ANP 635 Health Promotions Table
Research the risk factors of each selected patient population for diseases, the social determinants of health that affect this population, and functional and dysfunctional health patterns.
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Patient Population
Social Determinants of Health Barriers
Preventative Health Care
Required Health Promotion Education
Adolescent
Adult
Geriatric
ANP 635 Health Promotions Table
NURS 6051 Week 8 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
The adoption of diverse technologies of healthcare within the healthcare systems has greatly impacted patient outcomes as well as operations’ efficiency. As a result the current healthcare systems in most countries integrate various technologies among them being online appointment scheduling, where healthcare resources are utilized to their fullest and in most effective and promising manner. Through this online scheduling, patient care coordination is enhanced, and the delivery of healthcare is guaranteed to be both safer and more efficient currently and in the future (Aburayya et al., 2020). Quality evaluation as well as the patient outcomes evaluation can be accomplished easily using these approaches. The purpose of this paper is to perform an evaluation of four research works whose main focus is the impact that online appointment booking systems have on patient outcomes as well as the efficiency of operations.
Srinivas, S., & Ravindran, A. R. (2020). Designing schedule configuration of a hybrid appointment system for a two-stage outpatient clinic with multiple servers.
Health care management science
,
23
, 360-386.
https://doi.org/10.1007/s10729-019-09501-4
The first articles authored by Srinivas & Ravindran (2020) dwells on development of a hybrid appointment system designed specifically for a two-stage outpatient clinic that employs numerous servers. The paper examines the critical essential of making use of the scheduling of setups that help in efficiently and effectively managing the processes of patient flow as well as resource allocation, especially when dealing with critical healthcare environments. The authors propose that the integration of mathematical modeling and simulation approaches would provide an excellent method towards developing the best and most practical appointment system. The hybrid approach combines scheduled appointments and walk-in possibilities to provide flexibility in addressing various types of patients and their choices. This study aims at looking the rules of scheduling that aim at minimizing the wait times for patients as well as ensuring the use of resources owned by the healthcare organizations are maximized (Srinivas & Ravindran, 2020). The factors to be considered in that case include the patterns of patient arrivals, time taken to offer services per patients well as number of staff providing the services.
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Through this though research and analysis, authors of this article determined the performance of this system of scheduling. From the findings of the article, the hybrid offers a better performance compared to the scheduling systems at standard levels (Srinivas & Ravindran, 2020). This article also provide insights pertaining the factors influencing the performance of this system including, the time taken to schedule each appointment, number of patients visiting the facility physically, as well as the performance of the servers. Through these factors, they foster the development of a two stages as well as multiple servers that can serve diverse patients at a given period. Healthcare managers and policymakers therefore benefit from this article through adding the knowledge concerning the implementation of appointment systems, hence improving healthcare services and delivery at organizational level.
Habibi, M. R. M., Mohammadabadi, F., Tabesh, H., Vakili-Arki, H., Abu-Hanna, A., & Eslami, S. (2019). Effect of an online appointment scheduling system on evaluation metrics of outpatient scheduling system: a before-after multicenterstudy.
Journal of medical systems
,
43
, 1-9.
https://doi.org/10.1007/s10916-019-1383-5
The article by Habibi et al (2019) on the other hand explores the effect of implementing appointment scheduling system towards the assessment measures pertaining the healthcare outcomes assessment in healthcare settings that contain multiple centers. The researchers of the study made use of a multicenter type of design towards conducting the assessments concerning the modifications required in the evaluation of measures prior to introducing this online based scheduling system. The diverse factors examined within this multiple healthcare environment comprised of patient waiting times, the satisfaction levels of patients, adherence to appointments as well as efficiency in terms of operations (Habibi et al., 2019). From the results obtained, there was a further enhancement on outpatient scheduling within outpatient healthcare and across the many centers that were considered after implementing this virtual system. The implementation of this new system impacted great benefits that consisted of reduced patient waiting times, appointment adherence increase by patients, improved patient satisfaction as well as improved operations within the centers considered. Other benefits that were highlighted by the authors consisted enhancing the facility’s reputation as a result of impacting improved satisfaction of patients as well as maximumly utilizing the resources of healthcare.
Millhiser, W. P., & Veral, E. A. (2019). A decision support system for real-time scheduling of multiple patient classes in outpatient services.
Health care management science
,
22
, 180-195.
https://doi.org/10.1007/s10729-018-9430-1
Millhiser & Veral (2019) on the other hand explores the specific healthcare technology of decision support system (DSS) that is tailored mainly to improve the efficiency of the scheduling process, targeting diverse patients. It is a study that was conducted to offer a thorough intervention towards improving scheduling efficiency as well as enhancing the satisfaction of patients especially in healthcare facilities that serve patients from different cultures and populations (Millhiser & Veral, 2019). It is an objective that was achieved through considering the dynamical nature of outpatient scheduling. DSS is a type of technology that utilizes numerous methods of mathematical modeling, algorithms of machine learning as well as the optimization techniques of allocating patient appointments at once within different populations. It is an objective that is achieved through updated data. Clinical efficiency through this method is enhanced through considering the preferences of patients, their urgency on medication attention, as well as clinical resources’ availability. As such, it is a method that aims at attending to numerous patients within the shortest period NURS 6051 Week 8 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
The DSS efficacy in this research work is evaluated through multiple assessments that consist of running multiple simulations as well as case reports review within different outpatient settings. From the obtained results, the method is effective towards addressing the numerous demands of different categories of patients, thereby impacting improved outcomes of scheduling that are improved in comparison to traditional methods.
Yan, C., Huang, G. G., Kuo, Y. H., & Tang, J. (2022). Dynamic appointment scheduling for outpatient clinics with multiple physicians and patient choice.
Journal of Management Science and Engineering
,
7
(1), 19-35.
https://doi.org/10.1016/j.jmse.2021.02.002
The research by Yan et al. (2022) focuses on the development of a dynamic appointment scheduling systems required in outpatient clinics to be used by multiple healthcare providers. These are systems that are tailored to address the preferences of diverse patients’ by providing them with the freedom of choosing their appropriate appointments. The research therefore focused on developing the scheduling algorithms that have the ability to address the patient preferences as well as clinics’ operational requirements, in consideration with the dynamical nature posed by healthcare systems (Yan et al., 2022). A dynamic scheduling model is therefore suggested by the authors. The model suggested utilizes mathematical modeling in combination with various techniques of simulation towards modifying appointment allocations depending on the appointment choice of patient and clinical resources’ availability. It is a research that also offers diverse ways that could be used in modifying the demands of patients as well as physicians’ capabilities, hence fostering the efficiency and patient satisfaction in a healthcare setting. It is a study that utilizes extensive analysis using different statically software to assess the effectiveness of their claim.
Implementing dynamic appointment scheduling strategies according to the authors of this article offers an essential enhancement towards the performance of the available clinical indicators. The improvements consist of decreased waiting times for patients, increased use of organizational resources and physicians, as well as improved efficiency in operations at organizational level. According to Kong et al (2020), the static scheduling methods are outperformed by the dynamic methods of scheduling. The basic variables that mainly affect the dynamic methods are also outlined in the article. These consist of arrivals in patient patterns, duration between each appointment as well as appointment selection behavior portrayed by patients NURS 6051 Week 8 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
In a recap, the common focus of the articles selected is on the scheduling process observed in outpatient healthcare settings with the corresponding need of increasing efficiency satisfaction of patients as well as management of resources. The studies however utilize different methodologies towards and analyses methods towards addressing the outpatient scheduling dynamics, like utilization of online appointment systems as well as creating the dynamic algorithms of scheduling patient scheduling. The patient flow in healthcare facilities can be fostered through addressing the diverse requirements of patients as well as enhancing the clinical efficiency through utilizing mathematical modeling techniques, techniques of simulation as well as the technologies of decision support.
References
Aburayya, A., Al Marzouqi, A., Al Ayadeh, I., Albqaeen, A., & Mubarak, S. (2020). Evolving a hybrid appointment system for patient scheduling in primary healthcare centres in Dubai: Perceptions of patients and healthcare provider.
International Journal on Emerging Technologies
,
11
(2), 251-260.
Habibi, M. R. M., Mohammadabadi, F., Tabesh, H., Vakili-Arki, H., Abu-Hanna, A., & Eslami, S. (2019). Effect of an online appointment scheduling system on evaluation metrics of outpatient scheduling system: a before-after multicenterstudy.
Journal of medical systems
,
43
, 1-9.
https://doi.org/10.1007/s10916-019-1383-5
Kong, Q., Li, S., Liu, N., Teo, C. P., & Yan, Z. (2020). Appointment scheduling under time-dependent patient no-show behavior.
Management Science
,
66
(8), 3480-3500. https://doi.org/10.1287/mnsc.2019.3366
Millhiser, W. P., & Veral, E. A. (2019). A decision support system for real-time scheduling of multiple patient classes in outpatient services.
Health care management science
,
22
, 180-195.
https://doi.org/10.1007/s10729-018-9430-1
Srinivas, S., & Ravindran, A. R. (2020). Designing schedule configuration of a hybrid appointment system for a two-stage outpatient clinic with multiple servers.
Health care management science
,
23
, 360-386.
https://doi.org/10.1007/s10729-019-09501-4
Yan, C., Huang, G. G., Kuo, Y. H., & Tang, J. (2022). Dynamic appointment scheduling for outpatient clinics with multiple physicians and patient choice.
Journal of Management Science and Engineering
,
7
(1), 19-35.
https://doi.org/10.1016/j.jmse.2021.02.002
NURS 6051 Week 8 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.
Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.
In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.
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To Prepare:
Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery. NURS 6051 Week 8 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 5 peer-reviewed articles from your research.
The Assignment: (4-5 pages)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:
Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies. NURS 6051 Week 8 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.
Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.
In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.
To Prepare:
Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.” NURS 6051 Week 8 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.
Identify and select 5 peer-reviewed articles from your research.
The Assignment: (4-5 pages)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:
Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples. NURS 6051 Week 8 Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.
NURS 6521 Midterm Exam 2020
Midterm Exam 2020- part 1 Assignment
Question 1 A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a hospital setting?
• Question 2 A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate?
• Question 3 A nurse is creating a plan of care for a 68-year-old woman with a recent diagnosis of unstable angina and new prescription for nitroglycerin. Which of the following nursing diagnoses should the nurse prioritize in the planning of this patient’s care? NURS 6521 Midterm Exam 2020
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• Question 4 A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of
• Question 5 A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?
• Question 6 A patient has been prescribed an oral drug that is known to have a high first-pass effect. Which of the following measures has the potential to increase the amount of the free drug that is available to body cells?
• Question 7 A nurse is providing a patient with a list of drugs as a part of the patient’s plan of care. Which of the following drug nomenclatures should the nurse use to list the drugs?
• Question 8 Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process? • Question 9 During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
• Question 10 A home health nurse notes that there have been changes to a patient’s oral drug regimen. The nurse will closely monitor the new drug regimen to
• Question 11 What critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours?
• Question 12 A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
• Question 13 Which of the following will a nurse inform the patient is one of the most common adverse effects of guaifenesin (Robitussin)? NURS 6521 Midterm Exam 2020
• Question 14 A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication?
• Question 15 A nurse is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The nurse should anticipate that the drug will be administered • Question 16 A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to
• Question 17 A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important consideration when preparing to administer the new drugs?
• Question 18 A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?
• Question 19 The nurse’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?
• Question 20 An 80-year-old patient has been taking lorazepam since his wife died a year ago. He has been staying with his son, but will now move to an assisted living facility. Before admission to the assisted living facility, the patient’s physician has determined that the drug is no longer needed. The nurse at the facility will plan to
• Question 21 A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately?
• Question 22 The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system? • Question 23 A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient?
• Question 24 A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply. NURS 6521 Midterm Exam 2020.
• Question 25 A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy’s diagnosis?
• Question 26 A nurse working for a drug company is involved in phase III drug evaluation studies. Which of the following might the nurse be responsible for during this stage of drug development?
• Question 27 A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?
• Question 28 An unconscious patient has been brought to the hospital, and the physician has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication?
• Question 29 A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s
• Question 30 To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should
• Question 31 A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to %
Midterm Exam 2020- part 2 Assignment
Question 51 A 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may
• Question 52 A 70-year-old woman is starting on an acidic drug. The nurse is aware that food and nutrient intake can affect drug excretion by changing the urinary pH. About which of the following will the nurse question the patient concerning her diet?
• Question 53 A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that NURS 6521 Midterm Exam 2020
• Question 54 A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?
• Question 55 A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is
• Question 56 A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?
• Question 57 A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of
• Question 58 A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to
• Question 59 A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse’s assessment reveals that the patient is being treated for rheumatoid arthritis and hypertension. The patient lives in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the patient’s
• Question 60 A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient’s care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient’s existing drug regimen? NURS 6521 Midterm Exam 2020
• Question 61 A nurse is caring for a postsurgical patient who has small tortuous veins and had a difficult IV insertion. The patient is now receiving IV medications on a regular basis. What is the best nursing intervention to minimize the adverse effects of this drug therapy?
• Question 62 A patient with a diagnosis of nonsmall cell lung cancer is currently undergoing chemotherapy. At the encouragement of a family member, the patient has announced to the nurse his intention to complement this treatment with a regimen of herbal remedies. How should the nurse respond to this patient’s statement?
https://www.onlinenursingessays.com/wp-admin/post.php?post=41804&action=edit • Question 63 A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments?
• Question 64 A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?
• Question 65 A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? % NURS 6521 Midterm Exam 2020
Assessing Client Families Essay
Assignment 1: Practicum – Assessing Client Families
Introduction
Comprehensive family assessment involves evaluating the interactions in a family setting in order to determine factors that affect the family members. Accordingly, the assessment involves interviewing the children and other family members, collecting and analyzing the information, in order to identify the root cause of a specific problem within the family setup (Saltzman et al 2013 & Freedman, 2014). This assist will present a family assessment for a specific family. In accordance with the HIPAA regulations, anonymous names will be used to safeguard the confidentiality of the clients.
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Demographic Information
The family is made of four family members namely, Roderigo (father), Monica (wife), Lupita (daughter), and Lisa (daughter). Roderigo is a 38-year-old Africa American male, while Monica is a 36-year-old Latino female. Roderigo and Monica have two daughters Lupita (7 years) and Lisa (5 years). The family does not own a home but both Roderigo and Monica work as casual workers in a local company Assessing Client Families Essay.
Presenting Problem
A family friend visited the local children welfare offices and informed the available social worker that the parents were mistreating their children. On that material day, the father had physically abused both girls until the first-born daughter fainted. The family friend further reported that on many occasions the girls went without food as a punishment for any wrongdoing. The family friend further reported that the parents have been abusing their children for a very long time.
History of Present Illness
Roderigo reported that, on the material day, he was just about to go to work when he realized that a part of his money was missing. The two daughters denied having seen any money and therefore he decided to beat both of them in order to get the truth Assessing Client Families Essay. The mother was in the house but did nothing to save her daughters from the beating. Youngest daughter managed to get out when the father was still beating the sister and alerted a neighbor, who in turn called their family friend. The family friend decided to report the issue to the children welfare department.
Past Psychiatric
Roderigo disclosed that he diagnosed with borderline personality disorder when he was 16-years-old. No one else in the family has a history of mental health problem.
Medical History
No one in the family has any notable health problem
Substance use History
Roderigo reported that during his teenage years, he used to occasionally smoke marijuana and cocaine. However, he quit substance abuse when he turned 21-years after a cocaine overdose.
Development History
This element needs further assessment
Family Psychiatric History
Roderigo was once diagnosed with a borderline personality disorder. His father suffered from schizophrenia while his mother is still living with bipolar 2 disorder. No other significant history of psychiatric illness. Assessing Client Families Essay.
Psychosocial History
Roderigo, Monica, Lupita, and Lisa stay as a nuclear family. Both Roderigo and Monica work as casual workers. The family occasionally go out together over the weekend to enjoy each other’s company.
History of Abuse/Trauma
Monica was sexually abused by a relative when she was 15-years and underwent counseling therapy to overcome the trauma. Roderigo reported that he grew up in a dysfunctional family and his father always battered the mother and children as well.
Review of Systems
A further assessment is needed Assessing Client Families Essay
Mental Status Exam
All family members were oriented to time and place. The entire family participated in the therapy to ensure the root cause of the family problem was identified.
Differential Diagnosis
The father emotional swings, explosive anger issues, and borderline personality disorder and abusive towards his two daughters
Diagnosis
Child abuse and anger issues
Case Formulation
A family friend reported to the social worker at the local children welfare offices that Roderigo and Monica had been abusing their two daughters. On that material day, the father had physically abused both girls until the first-born daughter fainted. The family friend further reported that on many occasions the girls went without food as a punishment for any wrongdoing. The concerned social worker recommended Roderigo and Monica to undergo parenting classes while Roderigo also undergoes anger management therapy to help him manage his anger issues.
Treatment Plan
Treatment Goals
Roderigo and Monica will develop age-appropriate and effective disciplining strategies
Roderigo effectively control his explosive anger Assessing Client Families Essay
Treatment Strategies
Roderigo and Monica will undergo parenting classes twice per week and also Roderigo will attend anger management therapy one time weekly. Roderigo and Monica will be educated on the appropriate parenting and how to handle indiscipline in their children. As a result, they will use appropriate disciplining approaches (Wheeler, 2014). On the other hand, the anger management classes will ensure Roderigo is able to manage and control his anger any time the children misbehave.
Estimated Completion period
:
3 Months
Social Support System
Colleagues
Friends
Relatives
References
Freedman, J. (2014). Witnessing and positioning: Structuring narrative therapy with families and couples.
Australian & New Zealand Journal of Family Therapy
. 35(1), 20–30.
Saltzman, W. R., Pynoos, R. S., Lester, P., Layne, C. M., & Beardslee, W. R. (2013). Enhancing family resilience through family narrative co-construction.
Clinical Child and Family Psychology Review
. 16(3), 294–310.
Wheeler, K. (Ed.). (2014
). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
(2nd ed.). New York, NY: Springer Publishing Company.
Students will:
Assess client families presenting for psychotherapy
Develop genograms for client families presenting for psychotherapy
To prepare: Assessing Client Families Essay
Select a client family that you have observed or counseled at your practicum site.
Review pages 137–142 of Wheeler (2014) and the Hernandez Family Genogram video in this week’s Learning Resources.
Reflect on elements of writing a comprehensive client assessment and creating a genogram for the client you selected.
The Assignment
Part 1: Comprehensive Client Family Assessment
Create a comprehensive client assessment for your selected client family that addresses (without violating HIPAA regulations) the following:
Demographic information
Presenting problem
History or present illness
Past psychiatric history
Medical history
Substance use history
Developmental history
Family psychiatric history
Assessing Client Families Essay
Psychosocial history
History of abuse and/or trauma
Review of systems
Physical assessment
Mental status exam
Differential diagnosis
Case formulation
Treatment plan
Note: I f no information for medicines or past medical history clarify needs to be added, or no reported.
Part 2: Family Genogram(selected any family genogram)
Develop a genogram for the client family you selected. The genogram should extend back at least three generations (parents, grandparents, and great grandparents).
Required Readings
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
Standard 5B “Health Teaching and Health Promotion” (pages 55-56)
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.
Chapter 8, “Experiential Family Therapy” (pp. 129–147)
Chapter 13, “Narrative Therapy” (pp. 243–258)
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer. Assessing Client Families Essay
“Genograms” pp. 137-142
Cohn, A. S. (2014). Romeo and Julius: A narrative therapy intervention for sexual-minority couples. Journal of Family Psychotherapy, 25(1), 73–77. doi:10.1080/08975353.2014.881696
Note: Retrieved from Walden Library databases.
Escudero, V., Boogmans, E., Loots, G., & Friedlander, M. L. (2012). Alliance rupture and repair in conjoint family therapy: An exploratory study. Psychotherapy, 49(1), 26–37. doi:10.1037/a0026747
Note: Retrieved from Walden Library databases.
Freedman, J. (2014). Witnessing and positioning: Structuring narrative therapy with families and couples. Australian & New Zealand Journal of Family Therapy, 35(1), 20–30. doi:10.1002/anzf.1043
Note: Retrieved from Walden Library databases.
Phipps, W. D., & Vorster, C. (2011). Narrative therapy: A return to the intrapsychic perspective. Journal of Family Psychotherapy, 22(2), 128–147. doi:10.1080/08975353.2011.578036
Note: Retrieved from Walden Library databases.
Saltzman, W. R., Pynoos, R. S., Lester, P., Layne, C. M., & Beardslee, W. R. (2013). Enhancing family resilience through family narrative co-construction. Clinical Child and Family Psychology Review, 16(3), 294–310. doi:10.1007/s10567-013-0142-2
Note: Retrieved from Walden Library databases.
Required Media
Governors State University (Producer). (2009). Emotionally focused couples therapy [Video file]. Chicago, IL: Author.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 115 minutes.
Laureate Education (Producer). (2013b). Hernandez family genogram [Video file]. Baltimore, MD: Author. Assessing Client Families Essay.
Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
Group Therapy Progress Note
American Psychological Association | Division 12 http://www.div12.org/ 1
Client: __________________________________________________ Date: ___________
Group name:________________________________________________ Minutes:________
Group session # ______ Meeting attended is #:______ for this client.
Number present in group _____ of _____ scheduled Start time:________ End time: ________
Assessment of client
1. Participation level: ❑ Active/eager ❑ Variable ❑ Only responsive ❑ Minimal ❑ Withdrawn
2. Participation quality: ❑ Expected ❑ Supportive ❑ Sharing ❑ Attentive ❑ Intrusive
❑ Monopolizing ❑ Resistant ❑ Other: _____________________________________
3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________
4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other:_______________
5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ Disoriented ❑ Confused
❑ Disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other:__________________
6. Suicide/violence risk: ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt
7. Change in stressors: ❑ Less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic
8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able
9. Change in symptoms: ❑ Same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse
10. Other observations/evaluations:________________________________________________________
In-session procedures:
_______________________________________________________________________________
_______________________________________________________________________________
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_______________________________________________________________________________
_______________________________________________________________________________
__________ _____________________________________________________________________
Homework: Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
1.
2.
3.
Other Comments:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Signatures Date
Week 2 Journal Entry: Two Clients in Family Therapy
The family therapy involved two clients namely, Miss. A, a 17-year-old girl and the mother. This was the first time Miss. A was attending a counseling session. Miss. A has revealed to the parent that she was feeling suicidal and did not want to live anymore. The mother reported that for the last three months the daughter has become undisciplined and would argue with everyone in the house. The mother was very angry and had decided to throw her out. Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy.
Miss. A Description
Miss. A is a 17-year-old girl who attended family therapy with the mother. According to A, she has been feeling sad and hopeless for the last two months ever since her baby sister passed away. The mother adds that her classwork was exemplary before, but lately she is a poor performer in class. Miss. A reported that she is no longer interested in classwork or other activities she formerly enjoyed Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy. The mother added that the daughter rarely sleeps and always seems distracted. The client further reported that she feels suicidal, worthless, has lost weight because she has been having poor appetite, and she no longer has energy to do anything. The is also easily irritable, the reason she has been fighting with her mother.
Mother’s Description
The mother reported that she is unable to handle her daughter because she is also dealing with her issues. She reported that she was diagnosed with posttraumatic stress disorder (PTSD) when she was 21-years after she was sexually abused. She was brought up in a dysfunctional family and she was involved in substance abuse since her teenage years. She does not want her daughter to go through the mental torture she went through and thus she is overly strict with her daughter. She further reported that she also feels overwhelmed due to the loss of her last-born daughter and is unable to handle A’s tantrums. The mother underwent cognitive behavioral therapy after sexual abuse and has not received any other treatment since then.
Miss A’s Diagnosis
According to DSM-5, A manifests symptoms of major depressive disorder. The symptoms of major depressive disorder encompass appetite changes, sleep problems, irritability, fatigue, poor concentration, poor functioning while at work and academically, hopelessness, worthlessness, suicidal thoughts, etc. (Wang et al, 2017). Miss. A is manifesting majority of these symptoms and thus fits the diagnosis of major depressive disorder (Tendon, 2015).
Mother’s Diagnosis
The diagnosis of the mother is PTSD. Symptoms of PTSD include having had traumatic events such as sexual abuse, near-death events, etc (Lancaster et al, 2016). The mother went through a traumatic experience (sexual abuse) when she was young. The traumatic event has significantly distressed the mother and as a result she is having problems with her parenting.
Legal & Ethical Implications Allied to Counseling Clients
Legal and ethical issues associated with counseling of both clients consist of; informed consent, decision-making and maintaining confidentiality. The therapist is supposed to get informed consent from A and her mother before any treatment to ensure that they make informed treatment decisions. According to Bellesheim (2016) maintaining confidentiality during family therapy is important because there are numerous parties involved. Therefore, the therapist should thus ensure the two parties sign confidentiality forms and inform them that they should not disclose the information revealed during therapy to third parties.
References
Bellesheim K. (2016). Ethical Challenges and Legal Issues for Mental Health Professionals Working With Family Caregivers of Individuals with Serious Mental Illness.
Ethics & Behavior.
26(7), 607-620.
Lancaster C, Teeters J, Gros D & Back S. (2016). Posttraumatic Stress Disorder: Overview of Evidence-Based Assessment and Treatment.
J Clin Med
. 5(11), 105. Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
Tendon R. (2015). Bipolar and Depressive Disorders in Diagnostic and Statistical Manual of Mental Disorders-5: Clinical Implications of Revisions from Diagnostic and Statistical Manual of Mental Disorders-IV.
Indian J Psychol Med
. 37(1): 1–4.
Wang J, Wu X, Lai W
, et al
. (2017). Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis.
BMJ Open. 1(
7).
Students will:
Apply documentation skills to examine family therapy sessions *
Develop diagnoses for clients receiving family psychotherapy *
Analyze legal and ethical implications of counseling clients with psychiatric disorders *
Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session.
Then, address in your Practicum Journal the following:
Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session.
Describe (without violating HIPAA regulations) each client, and identify any pertinent history or medical information, including prescribed medications.
Using the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5), explain and justify your diagnosis for each client.
Explain any legal and/or ethical implications related to counseling each client.
Support your approach with evidence-based literature. Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
References
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
Chapter 12, “Family Therapy” (pp. 429–468)
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.
Chapter 3, “Basic Techniques of Family Therapy” (pp. 29–48)
Chapter 4, “The Fundamental Concepts of Family Therapy” (pp. 49–68)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: It is highly recommended that you use this resource as a reference guide throughout the course. Retrieved from Walden Library databases.
L’Abate, L. (2015). Highlights from 60 years of practice, research, and teaching in family therapy. American Journal of Family Therapy, 43(2), 180–196. doi:10.1080/01926187.2014.1002367
Note: Retrieved from Walden Library databases.
Mojta, C., Falconier, M. K., & Huebner, A. J. (2014). Fostering self-awareness in novice therapists using internal family systems therapy. American Journal of Family Therapy, 42(1), 67–78. doi:10.1080/01926187.2013.772870
Note: Retrieved from Walden Library databases.
Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025
Note: Retrieved from Walden Library databases.
Papero, D. V. (2014). Assisting the two-person system: An approach based on the Bowen theory. Australian & New Zealand Journal of Family Therapy, 35(4), 386–397. doi:10.1002/anzf.1079
Note: Retrieved from Walden Library databases. Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
ACE Star Model Of Knowledge Transformation: EBP Change Process
Student’s Name
Institution Of Affiliation
Course Name
Date
ORDER A PLAGIARISM-FREE PAPER HERE
Star Point 1: Discovery (Identify topic and practice issue)
Identify the
topic
and the
nursing practice issue
related to this topic. (This MUST involve a nursing practice issue.)
Ventilator-Associated Pneumonia (VAP) is a perfect example of healthcare-associated infection (HAI) in healthcare facilities particularly among adult hospitalized patients in ICU settings. As a gradually emerging concept, it remains to be an important problem among critically ill patients that results in serious complications. Therefore, the subject of evaluation is the increasing incidence of ventilator-associated pneumonia (VAP) among adult hospitalized patients under intubation or mechanical ventilation in ICU settings ACE Star Model Of Knowledge Transformation: EBP Change Process.
Briefly describe your
rationale
for your topic selection. Include the
scope
of the issue/problem.
Ventilator-Associated Pneumonia is a leading cause of mortality, morbidity, increased medical costs, prolonged hospital stays and poor health outcomes across healthcare settings in the United States. It particularly occurs among hospitalized patients in the ICU between 48-72 hours after mechanical ventilation or intubation. Its primary characteristics include signs of systemic infection, sputum changes, and continuous infiltration. As the contributor of half of all the hospital-acquired pneumonia infections, its prevalence has been estimated to be between 8-40% with the highest risk occurring within the 1
st
five days of admission. It has contributed to a reduction in patient safety and made healthcare organizations inefficient to execute the role of providing high quality, efficient and effective care. This explains why it is vital to define the clinical issue and its causes to develop effective intervention measures to prevent or reduce the incidences of Ventilator-Associated Pneumonia.
Star Point 2: Summary (Evidence to support the need for a change)
Describe the
practice problem in your own words
and formulate your PICOT question.
Critically ill patients who might be under sedation or unconscious while receiving treatment in the ICU/CCU setting require the support of ventilator machines to breathe properly. However, using these machines (mechanical ventilation) or intubation for more than 48 hours can lead to ventilator-associated pneumonia (VAP) which is a serious complication among critically ill patients. It is associated with prolonged stays in the hospital, prolonged periods of mechanical ventilation, additional medical costs, increased morbidity, and double mortality risk. Therefore, considering the risks associated with VAP, reduction or prevention should be a priority for nursing care.
PICOT Question
-In adult patients aged 40 years or older under intubation or mechanical ventilation in ICU settings (P) will the use of 0.2% oral chlorhexidine (I) compared to the use of normal saline(C) decrease the rate of Ventilator-Associated Pneumonia(O) from 16% to 10% within 6 weeks(T)?
List the systematic review chosen from the CCN Library databases. Type the complete
APA reference
for the systematic review selected.
Klompas, M., Speck, K., Howell, M. D., Greene, L. R., & Berenholtz, S. M. (2014). Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis.
JAMA internal medicine
,
174
(5), 751-761.
List and briefly describe
other sources
used for data and information. List any other
optional scholarly source
used as a supplement to the systematic review in
APA format.
1
.
Alimi, M., Manzari, Z. S., Bagheri Moghadam, A., & Rouhani, H. (2016). Evaluation of the Effects of Oronasal Versus Oral Disinfection with Chlorhexidine on Clinical Criteria of Ventilator-associated Pneumonia.
Evidence-Based Care
,
6
(3), 19-30.
Zhang, T. T., Tang, S. S., & Fu, L. J. (2014). The effectiveness of different concentrations of chlorhexidine for prevention of ventilator‐associated pneumonia: a meta‐analysis.
Journal of clinical nursing
,
23
(11-12), 1461-1475.
Villar, C. C., Pannuti, C. M., Nery, D. M., Morillo, C. M., Carmona, M. J. C., & Romito, G. A. (2016). Effectiveness of intraoral chlorhexidine protocols in the prevention of ventilator-associated pneumonia: a meta-analysis and systematic review.
Respiratory care
,
61
(9), 1245-1259.
Briefly
summarize
the main findings (
in your own words
) from the systematic review and the
strength
of the evidence
.
One of the major roles of healthcare providers is to prevent patient harm by enhancing safety. Based on the high incidences of VAP, nurses must implement effective measures to promote health outcomes. The rise in VAP infections has been attributed to oral hygiene due to the use of mechanical ventilators and intubation. The findings from the systematic review revealed that 0.2% oral chlorhexidine is effective in preventing VAP among adult patients in ICU settings as compared to normal saline ACE Star Model Of Knowledge Transformation: EBP Change Process. Thus its use should continuously be encouraged in ICU settings and be integrated into the management of patients.
Outline one or two
evidence-based solutions
you will consider for the trial project.
Using 0.2% oral chlorhexidine to maintain oral hygiene is vital in preventing and reducing Ventilator-Associated Pneumonia. 0.2% oral chlorhexidine decreases colonization of the oral cavity by bacteria which are the major pathogens that cause infection. Chlorhexidine decreases the risk of respiratory infections before, during and after intubation or mechanical ventilation.
An alternative solution is the use of normal saline and tooth brushing to maintain oral hygiene. However, there is limited evidence that supports their effectiveness in VAP prevention and related health outcomes. On the other hand, existing evidence recommends it as part of the VAP care bundle that should be given to patients alongside the use of oral chlorhexidine.
Star Point 3: Translation (Action Plan)
Identify
care standards, practice guidelines, or protocols
that may be in place to
support your intervention
planning (These may come from your organization or the other sources listed in your Summary section in Star Point 2).
The 2003 Centers for Disease Control Guidelines for Preventing Healthcare-Associated Pneumonia and the 2004 CDC Guidelines for the Management of Adults With Hospital-Acquired, Ventilator-Associated, and Healthcare-Associated Pneumonia give recommendations and guidelines that should be followed by healthcare providers to prevent, reduce and manage Ventilator-Associated Pneumonia.
List your
stakeholders
(by title and not names; include yourself) and describe their
roles and responsibilities
in the change process (no more than 5).
Management: development of practice guideline, care protocols, and policies to promote quality, safety and effectiveness in patient care. It also plans for seminars, conferences, and training for staff on basic standard operating procedures ACE Star Model Of Knowledge Transformation: EBP Change Process.
Physicians: directly involved in patient care by recommending ways and procedures to improve patient outcomes
Critical Care Nurses: directly involved in patient care by recommending ways and procedures to improve patient outcomes, coordinate patient care, administer medications and nurse patients.
Patients: Collaborate with all healthcare providers by providing relevant medical information that can be used in decision making at the point of care.
What specifically is
your nursing role in the change process
? Other nursing roles?
Nurses are first-line communication managers who ensure coordination of care with families and other healthcare providers for all patients in the ICU. They administer medications, monitor the patient for potential adverse effects and institute appropriate intervention measures where necessary to safeguard patients from harm.
List your stakeholders by
position titles
(charge nurse, pharmacist, etc.).-
Why are the members chosen
(stakeholders) important to your project?
Critical Care Nurses-4-Should implement the proposed care protocol and guidelines in terms of administration and care coordination with families and other healthcare providers
Critical Care Physicians-3 should ensure that all decisions made in prevention or management of patients with VAP follow the prescribed guidelines and protocol.
What type of
cost analysis
will be needed before a trial? Who needs to be involved with this?
Before the implementation of a trial, cost-effectiveness analysis and cost-benefit analysis will be needed. The primary costs will be incurred in the training of staff and the purchase of 0.2% oral chlorhexidine. Close to 8 physicians and 10 nurses will undergo the training in the trial period. Besides, there will be ongoing education to sensitize and increase awareness of other staff on the prior trial. This education will be conducted using flashcards, checklists, and brochures ACE Star Model Of Knowledge Transformation: EBP Change Process.
Star Point 4: (Implementation)
Describe the
process for gaining permission
to plan and begin a trial. Is there a specific group, committee, or nurse leader involved?
The critical care nurse head and the critical care physician head will write to the hospital’s leadership to seek permission to conduct the trial. This should include the clinical problem identified, its impacts on patients, staff and the organization and why change is essential. A detailed description of the proposed intervention measures to be implemented in the change process and the expected outcomes should also be included.
Describe the
plan for educating the staff
about the change process trial and how they will be impacted or asked to participate.
All the staff directly and indirectly involved in the change process will be educated on the change through a training program that will take place for one week. Staff will be asked to participate by availing themselves for training, recommending alternative changes and to propose measures for intervention. Staff will also be asked to provide feedback which will be used to make improvements in other areas of practice.
Outline the
implementation timeline
for the change process (start time/end time, what steps are to occur along the timeline).
17-9-2019 to 13-10-2019-Staff training on change
14-10-2019 to 21-10-2019-Printing sensitization and awareness resources
22-10-2019 to 10-11-2019-Developing guidelines, protocols, and policies on the use of Oral Chlorhexidine to reduce VAP
11-11-2019 to 25-11-2019- Evaluating outcomes in skills and knowledge
List the
measurable outcomes
based on the PICOT. How will these be measured?
Ventilator-associated pneumonia, duration of mechanical ventilation, mortality, antibiotic prescribing, intensive care unit and hospital length of stay
What
forms
, if any, might be used for recording purposes during the pilot change process. Describe.
During the pilot change process, it will be necessary to use mortality and morbidity forms, epidemiology forms and financial and utilization forms ACE Star Model Of Knowledge Transformation: EBP Change Process. Each of these forms will later be used to compare and measure baseline data and outcome data before and after the pilot change process.
What resources are available to staff (include yourself) during the change pilot?
Funds to facilitate training and purchase of oral chlorhexidine, a fully equipped 12 capacity ICU, wristwatches, pens, booklets, and flash disks will be provided during the change pilot.
Will there be
meetings
of certain stakeholders throughout the trial? If so, who and when will they meet?
The critical care nurses, physicians and a representative from the hospital’s leadership who are directly involved in the trial will meet daily in the entire trial period to assess the progress made through feedback. The meeting will purpose to provide daily reports that will be used to determine the benefits versus risks of the trial to the patients, healthcare providers, and the organization. Based on this information, decisions on whether or not to continue with the trial and other relevant adjustments will be made.
Star Point 5: (Evaluation)
How will you
report the outcomes
of the trial?
The trial committee will write a detailed report that describes the outcomes and findings, which will later be published in a peer-reviewed journal.
What would be the
next steps
for the use of the change process information?
This information will be used by the organization’s quality improvement committee to implement the proposed change within the organization, to positively influence patient health outcomes, organizational performance, and staff satisfaction.
Reference
Klompas, M., Speck, K., Howell, M. D., Greene, L. R., & Berenholtz, S. M. (2014). Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis.
JAMA internal medicine
,
174
(5), 751-761 ACE Star Model Of Knowledge Transformation: EBP Change Process.
Week 6 Assignment:
EBP Change Process form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.
Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.
Name: _____________________
Star Point 1: Discovery (Identify topic and practice issue)
Identify the
topic
and the
nursing practice issue
related to this topic. (This MUST involve a nursing practice issue.)
Briefly describe your
rationale
for your topic selection. Include the
scope
of the issue/problem.
Star Point 2: Summary (Evidence to support need for a change)
Describe the
practice problem in your own words
and formulate your PICOT question.
List the systematic review chosen
from the CCN Library databases
. Type the complete
APA reference
for the systematic review selected.
List and briefly describe
other sources
used for data and information. List any other
optional scholarly source
used as a supplement to the systematic review in
APA format.
Briefly
summarize
the main findings (
in your own words
) from the systematic review and the
strength
of the evidence
.
Outline one or two
evidence-based solutions
you will consider for the trial project.
Star Point 3: Translation (Action Plan)
Identify
care standards, practice guidelines, or protocols
that may be in place to
support your intervention
planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).
List your
stakeholders
(by title and not names; include yourself) and describe their
roles and responsibilities
in the change process (no more than 5).
What specifically is
your nursing role in the change process
? Other nursing roles?
List your stakeholders by
position titles
(charge nurse, pharmacist, etc.).
–
Why are the members chosen
(stakeholders) important to your project?
What type of
cost analysis
will be needed prior to a trial? Who needs to be involved with this?
Star Point 4: (Implementation)
Describe the
process for gaining permission
to plan and begin a trial. Is there a specific group, committee, or nurse leader involved?
Describe the
plan for educating the staff
about the change process trial and how they will be impacted or asked to participate.
Outline the
implementation timeline
for the change process (start time/end time, what steps are to occur along the timeline) ACE Star Model Of Knowledge Transformation: EBP Change Process.
List the
measurable outcomes
based on the PICOT. How will these be measured?
What
forms
, if any, might be used for recording purposes during the pilot change process. Describe.
What resources are available to staff (include yourself) during the change pilot?
Will there be
meetings
of certain stakeholders throughout the trial? If so, who and when will they meet?
Star Point 5: (Evaluation)
How will you
report the outcomes
of the trial?
What would be the
next steps
for the use of the change process information? ACE Star Model Of Knowledge Transformation: EBP Change Process
Week 6 Assignment:
EBP Change Process form
ACE Star Model of Knowledge Transformation
Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson.
Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.
Name: _____________________
Star Point 1: Discovery (Identify topic and practice issue)
Identify the
topic
and the
nursing practice issue
related to this topic. (This MUST involve a nursing practice issue EBP Change Process form.)
ORDER A PLAGIARISM-FREE PAPER HERE
Briefly describe your
rationale
for your topic selection. Include the
scope
of the issue/problem EBP Change Process form.
Star Point 2: Summary (Evidence to support need for a change)
Describe the
practice problem in your own words
and formulate your PICOT question.
List the systematic review chosen
from the CCN Library databases
. Type the complete
APA reference
for the systematic review selected.
List and briefly describe
other sources
used for data and information. List any other
optional scholarly source
used as a supplement to the systematic review in
APA format EBP Change Process form.
Briefly
summarize
the main findings (
in your own words
) from the systematic review and the
strength
of the evidence
.
Outline one or two
evidence-based solutions
you will consider for the trial project.
Star Point 3: Translation (Action Plan)
Identify
care standards, practice guidelines, or protocols
that may be in place to
support your intervention
planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).
List your
stakeholders
(by title and not names; include yourself) and describe their
roles and responsibilities
in the change process (no more than 5).
What specifically is
your nursing role in the change process
? Other nursing roles?
List your stakeholders by
position titles
(charge nurse, pharmacist, etc.).
–
Why are the members chosen
(stakeholders) important to your project? EBP Change Process form
What type of
cost analysis
will be needed prior to a trial? Who needs to be involved with this?
Star Point 4: (Implementation)
Describe the
process for gaining permission
to plan and begin a trial. Is there a specific group, committee, or nurse leader involved?
Describe the
plan for educating the staff
about the change process trial and how they will be impacted or asked to participate.
Outline the
implementation timeline
for the change process (start time/end time, what steps are to occur along the timeline).
List the
measurable outcomes
based on the PICOT. How will these be measured? EBP Change Process form
What
forms
, if any, might be used for recording purposes during the pilot change process. Describe.
What resources are available to staff (include yourself) during the change pilot?
Will there be
meetings
of certain stakeholders throughout the trial? If so, who and when will they meet?
Star Point 5: (Evaluation)
How will you
report the outcomes
of the trial?
What would be the
next steps
for the use of the change process information? EBP Change Process form
Impact of Ethnicity on Antidepressant Therapy Essay
Case 2: Volume 1, Case #7: The case of physician do not heal thyself
Provide the case number in the subject line of the Discussion thread.
List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.
List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics Impact of Ethnicity on Antidepressant Therapy Essay. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
ORDER A PLAGIARISM-FREE PAPER HERE
For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?
If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.
Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations
The Impact of Ethnicity on Antidepressant Therapy
Case 2: Volume 1, Case #7: The case of physician does not heal thyself
Three Questions
Within the last two weeks, how often have experienced sadness, feeling depressed or worthless and hopeless?
The rationale for asking this question is that sadness and feeling worthless and hopeless nearly daily and all day for two weeks or more is an indication of depression (Wang et al, 2017)
Have you been having any suicidal thoughts?
The rationale for asking this question is that the client’s answer to the question will enable the mental healthcare practitioner to rate the severity of the client’s depression (Mark et al, 2016)
How is your sleep? Are you able to sleep well?
The rationale for asking this question is that sleep disturbance is a symptom of depression and also indicates a higher for depression (Wang et al, 2017)
People in the Patient’s Life to Ask Questions
Friends
Do you know of life events that seem to be stressing the client?
The rationale for this question is to determine factors that contribute to the resistant depression in the client.
Does the client have reliable friends and family members?
The reason for asking this question is to get information about whether the client has any support system in his life. A reliable support system is very important for effective treatment of depression (Wang et al, 2017)
Appropriate Physical Exams and Diagnostic Tests Impact of Ethnicity on Antidepressant Therapy Essay
The physical and diagnostic examples appropriate for this client include blood tests and CT scan. The blood tests can reveal if the client has any health conditions that may be causing the depressive symptoms (Mark et al, 2016). The tests can test if the client is anemic, or has thyroid disorders; these conditions are associated with depressive symptoms. A CT scan can be used to rule out any brain condition such as a tumor that could be causing the depressive symptoms (Mark et al, 2016).
Differential Diagnosis
Treatment-resistant depression
Schizoaffective disorder
Bipolar disorder
The most probable diagnosis for this client is treatment-resistant depression. The client’s experiences manic and hypomanic symptoms are compatible with symptoms of major depressive disorder. Moreover, the client has used more than two antidepressants of the required period and dose, but there has been no total symptom remission.
Pharmacologic Agents and Dosing
Venlafaxine XR 450 mg: The mechanism of action of this medication is facilitating the activity of neurotransmitters within the CNS by hindering the reuptake of dopamine, norepinephrine, and serotonin. These neurotransmitters are associated with promoting mood improvement. The elimination half-life of venlafaxine is about 72 hours (Ahmed et al, 2019).
Sertraline 250 mg: The mechanism of this medication is through inhibition of SERT transporter and reuptake of dopamine. The elimination half-life of sertraline is between 26-32 hours (Howie et al, 2018).
The recommended medication for this client is Venlafaxine XR 450 mg. The rationale for choosing venlafaxine over sertraline is because venlafaxine acts through many mechanisms (hindering the reuptake of dopamine, norepinephrine, and serotonin) (Ahmed et al, 2019), whereas on the other hand sertraline’s mechanism of action is only by inhibiting reuptake of dopamine.
Contraindications of Venlafaxine
Venlafaxine is contraindicated for individuals with high cholesterol level, cardiovascular conditions, liver problems and hypertension (Ahmed et al, 2019). Some ethnicities have a higher risk of cardiovascular conditions which is a contraindication to using venlafaxine. Ethnicity may also impact the response of a person to treatment Impact of Ethnicity on Antidepressant Therapy Essay.
References
Ahmed A, Jenkins G, Rush J, Rung S, Bobo W, Wang R & Mark F. (2019). Pharmacokinetic-Pharmacodynamic interaction associated with venlafaxine-XR remission in patients with major depressive disorder with a history of citalopram/escitalopram treatment failure
.
J Affect Disord
. 1(246). 62–68.
Howie N, Herberg S, Durham E, Grey Z, Hill W, Cray J et al. (2018). Selective serotonin reuptake inhibitor sertraline inhibits bone healing in a calvarial defect model.
Int J Oral Sci
. 10(3), 25.
Mark C, How C & Ping Y. (2016). Major depression in primary care: making the diagnosis.
Singapore Med J
. 57(11), 591–597.
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NUR-646E Nurse Educator Electronic Portfolio Essay Example
Nurse Educator Electronic Portfolio
Description:
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For this program, you will be creating a working electronic portfolio that can be utilized when trying to obtain a position as a nurse educator. The electronic portfolio will encompass several artifacts from your practicum courses. Use the “Nurse Educator Electronic Portfolio,” resource to guide you in collecting the required artifacts for this. You will submit the completed electronic portfolio in NUR-665E. NUR-646E Nurse Educator Electronic Portfolio Essay Example
Benchmark -Nurse Educator Lesson Plan
Description:
As a nurse educator, you will be responsible for creating effective lessons for various settings.
Choose a teaching and learning experience from your clinical setting. You may use the clinical
experience from your Topic 4 discussion response.
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Based on the experience you chose, use the engagement, student learning, and creating effective
learning environment strategies that you have learned in this course to develop a lesson plan on
similar content for two additional settings (such as an asynchronous online session and teaching a nursing student in the clinical setting, etc.). Use the lesson plan examples found in the topic materials to assist you in creating your lesson outlines. .
This assignment will be used as an artifact for your electronic portfolio at the end of the course.
Include the following in your outline:
Lesson Objectives
Timeframe and target environment
Three to four teaching strategies-based on Evidence-Based Practice.
Activities
A summary of the types of assessments you would use in your lesson and why?
Provide rationale for the teaching strategies you implemented into each lesson and why they
differ.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the
Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become
familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite Benchmark -Nurse Educator Lesson Plan.
This assignment benchmarks the following competency:
Master of Science in Nursing with an Emphesis in Education
6.1: Apply instructional strategies grounded in evidence-based practice and learning theory that meet the unique needs of learners in diverse environments.
Nurse Educator Electronic Portfolio
Hello, my name is xxx. I hail from xxxx. I currently stay in xxxx.
Welome to my Teaching-Learning Electronic Portfolio. This is where I will share my individual and professional information and some of my work as a nursing student. Currently, I am enrolled in xxxx University, taking Master of Science in Nursing – Nursing Education cognate.
My career as a nurse professional began many years ago, where I started working as a registered nurse on xxxxx. I performed numerous nursing roles such as medication administration, operate medical equipment, perform patient education, conduct diagnostic tests, monitor patient health, take vital signs, advocate for patients’ wellbeing, and collaborate with the multidisciplinary team to ensure quality patient care. Currently, I work at the Veteran’s Hospital in medical ICU.
I started pursuing my nursing career in the year xxx where I earned my nursing diploma and then in the year xxx, I earned my Bachelor of Science in Nursing degree from xxx university. I then started my Masters nursing studies. I am very satisfied with my career, and very anxious to fulfil my dreams of becoming a Nurse Educator very soon. Benchmark -Nurse Educator Lesson Plan.
Course Code
Class Code
Assignment Title
Total Points
NUR-646E
NUR-646E-O500
Benchmark -Nurse Educator Lesson Plan
125.0
Criteria
Percentage
1: Unsatisfactory (0.00%)
2: Less Than Satisfactory (80.00%)
3: Satisfactory (88.00%)
4: Good (92.00%)
5: Excellent (100.00%)
Content
85.0%
Lesson Objectives
10.0%
A description of the lesson objectives is not included.
A description of the lesson objectives is incomplete or incorrect.
A description of the lesson objectives is included but lacks details.
A description of the lesson objectives is complete and includes supporting details.
A description of the lesson objectives is extremely thorough and includes substantial details.
Timeframe and Target Environment
5.0%
A statement of the timeframe and the target Environment is not included.
A statement of the timeframe and the target Environment is incomplete or incorrect.
A statement of the timeframe and the target Environment is included but lacks details.
A statement of the timeframe and the target Environment is complete and includes supporting details.
A statement of the timeframe and the target Environment is extremely thorough and includes substantial details.
Teaching Strategies Based on EBP (6.1)
20.0%
A description of the three to four teaching strategies based on EBP is not included.
A description of the three to four teaching strategies based on EBP is incomplete or incorrect.
A description of the three to four teaching strategies based on EBP is included but lacks details.
A description of the three to four teaching strategies based on EBP is complete and includes supporting details.
A description of the three to four teaching strategies based on EBP is extremely thorough and includes substantial details.
Activities
15.0%
A discussion of activities to use to teach content is not included.
A discussion of activities to use to teach content is incomplete or incorrect.
A discussion of activities to use to teach content is included but lacks details.
A discussion of activities to use to teach content is complete and includes supporting details.
A discussion of activities to use to teach content is extremely thorough and includes substantial details.
Benchmark -Nurse Educator Lesson Plan
Assessment Summary
15.0%
A summary of potential assessments for the lesson is not included.
A summary of potential assessments for the lesson is incomplete or incorrect.
A summary of potential assessments for the lesson is included but lacks details.
A summary of potential assessments for the lesson is complete includes supporting details.
A summary of potential assessments for the lesson is extremely thorough and includes substantial details.
Teaching Strategy Implementation and Rationale
20.0%
A rationale for the teaching strategies implemented in the lesson is not included.
A rationale for the teaching strategies implemented in the lesson is incomplete or incorrect.
A rationale for the teaching strategies implemented in the lesson is included but lacks details.
A rationale for the teaching strategies implemented in the lesson is complete includes supporting details.
A rationale for the teaching strategies implemented in the lesson is extremely thorough and includes substantial details.
Group 2Organization and Effectiveness
5.0%
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5.0%
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
Writer is clearly in command of standard, written, academic English.
Format
10.0%
Paper Format (Use of appropriate style for the major and assignment)
5.0%
Template is not used appropriately or documentation format is rarely followed correctly.
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
Template is used, and formatting is correct, although some minor errors may be present.
Template is fully used; There are virtually no errors in formatting style.
All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5.0%
Sources are not documented.
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage
100%
Benchmark -Nurse Educator Lesson Plan