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DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Full Course Assignments and Discussions – GCU DNP 810 Full Course Discussions GCU

DNP 810 Topic 1 DQ 1

Name three essential structural elements of a functional eukaryotic chromosome and describe their functions. Discuss the implications related to research, health, and life span in terms of one of the structural elements.

DNP 810 Topic 1 DQ 2

Describe the difference among replication, transcription, and translation for both DNA and RNA.

DNP 810 Topic 2 DQ 1

Describe at least four factors that can be associated in a complex inheritance health issue.

DNP 810 Topic 2 DQ 2

Compare two genomic tests used for screening, diagnosis, and management of a disease. Describe whether outcome data exists related to the utility of these tests and what the data shows, if available. DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Topic 3 DQ 1

Contrast two models used for multigenerational family health histories. Which do you prefer and why?

DNP 810 Topic 3 DQ 2

Describe the importance of a comprehensive health and physical assessment that includes information on environment, and genomic influences. Frame this answer through your current role, whether as an Advanced Registered Nurse Practitioner (ARNP) with a practice, or a nurse executive overseeing nursing practice in an organization.

DNP 810 Topic 4 DQ 1

Genetics testing is viewed as either positive or negative. When used to detect the genes for breast cancer, health insurance companies deny care based on genetics. Why? Describe one genetic test and its impact on health, prevention, screening, diagnostics, treatment selection, and treatment effectiveness.

DNP 810 Topic 4 DQ 2

Evidence-based practice and standardized clinical guidelines have improved organizations and the ability of providers to provide the care with the highest level of evidence to each patient. Describe one pharmacological agent with a protocol/clinical guideline that is used. Discuss how this protocol may not take into consideration genetic variations. What can be done to tailor care to each patient while providing standardized treatments?

DNP 810 Topic 5 DQ 1

Describe one health issue and discuss how nutrition can impact this health issue positively and negatively.

DNP 810 Topic 5 DQ 2

Choose one disorder of malnutrition. Discuss the genetic and environmental influences on this disorder, including prevalence rates, testing, treatment, and prognosis.

DNP 810 Topic 6 DQ 1

Discuss how genetic and genomics can play a role in a demand for new health services and how it may impact health care expenditures in the aging population. Give one example.

DNP 810 Topic 6 DQ 2

Describe one method that includes using evidence-based data to support a new or innovative ways to care for the aging now or in the future. How will it impact care and what are the anticipated outcomes?

DNP 810 Topic 7 DQ 1

Discuss how genetic and genomics can play a role in a demand for new health services and how it may impact health care expenditures in the chronic disease population. Give one example.

DNP 810 Topic 7 DQ 2

Describe one method that includes using evidence-based data to support a new or innovative way to care for those with chronic disease now or in the future. How will it impact care and what are the anticipated outcomes?

DNP 810 Topic 8 DQ 2

Choose one recent (within last 2 years) news story about genetic or genomic technology. Describe the issue presented. From the perspective as an RN or APRN, describe the ethical, cultural, religious, legal, fiscal, and societal implication.

DNP 810 Topic 8 DQ 2

Describe two issues that undermine the rights of clients in genetic- and genomic-related decision making and action. Discuss a potential solution for each as well as your role in this issue as the patient advocate.

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DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Full Course Assignment GCU

DNP 810 Week 1 Individual Success Plan (ISP)

Details: The Individual Success Plan (ISP) assignment in this course requires your collaboration with the course faculty early on to establish a plan for successful completion of mutually identified and agreed upon specific deliverables for your programmatic requirements. Programmatic requirements are: (1) completion of required practice immersion hours, (2) completion of work associated with program competencies, (3) work associated toward completion of your Direct Practice Improvement Project.

General Requirements: Use the following information to ensure successful completion of the assignment as it pertains to deliverables due in this course:

• Locate and download the Individual Success Plan (ISP) document in the DNP Program Documents folder in the DNP Program Materials section of the DC Network.
• Review the DNP Program Milestones document in the DC Network and identify which milestones apply to this course. Note: Not all courses have milestones.
• Determine what practice experiences you plan to seek in order to address each competency. Include how many hours you plan to set aside to meet your goals. Learners will apply concepts from each of their core courses to reflect upon, critically examine, and improve current practice, and are required to integrate scholarly readings to develop case reports that demonstrate increasingly complex and proficient practice.
• Use the ISP to develop a personal plan for completing your practice hours and how competencies will be met. Show all of the major milestones and deliverables.

Within the ISP, ensure you identify specific deliverables which can include the following: Individualized DNP practice immersion contracts; comprehensive clinical log of hours applied to doctoral level learning outcomes; learner evaluations; mentor evaluations; current and updated CV; scholarly activities; GCU DNP competency self-assessment; reflective journal; course goals and plan for how competencies and practice immersion hours will be met; faculty and mentor approvals of course goals and documented practice immersion hours; and DPI project milestones.

• Identify the specific deliverables you will complete throughout this course from those defined above or others negotiated with your faculty. You must turn in a new ISP in each course.
• Identify the remaining deliverables you will complete in the upcoming courses.
• List the challenges you expect to encounter as you continue the practice hour and competency requirements throughout this course? How might you overcome these challenges?
• You can renegotiate these deliverables with your faculty throughout this course and update your ISP accordingly.
• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• You not are required to submit this assignment to LopesWrite.

Directions: Complete the Contact Information table at the beginning of the ISP document and type in your signature and the date on which you completed the table. Read the information in the ISP document including the following:

1. Learner Expectations
2. Derivation of the ISP
3. Instructions for completing the ISP

Follow the instructions and complete the ISP. DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Week 1 Reading Check for Understanding

Details: Complete the questions listed in the “Problems” section of the textbook on pages 23, 39, and 58. Check your answers in the back of the textbook in the “Answers to Problems” appendix.

DNP 810 Week 2 Case Report Part 1

Details: You will be creating a case report in stages over four course topics. Use an example from your own personal practice, experience, or own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy. Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization in which you practice may specialize in treating.

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

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Include the following:

• Guidelines and reasons behind the FDA regulations for introducing new pharmaceutical agents (policy).
• The role that money and grants play in scientific advances; the economics of health care (capitalism).
• The role and involvement family plays into the health care decision.

Directions: For this assignment (Part 1 of the Case Report), write a 1,000-1,250 word paper incorporating genetics information learned from assigned readings in Topics 1 and 2. Include the following:

1. Describe the disease, its prevalence, and its incidence.
2. Discuss the laboratory testing that is possible.

Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the student, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10.

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. To earn portfolio practice hours, enter the following after the references section of your paper:

Practice Hours Completion Statement DNP-810 I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.

Case Report: Part 1  

DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Week 2 Reading Check for Understanding

Details: Complete the questions listed in the “Problems” section of the textbook on pages 84, 113, 147-149, 174, and 205. Check your answers in the back of the textbook in the “Answers to Problems” appendix.

DNP 810 Week 3 Case Report Part 2

Details: You will be creating a case report in stages over four course topics. This assignment will add to your previous work in Topic 2. Use an example from your own personal practice, experience, or own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy. Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization you practice in may specialize in treating.

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

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Directions: For this assignment (Part 2 of the Case Report), write a 1,000-1,250 word paper incorporating genetics information learned from assigned readings in Topics 1-3. Include the following:

1. Describe if chromosomal analysis is/was indicated.
2. Detail the causes of the disorder.
3. Describe the disorder in terms of its origin as either a single gene inheritance, or as a complex inheritance and considerations for practice and patient education.
4. Analyze the gene mutation of the disease, as well as whether it is acquired or inherited, and how the mutation occurs.

Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the student, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10. You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. To earn portfolio practice hours, enter the following after the references section of your paper:

Practice Hours Completion Statement DNP-810 I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.

Case Report: Part 2  

DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Week 3 Family History

Details: Taking a family history is an important step in determining current and future health needs and education. There are many tools available to complete a comprehensive health history. The Surgeon General’s Family Health History tool is part of the larger Family Health History Initiative that encourages people to talk about and write down health issues that seem to run in the family, bringing a larger focus on this important issue. This assignment allows the learner to use the tool and become familiar with this initiative.

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

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
• Use the Surgeon General’s Family History Tool at (http://www.hhs.gov/familyhistory/portrait/index.html) to complete this assignment.

Directions: Use the Surgeon General’s Family History Tool (http://www.hhs.gov/familyhistory/portrait/index.html) to document your own family history. Designate a proband for the pedigree with a disease or condition of interest. Write a 750-1,000 word summary of your findings. Include the following information:

1. Discussion of the heredity patterns discovered.
2. Evaluate the risk of transmission to other/new family members.
3. Propose the feasibility of using this tool in your own practice.

Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the student, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10. You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. To earn portfolio practice hours, enter the following after the references section of your paper:

Practice Hours Completion Statement DNP-810 I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.

Family History  

DNP 810 Full Course Assignments and Discussions – GCU

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DNP 810 Topic Week 4 Genetic Counseling

Details: With the increase in knowledge around genetic issues, it is important that all health care providers are prepared to have thorough genetic-based discussions now with their patients. In this assignment, you will synthesize your knowledge into a client case with a real or potential genetic health-related illness. General Guidelines: Use the following information to ensure successful completion of the assignment:

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
• Use the Surgeon General’s Family History Tool at (http://www.hhs.gov/familyhistory/portrait/index.html) to complete this assignment.

Directions: Write a 1,000-1,250 word paper addressing a client case that might benefit from the process of genetic counseling. Describe the reason for the genetic counseling based on the findings from your completion of the history tool. Discuss the possible reactions the patient may have to your counseling and how to avoid negative reactions. Imagine this assignment as if you are giving this counseling to a patient. Discuss the following:

1. Health.
2. Prevention
3. Screening
4. Diagnostics
5. Prognostics
6. Selection of treatment
7. Monitoring of treatment effectiveness

Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the student, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10.

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. To earn portfolio practice hours, enter the following after the references section of your paper:

Practice Hours Completion Statement DNP-810 I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.

Genetic Counseling  

DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Topic Week 5 Case Report Part 3

Details: You will be creating a case report in stages over four course topics. This assignment will add to your previous work in Topic 3. Use an example from your own personal practice, experience, or own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy. Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization you practice in may specialize in treating. General Requirements: Use the following information to ensure successful completion of the assignment:

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Directions: For this assignment (Part 3 of the Case Report), write a 1,000-1,250 word paper incorporating genetics information learned from assigned readings in Topics 1-5. Include the following:

1. Examine how genetics can influence policy issues.
2. Discuss any nutritional influences for the cause of this disease.
3. Discuss the process of nutritional assessment and counseling as it relates to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness.
4. Discuss the prevalence rates, testing, treatment, and prognosis as they relate to human nutrition.

Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the student, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10. You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. To earn portfolio practice hours, enter the following after the references section of your paper: Practice Hours Completion Statement DNP-810 I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.

DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Topic Week 6 Health Issues for the Aging

Details: As of 2014 health care expenditures in the United States are near 17% of our gross domestic product (GDP), with a major portion of Medicare funding goes towards chronic illness and care at the last 6 months of life. The Patient Protection and Affordable Care Act has made some initial legislative changes in our health system, but not sufficient to address our growing expenditures and caring for our large aging population. In this assignment, learners will synthesize issues in aging with health policy solutions by writing a paper on one health issue for older individuals addressed in the topic and offering a policy solution. Example of issue: In 2014, over 50% of the costs of institutional long-term care for older persons are paid for with public funds from Medicaid. General Guidelines: Use the following information to ensure successful completion of the assignment:

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Directions: Write a 1,000-1,250 word paper that addresses a health issue for older individuals. Include the following:

1. Evaluate what the literature suggests as a resolution to your chosen issue.
2. Discuss any attempts to incorporate the solution into public policy.
3. Determine the barriers to implementation of the solution.
4. Analyze the options being discussed for public and/or private funding.
5. Propose your own recommendation.

Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the student, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10. You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. To earn portfolio practice hours, enter the following after the references section of your paper: Practice Hours Completion Statement DNP-810 I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor. Health Issues for the Aging  

DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Topic Week 8 Case Report Cumulative

Details: You will be creating a case report in stages over four course topics. This assignment will add to your previous work in Topic 5. Use an example from your own personal practice, experience, or own personal/family; however, simulated cases are not acceptable for practice hours and therefore not acceptable for this assignment. Examples might include a patient with Duchesne’s muscular dystrophy. Huntington’s disease, Down’s syndrome, sickle cell anemia, BRCA 1 or BRCA 2 mutations, or other genetic disorder that you and/or the organization you practice in may specialize in treating. General Requirements: Use the following information to ensure successful completion of the assignment:

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.
• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Include the following:

• Guidelines and reasons behind the FDA regulations for introducing new pharmaceutical agents (policy).
• The role that money and grants play in scientific advances/the economics of health care (capitalism).
• The role and involvement family plays into the health care decision.

Directions: For this assignment (Conclusion of the Case Report), include previous Parts 1, 2, and 3 of the Case Report in one document, combined with additional genetics information learned from the assigned readings from all course topics. This final Case Report document should include the following:

1. Describe the disease, its prevalence, its incidence and general knowledge of the disease.
2. Discuss the laboratory testing that can be done.
3. Describe if chromosomal analysis is/was indicated, and detail the chromosomal change that caused the disease if it is a chromosomal disorder.
4. Describe the disorder in terms of its origin as either a single gene inheritance, or as a complex inheritance and considerations for practice and patient education.
5. Describe the gene mutation of the disease, as well as whether it is acquired or inherited, and how the mutation occurs.
6. Examine how genetics can influence policy issues.
7. Discuss any nutritional influences for this disease.
8. Process of nutritional assessment and counseling as it relates to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness.

Continue your paper with 1,000-1,250 words which include the following:

1. Discuss any ethical considerations for this disease.
2. Compare how genetics can improve care and health outcomes while reducing cost to usual practices.
3. Discuss the changes in approaches to care when new evidence warrants evaluation of other options for improving outcomes or decreasing adverse events.
4. Create a plan for how you might educate colleagues and/or patients on this genetic disorder.

Portfolio Practice Hours: Practice immersion assignments are based on your current course objectives, and are intended to be application-based learning using your real-world practice setting. These assignments earn practice immersion hours, and are indicated in the assignment by a Portfolio Practice Hours statement which reminds you, the student, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10. You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. To earn portfolio practice hours, enter the following after the references section of your paper: Practice Hours Completion Statement DNP-810 I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor. Case Report: Cumulative  

DNP 810 Full Course Assignments and Discussions – GCU

DNP 810 Topic Week 8 Final Evaluation by Mentor

Details: The mentor will perform a final clinical evaluation via the Typhon system. The mentor will receive an e-mail link at the beginning of Topic 6 to access the evaluation through Typhon. Students will access the completed mentor evaluations in Typhon under the tab for “EASI: Evaluation and Survey Instrument” and print out the completed evaluation, sign it, and upload the signed evaluation into LoudCloud. The course faculty will review the evaluation in LoudCloud and confirm in Typhon. It is the student’s responsibility to ensure that the mentor has completed evaluation. If the mentor does not receive the evaluation via the e-mail address on file with GCU, the student should contact the course faculty immediately. DNP 810 Full Course Assignments and Discussions

DNP 810 Topic Week 8 Reflective Journal

Details: Learners are required to maintain a Reflective Journal integrating leadership and inquiry into current practice. In your journal, you will reflect on the personal knowledge and skills gained in the current course addressing a variable combination of the following: new practice approaches, intraprofessional collaboration, health care delivery and clinical systems, ethical considerations in health care, population health concerns, the role of technology in improving health care outcomes, health policy, leadership and economic models, and/or health disparities. Outline what you discovered about your professional practice, personal strengths and weaknesses that surfaced, what additional resources and abilities could be introduced to a given situation to influence optimal outcomes, and finally how you met the competencies aligned to this course. Submit your Reflective Journal to both the instructor and the Typhon Tracking System under the corresponding course section. Learners must submit this deliverable in Typhon and LoudCloud. Failure to submit in both locations can result in an Incomplete for the course.

DNP 810 Topic Week 8 Scholarly Activities

Details: Throughout the DNP Program, learners are required to provide a report documenting participation in a minimum of four scholarly activities outside of clinical or professional practice. These reports will be due in specific courses throughout the program (listed below) and must be documented in your Practice Portfolio by the end of each course in which an activity report is due. Examples of scholarly activities include attending conferences, seminars, grand rounds, participating in policy and quality improvement committees, writing scholarly publications, participating in community planning, serving as a guest lecturer, etc. Involvement and contribution to interdisciplinary initiatives are also acceptable scholarly activities. DNP 810 Full Course Assignments and Discussions

Documentation of these activities is required in DNP-810, DNP-820, DNP-830, and DNP-840. A summary report of the scholarly activity including who, what, where, when, and take home points will be submitted as the assignment. Include the appropriate program competencies associated with the scholarly activity and the future professional goals related to this activity. You may use the attached template to help guide this assignment. Scholarly_ Activity_Summary_Template.doc 

DNP 810 Topic Week 8 Practice Hours Portfolio

Details: The Typhon Tracking System will be used to document and follow the status of your practice immersion hours throughout this and every subsequent course. Learners must be able to document a minimum of 50 concurrently or previously logged practice hours in association with this course, which will contribute to fulfillment of the total required 1,000 post-baccalaureate practice hours by the conclusion of the program. Please review the Practice Hours Portfolio Required Elements below, then review the Guidelines for Graduate Field Experience Manual document in the DC Network for details on what may/may not qualify as practice hours.

Practice Hours Portfolio Required Elements The Practice Hours Portfolio (using the Typhon Student Tracking System) will include all of the following elements:

1. Individual Success Plan signed off by mentor.
2. Comprehensive clinical log of hours applied to doctoral level learning outcomes.
3. Learner evaluations (final).
4. Practice mentor evaluations (final).
5. Current and updated CV (update each course as necessary).
6. Faculty approvals of the Individual Success Plan and documented practice immersion hours. (Learner is responsible for obtaining approvals.)
7. Practice mentor’s approval of the Individual Success Plan and documented practice immersion hours. (Learner is responsible for obtaining approvals.) DNP 810 Full Course Assignments and Discussions

Practice Hours Completion Statement Learners will track their practice hours within the Typhon Tracking System throughout each course and via the Practice Hours Completion Statement assignment provided in this assignment. Complete the following statement in a Word documen, submit to the instructor, and complete the Typhon Tracking System entries appropriate for this course. Create a Word document with the following text: DNP 810 Full Course Assignments and Discussions

Practice Hours Completion Statement DNP-810 I, (INSERT NAME), verify that I have completed (NUMBER OF) practice hours in association with the goals and objectives for this course. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor. DNP 810 Full Course Assignments and Discussions DNP 810 Full Course Assignments and Discussions

Sample Paper: Case Report: Application of Theory

Grand Canyon University: DNP-815

Suicide in Adolescence

Suicide in adolescence is the second most cause of death between the ages of 14-17 (Centers for Disease Control and Prevention (n.d.).  With the development of technology and the increase of social media, bullying can take many forms.  It does not necessarily have to be confined in face-to-face situations; social media has opened the door to innovative ways of bullying through the Internet.  Social media also can influence the young minds of adolescents.  Because of this, depression has increased throughout the years, resulting in more suicides (Centers for Disease Control and Prevention (n.d.).  The purpose of this case report is to address the problem of depression in adolescence and increasing suicide rates, by discussing how to assess for depression and provide treatment options and/or resources.

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Literature Review The following resources helped introduce the assessment of depression process with the use of an established questionnaire.  Allgaier, Pietsch, Frühe, Sigl-Glöckner, & Schulte-Körne (2012), in Screening for depression in adolescents: Validity of the patient health questionnaire in pediatric care, researches the appropriateness and validity of the Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-2 (PHQ-2) that is traditionally used to assess depression in adults, to be used to assess adolescents with depression. 

The study states that the PHQ-9, which was derived from the Primary Care Evaluation of Mental Disorders interview, is the gold standard for assessing Depressive Disorders in adults.  The results confirmed the appropriateness of the PHQ-9 and PHQ-2 to be used to assess depression in adolescents.  This was validated with results, charts, and data, which showed that PHQ-9 was more specific and sensitive to the detection of depression, as opposed to the PHQ-2. Arroll, et al. (2010), in Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population, further looked at the validity of the Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-2 (PHQ-2) to be used in the Primary Care setting. 

The intention is to identify depression earlier than seeing a Psychiatrist or Psychologist.  The study shares that about 50% of primary care providers miss the diagnosis of depression without the proper screening tool.  The study utilized a 3-arm randomized controlled population.  Sensitivity and specificity were calculated comparing the results of the screening tests with a reference standard.  The results concluded that using the PHQ-9 determined depression diagnosis with much more sensitivity than the PHQ-2.  The study provided data and tables to illustrate the findings.

Furthermore, Lowe, Lipps, Gibson, Jules, & Kutcher (2018), published Validation of the Kutcher adolescent depression scale in a Caribbean student sample, which addresses the reliability of the Kutcher Adolescent Depression Rating Scale (KADS) because adolescent depression detection has been limited within the Caribbean adolescent population.  This study was completed with a sample from elementary schools in Jamaica and Barbados.  Not only was KADS used for the study, but also the Adolescent Depression Rating Scale (ADRS), the Revised Children’s Anxiety and Depression Scale (RCADS), and state and trait anxiety visual analogue scales, as references to compare. ADRS and RCADS is currently the gold standard and more widely accepted in the Caribbean because it has been proven to have consistent validity and reliability.  The study suggested that the KADS assessment had an acceptable range of concurrent validity, and it correlated with the ADRS and RCADS.  

The study included flow charts, data, and tables to illustrate the effectiveness of KADS. Case Description with Applied Theories Adolescent depression has increased in the past years.  According to the National Institute of Mental Health (NIMH) (n.d.), in 2016, an estimated 3.1 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This number represented 12.8% of the U.S. population aged 12 to 17.  And according to the Centers for Disease Control and Prevention (n.d.), the second leading cause of death in adolescents (aged 15-19), is suicide.  The NIMH continues to add that 19% received treatment with a therapist, 19% received treatment with a therapist along with medication, only 2% received medication treatment alone, and an overwhelming 60% of adolescents did not receive any treatment at all.  Knowing that adolescents are at school majority of their weekday time, it might be best to have depression being assessed at the school level by a school nurse and assist in having treatment options offered and delivered earlier than seeking help at a doctor’s office.

Applying Watson’s Theory of Caring would assist in understanding the role of the school nurse to the adolescent student.  Watson’s theory focused on the human and nursing paradigm, where the goal is to balance and bring harmony between health and illness experiences.  This holistic approach to caring would prove beneficial to those dealing with depression.  While assessing a student on their possible depressive state, the school nurse can employ the Theory of Caring by assisting the student in recognizing their own emotional state of being and thereby giving the student a sense of capacity for actual self-healing (Ozan, Okumuş, & Lash, 2015). Furthering the relationship between school nurse and adolescent student, the use of Hildegard Peplau’s Theory of Interpersonal Relationships.  Peplau’s theory focuses on the three relationship stages of the school nurse and the adolescent student: (1) orientation, (2) working, and (3) termination.  Within orientation, the school nurse and the student are just getting to know and understand each other.  This is when the assessment of depression occurs and whether or not the student should be followed in regards to receiving possible treatment for depression.  If the student has been deemed to be in a depressive state, that is when the working relationship occurs.  The school nurse and the student begin to build a relationship built on trust, honesty, and openness. 

The student should feel that their emotional situation is recognized but at the same time understand that there are ways to assist in this emotional state.  During termination, the student has been given management skills and coping mechanisms, tools to deal with situations in school, life, family, and anything that might disrupt the progress of growth and healthy living mentally (Delaney, Shattell, & Johnson, 2017). Synthesized Literature Findings When creating a program that will help identify adolescent students at risk for depression and suicide, utilizing several nursing theories can be used to accomplish this goal.  Beginning with Watson’s Theory of Caring, the nurse becomes involved with the student to begin defining the relationship of school nurse and student.  With Peplau’s Theory of Interpersonal Relationships, the relationship begins with assessing the student’s risk of depression. 

Using the Patient Health Questionnaire-9 (PHQ-9) as an assessment tool to be used with adolescents was shown to have a sensitivity of 85.0% and specificity of 79.4% (Allgaier, Pietsch, Frühe, Sigl-Glöckner, & Schulte-Körne, 2012).  This was further solidified with Arroll, et al. (2010), who also used the PHQ-9 which resulted with 74% sensitivity and 91% specificity.  In both studies, the PHQ-9 was proven to be the better assessment tool for depression than the PHQ-2.  Because the PHQ-2 was limited to just 2 questions, details involving further assessment was found with the PHQ-9 that would not be discovered otherwise.  Allgaier, Pietsch, Frühe, Sigl-Glöckner, & Schulte-Körne (2012), continue to discuss that the PHQ-9 was determined to have a Cronbach’s alpha coefficient of .82.  This reliability shows that this questionnaire can be utilized not only in primary care for adults, but also with adolescents.

Case Summary Adolescent depression will only increase with the age of technology.  Bullying is far more easier to reach than just the arm length of a swinging fist.  A student can emotionally scar another student with just a simple click on a keyboard and social media post that can disseminate like wild fire to the masses.  School staff, especially nurses, can assist in identifying these students who are possible victims of bullying or at risk for depression or emotional assistance.  With over 60% of adolescents with depression not receiving any type of support whether psychological or pharmaceutical, is a staggering percentage that needs to be addressed (Centers for Disease Control and Prevention, n.d.).  School nurses are with adolescents almost every day and some visit the nurse office often. 

Signs and symptoms of depression in adolescents can take many shapes or forms.  Thus, using a depression assessment tool when a student comes into the office despite for what reason, can possibly clue in to students who may need help and are unable to really voice it or recognize they need the help. Intervention A useful intervention for most mood disorders is the utilization of cognitive based therapies.  Cognitive theory basically suggests that automatic thoughts of negative affect and depressed mood are what the mind cognitively distorts (Rnic, Dozois, & Martin, 2016).  Cognitive behavior therapy (CBT) is a type of psychotherapy that addresses emotional problems by boosting the person’s self-worth and happiness by modifying the initial negative thoughts, emotions, and/or behaviors.  

For example, when this author sees a rose, the hurtful memory of being forced into the bushes to take a picture and receiving several minor nicks on arms and legs from the thorns becomes apparent.  With CBT, this author can now change that negative thought process and remember that roses are beautiful and fragrant.  Keles & Idsoe (2018) did a meta analysis of group cognitive behavior therapy interventions for adolescents and had remarkable results.  It showed that the randomized controlled trials supported group CBT is effective for treating depression among adolescents.  It was also noted that it is more cost effective because it is group therapy and that it can be utilized outside of the clinic (Keles & Idsoe, 2018). Implementation Knowing that the PHQ-9 would be the most effective at detecting depression in adolescents, this questionnaire would be the basis of educating school nurses on how to use the tool. 

Educating school nurses on (1) what is deemed to be a high-risk score, (2) address the specific issues that the student might consider the factors that lead them to be emotionally vulnerable, and then (3) to begin the process of cognitive behavior therapy.  School nurses will be educated on how to assess, address issues, begin teachings of cognitive behavior therapy and then also refer to the school psychologist and social worker to give more added emotional support and guidance.  Additional resources for adolescents with depression will give those students more options on how to address their issues and with who is most compatible. Evaluation Evaluating whether the proposed case review is effective, it would be best to test it against Kolcaba’s Theory of Comfort. 

Because Kolcaba’s theory is holistic, addressing the pain of a patient (whether it is physical or emotional) is in regards to the three types of comfort: relief, ease, and transcendence.  And these 3 types of comfort are addressed in the four contexts of the holistic experience of: physical, psycho spiritual, socio cultural, and environmental. In order to fully evaluate the effectiveness of cognitive behavior therapy as an effective intervention for students who are at risk for depression and/or suicide, it is best to address Kolcaba’s Theory of Comfort within the three types of comfort themselves.

Relief.  Assessing comfort of with the use of observation charts or comfort scoring. Physical addresses the mood swings, any heart issues or breathing issues induced by depression or anxiety.  Psycho spiritual addressed anxiety and fear.  Socio Cultural addressed relief from feeling alienated.  And environmental addressed relief from environmental stressors such as social media contact.  This area of comfort could be evaluated with an observational checklist that included comfort level scoring and qualitative data retrieved from the patient.

Ease.  Physical addressed ease in pain and distressing symptoms.  Psycho spiritual addressed ease of fear and depression.  Socio cultural addressed ease in alienated feeling.  And environmental addressed ease from environmental stressors not being around the bullies or in contact with bullies via in person or web.  This can be evaluated by the patient verbalizing ease and contentment, and lack of fear or visual reduced anxious behavior.

Transcendence.  Physical addressed rising above pain and distressing symptoms.  Psycho spiritual addressed crying, fear, and depression.  Socio cultural addressed need for rising above the feeling of alienation, and need for support from family or significant other.  Environmental addressed the need to rise above the level of environmental stressors (Chandra, Raman, & Kolcaba, 2016).  This can be evaluated by overall level of depression of the patient was reduced and vocalizing tools in order to overcome emotional obstacles.  Comfort scores and observation checklist can also be utilized by seeing the student motivated to participate in activities, able to commit to active daily living activities, and the student is able to adjust to being alienated and feeling more confidence and self-worth in an otherwise very unwelcoming environment (Chandra, Raman, & Kolcaba, 2016). Kolcaba’s theory of comfort is significant.  It truly does address comfort in most, if not all, aspects nursing.  The need for comfort to be approached in the holistic manner is expressed, and the use of a taxonomic structure to address all constructs of the theory as a whole.  Kolcaba’s theory of comfort is parsimonious, meaning simple at best.  It is all containing and addresses issues thoroughly without use of much resources if any.

Conclusion Writing this conclusion is very difficult.  Just today, I just read an article of a student who was found dead by the custodian in his middle school at 6:30am (Vargas, 2019), apparently from a suicide.  Students are shocked, mourning, and grieving.  There has to be signs some say.  Within the article, counselors state that parents should look for signs of depression, changes in behavior, lack of appetite.  But, most times, adolescents don’t confide in their parents, they usually turn to their friends, but even that can be vague.  Some may come into a school nurse office stating they just don’t feel good. 

Seems benign, the school nurse does a cursory assessment with vitals and find nothing out of the ordinary.  And sends that student back to class after 20 minutes of rest.  What if the school nurse had a simple tool to ask sensitive questions that might not ever get asked?  The student is there, in the nurse office, the nurse can easily hand the student a questionnaire such as PHQ-9.  Most students will pass over the PHQ-9 without understanding the gravity of it, but there might be just student that might actually answer it truthfully and a school nurse will be able to assist that student in receiving services and much needed assistance.

Thus, a school nurse can be armed with the necessary tools to assess an adolescent in an open and non-clinical manner for possible depression.  If a student was found to be at risk for depression, the school nurse will again have the tools to assist that student in developing their own personal cognitive behavior therapy tools.  With the increasing rate of depression and suicide in adolescents, one more added advantage for those students to find help is to have it within the place they are located most of their waking hours like school.  School nurses have the education, compassion, and necessary capacity to be that bridge to help in the mental health of adolescents.

References : DNP 815 Week 7 Case Report: Application of Theory 

Allgaier, A., Pietsch, K., Frühe, B., Sigl-Glöckner, J., & Schulte-Körne, G. (2012).  Screening for depression in adolescents: Validity of the patient health questionnaire in pediatric care. Depression & Anxiety (1091-4269), 29(10), 906. doi:10.1002/da.21971

Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., & … Hatcher, S. (2010). Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Annals of Family Medicine, (4). 348. Centers for Disease Control and Prevention (n.d.). National center for health statistics: Adolescent health.  Retrieved from https://www.cdc.gov/nchs/fastats/adolescent-health.htm

Chandra, S. M., Raman, K., & Kolcaba, K. (2016). Application of Katharine Kolcaba Comfort Theory in Post Operative Child: Delivering Integrative Comfort Care Intervention by using Theory of Comfort. International Journal of Science and Research (IJSR),5(6), 1714-1720. doi:10.21275/v5i6.nov164670

Delaney, K. R., Shattell, M., & Johnson, M. E. (2017). Original Article: Capturing the Interpersonal Process of Psychiatric Nurses: A Model for Engagement. Archives of Psychiatric Nursing, 31, 634–640. https://doi-org.lopes.idm.oclc.org/10.1016/j.apnu.2017.08.003 Fawcett, J. (2005). Middle-range nursing theories are necessary for the advancement of the discipline. Aquichan , 5 (1), 32-43. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=21501730&site=ehost-live&scope=site

Keles, S., & Idsoe, T. (2018). A meta-analysis of group Cognitive Behavioral Therapy (CBT) interventions for adolescents with depression. Journal Of Adolescence, doi:10.1016/j.adolescence.2018.05.011

Kolcaba K. (2001). Evolution of the mid range theory of comfort for outcomes research. Nursing Outlook, 49(2), 86–92. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107034755&site=eds-live&scope=site

Koehn ML. (2000). Alternative and complementary therapies for labor and birth: an application of Kolcaba’s theory of holistic comfort. Holistic Nursing Practice, 15(1), 66–77. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106998146&site=eds-live&scope=site

Krinsky, R., Murillo, I., & Johnson, J. (2014). A practical application of Katharine Kolcaba’s comfort theory to cardiac patients. Applied Nursing Research, 27(2), 147–150. https://doi-org.lopes.idm.oclc.org/10.1016/j.apnr.2014.02.004

Lowe, G. A., Lipps, G. E., Gibson, R. C., Jules, M. A., & Kutcher, S. (2018). Validation of the Kutcher adolescent depression scale in a Caribbean student sample. CMAJ Open, 6(3), E248-E253 National Institute of Mental Health. (n.d.). Major depression.  Retrieved from https://www.nimh.nih.gov/health/statistics/major-depression.shtml#part_155031

Ozan, Y. D., Okumuş, H., & Lash, A. A. (2015). Implementation of Watson’s theory of human caring: a case study. International Journal of Caring Sciences, 8(1), 25–35. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103751480&site=eds-live&scope=site

Rnic, K., Dozois, D. J. A., & Martin, R. A. (2016). Cognitive distortions, humor styles, and depression. Europe’s Journal of Psychology, 12(3), 348–362. https://doi-org.lopes.idm.oclc.org/10.5964/ejop.v12i3.1118 Shu Hua NG. (2017). Application of Kolcaba’s Comfort Theory to the Management of a Patient with Hepatocellular Carcinoma. Singapore Nursing Journal, 44(1), 16–23. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124789969&site=eds-live&scope=site

Tektaş, P., & Çam, O. (2017). The effects of nursing care based on Watson’s theory of human caring on the mental health of pregnant women after a pregnancy loss. Archives of Psychiatric Nursing, 31(5), 440–446. https://doi-org.lopes.idm.oclc.org/10.1016/j.apnu.2017.07.002

Vargas, V. (March 5, 2019).  Shocking Death of Teen on Orange County Campus Closes Schools.  NBC News.  Retrieved from: https://www.nbclosangeles.com/news/local/Orange-County-teen-death-campus-closed-parents-506739621.html

DNP 815 Week 1 DQ 1 and 2

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DNP 815 All Weeks Discussions GCU

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DNP 815 Week 3 DQ 1 & 2

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