Tag: Clinical-Nursing

  • Left Sided Heart Failure Concept Map

    Left Sided Heart Failure Concept Map

    The Map should be about Left-Sided Heart Failure

    Assessment 1 – Concept map and guided questions.

    Information 1 – Getting started.

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    Your first assessment is generating a concept map for left heart failure and answering three questions related to a case study about a patient who has an acute exacerbation of heart failure. When preparing your assignment refer to the criteria and standards in the Learning Guide.

    You can begin this assessment now by finding readings about heart failure and summarising the information under the headings of the pathophysiology template. This information can then be used for your concept map.

    Some readings that you may find helpful to
    start
    your assignment are:

    Your textbook:

    Craft,J.A., Gordon,C.J., Huether,S.E., McCance, K.L., Brashers, V.L. & Rote,N.E.

    (2015).
    Understanding pathophysiology – ANZ adaptation
    (2nd ed.).

    Chatswood, NSW: Elsevier Australia. Chapter 23.

     

    Also:

    Aitken, L., Marshall,A. & Chaboyer, W. (2015).
     ACCCN’s critical care nursing

    (3rd  ed.). Chatswood, NSW: Elsevier Australia. Chapter 10.

     

    Wagner, K.D. (2014).
     High acuity nursing
    (6th ed.). Upper Saddler River, New

    Jersey: Pearson. Chapter13.

     

    (These books are available online from the Western Sydney University library). Left Sided Heart Failure Concept Map.

     

    This is just to begin. You will then find more readings to add to your information.

     

    Remember that the information in your concept map and answers to the questions must correlate with the references that you cite so keep an accurate record when preparing your assignment. The marker of your assessment will check your citations.

     

    An example of a pathophysiology template for a left-sided ischaemic stroke and a concept map using this information has been attached to start you thinking about how you will approach your assignment. The concept map has been generated using Word Left Sided Heart Failure Concept Map. However, if you wish, you may prefer to use a concept map template that you may find on the web.

     

    Below are the Sub-heading that needs to be in the Concept Map.

    Disease

    Definition

    AETIOLOGY

    PATHOGENESIS

    PATHOGENESIS

     
    DIAGNOSIS

    TREATMENT

    COURSE OF DISEASE

    PROGNOSIS

    PREVENTION

    The separate
    Reference page
    for Concept Map. You may have more than 2 reference

    Visually Stimulating,
    add pictures in the background and visually Below is an sample example but this concept map needs to look unique and visually very appealing, please.

    Add pictures of heart, lungs what ever connects to the Map and its information.

    I
    have attached a sample of the concept map of another topic to guide you what information requires in the map. Left Sided Heart Failure Concept Map.

    500 words and it is worth 25 Marks.

    Please see attach other files for questions and Marking Criteria.

     

    stroke_concept_map_map

     

    Pathophysiology template

     

    Disease
    : Ischaemic stroke affecting the dominant left cerebral hemisphere

    Definition
    :
    An ischaemic stroke is death of brain tissue resulting from an occluded artery caused either by an atherosclerotic obstruction or embolus that interrupts blood supply to the area of the brain supplied by the occluded artery. The sudden loss of blood circulation results in a corresponding loss of neurologic function (Jauch, 2014). Left Sided Heart Failure Concept Map.

     

    AETIOLOGY:

    A depletion of blood flow in a cerebral artery resulting from a:

    Thrombus –atherosclerotic plaque that has ruptured in a cerebral artery

    Embolus

    from heart e.g. left atrial thrombus, left ventricular thrombus, atrial fibrillation

    from carotid artery (Craft &Gordon,2011)

     

    PATHOGENESIS:

    Interruption of blood flow to cerebral tissue initiates a biochemical ischaemic cascade.

    Mitochondrial production of ATP ceases èdepolarisation è influx of sodium and calcium and efflux of potassium. Passive inflow of water into cells causes cytotoxic oedema and destruction of cells in infarct core.

    Membrane depolarization also stimulates the release of neurotransmitters. Glutamate release èexcessive calcium influx into nearby neurons (exocitotoxicity) èdestruction of cells by lipolysis, proteolysis and free radicals.

    Mitochondria break down releasing toxins and apoptotic factors.

    Injured brain tissue triggers inflammatory response èrelease of inflammatory mediators ècell death and oedema

    èdestruction of cells in
    infarct core
     ènecrosis

    èischaemic
    penumbra
    around core has diminished blood flow but preserved cellular metabolism.

     

    Areas of necrotic tissue are not able to conduct nerve impulses so functions such as initiating and conveying motor impulses, receiving and interpreting sensory information and speech control will be interrupted.

    (Bautista, 2014; Craft & Gordon, 2011; Maas & Safdieh,2009).

     

    CLINICAL MANIFESTATIONS:

     

    Just superior to the medullary junction, 90% of axons in the left pyramid cross to      the right ® right motor dysfunction.

    The middle cerebral artery supplies the frontal, temporal and parietal lobes as well as the basal ganglia and internal capsule.                                              (Tocco,2011). Left Sided Heart Failure Concept Map

     

    Therefore specific clinical manifestations include:

    Hemiplegia and weakness on right side of body

    Sensory loss on right side

    Inability to see the right visual field of each eye

    Aphasia

    Apraxia

    Dysarthria

    Impaired reasoning

    Behavioural changes

    Problems with memory

    (Bautista, 2014; Craft & Gordon, 2011).

     

    DIAGNOSIS

    Complete history

    Physical and neurological examination

    Brain MRI or CT scan – Essential in differentiating cerebral haemorrhage from ischaemic stroke. MRI is superior as cerebral ischaemia can be identified within minutes and can identify small areas of stroke.

    Other tests for vascular imaging can be used e.g. CT angiography, magnetic resonance angiography

    (Silverman & Rymer, 2009).

     

    TREATMENT

    The emphasis of ischaemic stroke treatment is placed on salvaging potentially reversible ischemic penumbra brain tissue, preventing secondary stroke and minimising longterm disability.                             (Jaunch, 2014).

     

    Reperfusion

    thrombolytic agent (e.g.tPA)

    intra-arterial technique

     

    Neuroprotection

    -antithrombotic therapy (e.g. aspirin)

     

    Nursing management

    Acute phase

    frequent evaluation of neurological status

    frequent evaluation of vital signs

    Monitor oxygen saturation – administer oxygen if required

    Screen for swallowing deficits and manage appropriate hydration and nutrition strategies

    Manage activities of daily living

    Screen for communication deficits and address appropriate communication strategies

    Prevent complications e,g pressure areas, contractures, DVT

    Assess urinary and faecal continence and address appropriately

    Left Sided Heart Failure Concept Map

     

    Rehabilitation

    begin as early as possible by preventing complications, passive and active movement and mobilizing as early as possible.

    Support and encourage activities provided by physiotherapists, occupational therapists and speech therapists

    Education – e.g. lifestyle modification, adherence to medications

    (National Stroke Foundation, 2010).

     

     

    COURSE OF DISEASE

     

    With reperfusion – blood is restored to the area and signs and symptoms gradually resolve

     

    Without treatment – Course is determined by severity of stroke. Ischaemia will extend to penumbra as stroke evolves, signs and symptoms worsen. As  cerebral oedema resolves, and with  structural and functional reorganisation recovery may continue for 6 months to a year. (peak recovery in about 3 months). Requires rehabilitation to optimise function. Left Sided Heart Failure Concept Map.

     

    (Teasell & Hussein, 2014).

    Complications

    Contractures

    Fatigue

    Incontinence

    Mood disturbances

    Falls

    Dysarthria and aphasia

     

    PROGNOSIS

    Stroke prognosis is influenced by factors such as age and stroke severity.

    One in five likely to die within one month of suffering ischaemic stroke.

    Of those who recover about 90% will experience some impairment

    Left Sided Heart Failure Concept Map

    (Dashe,2014)

     

    PREVENTION

    Eliminating modifiable risk factors will prevent an ischaemic stroke.

    Don’t smoke

    Diet high in fruit and vegetables, low in fats and salt

    30 minutes of moderate-intensity physical activity on most days of the week

    Maintain healthy BMI

    Limit alcohol to no more than two standard drinks per day

    (National Stroke Foundation, 2010)

     

    If a history of atrial fibrillation – ensure adherence to anticoagulation therapy.

     

    References

    Bautista, C. (2014). Disorders of Brain Function. In S. Grossman & C. Porth (Eds),

          Porth’s pathophysiology: Concepts of altered health states
    (9
    th
    ed.). (pp489-

    524). Philadelphia: Lippincott Williams & Wilkins.

    Craft, J. & Gordon, C. (2011), Alterations of Neurological Function across the

    Lifespan. In J.Craft, C.Gordon & A. Tiziani (Eds).
    Understanding

          Pathophysiology
    (pp 188-226). Sydney, Australia:Elsevier Australia.

    Dashe, J. F. (2014). Stroke prognosis in adults.
    UpToDate.
    Retrieved from:

    http://www.uptodate.com/contents/stroke-prognosis-in-adults

    Jaunch, E.C. (2014). Ischemic stroke treatment and management, Retrieved from:

    http://emedicine.medscape.com/article/1916852-overview

    Maas, E.B. & Rymer, M.M. (2009). Ischaemic stroke: Pathophysiology and Principles

    of Localization.
    Neurology 13 .
    Retrieved from:

    http://www.turner-white.com/pdf/brm_Neur_V13P1.pdf

    National Stroke Foundation (2010). 
    Clinical guidelines for stroke management

    Melbourne Australia.

    Silverman, I.E. & Rymer, M.M. (2009).
    An atlas of investigation and treatment.

          Ischaemic stroke.
    Clinical publishing:Oxford,U.K. Left Sided Heart Failure Concept Map

    Teasell, R.& Hussein, N. (2014)Brain reorganization, recovery and organizecare.

    In
    Stroke rehabilitation clinician handbook 2014.
    Retrieved from:

    http://www.ebrsr.com/sites/default/files/Chapter%202_Brain%20Reorganization,%20Recovery%20and%20Organized%20Care_June%2018%202014.pdf

    Tocco, S. (2011). Identify the vessel recognize the stroke.
    American Nurse Today

          9
    (6).
        Left Sided Heart Failure Concept Map

  • Using The Data/Information/Knowledge/Wisdom Continuum

    Assignment: Application:

    Using the Data/Information/Knowledge/Wisdom Continuum

    Have you ever gone online to search for a journal article on a specific topic? It is amazing to see the large number of journals that are available in the health care field. When you view the library in its entirety, you are viewing untapped data. Until you actually research for your particular topic, there is little structure. Once you have narrowed it down, you have information and once you apply the information, you have knowledge. Eventually, after thoughtful research and diligent practice, you reach the level of wisdom—knowledge applied in meaningful ways.

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    Are there areas in your practice that you believe should be more fully explored? The central aims of nursing informatics are to manage and communicate data, information, knowledge, and wisdom. This continuum represents the overarching structure of nursing informatics. In this Assignment, you develop a research question relevant to your practice area and relate how you would work through the progression from data to information, knowledge, and wisdom. Using The Data/Information/Knowledge/Wisdom Continuum

    To prepare:

    Review the information in Figure 6–2 in 
    Nursing Informatics and the Foundation of Knowledge
    .

    Develop a clinical question related to your area of practice that you would like to explore.

    Consider what you currently know about this topic. What additional information would you need to answer the question?

    Using the continuum of data, information, knowledge, and wisdom, determine how you would go about researching your question.

    Explore the available databases in the Walden Library. Identify which of these databases you would use to find the information or data you need.

    Once you have identified useful databases, how would you go about finding the most relevant articles and information?

    Consider how you would extract the relevant information from the articles.

    How would you take the information and organize it in a way that was useful? How could you take the step from simply having useful knowledge to gaining wisdom? Using The Data/Information/Knowledge/Wisdom Continuum

    By Day 7 of Week 4

    Write a 4-page paper that addresses the following: MUST BE APA FORMAT

    Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.

    Identify the databases and search words you would use. Using The Data/Information/Knowledge/Wisdom Continuum.

    Relate how you would take the information gleaned and turn it into useable knowledge.

    Can informatics be used to gain wisdom? Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search.

    Your paper must also include a title page, an introduction, a summary, and a reference page
    ( YOU CAN ONLY USE THE REFERENCES LISTED BELOW)
    .

     

    American Nurses Association. (2015).
    Nursing informatics: Scope & standards of practice
    (2nd ed.). Silver Springs, MD: Author.

    “Metastructures, Concepts, and Tools of Nursing Informatics”This chapter explores the connections between data, information, knowledge, and wisdom and how they work together in nursing informatics. It also covers the influence that concepts and tools have on the field of nursing. Using The Data/Information/Knowledge/Wisdom Continuum.

    McGonigle, D., & Mastrian, K. G. (2015).
    Nursing informatics and the foundation of knowledge
    (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

    Chapter 6, “Overview of Nursing Informatics”This chapter defines the foundations of nursing informatics (NI). The authors specify the disciplines that are integrated to form nursing informatics, along with major NI concepts.

    Brokel, J. (2010). Moving forward with NANDA-I nursing diagnoses with Health Information Technology for Economic and Clinical Health (HITECH) Act Legislation: News updates.
    International Journal of Nursing Terminologies & Classifications, 21
    (4), 182–185.

    Retrieved from the Walden Library databases.

     

    In this news brief, the author describes the initiatives that NANDA-I will implement to remain abreast of the HITECH legislation of 2009. The author explains two recommendations for the federal government’s role in managing vocabularies, value sets, and code sets throughout the health care system.

    Matney, S., Brewster, P. J., Sward, K. A., Cloyes, K. G., & Staggers, N. (2011). Philosophical approaches to the nursing informatics data-information-knowledge-wisdom framework.
    Advances in Nursing Science, 34
    (1), 6–18. Using The Data/Information/Knowledge/Wisdom Continuum

    Retrieved from the Walden Library databases.

     

    This article proposes a philosophical foundation for nursing informatics in which data, information, and knowledge can be synthesized by computer systems to support wisdom development. The authors describe how wisdom can add value to nursing informatics and to the nursing profession as a whole.

    Rutherford, M. A. (2008).
    Standardized nursing language: What does it mean for nursing practice? OJIN: The Online Journal of Issues in Nursing, 13
    (1). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/vol132008/No1Jan08/ArticlePreviousTopic/StandardizedNursingLanguage.html

     

    The author of this article provides justification for the use of a standardized nursing language, which will be necessary for incorporating electronic documentation into the health care field. The author defines standardized language in nursing, describes how such a language can be applied in a practice setting, and discusses the benefits of using a standardized language. Using The Data/Information/Knowledge/Wisdom Continuum

    Westra, B. L., Subramanian, A., Hart, C. M., Matney, S. A., Wilson, P. S., Huff, S. M., … Delaney, C. W. (2010). Achieving “meaningful use” of electronic health records through the integration of the Nursing Management Minimum Data Set.
    The Journal of Nursing Administration, 40
    (7–8), 336–343.

    Retrieved from the Walden Library databases.

     

    This article explains the nursing management minimum data set (NMMDS), which is a research-based minimum set of standard data for nursing management and administration. The article describes how the NMMDS can be used to minimize the burden on health care administrators and increase the value of electronic health records within the health care system. Using The Data/Information/Knowledge/Wisdom Continuum.

  • The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion

    The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion

    The systems development life cycle (SDLC) is a model for planning and implementing change within an organization. It is important for many individuals to be represented in the process, especially the end users of the system or the employees who must live with the change. As informatics become more and more widespread throughout the health care field, collaboration between information technology (IT) professionals and health care practitioners is becoming increasingly important. The nurse informaticist is able to combine the perspective of the information technology side with the clinical nursing perspective. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion

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    While the titles and specific responsibilities of nurse informaticists vary across organizations and practice settings, the fundamental purpose of the role remains the same. Nurse informaticists synthesize their knowledge of how technology can improve health care with an understanding of clinical practice and workflow. This is why nurse informaticists can be instrumental in facilitating the SDLC for informatics in health care. For this Discussion, you examine the relationship between the nurse informaticist and the use of the SDLC. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion

     

    To prepare:

     

    Review the information in this week’s Learning Resources on the SDLC and the role of the nurse informaticist. Reflect on Chapter 1 of the Dennis, Wixom, and Roth course text and consider how the information about the systems analyst role translates into nursing and health care.

    Consider a recent change in your organization related to the implementation of a new technology or system. How was this change handled? What was the general SDLC process? Who was involved, and what were the outcomes? The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

    Identify whether your organization (or one with which you are familiar) has a formal title or position for the nurse informaticist. This position may be called by a different name, such as nurse informatics specialist or informatics analyst, so be sure to review the position description.

    If your organization has a position for the nurse informaticist, what are the responsibilities of that position? If your organization does not have such a position, conduct research in the Walden Library and at credible online sources on the role of the nurse informaticist. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

    Reflect on the role of the nurse informaticist in the overall health care field. How is this position connected to the SDLC? Assess the benefits of having this specialized position within health care organizations and involving the nurse informaticist in the SDLC. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.
    Post by tomorrow 8/30/16 550 words in APA format with a minimum of 3 references from the list provided under Required Readings. Apply the level 1 headings as numbered below:

    1) A description of how the systems development life cycle is utilized in your organization (Hospital), or in one with which you are familiar, and assess its effectiveness.

     

    2)  Assess the role of the nurse informaticist in your organization. If the nurse informaticist is not a current position within your organization, provide a description of the generally accepted role of the nurse informaticist based on this week’s Learning Resources and your own research. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

     

    3)  Explain why it is important for the nurse informaticist to be involved in the SDLC process and the overall organizational benefits of having such involvement. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.
     

     

     

    Required Readings

     

    Dennis, A., Wixom, B. H., & Roth, R. M. (2015).
    Systems analysis and design
    (6th ed.). Hoboken, NJ: Wiley.

     

    Chapter 1, “The Systems Analyst and Information Systems Development” (pp. 1–34)

     

    In this chapter, the authors clarify the relationship between systems analysts and information systems development. The chapter also covers the basic business applications of information systems. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

     

    McGonigle, D., & Mastrian, K. G. (2015).
    Nursing informatics and the foundation of knowledge
    (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

     

    Chapter 10, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making” The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

     

     

     

    Chapter 11, “Administrative Information Systems”

     

    Quality, organizational decision making is a requisite to successful advancements in technology. This chapter explores how workplaces respond to the necessity for improved information systems. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

    Anderson, C., & Sensmeier, J. (2011). Nursing informatics scope of practice expands, salaries increase.
    Computers, Informatics, Nursing, 29
    (5), 319–320.

     

    Retrieved from the Walden Library databases.

     

    This article assesses the growing need for informaticists in the health care industry. The combination of clinical and information technology experience that informaticists possess makes them invaluable in assisting in the health care industry’s transition into a heavier use of information systems. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

     

    Houston, S. M. (2012). Nursing’s role in IT projects.
    Nursing Management, 43
    (1), 18–19.

     

    Retrieved from the Walden Library databases.

     

    The societal advancements of information technology (IT) are major factors in the governance of health care organizations. This article gives an overview of how nurse informaticists blend their clinical know-how with IT to improve workflow and patient care.

     

     

     

    McLane, S., & Turley, J. P. (2011). Informaticians: How they may benefit your healthcare organization.
    The Journal of Nursing Administration, 41
    (1), 29–35.

     

    Retrieved from the Walden Library databases.

     

    Nursing informaticists help guide the implementation of information systems into health care organizations. The authors of this article evaluate how informaticists effect change in management and improve meaningful use in nursing practice. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

     

    Prestigiacomo, J. (2012). The rise of the senior nurse informaticist.
    Healthcare Informatics, 29
    (2), 38–43.

     

    Retrieved from the Walden Library databases.

     

    The author of this article highlights the conditions of the health care industry and its growing reliance on data-driven decision making. Nurse informaticists are important in this transition, playing a major role in the development and utilization of electronic health records (EHRs).

     

    Warm, D., & Thomas, B. (2011). A review of the effectiveness of the clinical informaticist role.
    Nursing Standard, 25
    (44), 35–38.

     

    Retrieved from the Walden Library databases.

     

    Health care organizations rely heavily on information management and technology for organizational maintenance and patient care. This article examines the clinical informaticist’s role in facilitating the implementation of health information technology and spearheading clinical risk management. The Systems Development Life Cycle and the Nurse Informaticist Essay Discussion.

  • Worldview Analysis And Personal Inventory Essay

    Worldview Analysis And Personal Inventory Essay

    Based on the required topic study materials, write a reflection about worldview and respond to following:

    In 250-300      words, explain the Christian perspective of the nature of spirituality and      ethics in contrast to the perspective of postmodern relativism within      health care.

    In 250-300      words, explain what scientism is and describe two of the main arguments      against it.

    In 750-1,000      words, answer each of the worldview questions according to your own      personal perspective and worldview: (a) What is ultimate reality? (b) What      is the nature of the universe? (c) What is a human being? (d) What is      knowledge? (e) What is your basis of ethics? (f) What is the purpose of      your existence?

    Remember to support your reflection with the topic study materials. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines. Worldview Analysis And Personal Inventory Essay.

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    Rubric 

    · Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is clear, detailed, and demonstrates a deep understanding of the subject. Explanation is supported by topic study materials.

    · Explanation of scientism is clear and accurate. Explanations of two main arguments against scientism are clear and insightful. Details are clearly supported by topic study materials.

    · Each of the worldview questions is answered clearly and with deep personal insight.

    · Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Worldview Analysis And Personal Inventory Essay.

    · Writer is clearly in command of standard, written, academic English.

    · Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    · All format elements are correct.

    · Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Worldview Analysis And Personal Inventory Essay.

    What Is a Worldview?

    The following definitions are helpful:

    “A set of assumptions or beliefs about reality that affect how we think and how we live” (Cosgrove, 2006, p. 19).

    “The comprehensive perspective from which we interpret all of reality” (Keller, 2012, p. 157).

    Worldview is often described as a set of lenses through which we view the world. As a 
    descriptive
     lens, our worldview influences our perception of the world. What is true? What is reality? As a 
    prescriptive
     lens, our worldview influences our evaluation of what is true. What does it mean? How should we live?

    One may readily see that if one views the nature of the universe as consisting of only physical matter and energy, then that person’s understanding of the meaning of life and how we should live will likely be far different from one whose perception of the universe includes a spiritual realm where life continues after death and goodness is rewarded. Worldview Analysis And Personal Inventory Essay.

    While it is true that all people have their own private worldviews with values and beliefs that have been shaped by culture, education, experiences, and relationships, it is also valuable to speak of shared worldviews, those foundational assumptions or beliefs that many people hold in common. For the sake of this course, the course content will be reduced from the many-shared worldviews to three basic worldview families.

    What Are the Three Basic Worldview Families?

    Though there are many different worldviews, for the purpose of this course they have been simplified into three basic worldview families. There are many variations within these families. Worldview Analysis And Personal Inventory Essay.

    Atheism

    Atheism is the worldview of those who believe only in what their senses can detect–only what may be analyzed and understood in a scientific laboratory. This view believes in no God or spiritual realm. The cosmos consists of only the natural or physical realm of matter and energy. Other names often associated with this worldview family are naturalism and secular humanism. Most whose worldview values and behavior are aligned with atheism prefer to be considered agnostics. These are uncertain of the existence of God, skeptical for the most part, yet open to the possibility. Worldview Analysis And Personal Inventory Essay.

    Pantheism

    Pantheism is the worldview of spiritualism, the belief that “all is God” as the word implies. Pantheists believe in a spiritual realm, but no relational God who has revealed himself to humanity and is actively involved in the lives of those who believe in him. This worldview family consists of the Eastern religions of Hinduism and Buddhism, as well as the more eclectic Western belief known as New Age. Pantheists typically embrace an impersonal oneness of which all humans may become a part, becoming godlike themselves as they reach higher levels of spirituality. Worldview Analysis And Personal Inventory Essay.

     

    Theism

    Theism, or monotheism, is the worldview of the three major religions, Judaism, Christianity, and Islam. Though these three have huge differences rendering them incompatible with each other, they do nonetheless have some similarities. Theists all believe in a single, personal, and relational God who is the creator and sustainer of all that exists. They all likewise believe in absolute truth and morality, and an afterlife. The focus of this course is Christianity, so the course will be comparing these three worldviews: atheism, pantheism, and Christianity.

    Another common worldview name, deism, is somewhat of an enigma–having a basic belief in God, but a God who is not relational or involved in human life. So although falling under the broad category of theism, deists may effectively live as atheists. Many people have complex worldviews that are a mix of various beliefs from the major worldview families. Worldview Analysis And Personal Inventory Essay.

    How Do We Determine Our Worldview?

    There are six components that help to determine worldview. The following questions correspond to each component. Answering each of the following questions for yourself will help you begin thinking about your own worldview:

    What Is Ultimate Reality?

    Does reality consist basically of physical matter and energy, as the atheists believe? Is reality an impersonal spiritual entity that dominates the universe and to which all humans must endeavor to attain unity with, as the pantheists assert, or is there a personal and relational, all-powerful, and sovereign God who exists everywhere, but is separate from the physical world he created, as believed by Christians and other theists? Worldview Analysis And Personal Inventory Essay.

    What Is the Nature of the Universe?

    This is similar to the question above but focuses strictly on what one believes about the natural world. Is the universe strictly physical and yet eternal in one form or another? Is it merely an illusion intended as a battleground for us to work toward enlightenment, or was the universe created by God and far more complex than can be detected by scientists, consisting of both a physical and a spiritual realm?

    What Is a Human Being?

    Is a human basically a biological machine, just a higher level of animal? Is a human a type of god with powers to reach perfection, or is a human an off-the-charts creature designed in the image of God with an eternal spirit like his and similar abilities to reason, seek moral purity, communicate on a high level, create for beauty, and love even those who cannot love in return? Is death the end of existence, or is there a soul that lives on? Does that soul return in another life, or does it return to God and await judgment? Worldview Analysis And Personal Inventory Essay.

    What Is Knowledge?

    Is there such a thing as absolute truth, or is truth relative? Is true knowledge only that which may be acquired and understood through scientific means, or is there also knowledge that only may be acquired by revelation from God? Should you only trust your senses, or should you explore the spiritual realm and seek knowledge from God?

    What Is Your Basis of Ethics?

    How do you know right from wrong? Is morality learned, or is it designed into our conscience? Is there a set of absolute moral standards given by God, or is morality relative, a matter of culture, and what is acceptable to a society? Worldview Analysis And Personal Inventory Essay.

    What the Purpose of Your Existence?

    Is human life as you know it merely the result of some amazing cosmic accident, or is there an underlying meaning to history, a purpose toward which time will culminate? Does life have meaning and purpose for individuals, or is it simply whatever one makes it? Did the Creator design his children with a purpose? If so, what might that be?

    How Do We Test Our Worldview?

    Everyone (not only religious people) forms his or her worldview on the basis of faith (assumptions and presuppositions) and reason. So we must ask ourselves “how reasonable or consistent is our worldview?” Are there any contradictions that are apparent? Testing a worldview is critical because at the end of the day, most people want to make sure that they have 
    true
    beliefs about the world. The following tests are just some ways of determining whether or not a particular worldview is true. Consider only three basic tests summarized here:

    The Coherence Test
    checks the internal consistency of a worldview to see if one’s specific values and beliefs contradict any other beliefs within the worldview.

    The Correspondence Test
    examines how well a worldview corresponds to reality. It evaluates evidences and experiences to see if the worldview matches with what one perceives in the real world.

    The Practical Test
    evaluates a worldview’s livability. Does the worldview bring satisfaction as one faces life’s challenges, or is it found to be lacking? Worldview Analysis And Personal Inventory Essay.

     

    Foundations of Christian Spirituality and Ethics

    The foundational beliefs of Christianity inform the Christian understanding of the nature of spirituality and the nature of ethics. Thus, the way in which the Christian worldview answers the six questions above shapes a distinctly Christian spirituality and Christian ethic. The term 
    spirituality
    has many different definitions in popular culture and in different contexts. One influential definition claims, “spirituality is an aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred” (Puchalski et al., 2009). This definition is broad enough to give a general idea of what spirituality involves, but it does not give a full picture of a person’s spiritual life or spiritual needs. Those details will be filled in by examining a persons specific worldview. Worldview Analysis And Personal Inventory Essay.

    Spirituality in the Christian worldview has its foundations in the reality of a triune God who eternally exists as Father, Son, and Holy Spirit. God is one being in three persons and is the creator and sustainer of all that exists. He is all-knowing, all-powerful, and loving to his core, “And so we know and rely on the love God has for us. God is love. Whoever lives in love lives in God, and God in them” (1 John 4:16). This God has revealed himself in different ways to human beings, including through the natural world. However, he has revealed himself and his will for human beings most authoritatively through the Bible and in the person of Jesus Christ. In this view, whatever it means to be spiritual will in some sense be related directly or indirectly to God, and will come to be known primarily through the teachings of the Bible. Worldview Analysis And Personal Inventory Essay. Furthermore, Christian spirituality will refer to the beliefs and practices that are meant to reflect the proper functioning of God’s creation, and which promote right relationship to God and deeper knowledge of him. Many times spirituality is taken to be synonymous with the feeling of deep emotion or of oneness with a transcendent reality, but Christian spirituality is not limited to the experience of mere emotions or feelings. Feelings and emotions are an important part of being human, and they are even an important part of one’s relationship to God. Yet, spirituality in the Christian worldview is not dictated by the feelings or emotions one might be experiencing in the moment, but by trust in the goodness of God and obedience to him. Worldview Analysis And Personal Inventory Essay.

    In the same way that Christian spirituality finds its foundations in the reality of the triune God of the Bible, ethics also has its foundations in God. Ethics, broadly speaking, is the study of good and bad, right and wrong. Every worldview has to explain the foundations of ethics (in line with worldview question #5 above) such that it explains the basis of what counts as good and bad, right or wrong. In the Christian worldview, there is a God who exists and has created the world with a moral structure and purpose such that what is truly right and good is a reflection of God’s character. God’s own holy, loving and perfect character is the standard of right and wrong. Badness or what is wrong is then defined as anything that is contrary to God’s character, his will, or to his design and purpose for his creation. Worldview Analysis And Personal Inventory Essay.

    The Bible reveals what God’s character is like. Exodus 34:6-7 says,

    The LORD, the LORD, the compassionate and gracious God, slow to anger and abounding in love and faithfulness, maintaining love to thousands, and forgiving wickedness, rebellion and sin. Yet he does not leave the guilty unpunished; he punishes the children and their children for the sin of the parents to the third and fourth generation.

    Similarly, 1 John 4:7-9 says,

    Dear friends, let us love one another, for love comes from God. Everyone who loves has been born of God and knows God. Whoever does not love does not know God, because God is love. This is how God showed his love among us: He sent his one and only Son into the world that we might live through him. Worldview Analysis And Personal Inventory Essay.

    Psalm 18:30 declares, “As for God, his way is perfect: The LORD’s word is flawless; he shields all who take refuge in him.” Many more verses could be surveyed, but the Bible makes clear that God is perfectly good and holy. Knowing right and wrong then will mean knowing that which accords to God’s character.

    Right or wrong can be discovered in multiple ways. It can be discovered in God’s creation by examining the natural world or by the use of human reason. In this way, one discovers God’s design for the way things are supposed to be by examining what is built into creation; this is often referred to as “natural law.” For example, one can know by means of reason and observation that murder is wrong or that a broken bone is bad and not the way it is supposed to be. Conversely, one might come to know that feeding the homeless is good, and loving one’s spouse is right. One does not need to be religious or even believe in God to be able to know propositions of “natural law.” Nevertheless, the Christian worldview holds that these truths are built into the world by God. Second, right or wrong can be discovered by reading the Bible or looking at the example of Jesus Christ. Worldview Analysis And Personal Inventory Essay. The Bible reveals God’s commands and principles such as the Ten Commandments or the teachings of Jesus on the sermon on the mount
    .
    In addition, the Bible provides us with examples of virtuous people. The perfect man and moral exemplar (though much more than only a man and an exemplar) in the Christian tradition is Jesus Christ himself. The Christian is to not only obey God’s commands, but to be transformed into the kind of person that reflects the character of God. Jesus Christ is the perfect representation of such a life; Christians, thus, ought to embody the virtues and character of Jesus himself. The attaining of these virtues will not only be a matter of intellectual knowledge of right and wrong, but an active surrender and transformation by means of God’s own Holy Spirit. The wisdom to navigate all the complexities of ethical decision-making will be a consequence of a person’s character and the active guidance of the Holy Spirit. Worldview Analysis And Personal Inventory Essay.

    Knowledge of God, Knowledge of Ethics

    A key component of the foundations of Christian spirituality and ethics as described above is the view that people can have genuine 
    knowledge
     of God and 
    knowledge
     of right and wrong. A few observations about the word 
    knowledge
     need to be considered. First, by 
    knowledge
     we mean the opposite of mere opinion. Knowledge is more than just an educated guess; it is being in touch with the real world as it really is. Thus, knowledge in this sense is not merely 
    subjective
    , but is rather an 
    objective
     description of reality. For example, the proposition “the earth is round” is an 
    objectively
     true description of reality, even if some people happen to 
    subjectively
     deny that the earth is round. Subjective beliefs may be true or false. What would make 
    subjective
     beliefs true would be if they matched the real 
    objective
     world. Fundamentally, knowledge is the possession and awareness of 
    truth
    . Worldview Analysis And Personal Inventory Essay.

    There are two philosophies, however, that stand in contrast to the Christian belief that one can have knowledge of God and knowledge of right and wrong, namely 
    scientism
     and 
    postmodernism
    . These two philosophies are very influential in today’s society, although they are not compatible with the Christian worldview. It is important to understand these philosophies because not only are they not compatible with the Christian worldview, they arguably have negative effects on the practice of medicine and health care. Worldview Analysis And Personal Inventory Essay.

    Scientism

    Although the term 
    scientism
     has the word 
    science
     in it, it is crucial to recognize that (1) 
    scientism
     is not the same thing as (2) 
    science
    . In the Christian worldview, 
    science
     is a great and good thing. In fact, the Christian worldview has always encouraged careful investigation of the natural world. In the Christian worldview, medical technology is considered a good gift from God insofar as God has created the kind of world that has a structure that can be discovered and manipulated to bring about the good of human beings (Rae & Cox, 1999). 
    Scientism
    , however, is not compatible with the Christian worldview. Scientism is the belief that the best or 
    only
    way to have any knowledge of reality is by means of the sciences (Moreland & Craig, 2003, pp. 346-350). In other words, if something is not known scientifically then it is not known at all, and the only way to hold true beliefs about anything is to know them scientifically Worldview Analysis And Personal Inventory Essay.

    That may sound reasonable and even commonsense, but there are two problems with scientism: (1) scientism is a self-refuting philosophy, and (2) science has clear limits. First, if the only way to have true beliefs is through science, then the thesis of scientism itself (“the only way to have any knowledge of the world”) could not be true because it cannot be proven scientifically. Thus, the thesis of scientism fails its own truth test. Scientism’s thesis is, in fact, a philosophical statement. Philosophers call such propositions 
    self-refuting
    because they invalidate themselves by definition, similarly to someone claiming, “I cannot speak a word of English.” Worldview Analysis And Personal Inventory Essay.

    Second, while science is a powerful way of gaining knowledge of the natural world, science is limited and is not the only way of gaining knowledge. Consider the following two limitations of science (though there are many others); science cannot tell us anything about (1) ethics or (2) how one ought to use the results of science (University of California Museum of Paleontology, n.d.). Science is wonderful and 
    describes
     the way things are, but it has no authority to tell us what we 
    ought
     to do morally. Science cannot tell me whether or not I 
    ought
    to love my spouse, keep my promises, or give to the poor Worldview Analysis And Personal Inventory Essay. Even when it comes to ethical issues that involve science, science cannot determine what the right thing to do would be. For example, science might be able to describe the nasty effects of a terminal disease on a person or explain the state of a person’s brain if that person is in a vegetative state. However, science cannot determine whether euthanasia or physician-assisted suicide is good, bad, right, or wrong. Science also cannot determine how scientific data and results ought to be used. Science might enable the discovery of chemical processes or structures, but should the results be used for creating biotechnology to engineer human DNA? Should the results of scientific research be used to create bioweapons for military purposes? Such questions are beyond the bounds of what science can answer. Remember scientism is NOT science; it is a philosophical thesis that claims that science is the only methodology to gain knowledge and that every other claim to knowledge is either mere opinion or false. However, as Nicholas Rescher remarks, “to take this stance [of scientism] is not to celebrate science but to distort it” (as cited in Moreland & Craig, 2003) Worldview Analysis And Personal Inventory Essay.

    Postmodern Relativism

    Postmodernism is a broad philosophical position that claims that there is no such thing as truth or an objective reality that can be known. A common way in which postmodernism is expressed is through a view called 
    relativism
    . Relativism is the view that there is no such thing as truth in the common sense of that concept. Every claim about the nature of reality is simply 
    relative
     to either an individual or a society/culture. Another way to put this is to say that truth is 
    invented
     by people (whether it is individuals or entire societies) instead of being 
    discovered
    . According to this way of thinking, there is not genuine truth to be had or known, only 
    subjective
     opinions or beliefs. While certain questions are no doubt  matters of subjective opinion, such as “what is the best flavor of ice cream?” or “what is the proper way to shake hands?” not all questions are. This is most clearly seen when we consider 
    moral
     or 
    ethical
     propositions about right or wrong. It would be a serious mistake to claim that the propositions “murder is wrong” or “racism is evil” are mere subjective matters of opinion. However, that is what relativism implies. If all truth including morality is simply a human invention, then there is no standard for 
    genuine
     truth, and it follows that there is no 
    genuine
     right or wrong. However, this is certainly false. Whether or not the Nazi party, made up of thousands of individuals, believed that killing 6 million Jews was a good thing, we have to say without any hesitation that they were 
    genuinely
     wrong. But it is not possible to be wrong unless there is 
    genuine objective truth
    to be known. Worldview Analysis And Personal Inventory Essay.

    Both scientism and postmodern relativism are incompatible with the foundations of Christian spirituality and ethics. The Christian worldview holds 
    science
     in high regard and accepts it as one of the most powerful communal ways of obtaining knowledge about the world. However, contrary to 
    scientism
    ,the Christian worldview does not accept science as the only way of knowing things about the world. Secondly, contrary to postmodern relativism, the Christian worldview holds that 
    genuine objective knowledge
    of God and of right and wrong is possible. It follows then that who God is and what is right and wrong are not merely matters of subjective opinion, but genuine truths to be discovered. Worldview Analysis And Personal Inventory Essay.

    Conclusion

    The foundations discussed above provide the framework for Christian ways of ethical and spiritual decision-making in health care. It is important to understand therefore that the Christian way of ethical and spiritual decision-making is distinct from other worldviews and is not the same as Buddhist, Muslim, or even atheist ways of ethical and spiritual decision-making. It is not fair or respectful to paint all religions or worldviews with the same brush under the heading of “spirituality” and ignore the differences. Worldview Analysis And Personal Inventory Essay.

    Topic 2 will discuss a foundational principle to the practice of medicine and health care, as well as bioethics namely, the principle of 
    respect for persons
    . The Christian worldview goes even further and states all human beings are made in the 
    image of God
     and therefore have intrinsic value and are worthy of dignity and respect.

    Topic 3 will discuss the field of bioethics and introduce some of the main methodologies of ethical decision-making in health care. The focus in this section will be on the methodology called 
    principlism
    which stresses the application of four moral principles to all ethical decisions in health care. Prinipalism will be used and interpreted in light of the Christian worldview and the overarching narrative presented in the Bible. Worldview Analysis And Personal Inventory Essay.

    Topic 4 will briefly introduce issues of death, dying, and grief. The focus will be on ethical issues at the end of life and the Christian worldview regarding death in light of the biblical narrative and the hope of resurrection inaugurated by the person and work of Jesus Christ.

    Topic 5 will conclude with discussion about the facilitating of ethical and spiritual decision-making for patients, and the practical application of the principles and tools introduced in this course. Worldview Analysis And Personal Inventory Essay.

  • Benchmark – Human Experience Across The Health-Illness Continuum

    Benchmark – Human Experience Across The Health-Illness Continuum

    The benchmark assesses the following competency:

    Benchmark: 5.1. Understand the human experience across the     health-illness continuum.

    Research the health-illness continuum and its relevance to patient   care. In a 750-1,000 word paper, discuss the relevance of the   continuum to patient care and present a perspective of your current   state of health in relation to the wellness spectrum. Include the following:

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    Examine the health-illness continuum and discuss why this     perspective is important to consider in relation to health and the     human experience when caring for patients.

    Reflect on your     overall state of health. Discuss what behaviors support or detract     from your health and well-being. Explain where you currently fall on     the health-illness continuum. Benchmark – Human Experience Across The Health-Illness Continuum.

    Discuss the options and     resources available to you to help you move toward wellness on the     health-illness spectrum. Describe how these would assist in moving     you toward wellness (managing a chronic disease, recovering from an     illness, self-actualization, etc.).

    Prepare this assignment according to the guidelines found in the APA   Style Guide. An abstract or thesis is required. Benchmark – Human Experience Across The Health-Illness Continuum

  • NURS 6001: Foundations of Graduate Study – My Goals and Walden University Vision and Mission

    NURS 6001: Foundations of Graduate Study – My Goals and Walden University Vision and Mission

    INITIAL POST

    My Goals and Walden University Vision and Mission

    As a nurse for over 10 years and with the advances in technology applied to the health care arena, I have become more interested in the role of a nurse within informatics. My professional goal is to work full-time in the area of nursing informatics. Unfortunately, I knew that obtain this position, I needed to advance my degree. I began looking into various colleges and universities that can provide me with the education needed to obtain an advanced degree with a focus in nursing informatics.

    After several months of investigating, I located Walden University. At first, I was drawn to Walden because it offered the flexibility that I needed. NURS 6001: Foundations of Graduate Study – My Goals and Walden University Vision and Mission. However, as I investigated the university further, Walden’s mission and vision statement resonated with me. I knew I had made the right choice. The School of Nursing (SON) vision and mission statements described what I felt and thought yet could not put into words. According to the Walden University SON (2011a), their vision is for graduates to transform nursing to meet the needs of communities. Technology is transforming health care and the degree I will obtain at Walden will help me to assist my organization with this transformation.

    BUY A PLAGIARISM-FREE PAPER HERE

    Another reason I was drawn to Walden University was the high standards they have for all students. The SON stated in their mission that their program is “academically rigorous…contextually relevant…” (Walden University, 2011a, para. 4). This statement matches my academic goal. I am not looking for just a piece of paper at the end, I am looking to gain the necessary knowledge that I need to make an impact within my organization.

     Incorporation of Social Change

    Walden University (2011b) defined positive social change as a “deliberate process of creating and applying ideas, strategies, and actions to promote the worth, dignity, and development of individuals, communities, organizations, institutions, cultures, and societies” (para. 4). I have always had a feeling that I want my life to mean something and to have an effect on those around me whether it is directly or indirectly. As a nurse, the will to help others is a core foundation of why I got into nursing in the first place. I plan to incorporate social change with the knowledge gained at Walden University by “putting that knowledge into practice” (Walden University, 2010b, para. 3). I plan to contribute to my field when I graduate by helping lead my coworkers and my organization through the computerized changes and advancement of technology at work. While helping others, I will be part of the clinical informatics team as the team transitions the organization into new computerized programs. NURS 6001: Foundations of Graduate Study – My Goals and Walden University Vision and Mission.

    References

    Walden University. (2011a). About the school. Retrieved from

    http://www.waldenu.edu/Colleges-and-Schools/College-of-Health-Sciences/15863.htm

    Walden University. (2011b). Vision, mission, and goals. Retrieved from

    http://catalog.waldenu.edu/
    content.php?catoid=21&navoid=2450 NURS 6001: Foundations of Graduate Study – My Goals and Walden University Vision and Mission.

  • Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    Week 8: Cognitive Behavioral Therapy for Groups

    CBT is the most widely researched psychotherapeutic model with demonstrated effectiveness in the treatment of a wide range of emotional and behavioral problems. CBT is the first order of business and treatment of choice for most patients who need internal resources and coping skills enhanced.

    —Dr. Sharon M. Freeman Clevenger,
    Psychotherapy for the Advanced Practice Psychiatric Nurse

    Although designed for therapy with individuals, cognitive behavioral therapy (CBT) has also proven effective in group settings. With its many benefits, including cost-effectiveness and efficiency, this therapeutic approach allows the psychiatric mental health nurse practitioner to effectively treat a greater number of clients in a relatively short length of time. With the widespread use of CBT with groups, it is important for you to understand how to use this therapeutic approach in clinical settings. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays .

    This week, as you explore CBT for groups, you compare CBT in group and family settings. You also develop diagnoses for clients receiving group psychotherapy and consider legal and ethical implications of counseling these clients.

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    Learning Resources

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

    Required Readings

    Yalom, I. D., & Leszcz, M. (2005).
    The theory and practice of group psychotherapy
    (5th ed.). New York, NY: Basic Books.

    Chapter 11, “In the Beginning” (pp. 309–344)

    Yalom, I. D., & Leszcz, M. (2005).
    The theory and practice of group psychotherapy
    (5th ed.). New York, NY: Basic Books.

    Chapter 12, “The Advanced Group” (pp. 345–390)

    American Psychiatric Association. (2013).
    Diagnostic and statistical manual of mental disorders
    (5th ed.). Washington, DC: Author. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays .

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

    Bjornsson, A. S., Bidwell, L. C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz Seghete, K. L., … Craighead, W. E. (2011). Cognitive-behavioral group therapy versus group psychotherapy for social anxiety disorder among college students: A randomized controlled trial.
    Depression and Anxiety, 28
    (11), 1034–1042. doi:10.1002/da.20877

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

    Safak, Y., Karadere, M. E., Ozdel, K., Ozcan, T., Türkçapar, M. H., Kuru, E., & Yücens, B. (2014). The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder.
    Turkish Journal of Psychiatry, 25
    (4), 225–233. Retrieved from http://www.turkpsikiyatri.com/

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

    Document: Group Therapy Progress Note

     

    Discussion: Cognitive Behavioral Therapy: Group Settings Versus Family Settings

    As you might recall from Week 5, there are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in group settings and family settings, consider challenges of using this approach with your own groups. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays .

    Learning Objectives

    Students will:

    Compare the use of cognitive behavioral therapy for groups to cognitive behavioral therapy for families

    Analyze challenges of using cognitive behavioral therapy for groups

    Recommend effective strategies in cognitive behavioral therapy for groups

    To prepare:

    Reflect on your practicum experiences with CBT in group and family settings.

    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. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit! Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays 

    By Day 3

    Post
    an explanation of how the use of CBT in groups compares to its use in family settings. Provide specific examples from your own practicum experiences. Then, explain at least two challenges counselors might encounter when using CBT in the group setting. Support your response with specific examples from this week’s media.

    Read
    a selection of your colleagues’ responses.

    By Day 6

    Respond
    to at least
    two
    of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 8 Discussion Rubric

     

    Post by Day 3 and Respond by Day 6

    To participate in this Discussion:

    Week 8 Discussion

     

    Assignment 1: Practicum – Week 8 Journal Entry

    Learning Objectives

    Students will:

    Develop effective documentation skills for group therapy sessions *

    Develop diagnoses for clients receiving group psychotherapy *

    Evaluate the efficacy of cognitive behavioral therapy for groups *

    Analyze legal and ethical implications of counseling clients with psychiatric disorders *

    Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    *
     The Assignment related to this Learning Objective is introduced this week and submitted in Week 10.

    Select two clients you observed or counseled this week during a group therapy session. 
    Note:
     The two clients you select must have attended the same group session.

    Then, in your Practicum Journal, address the following:

    Using the Group Therapy Progress Note in this week’s Learning Resources, document the group session.

    Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications.

    Using the DSM-5, explain and justify your diagnosis for each client.

    Explain whether cognitive behavioral therapy would be effective with this group. Include expected outcomes based on this therapeutic approach. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    Explain any legal and/or ethical implications related to counseling each client.

    Support your approach with evidence-based literature.

    By Day 7 of Week 10

    Submit
     your Assignment.

    Assignment 2: Board Vitals

    This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

    These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.
    Cognitive Behavioral Therapy: Group Settings Versus Family Settings
    – Week 8 Discussion Sample Essays

    You can access Board Vitals through the link sent to you in email or by following the link below:

    https://www.boardvitals.com/

     

    By Day 7

    Complete the Board Vitals questions.

    Making Connections

    Now that you have:

    Explored cognitive behavioral therapy (CBT) for groups and compared CBT in group and family settings

    Developed diagnoses for clients receiving group psychotherapy and considered legal and ethical implications of counseling these clients

    Next week, you will:

    Explore psychotherapeutic approaches to group therapy for addiction

    Develop diagnoses for clients receiving psychotherapy for addiction and consider legal and ethical implications of counseling these clients Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

     

    Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays Individual vs. Family CBT

    Cognitive behavioral therapy is short-term psychotherapy that emphasizes the need for attitude change in order to maintain and promote behavior modification (Nichols, 2014). Cognitive behavior therapy (CBT) has been found to be effective in a broad range of disorders. CBT can be done as an individual treatment or in a family setting. Individual CBT has a broadly defined framework with an emphasis on harm-reduction, especially with clients that have anxiety and substance abuse (Wheeler, 2014).

    Cognitive-behavioral therapy for families is also brief and is solution-focused. Family CBT is focused on supporting members to act and think in a more adaptive manner, along with learning to make better decisions to create a friendlier, calmer family environment (Nichols, 2014). An example from practicum is a male (T.M) that participates in individual CBT once a week and family CBT once a week. T.M is struggling with alcoholism.

    He originally presented for individual CBT because he had been “told by his wife” that he had a problem with alcohol. He reported that he drank “a few vodka drinks” three times a week but none for six weeks. Individual CBT therapy is a collaborative process between the therapist and client that takes schemas and physiology into consideration when deciding the plan of care (Wheeler, 2014). We worked with him using open-ended questions to assist with obtaining cognitive and situational information.  He would become angry easily and it was a felt that he was not being truthful about his alcohol use. Each time he was questioned about it, the story would change. He attended two individual sessions and it was then recommended he begin family CBT with his significant other (S.M) because “things were not going well at home.”

    With family CBT, cognitions, emotions, and behaviors are seen as having a mutual influence on one another (Nichols, 2014). The first session was stressful, to say the least. T.M began talking about his alcohol use. S.M interrupted and said, “what about that one-time last month at the hotel. You were seeing things.” He became defensive, raised his voice, and said, “I was drugged. It had nothing to do with drinking.” She then looked down and was tearful. When he left the room to use the bathroom, S.M questioned if he could be tested for alcohol. This led the therapist to believe that T.M’s last use was not six weeks ago.

    T.M’s automatic thoughts were that his alcoholism was not a problem in the marriage or in life. One of the core principles in using CBT for SUDs is that the substance of abuse serves as a reinforcement of behavior (McHugh et al., 2010). Over time, the positive and negative reinforcing agents become associated with daily activities. CBT tries to decrease these effects by improving the events associated with abstinence or by developing skills to assist with reduction (McHugh et al., 2010).

    It was noticed that when T.M was alone, his stories would change. But when his wife was in the room, he would look at her while he spoke to ensure what he was saying was accurate. The therapist informed the client that it would be appropriate to continue individual therapy and family CBT once a week with the recommendation of joining the ready for change group. The CBT model for substance use states that, when a person is trying to maintain sobriety or reduce substance use, they are likely to have a relapse (Morin et al., 2017). Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    Ready for change meetings was recommended because like this week’s media showed, clients may relate to others that are going through similar situations. Getting T.M to realize that his alcohol use is a problem, is the primary goal currently. This example was shared because it shows the difficulties that may be encountered with psychotherapy and that both individual and family may be needed to ensure that goals are met. Some challenges that counselors face when using CBT in the family setting are wondering if the structure of the session and if the proper techniques were effective (Ringle et al., 2015). Evaluating and consulting with peers may also assist with meeting client and family goals.

    References

    McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. 
    The Psychiatric clinics of North America
    , 
    33
    (3), 511-25. doi:
    10.1016/j.psc.2010.04.012

    Morin, J., Harris, M., & Conrod, P.  (2017, October 05). A Review of CBT Treatments for Substance Use Disorders. 
    Oxford Handbooks Online.
     Ed.  Retrieved from
    http://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199935291.001.0001/oxfordhb-9780199935291-e-57.

    Nichols, M. (2014).
    The essentials of family therapy
    (6th ed.). Boston, MA: Pearson. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    Patterson, T. (2014). A Cognitive-Behavioral Systems Approach to Family Therapy. 
    Journal of Family Psychotherapy
    , 
    25
    (2), 132–144.
    https://doi-org.ezp.waldenulibrary.org/10.1080/08975353.2014.910023

    Ringle, V. A., Read, K. L., Edmunds, J. M., Brodman, D. M., Kendall, P. C., Barg, F., & Beidas, R. S. (2015). Barriers to and Facilitators in the Implementation of Cognitive-Behavioral Therapy for Youth Anxiety in the Community. 
    Psychiatric services (Washington, D.C.)
    , 
    66
    (9), 938-45. doi:
    10.1176/appi.ps.201400134

    Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to

    guide for evidence-based practice. New York, NY: Springer.

     

    Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays POST 2

    Cognitive Behavioral Therapy is one of the most effective psychotherapy approaches, whether it be used in group, family, or individual treatment. It is important to understand the purpose of it what its process consists off. It can be used to treat different mental health conditions, ranging from addiction to more severe illnesses. Its approach is to work with the patient into strategizing ways to change unhealthy thoughts and behaviors. Throughout the process, the patient not only learns solving skills, but also to re-evaluate and learn how to understand other’s perspectives, skill that helps build their confidence.

    Some believe group therapy is more effective than individual therapy, as established by Kellett, Clarke, and Matthews (2007, p. 211). It has been established that CBT in general can be effective, but based on the Johnson Family Session video, it leads me to believe that either group/family or individual would be effective depending on the condition that is being treated. It is clear from the video that the girl who had been sexually assaulted at the fraternity does not believe talking or sharing her experience, even if it is with other girls who went through the same experience, will help in any way. She still has some internal issues that need to be addressed individually in order to make progress and get her to a place where she can participate in group/family therapy with an awareness that it will help her and purpose to it. Another important aspect of having a client be committed to the treatment is that research has showed “Poor compliance can adversely affect the remaining group members who may become worried or insecure” (Söchting, Lau, Ogrodniczuk, 2018, p. 185).

    An example during practicum that supports my belief is the case of a terminally ill patient who had been recommended comfort care through hospice. She was ready to do so, understood and accepted her prognosis, but her daughters and husband were in denial. Every time they participated in a family session the patient held back on her wishes and verbalized whatever their wishes were as if they were her own. When treated as an individual client, she would express her concerns of not being able to “disappoint and abandon my family”. She had suffered all her life from anxiety, insecurities, severe depression, and low self-esteem. Those were issues that should have been addressed individually before she could fully engage in a family session in a healthy and productive way, if she would’ve had the time. CBT would have still been the choice of treatment for individual therapy for this client, as evidenced by Driessen et al. who stated it “is the psychotherapy method with the best evidence-base in the treatment of depression” (2017, p. 654). Not being fully engaged in the program, or believing the treatment will not help, or having other issues that need to be addressed on an individual basis, are all challenges presented in a family setting when relying on CBT.

    References

    Kellett, S., Clarke, S., & Matthews, L. (2007). Delivering Group Psychoeducational CBT in

    Primary Care: Comparing Outcomes with Individual CBT and Individual

    Psychodynamic-Interpersonal Psychotherapy.
    British Journal of Clinical Psychology,

               46(2).

    Söchting, I., Lau, M., & Ogrodniczuk, J. (2018). Predicting Compliance in Group CBT Using the

    Group Therapy Questionnaire.
    International Journal of Group Psychotherapy, 68(2).

    Driessen,E., Van, H. L., Peen, J., Don, F. J., Twisk, J. W. R., Cuijpers, P., & Dekker, J. J. M.

    (2017). Cognitive-Behavioral Versus Psychodynamic Therapy for Major Depression:

    Secondary Outcomes of a Randomized Clinical Trial. Journal of Consulting Clinical

    Psychology, 85)7).

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    Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays POST 3

    Week 8 discussion

    Cognitive Behavioral Therapy: Group Settings Versus Family Settings

    Cognitive behavioral therapy (CBT) is an effective treatment for a broad range of psychiatric disorders and problems (Naik et al. 2013). CBT can be offered as an individual treatment, in a family setting or used in a group setting. Group cognitive behavioral therapy (GCBT) may be a more efficient form of delivering CBT in areas of the mental health system where providing adequate amounts of treatment for patients is challenging (Naik et al. 2013). To be able to recommend the use of GCBT in mental health settings, more work needs to be undertaken to establish patients’ perceptions of such treatment and whether it is effective in reducing symptoms (e.g., anxiety, depression, distress) in actual practice settings. In a study done to show the effectiveness of group CBT, it was assumed that CBT efficacy varies widely depending on the disorder presented. CBT is highly effective in the treatment of adult unipolar depression, adolescent unipolar depression, bulimia nervosa, childhood depressive and anxiety disorders, generalized anxiety disorder, panic disorder with or without agoraphobia, post-traumatic stress disorder, schizophrenia, and social phobia (Naik et al. 2013). Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    Group cognitive behavioral therapy has also been shown to be more cost-effective because Group treatment has been presented as a more cost-effective method of treating a large number of children and adolescents especially in children or adolescent with anxiety disorders, depression, bulimia nervosa to mention but a few. Group CBT result in reduced medical and nonmedical costs, thereby contributing to a societal cost offset, but in a family setting, there is the scarcity of properly trained therapists and high costs (Hedman et al.2010). However, CBT is not readily available in healthcare settings. Therefore, it is essential to develop and evaluate methods of therapy that are more time- and cost-efficient. Because health care resources are limited, there has been an increasing demand for cost-effective treatments that reduce the societal costs of sick leave and health care consumption (Hedman et al.2010). Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    References:

    Hedman, E., Ljótsson, B., Andersson, E., Rück, C., Andersson, G., & Lindefors, N. (2010).

    Effectiveness and cost offset analysis of group CBT for hypochondriasis delivered in a

    psychiatric setting: an open trial. Cognitive Behaviour Therapy, 39(4), 239–250.

    https://doi-org.ezp.waldenulibrary.org/10.1080/16506073.2010.496460

    Naik, A., O’Brien, A., Gaskin, C., Munro, I., & Bloomer, M. (2013). The Acceptability and

    Efficacy of a Group Cognitive Behavioural Therapy Programme in a Community Mental

    Health Setting. Community Mental Health Journal, 49(3), 368–372. https://doi-

    org.ezp.waldenulibrary.org/10.1007/s10597-012-9484-3

     

    Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays POST 4

    Week 8 Discussion

    Cognitive behavioral therapy (CBT) is an evidence-based practice for therapy. CBT can be used in individual, group, or family therapy. The use of CBT in the family setting grew from the Thibaut and Kelley’s theory of social exchange (Nichols, 2014). The theory of social exchange states that people will endeavor to increase rewards and decrease sacrifice in a relationship. Thibaut and Kelly express that this behavior has the goal of maintaining homeostasis in the relationship which they call behavior exchange theory(Nichols, 2014). CBT postulates that one person’s behavior affects how another person will react to them. CBT use in group therapy has a similar premise the difference between group CBT and family CBT is schemas (Wheeler, 2014). Schemas are a persons core beliefs, and these underlying beliefs shape the way a person responds even if it is unconsciously done. One challenge in the group setting is group members may attempt to bring the family schemas they possess into the group(Wheeler, 2014). Another challenge in the group setting with CBT is keeping group members focused on the here and now; even if the factors leading to the behavior was in the past (Wheeler, 2014). I have seen this in my practicum experience in the group therapy the therapist has to work hard on keeping members in the here and now and reinforcing the goal of change. In the family therapy sessions, I have seen more struggles over how to blend two family schemas into one where everyone can be happy. Creating new schemas is generally especially difficult for the families I have seen because they have autistic children which changes how families must react to behaviors. Bjornsson, Bidwell, and Brosse at el report that CBT in the group may be less effective because the concentration on restructuring activities, prevents the formation of group dynamics that is crucial in group therapy (2011). Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

     

    References

    Bjornsson, A. S., Bidwell, C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz, K. L., … Craighead, W. E. (2011). Cognitive-Behavioral Group Therapy Versus Group Psychotherapy For Social Anxiety Disorder Among College Students: A Randomized Controlled Trial.
    Depression and Anxiety
    ,
    28
    (11), 1034-1042. http://dx.doi.org/10.1002/da.20877

    Nichols, M. (2014).
    The essential of family therapy
    (6th ed.). Boston, MA: Pearson.

    Wheeler, K. (2014).
    Psychotherapy for the Advanced Practice Psychiatric Nurse
    (2nd ed.). New York, NY: Springer Publishing Company. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

  • Nurs 6640 week 1 discussion – Psychotherapy and Biology Sample essay

    Nurs 6640 week 1 discussion – Psychotherapy and Biology Sample essay

    Psychotherapy and Biology

    Before the question of whether psychotherapy has a biological basis, we must first understand what psychotherapy means. Psychotherapy is “any alteration in an individual’s interpersonal environment, relationships, or life situation brought about especially by a qualified therapist and intended to have the effect of alleviating symptoms of mental or emotional disturbance” (Merriam-Webster, 2018).

    There is an increasing consensus with evidence provided by neuroscience, psychology, and the cognitive sciences the psychotherapy does have a biological basis (Prosser, Helfer, & Leucht, 2016). The combination of these three sciences developed the free-energy principle which acknowledges that the environments we inhabit are complex and ever changing and the brain must constantly adapt to these changes (Prosser, Helfer, & Leuch, 2016). The free-energy framework claims that the brain attempts to adapt to the changing environment by minimizing prediction error, and by doing this the brain changes how the structure of the environment is encoded in the brain sometimes causing mental disorders (Prosser, Helfer, & Leucht, 2016). Nurs 6640 week 1 discussion – Psychotherapy and Biology Sample essay.

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    Psychotherapy has also been shown to change activity levels in the prefrontal cortex. According to a UCLA study on depression people with this condition had abnormally high activity in the prefrontal cortex (Deen, 2015). The researchers found that the patients who participated in interpersonal therapy had a decrease in prefrontal cortex activity (Deen, 2015). The author continues with a study preformed in the Netherlands with individuals with chronic fatigue syndrome (CFS). It was found the people with CFS have a decrease in the gray matter in the brain but after several sessions of cognitive behavioral therapy there was a significant increase in gray matter volume in the prefrontal cortex (Deen, 2015).

    Influences on Psychotherapy Treatment

    There are many factors that influence a person’s value of psychotherapy including socioeconomic status, race and racial beliefs, racial match, and religious factors. Nurs 6640 week 1 discussion – Psychotherapy and Biology Sample essay. With many factors potentially influencing the clients perspective of psychotherapy it is important that the practitioner become culturally competent.

    Racial factors can hinder quality care for the mental health patient. In some studies racial match of clients can be associated with an increase in the utilization of mental health services and promote favorable outcomes (Meyer & Zane, 2013, p. 3). The increase in more favorable outcomes could be because the ethnic minority clients may view ethnically similar psychotherapists as a more credible source of help because the assume a shared culture or values (Meyer & Zane, 2013, p. 3) Nurs 6640 week 1 discussion – Psychotherapy and Biology Sample essay.

    As stated before, there are many factors that can influence the value a person placed on psychotherapy, even the words used can increase the value a client places on therapy. Regarding the Navajo and psychotherapy, they see it as a practice pertaining to illness and healing and the terminology used becomes important (Lewis-Fernández, 2011, p. 5). When the word belief is applied to aspects of therapy it carries the connotation of falsehood, instead of saying what is your belief on mental illness and psych therapy one should use the terms values, attitudes on, view, but never beliefs (Lewis-Fernández, 2011, p. 6). Nurs 6640 week 1 discussion – Psychotherapy and Biology Sample essay In this example of culture and how it influences psychotherapy it would be very important to be culturally competent in the Navajo culture because just the verbiage used could alter the outcome of psychotherapy.

    References

    Deen, S. (2015). How Psychotherapy Changes the Brain.
    American Psychiatric Association
    .

    Lewis-Fernández, R. (2011). Commentary on “Elements of Psychotherapy in Navaho Religion”: A Perspective from Contemporary Cultural Psychiatry.
    Psychiatry: Interpersonal and Biological Processes
    ,
    74
    (4), 293-300. doi:10.1521/psyc.2011.74.4.293 Nurs 6640 week 1 discussion – Psychotherapy and Biology Sample essay

    Merriam-Webster. (2018, February 24). PSYCHOTHERAPY. Retrieved from https://www.merriam-webster.com/dictionary/psychotherapy

    Meyer, O. L., & Zane, N. (2013). THE INFLUENCE OF RACE AND ETHNICITY IN CLIENTS’ EXPERIENCES OF MENTAL HEALTH TREATMENT.
    Journal of Community Psychology
    ,
    41
    (7), 884-901. doi:10.1002/jcop.21580

    Prosser, A., Helfer, B., & Leucht, S. (2016). Biological v. psychosocial treatments: A myth about pharmacotherapy v. psychotherapy.
    British Journal of Psychiatry
    ,
    208
    (04), 309-311. doi:10.1192/bjp.bp.115.178368 Nurs 6640 week 1 discussion – Psychotherapy and Biology Sample essay

  • DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    Week Two Assignment Instructions DNP 820

    Please read the instructions thoroughly there are strict requirements

    I need at least 10 different articles/literature reviews added to the ones in the 815 attachment. I have also included the chart to be filled out All within 5 years and pertinent to the subject.

    Tutor MUST have a good command of the English language

    The Rubric must be followed,

    and all the requirements met DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

    This is a thorough professor, and she has strict requirements

    I have attached the PICOT and the first 10 points (DNP 815) assignment. This is a continuation of that assignment. Please read the attachments

    The following needs to be addressed:

    Please note the followings: The introduction and the literature review are complete and thorough. The problem statement is written clearly PICOT is clear and very good Sample: 

    ·
    How will you determine the sample size? 

    ·
    What are the inclusion/exclusion criteria of the subjects? Methodology: Why is the selected methodology is appropriate? Please justify! 

    ·
    Data collection approach needs to be clear. How will you collect your data? What is needed here is to describe the process of collecting data form signing the informed consent until completing the measuring.

    ·
    Data analysis-What test will you use to answer your research question? 

    Clinical/PICOT Questions:  

    “In adult patients with CVC

    at a Clear Lake Regional Medical Center, does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to standard care over a one-month period?” DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    P: Patients with Central Venous Catheters

    I: Staff re-education related to Hygiene of the hub

    C: Other hospitals

    O: Reduce probability of CLABSIs

    T: Two months

    “In Patients > 65 years of age with central line catheters at a Clear Lake Regional Medical Center, how does staff training of key personnel and reinforcement of central line catheter hub hygiene after its insertion, along with the apt cleansing of the insertion site, before every approach compared with other area hospitals, reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections) over a one-month period?”

    P: Patients > 65 years of age with a Central line

    I: Staff training and reinforcement of Central Catheter, Hub Hygiene 

    C: Other area hospitals 

    O: Reduce probability of CLABSIs

    “In adult patients, with

    define CVC (CVC), does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to pre and post-intervention assessments 

    1. I used central Missouri as an example, replace with a description of your site. 

    2. While you might be interested in CLASBI rates as a primary variable, there are other patient outcomes that would also be important to consider DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    3. Ensure you can find validity and reliability measures on CLASBI rates if you cannot, we need to determine another question to help

    4. How are your two comparison groups different, as they are currently stated the groups seem very much the same, could you state, standard care instead of pre and post intervention assessments? 

    5. One month is the longest time you can use for a prospective project

    Please note the following regarding the instructors grading

    IMPORTANT INFORMATION ABOUT MY GRADING STYLE

    As you prepare for written papers and manuscripts I’d like to give you some details about my grading style. I provide significant feedback on your papers, this is because I believe you should be working towards improving your writing so that at the end of this program you are able to successfully write your DPI project. In order to write well, you need feedback and you need to review that feedback and make progress on the next written work. To that end I always grade accordingly. This means that if I provide feedback one an item (for example APA format of your reference page) I expect that this will be improved on the next written submission. Otherwise I will deduct additional points. In addition, some other criteria to get down pat now. References should always DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    1.

    Be current, no older than 5 years that means 5 years from your proposed graduation date (2014-2019). Otherwise you will have to redo everything in DNP 955.

    2.

    Be primary sources. You can no longer cite Young declared literary war in 1956 (as cited by Brown 2006). You must cite Young 1956. That means go find that paper and read it and make sure that you agree with what Brown said. What if you don’t agree due to some very valid points? Then the literary war is not what occurred, but instead you have concerns regarding point ____, ____, and ____.

    3.

    You may no longer cite textbooks, they are 1) secondary sources and 2) not current enough, and please use peer reviewed manuscripts.

    One more item that is not a reference. You may not use direct quotes any longer. There is no need. This may be difficult at first, but you are moving towards a different type of writing. This is manuscript writing (scientific writing). Scientific writing is terse, clear, and concise. No frilly words. In order to avoid the use of direct quotes you will synthesize the literature. There is a great resource for synthesizing the literature under Resources – Add-ons. These are also some other great writing resources there.

    Details:

    In the prospectus, proposal, and scholarly project there are 10 strategic points that need to be clear, simple, correct, and aligned to ensure the research is doable, valuable, and credible. The 10 strategic points emerge from researching literature on a topic that is based on or aligned with the learner’s personal passion, future career purpose, and degree area. These 10 points provide a guiding vision for DPI Project. In this assignment, you will continue the work begun in DNP-815, working on your draft of a document addressing the 10 key strategic points that define your intended research focus and approach. DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project.

    General Requirements:

    Use the following information to ensure successful completion of the assignment:

    Locate      the “The 10 Strategic Points for the      Prospectus, Proposal, and Direct Practice Improvement Project” that      you completed in DNP-815.

    Doctoral      learners are required to use APA style for their writing assignments. The      APA Style Guide is located in the      Student Success Center. An abstract is not required.

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

    You      are required to submit this assignment to Turnitin. Please refer to the      directions in the Student Success Center.

    Directions:

    Use the “The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project” resource to draft statements for each of the 10 points for your intended research study.

    You worked on this last in DNP 815. Pick up from where you left off
    (if you transferred in and did not complete this, you will have to begin fresh).
    Please include a copy of your last instructor feedback when you submit this assignment. You can either copy and paste the instructor feedback into your current paper (as an appendix and clearly marked); or upload two separate papers. I expect significant improvement from your last submission.

    Please review the 10 Strategic Points document for additional instructions and an example. Add references to this document,
    I suggest 5-10 at this point.
    You need to realize that your literature review chapter will need at least 50+ articles by the time you get to DNP 955, so work on expanding your literature search each week, to include more and more to this paper as you move through each course. If you cannot locate 50+ articles you can ask your faculty for assistance or chose a different topic. DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

     

    For the methodology and design sections. Methodology should cover the broad methods you plan to use (qualitative, quantitative, or mixed methods). The design portion will then go into more detail and discuss the design (i.e. correlational, cross-sectional, pre/posttest, etc.). Describe each and explain why your chosen methodology and design are appropriate to your topic and project questions. You may NOT use qualitative, GCU leadership does not support a qualitative methodology.

    Intervention. You must have an intervention that you implement. Since you cannot evaluate a project that has already been implemented, please write up a description of your intervention and what your role will be in implementing this intervention. This is not a section listed on your 10 Strategic Points document as of yet, so add it after the methodology and design sections. Describe step by step what the intervention consists of, how it is evidence based, how you will implement, and your role in implementation.

    Data collection should go step by step (extremely over-detailed) on how you will collect the data. Tell me about all instruments, surveys, and/or questions you will ask of participants. One MUST be a valid and reliable tool.

    Data Analysis. Tell me the specific statistics you will use. Start with descriptive statistics, which ones will you use, why (cite current primary sources). Then tell me how you will compare your data (which statistic), what your p value will be before you start your data collection.

    Apply Rubrics

     

     

    1

    Unsatisfactory

    0.00%

    2

    Does Not Meet Expectations

    74.00%

    3

    Approaching Meeting Expectations

    87.00%

    4

    Meets Expectations

    100.00%

    100.0 %Content

     

    10.0 %Topic: Provides a broad project topic area/title.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    15.0 %Literature Review: Lists primary points for four sections in the Literature Review: (a) Background of the problem/gap and the need for the project based on citations from the literature; (b) Theoretical foundations (models and theories to be foundation for study); (c) Review of literature topics with key concept (??) for each one; (d) Summary.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    10.0 %Problem Statement: Describes the problem to address through the project based on defined gaps or needs from the literature.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    10.0 %Sample and Location: Identifies sample, needed sample size, and location.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    10.0 %Clinical/PICOT Questions: Provides clinical/PICOT questions to all of the collected data needed to address the problem statement.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    5.0 %Variables

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    10.0 %Methodology and Design: Describes the selected methodology and specific research design to address problem statement and clinical/PICOT questions.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    10.0 %Purpose Statement: Provides one sentence statement of purpose including the problem statement, methodology, design, population sample, and location.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    10.0 %Data Collection: Describes primary instruments and sources of data to answer research questions. Reliability and Validity of the instruments are addressed.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

    10.0 %Data Analysis: Describes the specific data analysis approaches to be used to address clinical/PICOT questions. The statistical test(s) that will be used must be identified and must be appropriate for the level of data and the clinical/PICOT question.

    Item is not present.

    Not all components are present. Large gaps are present in the components that leave the reader with significant questions.

    Component is present and adequate. Small gaps are present that leave the reader with questions.

    Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions.

     

    The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project

    Introduction

    In the Prospectus, Proposal, and Direct Practice Improvement Project there are
    10 key or strategic points
    that need to be
    clear, simple, correct, and aligned
    to ensure the project is
    doable, valuable, and credible
    . These points, which provide a guide or vision for the project, are present in almost any research. They are defined within “The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project” (10 Strategic Points) document.

    The ten strategic points are developed in table format.

    The 10 Strategic Points

    The 10 strategic points emerge from researching literature on a topic that is based on, or aligned with, the defined need in the literature as well as the learner’s personal passion, future career purpose, and degree area. The 10 Strategic Points document
    includes
    the following 10 key or strategic points that define the project focus and approach:

    Topic (10%)
    – Provides a broad project topic area/title.

    Literature Review (15%)
    – Lists primary points for four sections in the Literature Review:

    Background of the problem/gap and the need for the project based on citations from the literature.

    Theoretical foundations (models and theories to be foundation for project).

    Review of literature topics with key theme for each one.

    Summary.

    Problem Statement (10%)
    – Describes the problem to address through the project based on defined needs or gaps in practice from the literature.

    Sample and Location (10%)
    – Identifies sample, needed sample size, and location.

    Clinical/PICOT Questions (10%)
    – Provides clinical/PICOT questions to collect data to address the problem statement.

    Variables (5%)
    – Identifies and describes independent and dependent variables.

    Methodology and Design

    (10%)
    – Describes the selected methodology and specific project design to address problem statement and clinical questions

    Purpose Statement (10%)
    – Provides one sentence statement of purpose including the problem statement, methodology, design, population sample, and location.

    Data Collection (10%)
    – Describes primary instruments to answer clinical questions.

    Data Analysis

    (10%)
    – Describes the specific data analysis approaches to be used to address clinical/PICOT questions.

    The Process for Defining the 10 Strategic Points

    The order of the 10 strategic points listed above reflects the order in which the learner completes the work product. The first five strategic points focus primarily on defining the focus for the project based on a clearly defined need or gap from the literature as well as the learner’s passion, purpose, and specialty area focus. First, learners identify a broad topic area to investigate for their Direct Practice Improvement (DPI) Project based on a clearly defined need or gap from the literature or practice problem, and one in which they are interested based on personal passion, future career purpose, and degree being pursued. Second, learners complete a review of the literature to define the need or gap to be addressed, the theories and models that will provide a foundation for the project, related topics that are needed to demonstrate the learner’s expertise in the field, and to define the key strategic points behind the learner’s proposed research. Third, the learners develop a clear, simple, one-sentence problem statement that defines the problem or gap that will be addressed by the DPI project. Fourth, learners identify potential population samples for which they would have access in order to collect the data for the project, considering the fact the quantitative study sample sizes need to be much larger than those for qualitative studies. Fifth, learners develop the clinical/PICOT question(s) that will define the data needed to address the problem statement.

    Based on the first five strategic points above, learners next define the key aspects of the project methodology through the last five strategic points. The sixth point describes the independent and dependent variables. Seventh, learners determine if the project will be a qualitative, quantitative or mixed methodology. Due to the nature of the DPI project requirements, most projects will be utilizing a quantitative method because learners are not creating new research in a qualitative study. Qualitative projects often do not facilitate the intervention needed to demonstrate direct practice improvement. Please note that if you choose a qualitative project, you are still responsible for ensuring practice improvement is demonstrated through your work. Additionally, learners must be able to perform both qualitative and quantitative data analysis. A qualitative project with numbers or descriptive statistics does not mean it is mixed method study. Qualitative data can be displayed using tables, charts, graphs and descriptive statistics. Following are samples for a quantitative project and a qualitative project. A mixed method project, which includes quantitative and qualitative methods, takes much more time and many more resources to complete and
    is not recommended
    unless learners have a significant amount of extra time and resources to complete it.

    For the eighth strategic point, learners develop a purpose statement by integrating the problem statement, methodology, design, sample, and location. Ninth, learners identify the data they will need to collect to address the clinical questions or hypotheses and how they will collect the data (e.g., interviews, focus groups, observations, tested and validated instruments or surveys, databases, public media, etc.). Tenth and last, learners identify the appropriate data analysis, based on their project design, which will be used to answer the clinical questions and address the problem statement.

    Criteria for Evaluating the 10 Strategic Points: Clear, Simple, Correct, and Aligned

    When developing a project, it is important to define the 10 strategic points so they are
    simple
    ,
    clear
    , and
    correct
    in order to ensure that anyone who reviews them will easily understand them. It is important to
    align
    all of the 10 strategic points to ensure it will be possible to conduct and complete the project. The problem statement must come out of the literature or practice problem. The clinical questions must collect the data needed to answer the problem statement. The methodology and design must be appropriate for the problem statement and PICOT questions. The data collection and data analysis must provide the information to answer the PICOT questions.

    Developing the 10 Strategic Points document as a two- or three-page document can help ensure clarity, simplicity, correctness, and alignment of each of these 10 key or strategic points in the prospectus, proposal, and Direct Practice Improvement Project. Developing these 10 strategic points in this format also provides an easy-to-use use template to ensure the 10 strategic points will always be worded the same throughout the prospectus, proposal, and Direct Practice Improvement Project. DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project.

    Value of the 10 Strategic Points Document

    The 10 Strategic Points document can be used for communicating and aligning key stakeholders for the Direct Practice Improvement Project. This document can be used to obtain agreement between the learner and the chair regarding the initial focus and approach for the project. The document can be used to review the proposed project with the people or organizations from whom learners need to gain permission to conduct their research, a critical step required before learners can develop their proposal. The document also proves useful for communicating the Direct Practice Improvement Project focus when attracting a Content Expert, as well as for reviewing the proposal with the Direct Practice Improvement Project committee and the AQR reviewers. Learners may choose to consult methodologists, statisticians, and editors in the process of developing the final manuscript. DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project.

    Examples of the 10 Strategic Points Document

    It is important that the 10 strategic points are clear, concise, doable, and aligned throughout the prospectus, proposal, and Direct Practice Improvement Project. Provided below is an example of a completed 10 Strategic Points document for a quantitative project. A blank 10 Strategic Points Table template is provided following the example for learners to use when developing their own 10 Strategic Point documents.

    Example: 10 Strategic Points Document for a Quantitative Project

    The 10 Strategic Points

    Comments or Feedback

    Broad Topic Area

    1.     
    Broad Topic Area:

    Hint: What would I title my project?

    Literature Review

    2.     
    Literature Review:

    List primary points for four sections in the Literature Review: Background of the problem/gap; theoretical foundations (models and theories to be foundation for study); review of literature topics with key theme for each one; and summary.

    a.     
    Background of the Problem/Gap:

    ·         Rural ambulatory clinics have had to reorganize their management structures to enhance reimbursement.

    ·         Access to appropriate health services for rural Americans needs to be improved in areas where specialists are not available (Schoenberg, 2012).

    ·         Telehealth nursing services can be provided through rural health clinics to support specialty clinics (Schoenberg, 2012).

    ·         Approximately 200 telemedicine networks have been established nationwide. (American Telemedicine Association, 2017)

    b.     
    Theoretical Foundations (models and theories to be foundation for study):

    ·         The Greenhalgh’s Dissemination of Innovations model (Greenhalgh, Robert, Bate, Macfarlane, & Kyriakidau, 2005) can be used to implement rural telehealth services for rural Americans.

    ·         The D&M Information System Success model (DeLone &McLean, 2003) is a framework to conceptualize and operationalize information system success.

    ·         Path constitution theory combines two contrasting perspectives on technology, path dependence, and path creation (Singh, Mathiassen, & Mishra, 2015).

    c.      
    Review of Literature Topics With Key Organizing Concepts or Topics for Each One

    Rural Telehealth Services:

    ·         Rural telehealth can improve care in burn patients (McWilliams, Hendricks, Twigg, Wood, & Giles, 2016); smoking cessation (Carlson, Lounsberry, Maciejewski, Wright, Collacutt, & Taenzer, 2011), psychotherapy (Gonzales & Brossart, 2015);  cancer education (Doorenbos et al., 2011); diabetes (Holloway, Coon, Kersten, & Clemins, 2011).

    Population Specific Telehealth Services:

    ·         Community based telehealth: Home-based telehealth can enhance older adults’ access to care and facilitate patient-provider collaboration which may in turn improve patient self-management (Hsieh, Tsai, Chic, & Lin, 2015).

    ·         Chronically ill: Disease management needs of chronically ill patients include prescription refills, medication and symptom management, lab results, and patient education (Vinson, McCallum, Thornlow, & Champagne, 2011).

    ·         Rural Native American telehealth:  Telehealth can improve health disparities in Native American communities (Kruse, Bouffard, Dougherty, & Parro, 2016).

    ·         Diabetes education and management:  Telehealth education improves glycemic control (Barker, Mallow, Theeke, & Schwertfeger, 2016).

    ·         Mental health emergencies can be managed effectively through telehealth services (Saurman et al., 2011).

    Settings:

    ·         Rural health clinic/hospital (Carlson et al., 2011); Doorenbos et al., 2011; Gonzales & Brossart, 2015; Holloway et al., 2011).

    ·         Home-based (Demiris et al., 2103).

    ·         Community center (Demiris et al., 2103).

    ·         Library (Demiris et al., 2103).

    ·         Smart phone, computer-based (Forchuk et al., 2016).

    Certifications:

    ·         National Committee for Quality Assurance (n.d). Disease Management Accreditation. Retrieved from http://www.ncqa.org/programs/accreditation/disease-management-dm

    ·         American Association of Critical Care Nurses (n.d.). CCRN-E: Certification for Tele-ICU Nurses. Retrieved from https://www.aacn.org/certification?tab=First-Time%20Certification

    ·         Acute stroke ready designation (Slivinski, Johes, Whitehead, & Hooper, 2017).

    Network Systems
    :

    ·         American Telemedicine Association: approximately 200 telemedicine networks have been established nationwide (Frederick, 2013).

    ·         Tablet PC Enabled Body Sensor System: real-time continuous collection of physiological parameters (Panicker, Kumar, 2016).

    d.     
    Summary

    ·         Gap/Problem: There is a need to implement evidence-based methods of improving health outcomes of rural residents through the use of telehealth.

    ·         Prior studies: Prior studies show that telehealth improves patient outcomes in diverse settings, including rural areas. DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    ·         Quantitative application: Sources of data exist to collect numerical data on the rate of follow-up with primary care provider in rural areas.

    ·         Significance: Improving rate of follow-up with primary care provider will improve health outcomes of rural residents.

    DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    Problem Statement

    3.     
    Problem Statement:

    Describe the variables/groups to study, in one sentence.

     

    A well-written problem statement begins with the big picture of the issue (
    macro)
    and works to the small, narrower, and more specific problem (
    micro
    ). It clearly communicates the significance, magnitude, and importance of the problem and transitions into the Purpose of the Project with a declarative statement such as: “It is not known if and to what degree/extent…” or “It is not known how/why and….”

    Other examples are:

    ·         While the literature indicates ____________, it is not known in _________ (organization/community) if __________.

    ·         It is not known how or to what extent ________________.

    While the literature indicates that telehealth is an important emerging technology for rural patient access, it is unknown if the implementation of telehealth impacts the rate of patient follow up for patients living in a rural area. DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    Clinical/

    PICOT Questions

    4.     
    Clinical/PICOT Questions:

    Provide PICOT question to guide the implementation and data collection of findings of the project:

    (P)
    Among adult patients in a rural care setting,
    (I)
    how does implementation of a telehealth program
    (C)
    compare to traditional commute-for-care (
    O)
    impact rate of follow-up with the primary care provider (
    T)
    over a period of four weeks.

    Sample

    5.     
    Sample (and Location):

    Identify sample, needed sample size, and location (study phenomena with small numbers and variables/groups with large numbers).

    a.       Location: Arizona

    b.      Population: Two neighboring rural towns equal distance from the nearest primary care provider.

    c.       Sample: 40 participants include a power analysis if appropriate. DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    Define Variables

    6.     
    Define Variables:

    a.      
    Independent Variable:
    Telehealth program.

    b.     
    Dependent Variable:
    Follow-up rate with primary care provider.

    Methodology  and Design

    7.     
    Methodology and Design:

    Name the selected methodology and specific design to address the problem statement and clinical questions:

    This project will use a quantitative methodology with a quasi-experimental design.

    Purpose Statement

    8.     
    Purpose Statement:

    Provide one sentence statement of purpose including the problem statement, sample, methodology, and design:

    Creswell (2003) provided some sample templates for developing purpose statements aligned with the different project methods as follows:

    The purpose of this
    quantitative
    ___________ (correlational, descriptive, etc.) project is to ____________ (compare or see to what degree a relationship exists) between/among ______________________ (independent variable) to ___________________ (dependent variable) for ________________ (participants) at ___________________ (project site/geographical location). The ________ (independent variable) will be defined/measured as/by _______ (provide a general definition). The
                                     
     (dependent variable) will be defined/measured as/by ______ (provide a general definition).

     

     

    Data Collection Approach

    9.     
    Data Collection Approach:

    Describe primary instruments that will be used to answer clinical question.

    Data Analysis Approach

    10. 
    Data Analysis Approach:

    Descriptive statistics will describe the sample characteristics and variable results. An independent t-tests will test for difference between the two groups of 40 participants (telehealth and commute-for-care) follow-up with primary physician. A priori analysis will be used to justify the sample size.

     

     

    10 Strategic Points Table

    (Use this table to complete the 10 Strategic Points document for your project.)

    10 Strategic Points

    Comments/Feedback

    Broad Topic Area

    Literature Review

    DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

    Problem Statement

    Clinical/PICO Questions

    Sample

    Define Variables

    Methodology  and Design

    Purpose Statement

     

     

    Data Collection Approach

    Data Analysis Approach

     

    DNP 820 – 10 Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

  • Assignment 1: Assessing The Genitalia And Rectum

    Assignment 1: Assessing The Genitalia And Rectum

    Patients are frequently uncomfortable discussing with health care professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.

    In this assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

    BUY A PLAGIARISM-FREE PAPER HERE

    In this assignment, you will analyze a SOAP note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. Assignment 1: Assessing The Genitalia And Rectum

    GENITALIA ASSESSMENT

    Subjective:

    CC: “I have bumps on my bottom that I want to have checked out.”

    HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed. Assignment 1: Assessing The Genitalia And Rectum.

    PMH: Asthma

    Medications: Symbicort 160/4.5mcg

    Allergies: NKDA

    FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

    Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

    Objective:

    VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs

    Heart: RRR, no murmurs

    Lungs: CTA, chest wall symmetrical

    Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact with a healed episiotomy scar present. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia

    Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

    Diagnostics: HSV specimen obtained

    Assessment:

    Chancre

    PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses. Assignment 1: Assessing The Genitalia And Rectum

    To prepare:

    With regard to the SOAP note case study provided:

    Review this week’s Learning Resources, and consider the insights they provide about the case study.

    Consider what history would be necessary to collect from the patient in the case study.

    Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

    Identify 
    at least five
     possible conditions that may be considered in a differential diagnosis for the patient.

    To complete:

    Refer to Chapter 5 of the Sullivan text. Analyze the SOAP note case study.  Using evidence based resources, answer the following questions and support your answers using current evidence from the literature.

    Analyze the subjective portion of the note. List additional information that should be included in the documentation.

    Analyze the objective portion of the note. List additional information that should be included in the documentation.

    Is the assessment supported by the subjective and objective information? Why or Why not?

    Would diagnostics be appropriate for this case and how would the results be used to make a diagnosis?

    Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Assignment 1: Assessing The Genitalia And Rectum. Explain your reasoning using at least 3 different references from current evidence based literature.

    CALSS RESOURCES

    Learning Resources

    Note:

    To access this week’s required library resources, please click on the link to the Course Readings List, found in the

    Course Materials

    section of your Syllabus.

    Required Readings

    Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015).
    Seidel’s guide to physical examination
    (8th ed.). St. Louis, MO: Elsevier Mosby.

    Chapter 16, “Breasts and Axillae” (pp. 350-369)

    This chapter focuses on examining the breasts and axillae. The authors describe the examination procedures and the anatomy and physiology of breasts.

    Chapter 18, “Female Genitalia” (pp. 416-465)

    In this chapter, the authors explain how to conduct an examination of female genitalia. The chapter also describes the form and function of female genitalia Assignment 1: Assessing The Genitalia And Rectum.

    Chapter 19, “Male Genitalia” (pp. 466-484)

    The authors explain the biology of the penis, testicles, epididymides, scrotum, prostate gland, and seminal vesicles. Additionally, the chapter explains how to perform an exam of these areas.

    Chapter 20, “Anus, Rectum, and Prostate” (pp. 485-500)

    This chapter focuses on performing an exam of the anus, rectum, and prostate. The authors also explain the anatomy and physiology of the anus, rectum, and prostate.

    Dains, J. E., Baumann, L. C., & Scheibel, P. (2016).
    Advanced health assessment and clinical diagnosis in primary care
    (5th ed.). St. Louis, MO: Elsevier Mosby.

    Chapter 5, “Amenorrhea” (pp. 47-60)

    Amenorrhea, or the absence of menstruation, is the focus of this chapter. The authors include key questions to ask patients when taking histories and explain what to look for in the physical exam.

    Chapter 6, “Breast Lumps and Nipple Discharge” (pp. 61-72)

    This chapter focuses on the important topic of breast lumps and nipple discharge. Because breast cancer is the most common type of cancer in women, it is important to get an accurate diagnosis. Information in the chapter includes key questions to ask and what to look for in the physical exam Assignment 1: Assessing The Genitalia And Rectum.

    Chapter 7, “Breast Pain” (pp. 73-80)

    Determining the cause of breast pain can be difficult. This chapter examines how to determine the likely cause of the pain through diagnostic tests, physical examination, and careful analysis of a patient’s health history.

    Chapter 27, “Penile Discharge” (pp. 318-324)

    The focus of this chapter is on how to diagnose the causes of penile discharge. The authors include specific questions to ask when gathering a patient’s history to narrow down the likely diagnosis. They also give advice on performing a focused physical exam.

    Chapter 36, “Vaginal Bleeding” (pp. 419-433)

    In this chapter, the causes of vaginal bleeding are explored. The authors focus on symptoms outside the regular menstrual cycle. The authors discuss key questions to ask the patient, as well as specific physical examination procedures and laboratory studies that may be useful in reaching a diagnosis.

    Chapter 37, “Vaginal Discharge and Itching” (pp. 434-445)

    This chapter examines the process of identifying causes of vaginal discharge and itching. The authors include questions on the characteristics of the discharge, the possibility of the issues being the result of a sexually transmitted infection, and how often the discharge occurs. A chart highlights potential diagnoses based on patient history, physical findings, and diagnostic studies. Assignment 1: Assessing The Genitalia And Rectum.

    Sullivan, D. D. (2012).
    Guide to clinical documentation
    (2nd ed.). Philadelphia, PA: F. A. Davis.

    Chapter 3, “Adult Preventative Care Visits” (“Gender Specific Screenings”; pp. 48–49)
    Note:
    Download the Physical Examination Objective Data Checklist to use as you complete the Head-to-Toe Physical Assessment Video assignment.

    Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical examination objective data checklist. In
    Mosby’s guide to physical examination
    (7th ed.). St. Louis, MO: Elsevier Mosby.

    This Physical Examination Objective Data Checklist was published as a companion to
    Seidel’s guide to physical examination
    (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

    Cucci, E. Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G. (2015). Sclerosing adenosis of the breast: Report of two cases and review of the literature. Polish Journal of Radiology, 80, 122–127. doi:10.12659/PJR.892706. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/ 

    Sabbagh, C., Mauvis, F., Vecten, A., Ainseba, N., Cosse, C., Diouf, M., & Regimbeau, J. M. (2014). What is the best position for analyzing the lower and middle rectum and sphincter function in a digital rectal examination? A randomized, controlled study in men. Digestive and Liver Disease, 46(12), 1082–1085. doi:10.1016/j.dld.2014.08.045

    Retrieved from the Walden Library Databases. Assignment 1: Assessing The Genitalia And Rectum

    Westhoff, C. L., Jones, H. E., & Guiahi, M. (2011). Do new guidelines and technology make the routine pelvic examination obsolete?
    Journal of Women’s Health, 20
    (1), 5–10.

    Retrieved from the Walden Library databases.

    This article describes the benefits of new technology and guidelines for pelvic exams. The authors also detail which guidelines and technology may become obsolete.

    Centers for Disease Control and Prevention. (2012).
    Sexually transmitted diseases (STDs)
    . Retrieved from http://www.cdc.gov/std/#

    This section of the CDC website provides a range of information on sexually transmitted diseases (STDs). The website includes reports on STDs, related projects and initiatives, treatment information, and program tools.

    University of Virginia. (n.d.).
    Introduction to radiology: An online interactive tutorial
    . Retrieved from http://www.med-ed.virginia.edu/courses/rad/index.html

    This website provides an introduction to radiology and imaging. For this week, focus on genitourinary radiology, as well as the cross-sectional female pelvis and the cross-sectional male pelvis in abdominal radiology.

    Required Media

    Online media for
    Seidel’s Guide to Physical Examination

    It is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 16 and 18–20 that relate to special examinations, including breast, genital, prostate, and rectal. Refer to the Week 4 Learning Resources area for access instructions on https://evolve.elsevier.com/.

    Optional Resources

    LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014).
    DeGowin’s diagnostic examination
    (10th ed.). New York, NY: McGraw Hill Medical.

    Chapter 8, “The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts” (Section 2, “The Breasts,” pp. 434–444)

    Section 2 of this chapter focuses on the anatomy and physiology of breasts. The section provides descriptions of breast examinations and common breast conditions. Assignment 1: Assessing The Genitalia And Rectum

    Chapter 11, “The Female Genitalia and Reproductive System” (pp. 541–562)

    In this chapter, the authors provide an overview of the female reproductive system. The authors also describe symptoms of disorders in the reproductive system.

    Chapter 12, “The Male Genitalia and Reproductive System” (pp. 563–584)

    The authors of this chapter detail the anatomy of the male reproductive system. Additionally, the authors describe how to conduct an exam of the male reproductive system.

    Review of Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid” (pp. 445–527) Assignment 1: Assessing The Genitalia And Rectum