Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies
Module 4 Assignment is due by Day 7 of Week 8.
In this Assignment, you will review four (4) existing research focused on the application of clinical systems and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery. After reviewing, you will summarize your findings. Read the assignment instructions and rubric carefully.
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:
Identify the four (4) peer-reviewed, current (published within the last 5 years), scholarly articles. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies. Cite each in APA format.
Include an introduction explaining the purpose of the paper.
Summarizeeach study. Avoid direct quotations. Paraphrase, explain, and integrate information obtained from peer-reviewed research with appropriate citation to demonstrate your knowledge, synthesis, and critical thinking.
For each study, explain the improvementto outcomes, efficiencies, and lessons learned from the application of the clinical system. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.
In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.
Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
Consider which of the conditions is most likely to be the correct diagnosis, and why.
Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.
Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.
Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.
The Lab Assignment
Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning 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 9, “Skin, Hair, and Nails”
This chapter reviews the basic anatomy and physiology of skin, hair, and nails. The chapter also describes guidelines for proper skin, hair, and nails assessments.
Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis.
Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center.
This section explains the procedural knowledge needed prior to performing various dermatological procedures.
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.
Note: Download and use the Student Checklist and the Key Points when you conduct your assessment of the skin, hair, and nails in this Week’s Lab Assignment.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Weeks 1 and 3)
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.
Chapter 6, “The Skin and Nails”
In this chapter, the authors provide guidelines and procedures to aid in the diagnosis of skin and nail disorders. The chapter supplies descriptions and pictures of common skin and nail conditions.
Module 3 Introduction
Dr. Tara Harris reviews the overall expectations for Module 3. Consider how you will manage your time as you review your media and Learning Resources for your Discussions, Case Study Lab Assignments, DCE Assignments, and your Midterm exam (12m).
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript
Skin, Hair, and Nails – Week 4 (19m)
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript
Online media for Seidel’s Guide to Physical Examination
In addition to this week’s media, it is highly recommended that you access and view the online resources included with the text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapter 8 that relate to the assessment of the skin, hair, and nails.
Click on the plus sign icon for Resources on the left side of the screen.
Click on the name of the textbook for this course.
Expand the menu on the left to locate all the chapters.
Navigate to the desired content (checklists, videos, animations, etc.).
Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.
Suturing Tutorials
The following suturing tutorials provide instruction on the basic interrupted suture, as well as the vertical and horizontal mattress suturing techniques
Welcome to week 4
We are entering week 4. Students have 2 assignments due this week. You will choose a lesion to document the SOAP note and secondly, this week is our first Shadow Health Assignment. There are several student tips, how to upload the lab pass, etc. located in the course. Regarding the SOAP notes, there is not enough information. I advise you to make up the information that is not there (ie. Health hx, social hx, etc). This will allow you to critically think as you develop the notes.
You need to know that the DCE score is not the only score that counts as your grade, it is only a portion of the grade. You must complete the documentation portion. Also, we have noted that in SH, the ROS is not located in the documentation portion but is located in the subjective data collection portion. Remember to document as the SOAP order. I advise you to review my SOAP document send last week for guidance.
Last week we engulfed in great conversation on the risks of our findings about growth, measurements, and nutrition of children and their families. As practitioners, it’s important to communicate professionally, ask the right questions, and guide families as they strive to have healthier and happy lives. This week we will begin to review assessments of body systems. Skin, Hair, and Nails will be covered. I encourage you to perform the assessment of Skin, Hair, and Nails so that you may be proficient with it for the overall assessment. You are able to access the check lists by enrolling into the evolve website in your resources.
You first assignment for this week is to be written in a SOAP Note format (NO NARRATIVES). There is a template/sample for you to follow posted in your announcements at the beginning of the semester. You will need to put in the missing information in the note (some may be made up ie meds, hx, parts of the ROS and PE). In the Assessment/Plan, you will document your differential diagnoses as per the assignment. I will comment on your notes and if needed, send you an email if I need to help you with them more. Assignment 1:
The Lab Assignment
· Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
· Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. Comprehensive SOAP Template
Note: The mnemonic below is included for your reference and should be removed before the submission of your final note.
O = onset of symptom (acute/gradual)
L= location
D= duration (recent/chronic)
C= character
A= associated symptoms/aggravating factors
R= relieving factors
T= treatments previously tried – response? Why discontinued?
S= severity
SUBJECTIVE DATA: Include what the patient tells you, but organize the information.
Chief Complaint (CC): In just a few words, explain why the patient came to the clinic.
History of Present Illness (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. You need to start EVERY HPI with age, race, and gender (i.e. 34-year-old AA male). You must include the 7 attributes of each principal symptom:
1. Location
2. Quality
3. Quantity or severity
4. Timing, including onset, duration, and frequency
5. Setting in which it occurs
6. Factors that have aggravated or relieved the symptom
7. Associated manifestations
Medications: Include over the counter, vitamin, and herbal supplements. List each one by name with dosage and frequency.
Allergies: Include specific reactions to medications, foods, insects, and environmental factors.
Past Medical History (PMH): Include illnesses (also childhood illnesses), hospitalizations, and risky sexual behaviors.
Past Surgical History (PSH): Include dates, indications, and types of operations.
Sexual/Reproductive History: If applicable, include obstetric history, menstrual history, methods of contraception, and sexual function.
Personal/Social History: Include tobacco use, alcohol use, drug use, patient’s interests, ADL’s and IADL’s if applicable, and exercise and eating habits.
Immunization History: Includelast Tdp, Flu, pneumonia, etc.
Significant Family History: Include history of parents, Grandparents, siblings, and children.
Lifestyle: Include cultural factors, economic factors, safety, and support systems.
Review of Systems: From head-to-toe, include each system that covers the Chief Complaint, History of Present Illness, and History (this includes the systems that address any previous diagnoses).Remember that the information you include in this section is based on what the patient tells you. You do not need to do them all unless you are doing a total H&P. To ensure that you include all essentials in your case, refer to Chapter 2 of the Sullivan text.
General: Include any recent weight changes, weakness, fatigue, or fever, but do not restate HPI data here. HEENT: Neck: Breasts: Respiratory: Cardiovascular/Peripheral Vascular: Gastrointestinal: Genitourinary: Musculoskeletal: Psychiatric: Neurological: Skin: Include rashes, lumps, sores, itching, dryness, changes, etc. Hematologic: Endocrine: Allergic/Immunologic:
OBJECTIVE DATA: From head-to-toe, includewhat 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 unless you are doing a total H&P. Do not use WNL or normal. You must describe what you see.
Physical Exam: Vital signs: Include vital signs, ht, wt, and BMI. General: Include general state of health, posture, motor activity, and gait. This may also include dress, grooming, hygiene, odors of body or breath, facial expression, manner, level of conscience, and affect and reactions to people and things. HEENT: Neck: Chest/Lungs: Always include this in your PE. Heart/Peripheral Vascular: Always include the heart in your PE. Abdomen: Genital/Rectal: Musculoskeletal: Neurological: Skin:
ASSESSMENT: List your priority diagnosis(es). For each priority diagnosis, list at least 3 differential diagnoses, each of which must be supported with evidence and guidelines. Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses.For holistic care, you need to include previous diagnoses and indicate whether these are controlled or not controlled. These should also be included in your treatment plan.
PLAN: This section is not required for the assignments in this course (NURS 6512), but will be required for future courses.
Treatment Plan: If applicable, include both pharmacological and nonpharmacological strategies, alternative therapies, follow-up recommendations, referrals, consultations, and any additional labs, x-ray, or other diagnostics. Support the treatment plan with evidence and guidelines.
Health Promotion: Include exercise, diet, and safety recommendations, as well as any other health promotion strategies for the patient/family. Support the health promotion recommendations and strategies with evidence and guidelines.
Disease Prevention: As appropriate for the patient’s age, include disease prevention recommendations and strategies such as fasting lipid profile, mammography, colonoscopy, immunizations, etc. Support the disease prevention recommendations and strategies with evidence and guidelines.
REFLECTION: Reflect on your clinical experience and consider the following questions: What did you learn from this experience? What would you do differently? Do you agree with your preceptor based on the evidence?
Assignment: Practicum – Week 1 Journal Entry
As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your practicum experience. By applying the concepts you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.
Learning Objectives Students will:
· Analyze nursing and counseling theories to guide practice in psychotherapy*
· Summarize goals and objectives for personal practicum experiences*
· Produce timelines for practicum activities*
In preparation for this course’s practicum experience, address the following in your Practicum Journal: Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.
Explain why you selected these theories. Support your approach with evidence-based literature.
Develop at least three goals and at least three objectives for the practicum experience in this course.
Create a timeline of practicum activities based on your practicum requirements.
Required Readings
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
· Standard 5A “Coordination of Care” (page 54)
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
· Chapter 11, “Group Therapy” (pp. 407–428)
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.
· Chapter 1, “The Foundations of Family Therapy” (pp. 1–6)
· Chapter 2, “The Evolution of Family Therapy” (pp. 7–28)
Breeskin, J. (2011). Procedures and guidelines for group therapy. The Group Psychologist, 21(1). Retrieved from http://www.apadivisions.org/division-49/publications/newsletter/group-psychologist/2011/04/group-procedures.aspx
Khawaja, I. S., Pollock, K., & Westermeyer, J. J. (2011). The diminishing role of psychiatry in group psychotherapy: A commentary and recommendations for change. Innovations in Clinical Neuroscience, 8(11), 20–23. Retrieved from http://innovationscns.com/ Note: You will access this article from the Walden Library databases.
Koukourikos, K., & Pasmatzi, E. (2014). Group therapy in psychotic inpatients. Health Science Journal, 8(3), 400–408. Retrieved from http://www.hsj.gr/medicine/group-therapy-in-psychotic-inpatients.php?aid=2644 Note: You will access this article from the Walden Library databases.
Lego, S. (1998). The application of Peplau’s theory to group psychotherapy. Journal of Psychiatric & Mental Health Nursing, 5(3), 193–196. doi:10.1046/j.1365-2850.1998.00129.x Note: You will access this article from the Walden Library databases.
McClanahan, K. K. (2014). Can confidentiality be maintained in group therapy? Retrieved from http://nationalpsychologist.com/2014/07/can-confidentiality-be-maintained-in-group-therapy/102566.html
U.S. Department of Health & Human Services. (2014). HIPAA privacy rule and sharing information related to mental health. Retrieved from http://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/special/mhguidancepdf.pdf
Laureate Education (Producer). (2015). Microskills: Family counseling techniques 1 [Video file]. Baltimore, MD: Author. Note: The approximate length of this media piece is 32 minutes.
Laureate Education (Producer). (2015). Microskills: Family counseling techniques 2 [Video file]. Baltimore, MD: Author. Note: The approximate length of this media piece is 32 minutes.
Laureate Education (Producer). (2015). Microskills: Family counseling techniques 3 [Video file]. Baltimore, MD: Author. Note: The approximate length of this media piece is 24 minutes.
Sommers, G., Feldman, S., & Knowlton, K. (Producers). (2008a). Legal and ethical issues for mental health professionals, volume 1: Confidentiality, privilege, reporting, and duty to warn [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 140 minutes.
Sommers, G., Feldman, S., & Knowlton, K. (Producers). (2008b). Legal and ethical issues for mental health professionals, volume 2: Dual relationships, boundaries, standards of care and termination [Video file]. Mill Valley, CA: Psychotherapy.net.
Do you believe you have the traits to be an effective leader? Perhaps you are already in a supervisory role, but as has been discussed previously, appointment does not guarantee leadership skills.
How can you evaluate your own leadership skills and behaviors? You can start by analyzing your performance in specific areas of leadership. In this Discussion, you will complete Gallup’s StrengthsFinder assessment. This assessment will identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success and examine how the results relate to your leadership traits. To Prepare:
Complete the StrengthsFinder assessment instrument, per the instructions found in this Module’s Learning Resources.
Please Note: This Assessment will take roughly 30 minutes to complete.
NOTE: Please keep your report. You will need your results for future courses. Technical Issues with Gallup:
If you have technical issues after registering, please contact the Gallup Education Support group by phone at +1.866-346-4408. Support is available 24 hours/day from 6:00 p.m. Sunday U.S. Central Time through 5:00 p.m. Friday U.S. Central Time.
Reflect on the results of your Assessment, and consider how the results relate to your leadership traits.
By Day 3 of Week 5
Post a brief description of your results from the StrengthsFinder assessment. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your StrengthsFinder assessment. Be specific.
By Day 6 of Week 5
Respond to at least two of your colleagues on two different days by making recommendations for how they might strengthen the leadership behaviors profiled in their StrengthsFinder assessment, or by commenting on lessons to be learned from the results that can be applied to personal leadership philosophies and behaviors.
Learning Resources
Required Readings
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization/msn-fp6016-health-care-organizations-medication-errors/: Foundations” (pp. 7–20 ONLY)
Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)
Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194)
Rath, T. (2007). Strengths Finder 2.0 – with Access Code.
Purchase the access code from the Walden bookstore. Then follow the instructions in the document “How to Access the Strengths Finder 2.0.
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
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219–232)
Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186
Note: You will access this article from the Walden Library databases.
Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396
Note: You will access this article from the Walden Library databases.
Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483
Note: You will access this article from the Walden Library databases.
Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x
Note: You will access this article from the Walden Library databases.
Discussion: Patient Preferences and Decision Making
Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.
What has your experience been with patient involvement in treatment or healthcare decisions?
In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.
To Prepare:
Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at /orders/decisionaid.ohri.ca/.
Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.
NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.
By Day 3 of Week 8
Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.
By Day 6 of Week 8
Respond to at least two of your colleagues on two different days and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 8
To participate in this Discussion:
Week 8 Discussion
Assignment: Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change
The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.
In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.
To Prepare:
Reflect on the four peer-reviewed articles you critically appraised in Module 4.
Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.
The Assignment: (Evidence-Based Project)
Part 5: Recommending an Evidence-Based Practice Change
Create an 8- to 9-slide PowerPoint presentation in which you do the following:
Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
Add a lessons learned section that includes the following:
A summary of the critical appraisal of the peer-reviewed articles you previously submitted
An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides).NURS-6052 Module 5: Evidence-Based Decision Making (Weeks 8-9)
By Day 7 of Week 9
Submit Part 5 of your Evidence-Based Project.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK9Assgn+last name+first initial.(extension)” as the name.
Click the Week 9 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 9 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 “WK9Assgn+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.
Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.
Submit your Week 9 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 9
To submit your Assignment:
Week 9 Assignment
To go to the next week:
Module 6
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Discussion Week 8 – NURS 6052: Developing a Culture of Evidence-Based Practice
As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.
In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.
To Prepare:
· Review the Resources (See below references and attached PDF documents) and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
· This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
· Reflect on which type of dissemination strategy you might use to communicate EBP.
Instructions:
1. Post at least two dissemination strategies you would be most inclined to use and explain why.
2. Explain which dissemination strategies you would be least inclined to use and explain why.
3. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use.
4. Be specific and provide examples.
5. Explain how you might overcome the barriers you identified.
** At least 3 References**
Resources from School – References (attached documents)
Gallagher-Ford, Lynn MSN, RN, NE-BC; Fineout-Overholt, Ellen PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek PhD, RN, CPNP/PMHNP, FNAP, FAAN; Stillwell, Susan B. DNP, RN, CNE Evidence-Based Practice, Step by Step: Implementing an Evidence-Based Practice Change, AJN, American Journal of Nursing: March 2011 – Volume 111 – Issue 3 – p 54-60 doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7e
Newhouse, R. P. , Dearholt, S. , Poe, S. , Pugh, L. C. & White, K. M. (2007). Organizational Change Strategies for Evidence-Based Practice. JONA: The Journal of Nursing Administration, 37(12), 552-557. doi: 10.1097/01.NNA.0000302384.91366.8f.
Melnyk, B. M. (2012). Achieving a High-Reliability Organization Through Implementation of the ARCC Model for Systemwide Sustainability of Evidence-Based Practice. Nursing Administration Quarterly, 36(2), 127–135. doi: 10.1097/NAQ.0b013e318249fb6a.
Melnyk, B. M. , Fineout-Overholt, E. , Gallagher-Ford, L. & Stillwell, S. B. (2011). Evidence-Based Practice, Step by Step: Sustaining Evidence-Based Practice Through Organizational Policies and an Innovative Model. AJN, American Journal of Nursing, 111(9), 57-60. doi: 10.1097/01.NAJ.0000405063.97774.0e.
Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A Test of the ARCC (c) Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. WORLDVIEWS ON EVIDENCE-BASED NURSING, 14(1), 5–9. /orders/doi-org.ezp.waldenulibrary.org/10.1111/wvn.12188
INSTRUCTIONS: Respond to your colleague by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.
**At least 2 references per reply, and they need to support information in the reply**
Agreeing with Melnyk & Fineout-Overholt (2018), creating awareness and interest should be the first strategy to disseminate evidence-based practice within an organization. To prepare an organization for change, leadership is essential (Newhouse et al., 2007). Leadership must gather their staff and explain that modifications are necessary and required to be utilized.
Spreading awareness and interest can present challenges as many employees may ignore the announcements, advertisements, and newsletters that were utilized. As employees enter the organization, many focus on the task at hand and not the bigger picture. Those employees may only view the attended EBP as “if the job wants us to work a certain way, they will tell us personally.” This way of the employees’ thinking is a barrier to diffusing awareness and interest of EBP.
Dissemination Strategy 2 and its Possible Barrier
According to Melnyk & Fineout-Overholt (2018), an additional strategy to disseminating EBP can build knowledge and commitment. Conducting a transdisciplinary team training in which leadership and employees learn about the EB and how to accomplish it (Melnyk, 2012) will lead to all staff being in unity.
Along with building knowledge and commitment of the EBP, barriers can emerge. Some colleagues may disagree and disapprove of the need for the new EBP, as many seasoned colleagues are too familiar with how tasks were performed in the “old days.” Those colleagues require further education and explanation, by leadership, on how the EBP can improve topics.
Least Inclined Dissemination Strategy
I believe that the least persuasive strategy can be pursuing integration and sustained usage. Melnyk & Fineout-Overholt (2018) described this strategy includes celebrations of the local unit’s progression, public acknowledgment, and individualized memos to staff. This comes in the form of the famous repetitive pizza parties given by management, that many staff are appreciative of but wishfully think they deserve more.
This strategy requires improvement to fully grasp the staff’s attention to show the organization’s appreciation properly. Pay-for-performance incentives have placed organizations under pressure to increase their level of care and avoid sentinel incidents (Melnyk, 2012), which may be a more persuasive strategy than a nutriment incentive.
References
Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of the evidence-based practice. Nursing Administration Quarterly, 36(2), 127-135. Doi: 10.1097/NAQ.0b013e318249fb6a
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice(4th ed.). Philadelphia, PA: Wolters Kluwer.
Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552-557. Doi: 0.1097/01.NNA.0000302384.8f
INSTRUCTIONS: Respond to your colleague by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.
**At least 2 references per reply, and they need to support information in the reply**
Dissemination is the act of sharing and distributing information through different materials to a specific audience to increase their reach for evidence and effectively use evidence-based literature. It occurs through various channels, social contexts, and settings spreading knowledge of evidence-based practice (EBP) interventions on a wide scale within or across practice settings.
Dissemination Strategies I would be most inclined to use and why
I would be most bent on using passive and active dissemination strategies. Passive strategies include sending mass emails and information publications or posting details about evidence to a website and scientific publications in a searchable database for an untargeted audience (Vedel et al., 2018). The approach is less costly in terms of translating knowledge and is highly feasible. In contrast, active dissemination strategies comprise efforts that spread knowledge to a targeted group through practical guidance, prompts, and information media campaigns (Melnyk et al., 2011). I would use active dissemination to increase the reach of motivation and people’s ability to apply and use evidence. Both strategies would be effective in ensuring widespread EBP use on various clinical practices and interventions.
Dissemination Strategies I would be least inclined to use and why
The dissemination strategy that I would be least inclined to use is passive because it involves untargeted information dissemination. Here, the message is untailored, and the delivery is unplanned or uncontrolled. Hence, it is generally ineffective and only results in minimal practice changes.
Two Barriers I might Encounter when using the Dissemination Strategies, I am most inclined to use.
I would be most inclined to use active dissemination because it involves communicating facts actively by targeting a specific audience. Lack of EBP knowledge and fear of the unknown is the most critical barrier in using the approach, making it hard to convince colleagues to come on board and understand the process (Brownson et al., 2018).
How I might Overcome the Barriers I identified
To overcome this barrier, it is critical for the strategy to include resources for learning about EBP, which should be emphasized and taught through nursing schools and selected development centers. Active dissemination is also costly and time-consuming, leading to burnout and stress (Gallagher-Ford et al., 2011). However, this can be overcome by increasing resources and the number of personnel involved in dissemination.
References
Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: New approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102–111. /orders/doi.org/10.1097/PHH.0000000000000673
Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence- based practice change. The American Journal of Nursing, 111(3), 54–60. /orders/doi.org/10.1097/10.1097/01.NAJ.0000395243.14347.7e
Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. The American Journal of Nursing, 111(9), 57–60. /orders/doi.org/10.1097/01.NAJ.0000405063.97774.0e
Vedel, I., Le Berre, M., Sourial, N., Arsenault-Lapierre, G., Bergman, H., & Lapointe, L. (2018). Shedding light on conditions for the successful passive dissemination of recommendations in primary care: A mixed methods study. Implementation Science, 13(1), 1–12. /orders/doi.org/10.1186/s13012-018-0822-x
Name: NURS_6052_Module05_Week09_Discussion_Rubric
Novice
Competent
Proficient
New Column4
Main Posting
Points: Points Range: 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. Feedback:
Points: Points Range: 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. Feedback:
Points: Points Range: 35 (35%) – 39 (39%) Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors. Feedback:
Points: Points Range: 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style. Feedback:
Main Post: Timeliness
Points: Points Range: 10 (10%) – 10 (10%) Posts main post by day 3. Feedback:
Points: Points Range: 0 (0%) – 0 (0%) Feedback:
Points: Points Range: 0 (0%) – 0 (0%) Feedback:
Points: Points Range: 0 (0%) – 0 (0%) Does not post by day 3. Feedback:
First Response
Points: Points Range: 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. Feedback:
Points: Points Range: 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. Feedback:
Points: Points Range: 13 (13%) – 14 (14%) Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. Feedback:
Points: Points Range: 0 (0%) – 12 (12%) Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. Feedback:
Second Response
Points: Points Range: 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. Feedback:
Points: Points Range: 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. Feedback:
Points: Points Range: 12 (12%) – 13 (13%) Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. Feedback:
Points: Points Range: 0 (0%) – 11 (11%) Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. Feedback:
Participation
Points: Points Range: 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days. Feedback:
Points: Points Range: 0 (0%) – 0 (0%) Feedback:
Points: Points Range: 0 (0%) – 0 (0%) Feedback:
Points: Points Range: 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days. Feedback:
Total Points: 100
Name: NURS_6052_Module05_Week09_Discussion_Rubric
ADDITIONAL INSTRUCTIONS FOR THE CLASS
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Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.
LopesWrite Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
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ASSIGNMENT 1 (Short Answer Assessment) AND ASSIGNMENT 2 (Assessing And Treating Patients With Sleep/Wake Disorders)
WK8 Short Answer Assignment (ASSIGNMENT 1 SHOULDN’T BE MORE THAN 2 PAGES)
Assignment 1: Short Answer Assessment
As a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.
To Prepare
· Review the Learning Resources for this week.
· Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.
· Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health.
To complete:
Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.
1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
2. List 4 predictors of late onset generalized anxiety disorder.
3. List 4 potential neurobiology causes of psychotic major depression.
4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.
By Day 7
This Assignment is due.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
· Please save your Assignment using the naming convention “WK8Assgn1+last name+first initial.(extension)” as the name.
· Click the Week 8 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
· Click the Week 8 Assignment 1 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 “WK8Assgn1+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 8 Assignment 1 Rubric
Assignment 2: Assessing and Treating Patients With Sleep/Wake Disorders
Sleep disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health, safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with psychopharmacologic treatments, however, many of these drugs can have negative effects on other aspects of a patient’s health and well-being. Additionally, while psychopharmacologic treatments may be able to address issues with sleep, they can also exert potential challenges with waking patterns. Thus, it is important for the psychiatric nurse practitioner to carefully evaluate the best psychopharmacologic treatments for patients that present with sleep/wake disorders.
Reference: Mayo Clinic. (2020). Sleep disorders. /orders/www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018
To prepare for this Assignment:
· Review this week’s Learning Resources, including the Medication Resources indicated for this week.
· Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with sleep/wake disorders.
The Assignment: 5 pages not more than 6 pages please
Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page)
· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
· Which decision did you select?
· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Conclusion (1 page)
· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.
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 provides an example of those required elements (available at /orders/academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.
By Day 7 Submit your Assignment.
Submission and Grading Information To submit your completed Assignment for review and grading, do the following:
· Please save your Assignment using the naming convention “WK8Assgn2+last name+first initial.(extension)” as the name.
· Click the Week 8 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
· Click the Week 8 Assignment 2 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 “WK8Assgn2+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.
BACKGROUND
This week, we examine a 31-year-old male who presents to the office with a chief complaint of insomnia.
SUBJECTIVE
Patient is a 31-year-old male. He states that his insomnia has gotten progressively worse over the past 6 months. Per the patient, he has never been a “great sleeper” but is now having difficulty both falling asleep and staying asleep at night. The problem began approximately 6 months ago after the sudden loss of his fiancé. The patient states this is affecting his ability to perform his job, which is a forklift operator at a local chemical company. The patient states he has used diphenhydramine in the past to sleep but does not like the way it makes him feel the morning after. He states he has fallen asleep on the job due to lack of sleep from the night before. The patient’s medical record from his previous physician states that he has a history of opiate abuse, which began after he broke his ankle in a skiing accident and was prescribed hydrocodone/apap (acetaminophen) for acute pain management. The patient has not received a prescription for an opiate analgesic in 4 years. The patient states recently he has been using alcohol to help him fall asleep, approximately four beers prior to bed.
MENTAL STATUS EXAM
The patient is alert and oriented to person, place, time, event. He makes good eye contact and is dressed appropriately for time of year. He denies auditory/visual hallucinations. Judgement, insight, and reality contact are all intact. Patient denies suicidal/homicidal ideation, and is future oriented.
This week your Discussion will focus on interprofessional practice. This Discussion is an opportunity for you to examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.
To prepare:
Identify a professional nursing organization and review their position on interprofessional practice
Ms. Tuckerno has been diagnosed with multiple sclerosis (MS). The patient receives care at an internal medicine clinic. Her internist is not in the office today and she is being treated by the nurse practitioner. The patient is on two medications for her MS, three different blood pressure medications, one medication for thyroid disease, one diabetic pill daily, insulin injections twice a day, she uses medical cannabis, and uses eye drops for glaucoma. Upon assessing the patient, the nurse practitioner (NP) decides her treatment plan should be adjusted. The NP discontinues some of the patient’s meds and discontinues medical cannabis. She orders the patient to follow up in two weeks.
The patient returns and is seen by her internist. The internist speaks with the patient and reviews her medical chart. The internist states to the patient, “I am dissatisfied with the care you received from the nurse practitioner.” The internist places the patient back on originally prescribed medications and medical cannabis.
Post 2 pages on : An explanation of your understanding of interprofessional practice.
Also, explain the position on interprofessional practice for a professional nursing organization that you are a member of or of which you plan to become a member.
Then, explain what you think is the best collaborative approach to manage Ms. Tuckerno’s care.
References
Required Readings
Altman, S. H., Butler, A. S., Shern, L. (Eds.). (2015). Assessing Progress on the IOM Report The Future of Nursing. Washington, DC: The National Academies Press. Retrieved from http://www.nationalacademies.org/hmd/Reports/2015/Assessing-Progress-on-the-IOM-Report-The-Future-of-Nursing.aspx doi: 10.17226/21838
Bankston, K., & Glazer, G., (2013) Legislative: Interprofessional collaboration: What’s taking so long? OJIN: The Online Journal of Issues in Nursing, 19(1).
Buppert, C. (2015). Appendix 11-D: Sample Professional Services Agreement. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (417-422). Burlington, MA: Jones & Bartlett.
Buppert, C. (2015). Legal Scope of Nurse Practitioner Practice. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (37-78). Burlington, MA: Jones & Bartlett.
Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2).
Note: Retrieved from the Walden Library databases.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2014). Collaboration. In Advanced Practice Nursing: An Integrative Approach (5th ed.) (299-327). St. Louis, MO: Elsevier Saunders.
What curative factors might be important for this group and why?
What “exclusion criteria” did the authors mention?
· Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own client groups. If so, how? If not, why?
· Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article. Note: The presentation should be 5–10 slides, not including the title and reference slides.
Week 6: Foundations of Group Work and Types of Groups
Evaluate the following group therapy article below. (See attached article)
Bélanger, C., Laporte, L., Sabourin, S., & Wright, J. (2015). The effect of cognitive-behavioral group marital therapy on marital happiness and problem solving self-appraisal. American Journal of Family Therapy, 43(2), 103–118. doi:10.1080/01926187.2014.956614
Applying Current Literature to Clinical Practice
The Assignment
In a 5- to 10-slide PowerPoint presentation, address the following:
· Provide an overview of the article you selected, including answers to the following questions:
· What type of group was discussed?
· Who were the participants in the group? Why were they selected?
· What was the setting of the group?
· How often did the group meet?
· What was the duration of the group therapy?
· What curative factors might be important for this group and why?
· What “exclusion criteria” did the authors mention?
· Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own client groups. If so, how? If not, why?
· Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.
Note: The presentation should be 5–10 slides , not including the title and reference slides . Include presenter notes (no more than a half page per slide) and use tables and/or diagrams where appropriate. Be sure to support your work with specific citations from the article you selected. Support your presentation with evidence-based literature.
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
· Chapter 11, “Group Therapy” (Review pp. 407–428.)
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
· Chapter 1, “The Therapeutic Factors” (pp. 1–18)
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
· Chapter 2, “Interpersonal Learning” (pp. 19–52)
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
· Chapter 3, “Group Cohesiveness” (pp. 53–76)
Leszcz, M., & Kobos, J. C. (2008). Evidence-based group psychotherapy: Using AGPA’s practice guidelines to enhance clinical effectiveness. Journal of Clinical Psychology, 64(11), 1238–1260. doi:10.1002/jclp.20531
Note: Retrieved from Walden Library databases.
Marmarosh, C. L. (2014). Empirical research on attachment in group psychotherapy: Moving the field forward. Psychotherapy, 51(1), 88–92. doi:10.1037/a0032523
Note: Retrieved from Walden Library databases.
Microsoft. (2017). Basic tasks for creating a PowerPoint presentation. Retrieved from /orders/support.office.com/en-us/article/Basic-tasks-for-creating-a-PowerPoint-2013-presentation-efbbc1cd-c5f1-4264-b48e-c8a7b0334e36
Tasca, G. A. (2014). Attachment and group psychotherapy: Introduction to a special section. Psychotherapy, 51(1), 53–56. doi:10.1037/a0033015
Note: Retrieved from Walden Library databases.
Tasca, G. A., Francis, K., & Balfour, L. (2014). Group psychotherapy levels of interventions: A clinical process commentary. Psychotherapy, 51(1), 25–29. doi:10.1037/a0032520
Note: Retrieved from Walden Library databases.
Week 6: Discussion: Treatment Of Psychiatric Emergencies In Children Versus Adults
Week 6: Discussion: Treatment Of Psychiatric Emergencies
The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations.
In this week’s Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.
Learning Objectives
Students will:
Compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients
Review the Learning Resources concerning emergency psychiatric medicine.
Consider a case where an adult client had a psychiatric emergency. If you have not had a personal experience with an adult client who had a psychiatric emergency, you can conduct an internet or library search to identify one.
POST
Briefly describe the case you selected.
Explain how you would treat the client differently if he or she were a child or adolescent.
Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.
Discussion: Treatment of Psychiatric Emergencies in Children versus Adults
In this week’s Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.
Post answers to the three questions below:
1. Briefly describe the case you selected (make up one).
2. Explain how you would treat the client differently if he or she were a child or adolescent.
3. Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.
References (also outside references welcomed)
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 23, “Emergency Psychiatric Medicine” (pp. 785–790)
· Chapter 31, “Child Psychiatry” (pp. 1226–1253)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
· “Bipolar and Related Disorders”
Note: You will access this book from the Walden Library databases.
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.
· Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)
· Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)
ADDITIONAL INSTRUCTIONS FOR THE CLASS
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Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. Week 6: Discussion: Treatment Of Psychiatric Emergencies In Children Versus Adults
LopesWrite Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
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Week 3: Personality Disorders
Discussion: Treatment of Personality Disorders – Histrionic 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.
Week 3: Personality Disorders
Discussion: Treatment of Personality Disorders – Histrionic 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
