Tag: Clinical-Nursing

NURS 8410 Week 4 Discussion: The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice Discussion Essay

Discussion: The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice

Fawcett and Garity (2009) present an overview of the relationship between theory, knowledge, research, nursing research, and evidence-based practice. As you prepare for this Discussion, reflect on your own specialty area and consider how the authors’ definitions of 
evidence-based practice
and of 
research
 align with your understanding of these concepts based on your professional experiences and your experiences as a doctoral student embarking on your EBP Assignment.

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To prepare:

Reflect on Fawcett and Garity’s definitions of 
knowledge
, 
theory
, 
research
 and 
evidence-based practice
presented in the Learning Resources. How do these definitions align with your understanding of the concepts? The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice Discussion Essay.

How does this interrelationship support or guide your EBP Assignment?

By Day 3

Post
 a cohesive scholarly response that addresses the following:

How do Fawcett and Garity’s definitions align with your understanding of knowledge, theory, research and evidence-based practice? Support your response with evidence from the literature. The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice Discussion Essay.

Discuss the interrelationship between theory, knowledge, research and evidence-based practice.

How does this interrelationship support or guide your EBP Assignment?

Read
 a selection of your colleagues’ responses.

By Day 6

Respond
 to 
two
 of your colleagues in one or more of the following ways:

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

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

Offer and support an alternative perspective using readings from the classroom and/or from your own research in the Walden Library. The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice Discussion Essay.

Validate an idea with your own experience and additional research.

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

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return
 to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

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Rubric Detail

Select 
Grid View
 or 
List View
 to change the rubric’s layout.

Name: NURS_8410_ Week4_Discussion_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTIONDiscussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice Discussion Essay

6 
(20%)
 – 6 
(20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

6 
(20%)
 – 6 
(20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice Discussion Essay

CONTRIBUTION TO THE DISCUSSION

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

6 
(20%)
 – 6 
(20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING

6 
(20%)
 – 6 
(20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

5 
(16.67%)
 – 5 
(16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

4 
(13.33%)
 – 4 
(13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

0 
(0%)
 – 3 
(10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice Discussion Essay

Total Points: 30

Name: NURS_8410_ Week4_Discussion_Rubric

NURS 8410 Week 5 Discussion: New Models for Evidence-Based Practice Essay

New Models for Evidence-Based Practice

A professional goal for DNP-prepared nurses is to produce new evidence-based models of care and develop evidence-based guidelines. As you continue to develop and engage in your EBP Assignment, keep this aim in mind. What could help to facilitate the acceptance of new practices?

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As noted in earlier weeks, every specialty area should base practice on research and evidence. For example, in informatics, an informatician who plans to implement a new health information system would be wise to follow a model that research shows has been effective. New Models for Evidence-Based Practice Essay. Similarly, those involved in leadership or management can review change models and theories, exploring current evidence on best practices that produce positive results. For this Discussion, you evaluate evidence-based practice models, change theories, and frameworks that assist with the adoption of new evidence-based practice approaches.

To prepare for New Models for Evidence-Based Practice:

Reflect on your practicum setting and the use of evidence-based practice models. How are these models used? If they are not used, how might the integration of an evidence-based practice model change practice?

Review the Rosswurm and Larrabee article presented in the Learning Resources focusing on the model they present for integrating new evidence-based practices.

Research and locate an evidence-based practice model from nursing or another discipline that could be used in your specialty area to lead a systematic change to evidence-based practice approaches. You may also use a model or framework discussed in your course text, 
Translation of Evidence Into Nursing and Health Care Practice
. New Models for Evidence-Based Practice Essay.

Consider how using a model for evidence-based practice can facilitate adoption of new approaches to practice.

By Day 3 of New Models for Evidence-Based Practice

Post
 a cohesive response that addresses the following:

Discuss the use of evidence-based models in your practicum setting.

Describe a model for evidence-based practice or change theories and frameworks that you could utilize to facilitate the adoption of new approaches to practice. Substantiate your selection with evidence from the literature.

Read
 a selection of your colleagues’ postings.

By Day 6 of New Models for Evidence-Based Practice

Respond
 to 
two
 of your colleagues in one or more of the following ways:

Provide specific feedback on your colleague’s chosen research method and selected evidence-based practice model.

Suggest another model if appropriate.

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

Offer and support an alternative perspective using readings from the classroom and/or from your own research in the Walden Library. New Models for Evidence-Based Practice Essay.

Validate an idea with your own experience and additional research.

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

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return
 to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Rubric Detail

Select 
Grid View
 or 
List View
 to change the rubric’s layout.

Name: NURS_8410_ Week5_Discussion_Rubric

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTIONDiscussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

New Models for Evidence-Based Practice Essay

6 
(20%)
 – 6 
(20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

New Models for Evidence-Based Practice Essay

CONTENT KNOWLEDGE

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

6 
(20%)
 – 6 
(20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

New Models for Evidence-Based Practice Essay

CONTRIBUTION TO THE DISCUSSION

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

6 
(20%)
 – 6 
(20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING

6 
(20%)
 – 6 
(20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

5 
(16.67%)
 – 5 
(16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

4 
(13.33%)
 – 4 
(13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

0 
(0%)
 – 3 
(10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

New Models for Evidence-Based Practice Essay

Total Points: 30

Name: NURS_8410_ Week5_Discussion_Rubric

NURS 8410 Week 5 Assignment: Application 2: Laying the Foundation for New Approaches to Practice

Application 2: Laying the Foundation for New Approaches to Practice

As frequently noted in the literature, there is often a gap between research evidence and practice. This is not a new phenomenon; however, with the rapid growth of knowledge, it is essential that nurses hone their ability to identify this gap, determine best practices based on the evidence, and then apply this evidence to practice through the development of new approaches. In order for that to transpire, nurses must be skilled in leading change efforts so that adoption of new practice approaches can be successful.

For your EBP Assignment in Week 2 (Application 1), you identified an issue in your practicum setting in which the outcome is different from what would be expected according to the research literature. This week, continue to explore current research literature looking for new evidence to address the problem. In addition, you build on the work you began in this week’s Discussion and select an evidence-based practice model and change theory or framework that will support your efforts.

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To prepare for Application 2
 address the following:

How current is the science underlying the practices related to your EBP Assignment issue?

Consider possible causes of the difference in outcomes from what would be expected according to the research literature.

Evaluate the effect the EBP Assignment issue is having in practice.

Using the Walden Library and other credible sources, locate current research evidence of new practices that are effective in addressing the issue.

Use the GRADE model presented in the Guyatt et al. (2011) article to evaluate the research evidence.

The full Application 2 is due by 
Day 7
 of this week. Instructions for how to prepare for previous sections of this Application have been provided in Week 4.

To complete Application 2: Laying the Foundation for New Approaches to Practice:

In a 3- to 5-page paper, include the following:

A brief summary of the currency of the science underlying the practices used to address your EBP Assignment issue. Laying the Foundation for New Approaches to Practice.

Possible causes of the difference in outcomes from what would be expected according to the research literature

The effect the EBP Assignment issue is having in practice

Current research evidence on new practices for addressing the EBP Assignment issue

A summary of the evidence-based practice model (including models from other disciplines as appropriate) and/or change theory or framework you will utilize to systematically integrate new approaches to practice to address the issue

By Day 7 OF Application 2: Laying the Foundation for New Approaches to Practice

Application 2 is due.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK5Assgn+last name+first initial.(extension)” as the name.

Click the 
Week 5 Assignment Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 5 Assignment 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK5Assgn+last name+first initial.(extension)” and click 
Open
.

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

Click on the 
Submit
 button to complete your submission.

NURS 8410 Week 5: New Practice Approaches, Part II

A hallmark of the DNP-prepared nurse is the ability to go into a health setting, identify a problem, examine the evidence, and develop new approaches in practice to improve outcomes for patients, populations, and/or organizations. This, in turn, can lead to the development of new models of evidence-based practice. Laying the Foundation for New Approaches to Practice.

This week you examine evidence-based practice models and frameworks that assist with the adoption of new practice approaches. You apply this focus as you continue your practicum experience.

Laying the Foundation for New Approaches to Practice Learning Objectives

Students will:

Evaluate the use of evidence-based practice models and change theories and frameworks for facilitating the adoption of new practice approaches

Appraise current evidence for addressing a practice issue

Evaluate the quality of evidence using the GRADE guidelines

Photo Credit: [Squaredpixels]/[iStock / Getty Images Plus]/Getty Images

Laying the Foundation for New Approaches to Practice Learning Resources

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

Required Readings FOR Application 2: Laying the Foundation for New Approaches to Practice

Gallagher-Ford, L., Fineout-Overhold, E., Melnyk, B.M. & Stillwell, S.B. (2011). Evidence-based practice step-by-step: Implementing an evidence-based practice change. 
American Journal of Nursing
, 111(3), 54-60.

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

Rosswurm, M. A., & Larrabee, J. H. (1999). A model for change to evidence-based practice. 
Journal of Nursing Scholarship
, 31(4), 317-322.

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

Pryse, Y., McDaniel, A., & Schafer, J. (2014). Psychometric analysis of two new scales: The evidence-based practice nursing leadership and work environment scales. 
Worldviews on Evidence-Based Nursing
, 11(4), 240-247.

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

Sadeghi-Bazargani, H., Tabrizi, J.S., & Azami-Aghdash, S. (2014). Barriers to evidence-based medicine: A systematic review. 
Journal of Evaluation in Clinical Practice
, 20, 793-802.

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

Schaffer, M.A., Sandau, K.E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: overview and practical applications. 
Journal of Advanced Nursing
, 69(5), 1197-1209.

Note:
You will access this article from the Walden Library databases Laying the Foundation for New Approaches to Practice.

NURS 8410 Week 6 Discussion: Developing and Evaluating New Practice Approaches

Discussion: Developing and Evaluating New Practice Approaches

One of the exciting aspects of participating in the health care field is the discovery of new techniques, treatments, and technologies that improve the quality of care and improve health outcomes. As someone engaged in advanced nursing practice, you have the opportunity to search for new solutions to issues in your specialty area. What tools can you use to guide the discovery process? What needs to be considered as you determine new practice approaches to address issues in health care? Developing and Evaluating New Practice Approaches. This week, you consider new ways to address the EBP Assignment issue you identified in Week 2.

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To prepare for Discussion: Developing and Evaluating New Practice Approaches:

Reflect on your analysis of the evidence base that addresses your selected issue from the EBP Assignment (identified during Week 2).

Using methods articulated in the Learning Resources, formulate new evidence-based practice strategies to address the issue and improve health care quality.

What are the theoretical bases for your proposed strategies?

Developing and Evaluating New Practice Approaches

What might be the economic impact of implementing your proposed strategies?

By Day 3 of 
Discussion: Developing and Evaluating New Practice Approaches

Post
 a cohesive response that addresses the following:

Briefly summarize your selected issue and propose new evidence-based practice strategies. Describe the theoretical basis for your strategies.

Discuss the potential economic impact of your suggested strategies.

How could the new practice strategies improve health care quality?

Read
 a selection of your colleagues’ postings.

By Day 6 of 
Discussion: Developing and Evaluating New Practice Approaches

Respond
 to 
two
 of your colleagues in one or more of the following ways:

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

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. Developing and Evaluating New Practice Approaches.

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

Validate an idea with your own experience and additional research.

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

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return
 to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Rubric Detail

Select 
Grid View
 or 
List View
 to change the rubric’s layout.

Name: NURS_8410_ Week6_Discussion_Rubric

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTIONDiscussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

Developing and Evaluating New Practice Approaches

6 
(20%)
 – 6 
(20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

6 
(20%)
 – 6 
(20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

Developing and Evaluating New Practice Approaches

CONTRIBUTION TO THE DISCUSSION

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

6 
(20%)
 – 6 
(20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING

6 
(20%)
 – 6 
(20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

5 
(16.67%)
 – 5 
(16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

4 
(13.33%)
 – 4 
(13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

0 
(0%)
 – 3 
(10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

Developing and Evaluating New Practice Approaches

NURS 8410 Week 6 Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice

Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice

This week you begin working on Application 3. As a nurse engaged in advanced practice, you have the exciting opportunity to be a leader in translating evidence into practice.

For this first section of Application 3, consider the economic and financial implications of addressing your EBP Assignment issue. NURS 8410 Week 6 Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice. In addition, reflect on your leadership skills. As a DNP-prepared nurse, you are expected to employ the principles of business, finance, and health policy in the development of initiatives that will improve the quality of care delivered.

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Prepare
 for this week’s section of Application 3 as follows:

Continue (from this week’s Discussion) to evaluate the new strategies you developed to address your selected issue and the potential economic impact.

Review Chapter 6 in the course text, Translation of Evidence Into Nursing and Health Care Practice, and ask yourself the following: How are these activities enhancing my leadership skills? How does translating evidence enable me, as a leader, to affect or strengthen health care delivery and my nursing practice?

You will build on this Application next week as you look at advancing new approaches to practice through the policy process. NURS 8410 Week 6 Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice.

By Day 7 of Week 7 OF Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice

Application 3 is due. You do not need to submit anything this week.

Practicum FOR  Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice

Continue to keep a time log and journal of your practicum experiences. See the Practicum Guidelines located in the Practicum area of the Course Overview page for a complete description of the practicum.

By Day 7 of Week 7 OF Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice

Reminder:
 You will submit your time log and a journal entry in Week 7.

Week in Review

This week
, you evaluated economic impacts of new practice strategies and integrated theoretical foundations in developing evidence-based practice strategies. You also appraised your personal growth in leadership skills.

Next week
, you will explore how to utilize the concepts presented in earlier weeks to advocate for health care policy to improve health-related outcomes.

NURS 8410 Week 6: The Application of New Practice Approaches, Part I

The first several weeks of this course have presented the foundational information necessary for you and your colleagues to develop new practice strategies. Think of the EBP Assignment issue that you have been addressing in this course. NURS 8410 Week 6 Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice. How could you synthesize the evidence you reviewed for Application 2 and what you have learned in this course to create a new approach?

This week you formulate evidence-based practice strategies designed to promote health care quality, and develop a plan for evaluating these strategies as well. As you begin Application 3, you consider the financial and economic impact of implementing these new strategies. As you continue your practicum experience, you are asked to reflect on your leadership skills and your ability to integrate business, finance, and health policy principles in the development of initiatives that will improve the quality of care delivered.

Learning Objectives

Students will:

Integrate theoretical foundations in the development of evidence-based practice strategies

Evaluate the potential economic impact of new practice strategies that address a selected specialty issue

Appraise personal growth in leadership skills

NURS 8410 Week 6 Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice

Photo Credit: Hero Images / Hero Images / Getty Images

Learning Resources

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

NURS 8410 Week 6 Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice Required Readings

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). 
Translation of evidence into nursing and health care practice
 (2nd ed.). New York, NY: Springer.

Chapter 6, “Translation of Evidence for Leadership”

Balakas, K., Sparks, L., Steurer, L., & Bryant, T. (2013). An outcome of evidence-based practiced education: Sustained clinical decision-making among bedside nurses. 
Journal of Pediatric Nursing
, 28, 479-485.

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

Brown, D.S. (2012). Interview with quality leaders: Dr. Donna E. Shalala and Dr. Linda Burnes Bolton on the committee on the Robert Wood Johnson Foundation initiative on the future of nursing at the Institute of Medicine. 
Journal for Healthcare Quality
, 24(4), 40-44.

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

Brandt, B., Lutfiyya, M.N., King, J.A., & Chioresco, C. ( 2014). A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim. 
Journal of Interprofessional Care
, 28(5), 393-399.

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

Grindel, C.G. (2016). Clinical leadership: A call to action. Med-Surg Nursing, 25(1), 9-16.

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

Mannix, J., Wilkes, L, & Daly, J. (2015). Grace under fire: Aesthetic leadership in clinical nursing, 
Journal of Clinical Nursing
, 24, 2649-2658.

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

Stetler, C.B., Ritchie, J.A., Rycroft-Malone, J., & Charns, M.P. (2014). Leadership for evidence-based practice: Strategic and functional behaviors for institutionalizing EBP. 
Worldviews on Evidence-Based Nursing
, 11(4), 219-226.

Note:
You will access this article from the Walden Library databases. NURS 8410 Week 6 Assignment: Application 3: Becoming a Leader in the Translation of Evidence to Practice.

NURS 8100 Discussion: Policy and State Boards of Nursing Essay

Policy and State Boards of Nursing

Within the far-reaching and multi-layered realm of policy and reform, government at the state level plays an essential role. Consider the federally enacted PPACA’s individual mandate which sought to increase the number of consumers who receive insurance coverage and, therefore, greater access to care. In a system that is already stretched beyond capacity and confronting a nursing shortage, how can the health care system meet this increased demand? Policy and State Boards of Nursing Essay. Since state boards of nursing determine scope of practice, it is important to stay up to date and current with the policies and regulations that are created by the state board of nursing.

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To prepare for Policy and State Boards of Nursing:

Review the Thomas, Benbow, and Ayars article and the Watson and Hillman article focusing on how states regulate advanced nursing practice and how legislative changes are impacting scope of practice.

Visit your state board of nursing website and/or contact the board to determine how the state board controls advanced practice through regulations. Policy and State Boards of Nursing Essay.

Determine if your state board has created any new policies or regulations that address changes to scope of practice in response to legislative changes.

By Day 3 of Policy and State Boards of Nursing

Post
 a cohesive response that addresses the following:

What are the most recent regulations promulgated through your state board of nursing for advanced practice?

How are the state regulations supported within your place of employment?

How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States? Policy and State Boards of Nursing Essay.

Read
 a selection of your colleagues’ postings.

By Day 6 of Policy and State Boards of Nursing

Respond
 to at least 
two
 of your colleagues selecting someone from a different state and comparing your state’s scope of practice with your colleague’s. Share any insights and implications for practice.

Note:
 Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return
 to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources Policy and State Boards of Nursing Essay.

NURS 8100 Week 9: State and Local Role in Health Care Policy

As noted previously, policy is enacted and carried out through multiple levels of government. This week, the focus turns to the role of state and local government in policy making, with particular attention to the function of state boards of nursing in the regulation of practice. In light of health care reform efforts, scope of practice issues are of central importance and this falls under the purview of state boards of nursing. How do the states differ in terms of scope of practice? What impact does this have on professional nurses across the United States?

Learning Objectives

Students will:

Analyze the role of state boards of nursing in the regulation of nursing practice

Assess state and local politics and issues surrounding a current health care policy

Photo Credit: [poplasen]/[iStock / Getty Images Plus]/Getty Images

Policy and State Boards of Nursing Essay Learning Resources

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

Required Readings

Chen, A. S., & Weir, M. (2009). The long shadow of the past: Risk pooling and the political development of health care reform in the States. 
Journal of Health Politics, Policy & Law, 34
(5), 679–716.

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

The authors provide an analysis of varying state health care policies, with a basic premise that health care risk is either “pooled”—shared, or “actuarial”—segmented by risk level. Most states have taken a segmented approach to health care, and therefore, have not solved health care issues such as rising costs and access to care. Policy and State Boards of Nursing Essay. The authors maintain that federal action is needed to create a uniformed approach to health care.

Junghee, L. (2009). Cultural, social, and political influences on state-level indigent health care policy formation. 
Journal of Policy Practice, 8
(2), 129–146.

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

This article provides details on a 50-state study of Medicaid spending. The authors concluded that political and economic factors can positively predict individual state Medicaid spending, and that actual need has a negative impact on spending. In conclusion, a uniform, federal structure may be the only method to ensure equal access to Medicaid. Policy and State Boards of Nursing Essay.

Mills, A., Engelhard, C. L., & Tereskerz, P. M. (2010). Truth and consequences—Insurance-premium rate regulation and the ACA. 
New England Journal of Medicine 363
(10), 899–901.

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

O’Connor, J. C., MacNeil, A., Chriqui, J. F., Tynan, M., Bates, H., & Eidson, S. K. (2008). Preemption of local smoke-free air ordinances: The implications of judicial opinions for meeting national health objectives. 
Journal of Law, Medicine & Ethics, 36
(2), 403– 412.

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

Sommers, B. (2010). Enrolling eligible children in Medicaid and CHIP: A research update. 
Health Affairs, 29
(7), 1350.

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

 

The enrollment and retention of eligible children in Medicaid and Children’s Health Insurance Program (CHIP) is a health care concern. The article concludes that some state processes have mitigated this issue but other requirements, such as providing citizenship documentation, may have a detrimental effect. Therefore, these concerns should be incorporated into the implementation on PPACA of 2010.

Thomas, M. B., Benbow, D. A., & Ayars, V. D. (2010). Continued competency and board regulation: One state expands options. 
Journal of Continuing Education in Nursing, 41
(11), 524-528.

Note:
You will access this article from the Walden Library databases Policy and State Boards of Nursing Essay.

The authors use the changes instituted by the state of Texas in regard to the licensing of nurses to illustrate the need to adapt state licensing requirements to the changing diversity and scopes of practice among nurses.

Watson, E., & Hillman, H. (2010). Advanced practice registered nursing: Licensure, education, scope of practice, and liability issues. 
Journal of Legal Nurse Consulting, 21
(3), 25–29.

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

 

The expanded role of the advanced practice nurse has led to changes in licensure, education, certification, and scope of practice definitions. The author points out that this expanded role has led to increased liability and accountability concerns as well.

Yue, L., Harrington, C., Spector, W. D., & Mukamel, D. B. (2010). State regulatory enforcement and nursing home termination from the Medicare and Medicaid programs. 
Health Services Research, 45
(6p1), 1796-1814. doi:10.1111/j.1475-6773.2010.01164.x Policy and State Boards of Nursing Essay

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

 

Those nursing homes receiving Medicare and Medicaid funding are subject to strict quality and safety regulations. This article examines the consequences of enforcing those federal quality standards.

Optional Resources

Wieck, K. L., Oehler, T., Green, A., & Jordan, C. (2004). Safe nurse staffing: A win-win collaboration model for influencing health policy. 
Nursing Education Perspectives, 31
(3), 160-166.

NURS 8100 Week 1 Assignment 1: Issues in Health Care Reform (Interview)

Continue to work on this Assignment, assigned in Week 2. Your Health Care Reform interview is due by 
Day 7
of this week. Policy and State Boards of Nursing Essay.

By Day 7

Submit this Assignment.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK9Assgn1+last name+first initial.(extension)” as the name.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK9Assgn1+last name+first initial.(extension)” and click 
Open
.

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

Click on the 
Submit
 button to complete your submission.

Assignment 1: Issues in Health Care Reform (Interview)

Continue to work on this Assignment, assigned in Week 2. Your Health Care Reform interview is due by 
Day 7
 of this week.

By Day 7

Submit this Assignment.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK9Assgn1+last name+first initial.(extension)” as the name. Policy and State Boards of Nursing Essay.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK9Assgn1+last name+first initial.(extension)” and click 
Open
.

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

Click on the 
Submit
 button to complete your submission.

Policy and State Boards of Nursing Essay Rubric Detail

Select 
Grid View
 or 
List View
 to change the rubric’s layout.

Name: NURS_8100_Week9_Discussion_Rubric

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTIONDiscussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

Policy and State Boards of Nursing Essay

6 
(20%)
 – 6 
(20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

Policy and State Boards of Nursing Essay

CONTENT KNOWLEDGE

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

Policy and State Boards of Nursing Essay

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

6 
(20%)
 – 6 
(20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

CONTRIBUTION TO THE DISCUSSION

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

6 
(20%)
 – 6 
(20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

Policy and State Boards of Nursing Essay

QUALITY OF WRITING

6 
(20%)
 – 6 
(20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

5 
(16.67%)
 – 5 
(16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

Policy and State Boards of Nursing Essay

4 
(13.33%)
 – 4 
(13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

0 
(0%)
 – 3 
(10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

Policy and State Boards of Nursing Essay

Total Points: 30

Name: NURS_8100_Week9_Discussion_Rubric

Nursing and Health Policy in Other Nations Essay Assignment paper

NURS 8100 Week 10 Discussion: Nursing and Health Policy in Other Nations

Discussion: Nursing and Health Policy in Other Nations

Think for a moment about nurses who relocate because of professional opportunities. How could such a seemingly personal decision have a detrimental impact on global health care? As presented in this week’s Learning Resources, nurse migration is of global concern. In response to this issue, international health care organizations such as the World Health Organization (WHO) and the International Council of Nurses (ICN) have positioned themselves to craft related policy as a solution. Nursing and Health Policy in Other Nations Essay Assignment paper This is just one example of a global nursing policy effort.

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To prepare for Discussion: Nursing and Health Policy in Other Nations:

With information from the Learning Resources in mind, select a U.S. nursing- or health-related policy.

Search the web and locate a similar policy in another country.

Consider how the two policies are similar and dissimilar.

Nursing and Health Policy in Other Nations Essay Assignment paper

Was an international organization involved in promoting the policies? If not, should they have been?

By Day 3 of Discussion: Nursing and Health Policy in Other Nations

Post
 a cohesive response that addresses the following:

Post information on the nursing or health-related policies you located including a reference to the source.

Indicate the country you are comparing to the U.S.

Compare and contrast the two policies. What insights did you gain as a result of this comparison?

What is the role of international organizations in developing policy? Nursing and Health Policy in Other Nations Essay Assignment paper Provide a specific example.

Read
 a selection of your colleagues’ postings.

By Day 6 of Discussion: Nursing and Health Policy in Other Nations

Respond
 to at least 
two
 of your colleagues in one or more of the following ways:

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

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

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library. Nursing and Health Policy in Other Nations Essay Assignment paper.

Validate an idea with your own experience and additional research.

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

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Note:
 Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return
 to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues. Discussion: Nursing and Health Policy in Other Nations

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources. Discussion: Nursing and Health Policy in Other Nations Nursing and Health Policy in Other Nations Essay Assignment paper.

NURS 8100 Week 10: Nursing and Health Policy: The International Perspective

To be a professional nurse today means having a world view. With the internationalization of health care issues, it is important to broaden your perspective and explore international health policy and nursing practice.

This week, you will focus on global health care policy. You will examine the nursing profession through an international lens, as well as investigate global efforts to promote health policies and improve health care delivery around the world.

Nursing and Health Policy in Other Nations Essay Assignment paper Learning Objectives

Students will:

Compare and contrast U.S. nursing or health-related policies with those of another country

Evaluate the role of international nursing or health organizations in developing or supporting nursing policy

Photo Credit: [Bartosz Hadyniak]/[Vetta]/Getty Images

Nursing and Health Policy in Other Nations Essay Assignment paper Learning Resources

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

Required Readings

Bodenheimer, T., & Grumbach, K. (2016). 
Understanding health policy: A clinical approach
 (7th ed.). New York, NY: McGraw-Hill Medical.

Chapter 14, “Health Care in Four Nations”This chapter compares the health care systems in Germany, Canada, United Kingdom, and Japan. All these nations offer universal health care; however, they organize and finance health care in varying ways. Nursing and Health Policy in Other Nations Essay Assignment paper.

Asadov, D.A., & Aripov, T. Y. (2009). The quality of care in post-soviet Uzbekistan: Are health reforms and international efforts succeeding? 
Public Health, 123
(11), 725–728.

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

 

The authors discuss why health care initiatives in developing countries, such as Uzbekistan, are not succeeding, even with international involvement. They suggest involving regional input and consideration for better success.

Baillie, L., & Gallagher, A. (2009). Evaluation of the Royal College of Nursing’s ‘Dignity: At the heart of everything we do’ campaign: Exploring challenges and enablers. 
Journal of Research in Nursing, 15
(1), 15–28.

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

 

This article provides details from a study concerning the Royal College of Nursing’s campaign to promote dignity in care. The authors focus on two aspects of the study—“enablers” and “challenges” of providing dignity in care to patients. Nursing and Health Policy in Other Nations Essay Assignment paper.

Clarke, S. P., & Aiken, L. H. (2008). An international hospital outcomes research agenda focused on nursing: Lessons from a decade of collaboration. 
Journal of Clinical Nursing, 17
(24), 3317–3323.

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

The authors depict findings from an international nursing survey, which concludes that nurses work experiences (positive and negative) are remarkably consistent across countries, regardless of cultural differences. The authors propose that a global effort to improve the nurses work environments will lead to improved patient care.

Crigger, N. (2008). Towards a viable and just global nursing ethics. 
Nursing Ethics, 15
 (1), 17–27.

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

 

This article discusses global justice and the nursing profession, and proposes five characteristics to guide global ethics. The author proposes that technology and business can act as barriers to global justice.

Eckenwiler, L. A. (2009). The WHO code of practice on the international recruitment of health personnel: We have only just begun. 
Developing World Bioethics, 9
(1).

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

The World Health Organization (WHO) has drafted a Code of Practice to encourage global health care policies. The author focuses on the detrimental impact of health care professionals migrating from source countries (usually the global South) to destination countries. The author suggests that WHO could be more specific in the code relating to stakeholders and shared responsibilities to promote collaboration by all parties involved in global health care. Nursing and Health Policy in Other Nations Essay Assignment paper.

Koch, K., Schurmann, C., & Sawicki, P. (2010). The German health care system in international comparison: A patient perspective. 
Deutsches Arzteblatt International 107
(24), 427–434.

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

 

This article provides information gleaned from a Commonwealth Fund survey on international health care experiences. The authors report a variation in patient experiences and satisfaction internationally but German respondents reported less satisfaction than most countries. German patients tend to be seen by more than one doctor, and perhaps the reported dissatisfaction can be traced to a lack of coordination in care.

Lartey, S., Cummings, G., & Profetto-McGrath, J. (2014). Interventions that promote retention of experienced registered nurses in health care settings: A systematic review. 
Journal of Nursing Management, 22
(8), 1027-1041. doi:10.1111/jonm.12105

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

The authors of this study examine the effectiveness of strategies for retaining experienced Registered Nurses. Noting the challenges of nursing shortages on a global scale, the authors explore those factors that could promote the retention of experienced nurses and suggest new opportunities for fulfilling a sustained nursing workforce.

Tyer-Viola, L., Nicholas, P., Corless, I., Barry, D., Hoyt, P., Fitzpatrick, J., & Davis, S. (2009). Social responsibility of nursing: a global perspective. 
Policy, Politics & Nursing Practice, 10
(2), 110–118. doi: 10.1177/1527154409339528

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

 

This article depicts a study that examines nursing, social responsibility, and global health. The authors focus on concepts such as social justice, human rights, nurse migration, and nurse education as well as strategies to address these issues.

World Health Organization (WHO). (2010). 
Managing health workforce migration—The global Code of Practice
. Retrieved from http://www.who.int/hrh/migration/code/practice/en/index.html Nursing and Health Policy in Other Nations Essay Assignment paper

In 2010, WHO created the “Code of Practice on the International Recruitment of Health Personnel,” which urges a global policy on the recruitment of health care workers that would result in better global health care outcomes.

International Council of Nurses. (2010). 
International Council of Nurses
. Retrieved from http://www.icn.ch/

This website provides information from the ICN, an international federation of nurses associations. The ICN is a global organization, operated by nurses that advocates the profession of nursing and promotes global health care policy.

Royal College of Nursing. (2011). 
The Royal College of Nursing
. Retrieved from http://www.rcn.org.uk/

The RCN represents the interests of nurses in the United Kingdom and promotes health care policy.

Nursing and Health Policy in Other Nations Essay Assignment paper Optional Resources

Evans, C., & Ndirangu, E. (2008). The nursing implications of routine provider-initiated HIV testing and counseling in sub-Saharan Africa: A critical review of new policy guidance from WHO/UNAIDS. 
International Journal of Nursing Studies, 46
(5), 723–731.

France, C. (2008). The form and context of federalism: Meaning for health care financing. 
Journal of Health Politics, Policy & Law, 33
(4), 649–705. doi: 10.1215/03616878-2008-012

International Nursing Review. (2009). ICN initiative to fortify health workforce will open new Centre in Uganda. 
International Nursing Review, 56
(2), 151–152.

Pulcini, J., Jelic, M., Gul, R., & Loke, A. Y. (2010). An international survey on advanced practice nursing education, practice, and regulation. 
Journal of Nursing Scholarship, 42
(1), 31–39.

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTIONDiscussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

Nursing and Health Policy in Other Nations Essay Assignment paper

6 
(20%)
 – 6 
(20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

Nursing and Health Policy in Other Nations Essay Assignment paper

CONTENT KNOWLEDGE

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

6 
(20%)
 – 6 
(20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

Nursing and Health Policy in Other Nations Essay Assignment paper

CONTRIBUTION TO THE DISCUSSION

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

Nursing and Health Policy in Other Nations Essay Assignment paper

6 
(20%)
 – 6 
(20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

Nursing and Health Policy in Other Nations Essay Assignment paper

QUALITY OF WRITING

6 
(20%)
 – 6 
(20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

5 
(16.67%)
 – 5 
(16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

4 
(13.33%)
 – 4 
(13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

0 
(0%)
 – 3 
(10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

Nursing and Health Policy in Other Nations Essay Assignment paper

Paranoid and obsessive compulsive personality disorders essay examples

Obsessive-compulsive personality disorder (ocpd)

QUESTION

• Explain the diagnostic criteria for Obsessive compulsive personality disorder (ocpd)

• Explain the evidenced-based psychotherapy for the above personality diosrder

• Explain psychopharmacologic treatment for Obsessive compulsive personality disorder (ocpd .

• Describe clinical features from a client that led you to believe this client had this disorder. Align the clinical features with the DSM-5 criteria.

• Support your rationale with references to the Learning Resources or other academic resources.

Diagnostic Criteria for Paranoid Personality disorder (PPD)

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Paranoid Personality Disorder (PPD) is one of a group of mental health conditions called Cluster “A” Personality Disorders which involve the exhibition of odd/ eccentric ways of thinking; individuals with this disorder suffer from paranoia which is an unrelenting/ unending mistrust and suspicion of other people, even when there is no apparent reason to be suspicious (WebMD, 2018) Paranoid and obsessive compulsive personality disorders essay examples. PPD typically begins by early adulthood in the affected individuals and is usually more common in the male gender (men) than in the female, and individuals who suffer from PPD are always on guard because they believe that others are constantly trying to harm, humiliate, or threaten them (WebMD, 2018). The habits of blame, distrust and generally the unfounded beliefs might interfere with the sufferer’s ability to form close relationships (WebMD, 2018). The exact cause of this disorder is not known, but it is thought to be a combination of both biological and psychological factors; the fact that PPD is increasingly common in individuals who have close relatives with a diagnosis of schizophrenia suggests some genetic link between these two disorders, and early childhood experiences, such as physical or emotional trauma, also play a role in developing PPD during young adult life (WebMD, 2018).

In diagnosing PPD, the client may present as very formal in manner, and act frustrated/ baffled about having to seek mental health care and evidently showing muscle tension, restlessness, suspicion or the need to scan the environment for clues; the client will also show a humorless and serious mood but with goal-directed and logical speech, although, their arguments may not be true (Sadock, Sadock, & Ruiz, 2014). Moreover, PPD clients have thought contents that show evidence of projection, occasional ideas of reference, and they are always prejudiced  (Sadock, Sadock, & Ruiz, 2014).

Evidenced-based Psychotherapy and Psychopharmacologic Treatment for PPD

Currently, there are no Food and Drug Administration (FDA)-approved medications for PPD; medication is generally not a major focus of treatment for this disorder (Vyas & Khan, 2016). However, medications such as antidepressants, antianxiety, or anti-psychotic drugs, might be prescribed if the client’s symptoms are extreme or suffer from an associated psychological problem such as anxiety/ Depression in addition to PPD (WebMD, 2018). Cognitive-behavioral therapy (CBT) and psychodynamic therapy (PT) have been shown to be the effective treatment modalities for individuals diagnosed with PPD (Vyas & Khan, 2016). Furthermore, individuals with PPD do not typically seek treatment on their own because they believe that they do not have any problem, and when treatment is sought,  psychotherapy (CBT/ PT) is the first line/ treatment of choice for PPD (WebMD, 2018). Psychotherapy treatment will focus on increasing the client’s general coping skills, improving social interaction, communication skills, and self-esteem as well as ways to help reduce paranoia; however, because trust is an important factor in psychotherapy, treatment is usually challenging since individuals with PPD have extreme distrust of others and as a result, most clients with PPD do not follow/ stay compliant with their treatment plans (WebMD, 2018).

Clinical Features that Confirms Paranoid Personality Disorder using DSM-5

 

Mr. Jones is a 25-year-old white male with no prior psychiatric history brought to our office accompanied by his mother and sister who thinks that the client is getting worse with “bizarre behavior” which they started noticing about 2 years ago after he graduated from the University and has now become a big problem. This client is always suspicious of everything around him and thinks that his family and friends are against him and so, has stopped communicating with most of his friends and family members to his own detriment; his uncle recently helped him to get a banking job (he studied accountancy in the University) but refused to go or talk to his uncle because he believes that “it is all a set up.” He suspects that his mother is trying to encourage him to start working so that she can start exploiting him and making him pay all the bills. He is also preoccupied with doubts about his sister’s loyalty to him and unjustifiably questions her trustworthiness with anything or any situation that has to do with him.

Furthermore, the client’s mother verbalized his reluctance to confide in her as his mother because the client fears that his information will be known to everybody and be used to blackmail him in some ways. He also verbalized “I don’t like when people make unnecessary jokes around me because I believe that there is always a hidden meaning to every joke.” This client is able to hold grudges against people for an extended amount of time regardless of their relationship with him (family, friend, etc); he had held grudges with his mother for over a year over a very trivial issue in the past and even tried to attack her sister for intervening in the situation. Mr. Jones broke up with his girlfriend last summer due to the suspicion that she was having an affair; this issue also resulted in family problems because his family told him that his suspicion was unfounded.

This client’s signs and symptoms fit clearly into the 2013 DSM-5 manual by the American Psychiatric Association based on all the diagnostic features explained/ analyzed above by the client and his family. For a diagnosis of PPD to be made, the client must meet the two primary diagnostic criterion called A and B; four (4) out of the seven sub-features of criterion “A” must be met (he met six of these features) in addition to criterion “B” which explains that the client should not have his symptoms better explained by any psychotic episode in schizophrenia, or depressive disorder/ bipolar disorder with psychotic features (American Psychiatric Association, 2013). Mr. Jones does not have any other psychiatric history/ diagnosis and moreover, he does not have any diagnosed medical condition to which his current psychological symptoms can be attributed; this shows that he also met with criterion B to make a diagnosis of PPD.

References

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

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.

Vyas, A., & Khan, M. (2016). Paranoid Personality Disorder. The American Journal of Psychiatry Resident’s Journal. Retrieved from:
https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp-rj.2016.110103

WebMD. (2018). Paranoid Personality Disorder. Retrieved from: https://www.webmd.com/mental-health/paranoid-personality-disorder#2

 

Obsessive Compulsive Personality Disorder (OCPD)

There are many different types of personality disorders that affect many people today. Unfortunately, unlike other mental health disorders personality disorders often present a great challenge when considering treatment options. Because personality disorders describe long-standing and enduring patterns of behavior, they are most often diagnosed in adulthood due to the fact that a child or teen is under constant development, personality changes, and maturation, it is uncommon for them to be diagnosed in childhood or adolescence years (Bressert, 2017),    In the discussion this week, I will define the Obsessive-Compulsive Personality Disorder, identify the diagnostic criteria for the disorder, and describe clinical features from a client that led you to believe this client had this disorder.

What is Obsessive Compulsive Personality Disorder

According to the American Psychiatric Association, (2016)
Obsessive-compulsive
personality disorder 301.4 (F60.5) is characterized by a preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. According to Bressert, (2017), Obsessive-compulsive personality disorder is approximately twice as prevalent in males than females and occurs in between 2.1 and 7.9 percent of the general population. Because this type of personality disorder cause a person to focus so much on being perfect, and they are usually pre-occupied with with logic and intellect, the process of making simple daily life decisions and prioritizing which one to do first becomes extremely difficult for them to do.

Diagnostic Criteria

There are several identified symptoms of
Obsessive-compulsive
personality disorder (OCPD) when the disorder is present. However, four (or more) of the following must be present for one to receive a diagnosis:

Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost

Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).

Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).

Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)

Is unable to discard worn-out or worthless objects even when they have no sentimental value

Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things

Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes

Shows significant rigidity and stubbornness

Psychotherapy and Psychopharmacologic Treatment

As previously stated, it is not always easy finding the right treatment for someone suffering from a personality disorder. According to Ripoll, Triebwasser, and Siever (2011) In the USA there are no FDA-approved medications for the treatment of these disorders, so pharmacotherapy usually results off-label and pharmacological strategies remain lacking. However, evidence-based practice recommends a combined approach including both psychotherapy and pharmacotherapy. This is a very common form of treatment for all types of personality disorders especially those identified as Cluster C personality disorders which is what OCPD falls under. According to Bateman, Gunderson, and Mulder (2015), there are no randomized controlled trials of drug treatment for cluster C personality disorders, although it can be argued that antidepressants might be of some help, particularly, in patients with obsessive–compulsive personality disorder, as the use of SSRIs may decrease anxiety if it is present. When it comes to the therapy side of treatment for this disorder, the therapist will likely use a three-pronged approach to treatment, which typically includes: Cognitive Behavioral Therapy, medication and relaxation training. This type of treatment is typically long-term and is performed with a therapist that has experience in treating this kind of personality disorder (Healthline, 2016).

Clinical Features from a Client with OCPD

During clinicals we see a lot of clients with personality disorder who also present with other co-morbidities and mental health diagnosis like depression and anxiety. However, I recent assessed a client who present to the client with a chief complaint of anxiety. The client explained how she worked as a secretary at a law firm and how it was so important to her to make she that she did everything “perfectly” and how it bothered her to work with other people unless they made sure to do the job exactly how she did it. She expressed her concerns of increased stress and the need for a vacation with family and friends but is apprehensive about leaving for to long out of fear of the job not getting “done the right way”. When trying to explain to the client that there may me more than one way to complete the task and still get it done the right way, she quickly disagreed and became very defensive and increasingly anxious with just the idea of someone changing the process of getting the job done because it wasn’t her way. The client reported that her husband and children both have asked her to quit the job and spend some time at home as they can all see her obsession for it but refuses to step back at this time. Paranoid and obsessive compulsive personality disorders essay examples With all of these symptoms present, the client was diagnosed with OCPD.

References

American Psychiatric Association. (2016). The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia (5th ed.). Washington, DC.

 

Bateman AW, Gunderson J, Mulder R. Treatment of personality disorder. Lancet. 2015;385:735–743

 

Bressert, S. (2017, December 17). Obsessive Compulsive Personality Disorder. Retrieved from
https://psychcentral.com/disorders/obsessive-compulsive-personality-disorder/

 

Healthline. (2016, May 12). Psychotherapy vs. Medications: The Verdict Is In. Retrieved from
https://www.psychologytoday.com/blog/fulfillment-any-age/201507/psychotherapy-vs-medications-the-verdict-is-in

 

Ripoll LH, Triebwasser J, Siever LJ. Evidence-based pharmacotherapy for personality disorders. Int J Neuropsychopharmacol. 2011;14:1257–1288. Paranoid and obsessive compulsive personality disorders essay examples.

Learning Resources

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

Required Readings

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

Standard 12 “Leadership” (pages 76-77)

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

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

Chapter 22, “Personality Disorders” (pp. 742–762)

Chapter 13, “Psychosomatic Medicine” (pp. 451–464)

Gabbard, G. O. (2014).
Gabbard’s treatment of psychiatric disorders
(5th ed.). Washington, DC: American Psychiatric Publications Paranoid and obsessive compulsive personality disorders essay examples.

Chapter 68, “Paranoid, Schizotypal, and Schizoid Personality Disorders”

Chapter 69, “Antisocial Personality Disorder”

Chapter 70, “Borderline Personality Disorder”

Chapter 71, “Histrionic Personality Disorder”

Chapter 72, “Narcissistic Personality Disorder”

Chapter 73, “Cluster C Personality Disorders

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

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

“Personality Disorders”

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

Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders.
Psychiatry: Interpersonal & Biological Processes, 76
(1), 32–52. doi:10.1521/psyc.2013.76.1.32 Paranoid and obsessive compulsive personality disorders essay examples

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

Rees, C. S., & Pritchard, R. (2015).
Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52
(1), 45–55. doi:10.1037/a0035158

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

Required Media

Laureate Education. (2017a).
A woman with personality disorder
[Interactive media file]. Baltimore, MD: Author.

SUBJECTIVE

Rhonda is a 32-year-old Hispanic female who presents to your office for her initial appointment. When you ask what brought her to your office, she states: “I’m at the end of my rope, I don’t know what else to do.” She then bursts into tears. Rhonda explains that she has very few friends left, and everyone seems to have “abandoned” her. Rhonda explains that she goes out of her way to help other people, and to be nice to them, but this does not seem to help.

Rhonda then stands up and begins to pace around your office at times using wild hand gestures to explain the circumstances that led up to her making the appointment with you. She describes the recent breakup with her boyfriend as traumatic and explains “when we first met, he was the best guy in the world. He treated me really well. But he just became a complete monster! Even though he broke off the relationship with me, I was glad to see it end. I hate his guts!” Paranoid and obsessive compulsive personality disorders essay examples.

Rhonda explains that her current financial situation is also precarious. She states that she recently purchased an automobile, and is not certain how she is going to pay for it. She states that she had a car that was repossessed last year at that time, and that she borrowed some money from a friend to help pay for the car; the friend later turned around and accused her of theft. “It was my friend’s fault. She told me she would loan me the money and then backed out. I only took the money because she said she would loan it to me … people just can’t go back on their word like that when other people are counting on them.”

Rhonda reports that she was “always in trouble” as a kid. She states that people were always picking on her, to which she adds: “the other kids my age were just stupid. Paranoid and obsessive compulsive personality disorders essay examples . They didn’t know how to have fun.” She says “I have always been impulsive, but it’s fun. Sometimes people can be such prudes … you only go around life once, so you have to make the best of it.”

OBJECTIVE

Rhonda is currently single. She has no children. Educationally, she had completed two semesters toward her bachelor of arts degree in fine arts. Rhonda currently works as a waitress at a local restaurant. She has held this job for about 2 weeks. Prior to this, Rhonda worked as a housekeeper for a local hotel chain. She states that she was fired from this job because her coworkers were jealous of her and “planted” evidence of her stealing from hotel patrons. She was also arrested for cashing checks under an alias, for which she spent 120 days in jail. Paranoid and obsessive compulsive personality disorders essay examples.

Rhonda has a history of multiple incarcerations for offences ranging from larceny to possession of controlled substances to possession of an illegal firearm. She was also arrested several times for fighting and on at least one occasion, used a baseball bat to beat up a girl who she thought was trying to “set her up” with the police.

MENTAL STATUS EXAM

Rhonda is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. She reports her mood as “terrible!” Affect is labile and seems to change rapidly with the subject being discussed. Her eye contact is normal, but at times, she appears to stare at you. Rhonda is oriented to person, place, and time. She denies visual/auditory hallucinations, no overt paranoia or delusional thought processes noted. Rhonda denies any suicidal or homicidal ideation Paranoid and obsessive compulsive personality disorders essay examples.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER (PMHNP) GIVE TO RHONDA?

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.

 
Borderline Personality Disorder

 
Histrionic Personality Disorder

 
Antisocial Personality Disorder

Decision Point One

 
Borderline Personality Disorder

Decision Point Two

Refer to psychologist for psychological testing

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

The psychologist’s report indicates that a comprehensive psychological battery was performed for the purposes of diagnostic clarification. The end result suggested that Rhonda has traits of multiple personality disorder, but scores highest in antisocial personality traits, suggesting antisocial personality disorder (APD).

When Rhonda returns to the office, you review the psychologist’s report with her Paranoid and obsessive compulsive personality disorders essay examples. Rhonda seems upset, but also states “well, that’s why I am here, to get better … what do I need to do?”

Decision Point Three

Begin group-based cognitive behavioral therapy

Guidance to Student

DBT has not been demonstrated as an effective means of treating APD. There are currently no FDA-approved medications to treat APD either, and Abilify has been associated with an increase in impulse control issues (such as gambling). Also, prescribing medications to someone with antisocial personality disorder could lead to misuse or diversion.

Of the available choices, group-based cognitive behavior therapy may be useful in treating individuals with this personality disorder, but all “improvement” in signs/symptoms should be met with great skepticism.

Kernberg, O. (n.d.).
Psychoanalytic psychotherapy for personality disorders: An Interview with Otto Kernberg
, MD. [Video file]. Mill Valley, CA: Psychotherapy.net

Note:
This video is approximately 94 minutes of length. Paranoid and obsessive compulsive personality disorders essay examples You will access this article from Walden Library databases.

NURS 8100 Week 11 Discussion 1: Policy Analysis Summary Essay

Discussion 1: Policy Analysis Summary

Health care policy can facilitate or impede the delivery of services. For the past several weeks, you have been engaging in an authentic activity by critically analyzing a specific health care policy and various aspects of the impact associated with its implementation Policy Analysis Summary Essay. A critical step in the policy process is communicating your findings with others. This week, you will share information from your policy analysis and its implications.

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To prepare for Discussion 1: Policy Analysis Summary:

Briefly summarize your policy analysis, focusing on the implications for clinical practice that may be most relevant or interesting for your colleagues. Include how evidence-based practice influenced the policy, policy options, or solutions. Policy Analysis Summary Essay.

By Day 3 of Discussion 1: Policy Analysis Summary

Post
 a 1- to 2-paragraph succinct summary of your policy analysis paper. Include at least two of the options or solutions for addressing the policy and the resulting implications for nursing practice and health care consumers.

Read
 a selection of your colleagues’ postings.

By Day 5 of Discussion 1: Policy Analysis Summary

Respond 
to at least 
two
 of your colleagues sharing insights or contrasting perspectives based on readings and evidence, and the practice implications of the policy.

Note:
 Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return
to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues Policy Analysis Summary Essay.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

NURS 8100 Week 11: Policy and Practice

As noted in 
Understanding Health Policy,
 “policies tend to evolve in a cyclical process of finding solutions that create new problems that require new solutions,” (p. 205). The tensions created by the pulls between quality care and cost containment, for instance, or between caring for the individual and concern with the common good, arise as new policies are introduced at all levels: national, state, local, and institutional. Policy Analysis Summary Essay When this occurs, new procedures may need to be implemented in the practice setting.

This week, you will reflect on the implications of health care policies for consumers and health care providers. You will also consider the reciprocal relationship between policy and practice as you explore how policy influences nursing practice and how evidence-based nursing practice influences policy. Additionally, you will propose a strategy for how nurses can advocate for themselves, their patients, and the profession through involvement in health care policy.

Note:
 This week you will complete the Discussion in a small group. Your instructor will notify you of your group assignment by Day 1 of this week.

Policy Analysis Summary Essay Learning Objectives

Students will:

Assess the implications of various policy options and solutions to consumers of health care and nursing practice

Outline current evidence that supports suggested options and solutions to a policy issue Policy Analysis Summary Essay

Propose an advocacy strategy nurses may employ to address a practice issue through the policy process

Photo Credit: [Ariel Skelley]/[Blend Images]/Getty Images

Policy Analysis Summary Essay Learning Resources

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

Required Readings

Bodenheimer, T., & Grumbach, K. (2016). 
Understanding health policy: A clinical approach
 (7th ed.). New York, NY: McGraw-Hill Medical.

Chapter 17, “Conclusion: Tensions and Challenges”This chapter concludes with final thoughts on the challenge of providing quality health care and controlling health care costs. The solution is likely to be resolved only by a collaborative approach, involving all health care stakeholders, and by health professionals taking the lead.

Howard, J., Levy, F., Mareiniss, D. P., Craven, C. K., McCarthy, M., Epstein-Peterson, Z. D., & et al. (2010). New legal protections for reporting patient errors under the Patient Safety and Quality Improvement Act: A review of the medical literature and analysis. 
Journal of Patient Safety, 6
(3), 147-152.

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

The authors studied the dissemination of information on the Patient Safety and Quality Improvement Act (PSQIA), a federal act that affords protection to those reporting medical errors. They found medical literature to be inadequate in this regard, and as a result, medical personnel were uninformed on their legal protections. This lack of information has become a barrier to policy implementation.

Jacobson, N., Butterill, D., & Goering, P. (2003). Development of a framework for knowledge translation: Understanding user context. 
Journal of Health Services Research & Policy, 8
(2), 94–99.

Note:
You will access this article from the Walden Library databases. Policy Analysis Summary Essay.

Lau, B., San Miguel, S., & Chow, J. (2010). Policy and clinical practice: Audit tools to measure adherence. 
Renal Society of Australasia Journal, 6
(1), 36–40.

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

The authors study the compliance to renal-care policies by health care professionals. They conclude with the necessity for nurses to support evidence-based protocols as well as to obtain continuing education on new protocols.

McCracken, A. (2010). Advocacy: It is time to be the change. 
Journal of Gerontological Nursing, 36
(3), 15-17.

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

The author proposes that nurses, as patient advocates, need to be more involved in the making of health care policy instead of reacting to policies that are constantly changing. The article provides a guide to help organize initial policy efforts.

Nannini, A., & Houde, S. C. (2010). Translating evidence from systematic reviews for policy makers. 
Journal of Gerontological Nursing, 36
(6), 22–26.

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

The article cites geronotological nurses as examples of those who are able to translate research into policy briefs that can be clearly understood by policy makers. Geronotological nurses are in this unique position because of their clinical experience and educational background.

Paterson, B. L., Duffet-Leger, L., & Cuttenden, K. (2009). Contextual factors influencing the evolution of nurses’ roles in a primary health care clinic Policy Analysis Summary Essay.
Public Health Nursing, 26
(5), 421-429.

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

This article provides details on a study conducted in a nurse-managed clinic related to the changing roles of nurses. The authors found that nurses, in response to social, political, and economic forces, became involved in advocacy for the clinic through political action, government funding issues, and media relations roles.

Sistrom, M. (2010). Oregon’s Senate bill 560: Practical policy lessons for nurse advocates. 
Policy, Politics, & Nursing Practice, 11
(1), 29-35. doi: 10.1177/1527154410370786

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

The author uses the efforts by a nurse advocate in lobbying for an Oregon bill related to healthy food in public schools to illustrate nurse advocacy and policy making. The bill, developed in response to childhood obesity, did not immediately become law. The author concludes with the importance of considering the political environment when creating successful policy. Policy Analysis Summary Essay.

Spenceley, S. M., Reutter, L., & Allen, M. N. (2006). The road less traveled: Nursing advocacy at the policy level. 
Policy, Politics, & Nursing Practice, 7
(3), 180-194. doi: 10.1177/1527154410370786

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

Nurses have always been advocates at the patient-level of care, but the authors of this article promote the need for all nurses to become advocates at the policy level as well. They discuss factors that have kept nurses from getting involved with policy making and they provide strategies to resolve these challenges.

Wyatt, E. (2009). Health policy advocacy: Oncology nurses make a difference. 
ONS Connect, 24
(10), 12-15.

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

The author presents information on two nurses who have become health care policy advocates—one as a policy maker and one as an elected legislator. Both have been able to use their perspectives from their nursing careers to affect health policy.

Zomorodi, M., & Foley, B. J. (2009). The nature of advocacy vs. paternalism in nursing: Clarifying the ‘thin line.’ 
Journal of Advanced Nursing, 65
(8), 1746-1752.

Note:
You will access this article from the Walden Library databases Policy Analysis Summary Essay.

The authors attempt to distinguish the concepts of advocating for a patient and paternalism, or overriding a patient’s wishes. They provide clinical examples to illustrate the differences between these concepts, and they conclude with strategies to use in practice.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). 
Healthcare policy and advocacy: Advocating through policy.
 Baltimore: Author.

Note: 
The approximate length of this media piece is 7 minutes.

In this media presentation, Dr. Joan Stanley and Dr. Kathleen White discuss how nurses can influence practice and engage in advocacy through the policy process Policy Analysis Summary Essay.

 

Optional Resources

Birnbaum, D. (2009). North American perspectives: POA, HAC and never events. 
Clinical Governance: An International Journal, 14
(3), 242–244.

Policy Analysis Summary Essay Rubric Detail

Select 
Grid View
 or 
List View
 to change the rubric’s layout.

Name: NURS_8100_Week11_Discussion1_Rubric

Excellent

Good

Fair

Poor

RESPONSIVENESS TO DISCUSSION QUESTIONDiscussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

Policy Analysis Summary Essay

6 
(20%)
 – 6 
(20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

6 
(20%)
 – 6 
(20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

Policy Analysis Summary Essay

CONTRIBUTION TO THE DISCUSSION

8 
(26.67%)
 – 8 
(26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

7 
(23.33%)
 – 7 
(23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

6 
(20%)
 – 6 
(20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

0 
(0%)
 – 5 
(16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

Policy Analysis Summary Essay

QUALITY OF WRITING

6 
(20%)
 – 6 
(20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

5 
(16.67%)
 – 5 
(16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

4 
(13.33%)
 – 4 
(13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

0 
(0%)
 – 3 
(10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

Policy Analysis Summary Essay

Personality Disorders Decision Tree Case Study Assignment Example

Decision Tree: Personality Disorders

As described by the American Psychiatric Association (APA) (2013), ‘‘personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment’’. There are different types of personality disorders classified into three clusters. Cluster A individuals are described as the odd or eccentric, cluster B as the dramatic, emotional, or erratic and cluster C as the anxious or fearful. The purpose of this paper is to discuss the case study of a young woman with personality disorder. This Personality Disorders Decision Tree Case Study Assignment Example will explore threes decisions relating to differential diagnosis, psychotherapy and psychopharmacology based on the presented clinical manifestations.

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Decision One

The clinical manifestation presented in the case study are indicative of more than one personality disorder, specifically borderline personality disorder (BPD) and antisocial personality disorder (ASPD). Patients exhibits a fear of abandonment which aligns with BPD. The patient mentioned an interpersonal relationship involvement which she exhibited idolization for the man of her interest, and now is devaluing the man. This is also evident in BPD as outlined by diagnostic criteria set forth by the APA (2013).

My diagnosis for this patient is ASPD, because the client exhibits clinical manifestations of ASPD than BPD. One of the reasons that led me to the diagnosis of ASPD is the client’s lack of remorse. The client stole from a friend, instead of being sorry, client’s blames friend instead. Personality Disorders Decision Tree Case Study Assignment Example. Client exhibits lack of respect for social norm and failure to comply with the law as evidenced by more than one record of arrest. The client fails to upholding financial obligation and is deceitful. Client shows irresponsibility evidenced by inability to keep a job. These presentations are evident in clients with ASPD as outlined in the DSM-5.

The two personality disorders which are classified as cluster B personality disorders by the APA (2013) have clinical manifestations which overlap, thus needs to be ruled out as differential diagnoses for each other. As described on the DSM-5 diagnostic criteria, BPD and ASD have similar features of impulsivity, aggression and manipulative behaviors, which client exhibits in the case study. The differing manifestation between the two  is that in BPD, clients seek out interpersonal relationship, while ASPD client is unable to form any attachment to relationship. Clients with BPD exhibit self-mutilating behaviors and self-aggression, while in  ASPD,  aggression is directed on others. In ASPD clients are egocentric (also seen in narcisstic personality disorder), while BPD clients have a poor image of self Personality Disorders Decision Tree Case Study Assignment Example.

Decision Two

Since the client exhibits symptoms which are synonymous with one more than personality disorder, specifically borderline and antisocial; the best decision is to opt to conduct a psychological testing. This will to further help the practitioner to decipher between the two diagnoses or conclude that patient indeed has the two personality disorders which is a possible occurrence Personality Disorders Decision Tree Case Study Assignment Example. Psychological testing can be in the form of rating scales which includes questionnaires, checklists e.t c. According to Sadock, Sadock and Ruiz (2014), these scales are useful for monitoring patient overtime or to provide a comprehensive assessment information that was not obtained during a routine clinical interview.

There is limited evidence from existing literatures on the effectiveness of medications to target the core symptoms of ASPD. Khalifa et al. (2010) mentions that pharmacological interventions are not to be considered as monotherapy but as adjunctive intervention to target associated symptoms of ASPD such as depression, aggression etc.  The option of Haldol, an antipsychotic medication can be used to address aggression but does not treat the core features of the disorder such as lack of remorse, deceitfulness. Furthermore, the plethora of side effects known to be caused by the medication can increase noncompliance. Psychotherapy can be beneficial, but psychodynamic is not appropriate for this patient because it may require patient to address emotional states. Personality Disorders Decision Tree Case Study Assignment Example. According to Hesse (2010), probing about ‘feeling states’ is unhelpful because the ASPD client may have difficulty accessing such state and may become aggressive when made to confront personal shortcoming.

Decision Three

In decision three, the recommendation is for a group-based cognitive therapy. Latuda an antipsychotic can be used to treat aggression but not the core symptoms of ASPD. Dialectical behavioral therapy will be more appropriate in the client with BPD than in ASPD. The most cited effective psychotherapeutic approach used in ASPD is cognitive behavioral therapy (CBT). Personality Disorders Decision Tree Case Study Assignment Example. This approach helps the client address distorted beliefs about self, others and the world. CBT can be used to enhance social and intrapersonal functioning.

A group setting may be beneficial for these clients as they may be able to learn from others experience or information shared about self. Psychotherapy for ASPD should be met with skepticism, but Hesse (2010) suggested that approaches that includes employing moral reasoning, cognitive behavioral approach, applying a social information processing approach, and planning for relapse prevention should be used. Additionally, the clients need a high level of external structure that includes supervision of the patient and reinforcement of positive social behaviors to yield increased outcomes for ASPD clients (Hesse, 2010). Personality Disorders Decision Tree Case Study Assignment Example.

Ethical and Legal Considerations

Due to the clinical manifestation of ASPD, some clinicians believe that it is hopeless to treat ASPD clients due to their clinical manifestation of aggression, deceitfulness and manipulation. Clients tends to be noncompliant, fueling the clinician’s pessimism. Existence of pessimism can hinder practitioners from upholding the ethical principles to do no harm and to do the best for the patient to full capacity. Hatchet (2015), implores clinicians to turn to published studies to become more aware of treatment options and to avoid expert opinions or clinical myths in regards to treating clients with ASPD.  For these clients, autonomy may be purposely compromised to prevent harm to the patient and to others. This is seen in cases where patient refuse to comply with treatment plan or ordered into treatment and remain in treatment until deemed fit to come out of treatment.

Conclusion

It is essential for the practitioner to be knowledgeable about personality s disorder to effectively care for the patient. The practitioner should explore various options of medication, used to target accompanied symptoms. Psychotherapy, even though some might argue of its effectiveness, should not be ruled out. Assessment tools should be used to guide the clinicians, in diagnosing, especially with disorders that have overlapping symptoms Personality Disorders Decision Tree Case Study Assignment Example.

 

References

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

(5th ed.). Washington, DC: Author.

Khalifa, N., Duggan, C., Stoffers, J., Huband, N., Völlm, B. A., Ferriter, M., & Lieb, K. (2010). Pharmacological interventions for antisocial personality disorder.
The cochrane database of systematic Reviews
, (8). Doi: 10.1002/14651858.CD007667.pub2

Hatchett, G. T. (2015). Treatment guidelines for clients with antisocial personality disorder.
Journal of mental health counseling, 37
(1). Retrieved from Walden University Database

Hesse, M. (2010). What should be done with antisocial personality disorder in the new edition of the diagnostic and statistical manual of mental disorders (DSM-V)?
Biomed central medicine
,
8
(66). DOI: 10.1186/1741-7015-8-66

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.

 

Assignment: Decision Tree

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

The Assignment:

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

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?

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

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

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

Decision #2: Treatment Plan for Psychotherapy

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

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

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

Decision #3: Treatment Plan for Psychopharmacology

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

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

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

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

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

Case #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.

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.

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. Personality Disorders Decision Tree Case Study Assignment Example.

 

Decision Point One

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

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

 Generalized Anxiety Disorder (GAD)

 Obsessive Compulsive Disorder

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

ANSWER CHOOSEN
:
Obsessive Compulsive Disorder

 

Decision Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

Begin Zoloft 50 mg orally daily

Begin Fluvoxamine immediate release 25 mg orally at bedtime

Begin Fluvoxamine controlled release 100 mg orally in the morning

Discontinue Zoloft and begin Fluvoxamine controlled release 100 mg orally every morning In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this. Zoloft is FDA-approved to treat OCD in children. However, between ages 6 and 12, it should be started at 25 mg orally daily. If starting doses are too high, the child may experience side effects that he associates with the medication and as such, may refuse to take the medication. Starting at too high a dose can result in unfavorable side effects (gastrointestinal side effects are notable in this drug), and we can see that Tyrel is experiencing nausea and decreased appetite. In this case, it is recommended to wait to see if the side effects dissipate. Decreasing the dose to 12.5 mg orally daily for about 3 or 4 days, then going back to 25 mg orally daily may help to overcome the unfavorable side effects. If side effects persist, the PMHNP may need to consider switching to a different medication. Personality Disorders Decision Tree Case Study Assignment Example. Fluvoxamine controlled release is not FDA-approved for use in children with OCD (see “Special Populations: Children and Adolescents” in the Fluvoxamine monograph of Stahl’s
Prescriber’s Guide
for further details). Fluvoxamine 100 mg orally daily may not be tolerated in the morning secondary to the drug’s sigma-1 antagonist properties, which can cause sedation. Dosing of Fluvoxamine should be such that the larger dose is given in the evening to minimize daytime sedation. Personality Disorders Decision Tree Case Study Assignment Example It is also worth noting that nothing in the scenario tells us that the Zoloft will not be effective.

 

ANSWER CHOOSEN:
Begin Fluvoxamine immediate release 25

mg orally at bedtime

Client returns to clinic in four weeks

Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall. Personality Disorders Decision Tree Case Study Assignment Example.

She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while.

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.

She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while.

 

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

Increase Fluvoxamine to 50 mg orally at bedtime

Augment with an atypical antipsychotic such as Abilify

Augment treatment with cognitive behavioral therapy

 ANSWER CHOOSEN:
Increase Fluvoxamine to 50 mg orally at

bedtime

Guidance to Student

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

Fluvoxamine immediate release is FDA-approved for the treatment of OCD in children aged 8 years and older. Fluvoxamine’s sigma-1 antagonist properties may cause sedation and as such, it should be dosed in the evening/bedtime.

At this point, it would be appropriate to consider increasing the bedtime dose, especially since the child is responding to the medication and there are no negative side effects.

Atypical antipsychotics are typically not used in the treatment of OCD. There is also nothing to tell us that an atypical antipsychotic would be necessary (e.g., no psychotic symptoms). Personality Disorders Decision Tree Case Study Assignment Example Additionally, the child seems to be responding to the medication, so there is no rationale as to why an atypical antipsychotic would be added to the current regimen.

Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. The PMHNP should augment medication therapy with CBT. If further assessment determines that Tyrel has social anxiety disorder, CBT is effective in treating this condition as well.

 

Learning Resources

Required Readings

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

Chapter 31, “Child Psychiatry” (pp. 1253–1268)

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

“Anxiety Disorders”

American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder.
Journal of the American Academy of Child & Adolescent Psychiatry
,
51
(1), 98–113. Retrieved from http://www.jaacap.com/article/S0890-8567(11)00882-3/pdf

 

McClelland, M., Crombez, M-M., Crombez, C., Wenz, C., Lisius, M., Mattia, A., & Marku, S. (2015). Implications for advanced practice nurses when pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is suspected: A qualitative study.
Journal of Pediatric Health Care
,
29
(5), 442–452. doi:10.1016/j.pedhc.2015.03.005

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

  

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

 

SEE ATTACHECD DECISION TREE ASSIGNMENT EXAMPLE

Client returns to clinic in four weeks

Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.

She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while. Personality Disorders Decision Tree Case Study Assignment Example.

Client returns to clinic in four weeks

Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.

She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while. Personality Disorders Decision Tree Case Study Assignment Example.