in afternoon classes. The reason for this is because inattention symptoms surfaced following the wearing off of the drug’s effect. Secondly, the client reported appetite loss after she started taking Adderall. Loss of appetite is among the main side effects of Adderall. (Briars & Todd, 2016).

Decision #3: Treatment Plan for Psychopharmacology

The selected decision third decision is for the client to be added a small dose of immediate-release of Adderall during the early afternoon. This decision was chosen because the first medication is wearing off and thus the client is not able to maintain attention in the afternoon. Therefore, addition of small dose of Adderall during afternoon will assist the client to be attentive even in the afternoon (Briars & Todd, 2016). The other alternative decisions would not be useful in addressing the inattention evident in the client during afternoon hours.

Ethical Considerations

The most important ethical consideration in this client is the addition associated with medications used to treat ADHD. It is important to explain to the client’s family regarding the potential side effects and addictive aspect (Keilow et al, 2018). In addition, during the client’s treatment, close monitoring should be done and only the prescribed dose should be released to the client. Moreover, the care provider should seek informed consent from the client’s parents and explain comprehensively regarding the available treatment choices so that they can make an informed decision. Finally, it is important to maintain confidentiality and ensure the client’s information is not disclosed to the third parties (Keilow et al, 2018) Practicum Decision Tree – young girl with difficulties in school case study.

Conclusion

The first decision is that Katie’s diagnosis is 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation. This is because Katie is manifesting symptoms consistent with symptoms of (inattention) ADHD, according to the DSM-5 criteria for.  The second decision that was chosen is for the client to start Adderall XR 10 mg orally daily. This decision was chosen because the efficacy of Adderall in the treatment of ADHD symptoms has been demonstrated. Since the client is still manifesting inattention in the afternoon, the subsequent decision is addition of small dose of immediate-release of Adderall in the early afternoon. This will ensure the client maintains attention in the afternoon. Ethical considerations include being attentive of addiction associated with ADHD medications, educating the clients family about the side effects of the medications, seeking informed consent, and ensuring confidentiality throughout Katie’s treatment.

 

References

Brown K, Samuel S & Patel D. (2018). Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners.
Transl Pediatr
. 7(1), 36–47.

Briars L & Todd T. (2016). A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder.
J Pediatr Pharmacol Ther
. 21(3), 192–206. Practicum Decision Tree – young girl with difficulties in school case study

Emser T, Johnston B, Steele D, Sandra K, Lisa T & Hanna C. (2018). Assessing ADHD symptoms in children and adults: evaluating the role of objective measures.
Behav Brain Funct
. 14(11).

Keilow M, Holm A & Fallesen P. (2018). Medical treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) and children’s academic performance.
PLoS ONE
. 13(11), e0207905.

Tong L, Xiong X &Tan H. (2016). Attention-Deficit/Hyperactivity Disorder and Lifestyle-Related Behaviors in Children.
PLoS ONE
. 11(9), e0163434.

 

Review of Diagnosis in Attention Deficit Hyperactivity Disorder (ADHD): The Case of 8 Year-Old Caucasian Girl Katie

Introduction

           
Katie is a female 8 year-old Caucasian child who is brought to the clinic by her parents. She has a previous provisional diagnosis of attention deficit hyperactivity disorder or ADHD. Katie is having difficulties in school with concentration and performance. She is also not socializing well with her peers and likes to keep to herself. Her attention span is also short. Katie was born to mature parents (47 and 49 years old respectively) and had notable low wellness scores at birth. The parents bring with them the Connor’s Teacher Rating Scale form which had been filled by her teacher at school. This is helpful in assessing her condition and arriving at the correct diagnosis. Practicum Decision Tree – young girl with difficulties in school case study

Decision Point Number 1

In using the available assessment tools and based on what the parents and the teacher had reported, the diagnosis of ADHD with predominantly inattentive presentation was made as stated above. According to the fifth edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
, inattention such as Katie’s must meet criterion A. 1 (a)-(i) for this diagnosis to be reached (APA, 2013). This was met by Katie because her Conner’s Teacher Rating Scale shows that she is easily distracted at school and has the habit of only paying attention to what she has interest in. She is also quite forgetful of what she has been taught in school, attributable too to her inattention. The hope in arriving at this diagnosis was that Katie would be started on ADHD treatment at the right time; a fact that would place her in a better position to be free of her symptoms in the shortest time possible (Wender & Tomb, 2017). However, on close assessment during the revisit session, subjective evidence showed clearly that Katie was also evidently hyperactive as she could not stay in one place during the interview with the psychiatric-mental health nurse practitioner or PMHNP. Apart from the fact that her answers were short, it was also revealed that she also wonders in thought while in class. Practicum Decision Tree – young girl with difficulties in school case study. Her mental status examination was however largely unremarkable.  She was oriented in all aspects and was dressed appropriately for both the time of the day and the weather. The only thing that stood out was that she had an imaginary friend by the name “Audrey.” Because of these findings, the presentation of the diagnosis had to be reviewed from predominantly inattentive to combined presentation (APA, 2013; Wender & Tomb, 2017). This is because her symptoms largely agreed also with criterion A. 2 (a)-(i) on hyperactivity and impulsivity. Moreover, she also fitted in with the rest f the criteria B, C, D, and E (APA, 2013). Thus the summary of her definitive diagnosis is ADHD with inattention, hyperactivity, and impulsivity. There wasn’t much difference in the initial decision and the revised one in terms of the results as the diagnosis itself has not changed but only the presentation. The fact that she had not started to show any significant response to treatment is to be expected because ADHD response to pharmacologic treatment typically takes weeks (Stahl, 2014; Katzung, 2018). Practicum Decision Tree – young girl with difficulties in school case study.

Decision Point Number 2

           
On the return visit the girl was put on wellbutrin (bupropion) 75 mg daily to be taken by mouth. This decision was taken because this s a major norepinephrine dopamine reuptake inhibitor or NDRI approved by the Food and Drug Administration (FDA) for the treatment of ADHD (Stahl, 2014; Katzung, 2018; Nursingworld.org, n.d.). The other reason for choosing wellbutrin is that it continues to work for several years later and in the process deters the recurrence of symptoms (Stahl, 2014). This long term remission is what was intended to be achieved by this choice. Wellbutrin is one of the best pharmacotherapeutic agents available for treating ADHD. However, its effects are normally not felt immediately and its full therapeutic action may be evident from up to four weeks later (Stahl, 2014). The results of this decision to start wellbutrin and what was expected are not significantly different for two reasons. First is that as stated it takes weeks for the full impact of the drug to be felt (this patient returned after four weeks). Two is that the questions that Katie is asking are not part of the known side effects of the drug (Stahl, 2014).

Decision Point Number 3

As stated above, wellbutrin (bupropion) does not cause the patient to ask the type of questions that Katie is asking as a side effect (Stahl, 2014). Therefore, the decision taken in this instance is to reassure the patients that those questions she is asking are just part of her normal developmental progress given her age. They have got nothing to do with the treatment which is evidence-based. Practicum Decision Tree – young girl with difficulties in school case study As at now, there is no evidence to suggest that the drug may cause such behavior. Therefore, because the overall response is so far promising (the teacher says the girl has started being more attentive and is doing her academic work), the dose of bupropion will be doubled to 150 mg daily. By making this decision, the hope is to augment the noted effect of the drug and ensure long-lasting remission. One consideration though is that the questions about death by Katie may persist. This would mean she is having some sort of suicidal ideation which may be caused by the wellbutrin (Stahl, 2014; Wender & Tomb, 2017). If this occurs, it would mean the results of the intervention and the expectations would be different, due to the fact that antidepressants generally may at times cause suicidal ideation. In that case, the drug would be changed from wellbutrin to concerta 18 mg
mane
per day. this would also be supported by psychotherapy in terms of training in social skills to improve her engagement with her peers and take her mind away from suicidal thoughts (Corey, 2017). In doing all this, the ethical principle of nonmaleficence (not causing harm) has to be remembered as continuing a drug that may result in her committing suicide will be immoral. Also the decision of the parents on treatment options has to be respected – ethical principle of autonomy (Haswell, 2019).

References

American Psychiatric Association [APA] (2013).
Diagnostic and Statistical Manual of Mental Disorders (DSM-5),
5
th
ed. Arlington, VA: APA.

Corey, G. (2017).
Theory and practice of counselling and psychotherapy,
10
th
ed. Boston, MA: Cengage Learning.

Haswell, N. (2019). The four ethical principles and their application in aesthetic practice.
Journal of Aesthetic Nursing
, 8(4), 177-179. Doi: 10.12968/joan.2019.8.4.177

Katzung, B.G. (Ed) (2018).
Basic and clinical pharmacology, 14
th
ed
. New York, NY: McGraw-Hill Education.

Nursingworld.org (n.d.).
Pharmacological Principles
. Retrieved 14 June 2019 from
https://www.nursingworld.org/~4ae124/globalassets/catalog/sample-chapters/pmhnpsamplechapter.pdf

Stahl, S.M. (2014).
Stahl’s essential psychopharmacology: Prescriber’s guide
, 5
th
ed. New York, NY: Cambridge University Press.

Wender, P.H. & Tomb, D.A. (2017). ADHD:
A guide to understanding symptoms, causes, diagnosis, treatment, and changes over time in children, adolescents, and adults
, 5
th
ed. New York, NY: Oxford University Press. Practicum Decision Tree – young girl with difficulties in school case study

Change Implementation And Management Plan

As a professional, you will be called upon to share expertise, inform, educate, and advocate. Your efforts in these areas can help lead others through change. In this Assignment, you will propose a change within your organization and present a comprehensive plan to implement the change you propose.

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To Prepare:

Review the Resources and identify one change that you believe is called for in your organization/workplace.

This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.

Reflect on how you might implement this change and how you might communicate this change to organizational leadership.

The Assignment (5-6-minute PowerPoint presentation):

Change Implementation and Management Plan

Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose.

Your presentation should be 5–6 minutes in length and should include a video with you as presenter. Change Implementation And Management Plan

Your Change Implementation and Management Plan should include the following:

An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)

A description of the change being proposed

Justifications for the change, including why addressing it will have a positive impact on your organization/workplace

Details about the type and scope of the proposed change

Identification of the stakeholders impacted by the change

Identification of a change management team (by title/role)

A plan for communicating the change you propose

A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

APA citation 3 to 5 reference within the 5 years

Change Implementation And Management Plan

Diary of Medical Mission Trip

Watch the “Diary of Medical Mission Trip” videos dealing with the catastrophic earthquake in Haiti in 2010. Reflect on this natural disaster by answering the following questions:

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Propose one example of a nursing intervention related to the disaster from each of the following levels: primary prevention, secondary prevention, and tertiary prevention. Provide innovative examples that have not been discussed by previous students.

Under which phase of the disaster do the three proposed interventions fall? Explain why you chose that phase.

With what people or agencies would you work in facilitating the proposed interventions and why?

Diary of Medical Mission Trip

Community Teaching Work Plan Proposal Example

Based on the feedback offered by the provider, (in the attached interview form) prepare a 1-2 page pamphlet presentation based on the Teaching Work Plan (attached) and present the information to your local home health center. 
General Requirements

Solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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Community Teaching Work Plan Proposal

Planning and Topic

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

Bioterrorism/Disaster

Environmental Issues

Primary Prevention/Health Promotion

Secondary Prevention/Screenings for a Vulnerable Population

Planning Before Teaching:

K. P. Nurse Practitioner

 

Estimated Time Teaching Will Last:
2 hours

Location of Teaching:
Classroom

 

Supplies, Material, Equipment Needed:
Pamphlets, presentation

Estimated Cost:
$20,000

 

Community and Target Aggregate
: Teenagers in 9
th
to 12
th
grade

 

Topic
: A Community Education Program for the Primary Prevention of Diabetes.

Community Teaching Work Plan Proposal Example

 

Identification of Focus for Community Teaching

The focus of this community teaching program is health promotion/primary prevention for Type 2 Diabetes. Health promotion initiatives involve processes of enabling people within certain communities to increase their control of their health. Health promotion activities such as the planned diabetes prevention education aim to help people to improve their health so that they can achieve a better state of physical, mental, and social wellbeing. In particular, this teaching program will help the targeted community to understand the risks of diabetes and the measures that they must take to prevent Type 2 diabetes, which is a lifestyle related illness.

 

Epidemiological Rationale for Topic

Type 2 diabetes is a significant health issue that affects most populations globally. According to the World Health Organization (WHO), over 422 million people suffer from Type 2 Diabetes in the world. This represents a significant increase from the 108 million value recorded in 1980 (WHO, 2018). The United States also has an increasing prevalence trend similar to the global statistics. Type 2 Diabetes is one of the leading public health issues affecting the U.S. population.   The Centers for Disease Control and Prevention (CDC) estimates that 9.6% of the population, representing around 21 million people in the United States have Type 2 Diabetes. Almost 1.3 million adults are diagnosed with his health condition every year (American Diabetes Association, 2017). Diabetes is also a leading cause of mortality in the United States. Georgia, which is the community of focus for this teaching program also reflects the same trends when it comes to diabetes prevalence. It is estimated that 1 in every 10 adults in Georgia has diabetes. The rates of diabetes in this state have increased by at least 50% since 2000 (Georgia Department of Health, 2015). Therefore, there is a need for health promotion to help people prevent the development of Type 2 diabetes. Community Teaching Work Plan Proposal Example
 

Teaching Plan Criteria

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

Nursing Diagnosis
:

There is an increasing rate of diabetes diagnoses in the community. Type 2 diabetes is associated with poor eating habits and poor engagement in physical activity. Therefore, there is a need to educate the members of the community on strategies that they can apply to prevent the development of diabetes. This teaching plan will be focused in teaching lifestyle changes that are needed to promote good health and wellbeing.

 

 

 

 

Readiness for Learning:

Assessing the target population’s readiness to learn is important to ensure that the teaching program is effective. The following are the factors that will be examined to determine the readiness of the targeted population to learn.

Emotional Readiness:

 

First, the information processing capacity of the targeted audience will be examined. It is important to ensure that the people to be involved in the teaching program have the right emotional capacity to learn (Hung et al., 2010). The mental health of the beneficiaries of this teaching program needs to be in the right state so that they can have the cognitive capacity to understand the components of the teachings.

 

Experiential readiness: For experiential learning readiness, the level of prior learning will be examined. The target population will be examined on the prior knowledge they have on type 2 diabetes. This information is important in determining the kind of content that needs to be included and emphasized on the teaching program (Hung et al., 2010).  The targeted population’s demonstration of interest should also be examined. A demonstration of interest in the learning material shows that the person is ready to learn.

 

 

 

 

Learning Theory to Be Utilized
:

 

The theory to be applied in this teaching program is that of the health belief model. This is a theory of psychological and social behavior change model that works by predicting health-related behaviors. This theory is based in the assumption that the perceived beliefs about health problems and the effects of health promotion behaviors will affect health promotion behaviors (Skinner, Tiro, & Champion, 2015). For instance, when people understand the extent to which a health care issue affects the population to which they belong, their vulnerability to that illness, and the actions they can take to prevent the health issue, they are likely to make some effort in changing their behaviors in a way that influences their health and wellbeing. In this teaching program, it is expected that the beliefs of the targeted population on Type 2 diabetes, their understanding of the risk factors, and health promotion behaviors will promote lifestyle changes to reduce the prevalence of health issue.

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

The goal of this teaching is to reduce the disease burden of type 2 diabetes and improve the general wellbeing of affected people, or those at risk of type 2 diabetes (Healthy People 2020.

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

 

The Alma-Ata Health for All Global Initiatives are a set of short declarations, co-sponsored by the WHO, expressing the need for urgent action for the improvement of global health. One of the declarations states, “Governments have a responsibility for the health of their people which can be fulfilled only by the provision of adequate health and social measures.” The goal presented above is a reflection of government action to take social measures for the improvement of the wellbeing of the targeted population.

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

Behavioral Objective 
and Domain
Example – Third-grade students will name one healthy food choice in each of the five food groups by the end of the presentation. (Cognitive Domain)

Content  

(be specific)Example – The Food Pyramid has five food groups which are….Healthy foods from each group are….
Unhealthy foods containing a lot of sugar or fat are….

Strategies/Methods

(label and describe)

Example – Interactive poster presentation of the Food  Pyramid. After an explanation of the poster and each food category, allow students to place pictures of foods on the correct spot on the pyramid. Also, have the class analyze what a child had for lunch by putting names of foods on the poster and discussing what food group still needs to be eaten throughout day.

1)      1. Students will define Type 2 diabetes (cognitive domain)

2)      1. The teacher will define Type 2 Diabetes. This is a chronic condition that prevents the body from using its insulin as required.

3)      1. A presentation will be used demonstrating the definition of type 2 diabetes. A pictorial representation of the characteristics that are associated with this health issue will be included to engage the students.

4)      2. The students will be able to name factors that cause type 2 diabetes (cognitive domain).

5)      2. Contributing factors to type 2 diabetes: the teacher will explain the factors that cause the development of type 2 diabetes.

6)      2. A video case presentation of a hypothetical patient who lived a lifestyle that led to the diabetes. The students will learn the emphasized risk factors from the life of this patient.

7)      3. Students will demonstrate strategies that they plan to use to reduce risk of diabetes (cognitive domain).

3. Strategies for the prevention of diabetes: the teacher will make a presentation of the strategies that can be used to reduce the risk of type 2 diabetes.

3. Interactive tabular representation of risk reduction strategies with an explanation of the mechanism through which the actions reduce the risk of diabetes.

8)      4.Students will develop an example of a meal plan for reducing the risk of diabetes (cognitive domain).

9)

10)

11)

4. The teacher will develop a healthy food pyramid that lists foods in tiers depending on how healthy of unhealthy they are. Students will use this pyramid to create their food plans.

4. An interactive video of the food pyramid will be used as part of the presentation to help students understand the differences between healthy and unhealthy foods.

 

 

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

 

Creativity has been applied in the selection of the interactive strategies for the class. It was important to make this teaching as relatable and effective as possible. For instance, the use of a hypothetical case study of a patient with diabetes helps the students to make a connection between the lesson and real-life experiences.

 

 

 

 

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

 

The definition of Type 2 Diabetes: I will examine the accuracy of the definition of diabetes that was developed by the students.

 

 

The number of factors that cause Type 2 Diabetes: I will examine the students’ ability to name the factors that contribute to the development of diabetes by examining the list that they develop.

 

 

Strategies to reduce diabetes risk: I will examine the list of factors that students list as strategies to reduce their risk of getting diabetes.

 

 

Food plan: I will evaluate the inclusion of healthy meals in the plans that have been developed by the students.

Community Teaching Work Plan Proposal Example

Planned Evaluation of Goal
:

 

The effectiveness of the teaching plan will be examined immediately after the lesson. The lesson involves teachings of behavior change that need to be applied for a long period of time. Therefore, the teaching effectiveness will need to examine the extent to which the students understand the behavioral changes that they will need to make after the class.

 

Planned Evaluation of Lesson and Teacher
(Process Evaluation):

 

Formative assessment: Within the lesson the teacher will ask questions to determine how well the students are understanding the concepts of the lesson. This will help to determine the effectiveness of the teaching process.

 

Barriers:

 

Attention issues: Students may frequently lose attention to the concepts of the class. This challenge will be reduced by making the classroom more engaging.

 

Low student motivation: There is a possibility for students to lack enough motivation to be a part of the class. A recognition system for meeting class objectives will be used to motivate students.

 

Therapeutic Communication

4.2 Communicate therapeutically with patients. Community Teaching Work Plan Proposal Example

 

Therapeutic communication is a face-to-face process of interaction that focuses on the improvement of the physical and emotional wellbeing of the patient. In this case, the students will be the patients whose wellbeing needs improvement.

The presentation will capture the interest of the audience by starting with a shocking fact about diabetes. The students’ interest will likely be captured when they see the seriousness of the issue that is about to be taught. To promote active learning, question and answer sessions will be used. This will give students a chance to ask for clarification in areas that they may be struggling to understand. The conclusion of the presentation will be an action appeal asking the students to make lifestyle changes.

Nonverbal communication strategies that will be used include facial expressions and hand gestures that are in line with what is being taught. This will help to make the teaching more interactive. Community Teaching Work Plan Proposal Example

 

References

American Diabetes Association (2017). Diabetes Statistics. Retrieved from:
https://www.diabetes.org/resources/statistics/statistics-about-diabetes

Georgia Department of Health (2015). Diabetes Report and Action Plan. Retrieved from:
https://www.alliantquality.org/sites/default/files/Georgia%20Diabetes%20Action%20Plan%20FINAL%20DEC%202015.pdf

Healthy People 2020 (2019). Diabetes. Retrieved from:
https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes

Hung, M. L., Chou, C., Chen, C. H., & Own, Z. Y. (2010). Learner readiness for online learning: Scale development and student perceptions.
Computers & Education
,
55
(3), 1080-1090.

Skinner, C. S., Tiro, J., & Champion, V. L. (2015). Background on the health belief model.
Health behavior: Theory, research, and practice
,

World Health Organization (2018). Diabetes. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/diabetes

 

Interview Questions

 

What is your name and title?
Janet Moreland, hospital Administrator

 

I know that in the past you worked as a community health nurse, how long did you hold that position?
For 15 years. I became a community health nurse in 1987, and was later promoted to senior community nursing supervisor.

 

How long have you been practicing in Palm Beach County, Florida?
For more than 35 years.

 

What is your role as a community health nurse?
I was responsible for Family planning, providing treatments, immunization and most importantly education.

 

I noticed you have experience in hospital, home health, skilled nursing, community and public health primary care environments and you are now the Administrator of Lakeside Medical Center. Which position would you say prepared you for your current position?
Healthcare administrator. Community Teaching Work Plan Proposal Example

 

 

How would you describe Palm Beach County in relation to other districts, are we progressive in comparison?
Yes, Palm Beach County has a really good healthcare system. Palm Beach County is really good structure as it relates to the needs of the insured and the uninsured.

 

Do you face any challenges when serving the community?
Somewhat… trying to help patients understand their diagnosis and the education related to it. We have to get out and in the community, we can’t expect them to come to us. We have to get them to understand the diagnosis and how to take care of themselves to live a healthy and productive life.

 

 

Do you think that Palm Beach County is a healthy community?
For example, many people are concerned with the air quality in this area. With what you’ve seen is this an issue, and do you think we suffer more than other area’s health wise? Looking at the data from 2018, although it only looked at race and ethnicity, Palm Beach County isn’t a healthy county. Diabetes, hypertension and people with cardiovascular issues is high. The hospital is looking into buying the property next to it where there will be a walking track, and a vegetable field.

 

 

Who do you believe is most at risk for health concerns in the County?
African American, related to diet, not only cardiovascular disease but also breast health. We have to get a navigator to go out into the community and educate the public. Most African Americans do t find out that they have breast cancer until it reaches a stage 3 or 4.

 

What are some of the health risk factors that cause diseases within Palm Beach County?
Hereditary,language barrier, diet, lack of exercise, education status, trying to get those who are at a5th grade level to understand.

 

How do you educate the community?
By getting back into the community and out of the hospital. Partnering with other organizations, and getting with the community liaison to bring back information from the community.

 

What are some of the challenges that you encounter when educating the community?
Understanding basic things such as food consumption, reading labels, being able to educate them and letting them know the importance of seeing a nutritionist, and not waiting until something bad happens before they see a doctor. They can no longer have to worry about transportation, because we know have several free methods of transportation in the community. Community Teaching Work Plan Proposal Example

 

For a person thinking of relocating to Palm Beach County, what advice would you give him or her about living a healthy?
Know the available resources and take advantage of it. Find a medical home, make and keep your appointments, ask for your medical records. Community Teaching Work Plan Proposal Example

NUR-635-D1Q1 Minimum of 300 words with two or more peer review reference

Depending on the board of nursing in your state, there may be additional requirements to become a prescriber after you complete your APRN program.

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Describe the necessary steps required, for the state Florida , in order to become a prescriber? After you have completed these steps, you decide to celebrate on a family vacation in a different state. Your sister asks you to refill her levothyroxine because she forgot to pack her medication. What are the legal and ethical implications as a new prescriber to consider in this situation? NUR-635-D1Q1

NUR-635-D1Q2R2 Minimum of 250 words with at least 2 peer review reference in APA format

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Identify the process of rational drug prescribing. Pick a condition and determine what steps you would complete specific to this condition to properly prescribe, manage, regulate, and educate the pharmaceutical need for your patient. What process would you institute in your future practice to ensure rational prescribing with new evidence-based practice guidelines? NUR-635-D1Q2R2

NUR 621-D2Q2R1

Minimum of 250 words with at least 2 peer review reference in APA format

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Uninsured patients can impact the financial status of a health care organization. What are the ethical implications of distributing scarce resources? How do you balance the cost of business versus the quality of care in order to ensure all patients are treated fairly and receive the care that they need?