Tag: Clinical-Nursing

Abortion Essay – NURS 6551 wk 1 discussion

Abortion

Abortion is defined as the termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus (Merriam-Webster, 2018). Abortion remains a highly debated subject in the U.S. and worldwide with strong opposing arguments about women’s right to choose versus fetal claim to life (McCurdy, 2016). Social, ethical, and legal factors relating to abortion vary greatly between states, countries, historical times, and social and religious groups (Marecek, Macleod, & Hoggart, 2017). Abortion Essay – NURS 6551 wk 1 discussion.

Legal and Political Factors

In 1973 the U.S. supreme court granted women the legal right to abortion after the case of Roe vs. Wade (Lopez, 2012), yet sentiment regarding abortion remains evenly split among the general population in the U.S. (McCurdy, 2016). Legal access to abortion varies greatly within the U.S. and across regions of the world. The Center for Reproductive Rights has grouped countries into 4 categories from “most restrictive”, where abortion is prohibited altogether or permitted only to save a woman’s life, to “least restrictive”, where there are no restrictions as to the reason for terminating a pregnancy (Marecek, Macleod, & Hoggart, 2017). Yet in many places the legality of abortion and the actual practice of it are not aligned, for example in Sri Lanka abortions are permitted only to preserve the life of the mother, but induced abortions are very common and it is estimated that nearly 45% of such abortions are carried out by qualified physicians; Another example is New Zealand where abortion is actually criminalized, yet women have good access to it (Marecek, Macleod, & Hoggart, 2017). Abortion Essay – NURS 6551 wk 1 discussion.

The issue of abortion and the right to choose vs. the fetal right to life is a very emotionally charged subject, and different political leaders and candidates use this subject to draw political support.

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Social Cultural and Religious Views

In the U.S., many pro-life or right-to-life advocates oppose women’s right to abortion; they use terms such as murder to express their deep feelings on the topic. The Catholic church and the Christian church are against abortion under any circumstance as well (Lopez, 2012). The church’s argument is that all life is sacred, and abortion terminates life; therefore, this idea must be rejected (Lopez, 2012). Other religions have less strict views on the topic; Islam is not clearly with or against abortion, and Judaism as well (ProCon.org, 2011).

 

Personal Perspectives

Prejudice is both an attitude and a cognitive process, the outcome of which is the practice of discrimination (Guilfoyle, Kelly, & St Pierre-Hansen, 2008). The issue of abortion carries deep sentiments and if the health care provider holds a belief or a value regarding the subject, it is easy to see how he or she can practice discrimination against his clients based on his or her beliefs and prejudices whether consciously or even unconsciously. As health care providers it is very important that we set our own values aside when caring for patients with different beliefs than our own. This may be very stressful and challenging, especially if the provider entered the field of health care based on those same values and beliefs that drive and motivate them. Abortion Essay – NURS 6551 wk 1 discussion.

We frequently deal with ethical dilemma in health care, it is crucial that we are aware of our own beliefs and prejudices, as well as our clients’, and furnish care that is ethical, unbiased, of the highest quality, and within our legal scope of practice.

 

 

References

Lopez, R. (2012). Perspectives on Abortion: Pro-Choice, Pro-Life, and What Lies in between.

European Journal of Social Sciences.

 

Marecek, J., Macleod, C., & Hoggart, L. (2017). Abortion in legal, social, and healthcare contexts.

Feminism & Psychology.
Retrieved from             http://journals.sagepub.com/doi/full/10.1177/0959353516689521

 

McCurdy, S. A. (2016). Abortion and public health: Time for another look.
The Linacre Quarterly.

           
83(1), 20-25. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102173/ Abortion Essay – NURS 6551 wk 1 discussion

 

Merriam-Webster. (2018). Definition of Abortion. Retrieved from https://www.merriam-

webster.com/dictionary/abortion

 

ProCon.org. (2011). US Religious Views on Abortion. Retrieved from

https://abortion.procon.org/view.resource.php?resourceID=004208

 

 

Discussion: Political, Social, and Sociocultural Influences on Women’s Health

As an advanced practice nurse, you must remain current on health issues that commonly impact women such as birth control, abortion, family planning, the human papillomavirus (HPV) vaccine, and human immunodeficiency virus (HIV). Many of these women’s health issues are heavily influenced by political, social, and sociocultural factors. These influences might not only affect a woman’s ability or desire to receive care, but also a provider’s ability or willingness to offer care. How might political, social, and sociocultural factors influence your personal perceptions of these women’s health issues? Abortion Essay – NURS 6551 wk 1 discussion

To prepare:

·        Review this week’s media presentation, as well as Chapter 1 of the Schuiling and Likis text.

·        Select and research one of the following women’s health issues: birth control, abortion, family planning, human papillomavirus (HPV) vaccine, human immunodeficiency virus (HIV) in women, or another issue approved by the course Instructor.

·        Consider the impact of political, social, and sociocultural factors on the women’s health issue you selected.

·        Reflect on how the personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue. Abortion Essay – NURS 6551 wk 1 discussion.

Post
 at least 250 words APA format (no introduction or conclusion)

1.     pick on subject from above

2.     explain the political impact of this women’s health issue,

3.     social factors of this women’s health issue

4.     sociocultural factors on this women’s health issue

5.     Explain how personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue. Abortion Essay – NURS 6551 wk 1 discussion

NURS 4005/4006 Week 5 Assignment: Dashboard Analysis and Nursing Plan Essay

Dashboard Analysis and Nursing Plan

 
In order for health care facilities to enhance and improve the care they deliver to their patients, they rely on data collected within their facility and from surveys sent out to patients. The information collected is formatted into a quarterly dashboard where goals are set for each quality indicator and then interpreted if the facility met those goals. Through the use of dashboards and quality indicators proactive decisions can be made based on actual events occurring, rather than changing the plan of care based on assumptions. The dashboard is effective in determining particular areas in which improvements would be beneficial to not only the care of the patient but the overall morale of the health care facility. The dashboard is also helpful in strategic planning, where the assessment of performance can be undertaken (Tomlinson, Hewitt, & Blackshaw, 2013). The overall objective of this paper is to analyze areas where the facility excels, and determining a plan of action to improve negative performance by utilizing evidenced based practice. NURS 4005/4006 Week 5 Assignment: Dashboard Analysis and Nursing Plan Essay.

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After carefully analyzing the data presented in this week’s dashboard, communication between the nurses and the patients excels. Nurses develop a good rapport with the majority of their patients and give thorough explanations of the care provided. However, their promptness and attention to detail needs to be an area addressed to improve patient outcomes. Thus, could also be the result of negative data reflected on the dashboard that represents patient safety measures such as falls, pressure ulcers, mislabeled specimens and uncontrolled pain. Patient safety is crucial in the plan of care and if not carefully addressed could lead to adverse events and outcomes.

Paying attention to details is important for avoiding errors, maintaining efficiency, preventing injuries, making a good impression and analyzing information. Attention to detail improves accuracy in performing tasks. Preventing errors is valuable when providing care to all patients. Careful management of details contributes to overall efficiency and success in the healthcare facility. Reducing errors also contributes to patient satisfaction. By developing a nurse-patient relationship you are able to address needs and concerns of the patient, as well as pick up on detail-oriented cues that will need implemented for each individual patient in order to maintain a balance of trust and communication during the patients stay.

Attention of detail leads to patient safety. Patient safety throughout the hospital should be developed by the leadership. Leadership assumes a role in establishing a culture of safety that minimizes hazards and patient harm by focusing on processes of care. The leaders of the organization are responsible for fostering an environment through their personal example; emphasizing patient safety as an organizational priority; providing education to medical and hospital staff regarding the commitment to reduction of medical errors; supporting proactive reduction in medical/health care errors; and integrating patient safety priorities into the new design and redesign of all relevant organization processes, functions and services (IHI, 2017).

There are many quality indicators that fall into the category of patient safety such as:  medication errors or adverse events, pressure ulcers, falls, restraint use, nosocomial infections, VTE, etc. Various tools can be set in place to ensure adequate monitoring of these areas to protect the patients and the facility. Conducting a thorough head-to-toe physical examination on admission is a high priority. Patients come into the hospital and we treat their presenting symptoms, however many times there may be an underlining problem that needs addressed to ensure an optimal outcome and patient experience. A full physical assessment gives you a thorough picture of the patient’s condition.

Best practice would be to conduct a fall risk assessment and a skin risk assessment on each patient every shift or as needed if there has been a change in the patient’s condition. With a fall risk assessment, it can determine what interventions need put in place to ensure patients are free from physical injury while in our care. The fall risk assessment we use at our facility is similar to the one presented by John Hopkins, called the JHFRAT (Hopkins Medicine, 2017). The fall risk assessment tool addresses various patient safety indicators such as: age, history of falls within 6 months, elimination of bowel and bladder (incontinence, urgency or frequency), medications (PCA/opiates, anticonvulsants, antihypertensive, diuretics, hypnotics, laxatives, sedatives, psychotropic, etc.), use of patient care equipment (IV infusion, chest tube, indwelling catheter, SCDs, etc.), mobility (unsteady gait or needs assistance), sensations (decrease in hearing, vision, etc.), and cognition (impulsive behavior, sedation, or altered mental status). If the patient scores greater than 6 then they are required to wear fall risk socks, fall risk bracelet, and bed/chair alarms are put in place. This is a great tool as we can reassess it multiple times throughout the day to ensure the safety of the patient and decrease the rate of falls on our dashboard to improve quality indicators. It also shows the patients that we are concerned for their safety and are putting all measures of safety in place to ensure a positive outcome.

Another best practice tool we can utilize would be the skin risk assessment to prevent and manage pressure ulcers. The Braden Scale for predicting pressure sore risk is a clinically validated tool that allows nurses and other health care providers to reliably score a patient/client’s level of risk for developing pressure ulcers. It measures functional capabilities of the patient that contribute to either higher intensity and duration of pressure or lower tissue tolerance for pressure. Lower levels of functioning indicate higher levels of risk for pressure ulcer development (NLM, 2013). The Braden Scale uses various categories to determine the patient’s skin risk such as: sensory perception (ability to respond meaningfully to pressure-related discomfort), moisture (degree to which skin is exposed to moisture), physical activity (degree of physical activity), mobility (ability to change and control body positions), nutrition (usual food intake pattern), and friction and shear risk. NURS 4005/4006 Week 5 Assignment: Dashboard Analysis and Nursing Plan Essay. A score of 18 or below alerts the nurse that the patient may be at risk for pressure areas, a score 9 or less determines that the patient is high risk. Interventions should be put in place to prevent pressure ulcers for at risk patients. The nurses should be required to inspect patients skin each shift, manage moisture on the skin, conduct a skin risk assessment each shift or as needed if there is a change in the patient’s condition, minimize pressure to bony prominence by reposition patient every 1-2 hours, increasing nutrition intake and hydration (if the patient is unable to consume these orally then intravenous methods need to be implemented). By completing each of these steps for all patients it will prevent secondary diagnosis and prolonging of patient stay. Maintaining skin integrity will increase the patient’s outcome and satisfaction. NURS 4005/4006 Week 5 Assignment: Dashboard Analysis and Nursing Plan Essay.

Through the use of quality indicators and data collection we have the ability to improve our patient satisfaction and the care we deliver on a daily basis. By utilizing best practices to maintain patient safety and recognizing the needs and concerns of our patients we can achieve high standards. We must realize though that perfect scores across the dashboard is unrealistic. Health care and evidenced-based practices are always changes and the care we are providing is becoming more acute. By continuing our education and having our patient’s safety as our number one priority we will continue to excel in the health care continuum. NURS 4005/4006 Week 5 Assignment: Dashboard Analysis and Nursing Plan Essay

 

References

Tomlinson, P., Hewitt, S., & Blackshaw, N. (2013). Joining up health and planning: How Joint Strategic Needs Assessment (JSNA) can inform health and wellbeing strategies and spatial planning. Perspectives In Public Health, 133(5), 254-262. Retrieved from:
http://dx.doi.org/10.1177/1757913913488331

Institute for Healthcare Improvement. (2017). Patient Safety Plan. St. Francis Health System: St. Joseph Medical Center. Bloomington, Illinois. Retrieved from:
http://www.ihi.org/resources/Pages/Tools/PatientSafetyPlan.aspx

Hopkins Medicine. (2017). Fall Risk Assessment: JHFRAT. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. Retrieved from:
http://www.hopkinsmedicine.org/institute_nursing/models_tools/fall_risk.html

National Library of Medication. (2013). Braden Scale. National Institutes of Health, Health & Human Services. Retrieved from:
https://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/LNC_BRADEN/
  NURS 4005/4006 Week 5 Assignment: Dashboard Analysis and Nursing Plan Essay

Nurs 6551 Abortion discussion Essay

To prepare:

Review this week’s media presentation, as well as Chapter 1 of the Schuiling and Likis text.

Select and research one of the following women’s health issues: birth control, abortion, family planning, human papillomavirus (HPV) vaccine, human immunodeficiency virus (HIV) in women, or another issue approved by the course Instructor.

Consider the impact of political, social, and sociocultural factors on the women’s health issue you selected.

Reflect on how the personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue. Nurs 6551 Abortion discussion Essay.

By Day 3

Post
an explanation of the women’s health issue you selected, including the impact of political, social, and sociocultural factors on this issue. Explain how personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.Nurs 6551 Abortion discussion Essay.

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Abortion

Abortion is something that is talked about a lot in today’s society. The decision to keep or terminate a pregnancy is a dilemma that young women face today when an unplanned pregnancy occurs. More and more people are viewing abortion as something that is okay. There was a total of 638,169 abortions reported to the Centers for Disease Control and Prevention from 49 reportable areas, these areas exclude California, Maryland, and New Hampshire (Centers for Disease Control and Prevention, 2018). From 2014 to 2015 there was a 2% decrease in the number of reported abortions (Centers for Disease Control and Prevention, 2018).

Political, Social, and Sociocultural Factors Impact Abortion

Political:
Politics’ has the ability to impact abortion rates significantly. Since Roe vs. Wade abortion has been a very heated political subject particularly between the left and right political parties in America.  This issue has been further polarized with some state senate’s trying to ban abortion while others try to expand its use.  An example of this would be the Reproduction Health Act that was passed in New York or the Heartbeat Bill passed in Ohio. The Reproduction Health Act that became affected as of January 22, 2019, allows for abortion to be legal within the first 24 week or after the first 24 weeks if it is to preserve the mother’s health or if the fetus isn’t viable (Find Law, 2019). It makes it where providers acting in good faith cannot be penalized (Find Law, 2019). In Ohio the House Bill 258 (Heartbeat Bill) prohibit an abortion of unborn child if a heartbeat is detected (Ohio Legislature, 2019) Nurs 6551 Abortion discussion Essay. Political polarization in America has caused the topic of abortion to be stigmatized or destigmatized, depending on the political faction one falls in.

Social:
Social opinion is well verbalized regarding abortion today. It is not uncommon for women to talk about abortion openly. There is even activist known as a pro-choice activist that verbalize that abortion is okay. Pro-choice activist strongly believe reproductive rights are human rights and that reproductive health care options including birth control and abortion care should be affordable (NARAL Pro-Choice America, n.d.). This is something that would not have been socially accepted years ago.

Sociocultural:
Women that experience the dilemma on whether they should or shouldn’t abort their child are subject to sociocultural and economic barriers that tend to limit their autonomy and places vulnerable pressure that influences or forces their decision on abortion (Frederico, Michielsen, Arnaldo, & Decat, 2018) Nurs 6551 Abortion discussion Essay.

                                                  Personal Perception of Providers regarding Abortion              

Personal perception should not play a role in providers ability or willingness to provide abortions. If a provider chooses to work at a facility that performs abortion, they should be willing to perform an abortion due to the code of ethics on autonomy. Autonomy allows patients to make their own decision without judgment or coercion from the person caring for them (Registered Nursing, n.d.). If the provider is not willing to participate in this activity, they need to ensure the place they become employed is against abortion practice. As healthcare professional it is not our job to judge the patient, it is just our job to care for a patient and respect their wishes. Nurs 6551 Abortion discussion Essay

Reference

Centers for Disease Control and Prevention. (2018, November 23). Abortion surveillance – United States, 2015. Retrieved February 22, 2019, from
https://www.cdc.gov/mmwr/volumes/67/ss/ss6713a1.htm

Find Law. (2019). New York abortion laws. Retrieved February 24, 2019, from
https://statelaws.findlaw.com/new-york-law/new-york-abortion-laws.html

Frederico, M., Michielsen, K., Arnaldo, C., & Decat, P. (2018). Factors influencing abortion decision-making processes among young women.
International journal of environmental research and public health, 15
(2), 329. doi: 10.3390/ijerph15020329

NARAL Pro-Choice America. (n.d.). Reproduction rights are human rights. Retrieved February 24, 2019, from
https://www.prochoiceamerica.org/

Ohio Legislature. (2019). House bill 258. Retrieved February 24, 2019, from
https://www.legislature.ohio.gov/legislation/legislation-summary?id=GA132-HB-258

Registered Nursing. (n.d.) Ethical practice: NCLEX-RN. Retrieved February 24, 2019, from
https://www.registerednursing.org/nclex/ethical-practice/
 Nurs 6551 Abortion discussion Essay

Health Delivery System Competencies Reflection Sample essays

Week 8: ReflectionReflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #4, the MSN Essential IV, and the Nurse Practitioner Core Competencies # 7.

Program Outcome #4
:  Integrate professional values through scholarship and service in health care. (Professional identity)

MSN Essential IV:
Translating and Integrating Scholarship into Practice Recognize that the master’s-prepared nurse applies research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results.

Nurse Practitioner Core Competencies # 7

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Health Delivery System Competencies

Applies knowledge of organizational practices and complex systems to improve health care delivery.

Effects health care change using broad based skills including negotiating, consensus-building, and

partnering.

Minimizes risk to patients and providers at the individual and systems level.

Facilitates the development of health care systems that address the needs of culturally diverse

Health Delivery System Competencies Reflection Sample essays

populations, providers, and other stakeholders.

Evaluates the impact of health care delivery on patients, providers, other stakeholders, and the

environment.

Analyzes organizational structure, functions and resources to improve the delivery of care.

Collaborates in planning for transitions across the continuum of care.

In the past seven weeks, this course has taught me important concepts that enhance my understanding in the health promotion of numerous conditions affecting the primary care setting. We learned to optimize one’s health through disease prevention and treatment implementation for neurological issues, pulmonary conditions, cardiovascular and hematological problems, mental health, and inflammatory disorders. This course has helped me achieve the master’s program outcome number four, the Master’s Essential IV, and the Nurse Practitioner Core Competency number seven competency. Health Delivery System Competencies Reflection Sample essays

 

Master’s Program Outcome #4:
Integrating professional values via scholarship and the provision of service in healthcare

 

In this course, we achieved the program’s outcome of professional identity by analyzing how primary care practice is organized and influenced by ethical, legal, economic, and political factors (Chamberlain University, 2019). Through evaluation of clinical cases and research, I was able to integrate professional values and thus, develop professional identity as a family nurse practitioner (FNP). The professional core values of a nurse practitioner was not only learned in theory, but implemented in practice as well. Integrating the professional core values of compassion, trustworthiness, and  accountability in clinical practice helped further my development of professionalism and my identity as a FNP. One instance in which I had exposure to this outcome was during my clinical rotation when I addressed a young female with bulimia nervosa disorder. It was evident that she was extremely anxious and expressed concern about her body image and eating habits. It was important to allow her to openly communicate about her emotions. While it was difficult to address all of her concerns in a time-constraint environment, I did the best I could to provide compassion and give her ample time to talk and ask questions about her treatment plan. Developing the trust and respect between myself and the patient was critical in optimizing her health outcome. Another instance that helped achieve this particular outcome was in the implementation of treatment plans for patients who struggled to obtain proper services in healthcare. During my clinical rotations, I had a patient who had multiple comorbidities and came in with a chief complaint of constipation. Through imaging, she was found to have bile duct cancer and had issues getting an initial evaluation appointment with an oncologist. Instead of placing another referral that would take a significant amount of time to address the patient’s issue, we placed a call to an oncologist colleague to expedite the care and accommodate for the patient. Furthermore, she was also counseled and supported with financial resources.

 

Master’s Essential IV:
Transforming and incorporating scholarship into practice

 

The Master’s Essential IV of transforming and incorporating scholarship into practice was also met during this course through interdisciplinary team participation, application of research outcomes within the primary care setting, dissemination of research results, and utilization of practice guidelines to improve health outcomes (American Association of Colleges of Nursing [AACN], 2011). This particular master’s essential was heavily emphasized throughout this course by using reliable sources of information, applying national guidelines, and integrating clinical judgment and perspectives of other professionals for treatment plans of various illnesses (AACN, 2011). For example, we applied different evidence-based clinical guidelines to help formulate treatment plans for patients in the weekly discussion posts. Case studies of different illnesses, such as pulmonary, cardiovascular, and mental health disorders, during week 2 and 3 were heavily discussed and supported with the latest recommendations of scholarly research, as well as national treatment guidelines from healthcare associations and governmental agencies, including the American Heart Association, the Centers for Disease Control and Prevention, and the American Psychological Association. Applying these practice guidelines to improve practice fulfilled incorporating scholarship into the primary care practice. This master’s essential was also fulfilled in a second example during week 6 where we were assigned mental health disorder case studies to present. Various mental health disorders were discussed and supported by reliable sources and each peer took on a leadership position to facilitate the discussion throughout the week. As leader of an assigned topic, I responded to peers and demonstrated my knowledge of the mental health disorder through discussion of hallmark symptoms, diagnostic tools, and treatment plans while acknowledging results and conclusions of others. This example fulfilled knowledge and research dissemination to enhance health outcomes for each case study patient and incorporate scholarship into clinical practice.

 

Nurse Practitioner Core Competency #7:
Health Delivery System Competencies

 

Lastly, the nurse practitioner core competency #7, which was established by the National Organization of Nurse Practitioner Faculties (NONPF), focuses on the competencies related to health delivery systems. This competency involves the application of knowledge generated from organizational practices, the support of healthcare needs of culturally diverse populations, the impact of healthcare change, the organizational structure of the healthcare system, and the collaboration in the continuity of care (NONPF, 2017). This competency was achieved in the clinical rotation by supporting continuity of care and incorporating cultural competence in the primary care office. For example, I saw an elderly male patient in the clinical rotation with complaints of hematuria intermittently for the past three weeks. The patient had not established care with a primary care provider in many years. We obtained a urine sample, which showed frank blood. The patient required a higher level of care and was subsequently referred to the nearest ER. We were able to call the facility and give report to the receiving physician. The patient was then evaluated emergently. This example demonstrated the process of collaborating and planning for transitions across the healthcare continuum. Health Delivery System Competencies Reflection Sample essays. The second example of achieving this competency deals with cultural competence in healthcare. In the clinical rotation, I saw a young Hispanic female patient who had depression and an eating disorder. Her mother had brought her into the office, but they both primarily spoke Spanish. The office generally does not have a high Hispanic population, but we had interpreter services to help facilitate the visitation. We were able to utilize the interpreter services to help formulate a treatment plan for the patient, as well as discuss her emotions with her mother. The goal of culturally competent healthcare care services is to provide the highest quality of care to every patient, regardless of race, ethnicity, cultural background, and English proficiency. Both the patient and her mother were very appreciative for taking the time to address their concerns. This example demonstrated support of healthcare needs of culturally diverse populations. Therefore, the accomplishment of outcomes in this course helped me prepare to meet the program’s outcome number four, the master’s Essential IV, and the NONPF competency number seven. Health Delivery System Competencies Reflection Sample essays.

References

American Association of Colleges of Nursing. (2011). The essentials of master’s education in nursing
.
Retrieved from http://www.aacnnursing.org/Portals/42/Publications/MastersEssentials11.pdf

Chamberlain University. (2019). Academic catalog 2019-2020
.
Retrieved from https://www.chamberlain.edu/docs/default-source/academics-admissions/catalog.pdf

National Organization of Nurse Practitioner Faculties. (2017). Nurse practitioner core competencies content
.
Retrieved from Health Delivery System Competencies Reflection Sample essayshttps://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/2017_NPCoreComps_with_Curric.pdf

 
After reflecting over the course of Advanced Clinical Diagnosis and Practice Across the Lifespan, the student identified achievements of the course outcomes.  This course had a few specific areas that the student reflected on that assisted her in preparing for the Master of Science program outcome #4, the Master of Science in Nursing (MSN) Essential IV, and the Nurse Practitioner Core Competency #7.

The professional outcome #4 is to “Integrate professional values through scholarship and service in health care.”  This outcome was achieved by taking the week 4 APEA predictor exam.  As the student studied for the exam, she identified several areas of improvement. Health Delivery System Competencies Reflection Sample essays  By reviewing a wide knowledge base of concepts seen in the primary care setting the student was to identify her areas of strengths and weaknesses.  The test was broken down into categories and assisted the student to find her professional identity.  Another way the student found her professional identity was through clinicals.  The preceptor pushed autonomy and let the student formulate the treatment plan while she would offer suggestions and advice.  The student realized that in a few short months that she would be in practice with varying levels of guidance depending on job location. The student identified her professional identity in the clinic which will aide her in her next rotation and future practice.

The MSN Essential IV is “Translating and integrating scholarship into practice recognize that the master’s prepared nurse applies research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results.” Health Delivery System Competencies Reflection Sample essays.  Over the course, the student achieved the MSN Essential IV by discussion in week 6 mental health presentation and in the clinical setting.  The student is accustomed to seeing a lot of mental health patients but sometimes has difficulty categorizing the present illness.  The week 6 presentation allowed each student to formulate a patient scenario with a diagnosis provided by the instructor.  The student saw how mental illness was related, but also how it differed form patient to patient.  This assignment assisted the student in identifying patient’s chief complaints, differentiate from different ailments, educate and act as a change agent, and evaluate results over time.  In the clinical setting, the student was able to educate teens about IUDs.  The NP she followed at the FQHC would insert IUDs that lasted for 5 years for $20.  Many teenage girls would come to the clinic and admit to being sexually active without the use of protection or teenagers that already had a few kids would come in asking for birth control options.  The student felt as if she was able to minimize teenage pregnancy or unwanted pregnancies by providing patients with the appropriate knowledge and offer an affordable pregnancy prevention method. Health Delivery System Competencies Reflection Sample essays.

The Nurse Practitioner Core Competency #7 is geared towards Health Delivery System Competencies.  In the course, the students were exposed to case studies, expected to formulate case studies, and created diagnoses based upon case studies other students provided.  The different levels and dynamics of the case studies opened up opportunities for the student to review articles, clinical practice guidelines, and the most up-to-date information for each disease process.  Real-life scenarios allowed the student to apply practice knowledge to complex systems and improve healthcare outcomes.  In the clinic setting, the student had many Hispanic patients who were Spanish speaking only.  This opened up a concept of culturally diverse patients and populations.  The student learned that diabetes is common amongst the Hispanic race related to their culturally diverse diet and heritage.  The student incorporated a sliding scale pay plan to make it affordable for the patients, utilized an on-site translator, and reviewed costs of medications to ensure the patient would pick up the prescription and adhere to the treatment plan.  The FQHC clinic allowed for the student to identify the organizational structure, function, and resources available for these types of low socioeconomic patient classes. Health Delivery System Competencies Reflection Sample essays

Thank you,

Therapeutic assessment interview

Identify an older adult age 65 +, use a 1st and last initial. Execute a therapeutic assessment interview with them for at least two interview sessions assessing their self-identified:

·  Demographics, life time education and career/employment

·  Two most significant (positive) times in their lives

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·  What past hardship or loss has the client successfully negotiated in the past?

·  Two personal strengths Therapeutic assessment interview

·  Engage them in identifying what is healthy versus non-healthy coping skills

·  Inquire of 2 healthy coping skills they have used in the past and/or now

·  Three (3) pieces of advice they would give to their younger self if they could?

·  Support the client in taking the 
Geriatric Depression Scale.pdf

·  Support the client in taking the 
Fulmer SPICES Assessment.pdf

·  Perform a 
Mini Mental State Exam.pdf
 and 
Patient_Stress_Questionnaire.pdf
 (attach here)

·  Perform a 
Hall, Hall, and Chapman Article.pdf

·  Report the findings from the Geriatric Depression Scale, Fulmer Spices, Patient stress questionnaire and the mini mental status exam

·  Discuss your older adult’s level of ego integrity vs. despair as described by psychoanalyst Erik Erikson. If you had to rate them on a scale of 1-10, with 1 representing a full state of despair and 10 representing full ego integrity, what rating would you give your older adult?

·  Describe at least two nursing diagnoses for this client. Therapeutic assessment interview

·  Create a plan of care for the client to include at least three nursing goals with two nursing interventions each.

The assignment should be written in an APA-formatted essay. The essay should be at least 1500 words in length and include at least two scholarly sources other than provided materials. Therapeutic assessment interview

Strengths Finder self assessment

From self assessment below ,please give 
a brief description of your results from the Strengths Finder assessment Below. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your Strengths Finder assessment. Be specific.  In addition,

Do you believe you have the traits to be an effective leader? Perhaps you are already in a supervisory role, but as has been discussed previously, appointment does not guarantee leadership skills.

How can you evaluate your own leadership skills and behaviors from the assessment that you completed? And please identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Strengths Finder self assessment. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success and examine how the results relate to your leadership traits. In addition,
RANK
 
STRENGTH

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1Individualization

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RELATIONSHIP BUILDING

People who are especially talented in the Individualization theme are intrigued with the unique qualities of each person. They have a gift for figuring out how people who are different can work together productively.

2Ideation

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STRATEGIC THINKING

People who are especially talented in the Ideation theme are fascinated by ideas. They are able to find connections between seemingly disparate phenomena. Strengths Finder self assessment

3Achiever

People who are especially talented in the Achiever theme have a great deal of stamina and work hard. They take great satisfaction from being busy and productive.

4

Competition

People who are especially talented in the Competition theme measure their progress against the performance of others. They strive to win first place and revel in contests.

5Learner

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STRATEGIC THINKING

People who are especially talented in the Learner theme have a great desire to learn and want to continuously improve. In particular, the process of learning, rather than the outcome, excites them. Strengths Finder self assessment

Social Determinate Of Health Contributing To A Family Health Status

Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Values/Health Perception

Nutrition

Sleep/Rest

Elimination

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Activity/Exercise

Cognitive

Sensory-Perception

Self-Perception

Role Relationship

Sexuality

Coping

Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-1,000-word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following:

Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family. Social Determinate Of Health Contributing To A Family Health Status

Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions.

Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.

Using the model, outline the steps for a family-centered health promotion. Include strategies for communication. Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria. Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is not required. Social Determinate Of Health Contributing To A Family Health Status

RUBRICS:
The SDOH directly affecting family health status are relevant, accurately identified and thoroughly described. The direct impact to the family, and why the factors are prevalent to the family, are discussed in detail. The discussion is well supported and illustrates insight into SDOH and their effect on family health status.

Screenings presented for each family member are age appropriate and highly relevant. Screenings correlate to the information gathered through family health assessment. Strong rationale and support is presented.

A health model is selected and thoroughly described. A detailed discussion of how the model will assist in creating a plan of action is presented. Reasons for why it is best for this family are clearly outlined. Strong rationale and support are provided to support reasoning Social Determinate Of Health Contributing To A Family Health Status

The health model is used to create a relevant and viable family-centered health promotion. The steps to achieve the desired outcome are described in detail. Appropriate strategies for communication with the family are clearly presented. The health promotion is well-designed and demonstrates an ability to assimilate findings and appropriately apply theoretical knowledge to achieve desired outcomes.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Social Determinate Of Health Contributing To A Family Health Status

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

Writer is clearly in command of standard, written, academic English. All format elements are correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Social Determinate Of Health Contributing To A Family Health Status

Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

sychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia. Pakistani Woman with Delusional Thought Processes Decision Tree Case Study.

Learning Objectives

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Students will:

Assess client factors and history to develop personalized plans of antipsychotic therapy for clients

Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy

Evaluate efficacy of treatment plans

Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan

 

To prepare for this Assignment:

Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

The Assignment

Examine Case Study: Pakistani Woman with Delusional Thought Processes.
You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

At each decision point stop to complete the following:

Decision #1

Which decision did you select?

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

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

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

Decision #2

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

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

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

Decision #3

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

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

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

SAMPLE  ONLY

 

NURS 6630

WEEK SEVEN

Case 2:
 
Volume 2, Case #11: The figment of a man who looked upon the lady

Introduction

Briefly, this is a scenario of a 42 year- old woman with a complex psychiatric history extending from depression, posttraumatic stress disorder, insomnia, visual hallucinations (little man)and impaired behavior with aggression. In the course of more than 36 months, the client was treated with Paroxetine (SSRI), Bupropion ( NDRI), Tiagabine, Ramelteon and , but finally a combination of Lexapro, Bupropion and quetiapine was able to decrease her symptoms . The client’s medical history includes diabetes, hypertension, CAD, hyperlipidemia, COPD, OSA, GERD, Glaucoma, overweight and a remote history of substance abuse. Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

Related Professional Questions

Certain medications or supplements can cause symptoms of mental illness and also due to her extensive medical history and usage of multiple medications I would ask the following questions:

1. Do you take any over -the – counter, herbal supplements or remedies and I would check for interactions with current medication regimen?

2. When and how often do you use your albuterol inhaler ? Some of the side effects of albuterol include anxiety, nervousness, and insomnia ( Cunha, 2016)

Sleep Hygiene: Do you keep regular sleep schedule ? Do you drink caffeine beverages close to bedtime?

Patient History

The patient may not be a reliable source of information, particularly that she has a significant mental illness that affects her functioning, hence verifying her responses with her direct family members, and mental social workers to get clues to the underlying or precipitating causes of mental crisis. Also checking facility records from previous encounters, or any psychiatric hospitalizations would be useful. Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

Diagnostics Testing

1. Thyroid Stimulating Hormone (TSH). Based on recent evidence, the prevalence of depressive symptoms in hypothyroidism was nearly 50%, and clinical depression occurs in more than 40% of people suffering from hypothyroidism ( Bhagwat, 2017) Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

2.
 Electrocardiogram (ECG) The client has cardiovascular diseases ( HTN, CAD), with risks of cardio complications. In the setting of taking antidepressants and antipsychotics, baseline ECG and possibly every three to six months would be appropriate.  Several atypical antipsychotics including quetiapine (Seroquel) are known to cause prolongation of the QT interval, hypothesized to occur via direct inhibition of the cardiac delayed potassium rectifier channel, which extends the ventricular repolarization process (Zhai et al., 2017)

Differential Diagnoses

1.
 
Posttraumatic Stress Disorder ( PTSD)_

2.
 
Major Depressive Disorder 
 
(MDD)

3.
 
Insomnia Disorder.

Pharmacotherapy Options for Sleep/ Wake cycle

1. Zolpidem (Ambien) 5mg oral at bedtime for Seven days.

Zolpidem is nonbenzodiazepine hypnotic, it works by enhancing GABA inhibitory actions that provide sedative hypnotic effects more selectively than other actions of GABA (Stahl, 2017). With its side effects of sedation,  low dose prescribed as the client has respiratory problems (sleep apnea OSA)).  Studies have shown that Zolpidem did not significantly worsen OSA as measured by the numbers and duration of pauses in breathing during sleep, but in one trial, it significantly lowered minimum oxygen levels during the night when compared with placebo ( Mason & Smith, 2015). Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

2. Trazadone 25 mg oral at bedtime for Thirty days.

Trazadone is a serotonin 2 antagonist/reuptake inhibitor, used in management of depression and insomnia. It is absorbed well, metabolized by CYP 450 3A4 with average half life of 6hrs. It has less side sedative effects compared to zolpidem (Stahl, 2017)

The best choice for the client would be Trazadone as there is no reliable evidence of dependence or withdraws and it can also work for the client’s depression. Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

Conclusion

The case was a perfect example how it is sometimes difficult to find effective pharmacological treatments of psychiatric illnesses. In the course of four years, the client was prescribed 5-6 medications targeting different neurotransmitters to improve the symptoms. Client’s polypharmacy increased risks of drug-drug interactions, and her medical comorbidities increased risks of adverse reactions. Lesson learned from this study was  that treatment  should be optimally initiated after diagnosis, and augment or switching to a new agent must be carefully  done in consideration of possible  side effects and better outcomes. Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

References

Bhagwat, N., Tayde, P., Sharma, P., Sharma, B., Dalwadi, P., Sonawane, A., … Varthakavi, P. (2017). Hypothyroidism and depression: Are cytokines the link? 
Indian Journal of Endocrinology and Metabolism
, 
21
(6), 886. Retrieved from https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=7&sid=aeb79c1d-68dc-40a4-bd10-f956796bc9e8%40sessionmgr101

Cunha, J. (2016). Common Side Effects of Ventolin HFA (Albuterol Sulfate Inhalation Aerosol) Drug Center – RxList. Retrieved from https://www.rxlist.com/ventolin-hfa-side-effects-drug-center.htm Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

Mason, M., & Smith, I. (2015). Effects of opioid, hypnotic and sedating medications on obstructive sleep apnoea (OSA) in adults with known OSA | Cochrane. Retrieved from http://www.cochrane.org/CD011090/AIRWAYS_effects-opioid-hypnotic-and-sedating-medications-obstructive-sleep-apnoea-osa-adults-known-osa

Zhai, D., Lang, Y., Dong, G., Liu, Y., Wang, X., Zhou, D., … Zhang, R. (2017). QTc interval lengthening in first-episode schizophrenia (FES) patients in the earliest stages of antipsychotic treatment. 
Schizophrenia Research
, 
179
, 70-74. Retrieved from https://resolver-ebscohost-com.ezp.waldenulibrary.org/openurl?ID=pmid%3a27727006&genre=article&atitle=QTc+interval+lengthening+in+first-episode+schizophrenia+(FES)+patien Pakistani Woman with Delusional Thought Processes Decision Tree Case Study

NURS 6541 Week 1 Discussion – Family Essay

Family

Every family is unique.  Families may differ in their structure, life cycle stages, functioning, social networks, beliefs, and other areas (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017).  Children depend on their families to nurture and support them throughout their lifetime (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017).  It is essential that healthcare providers include the family unit when providing care for pediatric patients.  Family-centered care, where the health care provider partners with the family when providing care for the child, is important to promote the development of the child and the family unit (Hagan, Shaw, & Duncan, 2017). To provide care that is family centered and foster an open mind, healthcare providers should periodically examine their own beliefs about families (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017). NURS 6541 Week 1 Discussion – Family Essay  Biased family views from the provider can negatively impact the assessment, treatment, and outcomes of the patient (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017).

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Culture

Culture is a dynamic learned pattern of behavior which influences how people view the world (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017).  Culture is shaped by ethnicity, gender, age, sexual orientation, spiritual beliefs, social status, educational attainment, economic status, and geographic location (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017). An individual’s culture constantly changes over time as they are exposed to other cultures (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017).  Healthcare providers can facilitate communication when they are aware of a patient’s cultural beliefs and integrate those beliefs into the assessment and treatment plans (Hagan, Shaw, & Duncan, 2017). The cultural beliefs of healthcare providers may strongly influence their medical recommendations (AAP, 2013). Health care providers should engage in self-reflection, self-knowledge and self-critique to understand their own cultural beliefs (AAP, 2013).   Understanding their own beliefs will enable them to consciously realign the power underlying patient-provider communication and allow them to practice with cultural humility (AAP, 2013). Cultural variations in communication, both verbal and nonverbal, can be a barrier to effective patient care (American Academy of Pediatrics, 2013).   Miscommunication in the patient -provider relationship can lead to problems such as an inaccurate history, misunderstanding of treatment recommendations, deferred follow-up visits, and poor patient outcomes (AAP, 2013).

Strategies to Assist Families with Making Health-Related Decisions

Establish an effective family-provider relationship: An effective family-provider relationship should be built on mutual respect, open and honest communication, trust, cultural competence, and collaboration (Hagan, Shaw, & Duncan, 2017). When providers and patients have an effective relationship, where they can successfully communicate and share in the decision-making process, treatment adherence will be increased, and better patient outcomes can be achieved (Smirnoff, 2013) NURS 6541 Week 1 Discussion – Family Essay.

Provide the family with appropriate information: Healthcare providers are an important source of information for the patient. Often, patients obtain information from outside sources (media, theorists, other family members, etc.) who may not have the best available evidence when they are providing recommendations to the family.  Healthcare providers should ensure that family members are provided with evidence-based information on all proposed treatment regimens, and this information should include the risks and benefits of each proposed treatment option (Hagan, Shaw, & Duncan, 2017).  Providing the patient with evidence-based information can help to facilitate the decision-making process NURS 6541 Week 1 Discussion – Family Essay.

Remove barriers to care: Providers can help patients to discover ways of obtaining needed resources, such as insurance, food, respite care, transportation, or monetary assistance, that may be needed to implement their health-related decisions (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017).

References

American Academy of Pediatrics. (2013). Policy Statement: Enhancing Pediatric Workforce Diversity and Providing Culturally Effective Pediatric Care: Implications for Practice, Education, and Policy Making.
Pediatrics
,
132
(4), e1105-e1116. doi:10.1542/peds.2013-2268.

Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017).
Pediatric Primary Care
(6
th
ed.). St. Louis, MO: Elsevier. NURS 6541 Week 1 Discussion – Family Essay

Hagan, J. F., Jr., Shaw, J. S., Duncan, P. M. (Eds.). (2017).
Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents
(4
th
ed.). Elk Grove Village, IL: American Academy of Pediatrics.

Smirnoff, L. A. (2013). Incorporating patient and family preferences into evidence-based medicine.
BMC Medical Informatics and Decision Making
,
13
(3), 1-7. Retrieved from http://www.biomedcentral.com/1472-6947/13/S3/S6. NURS 6541 Week 1 Discussion – Family Essay