Category: Nursing

NRS 490 RS Scholarly Activity Summary Example

Scholarly Activities NRS-490

Student’s Name

Institution of Affiliation

Course Name

Date

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Overview

This week, the scholarly activity that I took part in was a wound care seminar which lasted for four days. Routine seminars were a major part of this organization’s culture. The seminars were a source of empowerment and inspiration for nurses, physicians and other healthcare providers working in various units. The seminars provided the latest wound care management standards as a way of attaining excellence and improving patient health outcomes. It also presented an opportunity to obtain ongoing education credits and improve clinical outcomes in nursing practice. As a nurse, I always believe that the most significant aspects of nursing practice are: maintaining professional membership and remaining committed to lifelong learning. I also attended a pressure ulcer IDT meeting through which healthcare professionals learned from various wound specialization experts, asked questions and acquired new knowledge on what wasn’t taught in class. NRS 490 RS Scholarly Activity Summary Example

The pressure ulcer IDT meeting had four major goals: to develop a new pressure ulcer prevention program through well-defined roles and responsibilities of staff, to develop unit-level plans and to train staff on new strategies to reduce pressure ulcers. Both the seminar and the pressure ulcer IDT meeting were well planned for. The seminar was sponsored and organized by the American Professional Wound Care Association. The IDT meeting was headed by a certified wound care nurse and comprised of nutritionists, pharmacists, nurse practitioners, and physicians. To actualize its goal, the IDT meeting, identified and replaced routine clinical practices that either delayed or prevented wound healing based on organizational wound management guidelines. This resulted in the development of three teams: an implementation team, a wound care team and a unit-based team.

The whole activity was a motivation for nurses who were passionate about specializing in wound care. The key target of the seminar and pressure ulcer IDT meeting were healthcare professionals working in the surgical unit, palliative care, and the ICU.

Problem

Pressure ulcer IDT meeting reviewed two major issues who one quality of care and care coordination.

Quality of Care In Pressure Ulcer Management (1)

Coordination of care with Interdisciplinary Team(1)

NRS 490 RS Scholarly Activity Summary Example

Members of the IDT meeting analyzed each of the cases and listened to the input provided by every staff member who was present. In every case that was reviewed, a  particular set of questions were used to determine whether depending on the patient’s outcome the pressure ulcer care provided was either excellent, good or poor with regards to quality and care coordination. The findings were scored as 3, 2 or 1 respectively.

Solution

Quality of Care In Pressure Ulcer Management- the staff members gave it a score of 2. There were numerous gaps identified in nursing practice such as: failing to provide ongoing reports and communication, failure to integrate the prevention of pressure ulcer in continuous nursing processes. To address this, the implementation team, a wound care team and a unit-based team were formed. These teams were to come up with a communication policy that could clearly explain the how unit champions, unit managers and staff can communicate, give updates using collected data and probably share essential changes in patient safety in wound care plans. The unit-based team was mandated to identify communication strategies of telling families/patients on care progress and sharing skin and risk assessment data when handing over shift reports.

Coordination of care with Interdisciplinary Team (1) – the staff members gave it a score of 3 to imply that wound management care within the unit was excellent due to good coordination. Although there were no gaps in care that were identified, several recommendations were given on how to make care more coordinated including having more specific roles and responsibilities for every member of the interdisciplinary team.

Opportunity

           
By actively participating in this activity, I was able to improve individual knowledge and skills on wound management and ability to work with other professionals in interdisciplinary teams to provide coordinated care. I achieved the professional competency role (Domain 1) through teamwork with the surgical unit staff namely: nutritionist, pharmacists, wound care nurse specialist, wound specialization physicians and nurse practitioners to address key issues in pressure ulcer wound management (1.1), took management and leadership roles with an aim of  promoting holistic and cultural competent care(1.3) and  actively participated in the development of guidelines and policies to improve care delivery and accountability among healthcare team members for  improved clinical outcomes of patients with pressure ulcers (1.4). NRS 490 RS Scholarly Activity Summary Example

Similarly, by taking part in this scholarly activity, I was able to explore nursing theories and how they can be applied in clinical practice to positively influence clinical outcomes (Domain 2) This influenced the ability to use critical thinking to solve real patient scenarios (2.3). Since intense discussions were held and decisions made in the pressure ulcer the IDT meeting with the certified wound care nurse as the first line communication manager, the domain of informatics (Domain 4) was similarly addressed.

Program Competencies Addressed

The program competencies addressed by participating in this scholarly summary activity were competency 1.1, 1.3, 1.4, 2.3 and 4.3

 

References

Coffey, M., Fry, L., Cardenas, L. A., Wing, W., & Skinner, M. (2015). An interdisciplinary approach to pressure ulcer reduction.
Journal of the American Medical Directors Association
, 
16
(3), B18-B19.

Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: prevention and management. 
Journal of the American Academy of Dermatology
.

Mwebaza, I., Katende, G., Groves, S., & Nankumbi, J. (2014). Nurses’ knowledge, practices, and barriers in the care of patients with pressure ulcers in a Ugandan teaching hospital.
Nursing research and practice
, 
2014
.

 

Scholarly Activity Summary

 

This document describes the scholarly activity elements that should be included in a five paragraph summary. You may use this resource to help guide the preparation of the Scholarly Activities assignment, due in Topic 10.

Overview

This section consists of a single paragraph that succinctly describes the scholarly activity that you attended/participated in, the target market for the activity, and the benefit of the activity to you. NRS 490 RS Scholarly Activity Summary Example

Problem

This section consists of either a short narrative or a list of bullet points that concisely identifies the problems the scholarly activity is designed to solve. Educate: What is the current state of the activity topic? Explain why this is a problem, and for whom is it a problem? Inspire: What could a nurse achieve by participating in the scholarly activity? Use declarative sentences with simple words to communicate each point. Less is more.

Solution

This section consists of either a short paragraph or a list of bullet points that concisely describes the solution to a proposed practice problem that the scholarly activity addressed and how it addresses the problem outlined in the previous section.

Opportunity

This section consists of short paragraphs that define the opportunity that the scholarly activity is designed to capture. It is important to cover the objectives and goals that were met. How will attending/participating in this scholarly activity help you grow as a nurse?

Program Competencies Addressed

This section consists of a list of program competencies that were addressed in this scholarly activity. Please use the list from the ISP. NRS 490 RS Scholarly Activity Summary Example

Behavioral systems model essay example

Paper 4 – Nursing or Interprofessional “Theory”: Philosophy, Conceptual Model, or Grand Theory – Describe a nursing or interprofessional “theory” (i.e., a philosophy, conceptual model, or grand theory

Within your Paper 4, in addition to the specifications below, include a brief discussion of the relevance of the theory for your chosen advanced nursing practice role (psychiatric mental health nurse practitioner role) with diverse populations.

10% Introduction – Briefly introduce the focus of the paper.

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70% Discussion – Clearly, thoroughly, and succinctly discuss the focus of the paper, showing evidence of reading of professional literature and synthesis of the focus

10% Summary – Briefly summarize the key points and conclusions from the discussion.

10% Format – Consistently use APA format (6th edition) and correct English grammar across these papers, from the title page through the reference list. These papers must adhere to the following guidelines (all of which are in agreement with APA, 6th ed., format), as well as the other guidelines specified in the APA Manual (6th ed.): (a) be typed in a current version of Microsoft Word that can be opened by the course faculty; (b) be typed in Times New Roman typeface, with 12-point font size; (c) have doublespacing between all lines, including the title page and reference list; (d) have 1-1½ inch margins (top, bottom, right, and left); (e) include a title page and reference page; (f) have headings between sections; and (g) have a running head and page numbers..

Grading Rubric for Papers 1-4 The points for the first three criteria for Papers 1-4 are based on the level of evidence of critical thinking and synthesis related to the criteria and specific focus of the paper, including clarity, thoroughness, evidence of reading professional literature (as applicable to the criteria). For the fourth criteria (i.e., Format), the points are based on the level of evidence/achievement in terms of the accuracy of the format (APA, 6th edition), including grammar, across the paper. Behavioral systems model essay example

*Note: Your grade on your papers will be reduced by 10% within each section of the paper each time that a primary reference is needed and is not included in the section of the paper and/or for each secondary reference used within the section of the paper. Again, it is essential that you only include primary references.

 

Behavioral systems model

Name

Institution

Behavioral systems model

Models in nursing practice are tools that verbalize awareness of professional expectations. An example of this can be seen in the behavioral systems model (BSM) that was first presented by Dorothy Johnson. The model focuses on Johnson’s understanding that research-based knowledge plays a critical role in nursing care and outcomes, proposing that effective and efficient behavioral functioning are important in patients to prevent illness (Masters, 2015). The present paper explores BSM as a tool that facilitates efficient and effective nursing care.

Discussion

BSM is based on the awareness that nursing care focuses on applying external elements to optimize patients’ behaviors through preservation the organization and integration of these behaviors so that they do not become threats to the patients’ physical and social health to result in illness. In this case, patients are identified as having a behavioral system comprised of seven subsystems that include achievement, aggression, sexuality, eliminative, ingestive, dependency, and affiliative. The seven subsystems are expected to meet three functional requirements for the patient to be healthy. The first requirement is stimulation for growth. The second requirement is the provision of a nurturing environment. The third requirement is offering protection from noxious influences. Inabilities to meet any one of the three functional requirements results in a state of imbalance whereby nurses intervene to create balance (Masters, 2015). Behavioral systems model essay example

Johnson’s conceptualization of BSM is based on the premise that nurses act in their professional capacity to improve society’s welfare through distinctive approaches. This awareness resulted in the model identifying four nursing goals. The first goal of nursing is to aid patients whose behavior is proportional to (commensurate with) social demands. The second goal of nursing is to aid patients who have the capacity to modify their behavior to support biological imperatives. The third goal of nursing is to aid patients who are able to maximize the benefits received from the skills and knowledge of medical personnel. The fourth goal of nursing is to aid patients whose behavior does not offer evidence of unnecessary trauma as a consequence of illness (Alligood, 2014).

BSM makes assumptions about systems and the structure and function of subsystems. There are four assumptions for each system. First, a system is comprised of the elements and parts of behavior to include integration, interdependency, interaction, and organization. Secondly, a system seeks to balance the forces that act upon and within it, using automatic adaptations and adjustments to balance the natural forces. In addition, behavior is characterized by constancy and regularity seen in the results and requirements, and this is necessary for functionality. Finally, balances in the system reflect successful adaptations and adjustments (Chinn & Kramer, 2015).

There are four assumptions for the structure and function of each subsystem. First, subsystems produce observable outcomes. Also, subsystems have a definite scope of actions and repertoire of choices. In addition, the behavior is characterized by predisposition to act with reference to an objective in certain ways rather than other ways. The fourth assumption is that the objectives of behaviors are based on the drive for the behavior and the form that it takes. In addition, three functional requirements are presented based on the awareness that behaviors are amenable to explanation and description if they are sufficiently stable, predictable, recurrent, purposeful and orderly. Secondly, each subsystem serves the primary function of preventing stagnation and enhancing growth. Thirdly, systems are protected to harmful influences (Chinn & Kramer, 2015).

Based on BSM, the nursing process has four components.  Assessment that offers details about the biological system in terms of the subsystems. Secondly, diagnosis is presented based on behavioral performance to include dominance, incompatibility, discrepancy, and insufficiency. Thirdly, planning and implementation occur to bring about system balance through stimulating, nurturing and protecting the relevant subsystems. Finally, evaluation is conducted to determine if the system has achieved balance (Zaccagnini & White, 2011). Behavioral systems model essay example

Conclusion

BSM is a nursing care model that advocates for fostering effective and efficient behavioral functioning as important for preventing illness. In addition, patients are defined by a behavioral system comprised of seven subsystems with each one having four structural characteristics. Besides that, each subsystem has four functional requirements that include protection, providing a nurturing environment, and stimulating growth. In this respect, BSM is a tool that facilitates efficient and effective nursing care.

References

Masters, K. (2015). Nursing
theories: a framework for professional practice
(2
nd
ed.). Burlington, MA: Jones & Bartlett Learning.

Alligood, M. (2014).
Nursing theorists and their work
(8
th
ed.). St. Louis, MO: Elsevier/Mosby.

Chinn, P. & Kramer, M. (2015).
Knowledge development in nursing: theory and process
(9
th
ed.). St. Louis, MO: Elsevier/Mosby.

Zaccagnini, M. & White, K. (2011).
The doctor of nursing practice essentials: a new model for advanced practice nursing
. Sudbury, MA: Jones & Bartlett Learning. Behavioral systems model essay example

NURS 4100 Common Flaws in Quantitative nursing Studies

NURS 4100 -Quality and Safety Through Evidence-Based Practice

BSN Completion Program

Walden University

Critical Appraisal of Qualitative Research

Smucker, D., Regan, S., Elder, N., &   Gerrety, E. (2014). Patient safety   incidents in home hospice care:

The experiences of hospice interdisciplinary team members. 
Journal of Palliative Medicine,

17
(5), 540-544.

Quality

Is the journal peer-reviewed?

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Are the authors qualified to conduct the research?

Focus of Study

What experience or situation are the researchers seeking to understand?

Study Design

What is the expected outcome of the study?

Do the researchers want to describe an event, explain a cultural experience or generate a theory?

What is the study design?

Data Collection

Who were the sample and how were they recruited?

How were the data collected?

Control

How did the researchers control their biases or preconceptions during the data collection process?

Data Analysis

How were the data analyzed?

Do the authors include direct quotes and generalized statements as examples of data?

Results

What are the main findings of the study?

What themes emerged from the analysis?

Recommendations

Do the authors provide recommendations for future research?

Limitations

Are the limitations of the study discussed?

 

APPENDIX F

Appraisal Guide:

Findings of a Quantitative Study

 

 

APA Formatted Citation: (4 pts.)

Answer Here:

 

 

Synopsis
(16 pts.)

What was the purpose of the study (research questions, purposes, and hypotheses)?

Answer Here:

 

How was the sample obtained?

Answer Here:

 

What inclusion or exclusion criteria were used?

Answer Here:

 

Who from the sample actually participated or contributed data (demographic or clinical profile and dropout rate)?

Answer Here:

 

What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?

Answer Here:

 

Was an intervention tested? Answer Yes or No

 

How was the sample size determined?

Answer Here:

 

Were patients randomly assigned to treatment groups?

Answer Here:

 

What are the main findings of the study? (10 pts.)

Answer Here:

 

Credibility
(14 pts.)

 

Yes

No

Not Clear

Is the study published in a source that required peer review?

 

 

 

*Did the data obtained and the analysis conducted answer the research question?

 

 

 

Were the measuring instruments reliable and valid?

 

 

 

*Were important extraneous variables and bias controlled?

 

 

 

*If an intervention was tested, answer the following five questions:

 

 

 

Were participants randomly assigned to groups and were the two groups similar at the start (before the intervention)?

 

 

 

Were the interventions well defined and consistently delivered?

 

 

 

Were the groups treated equally other than the difference in interventions?

 

 

 

If no difference was found, was the sample size large enough to detect a difference if one existed?

 

 

 

If a difference was found, are you confident it was due to the intervention?

 

 

 

Are the findings consistent with findings from other studies?

 

 

 

 

All

Some

No

ARE THE FINDINGS CREDIBLE?                  

 

 

 

 

 

 

 

 

Clinical Significance
(6 pts.)

 

Note any difference in means, r
2
s, or measures of clinical effects (ABI, NNT, RR, OR)

Answer Here: NURS 4100 Common Flaws in Quantitative nursing Studies

 

Yes

No

Not Clear

*Is the target population clearly described?

*Is the frequency, association, or treatment effect impressive enough for you to be confident that the finding would make a clinical difference if used as the basis for care?

 

All

Some

No

ARE THE FINDINGS CLINICALLY

SIGNIFICANT?
                                                    

 

*= Important criteria

 

Comments

Answer Here:

 

Common Flaws in Quantitative Studies

The common flaws associated with quantitative studies include inappropriate representation of the target population; requires large sample size to collect data; lack of ability to control the environment; limited outcomes; and complicated data analysis methods (Rahman, 2017).

Inappropriate representation of the target population can interfere with the study’s targeted aims and objectives. In spite of using the suitable sampling plan, representation of the study participants depends on the probability distribution of the available data. This can result in inaccuracy of probability distribution and result in inaccuracy in proposition (Ponto, 2015). Secondly, quantitative studies need large sample sizes and lack of adequate resources may hinder use of adequate sample size when conducting research and hence affect generalization of the study results (Regnault et al, 2018). Moreover, controlling the environment when conducting quantitative research is difficult. As Rahman (2017) explains, when conducting quantitative research, it can be problematic to control the environment where the respondents give answers during the survey or in the questionnaires. The responses are dependent on specific time and conditions existing during that specific time-frame. NURS 4100 Common Flaws in Quantitative nursing Studies

In addition, quantitative researches are associated with limited outcomes due to the structured questionnaires and surveys with close-ended questions. Therefore, the respondents have limited options when it comes to responses and the close-ended questions leads to restricted outcomes delineated within the research proposal (Ponto, 2015). Therefore, the findings do not always represent the actual happenings, in a generalized form. Finally, quantitative studies require complex data analysis methods such as statistical analysis which can be challenging to researchers without knowledge on statistics (Queirós et al, 2017). The requirement to perform efficient statistical confirmation of findings is very challenging within a quantitative study.

 

 

References

Queirós A, Faria D & Almeida F. (2017). Strengths and Limitations of Qualitative and Quantitative Research Methods.
European Journal of Education Studies
. 3(9).

Ponto J. (2015). Understanding and Evaluating Survey Research.
J Adv Pract Oncol
. 6(2), 168–171.

Rahman, S. (2017). The advantages and disadvantages of using qualitative and quantitative approaches and methods in language “testing and assessment” research: a literature review.
Journal of Education and Learning
. 6(1), 102-112. NURS 4100 Common Flaws in Quantitative nursing Studies

Regnault A, Tom W & Barbic S. (2018). Towards the use of mixed methods inquiry as best practice in health outcomes research.
J Patient Rep Outcomes
. 2(19).

 

 

APPENDIX F

Appraisal Guide:

Findings of a Quantitative Study

 

 

APA Formatted Citation: (4 pts.)

Answer Here:

 

 

Synopsis
(16 pts.)

What was the purpose of the study (research questions, purposes, and hypotheses)?

Answer Here:

 

How was the sample obtained? NURS 4100 Common Flaws in Quantitative nursing Studies

Answer Here:

 

What inclusion or exclusion criteria were used?

Answer Here:

 

Who from the sample actually participated or contributed data (demographic or clinical profile and dropout rate)?

Answer Here:

 

What methods were used to collect data (e.g., sequence, timing, types of data, and measures)?

Answer Here:

 

Was an intervention tested? Answer Yes or No

 

How was the sample size determined?

Answer Here:

 

Were patients randomly assigned to treatment groups?

Answer Here:

 

What are the main findings of the study? (10 pts.)

Answer Here:

 

Credibility
(14 pts.)

 

Yes

No

Not Clear

Is the study published in a source that required peer review?

 

 

 

*Did the data obtained and the analysis conducted answer the research question?

 

 

 

Were the measuring instruments reliable and valid?

 

 

 

*Were important extraneous variables and bias controlled?

 

 

 

*If an intervention was tested, answer the following five questions:

 

 

 

Were participants randomly assigned to groups and were the two groups similar at the start (before the intervention)?

 

 

 

Were the interventions well defined and consistently delivered? NURS 4100 Common Flaws in Quantitative nursing Studies

 

 

 

Were the groups treated equally other than the difference in interventions?

 

 

 

If no difference was found, was the sample size large enough to detect a difference if one existed?

 

 

 

If a difference was found, are you confident it was due to the intervention?

 

 

 

Are the findings consistent with findings from other studies?

 

 

 

 

All

Some

No

ARE THE FINDINGS CREDIBLE?                  

 

 

 

 

 

 

 

 

Clinical Significance
(6 pts.)

 

Note any difference in means, r
2
s, or measures of clinical effects (ABI, NNT, RR, OR)

Answer Here:

 

Yes

No

Not Clear

*Is the target population clearly described?

*Is the frequency, association, or treatment effect impressive enough for you to be confident that the finding would make a clinical difference if used as the basis for care?

 

All

Some

No

ARE THE FINDINGS CLINICALLY

SIGNIFICANT?
                                                    

 

*= Important criteria NURS 4100 Common Flaws in Quantitative nursing Studies

NURS 6050 agenda comparison grid and fact sheet Example

Part 1: Agenda Comparison Grid

Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:

Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.

Describe the administrative agenda focus related to the issue you selected.

Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

Explain how each of the presidential administrations approached the issue. NURS 6050 agenda comparison grid and fact sheet Example

(A draft of Part 1: Agenda Comparison Grid should be posted to the Module 1 Discussion Board by Day 3 of Week 1.)

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Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?

Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

 

 

Part 3: Fact Sheet or Talking Points Brief

Based on the feedback that you received from your colleagues in the Discussion, revise Part 1: Agenda Comparison Grid and Part 2: Agenda Comparison Grid Analysis.

Then, using the information recorded on the template in Parts 1 and 2, develop a 1-page Fact Sheet or Talking Points Brief that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. You can use Microsoft Word or PowerPoint to create your Fact Sheet or Talking Point Brief. Be sure to address the following:

Summarize why this healthcare issue is important and should be included in the agenda for legislation.

Justify the role of the nurse in agenda setting for healthcare issues.

 

Agenda Comparison Grid Template

Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2

 

Part 1: Agenda Comparison Grid

 

Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas.

 

You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment.

 

 

Identify the Population Health concern you selected.

Opioid Crisis

 

Describe the Population Health concern you selected and the factors that contribute to it.

Drug overdose deaths continue to increase in the United States and continue to affect men and women from different backgrounds to include geographical, educational and ethnicity. The opioid crisis became prevalent in the late 1990’s partly to lack of information regarding the medications resulted from an increased rate in prescriptions drugs by subscribers (U.S. Department of State, 2017).

 

 

Administration (President Name)

(Donald J. Trump)

(Barack Obama)

(George W. Bush)

Describe the administrative agenda focus related to this issue for the current and two previous presidents.

 

The current administration has declared this crisis a public health emergency and talked about several ways to enforce and improve the crisis through improving access to prevention, treatment, and recovery services while targeting the availability and distribution of overdose-reversing drugs.

 

 

 

 

 

 

 

 

Some of the agenda of this president included a focus on healthcare availability allowing affected groups better and faster access to treatments and services while restricting prescribers ability to overprescribe (U.S. Department of State, 2012)

The focus of that administration was mainly focused on creative a budget for law enforcement because addiction was perceived as a crime rather than a public health issue.

Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.

According to the department of health and human services, “in 2017, HHS invested more than $900 million in opioid-specific funding, including to support state and local governments and civil society groups (HHS.gov, 2019).

 

 

 

 

 

 

 

 

Training is provided to first responders with access to availability of overdose-reversing drugs.

Funds were allocated to assist Training and resources were provided to law enforcement while offenders were sent to jails and/or rehabilitation services.

Explain how each of the presidential administrations approached the issue.

The current administration continues to approach the situation using a five-point strategy including prevention, treatment, recovery, research on addiction and pain, and advance the practice of pain management. HHS recommends prescribing Naloxone to patients at high risk for an opioid overdose (HHS.gov, 2019).

 

 

 

 

 

 

 

 

The administration approached the issue by ensuring that services were available to rural and underserved communities through easy access to services while providing access to public transportation. Physicians and nurses education included awareness and treatment of the crisis to reduce stigma and to improve adherence to treatments.

Although funding was available, the issue was approached at a criminal level rather than a health care crisis. More emphasis was placed on law enforcement ability to fight the issue as a crime while the most affected communities were left without treatments or services (CDC.gov, 2019).

 

References

 

U.S Department of Health and Human Services (HHS). National Opioid Crisis. (2019, August 27). The opioid epidemic in numbers. Retrieved from www.http:/hhs.gov

 

U.S. Department of State. (2012, February 12). President Bush announces drug control strategy. Retrieved from https://201-2009.state.gov/p/inl/rls/rm/8451.htm

 

What is the U.S. Opioid Epidemic? Opioid Crisis. (2019, August 27). Retrieved from Centers for Disease Control and Prevention (CDC). Retrieved from
http://wonder.cdc.gov
.

 

 

Part 2: Agenda Comparison Grid Analysis

 

Using the information you recorded in Part 1: Agenda Comparison Grid, complete the following to document information about the population health/healthcare issue your selected

 

Administration (President Name)

(Donald J. Trump)

(Obama Barack)

(George W. Bush)

Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?

 

The current administrative agency is more likely be responsible for helping me with my chosen healthcare issue of opioid crisis since more is being done today to come up with new ways to solve this issue than ever before. President Trump announced on October 26, 2017, that his administration had declared the opioid crisis a nationwide Public Health emergency (Whitehouse, March 2018}.

President Trump immobilized his entire administration to address this issue by labeling it as a public health emergency and directed the declaration of a nationwide public health emergency to address the issue (

This action allows for expanded access to telemedicine services, including services involving remote prescribing of medicine commonly used for substance abuse or mental health treatment (

The declaration opened up avenues necessary to combat the crisis. Ways to fight back the crisis include: prevention, treatment, and recovery.

 

 

 

 

 

 

Between 2013 and 2017, more than 67,000 people died of synthetic-opioid By 2016, thousands of people were dying from overdoses of fentanyl, the deadliest drug to ever hit U.S streets and the administration needed to take immediate action. By then, the epidemic had been escalating for over three years. (washingtonpost, March 2018)

The opioid crisis represented an extraordinary public health challenge, according to 11 experts back in 2016, the Obama administration considered the request but did not take immediate actions. The decision was one in a series of missed opportunities, oversights and half-measures by federal officials who failed to grasp how quickly, and fatal fentanyl was which contributed to the opioid epidemic.

After the 2016 election, at the urging of President Obama, Congress approved nearly $1 billion for oipiod treatment programs. Drug policy experts called that figure” a drop in the bucket”.(      ).

The administration had comprehensive approach to the opioid crisis which included passage of the Affordable Care Act, a push for funding to expand treatment and the updating of guidelines for prescribing opioids. The administration added money to accelerate data collection on overdoses. The administration also met held “roundtable” with grieving parents.

As law enforcement began cracking down in 2005 on prescription opioids such as Oxycontin and Vicodin, addicts turned to heroin, which was cheaper and more available. Then, in 2003, fentanyl arrived, and overdoses and deaths soared (whashingtonpost, March 2019).

NURS 6050 agenda comparison grid and fact sheet Example

 

How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?

For years, congress didn’t provide significant funding to combat the opioid epidemic. U.S. Customs and border protection didn’t have enough officers, properly trained dogs or sophisticated equipment to curb illegal fentanyl shipments entering the country from China and Mexico. The US postal service didn’t require electronic monitoring of international packages, making it difficult to detect parcel containing opioids ordered over the internet from China(     ).

Facing hotly contested midterm elections in 2018, Congress finally passed legislation aimed at addressing the increasingly politicized opioid crisis, including measures to force the Postal Office Service to start tracking international packages.

NURS 6050 agenda comparison grid and fact sheet Example

 

No one in Congress issued public statements or calls for actions despite the rise in overdoses and deaths

Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents?

 

Note: Part 3: of the Module 1: Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief is a 1-page Fact Sheet or Talking Points Brief the you will create in a separate document.

 

 

Part 2: Agenda Comparison Grid Analysis

Administration (President Name)

(Donald J. Trump)

(Obama Barack)

(George W. Bush)

Administrative Agency

-President Donald Trump’s administration declared the opioid crisis to be a public health emergency and was clear on some of the ways his administration would use to address the issue (Gostin, Hodge & Noe, 2017).

-He ensured the formation of the Commission on Combating Drug Addiction and the Opioid Crisis under the leadership of New Jersey governor Christ Christie. The commission provided 56 recommendations on how best to address the opioid crisis (Baker, 2017).

-Several Medicaid changes were proposed  to combat the crisis

– Trump signed the International Narcotics Trafficking Emergency Response By Detecting Incoming Contraband With Technology (INTERDICT) Act which was a boost for the country’s screening tools for the customs agents.

-President Trump’s administration approach to this issue is more aggressive as compared to previous administrations thus the best choice for addressing this issue.

-President Barack Obama’s administration was more aggressive than the administration of George Bush in addressing the opioid crisis.

– Although he implemented the Prescription Drug Abuse Prevention Plan the crisis did not incorporate the abuse and misuse of carefentanil and fentanyl (Nelson, Juurlink & Perrone, 2015).

-in 2010, he passed the Fair sentencing Act where different drugs were given different sentences.

-Signed the CARA Act into law to expand access to naloxone in efforts to combat the crisis (Painter, 2017).

-Obamas administration delayed efforts to curb the opioid crisis until the year 2015.

– The crisis was in its initial stages during George’s administration.

NURS 6050 agenda comparison grid and fact sheet Example

-Bush proved to be more reactive than proactive  in combating the crisis

– The national government was generally not well prepared in terms of resources and technology, which allowed the flourishing of the illegal drug market.

Agenda Setting

Under Trump’s administration, the agenda of addressing the opioid crisis was set and maintained by the administration’s leadership through a five-point strategy of prevention, treatment, recovery and research and advanced practice.

Barack’s administration set the opioid crisis agenda by championing for universal health coverage through the ACA to guarantee access to care in all community settings and nurse practitioners to fill the gaps in practice.

George Bush’s administration set and maintained the opioid crisis agenda from a legal perspective where a lot of emphasis was placed   on addressing the issue as a form of crime especially in community settings that had little or no access to care services.

Champion/Sponsor

Admiral James Winnefeld who formed the Stop Addiction Fatality Epidemic (SAFE) after losing their son to an opioid drug overdose in 2017.

Senator Sheldon Whitehouse who introduced the Comprehensive Addiction and Recovery Act that was signed into law in 2016 by president Obama.

Hillary Clinton, the US first lady from 1993-2001 when the opioid crisis had just began and US senator from 2001 to 2009 could be the best champion.

 

Part 3: Fact Sheet

Why the Opioid Crisis Is Important For the Legislation Agenda

Epidemiology

The opioid crisis affects people of all races, ages, and gender. However, older adults are the most affected due to high reliance on opioids to cope with very painful chronic illnesses.

The 2012-2013 data from the National Epidemiology Survey on Alcohol and associated conditions revealed that 2.5% of adults aged 65 and older used prescription opioids for 12 months with no medical indication (Gostin, Hodge & Noe, 2017).

5% of this population was later diagnosed with opioid use disorder.

Physical, Social, Physiological and Psychological Effects

Long term use of opioids can result in drowsiness, euphoria, and respiratory complications (McCarty, Priest & Korthuis, 2018).

In more severe cases, individuals can develop opioid use disorder with withdrawal symptoms, being unable to reduce or control their use, addiction, inability to perform educational and work responsibilities and activities of daily life, being tolerant, interpersonal and social problems (McCarty, Priest & Korthuis, 2018).

Mortality and Morbidity Rates

The opioid epidemic in the United States claims more than 30,000 individuals annually.

In the year 2017, more than 70,000 mortalities occurred from a drug overdose and 50,000 involved opioid use(Painter, 2017). NURS 6050 agenda comparison grid and fact sheet Example

The number of deaths and disability has gradually increased over the years.

Economic Implications

Managing opioid use disorder and its related symptoms has proven to be costly for individuals, households and the federal government.

Trump’s administration used approximately $11billion in the 2017-2018FY to address the opioid crisis in terms of prevention, recovery, treatment and promoting the continuum of care (Gostin, Hodge & Noe (2017)

Nurse’s Role In Opioid Crisis Agenda Setting

Prevention and Early Recognition

Nurses can have a significant role in early recognition and prevention of opioid misuse and abuse since they are at the first contact with patients and spend more time with them.

Prescription Monitoring

Nurses are positioned to identify patients who start to gradually be addicted to opioids by monitoring prescriptions (Murthy, 2016).

Advocacy

Nurses can advocate for the implementation of appropriate policies and strategies of pain management, develop new standards on how to write opioid prescriptions and protocols for opioid addiction treatment for released convicts.

 

References

Baker, D. W. (2017). History of The Joint Commission’s pain standards: lessons for today’s prescription opioid epidemic. 
Jama
, 
317
(11), 1117-1118. NURS 6050 agenda comparison grid and fact sheet Example

Christie, C., Baker, C., Cooper, R., Kennedy, P. J., Madras, B., & Bondi, P. (2017). The president’s commission on combating drug addiction and the opioid crisis. 
Washington, DC, US Government Printing Office, Nov
, 
1
.

Gostin, L. O., Hodge, J. G., & Noe, S. A. (2017). Reframing the opioid epidemic as a national emergency. 
Jama
, 
318
(16), 1539-1540.

McCarty, D., Priest, K. C., & Korthuis, P. T. (2018). Treatment and prevention of opioid use disorder: challenges and opportunities. 
Annual review of public health
, 
39
, 525-541.

Murthy, V. H. (2016). Ending the opioid epidemic—a call to action. 
New England Journal of Medicine
, 
375
(25), 2413-2415.

Nelson, L. S., Juurlink, D. N., & Perrone, J. (2015). Addressing the opioid epidemic. 
Jama
, 
314
(14), 1453-1454.

Painter, S. G. (2017). Opiate crisis and healthcare reform in America: A review for nurses. 
OJIN: The Online Journal of Issues in Nursing
, 
22
(2).

Saloner, B., McGinty, E. E., Beletsky, L., Bluthenthal, R., Beyrer, C., Botticelli, M., & Sherman, S. G. (2018). A public health strategy for the opioid crisis. 
Public Health Reports
, 
133
(1_suppl), 24S-34S. NURS 6050 agenda comparison grid and fact sheet Example

This Nursing theories – received view and perceived view assignment is an online discussion question. It only needs to be a paragraph (250 word minimum) with one scholarly source in APA format.

Assignment: Debate with classmates on the dominant philosophical schools of thought in nursing (received view and perceived view). Which view encompasses the profession of nursing? Why? Provide an example

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Nursing theory

Nursing theories are the fundamental nature of existence, reality and knowledge that act as the guiding principles for the nurse profession. In fact, they explain the attitudes and models that individuals should adopt in their professional behavior as nurses. The diverse nature of the nurse specialties makes it difficult to identify a single theory that encompassing all the specialties in the nursing profession. To be more precise, the nurse practice fields and specialties influence the theories adopted since each theory is intended to guide nurses in caring for patients within a specific health care environment. Each nursing theory typically explains the nursing process for the practice field, identifies the ideal role of the nurse, and defines nursing practice. The theories are created by nurses from their observations during practice, as well as the professional methodologies they develop and apply. Once presented and accepted, the theory is considered a legitimate model of nursing practice within a particular environment. Besides that, each nurse identifies a theory that guides personal philosophy (approach to nursing). The philosophy explains what the nurse believes in, role of nursing in health care, interactions with patients, and ethical principles (Cherry & Jacob, 2016). This understanding makes it clear that nursing theories are subjected to receive and perceived views. Received views are common among novice nurses who rely on theoretical knowledge to identify the relevant nursing theories. They adopt these theories and test them (through experimentation and observation) within the practice environment to determine relevance and whether changes are necessary. Overtime and as the nurses become experts, they start relying on the perceived views that allows them to perceive existing theories with skepticism, present new theories and revise the existing theories based on collectively learned reality, interpretation, interrelatedness and lived experiences (Cherry & Jacob, 2016). In this respect, both the perceived and received views both encompass the profession of nursing.

Reference

Cherry, B. & Jacob, S. (2016).
Contemporary nursing: issues, trends, & management
. Amsterdam: Elsevier Health Sciences.

 

Threaded Discussion:

Assignment Guidelines with Scoring Rubric

Purpose:

The purpose of required threaded discussions is an interactive dialogue among instructors and students to assist the student in organizing, integrating, applying and critically appraising one’s knowledge regarding the nursing profession and selected area of practice.  Scholarly information obtained from current sources as well as professional communication is required.  Application of information to professional experiences promotes the analysis and use of principles, knowledge and information learned and related to real-life professional situations.  Interactive dialogue among instructors and peers foster the development of a learning community as ideas, perspectives and knowledge is shared.

 

Due Date:
First initial posting to the required threaded discussion topic is due by Wednesday, 11:59 pm MT.  Peer and instructor responses are due by Sunday 11:59 pm MT. All posts for week 8 are due by the close of class on Saturday 11:59 pm MT.  Please note that the late assignment policy does not apply to the threaded discussions.

 

Total Points Possible:
Varies with course, please see specific course syllabus.  These guidelines are for a required threaded discussion worth 50 points. Please note that week 8 will be worth only 25 points.

Requirements:

Description of the Assignment

Initial posting: This is defined to be the initial post in which the student responds to the

required threaded discussion topic.  The first posting by a student within the required

discussion area is considered to be the initial posting and will be evaluated using the rubric

criteria.  Scholarship in communication is expected.  Required scholarly source(s) provide

Nursing theories – received view and perceived view

specific information that thoroughly address the required topic.  For the initial posting,

one scholarly source must be presented.  The scholarly source must be an outside

The initial posting must occur before Wednesday, 11:59 pm MT.  Initial postings must be at a minimum of 300 words.  References do not apply toward word count.
ONLY in Week 8,
the initial posting must be a minimum of 200 words with a scholarly reference.  It remains due by Wednesday, 11:59 pm MT.

Peer responses:  As part of the threaded discussion requirements, the student must

The peer response must occur on a separate day from the initial posting and instructor response (see below). This peer response must occur before Sunday, 11:59 pm MT.  This response does not require a scholarly reference unless information is paraphrased and/or direct quotes are used, then APA guidelines apply.  Peer responses must be a minimum of 150 words. References do not apply toward word count.

Instructor response:  The student must respond to an instructor’s follow-up questions. The

instructor’s question may be directed to the student or may be a question directed to another

student in the section.  The response must be comprehensive and scholarly in nature.  Instructor

responses must be a minimum of 150 words.  References do not apply toward word count.

The response to the instructor must occur on a day different from the initial post and a day

different from the peer response. Responses to the instructor must occur before Sunday, 11:59

pm MT.

For week 8 only:
Students are expected to post a peer response or an instructor post but are not

required to do both. These posts must be a minimum of 100 words. References do not apply

toward word count. The peer or instructor response must be on a different day than the initial

post and must occur before Saturday, 11:59 pm MT due to the shorter week.

 

Posting Requirements:

The initial posting must be provided before Wednesday, 11:59 pm MT.

The initial posting must have at least one scholarly outside source that is cited within the

posting and referenced.  Required course textbooks, assigned readings and lesson information

are not considered to be outside scholarly sources.

Initial posting must be a minimum of 300 words; peer responses and instructor responses a

minimum 150 words.

The peer responses and instructor responses must be provided before Sunday, 11:59 pm MT.

All postings are substantive and relate to the graded threaded discussion topic.

Only one small quote (15 words or less) within the entire initial posting is accepted.

Postings must occur on 3 separate days.

For week 8 only:
the required postings are amended due to the shorter week. Two posts are

required. One initial post and either a peer response or an instructor response. Initial post must

be a minimum of 200 words and the peer or instructor response must be a minimum of 100

words. Both posts are required to be on two separate days. All posts must be made by

Saturday, 11:59 pm MT.

 

Criteria for Content

Scholarliness: In this category, the student will conduct a search of the current databases and locate valid, relevant, and reliable information for the required topic.  Each reference must be scholarly.

Application of Course Knowledge: In this category, the student demonstrates the ability to analyze and apply principles, knowledge, and information learned in the course lesson and outside readings. This information is then applied to a real-life professional situation as an example.

Participation Requirement: One initial posting, one peer response and one instructor response (for a total of 3 posts for the week) are required on 3 separate days.

Participation Deadline: The student must provide a substantive response to the graded threaded discussion topic. This must be posted by Wednesday, 11:59 pm MT of each week. Peer and instructor responses must be posted by Sunday, 11:59 pm MT.

For week 8 only:
the required postings are amended due to the shorter week. Two posts are     One initial post and either a peer response or an instructor response. Initial post must be a minimum of 200 words and the peer or instructor response must be a minimum of 100 words. Both posts are required to be on two separate days. All posts must be made by Saturday, 11:59 pm MT.

Criteria for Format and Special Instructions

Instructor reserves the right to submit any threaded discussion posting to TurnItIn in order to verify the originality.

When journals are used as the outside source of information, it is preferred that the journal be peer reviewed. The Chamberlain online librarian is very helpful in assisting you to find an article related to your topic. If you have questions concerning scholarly sources, please refer to the handout entitled “What is a scholarly source” located under “Course Resources” tab.

Web sites vary in quality and scholarship. It is the responsibility of the student to determine the scholarly nature of the web site.  If the instructor determines that the site failed to demonstrate scholarship, points maybe deducted.  Students are cautioned to use care regarding .com sites.  Some .com sites are excellent such as American Heart Association, but others are built by individuals and scholarliness is lacking.  It is recommended that you check with your instructor before using a .com website as a reference.

Only one small quote (15 words or less) within the entire initial posting is acceptable. It is expected that the student will paraphrase the information when presenting information from a scholarly source.  The scholarly source(s) for the paraphrased information must be cited using APA format. Do not include a number of small quotes even if they are just a few words as your instructor considers a quote to be a quote no matter its limited size.

 

 

 

 

 

 

 

Category

Points for

Weeks 1 – 7

Points for

Week 8 ONLY

%

Description

Scholarliness

16

8

32

Demonstrates achievement of scholarly inquiry for professional and academic topics.

Application of Course Knowledge

16

8

32

Demonstrate the ability to analyze and apply principles, knowledge and information learned in the course lesson and outside readings and relate them to real-life professional situations.

Interactive Dialogue

10

5

20

Initial post should be a minimum of 300 words

The peer and instructor responses should be a minimum of 150 words each.

Responses are substantive and relate to the graded threaded discussion topic.

Week 8 only:

Initial posts should be a minimum of 200 words.

The peer or instructor response should be a minimum of 100 words.

Grammar, Syntax, and APA

8

4

16

Students are expected to demonstrate proper grammar, syntax, and APA style of writing.  Correct APA format is expected within the text of the assignment as well as the reference page(s).

Participation Requirements

5 points deducted if not demonstrated

 Initial, peer, and faculty postings were made on 3 separate days.

Week 8 only: Initial, and peer or faculty posts were made on 2 separate days.

Participation Deadline

5 points deducted if not demonstrated

The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

 

The peer and instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT

 

Week 8 only:

Both initial posting and peer or instructor responses are to be posted no later than Saturday, 11:59 pm MT.

TOTAL

50 points

25 points

100

 

 

 

 

 

Grading Rubric Guidelines Week 1-7

 

Performance  Category

100% or highest level of performance

100%

 

16 points

Very good or high level of performance

88%

 

14 points

Acceptable level of performance

81%

 

13 points

Inadequate demonstration of expectations

68%

 

11 points

 

Deficient  level of performance

56%

 

9 points

 

Failing level

of performance

 

55% or less

 

0 points

 

16 Points

14 Points

13 Points

11 Points

9 Points

0 Points

Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic topics.

 

Presentation of information was exceptional and included
all
of the following elements:

 

 

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information was good, but was superficial in places and included all of the following elements:

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information was minimally demonstrated in all of the following elements:

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information is unsatisfactory in
one
of the following elements:

 

 

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information is unsatisfactory in
two
of the following elements:

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information is unsatisfactory in
three

or more
of the following elements

 

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

 

16 Points

14 Points

13 Points

11 Points

9 Points

0 Points

Application of Course Knowledge

Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations

 

 

Presentation of information was exceptional and included
all
of the following elements:

 

·   Applies principles, knowledge and information from   scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

 

Presentation of information was good, but was superficial in places and included
all
of the following elements:

·   Applies principles, knowledge and information from scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

Presentation of information was minimally demonstrated in the
all
of the following elements:

·   Applies principles, knowledge and information from scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

Presentation of information is unsatisfactory in
one
of the following elements:

·   Applies principles, knowledge and information from scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from and scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

Presentation of information is unsatisfactory in
two
of the following elements:

·   Applies principles, knowledge and information from scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

Presentation of information is unsatisfactory in
three
of the following elements

 

·   Applies principles, knowledge and information and scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

10 Points

9 Points

 

 

6 Points

0 Points

Interactive Dialogue

 

Initial post should be a minimum of 300 words (references do not count toward word count)

The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)

Responses are substantive and relate to the topic.

Demonstrated
all
of the following:

 

·         Initial post must be a minimum of 300 words.

 

·         The peer and instructor responses must be a minimum of 150 words each.

 

·         Responses are

substantive.

 

·         Responses are related to the topic of discussion.

 

Demonstrated 3 of the following:

·         Initial post must be a minimum of 300 words.

 

·         The peer and instructor responses must be a minimum of 150 words each.

 

·         Responses are substantive.

 

·            Responses are related to the topic of discussion.

Demonstrated 2 of the following:

·         Initial post must be a minimum of 300 words.

 

·         The peer and instructor responses must be a minimum of 150 words each.

 

·         Responses are

substantive.

 

·         Responses are related to the topic of discussion.

 

Demonstrated 1 or less of the following:

·         Initial post must be a minimum of 300 words.

 

·         The peer and instructor responses must be a minimum of 150 words each.

 

·         Responses are

substantive.

 

·         Responses are related to the topic of discussion.

 

8 Points

7 Points

6 Points

5 Points

4 Points

0 Points

Grammar, Syntax, APA

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

 

·         Error is defined to be a unique APA error. Same type of error is only counted as one error.

The following was present:

 

·   0-3 errors in APA format

 

AND

 

 

·   Responses have

0-3 grammatical,

spelling or

punctuation

errors.

 

AND

 

·   Writing style is generally clear, focused on topic,

and facilitates communication.

 

 

The following was present:

 

·   4-6 errors in APA format.

 

AND/OR

 

·   Responses have

4-5 grammatical,

spelling or

punctuation

errors.

 

AND/OR

 

 

·   Writing style is somewhat

focused on topic.

The following was present:

 

·   7-9 errors in APA format.

 

AND/OR

 

 

·   Responses have

6-7 grammatical, spelling or

punctuation

errors.

 

AND/OR

 

 

·   Writing style is

slightly focused

on topic making discussion difficult to understand.

The following was

present:

Nursing theories – received view and perceived view

 

·   10- 12 errors in APA format

 

AND/OR

 

 

·   Responses have 8-9 grammatical, spelling and punctuation

errors.

 

AND/OR

 

·   Writing style is not focused on topic, making discussion difficult to understand.

 

 

The following was

present:

 

·   13 – 15 errors in

APA format

 

AND/OR

 

·   Responses have

8-10 grammatical,

spelling or

punctuation

errors.

 

AND/OR

 

·   Writing style is not focused on topic, making discussion difficult to understand.

 

AND/OR

 

·   The student

continues to make repeated mistakes

in any of the above areas after written correction by the instructor.

 

The following was present:

 

·   16 to greater errors in APA format.

 

AND/OR

 

·   Responses have more than 10 grammatical, spelling or punctuation errors.

 

AND/OR

 

·   Writing style does not facilitate communication

 

 

0 Points Lost

 

 

 

 

5 Points Lost

Participation Requirements

 

Demonstrated the following:

 

·         Initial, peer, and faculty postings were made on 3 separate days

 

Failed to demonstrate the following:

 

·         Initial, peer, and faculty postings were made on 3 separate days

 

0 Points Lost

 

 

 

 

5 Points Lost

Due Date Requirements

Demonstrated
all
of the following:

 

·         The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

 

·         A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

Nursing theories – received view and perceived view

 

 

 

Demonstrates
one

or less
of the following.

·         The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

 

·         A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.

 

 

 

 

 

Grading Rubric Guidelines Week 8 ONLY

 

Performance  Category

100% or highest level of performance

100%

Very good or high level of performance

88%

Acceptable level of performance

81%

Inadequate demonstration of expectations

68%

Deficient  level of performance

56%

Nursing theories – received view and perceived view

Failing level

of performance

55% or less

 

8 Points

7 Points

6 Points

5 Points

4 Points

0 Points

Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic topics.

 

Presentation of information was exceptional and included
all
of the following elements:

 

 

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information was good, but was superficial in places and included all of the following elements:

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information was minimally demonstrated in all of the following elements:

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information is unsatisfactory in
one
of the following elements:

 

 

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information is unsatisfactory in
two
of the following elements:

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

Presentation of information is unsatisfactory in
three

or more
of the following elements

·         Provides evidence of scholarly inquiry relevant to required TD topic(s).

 

·         Presents specific information from scholarly sources to develop a comprehensive presentation of facts.

 

·         Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*

 

·         Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.

 

8 Points

7 Points

6 Points

5 Points

4 Points

0 Points

Application of Course Knowledge
–

Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations

 

 

Presentation of information was exceptional and included
all
of the following elements:

 

·   Applies principles, knowledge and information from   scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

 

Presentation of information was good, but was superficial in places and included
all
of the following elements:

·   Applies principles, knowledge and information from scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

Presentation of information was minimally demonstrated in the
all
of the following elements:

·   Applies principles, knowledge and information from scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

Presentation of information is unsatisfactory in
one
of the following elements:

·   Applies principles, knowledge and information from scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from and scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

Presentation of information is unsatisfactory in
two
of the following elements:

·   Applies principles, knowledge and information from scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned from scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

Presentation of information is unsatisfactory in
three
of the following elements

 

·   Applies principles, knowledge and information and scholarly resources to the required topic.

 

·   Applies facts, principles or concepts learned scholarly resources to a professional experience.

 

·   Application of information is comprehensive and specific to the required topic.

 

5 Points

4 Points

 

 

2 Points

0 Points

Interactive Dialogue

For Week 8 only:

 

Initial post should be a minimum of 200 words (references do not count toward word count)

The peer and instructor responses must be a minimum of 100 words each (references do not count toward word count)

Responses are substantive and relate to the topic.

Demonstrated
all
of the following:

 

·         Initial post must be a minimum of 200 words.

 

·         The peer or instructor responses must be a minimum of 100 words each.

 

·         Responses are

substantive.

 

·         Responses are related to the topic of discussion.

 

 

Demonstrated 3 of the following:

·         Initial post must be a minimum of 200 words.

 

·         The peer or instructor responses must be a minimum of 100 words each.

 

·         Responses are

substantive.

Nursing theories – received view and perceived view

 

·         Responses are related to the topic of discussion.

Demonstrated 2 of the following:

 

 

·         Initial post must be a minimum of 200 words.

 

·         The peer or instructor responses must be a minimum of 100 words each.

 

·         Responses are

substantive.

Nursing theories – received view and perceived view

 

·         Responses are related to the topic of discussion.

Demonstrated 1 or less of the following:

·         Initial post must be a minimum of 200 words.

 

·         The peer or instructor responses must be a minimum of 100 words each.

 

·         Responses are

substantive.

 

·         Responses are related to the topic of discussion.

 

4 Points

 

3 Points

2 Points

 

0 Points

Grammar, Syntax, APA

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition

·         Error is defined to be a unique APA error. Same type of error is only counted as one error.

The following was present:

 

·   0-4 errors in APA

format

 

AND

 

 

·   Responses have

0-4 grammatical,

spelling or

punctuation

errors.

 

AND

 

·   Writing style is

generally clear,

focused on topic,

and facilitates communication.

 

 

The following was present:

 

·   5-9 errors in APA format.

 

AND/OR

 

 

·   Responses have

5-9 grammatical, spelling or

punctuation

errors.

 

AND/OR

 

 

·   Writing style is

slightly focused

on topic making discussion difficult

to understand.

The following was

present:

 

·   10- 13 errors in

APA format

 

AND/OR

 

 

·   Responses have

10-13 grammatical, spelling and

punctuation errors.

 

AND/OR

 

·   Writing style is not focused on topic,

making discussion difficult to

understand.

 

 

The following was present:

 

·   14 to greater errors in APA format.

 

AND/OR

 

·   Responses have more

than 14 grammatical, spelling or punctuation errors.

 

AND/OR

 

·   Writing style does not facilitate communication

 

 

0 Points Lost

 

 

 

 

5 Points Lost

Participation Requirements

 

For Week 8 ONLY:

Demonstrated the following:

·         Initial, and peer or faculty postings were made on 2 separate days

 

Failed to demonstrate the following:

·         Initial, and peer or faculty postings were made on 2 separate days

 

 

0 Points Lost

5 Points Lost

Due Date Requirements

 

 

For Week 8 ONLY:

 

Demonstrated
all
of the following:

 

·         The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

 

·         A minimum of one peer or one instructor response is to be posted within the course no later than Saturday, 11:59 pm MT.

 

 

 

 

 

Demonstrates
one

or less
of the following.

·         The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT.

 

·         A minimum of one peer or one instructor response is to be posted within the course no later than Saturday, 11:59 pm MT.

 

 

NOTE:
To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 pm MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 pm MT Saturday. All discussion requirements must be completed by 11:59 pm MT Saturday of the eighth week. Nursing theories – received view and perceived view

*Scholarly source:
Per the APA Guidelines in Course Resources, only scholarly sources should be used in assignments and threaded discussions. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Your textbook and lesson are not considered to be an outside scholarly source. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available data bases for a peer reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These web sites
are not considered scholarly
as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example American Heart Association is a .com site with scholarship and quality.  It is the responsibility of the student to determine the scholarship and quality of any .com site.  Ask your instructor before using any site that you are unsure of.   If the instructor determines that the site does not demonstrate scholarship or quality, points will be deducted for not using scholarly sources. Current outside scholarly sources are required for the initial posting.  This is defined to be 5 years or less.  Instructor permission must be obtained if using a source that is older than 5 years. Nursing theories – received view and perceived view

NURS 6660 Voluntary and Involuntary Commitment Essay

Decision Between Voluntary and Involuntary Psychiatric Commitment in the Case of a Suicidal Fourteen Year-Old

Voluntarily committing a patient to psychiatric care means that they or their family freely give consent for the same. Involuntarily committing them on the other hand implies that they or their family have not freely given their consent for the same. Based on this particular scenario in the case study, therefore, what would be recommended would be that the minor be involuntarily committed. This is because first and foremost the divorced parents cannot agree whether this adolescent suicide attempt patient should be admitted or not. Secondly, suicidality is the most common reason for inpatient psychiatric admission, with up to 75% of child, adolescent, and adult patients getting hospitalized for the reason of wanting to harm self (National Academy of Sciences, 2019) NURS 6660 Voluntary and Involuntary Commitment Essay.

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Based on Indiana laws, this client is eligible for involuntary commitment. According to Indiana code 12-26-1-1 sec. 1, a client who is deemed to be a danger to themselves by virtue of being mentally unstable can be committed to psychiatric care involuntarily (LawServer Online, 2019). This can either be emergency detention for a maximum of 72 hours (IC 12-26-5) or temporary commitment for a maximum of 90 days (IC 12-26-6). In Indiana, the temporary commitment requires that the PMHNP petitions the municipal court to grant this by giving a written statement outlining the results of examination and assessment as well as the professional expert opinion. However, another physician or clinician giving the same reasons must also be produced (Pace, 2017) NURS 6660 Voluntary and Involuntary Commitment Essay. Because this young client wants to kill himself, he is eligible for involuntarily commitment under this statute by virtue of intent to harm self.

The understanding of the Indiana state laws therefore served to confirm the initial PMHNP opinion that this client required involuntary commitment to the psychiatric unit. Statistics show that close to half of completed suicides in the United States are related to an underlying mental disorder. Also, involuntary commitment is known to be tied to many common suicide risk factors (American Academy of Sciences, 2019). This child is dangerous to himself and may attempt to kill himself once again. According to Ng and Kelly (2012), perception of dangerousness is a factor associated with involuntary commitment or admission NURS 6660 Voluntary and Involuntary Commitment Essay.

If this client were not eligible for involuntary commitment, to support the parents in voluntary commitment some of the actions that would be taken would include thorough assessment of the child for future suicide risk. This would be through either or both the Scale for Suicide Ideation (SSI) and/ or the Beck Hopelessness Scale. Also, if the client were not eligible for involuntary commitment, one of the actions that would be taken to start treatment would be to initiate the psychotherapeutic intervention of cognitive behavioral therapy or CBT (National Academy of Sciences, 2019). This is a non-pharmacologic intervention that intends to modify the client’s behavior and positively influence and direct his future actions. Other measures of psychotherapy that would be attempted would include group psychotherapy. In this, the therapeutic factors of universality and altruism would help the client realise that they are not only alone in what they are going through; but also that there are other persons who care about them and their wellbeing NURS 6660 Voluntary and Involuntary Commitment Essay.  Needless to say, the divorced parents would also benefit from some counselling individually in order to know how to cope with their son’s condition.

 

References

LawServer Online, Inc. (2019).
Indiana code 12-26-1-1. Statutes under which mentally ill and either dangerous or gravely disabled may be involuntarily detained or committed
. Retrieved from
https://www.lawserver.com/law/state/indiana/in-code/indiana_code_12-26-1-1

National Academy of Sciences, (2019).
Chapter: 7 medical and psychotherapeutic interventions
. Retrieved from
https://www.nap.edu/read/10398/chapter/9#231

Ng, X.T. & Kelly, B.D. (2012). Voluntary and involuntary care: Three-year study of demographic and diagnostic admission statistics at an inner-city adult psychiatry unit.
International Journal of Law and Psychiatry, 35
, 317-326. Doi: 10.1016/j.ijlp.2012.04.008

Pace, T. (2017, July 21). How to have someone committed to a psychiatric facility in Indiana.
Legal Beagle
. Retrieved from
https://legalbeagle.com/8573504-someone-committed-psychiatric-facility-indiana.html

 

 

Review the Learning Resources concerning voluntary and involuntary commitment.

Read the Week 7 Scenario in your Learning Resources.

Research your state’s laws concerning voluntary and involuntary commitment

NURS 6660 Voluntary and Involuntary Commitment Essay

 

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?

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. NURS 6660 Voluntary and Involuntary Commitment Essay.

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 NURS 6660 Voluntary and Involuntary Commitment Essay.

 

…were not eligible for involuntary commitment, to support the parents in voluntary commitment some of the actions that would be taken would include thorough assessment of the child for future suicide risk. This would be through either or both the Scale for Suicide Ideation (SSI) and/ or the Beck Hopelessness Scale. Also, if the client were not eligible for involuntary commitment, one of the actions that would be taken to start treatment would be to initiate the psychotherapeutic intervention of cognitive behavioral therapy or CBT (National Academy of Sciences, 2019). This is a non-pharmacologic intervention that intends to modify the client’s behavior and positively influence and direct his future actions. Other measures of psychotherapy that would be attempted would include group psychotherapy. In this, the therapeutic factors of universality and altruism would help the client realise that they are not only alone in what they are going through; but also that there are other persons who care about them and their wellbeing.  Needless to say, the divorced parents would also benefit from some counselling individually in order to know how to cope with their son’s condition NURS 6660 Voluntary and Involuntary Commitment Essay.

 

References

LawServer Online, Inc. (2019).
Indiana code 12-26-1-1. Statutes under which mentally ill and either dangerous or gravely disabled may be involuntarily detained or committed
. Retrieved from
https://www.lawserver.com/law/state/indiana/in-code/indiana_code_12-26-1-1

National Academy of Sciences, (2019).
Chapter: 7 medical and psychotherapeutic interventions
. Retrieved from
https://www.nap.edu/read/10398/chapter/9#231

Ng, X.T. & Kelly, B.D. (2012). Voluntary and involuntary care: Three-year study of demographic and diagnostic admission statistics at an inner-city adult psychiatry unit.
International Journal of Law and Psychiatry, 35
, 317-326. Doi: 10.1016/j.ijlp.2012.04.008

Pace, T. (2017, July 21). How to have someone committed to a psychiatric facility in Indiana.
Legal Beagle
. Retrieved from
https://legalbeagle.com/8573504-someone-committed-psychiatric-facility-indiana.html
 NURS 6660 Voluntary and Involuntary Commitment Essay

Treatment of Psychiatric Emergencies in Children Versus Adults Essay

Consider a case where your adult client had a psychiatric emergency.(make one up)

Briefly describe the case you selected.

Explain how you would treat the client differently if he or she were a child or adolescent.

Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case

Treatment of psychiatric emergencies

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Briefly describe the case you selected.

The case involves Peter (pseudonym), a 27-year-old Caucasian male who was brought into the emergency room following an attempted suicide with a drug overdose Treatment of Psychiatric Emergencies in Children Versus Adults Essay. He was found comatose in his bedroom of the home he shares with two friends. The friends report that he had come in early from work and went into his bedroom. He had been there for 45 minutes when his friends heard commotion in his bedroom and went in to find hum convulsing. A suicide note and an empty bottle of pills were on the bed beside him. His medical records reveals that he lived as a health child and adult, experiencing common ailments such as asthma, pneumonia and chickenpox. Over the last two years, he frequently complained of heartburn and episodes of pharyngitis and rashes, and an episode of venereal warts. In the last six months leading to the suicide attempt, Peter gained significant weight. His housemates indicate that the weight gain may have been caused by pleasure eating since he discovered his fiancée cheating on him, an event that may have precipitated the pleasure eating. There is evidence of substance, suicidal ideation and mental health issues in the client. He was diagnosed with depression and anxiety disorder four months ago. Xanax (anxiolytic) and Celexa (antidepressant) were prescribed to manage the disorder. The friend report that Peter was the ‘life of the party’ and ‘jokester’ prior to breaking up with his fiancée, but had become dull since the breakup Treatment of Psychiatric Emergencies in Children Versus Adults Essay.

Explain how you would treat the client differently if he or she were a child or adolescent.

Treatment for suicide among adults is similar for treatment among children and adolescents. In this case, the treatment would be presented s acute management of the suicidal behavior to include psychopharmacology and psychotherapies. The first step is to establish a relationship with the client and family or friends, while also establishing the importance of treatment Treatment of Psychiatric Emergencies in Children Versus Adults Essay. This is particularly important for children and adolescent clients since they would require consent from a parent or legal guardian for the treatment to proceed. This step is slightly different for adult clients since the client has the legal right to make treatment decisions (Sadock, B., Sadock, V. & Ruiz, 2014). Another significant detail is that for children and adolescent clients, discussion with the family would typically involve the case aspects being discussed with the therapist presenting the treatment options. On the other hand, treatment for adult clients involve the therapist collecting details about the case from the client’s family and friends, and not discussing the case details unless with the express permission from the client (American Nurses Association, 2014).

Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case

There are ethical issues that must be considered when working with a child or an adolescent emergency case. The first issue is the therapeutic boundary with the therapist often challenged to refrain from engaging in actions that could confuse the boundaries. This is especially so when dealing with clients who find it difficult to express their impulses and longings in words. For instance, they could ask questions about how the therapist behaves as a parent. They could also challenge the boundaries by posing embarrassing and challenging questions (Smith, 2012). The second issue is client autonomy with regards to the client contributing to decisions based on objectivity and understanding. Including children and adolescents in decision making about treatment is respectful and strengthens the working alliance Treatment of Psychiatric Emergencies in Children Versus Adults Essay. The third issue is confidentiality, especially when the parents demand to know case details that the client expects to be kept confidential (Allen & Spitzer, 2015). The three ethical issues are common when working with child and adolescent clients.

References

Allen, K. & Spitzer, W. (2015).
Social work practice in healthcare: advanced approaches and emerging trends
. Thousand Oaks, CA: SAGE Publications.

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

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

Smith, G. (2012).
Psychological interventions in mental health nursing
. Berkshire: Open University Press Treatment of Psychiatric Emergencies in Children Versus Adults Essay.

NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay

Assessing and Treating Pediatric Clients

Introduction

The case study is on an 8-year-old boy, manifesting psychiatric symptoms. The mother reported that the client had become very nervous and worried. He also spends most of the time cleaning his hand because he fears his hands could get contaminated and become sick like he previously did. The client has also been avoiding playing with his friend and attending school. Other symptoms include irritability and sleep problems. Accordingly, this assignment involves making decisions about the diagnosis for the client and treatment choices. The paper will conclude by discussing ethical aspects likely to impact the treatment of the client.

Decision Point One

According to the presented symptoms for this client, the decision regarding the diagnosis of the client is that he has…

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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 NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay

 

Case #2

Anxiety disorder, OCD, or something else?

BACKGROUND

Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for. NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

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

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

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

OBJECTIVE

During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

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

MENTAL STATUS EXAM

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

Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters. NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

Decision Point One

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

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

Generalized Anxiety Disorder (GAD)

Obsessive Compulsive Disorder

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

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/index.html

Obsessive Compulsive Disorder was chosen for the diagnosis in Decision 1

Begin Fluvoxamine immediate release 25mg orally at bedtime was chosen for Decision 2

Augment therapy with cognative behavior therapy was chosen for Decision 3 NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay

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. NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

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. NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

Why were they different?

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

 

Assessing and Treating Pediatric Clients

Introduction

The case study is on an 8-year-old boy, manifesting psychiatric symptoms. The mother reported that the client had become very nervous and worried. He also spends most of the time cleaning his hand because he fears his hands could get contaminated and become sick like he previously did. The client has also been avoiding playing with his friend and attending school. Other symptoms include irritability and sleep problems. Accordingly, this assignment involves making decisions about the diagnosis for the client and treatment choices. The paper will conclude by discussing ethical aspects likely to impact the treatment of the client. NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

Decision Point One

According to the presented symptoms for this client, the decision regarding the diagnosis of the client is that he has obsessive-compulsive disorder (OCD). The reason why this decision was selected is that he presents symptoms akin to OCD symptoms. According to the DSM-5 criteria, symptoms of OCD include repetitive ritualized behaviors and intrusive obsessions. The symptoms of OCD lead to anxiety and distress to the client (Sachs & Eefurth, 2018). Examples of compulsions in people with OCD consist hand washing, avoidance, routine praying, routinized behaviors, among other behaviors (Sachs & Eefurth, 2018). In this case study, the client manifests anxiety and the ritualistic compulsive behavior include handwashing.

The intrusive obsession presented by this client is his fear of his hand becoming contaminated with germs and as a result, becoming sick (Sachs & Eefurth, 2018). Nonetheless, the client may also be having social phobia as manifested by his school avoidance and avoiding socializing with his friends.

 

Decision Point Two

The second decision for this client is to begin Fluvoxamine immediate release 25 mg orally at bedtime. The reason why this medication was chosen is that it is an SSRI and it is FDA approved for children who are 8-years and above (Pittenger & Bloch, 2014). The medication works by hindering the reuptake of serotonin within the brain. Additionally, evidence has demonstrated the efficacy of Fluvoxamine in treatment of OCD in children by improving the symptoms. In addition, the medication has been shown to be tolerable and safe for pediatric population. Because fluvoxamine has sigma-1 antagonist effects and thus causes sedation, it is supposed to be administered during bedtime (Thamby & Jaisoorya, 2019). NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

Selection of this decision hoped that the OCD symptoms in the client would decrease. This can be manifested by reduced handwashing and reduced fear of contamination as well as reduced anxiety. This is because the efficacy of the drug has been demonstrated in treatment of OCD in children (Pittenger & Bloch, 2014). Secondly, it was hoped that the client would tolerate the drug and thus not have any adverse side effect.

The result of this decision was just as it was expected because there was a decrease in the symptoms in the client in the client as the handwashing reduced and anxiety as well. The sociability of the client also improved as he began interacting with his friend. The symptom improvement in this client is attributable to the efficacy of fluvoxamine in improving symptoms of OCD (Thamby & Jaisoorya, 2019). In addition, the client did not report any side effects from the medication. NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

Decision Point Three

The chosen third decision was for the client to augment the treatment using cognitive behavior therapy. The reason for this choice is because CBT has been demonstrated to be effective when treating OCD and the therapy does not carry any side effects or risks (Wu et al, 2016). When treating OCD, cognitive behavior therapy uses exposure and response prevention (ERP) and cognitive therapy to alter the thoughts and behavior of an individual. During the step of exposure-response prevention (ERP), the person with OCD is kept in a situation likely to expose him/her to the obsessions and the client is advised not to conduct compulsions that they normally perform to ease the anxiety and distress (Tundo et al, 2016). In this case the client would be exposed to a contaminated area and requested not to perform hand-washing NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay. After this, cognitive therapy is then applied where the therapist helps the client to alter the negative thinking pattern associated with the obsession and compulsive behavior (Tundo et al, 2016). The client is helped to identify the patterns that cause distress and negative behavior such as the compulsions and adopt a more adaptive thinking pattern and hence reduce the anxiety, distress, as well as the negative behavior associated with performing the compulsive acts (Wu et al, 2016).

Ethical Considerations

The ethical considerations that could affect the client’s treatment plan include informed consent. Since medications such as Fluvoxamine is associated with specific side effects, it would be important to inform the parents of the client about the possible side effects as well as provide full information about all available treatment options to enable them to make an informed treatment choice (Pittenger & Bloch, 2014) NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

Conclusion

The client’s diagnosis is OCD because the client is obsessing with his hands becoming contaminated and performs compulsive behavior of ritualistic handwashing. The second decision is for the client to start client fluvoxamine immediate release 25 mg due to the medication’s efficacy in the treatment of OCD in children.  the last decision is to augment the treatment with CBT due to its efficacy in lowering OCD symptoms. Lastly, the ethical consideration applicable for this client is informed consent to allow the parents make an informed treatment choice. NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

 

References

Pittenger C & Bloch M. (2014). Pharmacological treatment of obsessive-compulsive disorder.
Psychiatr
Clin North Am
. 37(3), 375–391.

Sachs G & Eefurth A. (2018). Obsessive Compulsive and Related Disorders: From the Biological Basis to a Rational Pharmacological Treatment.
Int J Neuropsychopharmacology
. 21(1), 59–62.

Thamby A & Jaisoorya T. (2019). Antipsychotic augmentation in the treatment of obsessive-compulsive disorder.
Indian J Psychiatry
. 61(Suppl 1), S51–S57.

Tundo A & Necci R. (2016). Cognitive-behavioral therapy for obsessive-compulsive disorder co-occurring with psychosis: Systematic review of evidence.
World J Psychiatry
.  6(4), 449–455.

Wu Y, Lang Z & Zhang H. (2016). Efficacy of Cognitive-Behavioral Therapy in Pediatric Obsessive-Compulsive Disorder: A Meta-Analysis.
Med Sci Monit
. 1(22), 1646–1653. NURS 6660 week 5 decision tree assignment – obsessive-compulsive disorder (OCD) Essay.

NURS 6650 Clinical Supervision – anxiety disorder Essay

consider a client whom you do not think is adequately progressing according to expected clinical outcomes.

Reflect on a child or adolescent client you are currently counseling or have previously counseled at your practicum site who has been diagnosed with an anxiety disorder.

Describe the client. Note: Do not use the client’s actual name.

Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.

Identify any additional information about this client that may potentially impact expected outcomes.

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J.T is a 16 year old Caucasian male patient. He presents to the clinic with the claim that he experienced increased anxiety. He has been experiencing anxiety attacks for the last six months which have increased intensely for the last two weeks. He has been on anxiety medication during the last one week and reports minimal positive progression.  He reports increased insomnia and shakiness since the beginning of his treatment plan and considers the drugs ‘futile and more sickening’. NURS 6650 Clinical Supervision – anxiety disorder Essay The symptoms are currently affecting his daily activities. He is often tensed and has difficulties paying attention in class and finishing his assignments.

On examination, J.T. feels stressed all the time and worries about failing his examinations constantly. He is also afraid of making presentations in class which increases tension since one of his teachers expects the class members to participate in public speaking from time to time. He exhibits normal speech volume, rate and coherent articulation. He appears tensed but with intact language skills. The general demeanor and facial expressions demonstrate a stressed mood. The affect is appropriate, congruent and affluent with no delusion and hallucination signs. He does not abuse drugs but he is under pressure to try by his peers. Cognitive functioning and memory are age appropriate and intact. NURS 6650 Clinical Supervision – anxiety disorder Essay.

Therapeutic Approach

The patient will be treated using thee cognitive behavioral therapy which is considered to the most effective approach towards anxiety disorder management. This will be combined with the exposure therapy which was not included in the previous treatment plan. The objective of these combined techniques will be to overcome the clients fear, calm their mind and reduce their levels of anxiety. Exposure therapy will involve exposing the client to his fearful situations to relieve the tension that triggers anxiety (Topper et al., 2017). The client will be requested to think of the scary situations and direct exposure through systematic desensitization. Relaxation techniques will be applied to confront the trigger in this case NURS 6650 Clinical Supervision – anxiety disorder Essay.

Cognitive behavior therapy addresses negative distortions and behaviors thus changing our perception of the selves and the world (Hofmann & Otto, 2017). This in turn develops positive behaviors that help in the adaptation to the reality and reduction of fears that trigger anxiety. This will modify the client’s thoughts and behaviors as well as his cognitions to determine the anxiety triggers. Moreover, it will address the reactions and behaviors towards different situations particularly public speaking, socialization and examination situations which are identified as the key triggers to his anxiety. This will be followed by the process of cognitive restructuring or thought challenging which will entail the identification of the client’s thoughts, challenging the negative ones through evaluation of the provoking thoughts, questioning evidence, analyzing beliefs and evaluating the reality of negative predictions (Stein & Sareen, 2015). Consequently, the negative thoughts will be replaced by the realistic thoughts.

Additional information

The history of the client’s sickness will be an added advantage to accurate diagnosis and treatment. This will help learn the previous mental conditions experience before and the type of treatment that were effective in the management of the condition. Moreover the family history will facilitate the identification of probable disorders that might run in the family and hence improve clinical decision-making. Additionally, information regarding their allergies will help determine the cause of minimal progress of the treatment plan that involved the use of medication (Lader, 2015). This is because; allergies could worsen the client’s symptoms rather than improve them and hence risk the patient’s safety NURS 6650 Clinical Supervision – anxiety disorder Essay.

References

Hofmann, S. G., & Otto, M. W. (2017). 
Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder specific treatment techniques
. Routledge.

Lader, M. (2015). Generalized anxiety disorder. 
Encyclopedia of psychopharmacology
, 699-702.

Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. 
New England Journal of Medicine
, 
373
(21), 2059-2068.

Topper, M., Emmelkamp, P. M., Watkins, E., & Ehring, T. (2017). Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: A randomized controlled trial. 
Behaviour research and therapy
, 
90
, 123-136 NURS 6650 Clinical Supervision – anxiety disorder Essay.

NURS 6650 – Treating Childhood Abuse Essay

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?

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Child abuse is a global concern that affects the mental and physical stability of the victim. According to Thapar et al. (2015), there were 3.4 million referrals of child neglect and abuse cases in 2012. Many of the cases are caused by close relatives which makes reporting difficult due to fear and shame considering that children are still dependent on the abusers for provision. This paper explores abuse through the study of Morgan, a 19-year-old male’s, case with the aim of determining the assessment strategies foe abused patients, media and social media exposure and the mandatory reporting types for abuse cases NURS 6650 – Treating Childhood Abuse Essay.

Assessment Strategies

Physical examination is an effective strategy in assessing the signs of abuse. It identifies scars, deformities and other marks that suggest previous case of physical abuse. Inspection, palpation, percussion, and auscultation techniques are used to identify any deviations from the normal and also identify long-term effects of physical abuse on the patient (Sadock, Sadock, & Ruiz, 2014). On the other hand, psychological assessment screens for the mental status of the patient following the abuse incidences. For instance, the patient reports to have a depressed mood and panic attacked from the return of their abuser and this suggests that the event affects his mental wellbeing. This examination will involve the evaluation of the patient’s behavior, learning and thinking through psychological testing, observation, interviews and consultation (American Psychiatric Nurses Association, 2017) NURS 6650 – Treating Childhood Abuse Essay. These assessment strategies will inform accurate diagnosis as well as the formulation of the appropriate treatment plan.

Effects of exposure to the media and/or social media

The media and social media present increased exposure of persons to the outside world. Exposing patients to these platforms can have both positive and negative repercussions. For instance, exposure to the media and social media can help the client in getting psychological help from professionals. Additionally, he might be able to meet and interact with other individuals who have had familiar experiences and get to learn how to cope with the return of his abuser. On the other hand, exposure can result to bullying of the patient which could result to depression and social withdrawal among other mental problems. The patient might be ridiculed by the public subjecting them into significant distress which would eventually turn the patient into an abuser in the future. The exposure also breaches the privacy rights of the patients. on the contrary, it can also result in acceptance of the victim by the society as the media creates awareness of social crimes through his case NURS 6650 – Treating Childhood Abuse Essay. He might as well be used as the ambassador of the abused to share his experiences in the future and help others in their recovery.

Mandatory reporting required in this case

Mandatory reporting of abuse is a legal requirement in the United States for cases observed or suspected. Mandated reporters are responsible for reporting and in this case, the healthcare provider is expected to report to the child protective services (CPS). The report will be classified in the sexual abuse category since the patient was molested by their cousin during his childhood. The report will be filed with the child protection authorities as required by the Child Protection Act 1999 (Pfefferbaum & Shaw, 2013). Mandatory reporting will therefore be done to allow protection of the patient against future molestation and provide counselling on how to improve his quality of life even with the cousin currently out of prison NURS 6650 – Treating Childhood Abuse Essay.

 

References

American Psychiatric Nurses Association. (2017). Childhood and adolescent trauma. Retrieved from
http://www.apna.org/i4a/pages/index.cfm?pageID=4545

Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness.
Journal of the American Academy of Child & Adolescent Psychiatry
, 52(11), 1224–1238. Retrieved from
http://www.jaacap.com/article/S0890-8567(13)00550-9/pdf

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

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry
(6th ed.). Hoboken, NJ: Wiley Blackwell. NURS 6650 – Treating Childhood Abuse Essay.