THIS IS NOT A WRITTEN PAPER
please read article and answer following questions.
Walsh, A., Meagher-Stewart, D. & Macdonald, M. (2015). Persistent optimizing: How
mothers make food choices for their preschool children. Qualitative Health Research,
25(4), 527-539
Does not need complete sentences. Be brief, paraphrase and summarize each of the elements clearly
-research design
-purpose
-sample selection
-data collection methods
-plan for data analysis
-strength (2)-provide support for your explanation with citations from additional sources. apa format. last 5 years
-weakness (2) -provide support for your explanation with citations from additional sources. apa format. last 5 years
Focus on the research design, sample selection, data collection methods, and plan for data analysis as discussed in the Walsh et al. (2015) article.
Identify at least two strengths and two weaknesses of the article’s research method based on trustworthiness. You must provide support for your explanation with citations from additional sources.
The template includes an area for each element discussed in the study.
Be brief, paraphrase and summarize each of the elements clearly on the form
Qualitative research methods have 5 categories Phenomenological looks at life experiences and then interpreted by the researcher. Grounded Theory examines social situations to be able to formulate new theories. Ethnographic research focuses on different cultures to better understand the impact of that culture on their overall behavior and health. Exploratory Descriptive research is done to get a result or solution to a problem. Historical research studies the past to help steer future developments. Once the information is obtained, the researcher analyzes, interprets, and develops themes and subthemes.
The nature itself of qualitative research leads to bias in both the research and the subjects. The results of any of the methods used require the researcher to take the information and analyze it. There is nothing to compare this information to and does not take different variable into account. The information the researcher is analyzing could be biased itself due to the way the information is obtained; personal experience from subject, historical ‘facts’, or researchers observations. It would be challenging, if not imposible, to have a control group to compare when analyzing a persons feelings, actions, thoughts, or events that have already occured. There is also no interventions in qualitative research.
My patient safety problem from week 1 was the relationship between the readmission rates of patients with chronic diseases and medication adherence following a hospitalization. I do not feel qualitative research method would be a viable option for this research problem. The readmission rate itself deals with a number or amount which automatically uses quantitative research methods.
References
Gray, J. R, Grove, S. K., & Sutherland, S. (2017). The practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Elsevier. Laureate Education. (Producer). (2015b). Qualitative research designs [Video file]. Baltimore, MD: Walden University.
Respond to 2 people, Maria and Amber, using one or more of the following approaches:
· Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
· Suggest additional health-related risks that might be considered.
· Validate an idea with your own experience and additional research.
maria Week 1
Top of Form
Introduction
The medical interview process is the most important avenue in building a relationship with the patient regardless of race, culture, and age. Foundation for building a positive relationship with the patient based on communication built on courtesy, comfort, connection, and confirmation (Ball et al, 2015). By encouraging open communication, we may obtain more complete information, enhance the possibility of a more accurate diagnosis, and promote appropriate counseling, thus potentially improve adherence to treatment plans that benefit long term health.
Our 76 years old patient who is currently living in an urban setting and having disabilities. The interview takes place in a quiet and private environment such as the examination room. With the patient being disabled, I want to make sure he is fully accommodated as much as possible. Before I begin with my interview, I knock on the door as a courtesy, wash my hands, and since the interview begins with a meeting between strangers, clear introductions, and as well set of tone are important. The basic interview would start with the introduction, establishes names, roles, purpose (including an interest in the patient’s response to illness), the time limits of the interview, and ask him what he is preferred to be called. I will provide privacy by closing the door, pulled the curtain, and make sure that the television is turned off to eliminate the noise (Ball et al,2015). Next is I will assess the patient comfort level, make sure he is not in any distress. If family members or other visitors are in the patient’s room, I will also introduce myself to all those present and explain the purpose of the interview. I will also ask the patient if they can stay, I will also inform the family that the patient must be given a chance to speak without unreasonable interruptions. If the family does not comply, this problem must be addressed promptly. I will make sure I am in front of the patient and sitting at eye level if possible and remove any barrier between me and the patients such as bedside tables or desk and make certain that his information is confidential. After introductions completed and patient comfort assessed I will initiate further questioning by using an open-ended question to allow my patient freely and continuously regarding the reason what brought him, his past medical history, family history, social history and other concern he has. I will use nondirectional questions to encourage the patient to report any and all problems he is experiencing, I will use questions that are worded, avoid using technical terms and diagnostic level so that the patient has no difficulty understanding what is being asked. I will let the patient talk spontaneously rather than restricting and directing the flow of information with multiple questions because frequently interrupt patients on the interview will prevent them from expressing their major concerns. I will respond to the patient in a non-judgmental manner and use empathetic response, validation, and reassurance during the interview to be able to obtain necessary detail without staggering the patient yet aid to form a picture on what the patient is trying to say to determine the best care plan.
Risk Assessment
As people age, they become more susceptible to many risk factors. These factors could potentiate from one factor to the other. For example, the fact that my patient who is above 65 years old tend to be frail and have poor functional reserve even a significant slight illness or an adjustment in medication can predispose to a sudden disastrous functional decline which precipitates them to fall and becoming immobile or rapidly confused thus lead to poor adherence to treatment and automatically set them up to malnutrition thus induce them to failure to thrive (Fjell et al, 2018). Therefore, the risk assessment tool that I can employ is the Comprehensive Geriatric Assessment (CGA). It is an important way to implement the comprehensive management of aging populations. It integrates physical health, functional status, social adaptability, mental health, and environmental conditions and evaluates the elderly overall health objectively. Additionally, it also formulates and makes treatment plans that protect the health and functional status of the elderly to maximize their quality of life. This includes an extensive review of prescription and over the counter drugs, herbal products as well as immunization (Jiang & Li, 2016). The targeted question I would ask includes.
Do you live alone or your leaving with someone?
What medication are you currently taking and what do you use to organize them?
Do you drink alcohol or using any recreational drugs? Are you having trouble remembering stuff?
Have you fallen in the past 3 months?
Do you have trouble with your vision?
Have you lost weight in the past 6 months?
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby. Fjell, A., Cronfalk, B. S., Carstens, N., Rongve, A., Kvinge, L., Seiger, Å., Skaug, K., & Bostrom, A. M. (2018). Risk assessment during preventive home visits among older people. Journal of multidisciplinary healthcare, 11, 609–620. /orders/doi.org/10.2147/JMDH.S176646
Jiang, S., & Li, P. (2016). Current Development in Elderly Comprehensive Assessment and Research Methods. BioMed research international, 2016, 3528248. /orders/doi.org/10.1155/2016/3528248
Amber Week 1 Health History Discussion
Top of Form
Week 1 Discussion: Building a Health History
Initial Post
Health History
A health history is a conversation between the patient and health provider. It is
used to build and establish a relationship with the patient as well as reveal the issues and problems that need attention. The health perspective is a full report based on the patient’s perspective not the health care provider’s. It is imperative to give full attention during the time of interview to collect all data possible for best diagnosis and treatment. The patient I choose to do a health history on in this discussion is the 76 year old male with disabilities in an urban setting.
Interview and Communication Techniques
Before entering in the room to interview my patient I would do an overview of the patient’s health information that was already obtained. “A change in knowledge, experience, cognitive abilities, and personality may occur with aging”(Ball et al., 2015). Therefore it is important anticipate any effects this may have on the interview. After entering the room, introducing myself as a student at Walden University and full name is the first thing I would say. The older patient may have sensory losses due to his age such as hearing or seeing. I would speak clearly and slowly facing the patient due to the older age and disabilities. It is important not to shout at the patient because this can magnify the problem by deforming consonants and vowels. Adapting to the patient’s disabilities is ideal. I would use the caregiver or family member and health record as resources to find out the disabilities of the patient so the interview can be conducted in the best manner possible. If using a electronic device it is important to not neglect the patient. It builds trust and makes the interview more personable when facing the patient and listening as well as possible (Ball et al., 2015).
Risk Assessment Tool
The OLDCARTS assessment tool is used to ensure a comprehensive presentation by making sure all characteristics of the problem are identified. It can be used for the 76 year old male to get a baseline of what is going on with him. The aim of the OLDCARTS assessment is listed below (Ball et al., 2015).
1. Onset of the problem
2. Location of the problem
3. Duration of the problem
4. Character of the problem
5. Aggravating/associated factors of the problem
6. Relieving factors of the problem
7. Temporal factors of the problem
8. Severity of symptom
The next assessment tool that would be good to use for the 76 year old black male with disabilities would be the geriatric assessment. The geriatric assessment tool was created to evaluate an older person’s functional ability, physical health, psychological health and socioenvironmental circumstances. It differs from a regular comprehensive assessment by focusing on functional capacity and quality of life (Elsawy 2011).
The last assessment tool that could benefit in the proper health history performed on the older patient with disabilities is the Fulmer SPICES assessment tool for older adults. Problems seen in older adult include, sleep disorders, issues with eating or feeding, incontinence, confusion, problems with falling and poor skin integrity (Meridith & Terry 2002). SPICES stands for:
S is for Sleep disorders
P is for Problems with eating or feeding
I is for Incontinence
C is for confusion
E is for evidence of falls
S is for the skin breakdown
Heath History Questions
1. What brings you in today?
2. How long has this been going on?
3. What time of day does this effect you the most?
4. What are your living situation and your daily routine?
5. How does your disabilities effect what brought you in today?
Resources
Ball, J.W., Dains, J.E., Flynn J.A., Solomon, B.S., & Stewart, R.W. (2015). Seidel’s
guide to physical examination (8th ed.) St.Louis, MO: Elsevier Mosby.
Elsawy, B., Higgins, K.E.(2011). The geriatric assessment. American Family
Physician. Vol.83 pp.48‐56.
Meredith, W., & Terry, F. (2002). Fulmer SPICES: An Overall Assessment Tool of
Term Planning /nr708-week-5-political-competency-development-plan-assignment/
The “assignments” for this course are the planning and then tracking of your academic progress for the term and beyond. This planning and tracking are documented on the Term Plan. For this course, you must submit an initial term plan draft, an agreed-upon term plan (if revisions were required), a midterm progress check, and a final term plan to both plan and then track your progress. Your goal(s) for each term must indicate appropriate academic progress.
1. Open the Term Plan document, fill in the information at the top of the first page, and follow the instructions for completion:
Your Term Plan: Refer to the Doctoral Degree Coach and find the task that aligns with the end of the current term (the final day of the current quarter/semester). You can use this task as your term goal. Indicate your term goal(s) and what you will accomplish during the weeks of the term. Your tasks should make clear what you will be working on and your plans for appropriate substantive submissions to your Chair/Mentor. Remember that you must show PROGRESS each term to receive a satisfactory grade for the course. Also include your communication plan for the term.
Submit the completed Initial Term Plan in the course shell by Day 7 of Week 1 to meet course expectations and not be dropped from the course. Then complete the Negotiation & Commitment with your Chair/Mentor. (This requires communication between you and your Chair/Mentor.) Submit your Agreed-Upon Term Plan (if revisions were needed) in the course shell by Day 7 of Week 2. This is the Term Plan you must follow to make adequate academic progress for this course.
2. SMART GOALS can help you create a Term Goal that clearly articulates outcomes.
Specific: Set specific goals, which have a much greater chance of being accomplished than general goals.
Measurable: Establish concrete criteria for measuring progress toward the attainment of each goal you set.
Attainable: Ensure that you can map out a clear path to achieving your goal.
Realistic: Write a goal that represents an objective toward which you are both willing and able to work.
Timely: Ground your goal within a time frame (i.e., by the end of this term).
Adequate Progress Review: Throughout the term, track your progress on the Term Plan by entering dates for task completion and by making journal notes on activities completed or modifications needed, noting any barriers and strategies to overcome them. Your Chair/Mentor must approve any modifications and can add journal notes on the plan document for archival purposes (see the sample plans at the end of the Term Plan form). Submit your Updated Term Plan midterm, following your Progress Check. Submit the Final Term Plan by Day 7 of the final week of the term.
3. Looking Ahead: Think about your long-term goal (anticipated date of program completion) as you begin to work on your Term Goals and weekly tasks for next term. Complete the capstone stage goals. It is helpful to think about overall progress as you think about term-by-term progress. Begin with the end in mind!
Learning Objectives
Students will:
· Propose a personal academic plan for the Term
· Identify preferred strategies for committee communication
Assess personal academic plan for the Term.
Term Plan Assignment Grading
In the Grade Center, term plan assignments will be assessed using a Met/Revise/Not Met grading rubric. Term Plans should be revised and (re)submitted until the score of “Met” is achieved. If scored as “Met,” the Week 2 submission is not required.
Met | 1
Term Plan submitted with SMART term goal(s) indicating what will be accomplished during the term. Tasks clarify the plans for appropriate substantive submissions to the Chair/Mentor. Long-term goals are included on the Capstone Stage Goals.
Revise | .5
Term Plan requires revision and resubmission, prompting an opportunity to meet with the Chair to discuss how to revise and earn a “Met” grade. SMART term goal(s) and/or tasks need to be revised and/or clarified to indicate plans for capstone progress.
Not Met | 0
No Term Plan submission or unsatisfactory progress on term goals (at midterm or final submission).
Learning Resources
8-Week Doctoral Term Plan & Capstone Stage/Project
Student Name: Student ID:
Student Walden Email: Student Phone #:
Program and Specialization/Focus:
Mentor/Chair:
2nd Member (if applicable):
University Research Reviewer (if applicable):
Date Started Program:
Current Term Start Date: Stage of Capstone to Select Stage
Do you have an Individual Academic Plan (IAP)? Select One Note: Your Term Plan goals must align with your IAP.
Instructions
Your Term Plan: On the page labelled Your Term Plan, indicate your term goal(s), stretch goal(s), and the tasks you will accomplish during the weeks of the term. Your tasks should make clear what you will be working on and your plans for appropriate substantive submissions to your Mentor/chair(refer to the syllabus for more information). Remember that you must demonstrate substantial academic PROGRESS each term to receive a satisfactory grade for the course.
· indicate that you have read the course syllabus and understand the capstone course grading policies.
By Day 7 of Week 1[ Submit your Term Plan Draft for Mentor/Chair review, negotiation, and commitment.
By Day 7 of Week 2 [ Submit your completed, agreed-upon Term Plan. [ Chair notes acceptance on form].
SMART GOALS can help you create a Term Goal that clearly articulates outcomes.
· Specific: Set specific goals, which have a much greater chance of being accomplished than general goals.
· Measurable: Establish concrete criteria for measuring progress toward the attainment of each goal you set.
· Attainable: Ensure that you can map out a clear path to achieving your goal.
· Realistic: Write a goal that represents an objective toward which you are both willing and able to work.
· Timely: Ground your goal within a time frame (i.e., by the end of this term).
Midterm Progress Check and Adequate Progress Final Review: Throughout the term, track your progress on YOUR TERM PLAN by entering dates for task completion and by making journal notes on activities completed or modification needed, noting any barriers and strategies to overcome them. Your Mentor/Chair must approve any modifications and can add journal notes on the plan document for archival purposes. Submit your Updated Term Plan midterm, following your Midterm Progress Check. [ Chair assesses progress to date.] Submit your Final Term Plan by Day 7 of Week 8. [ Chair assesses final grade.]
Capstone Stage Goals: Think about your long-term goal (anticipated date of program completion) as you work on your Term Goal(s) and weekly tasks each term. Complete the Capstone Stage Goals. It is helpful to think about overall progress as you think about term-by term progress. Begin with the end in mind!
Term GOAL(S) [By the end of this term, I will have completed:
STRETCH GOAL(S) [ Additionally, by the end of this term, I will try to complete:
Mentor/Chair Feedback:
Week
Tasks Toward Term Goal(s) Date Completed Journal Notes
1. Submit Initial Term Plan by Day 7 of week 1, set up mentor/chair communication plan, and
Your Notes
Mentor/Chair Notes:
2. Term Plan Negotiation &
Commitment. Submit Term Plan by Day 7 of week 2
Your Notes:
Mentor/Chair Accepts Plan: [Select] Notes:
3.
Your Notes:
Mentor/Chair Notes:
4.
Your Notes:
Mentor/Chair Notes:
Midterm Progress Check [ Submit Updated Term Plan [ Mentor/Chair: [Select]
Mentor/Chair Feedback
5 Your Notes:
Mentor/Chair Notes:
6 Your Notes:
Mentor/Chair Notes:
7 Your Notes:
Mentor/Chair Notes:
8. Submit Final Term Plan by Your Notes:
Day 7 of week 8, and Mentor/Chair Notes:
Adequate Progress Final Review
Looking Ahead/ Capstone Stage Goals
To ensure that you meet your long-term goal for program completion, it is important to keep track of both your plan progress (each term) and your term-to-term/capstone stage progress toward completion.
Capstone Stage
Goal Date
Completion Date
Journal Notes
1. Prospectus Stage Completion (if applicable)
Your Notes:
Mentor/chair Notes:
2. Proposal/Plan Stage completion
Your Notes:
Mentor/chair Notes:
3. IRB Application and Approval
Your Notes:
Mentor/Chair Notes:
4. Final Study Stage Completion
Your Notes:
Mentor/Chair Notes:
5. CAO Approval and Publication
Your Notes:
Mentor/Chair Notes:
LONG-TERM GOAL [ Anticipated Date of Program Completion:
Notes: Time to completion will vary based on individual factors applicable to the student. Factors may be programmatic or academic, such as tuition and fee increase; transfer credits accepted by Walden; program or specialization changes; unsuccessful course completion; credit load per term; part-time vs. full-time enrollment; writing, research, and editing skills; use of external data for the doctoral study/dissertation; and individual progress in the program. Other factors may include personal issues such as the student’s employment obligations, caregiving responsibilities, or health issues, leaves of absences; or other personal circumstances.
SAMPLE Completed Term Plan/Week 1 Submission
Term Goal(s) By the end of this term, I will try to complete: A draft of my literature review Mentor/Chair Feedback:
Week
Tasks Toward Term Goal(s)
Date Completed
Journal Notes
1
Submit Initial Term Plan By Day 7 of Week 1. Meet with chair to review prospectus/goals.
Your Notes:
Mentor/Chair Notes:
2
Term Plan Negotiation & Commitment.
Submit Term Plan by Day 7 of Week 2. Complete prospectus document with revisions from last term and submit to chair.
Your Notes:
Mentor/chair Accepts Plan: [Select] Notes:
3
Review Writing Center Literature review resources and begin working on lit review.
Your Notes:
Mentor/Chair Notes:
4
Meet with chair for any final notes on prospectus. Submit to 2nd member.
Your Notes:
Mentor/Chair Notes:
Midterm Progress Check [ Submission Date Term Plan [Mentor/Chair: [ Select]
5
Submit my renegotiated term plan. Schedule one-on-one meeting with review.
Your Notes:
Mentor/Chair Notes:
6
Complete additional prospectus wishes and finalize document based on a feedback. Work on literature review.
Your Notes:
Mentor/Chair Notes:
7
Post the agreed-upon prospectus in MyDR.
Submit literature review draft to chair.
Your Notes:
Mentor/Chair Notes:
8
Submit Final Term Plan by Day 7 of Week 8.
Keep working on literature review. Adequate Progress Final Review.
Your Notes:
Mentor/Chair Notes:
SAMPLE Completed Final Term Plan [ Week 8 Submission
Term Goal(s) By the end of this term, I will have completed: My prospectus with committee consensus as “Met”.
STRETCH Goal(s) Additionally, by the end of this term, I will try to complete: A Draft of my literature review.
Mentor/Chair Feedback: Your goal is appropriate/realistic for the term. Make sure that you work on your Lit review while waiting for committee member feedback.
Week
Tasks Toward Term Goal(s)
Date Completed
Journal Notes
1
Submit Initial Term Plan by Day 7 of Week 1. Meet with chair to review prospectus/goals.
3/4/20XX
Your Notes: Submitted Plan-3/4. Will talk with chair on the phone every other week. Email, as needed. Mentor/Chair Accepts Plan: [Yes] Notes
2
Term Plan Negotiation & Commitment. Submit Term Plan by Day 7 of week 2. Complete prospectus document with revisions from last term and submit to chair.
3/11/20XX
Your Notes: Finished revisions this week! Mentor/Chair Accepts Plan:[Yes]: Submission-3/11/20XX
3
Review Writing Center literature review resources and begin working on lit review.
3/18/20XX
Your notes: Reviewed 2 archived webinars on writing the literature review. Begin writing literature review. Mentor/Chair Notes: Phone call -3/18/18.
4
Meet with chair for any final notes on prospectus. Submit to 2nd member.
3/20/20XX
Your Notes: Met with Chair early b/c out of town this work. Made final few revisions to prospectus. Mentor/Chair Notes: Sent to 2nd member -3/20/
Midterm Progress check [ Submission date Term Plan [ Mentor/Chair: [On Track]
Mentor/Chair feedback You are right on track to Meet your goals!
5 Submit my renegotiated term plan. Schedule one-on-one meeting with librarian to find more sources for literature review.
4/1/20XX
Your Notes: Renegotiated term plan with chair. Mentor/Chair Notes: Revised plan Ok’d
6 Complete additional progress revisions and finalize document based on all feedback. Work on literature review.
4/8/20XX
Your Notes: Finished revisions from 2nd member-received 4/2. Met with librarian-4/15. Mentor/Chair Notes: Prospectus-ready for submission.
7 Post the agreed-upon prospectus in MyDR. Submit literature review draft to chair.
4/15/20XX
Your Notes: Posted Prospectus 4/15. Mentor/Chair Notes: Doing review in system.
8 Submit Final Term Plan by Day 7 of Week 8. Adequate Progress Final Review.
4/22/20XX
Your Notes: Submitted End-of-Term Plan by Day 7. Also have 15 pages of literature review done! Mentor/Chair Notes: Prospectus goal “Met” in MyDR.
Week 8 Doctoral Term Plan & Capstone Stage Goals
Student Name: Student ID:
Student Walden Email: Student Phone #:
Program and Specialization/Focus:
Mentor/Chair:
2nd Member (if applicable):
University Research Reviewer (if applicable):
Date Started Program:
Current Term Start Date: Stage of Capstone: Click to select Stage
Do you have an individual Academic Plan (IAP)? Select one Note: Your Term Plan goals must align with your IAP.
Instructions
Your Term Plan: On the page labelled YOUR Term Plan, indicate your term goal(s), stretch goal(s), and the tasks you accomplish during the weeks of the term. Your tasks should make clear what you will be working on and your plans for appropriate substantive submissions to your Mentor/Chair (refer to the syllabus for more information). Remember that you must demonstrate substantial academic PROGRESS each term to receive a satisfactory grade for the course.
indicate that you have read the course syllabus and understand the capstone course grading policies.
By day 7 of week 1[Submit your Term Plan Draft for mentor/chair review, negotiation, and commitment.
By day 7 of week 2 [ Submit your completed, agreed-upon Term Plan. [ Chair notes acceptance on form.]
SMART GOALS can help you create a Term Goal that clearly articulates outcomes.
· Specific: Set specific goals, which have a much greater chance of being accomplished than general goals.
· Measurable: Establish concrete criteria for measuring progress toward the attainment of each goal you set.
· Attainable: Ensure that you can map out a clear path to achieving your goal.
· Realistic: Write a goal that represents an objective toward which you are both willing and able to work.
· Timely: Ground your goal within a time frame (i.e., by the end of this term).
Midterm Progress Check and Adequate Progress Final Review: Through out the term, track your progress on YOUR Term Plan by entering dates for task completion and by making journal notes on activities completed or modifications needed, noting any barriers and strategies to overcome them. Your purposes. Submit your updated Term Plan Midterm, following your midterm Progress Check. [Chair assesses progress to date.] Submit your final Term Plan by day 7 of Week 8. [Chair assesses final grade].
Capstone Stage Goals: Think about your long-term goal (anticipated date of program completion) as you work on your Term Plan by entering dates for task completion and by making journal notes on activities completed or modifications needed, noting any barriers and strategies to overcome them. Your Mentor/Chair must approve any modifications and can add journal notes on the plan document for archival purposes. Submit your updated Terme Plan midterm, following your Midterm Progress Check. [Chair assesses progress to date.] Submit your Final Term Plan by Day 7 of week 8. [Chair assesses final grade.]
Capstone Stage Goals: Think about your long-term goal (anticipated date of program completion) as you work on your Term Goal(s) and weekly tasks each term. Complete the Capstone Stage Goals. It is helpful to think about overall progress as you think about term-by-term progress. Begin with the end in mind!
Your Term Plan
Term Goal(s) By the end of this term, I will have completed:
STRETCH Goal(s) Additionally, by the end of this term, I will try to complete:
Mentor/Chair feedback:
Week
Tasks Toward term Goal(s)
Date completed
Journal Notes
1.
1. Submit Initial Term Plan by Day 7 of Week 1, set up Mentor/chair communication plan and
Your Notes:
Mentor/Chair Notes:
2.
Term Plan Negotiation & Commitment. Submit Term plan by Day 7 of week 2.
Your Notes:
Mentor/Chair Notes:
3.
Your notes:
Mentor/chair Notes:
4.
Your Notes:
Mentor/Chair Notes
Mid term Progress Check [Submit
Updated Term Plan
Mentor/chair: Select
Mentor/chair Feedback
5.
Your Notes:
Mentor/chair Notes:
6.
Your Notes:
Mentor/chair Notes:
7.
Your Notes:
Mentor/chair Notes:
8. Submit Final Term Plan by Day 7 of week 8, and Adequate Progress Final Review
Your Notes:
Mentor/chair Notes:
Long-Term: [Anticipated Date of Program Completion:
Note: Time to completion will vary based on individual factors applicable to the student. Factors may be programmatic or academic, such as tuition and fee increases; transfer credits accepted by Walden; program or specialization changes; unsuccessful course completion; credit load per term; part-time enrollment; writing, research, and editing skills; use of external data for the doctoral study/dissertation; and individual progress in the program. Other factors may include personal issues such as the student’s employment obligations, caregiving obligations, caregiving responsibilities, or health issues; leaves of absence; or other personal circumstances.
Sample Completed Term Plan [ Week 1 Submission
Term Goal(s) [ By the end of this, I will have completed: My prospectus with committee consensus as “Met”.
STRETCH Goal(s) [ Additionally, by the end of this term, I will try to complete: A draft of literature review.
Mentor/Chair Feedback:
Week
Tasks Toward Term Goals
Date Completed
Journal Notes
1
Submit Initial Term Plan by Day 7 of Week 1. Set up Mentor/chair to review prospectus/goals.
Your Notes:
Mentor/Chair Notes:
2
Term Plan Negotiation & Commitment.
Submit Term Plan by Day 7 of Week 2. Complete prospectus document with revisions from last term and submit to chair.
Your Notes:
Mentor/chair Accepts Plan: [ Select] Notes:
3
Review Writing Center literature review resources and begin working on lit review.
Your Notes:
Mentor/chair Notes:
4
Meet with chair for any final notes on prospectus. Submit to 2nd member.
Your Notes:
Mentor/chair Notes:
Midterm Progress Check [ Submission date Term Plan [ Mentor/Chair: [Select]
Mentor/Chair Feedback:
5
Submit my renegotiated term plan, Schedule one-on-one meeting with librarian or find more sources for literature review.
Your Notes:
Mentor/Chair Notes:
6
Complete additional prospectus revisions and finalize document based on the feedback.
Your Notes:
Mentor/Chair Notes:
7
Post the agreed-up prospectus in MyDR. Submit literature review draft to chair.
Your Notes:
Mentor/Chair Notes:
8
Submit Final Term Plan by Day 7 of Week 8.
Keep working on literature review.
Adequate Progress Final Review.
Your Notes:
Mentor/Chair Notes:
Sample Completed Final Term Plan [ Week 8 Submission
Term Goal(s) By the end of this term, I will have completed: My prospectus with committee consensus as “Met”.
STRETCH Goal(s) [ Additionally, by the end of this term, I will try to complete: A draft of my literature review.
Mentor/Chair feedback: Your goal is appropriate/realistic for the term. Make sure that you work your lit review while waiting for committee feedback.
Week
Tasks Toward Term Goal(s)
Date Completed
Journal Notes
1
Submit Initial Term Plan By Day 7 of week 1. Set up Mentor/chair to review prospectus/goals.
3/4/20XX
Your Notes: Submitted Plan-3/4. Will talk with chair on the phone every other week. Email, as needed. Mentor/chair Notes: Ok.
2
Term Plan Negotiation & Commitment. Submit Term Plan Day 7 of week 2. Complete prospectus document with revisions from last term and submit to chair.
3/11/20XX
Your Notes: Finished revisions this week!
Mentor/Chair Accepts Plan: [Yes] Notes: Submission.
3/11/20XX.
3
Review Writing Center literature review resources and begin working on lit review.
3/18/20XX
Your Notes: Reviewed 2 archived webinars on writing the literature review. Began writing literature review. Mentor/chair: Notes: Phone call-3/18/18
4
Meet with chair for any final notes on prospectus. Submit to 2nd member.
3/20/20
Chair Notes: Met with chair early b/c out of town this with. Made final few revisions to prospectus.
Mentor/chair Notes: Sent to 2nd member- 3/20.
Midterm Progress Check [ Submission date Term plan [ Mentor/chair [ On track]
Mentor/chair feedback. [ You are right on track to meet your goals.
5
Submit my renegotiated term plan. Schedule one-on-one meeting with librarian to find more resources for literature review.
4/1/20XX
Your Notes: Renegotiated term plan with chair.
Mentor/chair Notes: Revised plan Ok’d.
6
Complete additional prospectus revisions and finalize document based on all feedback. Work on literature review.
4/8/20XX
Your Notes: Finished revisions from 2nd member-received 4/2. Met with librarian-4/15. Mentor/chair Notes: Prospectus-ready for submission.
7
Post the agreed-upon prospectus in MyDR. Submit literature review draft to chair.
4/15/20XX
Your Notes: Posted prospectus 4/15.
Mentor/chair Notes: Doing review in system.
8
Submit Final Term Plan by Day 7 of Week 8.
Keep work on literature review.
Adequate Progress Final Review.
4/22/20XX
Your Notes: Submitted End-of-Term Plan by Day 7.
Also have 15 pages of lit review done!
Mentor/chair Notes: Prospectus goal “Met” in MyDR.
11-Week Doctoral Term Plan & Capstone Stage Goals
Student Name: Student ID:
Student Walden Email:
Program and Specialization/Focus:
Mentor/Chair:
2nd member (if applicable):
University Research Review (if applicable):
Date Started Program:
Current Term Start Date: Stage of Capstone: Click to select Stage
Do you have an Individual Academic Plan (IAP)? Select One Note: Your Term Plan goals must align with your IAP.
Instructions
Your term Plan: On the page labelled YOUR TERM PLAN, indicate your term goal(s), stretch goal(s), and the tasks you accomplish during the weeks of the term. Your tasks should make clear what you will be working on and your plans for appropriate substantive submissions to your Mentor/Chair (refer to the syllabus for more information). Remember that you must demonstrate substantial academic PROGRESS each term to receive a satisfactory grade for the course.
indicate that you have read the course syllabus and understand the capstone course grading policies.
By Day 7 of week 1 [ Submit your Term Plan Draft for Mentor/Chair review, negotiation, and commitment.
By Day 7 of week 2 [ Submit your completed, agreed-upon Term Plan. [Chair notes acceptance on Form.]
SMART GOALS can help you create a Term Goal that clearly articulates outcomes.
· Specific: Set specific goals, which have a much greater chance of being accomplished than general goals.
· Measurable: Establish concrete criteria for measuring progress toward the attainment of each goal you set.
· Attainable: Ensure that you map out a clear path to achieving your goal.
· Realistic: Write a goal that represents an objective towards which you are both willing and able to work.
· Timely: Ground your goal within a time frame (i.e, by the end of this term).
Midterm Progress Check and Adequate Progress Final Review: Throughout the term, track your progress on YOUR TERM PLAN by entering dates for task completion and by making journal notes on activities completed or modifications needed, noting any barriers and strategies to overcome them. Your Mentor/Chair must approve any modifications and can add journal notes on the plan document for archival purposes. Submit your Updated Term Plan midterm, following your Midterm Progress Check. [Chair assesses progress to date.] Submit your Final Term Plan by day 7 of week 11. [Chair assesses final grade.]
Capstone Stage Goals: Think about your long-term (anticipated data of program completed) as you work on your Term Goal(s) and weekly tasks each term. Complete the Capstone Stage Goals. It is helpful to think about overall progress as you think about term-by-term progress. Begin with the end in mind!
YOUR Term Plan
Term Goal(s) [ by the end of this term, I will have completed:
STRETCH GOAL(s) [ by the end of this term, I will try to complete:
Mentor/Chair Feedback:
Week
Tasks Toward Term Goals
Dates Completed
Journal Notes:
1
Submit Initial Term Plan by Day 7 of week 1, set up Mentor/chair communication plan and.
Your Notes:
Mentor/Chair Notes:
2
Term Plan Negotiation & Commitment.
Submit Term Plan by Day 7 of week 2, and
Your Notes:
Mentor/Chair Accepts Plan: [ Select] Notes:
3
Your Notes:
Mentor/Chair Notes:
4
Your Notes:
Mentor/Chair Notes:
5
Your Notes:
Mento/Chair Notes:
Midterm Progress Check [ Submit Updated term Plan [ mentor/Chair: [Select]
Mentor/Chair feedback
6
Your Notes:
Mentor/Chair Notes:
7
Your Notes:
Mentor/Chair Notes:
8
Your Notes:
Mentor/Chair Notes:
9
Your Notes:
Mentor/Chair Notes:
10
Your Notes:
Mentor/Chair Notes:
11
Submit Final Term Plan by Day 7 of the week 11, and Adequate Progress Final Review.
Your Notes:
Mentor/Chair Notes:
Looking Ahead [ Capstone Stage Goals
To ensure that you meet your-term goal for program completion, it is important to keep track of both your long-term goal for program completion, it is important to keep track of both your term plan progress (each term) and your term-to -term/capstone stage progress toward completion.
Capstone Stage
Goal Date
Completion Date
Journal Notes
1
Prospectus Stage Completion (if applicable).
Your Notes:
Mentor/Chair Notes:
2
Proposal/Plan Stage Completion
Your Notes:
Mentor/chair Notes:
3
IRB Application and Approval
Your Notes:
Mentor/Chair Notes:
4
Final Study Stage Completion
Your Notes:
Mentor/Chair Notes:
5
CAO Approval and Publication.
Your Notes:
Mentor/Chair Notes:
Long-Term Goal [ Anticipated Date of Program Completion:
Note: Time to completion will vary based on individual factors applicable to the student. Factors may be programmatic or academic, such as tuition and fee increase; transfer credits accepted by Walden; program or specialization changes; unsuccessful course completion; credit load per term; part-time vs. full-time enrollment; writing, research, and editing skills, use of external data for the doctoral study/dissertation, and individual; progress in the program. Other factors may include personal issues such as the student’s employment obligations, caregiving responsibilities, or health issues, leaves of absence; or other personal circumstances.
Sample Completed Term Plan [ Week 1 Submission
Term Goal(s) By the end of this term, I will have completed: My prospectus with committee consensus as “Met”.
STRETCH GOAL(S) Additionally, by the end of this term, I will try to complete: A draft of my literature review.
Mentor/chair Feedback:
Week
Tasks Toward Term Goal(s)
Date Completed
Journal Notes
1
Submit Initial Term Plan by day 7 of week 1. Set up Mentor/Chair communication plan. Meet with chair to review prospectus/goals.
Your Notes:
Mentor/Chair Notes:
2
Term Plan negotiation & commitment. Submit Term Plan by day 7 of week 2. Complete prospectus document with revisions from last term and submit to chair.
Your Notes:
Mentor/chair: Accepts Plan: [Select] Notes:
3
Review Writing center literature review resources and begin work.
Your Notes:
Mentor/Chair Accepts Plan: [Select] Notes:
4
Meet with chair for any final notes on prospectus.
Your Notes:
Mentor/Chair Notes:
5
Second member prospectus review.
Your Notes:
Mentor/Chair Notes:
Midterm Progress Check [ Submit to date term Plan [ Mentor/Chair: [Select]
Mentor/Chair Feedback:
6
Submit my renegotiated term plan.
Schedule one-on-meeting with member to find more sources for literature review.
Your Notes:
Mentor/Chair Notes:
7
Complete additional prospectus revisions and finalize document bases in all feedback.
Your Notes:
Mentor/Chair Notes:
8
Continue work on literature review.
Your Notes:
Mentor/Chair Notes:
9
Attend residency. Finalize Prospectus
Your Notes:
Mentor/Chair Notes:
10
Post the agreed-upon prospectus in MyDr.
Submit literature review draft to chair.
Your Notes:
Mentor/Chair Notes:
11
Submit Final Term Plan by Day 7 of week 11.
Keep working on literature review. Adequate Progress final Review.
Your Notes:
Mentor/Chair Notes:
Sample Completed Final Term Plan [ Week 11 Submission
TERM GOAL(S) By the end of this term, I will have completed: My prospectus with committee consensus as “Met”.
STRETCH GOAL(S) Additionally, by the end of this term, I will try to complete: A draft of my literature review.
Mentor/Chair Feedback: Your goal is appropriate/realistic for the term. Make sure that you work on your lit review while waiting for committee member feedback.
Week
Tasks Toward Term Goal(s)
Date Completed
Journal Notes
1
Submit Initial term Plan. Meet with chair to review prospectus/goals.
3/4/20XX
Your Notes: Submitted Plan ¾. Will talk with chair on the phone every other week. Email, as needed.
Mentor/chair Notes: Ok.
2
Term Plan Negotiation & Commitment. Submit Term plan by Day 7 of Week 2. Complete prospectus document with revisions from last term and submit to chair.
3/11/20XX
Your Notes: Finished revisions this week!
Mentor/Chair Accepts Plan: [Yes] Notes: Submission-3/11/20XX
3
Review Writing Center literature review resources and begin work.
3/18/20XX
Your Notes: Reviewed 2 archived webinars on writing the literature review. Begin writing literature review.
Mentor/chair Notes: Phone call- 3/18/18
4
Meet with Chair for any final notes on prospectus.
3/20/20XX
Your Notes: Meet the chair early b/c out of town this week. To do that few revisions to prospectus.
Mentor/Chair Notes: I’m OK w/prospectus-3/25
5
Second Member prospectus review.
3/2/20XX
Your Notes: To 2nd Member for review 1 week early!
Mentor/Chair Notes: To 2nd member -3/25
Midterm Progress Check [ Submit Updated Member [Mentor/Chair [On Track]
Mentor/Chair feedback find out if on a right track to meet your goals.
6
Submit my renegotiated plan.
Schedule one-on-one meeting w/chair to find more sources for literature review.
4/8/20XX
Your Notes: Renegotiated term plan with chair-4/8. Met with librarian-4/15.
Mentor/chair Notes: Plan Ok; 2nd returned revisions on April 9.
7
Complete additional prospectus revisions and finalize document based on all feedback. Work on literature review.
Your Notes: Still working on revisions-not done yet.
Mentor/Chair Notes: OK for next week.
8
Continue work on literature review.
4/29/20XX
Your Notes: Mostly done with revisions this week; finished after residency.
Mentor/Chair Notes: Ok-residency.
9
Attend residency. Finalize prospectus.
5/6/20XX
Your Notes: Went to the Atlanta residency this week. Met with chair-5/9/20XX.
Mentor/Chair Notes: Prospectus finalized 5/12/20XX.
10
Post the agreed-upon prospectus in MyDR. Submit literature review draft to chair.
5/13/20XX
Your Notes: Submitted and met with chair on next steps. Used the notes from the librarian to work on literature review this week. Have 8 pages so far.
Mentor/Chair Notes: keep working on lit review.
11
Submit Final Term Plan by day 7 of week 11.
Keep working on literature review. Adequate Progress Final Review.
5/20/20XX
Your Notes: Submitted End-of-Term Plan by day 7.
Also have 15 pages of lit review done!
Mentor/Chair Notes: Prospectus goal “Met” in MyDR.
Group 2: CASE STUDY 2: Numbness and Pain
A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.
To Prepare
By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least three possible conditions that may be considered in a differential diagnosis for the patient.
The Case Study Assignment
Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. Episodic/Focused SOAP Note Template
Patient Information:
Initials, Age, Sex, Race S. CC (chief complaint) a BRIEF statement identifying why the patient is here – in the patient’s own words – for instance “headache”, NOT “bad headache for 3 days”. HPI: This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the HPI might look like the following example:
Location: head
Onset: 3 days ago
Character: pounding, pressure around the eyes and temples
Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia
Timing: after being on the computer all day at work
Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not completely better
Severity: 7/10 pain scale Current Medications: include dosage, frequency, length of time used and reason for use; also include OTC or homeopathic products. Allergies: include medication, food, and environmental allergies separately (a description of what the allergy is ie angioedema, anaphylaxis, etc. This will help determine a true reaction vs intolerance). PMHx: include immunization status (note date of last tetanus for all adults), past major illnesses and surgeries. Depending on the CC, more info is sometimes needed Soc Hx: include occupation and major hobbies, family status, tobacco & alcohol use (previous and current use), any other pertinent data. Always add some health promo question here – such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system. Fam Hx: illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason for death of any deceased first degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent. ROS: cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe.
Example of Complete ROS:
GENERAL: No weight loss, fever, chills, weakness or fatigue.
HEENT: Eyes: No visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose or sore throat.
SKIN: No rash or itching.
CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema.
RESPIRATORY: No shortness of breath, cough or sputum.
GASTROINTESTINAL: No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.
GENITOURINARY: Burning on urination. Pregnancy. Last menstrual period, MM/DD/YYYY.
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.
MUSCULOSKELETAL: No muscle, back pain, joint pain or stiffness.
HEMATOLOGIC: No anemia, bleeding or bruising.
LYMPHATICS: No enlarged nodes. No history of splenectomy.
PSYCHIATRIC: No history of depression or anxiety.
ENDOCRINOLOGIC: No reports of sweating, cold or heat intolerance. No polyuria or polydipsia.
ALLERGIES: No history of asthma, hives, eczema or rhinitis. O. Physical exam: From head-to-toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head to toe format i.e. General: Head: EENT: etc. Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines) A. Differential Diagnoses (list a minimum of 3 differential diagnoses).Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence based guidelines. P.
This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.
References
You are required to include at least three evidence based peer-reviewed journal articles or evidenced based guidelines which relates to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 6th edition formatting.
READING RESOURCES
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 4, “Vital Signs and Pain Assessment” (Previously read in Week 6)
· Chapter 22, “Musculoskeletal System” This chapter describes the process of assessing the musculoskeletal system. In addition, the authors explore the anatomy and physiology of the musculoskeletal system.
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.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
· Chapter 2, “The Comprehensive History and Physical Exam” (“Muscle Strength Grading”) (Previously read in Weeks 1, 2, 3, 4, and 5)
· Chapter 3, “SOAP Notes” This section explains the procedural knowledge needed to perform musculoskeletal procedures.
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.
· Chapter 13, “The Spine, Pelvis, and Extremities” (pp. 585–682) In this chapter, the authors explain the physiology of the spine, pelvis, and extremities. The chapter also describes how to examine the spine, pelvis, and extremities.
Week 10 Assignment: Special Examinations—Breast, Genital, Prostate, And Rectal/Genitalia Assessment
Week 10 Assignment: Special Examinations—Breast, Genital, Prostate, And Rectal/Genitalia Assessment
Week 10 Assignment: Special Examinations—Breast, Genital, Prostate, And Rectal/Genitalia Assessment
Week 10 Assignment: Special Examinations—Breast, Genital, Prostate, And Rectal/Genitalia Assessment
In this Lab 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 a differential diagnosis with several possible conditions.
To Prepare
Review the Episodic note case study for this week’s Assignment.
Review this week’s Learning Resources, and consider the insights they provide about the case study. Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab Assignment.
Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided.
Consider what history would be necessary to collect from the patient in the case study.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
The Lab Assignment
Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.
Analyze the subjective portion of the note. List additional information that should be included in the documentation.
Analyze the objective portion of the note. List additional information that should be included in the documentation.
Is the assessment supported by the subjective and objective information? Why or why not?
Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?
Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.
Week10 Assignment: Special Examinations—Breast, Genital,Prostate, and Rectal/Genitalia assessment Subjective: CC: “I have bumps on my bottom that I want to have checked out.” HPI: AB, a 21-year-old WF college student reports to your clinic with externalbumps 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 thepast year. Her initial sexual contact occurred at age 18. She reports no abnormalvaginal discharge. She is unsure how long the bumps have been there butnoticed them about a week ago. Her last Pap smear exam was 3 years ago, andno dysplasia was found; the exam results were normal. She reports one sexuallytransmitted infection (chlamydia) about 2 years ago. She completed thetreatment 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. Urethralmeatus intact without erythema or discharge. Perineum intact. Vaginal mucosapink and moist with rugae present, pos for firm, round, small, painless ulcer notedon external labia Abd: soft, normoactive bowel sounds, neg rebound, neg Murphy’s, neg McBurney Diagnostics: HSV specimen obtained Assessment: Chancre PLAN:This section is not required for the assignments in this course (NURS 6512) butwill be required for future courses.
Attention Wizard Kim
Please be careful with week 6 Discussion/Assignment. Don’t Mix it up. Separate discussion different for assignment part.
Week 6 Discussion Part: Time Series in Health care 2 pages .
Week 6 Assignment Part: Time Series Analysis for BLAYER PHARM (5 pages) APA format 7th Ed.
Week 6 Rubrics
Week 6: Data-Driven Decision Making for Health care Administration
Time Series
As the healthcare landscape continues to evolve, so will trends predicting who will use healthcare services, when these healthcare services might be used, and where these healthcare services are offered. Undoubtedly, time series analyses can assist healthcare administration leaders in forecasting and predicting how their health services organization might address these trends for healthcare delivery. For example, time series analyses have been useful for forecasting national healthcare expenditures, predicting the future number of beds needed for regional hospitals, and even determining where the greatest healthcare utilization might occur across the country.
1. This week, you examine time series and forecast models. You consider how to adopt time series analysis for specific variables of interest and explore methods on how to apply time series analysis for healthcare administration practice solutions.
Learning Objectives
Students will:
· Evaluate time series and forecast models
· Analyze appropriate models to measure variables in analysis
· Apply time series analysis
Photo Credit: [Martin Barraud]/[Caiaimage]/Getty Images.
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 12, “Time Series Analysis and Forecasting”
Document: Week 6 Assignment Dataset (Excel file)
Pam is a healthcare administration leader for a large network of hospitals and health service centers that is attempting to predict future healthcare utilization at their centers over the next 5 years. She obtains data regarding patient use across the hospital network and health service centers and projects forward over the next 5 years to determine which areas might experience continued growth. After applying her time series model, she is able to demonstrate that, indeed, the hospital network and health service centers will experience significant growth. As she prepares to share her results and findings with the board, she also considers advocating for the development of a new regional health service center to fill one of the areas that will experience the most growth according to her forecast projections.
As a current or future healthcare administration leader, you may be asked to assess strategic planning and decision-making using time series analysis.
1. For this Discussion, review the resources for this week, and reflect on time series models and forecasting. Think about how you might implement these methods for healthcare administration practice.
By Day 3
Post a description of some variables that you might evaluate using time series in your health services organization or one with which you are familiar. Then, explain what types of models might be most appropriate to measure, and analyze these variables. 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 6 Discussion Rubric
Post by Day 3 and Respond by Day 5
To participate in this Discussion: Week 6 Discussion
Assignment Part (5 pages APA 7th Ed.)
Time Series Analysis for Blayer Pharm (Please use SPSS on YouTube to do this excel).
Blayer Pharm sells two types of blood pressure cuffs at more than 50 locations in the Midwest. The first style is a relatively expensive model, whereas the second is a standard, less expensive model. Although weekly demand for these two products is fairly stable from week to week, there is enough variation to concern management. There have been relatively unsophisticated attempts to forecast weekly demand but they haven’t been very successful. Sometimes demand (and the corresponding sales) is lower than forecasts, so inventory costs are high. Other times, the forecasts are too low. When this happens, and on-hand inventory is not sufficient to meet customer demand, Blayer requires expedited shipments to keep customers happy—and this nearly wipes out Blayer’s profit margin on the expedited units. Profits would almost certainly increase if demand could be forecast more accurately. Data on weekly sales of both products appear in the file for this week. A time series chart of the two sales variables indicates what Blayer management expected—namely, there is no evidence of any upward or downward trends or of any seasonality. In fact, it might appear that each series is an unpredictable sequence of random ups and downs.
1. For this Assignment, reflect on the scenario presented. Review the resources for this week and consider how you might apply time series analyses to address the case questions.
Note: For this Assignment, you will be using SPSS.
Document: Week 6 Assignment Dataset (Excel file).
The Assignment: (5 pages)
Use the dataset to answer the following questions. Provide complete analysis and graphs, as appropriate.
1. It is possible to forecast either series with some degree of accuracy or with an extrapolation method (where only past values of that series are used to forecast current and future values).
A. Perform an analysis with at least two different methods. Show your forecast results in table form (include your SPSS output tables).
B. Which method appears to be best? In narrative form, defend your choice of best method. Include a description of the level of accuracy of the chosen method.
2. Is it possible, when trying to forecast sales of one of your blood pressure cuff products, to somehow incorporate current or past sales of the other blood pressure cuff product in the forecast model? Why or why not? Explain your reasoning and how you would go about doing this.
3. Are these products “substitute” products or are they “complementary” products? Why? Conduct appropriate analyses to support your argument and include tabular results (i.e., your SPSS output).
By Day 7
Submit your answers and embedded SPSS 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 “WK6Assgn+last name+first initial.(extension)” as the name.
· Click the Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.
· Click the Week 6 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 “WK6Assgn+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 6 Assignment Rubric
The Assignment: (5 pages)
Use the dataset to answer the following questions. Provide complete analysis and graphs, as appropriate.
Week 6 Assignment Rubric Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 6 Assignment draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment: Week 6Assignment
The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.
When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.
Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.
To Prepare
Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
Reflect on situations in which children should be prescribed drugs for off-label use.
Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.
By Day 5 of Week 11
Write a 1-page narrative in APA format that addresses the following:
Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.
To Prepare
Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
Reflect on situations in which children should be prescribed drugs for off-label use.
Explain strategies to making off-label use and dosage of drugs safer for children from infancy to adolescence and descriptions and names of off-label drugs that require extra care and attention when used in pediatrics. Be specific.
By Day 5 of Week 11 Write a 1-page narrative in APA format that addresses the following:
Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.
Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD
“Fear,” according to the DSM-5, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease.
For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5 criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5 criteria.
To Prepare:
Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing anxiety, obsessive-compulsive, and trauma- and stressor-related disorders.
Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 4
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Sadock, B. J., Sadock, V. A., and Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
Chapter 9, Anxiety Disorders
Chapter 10, Obsessive-Compulsive and Related Disorders
Chapter 11, Trauma- and Stressor-Related Disorders
Chapter 31.11 Trauma-Stressor Related Disorders in Children
Chapter 31.13 Anxiety Disorders in Infancy, Childhood, and Adolescence
Chapter 31.14 Obsessive-Compulsive Disorder in Childhood and Adolescence
Video Case Selections for Assignment (click to expand/reduce)
Select one of the following videos to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.
Student Name
College of Nursing-PMHNP, Walden University
NRNP 6635: Psychopathology and Diagnostic Reasoning
Faculty Name
Assignment Due Date
Subjective: CC (chief complaint): HPI: Past Psychiatric History:
· General Statement:
· Caregivers (if applicable):
· Hospitalizations:
· Medication trials:
· Psychotherapy or Previous Psychiatric Diagnosis: Substance Current Use and History: Family Psychiatric/Substance Use History: Psychosocial History: Medical History: