Posts in category: Nursing Papers

Special Examinations Breast, Genital, Prostate, And Rectal

For this assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate at least 5 differential diagnosis with several possible conditions. Please remember to pretend that this is an actual patient and gives as much detail as possible!
CASE STUDY:
Subjective: • CC: “I have bumps on my bottom that I want to have checked out.”
• HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.
• PMH: Asthma
•Medications: Symbicort 160/4.5mcg
•Allergies: NKDA
•FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD •Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)
Objective: • VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs
•Heart: RRR, no murmurs
• Lungs: CTA, chest wall symmetrical
• Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia
• Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, negMcBurney
•Diagnostics: HSV specimen obtained
Assessment: • Chancre
REQUIRED READINGS
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
· Chapter 17, “Breasts and Axillae”
This chapter focuses on examining the breasts and axillae. The authors describe the examination procedures and the anatomy and physiology of breasts.
· Chapter 19, “Female Genitalia”
In this chapter, the authors explain how to conduct an examination of female genitalia. The chapter also describes the form and function of female genitalia.
· Chapter 20, “Male Genitalia”
The authors explain the biology of the penis, testicles, epididymides, scrotum, prostate gland, and seminal vesicles. Additionally, the chapter explains how to perform an exam of these areas.
· Chapter 21, “Anus, Rectum, and Prostate”
This chapter focuses on performing an exam of the anus, rectum, and prostate. The authors also explain the anatomy and physiology of the anus, rectum, and prostate.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.
Chapter 5, “Amenorrhea”
Amenorrhea, or the absence of menstruation, is the focus of this chapter. The authors include key questions to ask patients when taking histories and explain what to look for in the physical exam.
Chapter 6, “Breast Lumps and Nipple Discharge”
This chapter focuses on the important topic of breast lumps and nipple discharge. Because breast cancer is the most common type of cancer in women, it is important to get an accurate diagnosis. Information in the chapter includes key questions to ask and what to look for in the physical exam.
Chapter 7, “Breast Pain”
Determining the cause of breast pain can be difficult. This chapter examines how to determine the likely cause of the pain through diagnostic tests, physical examination, and careful analysis of a patient’s health history.
Chapter 27, “Penile Discharge”
The focus of this chapter is on how to diagnose the causes of penile discharge. The authors include specific questions to ask when gathering a patient’s history to narrow down the likely diagnosis. They also give advice on performing a focused physical exam.
Chapter 36, “Vaginal Bleeding”
In this chapter, the causes of vaginal bleeding are explored. The authors focus on symptoms outside the regular menstrual cycle. The authors discuss key questions to ask the patient as well as specific physical examination procedures and laboratory studies that may be useful in reaching a diagnosis.
Chapter 37, “Vaginal Discharge and Itching”
This chapter examines the process of identifying causes of vaginal discharge and itching. The authors include questions on the characteristics of the discharge, the possibility of the issues being the result of a sexually transmitted infection, and how often the discharge occurs. A chart highlights potential diagnoses based on patient history, physical findings, and diagnostic studies.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
· Chapter 3, “SOAP Notes” (Previously read in Week 8)
Cucci, E., Santoro, A., DiGesu, C., DiCerce, R., & Sallustio, G. (2015). Sclerosing adenosis of the breast: Report of two cases and review of the literature. Polish Journal of Radiology, 80, 122–127. doi:10.12659/PJR.892706. Retrieved from /orders/www.ncbi.nlm.nih.gov/pmc/articles/PMC4356184/  
Sabbagh , C., Mauvis, F., Vecten, A., Ainseba, N., Cosse, C., Diouf, M., & Regimbeau, J. M. (2014). What is the best position for analyzing the lower and middle rectum and sphincter function in a digital rectal examination? A randomized, controlled study in men. Digestive and Liver Disease, 46(12), 1082–1085. doi:10.1016/j.dld.2014.08.045
Westhoff , C. L., Jones, H. E., & Guiahi, M. (2011). Do new guidelines and technology make the routine pelvic examination obsolete? Journal of Women’s Health, 20(1), 5–10.
This article describes the benefits of new technology and guidelines for pelvic exams. The authors also detail which guidelines and technology may become obsolete.
Centers for Disease Control and Prevention. (2019). Sexually transmitted diseases (STDs). Retrieved from http://www.cdc.gov/std/#
This section of the CDC website provides a range of information on sexually transmitted diseases (STDs). The website includes reports on STDs, related projects and initiatives, treatment information, and program tools.

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Systematic Reviews: Searching and Analysis of the Literature

This Assignment expands upon the work you have been conducting for this week’s Discussion.) you will conduct a search for literature on your selected practice problem. A Literature Review Matrix template will be used to identify gaps in the literature.
To prepare:
Consider the practice problem you addressed in this week’s Discussion. (You may select a new issue if necessary, but it is not recommended): Practice problem chosen: Health literacy and self-care activities, self-efficacy, and health related outcome of patients with type 2 Diabetes.
Review the guidelines in the Literature Review Matrix, included in the Learning Resources.
Formulate a research question around your issue as indicated in Part I. Then
complete Part II of the Matrix, identifying the resources you will use, search terms and criteria, and Boolean search strings.
Using the Walden Library, locate 10 articles related to your research question. At least one article must be a systematic review.
All of the articles should be primary sources. NOTE: If appropriate, you may use the four articles you reviewed for this week’s Discussion.
Actual Assignment:
Complete Part I and Part II of the Literature Review Matrix template.
Begin working on Part III.
Review Part III of the Literature Review Matrix and notice which middle range theories were used most frequently in the articles you reviewed.
Consider the appropriate use of the theoretical frameworks in each article.
Review the information on empiricism presented in Chapter 1 of Theoretical Basis for Nursing and Chapter 6 in The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence as you consider your response to Part IV.
Complete Part III of the Literature Review Matrix.
In your analysis of the strengths and weaknesses of the existing literature, note the appropriate use of the theoretical frameworks.
Complete Part IV addressing the influence of empiricism on quantitative methodology.
REFERENCES
McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.
Chapter 10, “Introduction to Middle Range Nursing Theories”
Chapter 11, “Overview of Selected Middle Range Nursing Theories”
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.
Chapter 3, “Introduction to Quantitative Research”
Chapter 4, “Introduction to Qualitative Research”
Chapter 6 guides nurses through the process of identifying research objectives, developing research questions, and creating research hypotheses.
Chapter 7 examines the process of preparing for a literature review to support research efforts.
Chapter 13, “Outcomes Research”
Moran, K., Burson, R., & Conrad, D. (2017). The doctor of nursing practice scholarly project: A framework for success (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Review Chapter 6, “Developing the Scholarly Project”
Armola, R., Bourgault, A., Halm, M., Board, R., Bucher, L., Harrington, L., & … Medina, J. (2009). AACN levels of evidence: What’s new? Critical Care Nurse, 29(4), 70–73. doi: 10.4037/ccn2009969
Elkins, M. Y. (2010). Using PICO and the brief report to answer clinical questions. Nursing, 40(4), 59–60. doi: 10.1097/01.NURSE.0000369871.07714.39
Fawcett, J., & Garity, J. (2009). Chapter 6: Evaluation of middle-range theories. Evaluating Research for Evidence-Based Nursing. Philadelphia, Pennsylvania: F. A. Davis.
DeSanto-Madeya, S., & Fawcett, J. (2009). Toward Understanding and Measuring Adaptation Level in the Context of the Roy Adaptation Model. Nursing Science Quarterly, 22(4), 355–359.
Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part I an introduction to gathering, evaluating, and recording the evidence… fifth in a series. American Journal of Nursing, 110(7), 47–52. doi: 10.1097/01.NAJ.0000383935.22721.9c
Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5
Literature Review Matrix
Part I: PICO Analysis of Research Topic
P: Patient or Population
I: Anticipated Intervention
C: Comparison group or Current standard
O: Outcome desired
Source: Adapted from Elkins (2010)
Step 1: Frame your clinical question using the PICO method.
P:
I:
C:
O:
Part II: Search Strategy
Using the Walden Library and other appropriate databases, locate ten scholarly articles that pertain to a practice issue of interest to you and that is appropriate for an evidence-based practice project.
Step 1: Identify the resources you will utilize, or utilized, to find articles that pertain to your topic

Step 2: Identify search terms and criteria

Step 3: Identify Boolean search strings
Part III: Analysis of Literature
Step 1: Summarize the ten (10) articles you select from your search efforts completing the table below.

Step 2: Briefly summarize the history and purpose of your research question.
Step 3: Analysis of strengths and weaknesses of existing literature.

Step 4: What gap exists in the current literature? Explain.
Part IV: Identify the influence of empiricism on quantitative research methodology. Discuss its applicability to evidenced-based practice projects.

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Academic Success And Professional Plan

ASSIGNMENT WEEK 1
Begin creating an academic and professional network by identifying which academic and professional connections and resources you need to collaborate with to be successful in your MSN program and as a practicing nurse.
 
To Prepare:
 
Consider individuals, departments, teams, and/or resources within Walden University and within your profession that you believe can support your academic and professional success.
Identify at least two academic and at least two professional individuals, colleagues, or teams to collaborate with to help you be successful in your MSN program and as a practicing nurse.
Download the Academic Success and Professional Development Plan Template.
The Assignment:
 
Academic and Professional Network
 
Complete Part 1 of your Academic Success and Professional Development Plan Template. Be sure to address the following:
 
Clearly and accurately identify at least two academic individuals or teams to collaborate with to be successful in the MSN program and as a practicing nurse.
Clearly and accurately identify at least two professional individuals or teams to collaborate with to be successful in your MSN program and as a practicing nurse.
Clearly and thoroughly explain in detail why the academic and professional individuals/teams were selected to support success in the MSN program and as a practicing nurse.
Clearly and accurately explain how the academic and professional individuals/teams will support success in the MSN program and as a practicing nurse.
 
 
BELOW IS THE RUBRIC FOR ASSIGNMENT PLEASE, STRICTLY FOLLOW IT.
Complete Part 1 of your Academic Success and Professional Development Plan Template. Be sure to address the following: ·   Identify at least two academic and at least two professional individuals or teams to collaborate with to be successful in the MSN program and as a practicing nurse.–
Excellent 32 (32%) – 35 (35%)
Good 28 (28%) – 31 (31%)
Fair 25 (25%) – 27 (27%)
Poor 0 (0%) – 24 (24%)
·   Explain why these individuals and/or teams were selected and how they will support success in the MSN program and as a practicing nurse.–
Excellent 45 (45%) – 50 (50%)
Good 40 (40%) – 44 (44%)
Fair 35 (35%) – 39 (39%)
Poor 0 (0%) – 34 (34%)
Written Expression and Formatting – Paragraph Development and Organization:  Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.–
Excellent 5 (5%) – 5 (5%)
Good 4 (4%) – 4 (4%)
Fair 3.5 (3.5%) – 3.5 (3.5%)
Poor 0 (0%) – 3 (3%)
Written Expression and Formatting – English writing standards:  Correct grammar, mechanics, and proper punctuation–
Excellent 5 (5%) – 5 (5%)
Good 4 (4%) – 4 (4%)
Fair 3.5 (3.5%) – 3.5 (3.5%)
Poor 0 (0%) – 3 (3%)
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–
Excellent 5 (5%) – 5 (5%)
Good 4 (4%) – 4 (4%)
Fair 3.5 (3.5%) – 3.5 (3.5%)
Poor 0 (0%) – 3 (3%)

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Week 3: Personality Disorders

 
Discussion: Treatment of Personality Disorders – Schizotypal Personality Disorder
 
Explain the diagnostic criteria for your assigned personality disorder.
 
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned personality disorder.
 
Describe clinical features from a client that led you to believe this client had this disorder. Align the clinical features with the DSM-5 criteria.
 
References
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
· Standard 12 “Leadership” (pages 76-77)
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
· Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)
· Chapter 22, “Personality Disorders” (pp. 742–762)
· Chapter 13, “Psychosomatic Medicine” (pp. 451–464)
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
· Chapter 68, “Paranoid, Schizotypal, and Schizoid Personality Disorders”
· Chapter 69, “Antisocial Personality Disorder”
· Chapter 70, “Borderline Personality Disorder”
· Chapter 71, “Histrionic Personality Disorder”
· Chapter 72, “Narcissistic Personality Disorder”
· Chapter 73, “Cluster C Personality Disorders
Note: You will access this book from Walden Library databases.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
· “Personality Disorders”
Note: You will access this book from Walden Library databases.
Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders. Psychiatry: Interpersonal & Biological Processes, 76(1), 32–52. doi:10.1521/psyc.2013.76.1.32
Note: You will access this article from Walden Library databases.
Rees, C. S., & Pritchard, R. (2015). Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52(1), 45–55. doi:10.1037/a0035158
Note: You will access this article from Walden Library databases.
 
Laureate Education. (2017a). A woman with personality disorder [Interactive media file]. Baltimore, MD: Author.
 
Kernberg, O. (n.d.). Psychoanalytic psychotherapy for personality disorders: An Interview with Otto Kernberg, MD. [Video file]. Mill Valley, CA: Psychotherapy.net
Note: This video is approximately 94 minutes of length. You will access this article from Walden Library databases

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Work Environment Assessment

Discussion: Workplace Environment Assessment
How healthy is your workplace?
You may think your current organization operates seamlessly, or you may feel it has many issues. You may experience or even observe things that give you pause. Yet, much as you wouldn’t try to determine the health of a patient through mere observation, you should not attempt to gauge the health of your work environment based on observation and opinion. Often, there are issues you perceive as problems that others do not; similarly, issues may run much deeper than leadership recognizes.
There are many factors and measures that may impact organizational health. Among these is civility. While an organization can institute policies designed to promote such things as civility, how can it be sure these are managed effectively? In this Discussion, you will examine the use of tools in measuring workplace civility.
To Prepare:
· Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
· Review and complete the Work Environment Assessment Template in the Resources.
Post a brief description of the results of your Work Environment Assessment. Based on the results, how civil is your workplace? Explain why your workplace is or is not civil. Then, describe a situation where you have experienced incivility in the workplace. How was this addressed? Be specific and provide examples.
Assignment: Workplace Environment Assessment
Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.
In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.
To Prepare:
· Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
· Review the Work Environment Assessment Template.
· Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
· Select and review one or more of the following articles found in the Resources:
o Clark, Olender, Cardoni, and Kenski (2011)
o Clark (2018)
o Clark (2015)
o Griffin and Clark (2014)
The Assignment (3-6 pages total):
Part 1: Work Environment Assessment (1-2 pages)
· Review the Work Environment Assessment Template you completed for this Module’s Discussion.
· Describe the results of the Work Environment Assessment you completed on your workplace.
· Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
· Explain what the results of the Assessment suggest about the health and civility of your workplace.
Part 2: Reviewing the Literature (1-2 pages)
· Briefly describe the theory or concept presented in the article(s) you selected.
· Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
· Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.
Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)
· Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
· Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.
Resources to Use
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

• Chapter 5, “Collaborative      Leadership Contexts: Networks, Communication, Decision Making, and      Motivation” (pp. 121–144)
• Chapter 9, “Creating and      Shaping the Organizational Environment and Culture to Support Practice      Excellence” (pp. 247–278)
• Chapter 10, “Building Cohesive and Effective      Teams” (pp. 279–298)

Select at least ONE of the following:
Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. Journal of Nursing Administration, 41(7/8), 324–330. doi:10.1097/NNA.0b013e31822509c4
Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator. doi:10.1097/NNE.0000000000000563
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from /orders/www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf 
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535–542. doi:10.3928/00220124-20141122-02
Document: Work Environment Assessment Template (Word document)
 
Work Environment Assessment 
Template
Work Environment Assessment Template
Use this document to complete the Module 4 Workplace Environment Assessment.
 
Summary of Results – Clark Healthy Workplace Inventory 
 
Identify two things that surprised   you about the results. Also identify one idea that you believed prior to   conducting the Assessment that was confirmed.
 
What do the results of the Assessment   suggest about the health and civility of your workplace?
 
Briefly describe the theory or concept presented in the   article(s) you selected.
Explain how the theory or concept   presented in the article(s) relates to the results of your Work Environment   Assessment.
 
Explain how your organization   could apply the theory highlighted in your selected article(s) to improve   organizational health and/or create stronger work teams. Be specific and provide   examples.
 
General Notes/Comments

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Assignment: Academic Success and Professional Development Plan Part 3

Respond Info

Respond to Mackenzie and Heidi
* by offering additional thoughts regarding the examples shared, Software Development Life Cycle-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues.
 
Mackenzie Gray 
Top of Form
The Systems Development Life Cycle (SDLC) is a set of stages used when developing a new information system (Ungvarsky, 2019). The SDLC is a specific plan that helps the team throughout the entire process, from the idea of the system to the implementation (Ungvarsky, 2019). The development of SDLC for a healthcare organization should include a needs assessment that encompasses the needs of the organization’s healthcare workers, including physicians and nurses (McGonigle & Mastrian, 2017). The organization’s needs as a whole need to be represented, so solutions get proposed to meet the needs or address issues (McGonigle & Mastrian, 2017).
The waterfall model is one of the oldest methods used in SDLC and is linear; therefore, the model is sequential, and each stage provides information for the following stage (McGonigle & Mastrian, 2017). The waterfall model has six phases: feasibility, analysis, design, implementation, test, and maintain (McGonigle & Mastrian, 2017). Feasibility helps decide if the project could be initiated and typically addresses the following: technological, economics, legal, operational, and scheduling feasibility (McGonigle & Mastrian, 2017). Operational feasibility specifically helps determine if the project will be effective, meet the set expectations to achieve the goals of the project, or addressing the problem at hand (McGonigle & Mastrian, 2017). The analysis phase helps examine the requirements for the system and business needs (McGonigle & Mastrian, 2017). Analysis is an important step to assess the workflow (McGonigle & Mastrian, 2017). Excluding nurses from these crucial beginning phases could be detrimental to implementing a new health information technology system. Nurses work on the frontlines of healthcare and would be essential to decide if the system is feasible to the operations and workflow. For example, implementing a new EHR could be more cost-conscious; however, the documentation could cause inefficiency in the workflow.  The design phase helps the team decide what programs are necessary and discusses how they will interact, how the individual programs work, and what the look or feel will be (McGonigle & Mastrian, 2017). For example, nurses would be great resources to help design and decide specifics to be included in an EHR, as nurses are often documenting several times a shift and on multiple patients. The implementation phase occurs when the designed system is ready to use (McGonigle & Mastrian, 2017). The test phase evaluates the system to ensure the program works as it was designed (McGonigle & Mastrian, 2017). Nurses would be great resources to perform beta testing to ensure the system is adequate and performs as it should. The system must be maintained after the testing phase (McGonigle & Mastrian, 2017).
I have not been included in the selection and planning of a new health information technology system in my nursing practice. Being included in a decision-making process can result in increased satisfaction for workers and improve the overall morale of the organization. A study by Graham-Dickerson et al. (2013) concluded that involving staff nurses in decision-making had a positive impact on the work environment, and nurses reported feeling like part of a team when they were included.
References
Graham-Dickerson, P., Houser, J., Thomas, E., Casper, C., ErkenBrack, L., Wenzel, M., & Siegrist, M. (2013). The value of staff nurse involvement in decision making. Journal of Nursing Administration, 43(5), 286–292. /orders/doi-org.ezp.waldenulibrary.org/10.1097/NNA.0b013e31828eec15
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Ungvarsky, J. (2019). Systems development life cycle (SDLC). Salem Press Encyclopedia of Science. Retrieved from /orders/search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=ers&AN=119214383&site=eds-live&scope=site
Bottom of Form
 
Heidi
Top of Form
Nurses should be a part of the system development life cycle for many reasons.  Nurses can bring a variety of different references to the team.  They can provide their expertise in patient care to develop a successful program.
1. Planning-Software innovation requires collaboration with a team of people to understand what needs are to be met and how to best accomplish this (McLean, Frisch, & Roudsari, 2015).  Without involving nurses in this process, you would not know what issues need resolved and what the perceived problem is.  Nurses can easily identify what needs improved.  Involving nurses at this stage can help address problems that are not well known to everyone.  Nurses from different specialties should be involved.
2. Design– Nurses typically make up a large portion of the people who will be implementing or carrying out the program and using it on a daily basis.  Nurses who do not have input into design will sometimes find a system redundant or non- user friendly.  This can lead to frustration and sometimes a delay in care if the system is hard to navigate for the nurse. Most of this phase is done by the IT team (Singletary & Baker, 2019).  This would be a great stage to involve the nurse informaticist to bridge the gap between technology and nursing.  The easier it is to navigate the system the better the outcomes for the nurses.  Some programs are not well -designed leading to undue stress on the staff
3. Implementation-If nurses are not properly trained for implementation, they may be discouraged from using the program.  If there are no resources for this stage the staff will fail to comply with the program.  Nurses could potentially train as super-users for program implementation (Tyler, 2019).  Nurses need to have a go to person for any questions about the program and how to overcome them.
4. Maintenance/Evaluation– If program developers and participants do not get the input from nurses about the pros and cons of the system, they may never truly make it a great program.  Policies and procedures are always changing and there is a need to constantly evaluate the effectiveness of the system.  Nurses should be allowed to be part of this process so that the program can be edited based on the needs of the nurses and the patients.
I have been involved in the implementation of the Cerner program at the hospital I formerly worked at.  We switched to Cerner from a paper system, so it was quite the change and came with a lot of challenges.  All staff were trained on the system and a select few had additional training to be super users. Those who did not receive additional training were not as well prepared and, in my opinion, all staff should have had the additional education. We also had cheat sheets made out for us with the most frequently asked questions/problems that we used for resources.  It was a challenge to get everyone motivated to switch to an electronic health record from paper, but eventually we made the switch.  We also had a nurse informaticist who was available for questions or when problems came up with the system.  There were numerous times that the nursing staff voiced concern over an issue with the system being redundant or cumbersome, but the complaints never made a difference in editing the program.  Our complaints were never taken any further up the chain.
References
McLean, A., Frisch, N., & Roudsari, A. (2015, December 19). Nursing’s voice in healthcare IT acquisition decisions. Retrieved from http://cjni.net/journal/?p=4248
Singletary, V., & Baker, E. L. (2019). Building informatics-savvy health departments. Journal of Public Health Management and Practice, 25(6), 610-611. doi:10.1097/phh.0000000000001086
Tyler, D. (2019). A day in the life of a nurse informaticist. Journal of Informatics Nursing, 4(1), 18-20. Retrieved from /orders/search.proquest.com/openview/6eb08f968194395ecb5e118039adfe49/1?pq-origsite=gscholar&cbl=2044826
 
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The Role Of The RN/APRN In Policy Evaluation

The RN/APRN In Policy Evaluation

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

APA format, 350 words, scholar authors, and see references at the bottom
Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?
In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

By Day 3 of Week 9

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.
References

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 7, “Health Policy and Social Program Evaluation” (pp. 116–124 only)

Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261–1267.
Note: You will access this article from the Walden Library databases.

Shiramizu, B., Shambaugh, V., Petrovich, H., Seto, T. B., Ho, T., Mokuau, N., & Hedges, J. R. (2016). Leading by success: Impact of a clinical and translational research infrastructure program to address health inequities. Journal of Racial and Ethnic Health Disparities, 4(5), 983–991. doi:10.1007/s40615-016-0302-4
 

Williams, J. K., & Anderson, C. M. (2018). Omics research ethics considerations. Nursing Outlook, 66(4), 386–393. doi:10.1016/j.outlook.2018.05.003
Note: You will access this article from the Walden Library databases.

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Assignment

Assignment 1: Cognitive Behavioral Theory Versus Rational Emotive Behavioral Theory
While cognitive behavioral therapy (CBT) and  rational emotive  behavioral therapy (REBT) have many similarities, they  are distinctly  different therapeutic approaches. When assessing clients  and selecting  one of these therapies, you must recognize the importance  of not only  selecting the one that is best for the client, but also the  approach  that most aligns to your own skill set. For this Assignment, as  you  examine the similarities and differences between CBT and REBT,  consider  which therapeutic approach you might use with your clients.
Assignment 1: Cognitive Behavioral Theory Versus Rational Emotive Behavioral Theory
The Assignment
In a 1- to 2-page paper, address the following:
Describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.
Explain at least three differences between CBT and REBT.
Include  how  these differences might impact your practice as a mental health   counselor.
Explain which version of cognitive behavioral therapy you might use   with clients and why.
Support your approach with evidence-based   literature.
USE AT LEAST 4 REFERENCES
NOTE:Check Plagiarism
Required Readings
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.
· Chapter 8, “Cognitive Behavioral Therapy” (pp. 313–346)
 
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
 
Required Media
 
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.
 
 
Beck, A. (1994). Aaron Beck on cognitive therapy [Video file]. Mill Valley, CA: Psychotherapy.net.

 
Eysenck, H. (n.d.). Hans Eysenck on behavior therapy [Video file]. Mill Valley, CA: Psychotherapy.net.
 
Optional Resources
Ellis, A. (2012). Albert Ellis on REBT [Video file]. Mill Valley, CA: Psychotherapy.net.
 
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 50 minutes.

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Data-Driven Decision Making

Week 10: Data-Driven Decision-Making Health Care Administration
 
Simulation 2
 
As you examined last week, simulation is a useful analytic tool that healthcare administration might use to help enhance healthcare delivery in their health services organization. While it is impossible to anticipate every uncertainty that may impact healthcare delivery in a health services organization, these analytic tools are valuable for informing the types of decision making you enact as a current or future healthcare administration leader.
 
1.This week, you continue examining simulation as an analytic technique for healthcare administration practice. You consider the strength and weaknesses for simulation distributions and continue to apply advanced simulation techniques to address healthcare administration practice problems.
 
Learning Objectives
Students will:
 
· Analyze simulation distributions for healthcare administration practice
· Analyze strengths and weaknesses for simulation distributions
· Apply simulation techniques to healthcare administration practice
 
 
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
 
Required Readings
Albright, S. C., & Winston, W. L. (2017). Business analytics: Data analysis and decision making (6th ed.). Stamford, CT: Cengage Learning. Chapter 16, “Simulation Models”
 
Torabi, E., Froehle, C. M., Lindsell, C. J., Moomaw, C. J., Kanter, D., Kleindorfer, D., & Adeoye, O. (2016). Monte Carlo simulation modeling of a regional stroke team’s use of telemedicine. Academic Emergency Medicine, 23(1), 55–62. Note: Retrieved from the Walden Library databases.
 
 
 
Discussion Part
 
Simulation of Telemedicine
 
It may come as no surprise that advances in technology have had a dramatic impact on healthcare delivery. Advances in health information technology, such as patient portals; electronic health records (EHRs) or electronic medical records (EMRs); and real-time coordination of patient care, etc., all have greatly contributed to enhancements in healthcare delivery. However, they too presented several challenges to healthcare administration leaders and clinical staff in how to best orient and implement such technology to enhance healthcare delivery.
 
One such advancement in healthcare technology concerns the use of telemedicine to provide patient care and treatment. While delivery of patient care is usually a direct transaction, interfacing with patients and physicians virtually, or at a distance, could greatly enhance how healthcare services are delivered for certain situations, such as disaster events or in rural locales.
 
1. For this Discussion, review the resources for this week. Reflect on the Torabi et al. (2016) article in the resources for this week, and consider the distributions the authors selected for the given simulation.
 
By Day 3
Post a description of the distributions selected by the authors in the Torabi et al. (2016) article, and then explain whether the distributions selected are appropriate for practice, and why. Explain what was done well in the study, as well as areas of weakness for the considerations described by the authors. Be specific, and provide examples.
 
By Day 5
Continue the Discussion and respond to your colleagues in one or more of the following ways:
 
· Ask a probing question, substantiated with additional background information, evidence, or research.
· Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
· Offer and support an alternative perspective, using readings from the classroom or from your own research in the Walden Library.
· Validate an idea with your own experience and additional research.
 
· Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
· Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
 
Submission and Grading Information
Grading Criteria
To access your rubric:
 
Week 10 Discussion Rubric
 
Post by Day 3 and Respond by Day 5
To participate in this Discussion: Week 10 Discussion
 
 
 
 
Assignment Part
 
 
 
 
More Advanced Simulation in Health Care
Simulation in health care often involves more than trivial skills. For example, modeling all outpatient clinic operations in a particular facility would probably involve the use of multiple probability distributions and many calculations. Verifying and validating the simulation requires even more technical prowess. Healthcare administration leaders and decision makers must have the knowledge, skill, and abilities to build and understand these simulations.
 
For this Assignment, review the resources for this week, and reflect on the advanced simulation techniques highlighted. Consider how these advanced simulation techniques might apply to specific simulation models in a health services organization, and then complete the problems assigned for the Assignment.
 
The Assignment: (3 pages)
· Complete Problem 45 (Prizdol prescription drug) on page 887 of your course text.
Note: You will be using Excel and @Risk for this Assignment.
 
Problem 45 on Textbook Pg 887
The annual demand for Prizodol, a prescription drug manufactured and marketed by the NuFeel Company, is normally distributed with mean 50,000 and standard deviation 12,000. Assume that demand during each of the next 10 years is an independent random number from this distribution. NuFeel needs to determine how large a Prizodol plant to build to maximize its expected profit over the next 10 years. If the company builds a plant that can produce x units of Prizodol per year, it will cost $16 for each of these x units. NuFeel will produce only the amount demanded each year, and each unit of Prizodol produced will sell for $3.70. Each unit of Prizodol produced incurs a variable production cost of $0.20. It costs $0.40 per year to operate a unit of capacity.
a. Among the capacity levels of 30,000, 35,000, 40,000, 45,000,50,000,55,000, and 60,000 units per year, which level maximizes expected profit?
Use simulation to answer this question.
b. Using the capacity from your answer to part a. NuFeel can be 95% certain that actual profit for the 10-year period will be between what two values?
 
By Day 7
Submit your answers and embedded analysis as a Microsoft Word management report.
 
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
 
Please save your Assignment using the naming convention “WK10Assgn+last name+first initial. (extension)” as the name.
Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
 
Week 10 Assignment Rubric
 
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
 
Submit your Week 10 Assignment draft and review the originality report.
 
Submit Your Assignment by Day 7
To submit your Assignment: Week 10 Assignment

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