Practicum – Week 5 Journal Entry

Practicum – Week 5 Journal Entry

Describe each client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
Using the DSM-5, explain and justify your diagnosis for each client.
Explain whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches.
Explain any legal and/or ethical implications related to counseling each client.
Support your approach with evidence-based literature.
Assignment 1: Practicum – Week 5 Journal Entry
Learning Objectives
Students will:
· Develop effective documentation skills for family therapy sessions *
· Develop diagnoses for clients receiving family psychotherapy *
· Evaluate the efficacy of solution-focused therapy and cognitive behavioral therapy for families *
· Analyze legal and ethical implications of counseling clients with psychiatric disorders *
* The Assignment related to this Learning Objective is introduced this week and submitted in Week 7.
Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session. Do not select the same family you selected for Week 2.
Then, address in your Practicum Journal the following:
Describe each client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
Using the DSM-5, explain and justify your diagnosis for each client.
Explain whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches.
Explain any legal and/or ethical implications related to counseling each client.
Support your approach with evidence-based literature.
 
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
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
· Standard 5F “Milieu Therapy” (pages 60-61)
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
· Chapter 12, “Family Therapy” (Review pp. 429–468.)
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.
· Chapter 10, “Cognitive-Behavior Family Therapy” (pp. 166–189)
· Chapter 12, “Solution-Focused Therapy” (pp. 225–242)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Bond, C., Woods, K., Humphrey, N., Symes, W., & Green, L. (2013). Practitioner review: The effectiveness of solution focused brief therapy with children and families: A systematic and critical evaluation of the literature from 1990–2010. Journal of Child Psychology & Psychiatry, 54(7), 707–723. doi:10.1111/jcpp.12058
Note: Retrieved from Walden Library databases.
Conoley, C., Graham, J., Neu, T., Craig, M., O’Pry, A., Cardin, S., & … Parker, R. (2003). Solution-focused family therapy with three aggressive and oppositional-acting children: An N=1 empirical study. Family Process, 42(3), 361–374. doi:10.1111/j.1545-5300.2003.00361.x
Note: Retrieved from Walden Library databases.
de Castro, S., & Guterman, J. (2008). Solution-focused therapy for families coping with suicide. Journal of Marital & Family Therapy, 34(1), 93–106. doi:10.111/j.1752-0606.2008.00055.x
Note: Retrieved from Walden Library databases.
Patterson, T. (2014). A cognitive behavioral systems approach to family therapy. Journal of Family Psychotherapy, 25(2), 132–144. doi:10.1080/08975353.2014.910023
Note: Retrieved from Walden Library databases.
Perry, A. (2014). Cognitive behavioral therapy with couples and families. Sexual & Relationship Therapy, 29(3), 366–367. doi:10.1080/14681994.2014.909024
Note: Retrieved from Walden Library databases.
Ramisch, J., McVicker, M., & Sahin, Z. (2009). Helping low-conflict divorced parents establish appropriate boundaries using a variation of the miracle question: An integration of solution-focused therapy and structural family therapy. Journal of Divorce & Remarriage, 50(7), 481–495. doi:10.1080/10502550902970587
Note: Retrieved from Walden Library databases.
Washington, K. T., Wittenberg-Lyles, E., Oliver, D. P., Baldwin, P. K., Tappana, J., Wright, J. H., & Demiris, G. (2014). Rethinking family caregiving: Tailoring cognitive-behavioral therapies to the hospice experience. Health & Social Work, 39(4), 244–250. doi:10.1093/hsw/hlu031
Note: Retrieved from Walden Library databases.
Document: Group Therapy Progress Note
Required Media
Laureate Education (Producer). (2013c). Johnson family session 3 [Video file]. Author: Baltimore, MD.
 
Note: The approximate length of this media piece is 5 minutes.
 
Accessible player

 

Case Study Assignment: Assessing Neurological Symptoms

Case Study Assignment: Assessing Neurological Symptoms

Case Study Assignment: Assessing Neurological Symptoms

Case Study Assignment: Assessing Neurological Symptoms

Case Study Assignment: Assessing Neurological Symptoms

Case Study Assignment: Assessing Neurological Symptoms

Case Study Assignment: Assessing Neurological Symptoms

 CASE STUDY 3: Drooping of Face A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.
 

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 five 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.
 
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 7, “Mental Status”This chapter revolves around the mental status evaluation of an individual’s overall cognitive state. The chapter includes a list of mental abnormalities and their symptoms.
  • ·Chapter 23, “Neurologic System”The authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings.

ZERO PLAGIARISM
FIVE REFERENCES NOT MORE THAN 5YEARS
Comprehensive SOAP Template
Patient Initials: _______ Age: _______ Gender: _______
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: Include last 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, 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 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?
© 2019 Walden University Page 2 of 3

 

Linear Regression Exercises

Linear Regression Exercises

Linear Regression Exercises Due 10/13/17 by 10 pm
Simple Regression
Research Question: Does the number of hours worked per week (workweek) predict family income (income)?
Using Polit2SetA data set, run a simple regression using Family Income (income) as the outcome variable (Y) and Number of Hours Worked per Week (workweek) as the independent variable (X). When conducting any regression analysis, the dependent (outcome) variables is always (Y) and is placed on the y-axis, and the independent (predictor) variable is always (X) and is placed on the x-axis.
Follow these steps when using SPSS:
1. Open Polit2SetA data set.
2. Click on Analyze, then click on Regression, then Linear.
3. Move the dependent variable (income) in the box labeled “Dependent” by clicking the arrow button. The dependent variable is a continuous variable.
4. Move the independent variable (workweek) into the box labeled “Independent.”
5. Click on the Statistics button (right side of box) and click on DescriptivesEstimatesConfidence Interval (should be 95%), and Model Fit, then click on Continue.
6. Click on OK.
Assignment: Through analysis of the SPSS output, answer the following questions. Answer questions 1 – 10 individually, not in paragraph form
1. What is the total sample size?
2. What is the mean income and mean number of hours worked?
3. What is the correlation coefficient between the outcome and predictor variables? Is it significant? How would you describe the strength and direction of the relationship?
4. What it the value of R squared (coefficient of determination)? Interpret the value.
5. Interpret the standard error of the estimate? What information does this value provide to the researcher?
6. The model fit is determined by the ANOVA table results (F statistic = 37.226, 1,376 degrees of freedom, and the p value is .001). Based on these results, does the model fit the data? Briefly explain. (Hint: A significant finding indicates good model fit.)
7. Based on the coefficients, what is the value of the y-intercept (point at which the line of best fit crosses the y-axis)?
8. Based on the output, write out the regression equation for predicting family income.
9. Using the regression equation, what is the predicted monthly family income for women working 35 hours per week?
10. Using the regression equation, what is the predicted monthly family income for women working 20 hours per week?
For this assignment, answer question 1 through 10 individually. DO NOT ANSWER IN PARAGRAPH FORM.
Multiple Regression
Assignment: In this assignment we are trying to predict CES-D score (depression) in women. The research question is: How well do age, educational attainment, employment, abuse, and poor health predict depression?
Using Polit2SetC data set, run a multiple regression using CES-D Score (cesd) as the outcome variable (Y) and respondent’s age (age), educational attainment (educatn), currently employed (worknow), number, types of abuse (nabuse), and poor health (poorhlth) as the independent variables (X). When conducting any regression analysis, the dependent (outcome) variables is always (Y) and is placed on the y-axis, and the independent (predictor) variable is always (X) and is placed on the x-axis.
Follow these steps when using SPSS:
1. Open Polit2SetC data set.
2. Click on Analyze, then click on Regression, then Linear.
3. Move the dependent variable, CES-D Score (cesd) into the box labeled “Dependent” by clicking on the arrow button. The dependent variable is a continuous variable.
4. Move the independent variables (ageeducatnworknow, and poorhlth) into the box labeled “Independent.” This is the first block of variables to be entered into the analysis (block 1 of 1). Click on the bottom (top right of independent box), marked “Next”; this will give you another box to enter the next block of indepdent variables (block 2 of 2). Here you are to enter (nabuse). Note: Be sure the Method box states “Enter”.
5. Click on the Statistics button (right side of box) and click on DescriptivesEstimatesConfidence Interval (should be 95%), R square change, and Model Fit, and then click on Continue.
6. Click on OK.
Assignment: (When answering all questions, use the data on the coefficients panel from Model 2). Answer questions 1 – 5 individually, not in paragraph form
1. Analyze the data from the SPSS output and write a paragraph summarizing the findings. (Use the example in the SPSS output file as a guide for your write-up.)
2. Which of the predictors were significant predictors in the model?
3. Which of the predictors was the most relevant predictor in the model?
4. Interpret the unstandardized coefficents for educational attainment and poor health.
5. If you wanted to predict a woman’s current CES-D score based on the analysis, what would the unstandardized regression equation be? Include unstandardized coefficients in the equation.
For this assignment, answer question 1 through 5 individually. DO NOT ANSWER IN PARAGRAPH FORM.
Required Readings
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

  • Chapter 24, “Using      Statistics to Predict”

This chapter asserts that predictive analyses are based on probability theory instead of decision theory. It also analyzes how variation plays a critical role in simple linear regression and multiple regression.
Statistics and Data Analysis for Nursing Research

  • Chapter 9, “Correlation and      Simple Regression” (pp. 208–222)

This section of Chapter 9 discusses the simple regression equation and outlines major components of regression, including errors of prediction, residuals, OLS regression, and ordinary least-square regression.

  • Chapter 10, “Multiple      Regression”

Chapter 10 focuses on multiple regression as a statistical procedure and explains multivariate statistics and their relationship to multiple regression concepts, equations, and tests.

  • Chapter 12, “Logistic      Regression”

This chapter provides an overview of logistic regression, which is a form of statistical analysis frequently used in nursing research.
Optional Resources
Walden University. (n.d.). Linear regression. Retrieved August 1, 2011, from http://streaming.waldenu.edu/hdp/researchtutorials/educ8106_player/educ8106_linear_regression.html
Week 7 Linear Regression Exercises
Simple Regression
Research Question: Does the number of hours worked per week (workweek) predict family income (income)?
Using Polit2SetA data set, run a simple regression using Family Income (income) as the outcome variable (Y) and Number of Hours Worked per Week (workweek) as the independent variable (X). When conducting any regression analysis, the dependent (outcome) variables is always (Y) and is placed on the y-axis, and the independent (predictor) variable is always (X) and is placed on the x-axis.
Follow these steps when using SPSS:
1. Open Polit2SetA data set.
2. Click on Analyze, then click on Regression, then Linear.
3. Move the dependent variable (income) in the box labeled “Dependent” by clicking the arrow button. The dependent variable is a continuous variable.
4. Move the independent variable (workweek) into the box labeled “Independent.”
5. Click on the Statistics button (right side of box) and click on Descriptives, Estimates, Confidence Interval (should be 95%), and Model Fit, then click on Continue.
6. Click on OK.
Assignment: Through analysis of the SPSS output, answer the following questions.
1. What is the total sample size?
2. What is the mean income and mean number of hours worked?
3. What is the correlation coefficient between the outcome and predictor variables? Is it significant? How would you describe the strength and direction of the relationship?
4. What it the value of R squared (coefficient of determination)? Interpret the value.
5. Interpret the standard error of the estimate? What information does this value provide to the researcher?
6. The model fit is determined by the ANOVA table results (F statistic = 37.226, 1,376 degrees of freedom, and the p value is .001). Based on these results, does the model fit the data? Briefly explain. (Hint: A significant finding indicates good model fit.)
7. Based on the coefficients, what is the value of the y-intercept (point at which the line of best fit crosses the y-axis)?
8. Based on the output, write out the regression equation for predicting family income.
9. Using the regression equation, what is the predicted monthly family income for women working 35 hours per week?
10. Using the regression equation, what is the predicted monthly family income for women working 20 hours per week?
For this assignment, answer question 1 through 10 individually. DO NOT ANSWER IN PARAGRAPH FORM.
Multiple Regression
Assignment: In this assignment we are trying to predict CES-D score (depression) in women. The research question is: How well do age, educational attainment, employment, abuse, and poor health predict depression?
Using Polit2SetC data set, run a multiple regression using CES-D Score (cesd) as the outcome variable (Y) and respondent’s age (age), educational attainment (educatn), currently employed (worknow), number, types of abuse (nabuse), and poor health (poorhlth) as the independent variables (X). When conducting any regression analysis, the dependent (outcome) variables is always (Y) and is placed on the y-axis, and the independent (predictor) variable is always (X) and is placed on the x-axis.
Follow these steps when using SPSS:
1. Open Polit2SetC data set.
2. Click on Analyze, then click on Regression, then Linear.
3. Move the dependent variable, CES-D Score (cesd) into the box labeled “Dependent” by clicking on the arrow button. The dependent variable is a continuous variable.
4. Move the independent variables (age, educatn, worknow, and poorhlth) into the box labeled “Independent.” This is the first block of variables to be entered into the analysis (block 1 of 1). Click on the bottom (top right of independent box), marked “Next”; this will give you another box to enter the next block of indepdent variables (block 2 of 2). Here you are to enter (nabuse). Note: Be sure the Method box states “Enter”.
5. Click on the Statistics button (right side of box) and click on Descriptives, Estimates, Confidence Interval (should be 95%), R square change, and Model Fit, and then click on Continue.
6. Click on OK.
Assignment: (When answering all questions, use the data on the coefficients panel from Model 2).
1. Analyze the data from the SPSS output and write a paragraph summarizing the findings. (Use the example in the SPSS output file as a guide for your write-up.)
2. Which of the predictors were significant predictors in the model?
3. Which of the predictors was the most relevant predictor in the model?
4. Interpret the unstandardized coefficents for educational attainment and poor health.
5. If you wanted to predict a woman’s current CES-D score based on the analysis, what would the unstandardized regression equation be? Include unstandardized coefficients in the equation.
For this assignment, answer question 1 through 5 individually. DO NOT ANSWER IN PARAGRAPH FORM.
Required Readings
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.
· Chapter 24, “Using Statistics to Predict”
 
This chapter asserts that predictive analyses are based on probability theory instead of decision theory. It also analyzes how variation plays a critical role in simple linear regression and multiple regression.
Statistics and Data Analysis for Nursing Research
· Chapter 9, “Correlation and Simple Regression” (pp. 208–222)
 
This section of Chapter 9 discusses the simple regression equation and outlines major components of regression, including errors of prediction, residuals, OLS regression, and ordinary least-square regression.
 
· Chapter 10, “Multiple Regression”
 
Chapter 10 focuses on multiple regression as a statistical procedure and explains multivariate statistics and their relationship to multiple regression concepts, equations, and tests.
 
· Chapter 12, “Logistic Regression”
 
This chapter provides an overview of logistic regression, which is a form of statistical analysis frequently used in nursing research.
Optional Resources
Walden University. (n.d.). Linear regression. Retrieved August 1, 2011, from http://streaming.waldenu.edu/hdp/researchtutorials/educ8106_player/educ8106_linear_regressi

 

 

DNP 820 Week 6 Benchmark – Drafting A Literature Review

DNP 820 Week 6 Benchmark – Drafting A Literature Review

DNP 820 Week 6 Benchmark – Drafting A Literature Review
Tutor MUST have a good command of the English language
Sources need to be less than five years old and journal/scholarly articles.
Use only articles that are published between 2014-2018 (except for your theory articles which will be older as you must cite primary sources).
No textbook or direct quotes
Rubric Requirements must be met
This is a continuation of the literature review that is attached. The new assignment needs to be added to the attached document.
In this assignment, you will draft the body of a literature review. You will continue to add and revise this draft literature review (Chapter 2 of your DPI Project) as you progress through the program. You may be able to use the feedback and suggestions from your instructor (on the Introduction to the Literature Review assignment in Topic 4) to expand the literature review for this assignment.
General Requirements:
Use the following information to ensure successful completion of the assignment:

  • Use      the “Empirical Research Checklist” worksheet to ensure that each      article you select meets all of the established criteria.
  • Use      the “Research Article Chart” to provide a summary review of each      component of your assignment.
  • Submit      the completed Research Article Chart to your instructor.
  • Refer to the most recent prospectus template found in the DC Network      (dc.gcu.edu) for details and criteria for the Literature Review (Chapter      2).
  • Doctoral learners are required to use the APA style for their writing assignments. The      APA Style Guide is located in the      Student Success Center. An abstract is not required.
  • This assignment uses a rubric. Please review the rubric prior to the beginning to become familiar with the expectations for successful completion.
  • You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Directions:
Part 1: Selection of 15 Articles 
Select 15 empirical articles related to your PICOT question. Use the “Empirical Research Checklist” worksheet to ensure that each article you select meets all of the established criteria. At least one article must demonstrate a quantitative methodology.
Part 2: Research Article Chart
Using the articles acquired in Part 1, provide a summary review of each component using the “Research Article Chart” template.
Part 3: Literature Review
Prepare a Literature Review (Chapter 2) of 2,000-3,000 words for your scholarly project.
Utilizing the major concepts identified in the Topic 4 assignment, further develop each major concept and subtheme by locating 15 more empirical articles related to your project topic (30 articles total: 15 from Topic 4 assignment and 15 from Topic 6 assignment).
Use the “Research Article Chart” as a guide to analyze and synthesize (summarize) the literature into the paper you began in the Topic 4 assignment.
Based upon your review of the 15 additional research articles, expand on your summary of each major concept and your synthesis of the three identified subthemes that support each concept. At the end of each major concept, include a summary statement.

 
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS 
Central Line-Associated Bloodstream Infections Literature Review
Kerry S. Murphy
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Dr. Kari Lane
September 26, 2018
 
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS
Central Line-Associated Bloodstream Infections Literature Review
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter (CVC), refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. There were 200 articles that were established to talk about the CVCscatheter, CLABSIs, risk factors, intervention, and benefits of preventive measures. Through inclusion and exclusion criteria many journal articles , wereere left out because of being written in other languages rather than English. Therefore, the use of the English language index the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was used to search related ,journal articles. Other search tools include The National Center for Biotechnology Information (NCBI) – PubMed. Studies older than five years were excluded to ensure that the research remained current and up to date. Using real-time cases or conditions helps to improve the quality and validity of the resulted research. having done years ranging from 2012 and backwards, and lacking openness to the public. Therefore, 29 were used in the study.
 
Questions Posed in the Studies
Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have. Kadium, M. (2015) inquired into how the education program for one month, based on the evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care? Dougherty (20142) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva, Zong, Jeong, & Lee , (2015), and Esposito, Guillari & Angelillo (2017) concur..
O’Grady, Alexander, Burns, Delilnger, Garland, Heard, Lipsett, Masur, Mermel, Pearson, Raad, Randolph, Rupp, & Saint (20151), the inquiry focused into how Positive blood culture shows the relationship between CLABSI and CDC surveillance. Other researchers inquire into the CLABSI-related preventive measures implemented among adult patients hospitalized in an ICU. Such studies are by people like Perin, Erdmann, Higashi, Sasso, Bianco, et al. (2016), Masse, Edmond, & Diekema (2018), Oliveira, Stipp, Silva, Frederico, & Duarte (2016). In a research by Basinger, (2014), the research question questions into the causal effects of the Comprehensive Unit-based Safety Programs (CUSP) on the reduction of CLABSIs within the relationship CUSP team member webinar attendance has with the reduction of CLASBIs. Other questions were on how knowledge and education of the family and patient could help in the prevention of CLABSIs attack. Among such studies are; Kadium, (2015) and Powell (2018).
Other studies focused on how evidence-based practice, insertion, and maintenance of CVC could protect the patients from CLABSIs. Such research was done by Bianco, Coscarelli, Nobile, Pileggi, & Pavia (20143), WHO (2018) and Xu & Wu (2017). The final research is by Han, Liang, & Marschall, (20150), who question how the involvement of education to the family and the patient can help prevent CLABSIs attacks among patients on CVC care. Another study by Yazan & Regunath (2018) questions examines the relationships between Positive blood culture and CLABSI with CDC.
 
Identified Subthemes
From this, there are various subthemes that emerge in this study. These include; Hygiene and impact of this on the CVC situation. Most studies show that the more hygiene is considered and practiced, the lower the cases of CLABSI. Another concept is the knowledge that is necessary among nurses and patients handling CVC. Through knowledge m the care for CVC improves and infections reduce. Besides, there are Policies which enhance the correct application of knowledge and maintenance of hygiene in the health care, hence decreasreducing cases of infections.
Moreover, nurse experience is an essential subtopic for due to evidence that supports that with higher experience in the CVC wardsunits;, nurses tend to takeadhere and follow ptoticls and precautions and which help prevent infections that those without. Finally, there are Eevidence- Based Practices/Interventions such as proper fitting, disinfection and sterilization, iInsertion bundle, maintenance bundle, and quality improvement.
The reviewed literature has shown that the nurse, patients, family, and evidence versus non-evidence-based practice are important in the analysis of the situation. Besides, the setting, the type of catheter, and conditions affect the entire discussion.
 
Risk Factors Associated with CLABSIs
a. Contamination on Insertion
The catheter may gain entry into the bloodstream during the insertion of the line into the body of the patient. The rate of infections during insertion is substantially dependent on the hygiene levels that are put in place by the health care providers (Dick et al., 2015). The rates of infection during insertion happen to be high showing ignorance or lack of professionalism among the health caregivers. Contamination during insertion may also result from the instruments used and how sterilized they are.
b. Contaminated Skin of the Patient
The insertion is done on the body of the patient. A contaminated skin of the patient may contain germs which may enter the body during the insertion (Dombecki et al., 2017). The fact that patients have negligible knowledge concerning the different ways the infection may occur means that there is so much responsibility placed on the health caregivers. The infection rates due to unsanitary practices of the patients seem to have drawn the attention of the authors of the different articles analyzed. With the rates of CLABSIs rising each year, mortality rates have also increased. Researchers have made CLABSIs prevention a priority to address such risk factors to avoid or reduce infection rates.
c. Non-Compliance with the Central Line Maintenance
There are guidelines for healthcare professionals meant to reduce the chances of CLABSIs infection. Such guidelines include not using antiseptics and ensuring complete dressing changes (Orwoll et al., 2018). As much as these guidelines and policies are in place does not mean that compliance is definite. Cases of caregivers who do not comply with the stipulated guidelines are common and such levels of unprofessionalism have cost patients their lives.
Interventions
a. Removal of Unnecessary Lines
The authors agree that there are times patients will have lines which are no longer being used for any medical purpose. These are mainly patients who have spent so much time in the hospitals, and the chances of being discharged seem minimal (Sodek, 2016). The caregivers are meant to remove lines once they have served the purpose. The more these lines remain on the body of the patients the more the chances of infection. Bacteria and all other associated germs will easily enter the body.
b. Health Care Providers to Follow Recommendations
Healthcare professionals are trained on the best practices that are meant to ensure that the chances of patient infections are minimized or even eliminated entirely. Unfamiliarity creeps in at times, and the well-being of the patients is jeopardized (Stone et al., 2014). Just like any other profession, health care ties the professionals around practices which ensure ethical undertakings to safeguard the lives of the patients. The authors are for the idea that health care professionals should be just to patients and do what their work ethics dictates them to do. Such will ensure improved health and safety of the patients.
 
c. Encouraging Teamwork
In any health care setting, there are two main participants. These are the health caregivers and the patients. One of the authors suggests that teamwork between these two parties will go a long way in reducing the rates of these infections (Stone et al., 2014). Teamwork will ensure that there is knowledge sharing, that key concerns and risks that may be known to one of the parties are made known to the other. The impact teamwork will have ontowards preventing the cases of CLABSIs in hospitals is immeasurable. The same should be embraced and upheld.
CLABSIs associated infections/Transmissions
a. Hematogenous Transmission
This is an infection that is characterized by a primary tumor penetrating into blood vessels. They then get transported in the blood vessels and eventually into the distant parts of the body of the patient (Stone et al., 2014). Once at the distant sites, the cells will penetrate the walls of the vessels again and build a basis for another, a new tumor on the new site. Such are the same cases that happen with CLABSIs. Examples include catheter-associated Urinary Tract Infections (CAUTI) that can lead to CLABSI’s.
b. Catheter-associated Urinary Tract Infections (CAUTI)
A urinary tract infection (UTI) refers to an infection in any part of the urinary system. UTIs are also common healthcare-associated infections reported by both patients and healthcare givers. These infections are associated with urinary catheters, a tube that is used by doctors through the urethra to drain urine (Douglas, 2015). Most of hospitalized patients end up with urinary catheters inserted in their bladder. Prolonged use of catheters increases the risks of infections. Health caregivers should ensure that these catheters are removed when not being used to reduce the risk of patients contracting CLABSIs.
c. Contaminated Infusates
The term refers to the introduction of pathogens into the body of patients. The introduction of these pathogens occurs through the sterile used by the health care providers. During surgery or during other procedures which may require line insertion, bacteria may be introduced into the body of the patient (Stone et al., 2014). Contaminated infuscate happens to be one of the ways CLABSIs bacteria is introduced into the bloodstream. Patients and healthcare providers need to be educated on such risks.
Necessity for Interventions
a. Reduced incidences of CLABSIs
The preventive measures mentioned above by the authors of the different articles will go a long way toward reducing the incidents that are reported by patients and caregivers concerning CLABSIs (Klintworth et al., 2014). Encouraging adherence to the hygiene standards, the policies and the recommendations as they relate to CLABSIs infections will enable the creation of an environment that will enhance the well-being of the patients and also minimize the chances of contraction of the infections. The infection is deadly and is already costing patients and nations dearly.
b. Reduced morbidity
Morbidity has been defined as how often a disease occurs or is reported in a population. The morbidity rate is determined by examining the number of patients with a certain disease at a given period (Kim & Biorn, 2017). Reduced cases of a disease mean that preventive and treatment measures are effectively implemented by all stakeholders involved. CLABSIs infections are no exceptions here. The literature work of the previous authors appreciates that the health care institutions that have adopted the interventions measures above report few and reduced cases of the infection.
CLABSIs Symptoms
a. Site Discharge
The area where the catheter is placed should remain dry, and no discharge should be coming from the area. Some patients, however, may notice yellow or green discharge (Conley et al., 2018). The drainage should be a cause for alarm, and the authors have identified the discharges as some of the top indicators that something has gone wrong and healthcare providers should act up. Discharges show that the area is not fresh and has been exposed to bacteria and germs, something that should be of great concern.
b. Site Swelling
Patients may experience additional swelling at the place where the catheter line has been inserted. The swelling is an indicator that there is no healing that is taking place and that there is every reason to worry about the well-being of the patient (Castagna et al., 2016). The authors suggest that nurses should give attention to the recovery process of patients and ensure that such instances are noted and addressed. In cases where there is no close relationship between the health caregivers and the patients, such incidents may be hard to notice, and the patients end up suffering and worse still, be exposed to the ugly infection which may even cost them their lives.
c. Site Redness
A patient may develop red streaks at the area where the line has been inserted. Another warning sign that the patient may be headed to a CLABSIs. Again, if there is no close interaction between patients and their caregivers such may be hard to notice (Chesshyre et al., 2015). Worse still if the patient is not aware that such are causes for alarm. They may never report the same and end up risking their lives. Adult patients and children are at the greatest risk of these symptoms because in most cases they do not know what should be made known to the health care providers and what should not be a cause for worry.
Research Questions
a. How does the training of health-care providers on the risks and the preventive measures of CLABSIs impact the overall infection rates?
b. What is the level of knowledge of nurses regarding the use of evidence-based guidelines to prevent central venous catheter bloodstream infections?
c. Does an increase in nurse’s knowledge concerning CLABSIs infections reduce the number of infections in the Intensive Care Units?
 
Sample Populations
The authors have utilized different study populations to accomplish their objectives. The two major categories of respondents that are common to all authors are healthcare professionals and adult patients suffering from or who have suffered CLABSIs infections in the past (Hsu et al., 2014). These two categories have a rich knowledge of the study topic. Such enables researchers to collect adequate data for their research topics and also draw logical conclusions.
There are several processes through which people sample information in studies. For Alfonso et al. (2016), the search of the various database using key terms gave 291 records; however, based on relevance, only 4 articles were suitable for the study. In a study by Dougherty, there was convenience sampling of a population of registered nurses in the LTACH setting after the completion of orientation to the unit. Out of 52 eligible nurses, 31 participated in the survey response.
The study by Lin et al (2015) utilized a cross-sectional design in the qualitative analysis of sources based on the key concepts of the study. Perin et al. (2016) explored a purposive sampling and selection of 34 studies that formed a set through which to assess results after a systematic review of academic and health databases. In the sampling process, Esposito (2017) utilized a cross-sectional design in 16 non-teaching and teaching public and private hospitals with units utilizing CVCs for adult oncological patients. The target group was 472 nurses in the oncology and outpatient chemotherapy units of the selected hospitals.
Likewise, Oliveria et al. (2016) samples were collected through a cross-sectional study with questionnaires to 76 professionals in intensive care. Zu & Wu (2017) utilized the qualitative process and a systematic search of databases on CINAHL, ABI INFORM, and OVID through which they established more than a hundred articles before applying the exclusion-inclusion criteria and utilizing ten articles in the study. WHO (2018) held comprehensive research in various facilities to establish methods of improving infection prevention and control on catheter units. Bianco et al. (20153) used samples from a number of CLABSIs which were collected by the hospital-based IP in line with the NHAN approach and definition of CLABIs. The CUSP teams of hospitals receive monthly feedback on infections and quarterly feedback on rates of infection per 1,000 catheter days. Basinger’s (2016) samples were collected through a cross-sectional study with questionnaires to 76 professionals of varied gender and ages in intensive care. In another study by Chidambaram (2015) the samples used were acquired from existing studies. On the other hand, Radium (2015) utilized a convenience sampling of registered dialysis nurses in the hemodialysis unit was used in a pre and post-test educational interventional design among 60 registered dialysis nurses. Powell (2018) investigated information from 20 patients, three of whom were children and the rest adults. Masse, Edmond, & Diekema (2018) surveyed information from a literature review of studies ranging from 2008 to data to establish the infection prevention approaches performed outside the operating room. In most of the studies, the aspects of age, gender, and marital status were never necessary forin the study. The focus was on the usage of CVCs.
Limitations
There are several obvious limitations in the studies. For example, Esposito et al. (2017) opine that self-reported questionnaires affected accuracy in response; most respondents gave information that was positive rather than genitive on hygienic consideration of CVCs. Questionnaires ought to be anonymous to encourage correct reporting. He also notes that a cross-sectional study hindered establishing a causative relationship with outcomes of interest. Future studies need to focus on non-evidence-based practices and dressing of catheters and how they relate with CLABSI (Han et al., 20153). Also, the study by Basinger (20144) was limited by failure to separate the efforts that aim at improving the use of CUSP, related approaches, and technologies that reduce compliance in hygiene situations of CVC.
In the study by Afonso et al. (2015) the limitation was in the use of cumulative analysis on line-associated HABSI types while reporting the catheter culture is a diagnosis of infection lead to difficulties in isolating categorical data on attitudes, knowledge, and practical application of knowledge. Moreover, another study by Lin et al. (2015) showed that the limited time and consideration of barrier towards quality, an aspect that needed adequate time hindered acquisition of enough information. Furthermore, Perin et al. (2016) note that the use of one type of catheter hindered generalization of information to other health departments.
Chidambaram (2015) assert that there was limited evidence as a result of the utilization of the exploratory method when conducting a study on CLABSIs hence a lot of data never emerged clearly. According to Kadium (2015) the small sample size and short duration within which it was conducted limited the results that were acquired. Another problem emerged because there was no assessment of the learning styles of the patients. According to Powell (2018), some electronically captured information gave collinearity that challenged in the interpretation of results.
The Conclusions and Recommendations
Overall, there are various issues that are addressed in the various papers in this analysis. From the literature review, Afonso et al. (2016) conclude that hospitals achieve zero infections of CLABSI rates meaning the continued usage of surveillance together with a washcloth bathing for they curtail Gram-positive bacteria. Thus, hospitals with high baseline hygienic standards of care and lower CLABSI rates might benefit less from CHG washcloth bathing. Additionally, Lin et al. (2015) note that the adherence to the current evidence-based practice guidelines, education, and consideration or compliance to hygiene, and use of chlorhexidine antiseptic bathing instead of the soap helps in the prevention of CLABSIs. For example, according to O’Grady et al. (20151), maximal sterile, cautious insertion of catheters, avoidance of routine catheter replacement, usage of the antiseptic/antibiotic impregnated short-term central venous catheters and chlorhexidine-impregnated sponge dressings help to prevent and manage CLABSIs.
Similarly, Perin et al., (2016) opine that the consideration of necessary interventions on the catheters can prevent infections. According to Esposito et al. (2017) in situations where nurses have a positive attitude, and perceive hygiene as a risk in CLABSIs as well as where evidence-based practice programs are used, infection is likely to be prevented. There is still a low adherence to handwashing. Xu & Wu (2017) note that patient cooperation and knowledge of proper care for CVC prevent infections. There is a need for studying practical clinical nurse interventions in the care for CVC. In the study by Han et al (20153) state that blood culture is necessary for managing CVC patients. Formal training, years of experience, written policies, enhance compliance withto proper CVC care and reduce infections (Han et al., 20153). In a study by Bianco et al. (20153), there is a conclusion that less costly evidence-based education, CUSP prevent infections. It is also indicated that multidisciplinary education programs improve assistance to patients (Oliveira et al., 2016)
According to Afonso et al. (2016), an analysis into the topic requires separate primary, secondary and central line-associated HABSI types in reporting catheter culture during the diagnosis of bloodstream infection that increases certainty and lowering of risks of bias as a result of improper attribution of blood culture contaminants.
Furthermore, Powell (2018) notes that if hospitals use surveillance for antimicrobial use and resistance options in ambulatory surgery, and acute care hospitals, then infections will be eliminated. In the study by Chidambaram (2015), the conclusive view offers that the dental care process is necessary for pediatric CKD patients if studies on CVC are being held. Besides, CVC benefits CKD patients but poses a threat for long-term candidates due to negligence on disinfection and sterilization processes. According to Kadium (2015), high education levels do not affect pretest, but the completion of infection control course affects pretest scores. Another argument is that evidence-based care allows students to work purposefully. Moreover, the provision of continuous education enhanced retention and application of knowledge in tasks. In another study by Masse, Edmond, & Diekema (2018) as expert opinion high-quality evidence practice through sufficient evidence via trainings and assessment result in proper care for patients with catheters. Ultimately, WHO (2018) suggests that as long as a health care establishes a comprehensive action plan, assessment baseline, execution, checks the impact and establishes a sustainable long-termn plan, CLABSI cases can be prevented. It is thus necessary for future studies to focus on more than one type of catheter for results to be relevant to various departments of health.
From the above literature review, it is clear that evidence-based practice, policies, hygiene, education and attendance of workshops are important aspects that need to be studied. Besides, the consideration of the study population, using the adequate time for the study, having confidential questionnaires are part of the essentials of conducting a useful study on CVCs and CLABSI’s.
The conclusions and recommendations are drawn from what the authors had from their results. There is the need for continued monitoring and feedback concerning compliance with the set hygiene practices aimed at preventing CLABSIs infections. The infection basics, such as patient and health care providers’ education, should be addressed (Beverly et al., 2018). Public health funding has also been suggested as a recommendation towards the prevention of the infection. Further areas of the study should address different ways of tracking infections, whether they are high at the emergency rooms or the operation rooms. The areas for further research should also focus on strategies aimed at removing barriers in policies and practices.
 
References
 
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Basinger, M. A. (2014). The Reduction of Central Line-Associated Bloodstream Infections in Intensive Care Units through the Implementation of the Comprehensive Unit-Based Safety Program. Retrieved from m /orders/digitalscholarship.unlv.edu/thesesdissertations/2057/
Beverly, A. L., Hill, M. M., Camins, B. C., & Lee, R. A. (2018). Decreasing CLABSI incidence associated with decreasing MRSA Bacteremia LabID Incidence. American Journal of Infection Control, 46(6), S82.
Bianco, A., Coscarelli, P., Nobile, C. G., Pileggi, C., & Pavia, M. (2014). The reduction of risk in central line-associated bloodstream infections: Knowledge, attitudes, and evidence-based practices in health care workers. American Journal of Infection Control, 41(2), 107-112. doi:10.1016/j.ajic.2012.02.038 Comment by Microsoft Office User: Delete this reference and update with a reference that will be within 5 years of age based on your anticipated graduation date
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Chesshyre, E., Goff, Z., Bowen, A., & Carapetis, J. (2015). The prevention, diagnosis, and management of central venous line infections in children. Journal of Infection, 71, S59-S75.
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Dombecki, C., Vercher, J., Valyko, A., Mills, J., & Washer, L. (2017). Implementation of a Central Line-associated Bloodstream Infection (CLABSI). Prevention bundle for adult hematologic malignancy and bone marrow transplant patients. American Journal of Infection Control, 45(6), S103.
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Esposito, M. G. (2017). Knowledge, attitudes, and practice on the prevention of central line-associated bloodstream infections among nurses in oncological care: A cross-sectional study in an area of southern Italy. PLoS One, 1-11. doi:e0180473.
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Hsu, Y. J., Weeks, K., Yang, T., Sawyer, M. D., & Marsteller, J. A. (2014). Impact of self-reported guideline compliance: bloodstream infection prevention in a national collaborative. American journal of infection control, 42(10), S191-S196.
Kadium, M. (2015). Improving Nurses’ Knowledge to Reduce Catheter-Related Bloodstream Infection in Hemodialysis unit. Walden Dissertations and Doctoral Studies, 1-133.
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Klintworth, G., Stafford, J., O’connor, M., Leong, T., Hamley, L., Watson, K.,& Worth, L. J. (2014). Beyond the intensive care unit bundle: Implementation of a successful hospital-wide initiative to reduce central line-associated bloodstream infections. American journal of infection control, 42(6), 685-687.
Lin, M.L., Apisarnthanarak, A., Jaggi, N., Harrington, G., Morikane, K., Thu, T.A., Ching, P.Villanueva, V., Zhiyong Zong, Jeong, J.S. & Lee, C. (2015). APSIC guide for prevention of Central Line-Associated Bloodstream Infections (CLABSI) 5(16). /orders/doi.org/10.1186/s13756-016-0116-5
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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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    DNP 820 Week 6 Benchmark - Drafting A Literature Review
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Case Study Assignment: Assessing The Head, Eyes, Ears, Nose, And Throat

Case Study Assignment: Assessing The Head, Eyes, Ears, Nose, And Throat

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.
In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.
With regard to the case study you were assigned:
· Review this week’s Learning Resources and consider the insights they provide.
· Consider what history would be necessary to collect from the patient.
· 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 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.
Case Study 1:   This assignment you will be doing in SOAP format.
Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he’s taken Mucinex OTC the past 2 nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous
Episodic/Focused SOAP Note Exemplar
Focused SOAP Note for a patient with chest pain
S. CC: “Chest pain”  HPI: The patient is a 65 year old AA male who developed sudden onset of chest pain, which began early this morning.  The pain is described as “crushing” and is rated nine out of 10 in terms of intensity. The pain is located in the middle of the chest and is accompanied by shortness of breath. The patient reports feeling nauseous. The patient tried an antacid with minimal relief of his symptoms. PMH: Positive history of GERD and hypertension is controlled FH: Mother died at 78 of breast cancer; Father at 75 of CVA.  No history of premature cardiovascular disease in first degree relatives. SH : Negative for tobacco abuse, currently or previously; consumes moderate alcohol; married for 39 years  ROS    General–Negative for fevers, chills, fatigue Cardiovascular–Negative for orthopnea, PND, positive for intermittent lower extremity edema  Gastrointestinal–Positive for nausea without vomiting; negative for diarrhea, abdominal pain Pulmonary–Positive for intermittent dyspnea on exertion, negative for cough or hemoptysis
O.
VS: BP 186/102; P 94; R 22; T 97.8; 02 96% Wt 235lbs; Ht 70”
General–Pt appears diaphoretic and anxious
Cardiovascular–PMI is in the 5th inter-costal space at the mid clavicular line. A grade 2/6 systolic decrescendo murmur is heard best at the
second right inter-costal space which radiates to the neck.
A third heard sound is heard at the apex. No fourth heart sound or rub are heard. No cyanosis, clubbing, noted, positive for bilateral 2+ LE edema is noted.
Gastrointestinal–The abdomen is symmetrical without distention; bowel
sounds are normal in quality and intensity in all areas; a
bruit is heard in the right para-umbilical area. No masses or
splenomegaly are noted. Positive for mid-epigastric tenderness with deep palpation.
Pulmonary— Lungs are clear to auscultation and percussion bilaterally
Diagnostic results: EKG, CXR, CK-MB (support with evidenced and guidelines)
A.
Differential Diagnosis:
1) Myocardial Infarction (provide supportive documentation with evidence based guidelines).
2) Angina (provide supportive documentation with evidence based guidelines).
3) Costochondritis (provide supportive documentation with evidence based guidelines).
Primary Diagnosis/Presumptive Diagnosis: Myocardial Infarction
P. This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

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Case Study Assignment: Assessing The Head, Eyes, Ears, Nose, And Throat

 

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Who We Are 

We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.

Do you handle any type of coursework?

Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.

Is it hard to Place an Order?

  • 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
  • 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
  • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
  • 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – 

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

  • 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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  • Multiple answer questions

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

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Discussion: Ethical And Legal Foundations Of PMHNP Care

Discussion: Ethical And Legal Foundations Of PMHNP Care

Discussion: Ethical And Legal Foundations Of PMHNP Care

Discussion: Ethical And Legal Foundations Of PMHNP Care

Discussion: Ethical And Legal Foundations Of PMHNP Care

Advanced practice nursing in all specialties is guided by codes of ethics that put the care, rights, duty, health, and safety of the patient first and foremost. PMHNP practice is also guided by ethical codes specifically for psychiatry. These ethical codes are frameworks to guide clinical decision making; they are generally not prescriptive. They also represent the aspirational ideals for the profession. Laws, on the other hand, dictate the requirements that must be followed. In this way, legal codes may be thought to represent the minimum standards of care, and ethics represent the highest goals for care.
 
For this Discussion, you select a topic that has both legal and ethical implications for PMHNP practice and then perform a literature review on the topic. Your goal will be to identify the most salient legal and ethical facets of the issue for PMHNP practice, and also how these facets differ in the care of adult patients versus children. Keep in mind as you research your issue, that laws differ by state and your clinical practice will be dictated by the laws that govern your state.
To Prepare
Select one of the following ethical/legal topics:
Autonomy
Beneficence
Justice
Fidelity
Veracity
Involuntary hospitalization and due process of civil commitment
Informed assent/consent and capacity
Duty to warn
Restraints
HIPPA
Child and elder abuse reporting
Tort law
Negligence/malpractice
In the Walden library, locate a total of four scholarly, professional, or legal resources related to this topic. One should address ethical considerations related to this topic for adults, one should be on ethical considerations related to this topic for children/adolescents, one should be on legal considerations related to this topic for adults, and one should be on legal considerations related to this topic for children/adolescents.
By Day 3 of Week 2
Briefly identify the topic you selected. Then, summarize the articles you selected, explaining the most salient ethical and legal issues related to the topic as they concern psychiatric-mental health practice for children/adolescents and for adults. Explain how this information could apply to your clinical practice, including specific implications for practice within your state. Attach the PDFs of your articles.

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Discussion: Ethical And Legal Foundations Of PMHNP Care

 

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4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
 

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5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Who We Are 

We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.

Do you handle any type of coursework?

Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.

Is it hard to Place an Order?

  • 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
  • 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
  • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
  • 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – 

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

  • 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.

  • Guarantee

  • Zero Plagiarism
  • On-time delivery
  • A-Grade Papers
  • Free Revision
  • 24/7 Support
  • 100% Confidentiality
  • Professional Writers

  • Services Offered

  • Custom paper writing
  • Question and answers
  • Essay paper writing
  • Editing and proofreading
  • Plagiarism removal services
  • Multiple answer questions

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

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Developing A Health Advocacy

Developing A Health Advocacy

Week 9 Assignment
Continue on with building your final application due in week 10. You will submit one cogent paper that combines the previous two applications (Parts One and Two) from weeks 4 and 7, plus the new material mentioned in the week 8 application
 
Application: Developing a Health Advocacy Campaign
To be an effective advocate and to develop a successful health advocacy campaign, you must have a clear idea of the goals of your campaign program and be able to communicate those goals to others. In addition, it is the nature of nurses to want to help, but it is important to make sure that the vision you develop is manageable in size and scope. By researching what others have done, you will better appreciate what can realistically be accomplished. It is also wise to determine if others have similar goals and to work with these people to form strategic partnerships. If you begin your planning with a strong idea of your resources, assets, and capabilities, you will be much more likely to succeed and truly make a difference with those you hope to help.
 
You will develop a 10- to 12-page paper that outlines a health advocacy campaign designed to promote policies to improve the health of a population of your choice. This week, you will establish the framework for your campaign by identifying a population health concern of interest to you. You will then provide an overview of how you would approach advocating for this issue.
 
-In Week 9, you will consider legal and regulatory factors that have an impact on the issue and finally, in Week 10, you will identify ethical concerns that you could face as an advocate. Specific details for each aspect of this paper are provided each week.
 
This paper will serve as the Portfolio Application for the course.
Before you begin, review the complete Assignment.
This week, begin developing your health advocacy campaign by focusing on the following:
Week 10 Application
To prepare for this final portion of your paper:
·         Review provisions 7, 8, and 9 of the ANA Code of Ethics in relation to advocacy for population health.
·         Reflect on the ethical considerations you may need to take into account in your advocacy campaign.
·         Research the ethical considerations and lobbying laws relevant to the location where your advocacy campaign will occur.
·         Consider potential ethical dilemmas you might face in your campaign.
 
To complete: Revise and combine parts one and two of you previous papers and add the following:
·         Explain any ethical dilemmas that could arise during your advocacy campaign, and how you would resolve them.
·         Describe the ethics and lobbying laws that are applicable to your advocacy campaign.
·         Evaluate the special ethical challenges that are unique to the population you are addressing.
·         Provide a cohesive summary for your paper.
Reminder: You will submit one cogent paper that combines the previous applications (Parts One and Two) plus the new material.
 
Your paper should be about 10 pages of content, not including the title page and references. Be sure to paste the rubric at the end of your paper.
 
The final application builds upon the applications (Parts One and Two) completed in weeks 4 and 7.
To complete the final section of your paper:
·         Review provisions 7, 8, and 9 of the ANA Code of Ethics in relation to advocacy for population health.
·         Reflect on the ethical considerations you may need to take into account in your advocacy campaign.
·         Research the ethical considerations and lobbying laws relevant to the location where your advocacy campaign will occur.
·         Consider potential ethical dilemmas you might face in your campaign.
 
 
REFERENCES
Milstead, J. A. (2013). Health policy and politics: A nurse’s guide (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.
·         Chapter 3, “Government Response: Legislation—Politics: Playing the Game” (pp. 45–71) (review)
This chapter explores the multiple factors that influence the development of public policy through the legislative branch of government.
 
·         Chapter 9, “Policy Nurses Advance Policy Agendas in Many Arenas” (pp. 179–189)
The focus of this chapter is the role of policy nurses within nurse associations and it highlights specific organization that specifically deal with policy nurses and advocacy.
Begley, A. (2010). On being a good nurse: Reflections on the past and preparing for the future. International Journal of Nursing Practice16(6), 525–532.
Retrieved from the Walden Library databases.
 
In this article, the author reflects on the qualities of a good nurse in both the past and present. The article presents a 4-point framework that exemplifies the foundational qualities of modern professional ethics and conduct.
Davis-Alldritt, L. (2011). Presidential inaugural address: Advocacy, access, and achievement. Journal of School Nursing27(4), 249–251.
Retrieved from the Walden Library databases.
 
This address explicates links between school nursing, school health services, and student success. The author uses personal anecdotes to teach lessons in advocacy, access, and achievement.
Deyton, L., Hess, W. J., & Jackonis, M. J. (2008, Winter). War, its aftermath, and U.S. health policy: Toward a comprehensive health program for America’s military personnel, veterans, and their families. Journal of Law, Medicine, & Ethics, 36(4), 677–689.
Retrieved from the Walden Library databases.
Karpf, T., Ferguson, J. T., & Swift, R. (2010). Light still shines in the darkness: Decent care for all. Journal of Holistic Nursing28(4), 266–274.
Retrieved from the Walden Library databases.
 
This article details the challenges of health care crises at the global, national, and local levels. The text proposes a values-based approach to health care that takes into account the voices of the population being served, rather than excluding them.
Paquin, S. O. (2011). Social justice advocacy in nursing: What is it? How do we get there? Creative Nursing17(2), 63–67.
Retrieved from the Walden Library databases.
 
This text defines social justice advocacy and contrasts it to the patient-nurse advocacy model. The article also discusses social justice advocacy’s challenges and their potential solutions.
 
International Council of Nurses. (2008). Promoting health: Advocacy guide for health professionals. Retrieved from http://www.whpa.org/PPE_Advocacy_Guide.pdf
 
This web resource documents the efforts of the International Council of Nurses to ensure quality nursing care for all, as well as sound health policies globally through the advancement of nursing knowledge and presence worldwide.
 
 
Vancouver Coastal Health. (n.d.). Vancouver Coastal Health Population Health: Advocacy guidelines and resources. Retrieved from http://www.vch.ca/media/Population Health_Advocacy Guideline and Resources.pdf
 
This article presents guidelines, parameters, and resources for conducting population health advocacy.
 

Required Media

Laureate Education (Producer). (2012g). The needle exchange program. Baltimore, MD: Author.
 
Milstead, J. A. (2013). Health policy and politics: A nurse’s guide (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.

  • Chapter 4, “Government Regulation: Parallel and Powerful” (pp. 73–109)

This chapter explains the major concepts of the regulation of health professionals, with emphasis on advanced practice nurses (APN) and the process of licensure and credentialing.
ANA’s Foundation of Nursing Package – (Access this resource from the Walden Library databases through your NURS 6050 Course Readings List)

  • Guide to the Code of Ethics: Interpretation and ApplicationThis guide details the history, purpose and theory, application, and case studies of this must-have Code of Ethics.
  • Nursing Social Policy StatementThe Nursing Social Policy Statement provides an understanding of the social framework and obligations of the nursing profession.
  • Nursing: Scope & Standards of PracticeThis book contains several national standards of practice that can be used to inform the decision-making process, development, implementation, and evaluation of several functions and aspects of advanced practice nursing.

Gallagher, T. H. (2009). A 62-year-old woman with skin cancer who experienced wrong-site surgery: Review of medical error. JAMA: Journal of the American Medical Association, 302(6), 669–677.
Retrieved from the Walden Library databases.
 
The article showcases the different sides of medical error, from a 62-year-old patient who suffered and the components of the medical error’s impact and aftermath.
Reinhardt, U. E. (2010, Jan 30). Repercussions of simplicity. New York Times, p. A14.
Retrieved from the Walden Library databases.
 
This article determines that the government should take low-income families into account when determining mandatory health insurance because many Americans choose to go without insurance despite preexisting conditions presumably no longer being an issue.
 
Board on Health Care Services. (2007). Preventing medication errors: Quality Chasm Series. Washington, DC: The National Academies Press. Retrieved from http://www.nap.edu/openbook.php?record_id=11623&page=43

This article discusses the multilayered nature of medication error as a system of failures due to individual behaviors and conditions.
Running head: NURSING TECHNOLOGY PAPER
7
NURSING TECHNOLOGY PAPER

 
Nursing Technology Paper
Name: Zoeleni Kamara
Course: Nursing 6051-01
Transforming Nursing and Healthcare through Information Technology
September 25, 2016
 
 
 
Introduction
Like in any field, technology plays a crucial role in the field of nursing. Clinical question for this assignment is; has the use of electronic medication administration (eMAR) (Kelley, 2016) in any way improved the safety of medication in the healthcare setting? .Technology ensures that information is processed first and delivered to the right department or personnel. Data in any field is important because from these raw data important information can be derived. Such data is important for the study and control of diseases (epidemiology).Management of chronic diseases across the world has been so difficult, the situation is even worse when it comes to developing countries. For this reason therefore, having concrete data is important in the management of these diseases. It is from these data that important control and disease management can be implemented. The main role of nursing informatics is to ensure that patients get the best medical services.
Nursing informatics as an innovation over the social insurance framework stays in its outset phase of advancement and has not been generally used or boosted to its fullest potential by most healthcare facilities . Nursing informatics in the social insurance framework is an apparatus that underlines wellbeing and quality consideration results, which are devices that pioneers in medicinal services ought to unequivocally consider. Nursing informatics permits attendants to enter and get to patient data in a practical time period that matches individualized desires for every patient.
The use of electronic in the administration in the health sector across the world has not been that simple. It has been faced with a number of challenges some of which can be overcome within a short duration while others take a long time. Apart from the challenges facing the management of most diseases, having the data is the key strategy in its management. To work through the four steps of data, information, knowledge, and wisdom continuum, it should first of all ensure that I determine the pressure of the patient in the case of data. For instance, if the result will give 130/70 then this is the data. After having this data I will ensure that I also ask the patient if he or she has a history of blood pressures of about 150/100 for the last few years, this will lead me to information. This information will be necessary n the diagnosis of the condition. For example if in one way or the other the patient the patient has a well-known history of cardiac arrest and he or she is currently having a chest pain. The drastic drop in the blood pressure in some way can indicate an onset of serious myocardial infarction. This is what is referred as to knowledge. This is the right time that the patient should be given an oxygen, aspirin, and nitrates. That is wisdom.
The databases I would use in the search Allied Health Literature CINAHL and Nursing databases. I used the Walden University website to access the databases and the search words. From the website, I would narrow down the search engines to the field “Nursing” this is to ensure that the databases I would obtain are relevant to my field. Some of the search words I would use includes readmission, critical access hospital(CAH)( United States,2010), challenges, litigation, rural, cost, staff, joint commission, patients, ratio, Illinois, Wisconsin, trauma, hypertension, fatigue, fat deposition, narrowing of the blood vessels among others. These are the words are mostly used in the nursing and health profession.
To transform information into knowledge, I should first ensure that I am clear on my findings; this should be a guiding principle towards the transformation. I would determine the information understand the topic. Next, I would ensure that I gather all the necessary materials and sources to help me gather the information I require. I would then do an evaluation of the information obtained to ensure that the information is relevant to my field of study. I would then organize this information removing and eliminating those that are irrelevant; this will ensure that I don’t possess information that is not helpful to my field. The next step is to ensure that the piece of work is free of any plagiarism and spelling mistakes, this can be done by pro-reading. The last bid is to do an evaluation of what I have obtained from the whole exercise. By doing this would have gleaned and turned the information into knowledge.
Informatics can be used to gain wisdom. This is because wisdom in its early stage exists as data from which it graduates to information then to knowledge and finally to wisdom. All the information collected from the different sources cannot be useful, the useful ones can be assessed we learn something (knowledge).Wisdom guides us to either accept or reject some of this information. Without wisdom, some fake information can be taken to be true yet they are not. This can let to wrong decision making, in the hospital setting it can also lead to the wrong diagnosis, the wrong treatment which might, in turn, lead to more complications and eventually leading to the death of the patient. It is the role of any doctor or nurse to protect life, wrong judgments can cause lives and therefore having the right information is a key thing.
Summary
Data is very important, this is so because it is from here that meaningful information and conclusion can be made. A collection of these data should be done carefully or less information that is not relevant to a particular area or field would be collected. Information obtained should be able to address the clinical question; other information not relevant to the area should be eliminated. If this information is collected in the wrong database, the whole data, information, knowledge, and wisdom continuum will be affected. This will lead to wrong decision making. Nursing involves handling lives and therefore any mess can lead to loss of lives. Sharing of information in the health profession is important because it enables medical practitioners to communicate and share information. Creating knowledge in the nursing has been on the front line to empower the medical caretaker professionals to commission their parts successfully. It begins with the establishment of the requirements of data. The idea of the data-information-knowledge-wisdom (DIKW) continuum is the conversion of data into wisdom through subjective procedures important in nursing practice.
 
 
 
 
RESPONSE FROM MY INSTRUCTOR ON THIS PAPER
I enjoyed reading your paper, yet you did not appear to understand the instructions. Your introduction of the clinical question and your connection of the question to your area of practice were good. In your paper you delineated how you would work through some of the four steps of the data, information, knowledge, and wisdom continuum. You did not explain how the question could be answered at each level of the continuum. You identified databases, resources, and search terms used to investigate the question. Your explanation of how information can be synthesized to form knowledge and your evaluation of how the information gleaned from research could be converted into useableknowledge was missing. You did not explain how you would progress from simply having useful knowledge to the wisdom to make clinical decisions about the problem you identified. You provided an analysis of whether nursing informatics can be used to gain wisdom.
 
Your paper integrated 2 or more credible sources and no course resources, followed writing standards, and contained APA errors. You could improve your papers by substantially addressing all of the required topics, integrating 2 or more credible sources and 3 or more course resources, and applying correct APA format. You might want to consult the Writing Center’s APA document “Common Reference List Examples” and the course announcements. You might want to use the shells of the papers provided in an email, as a course announcement, and in “Doc Sharing” As this was the first paper, I added 10 points to everyone’s grade. I appreciate the effort you put into this assignment.
 
Reference
In Hannah, K. J., In Hussey, P., In Kennedy, M. A., & In Ball, M. J. (2015). Introduction to nursing informatics.
Information Resources Management Association. (2011). Clinical technologies: Concepts, methodologies, tools and applications. Hershey, PA: Medical Information Science Reference.
Kelley, T. (2016). Electronic health records for quality nursing & health care / Tiffany Kelley.
United States. (2010). Critical access hospital replacement process. Rockville, MD: U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy.
 

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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.

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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.

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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.

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NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 1 (Very Important For Me Please – Need Only A Work On This)

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 1 (Very Important For Me Please – Need Only A Work On This)

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 1 (Very Important For Me Please – Need Only A Work On This)

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 1 (Very Important For Me Please – Need Only A Work On This)

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 1 (Very Important For Me Please – Need Only A Work On This)

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 1 (Very Important For Me Please – Need Only A Work On This)

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 1 (Very Important For Me Please – Need Only A Work On This)

PLEASE READ ALL THE INSTRUCTIONS AND DO IT. IF YOU DONT READ ALL THE INSTRUCTIONS AND DONT FOLLWO IT, PLEASE DONT DO IT. I NEED THE POST ON TIME MENTIONED IN THE POST. ALL DOCUMENTS AND REFERENCES ARE ATTACHED.
 
 
Discussion: Preparing for Professional Transitions
 
Consider the following scenario:/nurs6531-week-6-assignment-practicum-experience-episodic-soap-note-2/
 
Marcus recalls the beginning of his career, when he started as a nurse at Grand View Hospital. He had heard the organization was soliciting proposals from various companies so they could weigh the pros and cons associated with adopting a new health information technology system. He has been curious about the request for proposal (RFP) process ever since. Now, as he looks forward to new professional opportunities, he would like to ensure that he develops the skills and expertise needed to formulate an RFP.
 
What are your professional aims? How can you apply what you have learned in your coursework to your practicum setting? How will you leverage your experiences in the practicum to facilitate your development as a nurse leader-manager or informaticist?
 
In this Discussion, you reflect on your aspirations and consider the transitions that may be required to achieve them. You identify professional development objectives and evaluate opportunities for achieving them through your experiences in the practicum.
Think about the professional role changes you have been undergoing or that you may undertake following completion of this MSN program.
Review the information related to professional development and role change in the Learning Resources, and conduct additional research as necessary to address any questions or concerns you may have.
Consider the following questions:
What types of professional positions interest you? Are they significantly different from the types of positions you have held in the past? If so, how?
What challenges are you likely to encounter as you transition into a new role?
What resources could help you to manage this change? Consider your inner resources (e.g., drawing on previous experiences, stress management), resources available to you through your relationships with others, and institutional supports.
 
Consider how you could use this Practicum Experience to apply what you have learned and enhance or acquire specialization skills and knowledge, regardless of whether you intend to change roles or stay in your current position for the time being.
 
Review the NURS 6600 Course Outcomes listed in the Syllabus. Determine how your experiences in the practicum could help you to achieve one or more of these outcomes.
Review the information in the Introduction to the Practicum (in this week’s Practicum area) and the School of Nursing Practicum Manual as necessary to ensure you have a clear understanding of the practicum requirements.
Review the suggestions for developing effective learning objectives provided in the Learning Resources.
 
Think of two or three objectives that could help guide your professional development during your practicum. These objectives, referred to as your practicum professional development objectives, must be:
Specific
Measurable
Attainable
Results-focused
Time-focused
Reflective of the higher-order domains of Bloom’s Taxonomy (i.e., Application level and above)
 
Select one or more practicum professional development objectives to focus on for this Discussion. (You may continue to hone these objectives as you work on this week’s Application Assignment.)
 
Reflect on how you could achieve each objective through your Practicum Experience.
 
Post an explanation of your professional aspirations and how you intend to use the Practicum Experience to promote career change and/or enhance your performance. Describe at least one objective to facilitate your professional growth, and explain the steps you could take to achieve the objective(s) during your Practicum Experience. Support your response with examples from the literature.
 
Read a selection of your colleagues’ responses.
 
Respond to at least two of your colleagues on two different days, using one or more of the following approaches:
Suggest strategies for using the Practicum Experience to deepen or broaden their knowledge.
Offer suggestions for refining their practicum professional objective(s).
 
Required Readings
 
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.
Cipriano, P. F., & Murphy, J. (2011). The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 286–289.
Note: Retrieved from the Walden Library databases.
 
“Technology tools will continue to revolutionize how we plan, deliver, document, review, evaluate, and derive the evidence about care” (p. 289). This article examines how nurses can use information technology to transform nursing and redesign the health care system. It focuses on the use of technology to promote quality and notes that technology can also be used to address challenges in education, research, leadership, and policy.
McKimm, J., & Swanwick, T. (2009). Setting learning objectives. British Journal of Hospital Medicine, 70(7), 406–409.
Note: Retrieved from the Walden Library databases.
 
This article clarifies the terminology associated with learning objectives and explains how learning objectives relate to professional development and the transformation from novice to expert. It also introduces common pitfalls when setting learning objectives and provides suggestions for avoiding them.
Murphy, J. (2011). The nursing informatics workforce: Who are they and what do they do? Nursing Economic$, 29(3), 150–153.
Note: Retrieved from the Walden Library databases.
 
The author examines the nursing informatics workforce, explaining that professionals in this well-established specialty area can play an integral role in transforming health care.
Sørensen, E. E., Delmar, C., & Pedersen, B. D. (2011). Leading nurses in dire straits: Head nurses’ navigation between nursing and leadership roles. Journal of Nursing Management, 19(4), 421–430.
Note: Retrieved from the Walden Library databases.
 
“Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity” (p. 421). In this article, the authors examine how individuals in key professional roles negotiate between and apply nursing and leadership skills.
Warm, D., & Thomas, B. (2011). A review of the effectiveness of the clinical informaticist role. Nursing Standard, 25(44), 35–38.
Note: Retrieved from the Walden Library databases.
 
The authors investigate the application of specialized knowledge and expertise to facilitate the appropriate use of emerging technologies in clinical settings. They argue for informaticists’ involvement in strategic development and delivery of information management and technology initiatives to promote patient-centered outcomes.
Wilkinson, J. E., Nutley, S. M., & Davies, H. T. O. (2011). An exploration of the roles of nurse managers in evidence-based practice implementation. Worldviews on Evidence-Based Nursing, 8(4), 236–246.
Note: Retrieved from the Walden Library databases.
 
In this article, the authors examine the role nurse managers should play in leading and facilitating evidence-based practice.
Armstrong, P. (2013). Bloom’s taxonomy. Retrieved from http://cft.vanderbilt.edu/teaching-guides/pedagogical/blooms-taxonomy/
 
Vanderbilt University provides this overview of Bloom’s taxonomy. This site also presents the original and updated versions of the taxonomy along with verb suggestions for each level.
Clark, D. (2013). Bloom’s taxonomy of learning domains. Retrieved from http://www.nwlink.com/~donclark/hrd/bloom.html
 
This article addresses three domains of learning: cognitive, affective, and psychomotor.
University of Central Florida, Office of Experiential Learning (n.d.). Writing SMART learning objectives, Retrieved from http://explearning.ucf.edu/registered-students/tips-for-success/writing-smart-learning-objectives/195
 
This blog post focuses on the distinction between learning outcomes and objectives. Consider this information as you develop your practicum professional development objectives this week.
The University of North Carolina at Charlotte, Center for Teaching & Learning. (2013). Writing objectives using Bloom’s taxonomy. Retrieved from http://teaching.uncc.edu/articles-books/best-practice-articles/goals-objectives/writing-objectives-using-blooms-taxonomy
 
This resource outlines elements of Bloom’s Taxonomy.
Document: Practicum Professional Experience Plan (Word Document)
 
Use this form to develop your Practicum Professional Experience Plan as outlined this week.
Document: Practicum Professional Experience Plan (Word Document)
 
Use this form to develop your Practicum Professional Experience Plan as outlined this week.
Document: Practicum Journal (Word Document)
 
During your Practicum Experience, you are  required to submit your time log and three journal entries. You will use this  form to complete your journal reflections.
Document: School of Nursing Practicum Manual: Master of Science in Nursing (MSN): Quarter-Based Programs (PDF)
 
This comprehensive manual outlines all of the requirements for the Practicum Experience.
Clinical Resources
Document: Introduction to Clinical Experiences (PowerPoint)
Document: Practicum Manual (PDF)
Required Media
Laureate Education (Producer). (2012a). Professional behavior in the practicum setting [Interactive media].
Note: Retrieved from the Walden Library databases.
 
In this audio presentation, Dr. Jeanne Morrison discusses topics that demonstrate professional behavior in the practicum setting, such as dressing professionally, punctuality, and communication.
Please click here for the Transcript (PDF).
 
Laureate Education (Producer). (2012b). Professional best practices [Interactive media].
Note: Retrieved from the Walden Library databases.
 
In this audio segment, Dr. Jeanne Morrison provides an overview of best practices and tips for students engaged in the Practicum Experience. She discusses what activities are included in practicum hours, the importance of staying in touch with your Preceptor, and strategies for dealing with stress.
Please click here for the Transcript (PDF).
 
Laureate Education (Producer). (2012c). Professionalism and the practicum experience [Interactive media].
Note: Retrieved from the Walden Library databases.
 
What is the Practicum Experience all about? What are the roles of the Faculty Member and the Preceptor? In this media presentation, Dr. Jeanne Morrison discusses these and other critical aspects of the Practicum Experience. She also provides an overview of the professional demeanor expected of all students throughout the Practicum Experience.
 
Please click here for the Transcript (PDF).

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  • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
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We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

  • 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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Experiential Vs Narrative Family Therapies

Experiential Vs Narrative Family Therapies

Assignment: Experiential Versus Narrative Family Therapies
Although experiential therapy and narrative  therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, you compare Experiential and Narrative Family Therapy.
Learning Objectives
Students will:
· Compare experiential family therapy to narrative family therapy
· Justify recommendations for family therapy
To prepare:
· Review this week’s Learning Resources and reflect on the insights they provide on experiential and family therapies.
The Assignment
In a 2- to 3-page paper, address the following:
· Summarize the key points of both experiential family therapy and narrative family therapy.
· Compare experiential family therapy to narrative family therapy, noting the strengths and weakness of each.
· Provide a description of a family that you think experiential family therapy would be appropriate, explain why, and justify your response using the Learning Resources.
Note: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.
Part 2: Family Genogram
Develop a genogram for the client family you selected. The genogram should extend back at least three generations (parents, grandparents, and great grandparents).
Required Readings( need 3 references).
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

  • Standard 5B “Health Teaching and Health      Promotion” (pages 55-56)

Cohn, A. S. (2014). Romeo and Julius: A narrative therapy intervention for sexual-minority couples. Journal of Family Psychotherapy, 25(1), 73-77. doi:10.1080/08975353.2014.881696
Escudero, V., Friedlander, M. L., Boogmans, E., & Loots, G. (2012). Alliance rupture and repair in conjoint family therapy: An exploratory study. Psychotherapy, 49(1), 26-37. doi:10.1037/a0026747
Freedman, J. (2014). Witnessing and positioning: Structuring narrative therapy with families and couples. Australian & New Zealand Journal of Family Therapy, 35(1), 20-30. doi:10.1002/anzf.1043
Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Boston, MA: Pearson.

  • Chapter 7, “Experiential      Family Therapy” (pp. 105-118
  • Chapter 12, “Narrative Therapy” (pp. 189-201)

Phipps, W. D., & Vorster, C. (2011). Narrative therapy: A return to the intrapsychic perspective. Journal of Family Psychotherapy, 22(2), 128-147. doi:10.1080/08975353.2011.578036
Saltzman, W. R., Pynoos, R. S., Lester, P., Layne, C. M., & Beardslee, W. R. (2013). Enhancing family resilience through family narrative co-construction. Clinical Child and Family Psychology Review, 16(3), 294-310.  doi:10.1007/s10567-013-0142-2
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

  • “Genograms” pp. 137-142

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    Experiential Vs Narrative Family Therapies

     

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    Who We Are 

    We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.

    Do you handle any type of coursework?

    Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.

    Is it hard to Place an Order?

    • 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
    • 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
    • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
    • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
    • 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

    SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – 

    We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

    • 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.

    • Guarantee

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    • On-time delivery
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    • Free Revision
    • 24/7 Support
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    • Custom paper writing
    • Question and answers
    • Essay paper writing
    • Editing and proofreading
    • Plagiarism removal services
    • Multiple answer questions

    SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS

    We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

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Developing PICO Questions

Developing PICO Questions

Developing PICO Questions
Determining the topic of an evaluation is one of the most important steps of the evaluation process. In the process of selecting a topic for evaluation, researchers should reflect on what information needs to be gathered and how it will be used. A PICO question can provide the foundation for this process. The PICO question requires researchers to determine the population to be studied, select the intervention that occurred or will occur (such as a new system), have a baseline with which to compare the evaluation, and finally, have a standard to measure the outcome of the project. Using a PICO question as a guideline helps ensure the evaluation is focused and effective.
In this Discussion, you generate a PICO question that corresponds to the Evaluation Plan Focus you developed last week.
 
To prepare:
 

  • Develop a PICO question based on the Evaluation Plan Focus Assignment completed last week.
  • Reflect on why it is important that this question be answered. Identify the “who cares?” factor.

By Day tomorrow 12/28/2016, write a minimum of 550 words essay in APA format with a minimum of 3 reference from the list provided below. Include the level one headings as numbered below:
 
1)      Post a summary of key points (evaluation goal, viewpoint, and model) from your Evaluation Plan Focus Assignment.
2)      Post your PICO question. Explain why you developed this question, and why it is important to be considered.
 
 
Required Readings
 
 
Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc.
 
Chapter 3, “Determining What to Study” (pp. 48–84)
 
This chapter focuses on how to identify the relevant questions to cover in an evaluation and how to ensure that the scope of the question is appropriate. It includes a description of different types of evaluations, including what they specifically focus on and the general type of questions they address.
 
 
Gschwandtner, T., Kaiser, K., & Miksch, S. (2011). Information requisition is the core of guideline-based medical care: Which information is needed for whom? Journal of Evaluation in Clinical Practice, 17(4), 713–721.
Retrieved from the Walden Library databases.
This article describes the construction of a comprehensive information source to be used in the development of computerized clinical practice guideline (CPG). The authors emphasize how the information source is designed to meet the informational requirements of anyone developing a CPG for any user group.
 
 
 
Lin, J. W., Chang, C. H., Lin, M. W., Ebell, M. H., & Chiang, J. H. (2011). Automating the process of critical appraisal and assessing the strength of evidence with information extraction technology. Journal of Evaluation in Clinical Practice, 17(4), 832–838.
Retrieved from the Walden Library databases.
The authors of this article explain a study that sought to create and evaluate a system to automatically determine a medical article’s evidence level. The authors describe the accuracy of the system and speculate on the causes of errors.
 
 
 
Swennen, M. H. J., vander Heijden, G. J. M. G., Blijham, G. H., & Kalkman, C. J. (2011). Career stage and work setting create different barriers for evidence-based medicine. Journal of Evaluation in Clinical Practice, 17(4), 775–785.
Retrieved from the Walden Library databases.
This article describes a study that examines how a doctor’s career stage and work setting are related to their perceptions of barriers to practicing evidence-based medicine (EBM). The authors also provide a framework for classifying the identified barriers.
 
 
 
Required Media
 
 
Laureate Education (Producer). (n.d.e). PICO question. Retrieved from CDN database. (NURS 6431)
 
 
 
This animation describes the basics of formulating a PICO question. The animation provides an example scenario of effectively generating a PICO question.
 
 
 
Optional Resources
 
 
Alliance for Health Reform. (2013). Health Information Technology. Retrieved from http://www.allhealth.org/issues.asp?wi=4
 
 
    American Health Information Management Association. Retrieved from http://www.ahima.org/
 
 
    Healthcare Information and Management Systems. (2013). Retrieved from http://www.himss.org/
 
 
    Kaiser.edu. (n.d.). Health information technology. Retrieved from http://kff.org/health-reform/issue-brief/building-an-information-technology-foundation-for-health/
 
 
National Center for Biotechnology Information. (n.d.). Health services/technology assessment texts (HSTAT). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK16710/

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ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT

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2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
3. Fill in your paper’s academic level, deadline and the required number of pages from the drop-down menus.
4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
 

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5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Who We Are 

We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.

Do you handle any type of coursework?

Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.

Is it hard to Place an Order?

  • 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
  • 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
  • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
  • 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – 

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

  • 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.

  • Guarantee

  • Zero Plagiarism
  • On-time delivery
  • A-Grade Papers
  • Free Revision
  • 24/7 Support
  • 100% Confidentiality
  • Professional Writers

  • Services Offered

  • Custom paper writing
  • Question and answers
  • Essay paper writing
  • Editing and proofreading
  • Plagiarism removal services
  • Multiple answer questions

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper