My Blog

Tag: Clinical-Nursing

  • Clinical Supervision Sample Essay Discussion Paper

    Clinical Supervision Sample Essay Discussion Paper

    Introduction

    According to Galovski et al., (2013), anxiety disorders are the most prevalent in the United States and are associated with a high illness burden. Anxiety disorders may include panic disorders, agoraphobias, or generalized anxiety disorders. They are characterized by feelings of fear, worry about the future and anxiety. In most primary care settings, they are not only undertreated but also under-recognized. The indication for treatment of anxiety disorders is linked to a patient showing distress or suffers from the resultant complications. Cognitive Behavioral therapy and SSRIs drugs have proven to be highly effective in the management of anxiety disorders. More specifically, Selective Serotonin Reuptake inhibitors are the first line drugs for treating anxiety disorders. This paper discusses the use of CBT as the therapeutic approach of choice for a patient with post-traumatic stress disorder in clinical settings Clinical Supervision Sample Essay Discussion Paper.

    ORDER A PLAGIARISM-FREE PAPER HERE

    Client Description

    SK is a 35 year old female has a previous diagnosis of Post-Traumatic Stress Disorder (PTSD) and is on follow-up.  She presents with complaints of flashbacks and nightmares. The patient frequently and openly expresses feelings of resentment against her mother blaming her for not intervening when she would be raped by her father when she was between 5-15 years old Clinical Supervision Sample Essay Discussion Paper. She acknowledges that she experiences uncontrollable thoughts about the rape incidences occasionally during the day and night and this has thus deferred her further studies at the moment.

    Explanation Of The Therapeutic Approach To Be Used With The Client And Perceived Effectiveness Of The Approach

    The therapeutic approach that would be most effective for this patient is cognitive behavioral therapy. Patients who suffer from PTSD are bitter about traumatic events that they may have experienced in the past. Collectively, these feelings, behaviors and thoughts give rise to psychological issues that present in the form of extreme fear, anxiety and anger (Syros, 2017). The most significant techniques of CBT to be used for this patient include: self-monitoring, cognitive restructuring and conducting behavioral experiments. In Self-restructuring, the patient will be asked to individual write down her thoughts to specific situations more so those that result to anxiety. In cognitive restructuring, the patient will be helped to evaluate whether or not she accurately interprets her thoughts (Kar, 2014).  In conducting behavioral experiments, the client will be helped to device newer ways of looking at situation, circumstances and the world. Clinical Supervision Sample Essay Discussion Paper.

    The perceived effectiveness of CBT on patients with anxiety disorder is that it helps them to change their negative thoughts and anxious states. Apart from focusing and recognizing their thought patterns, CBT helps patients with PTSD to change their anxious thinking patterns that frequently result to feelings of worry and social withdrawal (Ehlers, et al., 2013). Clinical Supervision Sample Essay Discussion Paper. More importantly, CBT is highly effective in helping the patient with anxiety to limit distorted thoughts by realistically looking at individual worries. Syros (2017) also notes that, the use of SSRIs medications alongside CBT is highly effective in reducing the symptoms of anxiety in patients with PTSD, therefore, alongside psychotherapy, SSRIs will be prescribed.

    Additional Information About This Client That May Have Potential Impact On Expected Outcomes

    SK is not married and marriage is not part of any of her current plans. Most of her company/circles of friends are girls who are slightly younger than her or approximately the same age. She has reportedly had several arguments and conflicts with men in social gatherings and at work where she often takes everything to a personal level. She has however not been consistent with both pharmacological medications as well as psychotherapy for the past six months but she has no good explanation as to why. Clinical Supervision Sample Essay Discussion Paper.

    Conclusion

    Anxiety disorders are the most prevalent psychological disorders in the US that are likely to be undertreated or under-recognized. Although they are many, post-traumatic stress disorder is a perfect example where patients present with feelings of fear, nightmares, flashbacks and blame. The best therapeutic approach for PTSD is cognitive behavioral therapy alongside SSRIs medications to reduce symptoms of anxiety. Clinical Supervision Sample Essay Discussion Paper CBT helps patients to do self-monitoring, cognitive restructuring and to conduct behavioral experiments to view the work and issues from a different perspective.

    References

    Ehlers, A., Clark, D. M., Hackmann, A., Grey, N., Liness, S., Wild, J., McManus, F. (2013).

    Intensive Cognitive Therapy for PTSD: A Feasibility Study. 
    Behavioural and Cognitive Psychotherapy
    , 
    38
    (4), 383–398.

    Galovski, T. E., Monson, C., Bruce, S. E., & Resick, P. A. (2013). Does Cognitive–Behavioral

    Therapy for PTSD Improve Perceived Health and Sleep Impairment? 
    Journal of Traumatic Stress
    , 
    22
    (3), 197–204. Clinical Supervision Sample Essay Discussion Paper.

    Kar, N. (2014). Cognitive behavioral therapy for the treatment of post-traumatic stress disorder:

    a review. 
    Neuropsychiatric Disease and Treatment
    , 
    7
    , 167–181.

    Syros, I. (2017). Cognitive behavioral therapy for the treatment of PTSD. 
    European Journal of

    Psychotraumatology
    , 
    8
    (sup4), 1351219.

     

    Discussion: Clinical Supervision

    Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes Clinical Supervision Sample Essay Discussion Paper.

    Learning Objectives

    Students will:

    Analyze clients presenting for treatment of anxiety disorders

    Evaluate effectiveness of therapeutic approaches for clients diagnosed with an anxiety disorder

    To Prepare
    :

    Review this week’s Learning Resources concerning treating patients with anxiety disorders.

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

    Note: 
    For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post Clinical Supervision Sample Essay Discussion Paper. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking
    Submit
    !

    By Day 3

    Post
     a 3- to 5-minute Kaltura video in which you do the following:

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

    Explain your therapeutic approach with the client, including the perceived effectiveness of your approach. Clinical Supervision Sample Essay Discussion Paper.

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

    Note:
     Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

    View
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
    of your colleagues by suggesting an alternate therapeutic approach. Support your feedback with evidence-based literature and/or your own experiences with clients. Clinical Supervision Sample Essay Discussion Paper.

    Introduction

    According to Galovski et al., (2013), anxiety disorders are the most prevalent in the United States and are associated with a high illness burden. Anxiety disorders may include panic disorders, agoraphobias, or generalized anxiety disorders. They are characterized by feelings of fear, worry about the future and anxiety. In most primary care settings, they are not only undertreated but also under-recognized Clinical Supervision Sample Essay Discussion Paper. The indication for treatment of anxiety disorders is linked to a patient showing distress or suffers from the resultant complications. Cognitive Behavioral therapy and SSRIs drugs have proven to be highly effective in the management of anxiety disorders. More specifically, Selective Serotonin Reuptake inhibitors are the first line drugs for treating anxiety disorders. This paper discusses the use of CBT as the therapeutic approach of choice for a patient with post-traumatic stress disorder in clinical settings. Clinical Supervision Sample Essay Discussion Paper.

    Client Description

    SK is a 35 year old female has a previous diagnosis of Post-Traumatic Stress Disorder (PTSD) and is on follow-up.  She presents with complaints of flashbacks and nightmares. The patient frequently and openly expresses feelings of resentment against her mother blaming her for not intervening when she would be raped by her father when she was between 5-15 years old. She acknowledges that she experiences uncontrollable thoughts about the rape incidences occasionally during the day and night and this has thus deferred her further studies at the moment.

    Explanation Of The Therapeutic Approach To Be Used With The Client And Perceived Effectiveness Of The Approach

    The therapeutic approach that would be most effective for this patient is cognitive behavioral therapy. Patients who suffer from PTSD are bitter about traumatic events that they may have experienced in the past. Collectively, these feelings, behaviors and thoughts give rise to psychological issues that present in the form of extreme fear, anxiety and anger (Syros, 2017). The most significant techniques of CBT to be used for this patient include: self-monitoring, cognitive restructuring and conducting behavioral experiments. Clinical Supervision Sample Essay Discussion Paper. In Self-restructuring, the patient will be asked to individual write down her thoughts to specific situations more so those that result to anxiety. In cognitive restructuring, the patient will be helped to evaluate whether or not she accurately interprets her thoughts (Kar, 2014).  In conducting behavioral experiments, the client will be helped to device newer ways of looking at situation, circumstances and the world.

    The perceived effectiveness of CBT on patients with anxiety disorder is that it helps them to change their negative thoughts and anxious states. Apart from focusing and recognizing their thought patterns, CBT helps patients with PTSD to change their anxious thinking patterns that frequently result to feelings of worry and social withdrawal (Ehlers, et al., 2013). More importantly, CBT is highly effective in helping the patient with anxiety to limit distorted thoughts by realistically looking at individual worries. Syros (2017) also notes that, the use of SSRIs medications alongside CBT is highly effective in reducing the symptoms of anxiety in patients with PTSD, therefore, alongside psychotherapy, SSRIs will be prescribed. Clinical Supervision Sample Essay Discussion Paper.

    Additional Information About This Client That May Have Potential Impact On Expected Outcomes

    SK is not married and marriage is not part of any of her current plans. Most of her company/circles of friends are girls who are slightly younger than her or approximately the same age. She has reportedly had several arguments and conflicts with men in social gatherings and at work where she often takes everything to a personal level. She has however not been consistent with both pharmacological medications as well as psychotherapy for the past six months but she has no good explanation as to why Clinical Supervision Sample Essay Discussion Paper.

    Conclusion

    Anxiety disorders are the most prevalent psychological disorders in the US that are likely to be undertreated or under-recognized. Although they are many, post-traumatic stress disorder is a perfect example where patients present with feelings of fear, nightmares, flashbacks and blame. The best therapeutic approach for PTSD is cognitive behavioral therapy alongside SSRIs medications to reduce symptoms of anxiety. CBT helps patients to do self-monitoring, cognitive restructuring and to conduct behavioral experiments to view the work and issues from a different perspective.

     
    References

    Ehlers, A., Clark, D. M., Hackmann, A., Grey, N., Liness, S., Wild, J., McManus, F. (2013).

    Intensive Cognitive Therapy for PTSD: A Feasibility Study. 
    Behavioural and Cognitive Psychotherapy
    , 
    38
    (4), 383–398. Clinical Supervision Sample Essay Discussion Paper.

    Galovski, T. E., Monson, C., Bruce, S. E., & Resick, P. A. (2013). Does Cognitive–Behavioral

    Therapy for PTSD Improve Perceived Health and Sleep Impairment? 
    Journal of Traumatic Stress
    , 
    22
    (3), 197–204.

    Kar, N. (2014). Cognitive behavioral therapy for the treatment of post-traumatic stress disorder:

    a review. 
    Neuropsychiatric Disease and Treatment
    , 
    7
    , 167–181.

    Syros, I. (2017). Cognitive behavioral therapy for the treatment of PTSD. 
    European Journal of

    Psychotraumatology
    , 
    8
    (sup4), 1351219. Clinical Supervision Sample Essay Discussion Paper.

  • Discussion: Clinical Supervision Essay

    Discussion: Clinical Supervision Essay

    Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes.

    Learning Objectives

    ORDER A PLAGIARISM-FREE PAPER HERE

    Students will:

    Analyze clients presenting for treatment of anxiety disorders

    Evaluate effectiveness of therapeutic approaches for clients diagnosed with an anxiety disorder Discussion: Clinical Supervision Essay.

    To Prepare
    :

    Review this week’s Learning Resources concerning treating patients with anxiety disorders.

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

    Note: 
    For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post Discussion: Clinical Supervision Essay. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking
    Submit
    !

    By Day 3

    Post
     a 3- to 5-minute Kaltura video in which you do the following:

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

    Explain your therapeutic approach with the client, including the perceived effectiveness of your approach. Discussion: Clinical Supervision Essay.

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

    Note:
     Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

    View
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
    of your colleagues by suggesting an alternate therapeutic approach. Support your feedback with evidence-based literature and/or your own experiences with clients Discussion: Clinical Supervision Essay.

  • PICOT Statement and Literature Search example essays

    PICOT Statement and Literature Search example essays

    The first step of the EBP process is to develop a question from the nursing practice problem of interest.

    Select a practice problem of interest to use as the focus of your research PICOT Statement and Literature Search example essays.

    Start with the patient and identify the clinical problems or issues that arise from clinical care.

    Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

    ORDER A PLAGIARISM-FREE PAPER HERE

    The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

    Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.

    Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed PICOT Statement and Literature Search example essays assignment should have a title page and a reference list with abstracts.

    Suggestions for locating qualitative and quantitative research articles from credible sources:

    Use a library database such as CINAHL Complete for your search.

    Using the advanced search page check the box beside ”Research Article” in the ”Limit Your Results” section.

    When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative. PICOT Statement and Literature Search example essays.

    To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. PICOT Statement and Literature Search example essays.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    PICOT Question and Literature Search

    Nursing practice problem

    Although nicotine replacement therapy is acknowledged as a strategy for smoking cessation, its efficacy is not well established. As such, there is a need to provide tangible evidence that compares nicotine replacement therapy with other strategies applied for the same purpose. The intention is to establish whether nicotine replacement therapy is worth receiving special attention from nursing practitioners. PICOT Statement and Literature Search example essays.

    PICOT Statement

    Population:
    in cigarette smokers older than 17 years

    Intervention:
    does nicotine replacement therapy

    Control:
    versus using other smoking cessation therapies

    Outcome:
    affect smoking cessation outcomes

    Time:
    over a period of three months?

    Literature Search (References List and Abstract)

    Silla, K., Beard, E. & Shahab, L. (2014). Nicotine replacement therapy use among smokers and ex-smokers: associated attitudes and beliefs: a qualitative study.
    BMC Public Health
    , 14, 1311. doi: 10.1186/1471-2458-14-1311 PICOT Statement and Literature Search example essays

    Abstract

    Background: Smokers who are unwilling or unable to quit smoking may benefit from using nicotine replacement therapy (NRT) for harm reduction. This may include the partial or complete substitution of cigarettes with NRT. A taxonomy of the characteristics of those using NRT for harm reduction would be helpful in tailoring advice and treatment. Although attempts to categorize those using NRT for harm reduction have been made, these have largely been based on quantitative data. PICOT Statement and Literature Search example essays. In order to provide further in-depth exploration of views, beliefs and experiences, the current study probed issues surrounding NRT and harm reduction qualitatively to better understand barriers and facilitators to this approach.

    Methods: Three groups of participants (n = 15) were recruited from a student sample: current smokers with a history of NRT use, smokers without a history of NRT use, and ex-smokers with a history of NRT use. Participants were asked about their demographic characteristics, smoking behaviors, intention and perceived ability to quit smoking, awareness and use of NRT, beliefs about the health consequences of using NRT, and the safety and efficacy of NRT, using semi-structured telephone interviews.

    Results: Twenty-four themes were identified; these themes were clustered into three main issues of cross-cutting themes: attitudes towards smoking and motivation to quit; smoking reduction and quit attempts; and beliefs, use and concerns about NRT. Those with a history of NRT use were more motivated and engaged with the quitting process than non-users. However, irrespective of smoking status and past NRT use, all participants showed misperceptions about NRT, such as the health consequences associated with NRT use.

    Conclusions: NRT users are more motivated to quit smoking than non-users and are more likely to employ techniques to assist their cessation attempts. The majority of smokers have misperceptions regarding the safety and efficacy of NRT which may act as a barrier to its usage.

    Barbeau, A., Burda, J. & Siegel, M. (2013). Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach.
    Addict Sci Clin Pract.
    , 8, 5. doi: 10.1186/1940-0640-8-5 PICOT Statement and Literature Search example essays.

    Abstract

    Background: Nicotine is widely recognized as an addictive psychoactive drug. Since most smokers are bio-behaviorally addicted, quitting can be very difficult and is often accompanied by withdrawal symptoms. Research indicates that nicotine replacement therapy (NRT) can double quit rates PICOT Statement and Literature Search example essays. However, the success rate for quitting remains low. E-cigarettes (electronic cigarettes) are battery-powered nicotine delivery devices used to inhale doses of vaporized nicotine from a handheld device similar in shape to a cigarette without the harmful chemicals present in tobacco products. Anecdotal evidence strongly suggests that e-cigarettes may be effective in helping smokers quit and preventing relapse, but there have been few published qualitative studies, especially among successful e-cigarette users, to support this evidence.

    Methods: Qualitative design using focus groups (N = 11); 9 men and 2 women. Focus groups were conducted by posing open-ended questions relating to the use of e-cigarettes, comparison of effectiveness between NRTs and e-cigarettes, barriers to quitting, and reasons for choosing e-cigarettes over other methods. PICOT Statement and Literature Search example essays.

    Results: Five themes emerged that describe users’ perceptions of why e-cigarettes are efficacious in quitting smoking: 1) bio-behavioral feedback, 2) social benefits, 3) hobby elements, 4) personal identity, and 5) distinction between smoking cessation and nicotine cessation. Additionally, subjects reported their experiences with NRTs compared with e-cigarettes, citing negative side effects of NRTs and their ineffectiveness at preventing relapse.

    Conclusion: These findings suggest tobacco control practitioners must pay increased attention to the importance of the behavioral and social components of smoking addiction. PICOT Statement and Literature Search example essays. By addressing these components in addition to nicotine dependence, e-cigarettes appear to help some tobacco smokers transition to a less harmful replacement tool, thereby maintaining cigarette abstinence.

    Buller, D., Halperin, A., Severson, H., Borland, R., Slater, M., Bettinghaus, E., Tinkelman, D., Cutter, G. & Woodall, G. (2014). Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a Trial Comparing Cessation Services.
    J Public Health Manag Pract.
    , 20(2), E7-E15. doi: 10.1097/PHH.0b013e3182a0b8c7

    Abstract

    Context: Young adult smokers have the highest smoking prevalence among all US age groups but are least likely to use evidence-based cessation counseling or medication to quit.

    Objective: Use and effectiveness of nicotine patch were explored in a randomized trial evaluating smoking cessation interventions with this population.

    Participants: Smokers aged 18 to 30 (n = 3094) were recruited through online and off-line methods and from telephone quit lines and analyzed. PICOT Statement and Literature Search example essays.

    Design: Smokers were enrolled in a pretest-posttest trial, and randomized to 1 of 3 cessation services.

    Setting: Trial delivering counseling services by self-help booklet, telephone quit lines, or online expert system in the 48 continental United States.

    Intervention: Smokers could request a free 2-week course of nicotine replacement therapy (NRT) patches from the project.

    Main Outcome Measure: Follow-up surveys at 12 and 26 weeks assessed smoking abstinence, use of NRT, counseling, and other cessation medications, and smoking-related variables.

    Results: Overall, 69.0% of smokers reported using NRT (M = 3.2 weeks) at 12 weeks and 74.8% (M = 3.3 weeks) at 26 weeks. More smokers who were sent the free nicotine patches (n = 1695; 54.8%) reported using NRT than those who did not receive them (12 weeks: 84.3% vs 41.9%, P < .001; 26 weeks: 87.6% vs 51.1%, P < .001). The use of NRT was associated with greater smoking abstinence at 12 weeks (P < .001) and 26 weeks (P < .05), especially if used for more than 2 weeks (P < .001). Smokers assigned to a self-help booklet or cessation Web site and heavier smokers were most likely to use NRT (P < .05), whereas those reporting marijuana use and binge drinking used NRT less (P < .05). PICOT Statement and Literature Search example essays. Conclusions: Many young adults were willing to try NRT, and it appeared to help them quit in the context of community-based cessation services. Strategies should be developed to make NRT available to this age group and support them in using it to prevent lifelong smoking. Rath, J., Villanti, A., Abrams, D. & Vallone, D. (2012). Patterns of Tobacco Use and Dual Use in US Young Adults: The Missing Link between Youth Prevention and Adult Cessation. Journal of Environmental and Public Health , Volume 2012 (2012), Article ID 679134. doi: 10.1155/2012/679134 Abstract Few studies address the developmental transition from youth tobacco use uptake to regular adulthood use, especially for noncigarette tobacco products. The current study uses online panel data from the Legacy Young Adult Cohort Study to describe the prevalence of cigarette, other tobacco product, and dual use in a nationally representative sample of young adults aged 18-34 (N = 4,201). Of the 23% of young adults who were current tobacco users, 30% reported dual use. Ever use, first product used, and current use were highest for cigarettes, cigars, little cigars, and hookah. Thirty-two percent of ever tobacco users reported tobacco product initiation after the age of 18 and 39% of regular users reported progressing to regular use during young adulthood. This study highlights the need for improved monitoring of polytobacco use across the life course and developing tailored efforts for young adults to prevent progression and further reduce overall population prevalence. PICOT Statement and Literature Search example essays. Thurgood, S., McNeill, A., Clark-Carter, D. & Brose, L. (2015). A Systematic Review of Smoking Cessation Interventions for Adults in Substance Abuse Treatment or Recovery. Nicotine & Tobacco Research , 18(5), 993-1001. doi: 10.1093/ntr/ntv127 Abstract Introduction: The aim was to evaluate the effectiveness of smoking cessation interventions for patients with substance use disorders. The secondary aim was to evaluate impact on substance use treatment outcomes. Methods: Randomized controlled trials involving adult smokers, recently or currently receiving inpatient or outpatient treatment for substance use disorders were reviewed. Databases, grey literature, reference lists, and journals were searched for relevant studies between 1990 and August 2014. Two authors extracted data and assessed quality. The primary outcome was biochemically verified continuous abstinence from smoking at 6 or 12 months, secondary outcomes were biochemically verified 7-day point prevalence smoking abstinence (PPA) at 6 or 12 months and substance use outcomes PICOT Statement and Literature Search example essays. Heterogeneity between studies precluded pooled analyses of the data. Results: Seventeen of 847 publications were included. Five studies reported significant effects on smoking cessation: (1) nicotine patches improved continuous abstinence at 6 months; (2) nicotine gum improved continuous abstinence at 12 months; (3) counseling, contingency management and relapse prevention improved continuous abstinence at 6 and 12 months; (4) cognitive behavioral therapy, plus nicotine replacement therapy (NRT), improved PPA at 6 months; and (5) a combination of bupropion, NRT, counseling and contingency management improved PPA at 6 months. Two studies showed some evidence of improved substance use outcomes with the remaining eight studies measuring substance use outcomes showing no difference. Conclusions: NRT, behavioral support, and combination approaches appear to increase smoking abstinence in those treated for substance use disorders. Higher quality studies are required to strengthen the evidence base. Garcia-Rodriguez, O., Secades-Villa, R., Florez-Salamanca, L., Okuda, M., Liu, S. & Blanco, C. (2014). Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a Trial Comparing Cessation Services. Drug Alcohol Depend. , 132(3), 479-485. doi: 10.1016/j.drugalcdep.2013.03.008 PICOT Statement and Literature Search example essays. Abstract Context: Young adult smokers have the highest smoking prevalence among all US age groups but are least likely to use evidence-based cessation counseling or medication to quit. Objective: Use and effectiveness of nicotine patch were explored in a randomized trial evaluating smoking cessation interventions with this population. PICOT Statement and Literature Search example essays. Participants: Smokers aged 18 to 30 (n = 3094) were recruited through online and off-line methods and from telephone quit lines and analyzed. Design: Smokers were enrolled in a pretest-posttest trial, and randomized to 1 of 3 cessation services. Setting: Trial delivering counseling services by self-help booklet, telephone quit lines, or online expert system in the 48 continental United States. Intervention: Smokers could request a free 2-week course of nicotine replacement therapy (NRT) patches from the project. Main Outcome Measure: Follow-up surveys at 12 and 26 weeks assessed smoking abstinence, use of NRT, counseling, and other cessation medications, and smoking-related variables PICOT Statement and Literature Search example essays. Results: Overall, 69.0% of smokers reported using NRT (M = 3.2 weeks) at 12 weeks and 74.8% (M = 3.3 weeks) at 26 weeks. More smokers who were sent the free nicotine patches (n = 1695; 54.8%) reported using NRT than those who did not receive them (12 weeks: 84.3% vs 41.9%, P < .001; 26 weeks: 87.6% vs 51.1%, P < .001). The use of NRT was associated with greater smoking abstinence at 12 weeks (P < .001) and 26 weeks (P < .05), especially if used for more than 2 weeks (P < .001). Smokers assigned to a self-help booklet or cessation Web site and heavier smokers were most likely to use NRT (P < .05), whereas those reporting marijuana use and binge drinking used NRT less (P < .05). Conclusions: Many young adults were willing to try NRT, and it appeared to help them quit in the context of community-based cessation services. Strategies should be developed to make NRT available to this age group and support them in using it to prevent lifelong smoking. PICOT Statement and Literature Search example essays.

  • research design methods and applications

    research design methods and applications

    During the past few weeks, you have considered the various elements of the research project. Compile all of the sections of your research strategy ideas from Week 3. Retrieve your survey/questionnaire results this week to complete your final project in Week 5. Your final research paper should be 1,500–2,000 words.

    Your research paper should include the following:

    ORDER A PLAGIARISM-FREE PAPER HERE

    Your Introduction and Purpose of the study from your Unit 3 Individual Project

    Your Literature Review from your Unit 3 Discussion Board, adding your Unit 1 articles

    Your Methodology from the Unit 3 Individual Project research design methods and applications

    Add your ethical considerations for the survey to your Methodology

    Add your measurement strategy to your Methodology

    Include a copy of the questionnaire or survey in the Methodology

    Provide your Data Analysis with survey results

    Data results should be provided in graphic form, making them user-friendly information

    Provide your Conclusion regarding the study. Be sure to tell how well you answered your research question, the status of your hypothesis (true/false), and the value of your survey results for your topic moving forward

    Based on comments from your instructor and peers in Weeks 3 and 4, edit and refine any sections of the final research paper. research design methods and applications.

  • Evidence-based practice and Nursing research

    Evidence-based practice and Nursing research

    Question #1-Identify two areas of nursing practice, which evidence-based practice has improved patient outcomes. State the study and its impact on patient care. How have these findings changed your nursing practice? Please support your response with a minimum of two supporting peer-reviewed articles.

    ORDER A PLAGIARISM-FREE PAPER HERE

    Question #2-Nursing research is used to study a dilemma or a problem in nursing. Examine a problem you have seen in nursing. Why should it be studied? Justify your rationale. Minimum of two references

    Response expected to be 150 words per question with two or more references using in-text citations and source referencing in APA 6th ed. formatting evidence-based practice and Nursing research.

    Discussion Questions

    Question #1-Identify two areas of nursing practice, which evidence-based practice has improved patient outcomes. State the study and its impact on patient care. How have these findings changed your nursing practice? Please support your response with a minimum of two supporting peer-reviewed articles.

    There are two areas in nursing practice in which evidence-based practice has improved patient outcomes. The first area is infection control. When accessing a medical facility owing to an illness, the last thing that a patient would want is to get a facility-acquired infection. In this case, it is noted that nurses can apply evidence-based infection control strategies to ensure that patient do not get such infections. Some of these strategies include disinfecting and washing hands, applying barrier precautions, wearing protective clothing, and keeping the environment clean. Nurses now understand that although the strategies applied in infection control adds to their responsibilities, it is worth the effort by avoiding preventable infections (Patterson, 2015). The second area is blood administration and intravenous catheter use. evidence-based practice and Nursing research Evidence-based practice suggests that nurses should use 19-gauge or smaller catheters to ensure the patients’ comfort without reducing its efficiency. In fact, evidence from Stupnyckj et al. (2014) shows that a catheter with a gauge smaller than 20 can safely be used among adult patients to transfuse blood. In this respect, evidence-based practice has improved infection control and intravenous catheter use in nursing practice.

    Question #2-Nursing research is used to study a dilemma or a problem in nursing. Examine a problem you have seen in nursing. Why should it be studied? Justify your rationale. Minimum of two references

    The interaction between patients and nurses is an important factor in ensuring that high-quality medical services are offered leading to patients reporting improved health and satisfaction. Still, it is important to note that interaction is a complex, dynamic, multi-factorial and multi-dimensional communication phenomenon. Having good interactions between the patients and nurses is an important aspect of care since it has a profound effect on how the patient perceives care outcome and quality, and improves the relationship between the two parties. In fact, it is undeniable that applying operative communication skills would allow nurses to effectively provide medical care in additional to other positive outcomes from patients that include cooperation, compliance, acceptance, and satisfaction. Despite this awareness, poor patient-nurse interactions still occur and is blamed on nurses lacking effective communication skills (Nilsen et al., 2014; Norouzinia et al., 2016). As such, there is need for evidence to show whether nurses acquiring effective communication skills would improve their interactions with patients. evidence-based practice and Nursing research.

    References

    Nilsen, M., Sereika, S., Hoffman, L., Barnato, A., Donovan, H. & Happ, M. (2014). Nurse and Patient Interaction Behaviors Effects on Nursing Care Quality for Mechanically Ventilated, Older Adults in the ICU.
    Res Gerontol Nurs
    ., 7(3), 113-125 evidence-based practice and Nursing research.

    Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M. & Samami, E. (2016). Communication Barriers Perceived by Nurses and Patients.
    Glob J Health Sci
    ., 8(6), 65-74.

    Patterson, C. (2015). Basic principles of infection control.
    Nursing made Incredibly Easy
    , 13(3), 28-37.

    Stupnyckyj, C., Smolarek, S., Reeves, C., McKeith, J. & Magnan, M. (2014). Changing blood transfusion policy and practice.
    Am J Nurs
    ., 114(12), 50-59. evidence-based practice and Nursing research.

  • SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines

    SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines

    Purpose

    Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice intervention used to identify, reduce, and prevent problematic use, abuse, and dependence on substances such as tobacco, alcohol and illicit drugs. The SBIRT model was incited by an Institute of Medicine (IOM) recommendation that called for community-based screening for health risk behaviors. The purpose of this assignment is to integrate SBIRT into nursing practice to help stimulate positive change at the individual and population focused level of care. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

    ORDER A PLAGIARISM-FREE PAPER HERE

    Background information

    SBIRT consists of three major components.

    Screening
    —A healthcare professional assesses a patient for concerning behaviors using standardized screening tools. Screening can occur in any healthcare setting.

    Brief Intervention
    —A healthcare professional engages a patient in a short conversation, providing feedback and advice regarding concerning behaviors. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

    Referral to Treatment
    —A healthcare professional provides a referral to resources and/or treatment options and additional services available (Substance Abuse and Mental Health Services Administration [SAMHSA], n.d.)

    Directions

    Prior to starting the presentation, you are to read the assigned training.

     

    SBIRT Education. (n.d.). 
    Overview of screening, assessment and brief intervention: a nursing response to the full spectrum of substance use.
    Retrieved from 
    https://hospitalsbirt.webs.com/nursingsbirt.htm (Links to an external site.)Links to an external site.

    Choose “Watch On Demand Recording”

    Start at minute 9:08/slide 12, end at 1hr 27 sec. (slide 80) SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines

    Or you may go directly to the YouTube video:

    SBIRT Education. (2015, May 10). 
    Overview of SBIRT: a nursing response to the full spectrum of substance use 
    [Video File]. Retrieved from
    Overview of SBIRT: A Nursing Response to the Full Spectrum of Substance Use (Links to an external site.)Links to an external site.

    Use this BNI checklist for the role play at the end: 
    BNI Checklist (Links to an external site.)Links to an external site.
        SBIRT Education. (n.d.). Brief negotiated            interview checklist [PDF Document]. Retrieved from 
    https://hospitalsbirt.webs.com/nursingsbirt.htm (Links to an external site.)Links to an external site.
           You are encouraged to review the assignment tutorial found at the end of the Academic Integrity Reminder.

    Next, choose one addiction or problem to focus on for this assignment from the options below. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines

    Alcohol
    will be used for this power point slide show.

    You are required to use one of the problems listed above. Assignments that do not follow the current guidelines or use the required forms or templates will be evaluated for evidence of an academic integrity violation. After the due date, there will be no opportunity for revision or resubmission of assignments that have been uploaded to the submission area. It is your responsibility to submit the correct assignment to the correct submission area.

    After you have chosen the addiction/problem, you are to research SBIRT training specific to that problem/addition. Before starting to work on the presentation, it is vital you understand how SBIRT is used with that particular addiction/problem. You must find at least two scholarly resources (other than readings assigned in the course) and one video resource. Search YouTube for one SBIRT training video from a reputable source that shows a provider using SBIRT with a patient. Watch this video so that you understand the steps of SBIRT SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

    You may choose to complete this assignment as a PowerPoint poster or PowerPoint multiple slide presentation. Download the 
    SBIRT PowerPoint poster(Links to an external site.)Links to an external site.
     or 
    slide presentation template (Links to an external site.)Links to an external site.
    .

    Submit the completed PowerPoint poster or slide presentation by Sunday, 11:59 p.m. MT at the end of Week 6.

    Length: The poster should be one page with all boxes on template complete. The slide presentation should be no more than twelve slides, not including the title and references slides. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

    Guidelines

    Below are the requirements needed for successful completion of the SBIRT: Screening, Brief Intervention, and Referral to Treatment presentation.

    Introduction to the problem and/or addiction: 
    Clearly identify the problem, and discuss specific statistics from your community related to this problem. You may use city or county data. For example, if you choose a specific drug, you should find the drug use rate in your city or county.

    Problem description
    :
    Utilize one scholarly reference (not assigned in this course) to describe this problem/addiction. Discuss reasons why this may be a problem in your community. Cite all sources. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

    SBIRT description: 
    Utilize at least one scholarly reference different from the one selected for the problem description above, and not assigned in this course, to describe how SBIRT is used with this specific addiction/problem. Identify specific steps and questions that are used.

    Video:
    Locate and describe at least one video that demonstrates SBIRT related to the addiction you chose.

    Citation:
    Cite all sources.

    Community resources: 
    Describe at least two available community resources to which you may refer people who have this problem or an increased potential for acquiring this problem. You are to provide the names of these resources and brief descriptions. You may use online resources if community resources are not available.

    Conclusion/future implications for nursing:
    Provide a summary of your findings. Discuss the use of SBIRT in nursing practice.

    References: 
    Provide all references for all sources utilized. Use APA format, however, a hanging indent is not necessary SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

    Best Practices in Preparing PowerPoint

    The following are best practices in preparing this presentation.

    Review directions thoroughly.

    We recommend that you use one of the linked templates. Replace the placeholder text with your own content. Use a black or colored font that is easy to read.

    Use short bullet points and large font for easier reading. For PowerPoint slides, use no more than eight lines per slide and no more than eight words per line.

    Reference

    Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). 
    SBIRT: Screening, Brief Intervention, and Referral to Treatment.

    Week 6 SBIRT Assignment

     

    Transcript (Links to an external site.)Links to an external site.

    Rubric

    NR443 SBIRT Presentation

    NR443 SBIRT Presentation

    Criteria

    Ratings

    Pts

    This criterion is linked to a Learning OutcomeIntroduction to problem

    25.0 pts

    Problem is adequately identified and statistical data about the problem in student’s community is clearly presented.

    22.0 pts

    Problem is adequately identified and statistical data presented, but data is not from the student’s community.

    20.0 pts

    Problem is identified and statistical data is presented but data is not relevant to this problem

    10.0 pts

    Problem is not clear or statistical data is not presented.

    0.0 pts

    Problem is not identified and statistical data is not presented.

    25.0 pts

    This criterion is linked to a Learning OutcomeProblem support with scholarly literature and problem rationale.

    45.0 pts

    Thoroughly presents at least one scholarly reference (not assigned in this course) to describe this problem and discusses relevant reasons why this is a problem in student’s community.

    40.0 pts

    Adequately presents at least one scholarly reference (not assigned in this course) to describe this problem and discusses reasons why this is a problem in student’s community.

    36.0 pts

    Presents a scholarly source that is not clearly relevant to problem and reasons for problem are described.

    17.0 pts

    Scholarly
    source is not presented or reasons for problem are not described.

    0.0 pts

    Scholarly
    source is not presented and reasons for problem are not described.

    45.0 pts

    This criterion is linked to a Learning OutcomeSBIRT

    55.0 pts

    Thoroughly addresses all of the following elements: • Utilizes at least one scholarly reference (not assigned in this course) to describe how SBIRT is used with this problem. • Identifies specific steps and questions that are used. • Describes at least one video that demonstrates SBIRT related to the problem discussed.

    48.0 pts

    Adequately addresses all of the elements listed in the first column.

    44.0 pts

    Missing one element listed in the first column.

    21.0 pts

    Missing two elements listed in first column.

    0.0 pts

    Does not address any of the elements listed in first column OR is not on one of the assigned addiction/problems.

    55.0 pts

    This criterion is linked to a Learning OutcomeCommunity Resources

    40.0 pts

    Thoroughly addresses all of the following elements: • two relevant community resources that could be used as a referral identified • provides the names of these resources • includes brief description of each referral resource

    35.0 pts

    Adequately addresses all of the elements listed in the first column.

    32.0 pts

    Missing one element listed in the first column.

    15.0 pts

    Missing two elements listed in the first column.

    0.0 pts

    Community resources not addressed.

    SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines

    40.0 pts

    This criterion is linked to a Learning OutcomeConclusion and Future Implications

    25.0 pts

    Thoroughly summarizes findings. Discusses the implications for the use of SBIRT in nursing practice.

    22.0 pts

    Adequately summarizes findings and use of SBIRT in nursing practice

    20.0 pts

    Summarizes findings but does not discuss use of SBIRT in nursing practice.

    10.0 pts

    Discusses use of SBIRT in nursing practice but does not summarize findings.

    0.0 pts

    Summary and use of SBIRT in nursing practice not present.

    25.0 pts

    This criterion is linked to a Learning OutcomeMechanics and organization

    20.0 pts

    Excellent mechanics and organization with minimal errors of the following: • well organized and logical, • appealing to eye, • includes creativity, • font is easy to read (short bullet points rather than sentences or paragraphs), • correct grammar, punctuation, and spelling, • professional wording is used.

    18.0 pts

    Good mechanics and organization considering the elements listed in the first column. A few errors noted.

    16.0 pts

    Fair mechanics and organization considering the elements listed in the first column. Some errors noted. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines

    8.0 pts

    Poor mechanics and organization considering the elements listed in the first column. Many errors noted.

    0.0 pts

    Very poor mechanics and organization considering the elements listed in the first column such that it is difficult to follow or understand.

    20.0 pts

    This criterion is linked to a Learning OutcomeAPA

    15.0 pts

    Excellent APA formatting with minimal errors of the following: • all sources cited on the slide or poster • all references listed in place provided in APA format • no more than one short quotation, and • length is no more than 12 slides for PowerPoint, excluding title and reference slides. For poster one page

    13.0 pts

    Good APA formatting considering the elements listed in the first column. A few APA errors noted.

    12.0 pts

    Fair APA formatting considering the elements listed in the first column. Some APA errors noted.

    6.0 pts

    Poor APA formatting considering the elements listed in the first column. Many APA errors noted.

    0.0 pts

    Very poor APA formatting such that paper is difficult to read. Numerous APA errors noted.

    15.0 pts

    Total Points: 225.0

    Previous
    Next

    Week 6/Assignment 3: SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation 

     

    Hello! This tutorial will review the 3
    rd
    course assignment, Screening, Brief Intervention, and Referral to Treatment (SBIRT). This assignment is due by 11:59 p.m. MT Sunday of Week 6.

     

    SBIRT is an evidence-based practice intervention used to identify, reduce, and prevent problematic use, abuse, and dependence on substances such as tobacco, alcohol, and illicit drugs. The SBIRT model was incited by an Institute of Medicine (IOM) recommendation that called for community-based screening for health-risk behaviors. The purpose of this assignment is to integrate SBIRT into nursing practice to help stimulate positive change at the individual and population-focused level of care. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

     

    SBIRT consists of three major components. Please review those on your screen now.

     

    Prior to starting the presentation, review the guidelines and rubric. You are to review the assigned reading/training. Be sure to review the guidelines as this may change from session to session to ensure we are sharing the most current information. Next, you will choose one addiction or problem to focus on for this assignment from the options provided in the guidelines. You must choose one of these topics, while there are other topics applicable, you must choose from the options.

     

    After you have chosen the addiction/problem, you are to research SBIRT training specific to that problem/addiction. Before starting to work on the presentation, it is vital you understand how SBIRT is used with that particular addiction/problem. You must find at least two scholarly resources (other than readings assigned in the course) and one video resource. Search YouTube for one SBIRT training video from a reputable source that shows a provider using SBIRT with a patient. Watch this video so that you understand the steps of SBIRT.

    You may choose to complete this presentation in poster or PowerPoint format. Templates are provided, but you are not required to use one.

    You will start the presentation with an introduction to the problem and/or addiction: Clearly identify the problem, and discuss specific statistics from your community related to this problem. You may use city or county data. For example, if you choose tobacco use, you should find the tobacco use rate in your city or county SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

    Next you will describe the problem. Utilize one scholarly reference (not assigned in this course) to describe this problem/addiction. Discuss reasons why this may be a problem in your community. Cite all sources.

     

    The next piece is the SBIRT description: Utilize at least one scholarly reference different from the one selected for the problem description above, and not assigned in this course, to describe how SBIRT is used with this specific addiction/problem. Identify specific steps and questions that are used. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines.

    Locate and describe at least one video that demonstrates SBIRT related to the addiction you chose. Cite all sources.

     

    Next describe at least two available community resources to which you may refer people who have this problem or an increased potential for acquiring this problem. You are to provide the names of these resources and brief descriptions. You may use online resources if community resources are not available.

     

    SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines You will end with a conclusion that includes a summary and future implications for nursing. You will also want to discuss the use of SBIRT in nursing practice.

     

    You must provide all references for all sources utilized. Use APA format; however, a hanging indent is not necessary. SBIRT: Screening, Brief Intervention, and Referral to Treatment Presentation Guidelines

  • Hospital Compare Performance Measurement

    Hospital Compare Performance Measurement

    Performance Measurement PowerPoint Slideshow Guidelines

    Purpose

    The purpose of this PowerPoint presentation is to locate and compare performance measurement data on common health conditions for the hospitals in your area. You will investigate the Centers for Medicare and Medicaid Services websites and locate the section called Hospital Compare. There you will find data for hospitals within a 50-mile radius of the community where you are working or had your prelicensure clinical experiences. You will prepare a PowerPoint presentation and share the results of your findings. Opportunities for improving performance measurement indicators will be shared.

    ORDER A PLAGIARISM-FREE PAPER HERE

    Course Outcomes

    Completion of this assignment enables the student to meet the following course outcomes.

    CO1: Apply leadership concepts, skills, and decision making in the provision of high-quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2) Hospital Compare Performance Measurement.

    CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)

    CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)

    CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and system-wide practice improvements that will improve the quality of healthcare delivery. (POs 2 and 3)

    CO8: Apply concepts of quality and safety using structure, process and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)

    Due Dates

    This assignment is to be submitted by Sunday, 11:59 p.m. MT, end of Week 6.

    Points

    This assignment is worth 200 points.

    Directions

    Review information found on the following website related to hospital compare http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalCompare.html (Links to an external site.)Links to an external site.

    Read the information carefully and then locate the following website. http://www.medicare.gov/hospitalcompare (Links to an external site.)Links to an external site.

    Search for hospitals within a 50-mile radius of the community where you are working or had your prelicensure clinical experiences. Type in your zip code. Select your hospital and two others. Select hospitals/facilities and choose compare. If you live in a remote area and there are no hospitals listed within a 50-mile radius, select a zip code for a family member or a close friend who does not live near you. The idea is to review comparative data.

    Click on the following topics to learn more. Hospital Compare Performance Measurement.

    Survey of patient’s experiences

    Timely and effective care (focus your search on two of the conditions that apply to services provided at the hospitals)

    Readmissions, complications, and deaths

    Carefully read the information provided.

    Develop a PowerPoint slideshow consisting of 8-10 slides. Include the following, keeping in mind what all this data means.

    Title slide with information pertinent to the course.

    List reasons to recommend the website Hospital Compare to consumers (patients).

    List reasons to recommend the website Hospital Compare to staff who may seek employment.

    For the slides below, clearly label the name of each hospital:

    Summarize patient experiences data for each hospital.

    Summarize timely and effective care data for two conditions.

    Summarize data for readmissions and complications and deaths.

    List recommendations for improving data for one selected facility.

    Summarize what you learned from this experience. Hospital Compare Performance Measurement.

    Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx (Links to an external site.)Links to an external site. The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSP CCSSS may be found in the course list in the student portal.

    Submit your PowerPoint slideshow by 11:59 p.m. MT, Sunday, end of Week 6.

    Best Practices in Preparing PowerPoint Presentations

    The following are best practices in preparing this presentation.

    Be creative.

    Incorporate graphics, clip art, or photographs to increase interest.

    Make easy to read with short bullet points and large font.

    Review directions thoroughly.

    Proofread prior to final submission.

    Spell check for spelling and grammar errors prior to final submission.

    Purpose

    The purpose of this PowerPoint presentation is to locate and compare performance measurement data on common health conditions for the hospitals in your area. You will investigate the Centers for Medicare and Medicaid Services websites and locate the section called Hospital Compare. There you will find data for hospitals within a 50-mile radius of the community where you are working or had your prelicensure clinical experiences. You will prepare a PowerPoint presentation and share the results of your findings. Opportunities for improving performance measurement indicators will be shared. Hospital Compare Performance Measurement.

    Course Outcomes

    Completion of this assignment enables the student to meet the following course outcomes.

    CO1: Apply leadership concepts, skills, and decision making in the provision of high-quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2)

    CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)

    CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)

    CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and system-wide practice improvements that will improve the quality of healthcare delivery. (POs 2 and 3)

    CO8: Apply concepts of quality and safety using structure, process and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)

    Due Dates

    This assignment is to be submitted by Sunday, 11:59 p.m. MT, end of Week 6. Hospital Compare Performance Measurement.

    Points

    This assignment is worth 200 points.

    Directions

    Review information found on the following website related to hospital compare http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalCompare.html (Links to an external site.)Links to an external site.

    Read the information carefully and then locate the following website. http://www.medicare.gov/hospitalcompare (Links to an external site.)Links to an external site.

    Search for hospitals within a 50-mile radius of the community where you are working or had your prelicensure clinical experiences. Type in your zip code. Select your hospital and two others. Select hospitals/facilities and choose compare. If you live in a remote area and there are no hospitals listed within a 50-mile radius, select a zip code for a family member or a close friend who does not live near you. The idea is to review comparative data. Hospital Compare Performance Measurement.

    Click on the following topics to learn more.

    Survey of patient’s experiences

    Timely and effective care (focus your search on two of the conditions that apply to services provided at the hospitals)

    Readmissions, complications, and deaths

    Carefully read the information provided.

    Develop a PowerPoint slideshow consisting of 8-10 slides. Include the following, keeping in mind what all this data means.

    Title slide with information pertinent to the course.

    List reasons to recommend the website Hospital Compare to consumers (patients).

    List reasons to recommend the website Hospital Compare to staff who may seek employment.

    For the slides below, clearly label the name of each hospital:

    Summarize patient experiences data for each hospital.

    Summarize timely and effective care data for two conditions. Hospital Compare Performance Measurement.

    Summarize data for readmissions and complications and deaths.

    List recommendations for improving data for one selected facility.

    Summarize what you learned from this experience.

    Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx (Links to an external site.)Links to an external site. The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSP CCSSS may be found in the course list in the student portal.

    Submit your PowerPoint slideshow by 11:59 p.m. MT, Sunday, end of Week 6.

    Best Practices in Preparing PowerPoint Presentations

    The following are best practices in preparing this presentation.

    Be creative.

    Incorporate graphics, clip art, or photographs to increase interest.

    Make easy to read with short bullet points and large font.

    Review directions thoroughly.

    Proofread prior to final submission.

    Spell check for spelling and grammar errors prior to final submission Hospital Compare Performance Measurement.

  • reimbursement rates for mental health treatments sample essays

    reimbursement rates for mental health treatments sample essays

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

    NURS 6670

    Reimbursement Rate Template

    ORDER A PLAGIARISM-FREE PAPER HERE

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

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

    CPT is divided into three categories of codes which includes Category

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

    performance measures.

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

    The difference between

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

     

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

     

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

    CPT code The private insurer reimbursement rate for PMHNP

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

    Diagnostic Evaluation

    90791

    $118.54

    $138.26

    $119.99

    $159.0

    Psychiatric Diagnostic Evaluation with Medical Services

    90792

    $125.13

    $159.74

    $116.58

    $130.0

    Psychotherapy, 30 minutes with patient and or family member

    90832

    $67.22

    $96.52

    $64.61

    $76.10

    Psychotherapy, 45 minutes with Patient and/or family member

    90834

    $89.88

    $115.63

    ORDER A PLAGIARISM-FREE PAPER HERE

    86.16

    94.89

    Psychotherapy for crisis; first 60 minutes

    90839

    140.66

    $164.28

    135.08

    143.54

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

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

    –

    14.pdf.

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

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

    CPT Code

    Footnote(s)

    Description

    90791

    1

    Psychiatric diagnostic evaluation

    90792

    1,3

    Psychiatric diagnostic evaluation with medical services

    90832

    2

    Psychotherapy, 30 minutes with patient and/or family member

    90833

    2,3

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

    evaluation and management service

    90834

    4

    Psychotherapy, 45 minutes with patient and/or family member

    90836

    3,4

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

    90837

    6

    Psychotherapy, 60 minutes with patient and/or family member

    90838

    3,6

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

    evaluation and management service

    90839

    6

    Psychotherapy for crisis; first 60 minutes

    90840

    2 each additional 30 minutes

    90846

    4

    Family psychotherapy (without the patient present)

    90847

    4

    Family psychotherapy (conjoint psychotherapy) (with patient present)

    90849

    4

    Multiple-family group psychotherapy

    90853

    4

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

    90870

    1, 5

    Electroconvulsive therapy (includes necessary monitoring)

    96101

    1

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

    emotionality, intellectual abilities, e.g., WAIS

    –

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

    Note:

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

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

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

    96118

    1

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

    Note:

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

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

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

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

    –

    management/coding

    –

    reimbursement

    –

    medicare

    –

    and

    –

    medicaid/coding

    –

    and

    –

    reimbursement

    http://www.mb

    –

    guide.org/medical

    –

    coding

    –

    guidelines.html

    Reference

    Dotson, P. (2013). CPT

    ®

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

    Advances in Wound Care

    ,

    2

    (10), 583

    –

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

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

    Code 77370 Journal of American College of Radiology,

    5 (8),

    937

    –

    93

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

    .

    J Am Coll Radiol

    .

    5:555

    –

    560.Retrieved from:

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

    –

    1440(08)00226

    –

    3/references

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

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

    eJCRfinal1

    –

    14.pdf.

    9 / 9

    Assignment 2-WK6DUWK7- Reimbursement Rates

    Week 6 Practicum Journal: Reimbursement Rates

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

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

    Learning Objectives reimbursement rates for mental health treatments sample essays

    Students will:

    • Analyze reimbursement rates for mental health treatments

    To prepare for this Practicum Journal:

    • Research reimbursement rates for various treatment modalities.

    • Compare NP rates to other provider rates.

    For this Practicum Journal:

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

     

    Practicum Journal: Reimbursement Rates

                                    Analyze reimbursement rates for mental health treatments

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

    The outlook of reimbursement rates for various treatment modalities.

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

    Contrasting NP reimbursement rates to other provider rates.

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

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

     
    Psychiatric Business Template

    Reimbursement Rate Template

    Type of Service

     

    CPT code

    Private insurer reimbursement rate for PMHNP

    Private insurer reimbursement rate for physicians

    Medicare

    reimbursement rate for PMHNP

    Medicare

    reimbursement rate for physician

    Psychiatric diagnosis evaluation

    90791

    $135.42

    $159.32

    $117.76

     $138.54

    Psychiatric diagnostic evaluation with medical services

     90792

    $135.42

    $159.32

    $117.76

     $138.54

    Electroconvulsive therapy (includes necessary monitoring)

    90870

    $155.10

    $182.47

    $97.25

    $114.41

    Psychological testing, interpretation and reporting per hour by a psychologist

    96101

    $83.24

    $97.93

    $72.38

    $85.16

    Neuropsychological testing, interpretation and reporting by a psychologist

     

    96118

    $98.15

    $115.47

    $85.35

    $100.41

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

     

     

    Reference

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

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

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

    Billing, Reimbursement And Financing

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

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

    NURS 6670

    Reimbursement Rate Template

    ORDER A PLAGIARISM-FREE PAPER NOW

     

    Type of Service

    eg. -New office visit

    -Established office visit

    -Inpatient hospital

    -individual psychotherapy

    -group psychotherapy (see examples below)

    CPT code

    Private insurer reimbursement rate for PMHNP

    Private insurer reimbursement rate for physicians

    Medicare

    reimbursement rate for PMHNP

    reimbursement rates for mental health treatments sample essays

    Medicare

    reimbursement rate for physician

     

    Psychiatric diagnostic evaluation

     

    90791

     

    Psychiatric diagnostic evaluation with medical services

     

    90792

     

    Electroconvulsive therapy (includes necessary monitoring)

     

    90870

     

    Psychological testing

     

    96101

    reimbursement rates for mental health treatments sample essays

     

    Neuropsychological testing battery

     

    96118

     

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

    CPT Codes for Psychiatric and Psychological Procedures

     

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

     

    CPT Code

    Footnote(s)

    Description

    90791

    1

    Psychiatric diagnostic evaluation

    90792

    1,3

    Psychiatric diagnostic evaluation with medical services

    90832

    2

    Psychotherapy, 30 minutes with patient and/or family member

    90833

    2,3

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

    90834

    4

    Psychotherapy, 45 minutes with patient and/or family member

    90836

    3,4

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

    90837

    6

    Psychotherapy, 60 minutes with patient and/or family member

    90838

    3,6

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

    90839

    6

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

    90840

    2

    each additional 30 minutes

    90846

    4

    Family psychotherapy (without the patient present)

    90847

    4

    Family psychotherapy (conjoint psychotherapy) (with patient present)

    90849

    4

    Multiple-family group psychotherapy

    90853

    4

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

    90870

    1, 5

    Electroconvulsive therapy (includes necessary monitoring)

    96101

    1

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

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

    96118

    1

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

     

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

    Links to websites that discuss this:

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

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

    reimbursement rates for mental health treatments sample essays

  • Quality of life self care wheel scores sample essay paper

    Quality of life self care wheel scores sample essay paper

    Part 2: How Am I Doing?

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

    ORDER A PLAGIARISM-FREE PAPER HERE

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

    Share in a 2 page paper, the following:

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

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

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

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

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

    How Am I Doing?

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

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

  • Bipolar Disorder Sample Essay – Captain of the Ship Project

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

    ORDER A PLAGIARISM-FREE PAPER HERE

                                              HPI and Clinical Impression for the Client

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

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

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

    Objective: Mental Status Examination

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

    Diagnosis

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

    Recommended Psychopharmacologic Treatments

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

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

    Recommended Psychotherapy Choices

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

    Medical Management Needs, Primary Care Needs and Community Support Resources

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

    Plan for Follow-up and Collaboration with Other Providers

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

    Conclusion

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

     

    References

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

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

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

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

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

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

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

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

    Press

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

    Assignment 1-WK7

    Captain of the Ship Project – Obsessive-Compulsive Disorders

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

    Learning Objectives

    Students will:

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

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

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

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

    • Recommend follow-up plans for clients with depression disorders

    QUESTION

    To prepare for this Assignment:

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

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

    • Describe the HPI and clinical impression for the client.

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

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

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

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

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

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

    Learning Resources

    Required Readings

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

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

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

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

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

    Chapter 21, “Obsessive-Compulsive Disorder”

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

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

    “Obsessive-Compulsive and Related Disorders”

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

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

     

    Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

     

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

     

     

    Obsessive-compulsive disorder

    citalopram

    clomipramine

    escitalopram

    fluoxetine

    fluvoxamine

    paroxetine

    sertraline

    venlafaxine

    vilazodone

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

     

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

    Required Media

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

     

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

    Optional Resources

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

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

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

                                              HPI and Clinical Impression for the Client

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

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

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

    Objective: Mental Status Examination

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

    Diagnosis

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

    Recommended Psychopharmacologic Treatments

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

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

    Recommended Psychotherapy Choices

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

    Medical Management Needs, Primary Care Needs and Community Support Resources

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

    Plan for Follow-up and Collaboration with Other Providers

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

    Conclusion

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

     

    References

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

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

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

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

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

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

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

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

    Press

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