Capstone Part 1

Capstone Paper, Part I
· Introduction (Completed in Week 1) 
o State the practice problem in measurable terms and that reflect quality indicators.
This is the same problem described in the Week 1 Practice Experience discussion.
Provide the rationale for selecting the practice problem
o Include a purpose statement.
· Analysis of Evidence (Completed in Week 2) 
o Synthesize a minimum of 5 evidence-based practice resources that support your practice problem. Include a minimum of two to three research studies obtained from the Walden Library.
· Quality Improvement Process (Completed in Week 3)
o Describe the quality improvement process and a brief overview the quality model that will be used to improve your practice problem. Include a description of a quality tool that will be used in the quality improvement plan.
o This process will be used to support the detailed proposed quality improvement plan in Week 4
o Explain why the specific quality model was selected and document your explanation with references.
o Summary
§ Summarize the key points discussed in the paper.

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

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Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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Assignment 2 – Week 4 Practicum: Decision Tree

Assignment 2 – Week 4 Practicum: Decision Tree

Practicum: Decision Tree
For this Assignment, you examine the client case study in this week’s Learning Resources. Consider how you might assess and treat pediatric clients presenting with symptoms noted in the case.
Note:  For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.
                                                              The Assignment:
Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.
(N: B. A CASE STUDY WITH ANSWER SAMPLE IS ATTACHED WITH THIS ASSIGNMENT)
At each Decision Point, stop to complete the following:
· Decision #1: Differential Diagnosis
o Which Decision did you select?
o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
· Decision #2: Treatment Plan for Psychotherapy
o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
· Decision #3: Treatment Plan for Psychopharmacology
o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
· Also include how ethical considerations might impact your treatment plan and communication with clients and their families.
Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.
Case #1
A young girl with difficulties in school
                                                                               BACKGROUND
In psychopharmacology you met Katie, an 8-year-old Caucasian female, who was brought to your office by her mother (age 47) and father (age 49). You worked through the case by recommending possible ADHD medications. As you progress in your PMHNP program, the cases will involve more information for you to sort through.
For this case, you see Katie and her parents again. The parents have reported that the medication given to Katie does not seem to be helping. This has prompted you to reconsider the diagnosis of ADHD. You will consider other differential diagnoses and determine what information you need to accurately assess the DSM-5 criteria to make the diagnosis of ADHD or another disorder with similar diagnostic features.
When parents bring their child to your office, they may have read symptoms on the internet or they may have been told by the school “your child has ADHD”. Your diagnosis will either confirm or refute that diagnosis.
Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine a differential diagnosis and to begin medication, if indicated. The PMHNP makes this diagnostic decision based on interviews and observations of the child, her parents, and the assessment of the parents and teacher.
To start, consider what assessment tools you might need to evaluate Katie.
· Child Behavior Check List
· Conners’ Teacher Rating Scale
The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised” (Available at: http://www.doctorrudy.com/files/teacher_add_adhd_short.pdf). This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, makes careless mistakes in her schoolwork, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. She has difficulty interacting with peers in the classroom and likes to play by herself at recess.
When interviewing Katie’s parents, you ask about pre- and post-natal history and you note that Katie is the first born with parents who were close to 40 years old when she was born. She had a low 5 minute Apgar score. The parents say that she met normal developmental milestones and possibly had some difficulty with sleep during the pre-school years. They notice that Katie has difficulty socializing with peers, she is quiet at home and spends a lot of time watching TV.
 
SUBJECTIVE
You observe Katie in the office and she is not able to sit still during the interview. She is constantly interrupting both you and her parents. Katie reports that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds some subjects boring or too difficult, and sometimes hard because she feels “lost”. She admits that her mind does wander during class. “Sometimes” Katie reports “I will just be thinking about something else and not looking at the teacher or other students in the class.”
Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. She offers no other concerns at this time.
Katie’s parents appear somewhat anxious about their daughter’s problems. You notice the mother is fidgeting with her rings and watch while you are talking. The father is tapping his foot. Other than that, they seem attentive and straight forward in the interview process.
 
                                                                  MENTAL STATUS EXAM
The client is an 8-year-old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is neutral. Katie says that she doesn’t hear any ‘voices’ in her head but does admit to having an imaginary friend, ‘Audrey’. No reports of delusional or paranoid thought processes. Attention and concentration are somewhat limited based on Katie’s short answers to your questions.
Decision Point One
BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHAT IS YOUR DIAGNOSIS FOR KATIE?
In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.
 
299.00 Autism Spectrum Disorder (ASD), mild and co-occurring; 300.23 Social Anxiety Disorder
315.0 Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics
314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation
ANSWER CHOOSEN: Attention Deficit Hyperactivity Disorder, 
predominantly inattentive presentation 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation
RESULTS OF DECISION POINT ONE
·  Client returns to clinic in four weeks
·  You selected Attention deficit hyperactivity disorder, predominantly inattentive presentation. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer
· Decision Point Two

· BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

·  Wellbutrin 75 mg orally daily
·
·  Strattera 25 mg orally daily
·
·  Adderall XR 10 mg orally daily
ANSWER CHOOSEN: Adderall XR 10 mg orally daily
 RESULTS OF DECISION POINT TWO
·  Client returns to clinic in four weeks
·  Katie’s parents seem absolutely delighted upon their return stating that Katie is paying more attention in school, but note that there is still room for improvement, particularly in the afternoon
·  They report that Katie’s teacher has reported that Katie is able to maintain her attention throughout the morning classes but come afternoon, she “daydreams.”
·  Katie’s parents are also concerned about her decrease in appetite since starting the medication.
Decision Point Three
BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.
 
 Katie’s parents that weight loss is common with stimulant medications 
used to treat ADHD
 medication with family thearpy
 a small dose of immediate release Adderall in the early afternoon
ANSWER CHOOSEN: Add a small dose of immediate release Adderall in the 
early afternoon
                                             Guidance to Student
Whereas weight loss is common with stimulant medication, this option does not address Katie’s parents’ concerns about the return of symptoms in the afternoon.
Augmentation with family therapy is also a good idea as it can help Katie with her symptoms and further help her parents to understand the unique challenges that Katie experiences, as well as ways that they can help her with symptoms, however, this option does not address the return of inattentive symptoms in the afternoon.
Adding a small dose of immediate relate Adderall in the afternoon can help Katie to maintain attention throughout the afternoon and into the early evening when she must do homework. This would be the best option.
                                                  Learning Resources
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 3, “Contributions of the Sociocultural      Sciences” (pp. 131–150)
• Chapter      31, “Child Psychiatry” (pp. 1152–1181, 1244–1253)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• “Neurodevelopmental Disorders”

o “Intellectual Disabilities”
o “Communication Disorders”

• “Disruptive, Impulse-Control, and Conduct Disorders”

Volkmar, F., Siegel, M., Woodbury-Smith, M., King, B., McCracken, J., & State, M. (2014). Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(2), 237–257. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00819-8/pdf 
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
 
                                                       Required Media
Laureate Education (Producer). (2017b). A young girl with difficulties in school [Multimedia file]. Baltimore, MD: Author. (SEE THE ATTACHED CASE STUDY SAMPLE WITH ANSWER)
                                               Optional Resources
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter      51, “Autism Spectrum Disorder” (pp. 665–682)

Decision Tree: Personality Disorders

Frank Jones Sam’s University
Nurs 3333: PMHNP Role IV
Dr. Joe Mark
October 20 , 2010

Decision Tree: Personality Disorders
As described by the American Psychiatric Association (APA) (2013), ‘‘personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment’’. There are different types of personality disorders classified into three clusters. Cluster A individuals are described as the odd or eccentric, cluster B as the dramatic, emotional, or erratic and cluster C as the anxious or fearful. The purpose of this paper is to discuss the case study of a young woman with personality disorder. This paper will explore threes decisions relating to differential diagnosis, psychotherapy and psychopharmacology based on the presented clinical manifestations.
Decision One
The clinical manifestation presented in the case study are indicative of more than one personality disorder, specifically borderline personality disorder (BPD) and antisocial personality disorder (ASPD). Patients exhibits a fear of abandonment which aligns with BPD. The patient mentioned an interpersonal relationship involvement which she exhibited idolization for the man of her interest, and now is devaluing the man. This is also evident in BPD as outlined by diagnostic criteria set forth by the APA (2013).
My diagnosis for this patient is ASPD, because the client exhibits clinical manifestations of ASPD than BPD. One of the reasons that led me to the diagnosis of ASPD is the client’s lack of remorse. The client stole from a friend, instead of being sorry, client’s blames friend instead. Client exhibits lack of respect for social norm and failure to comply with the law as evidenced by more than one record of arrest. The client fails to upholding financial obligation and is deceitful. Client shows irresponsibility evidenced by inability to keep a job. These presentations are evident in clients with ASPD as outlined in the DSM-5.
The two personality disorders which are classified as cluster B personality disorders by the APA (2013) have clinical manifestations which overlap, thus needs to be ruled out as differential diagnoses for each other. As described on the DSM-5 diagnostic criteria, BPD and ASD have similar features of impulsivity, aggression and manipulative behaviors, which client exhibits in the case study. The differing manifestation between the two is that in BPD, clients seek out interpersonal relationship, while ASPD client is unable to form any attachment to relationship. Clients with BPD exhibit self-mutilating behaviors and self-aggression, while in ASPD, aggression is directed on others. In ASPD clients are egocentric (also seen in narcisstic personality disorder), while BPD clients have a poor image of self.
Decision Two
Since the client exhibits symptoms which are synonymous with one more than personality disorder, specifically borderline and antisocial; the best decision is to opt to conduct a psychological testing. This will to further help the practitioner to decipher between the two diagnoses or conclude that patient indeed has the two personality disorders which is a possible occurrence. Psychological testing can be in the form of rating scales which includes questionnaires, checklists e.t c. According to Sadock, Sadock and Ruiz (2014), these scales are useful for monitoring patient overtime or to provide a comprehensive assessment information that was not obtained during a routine clinical interview.
There is limited evidence from existing literatures on the effectiveness of medications to target the core symptoms of ASPD. Khalifa et al. (2010) mentions that pharmacological interventions are not to be considered as monotherapy but as adjunctive intervention to target associated symptoms of ASPD such as depression, aggression etc. The option of Haldol, an antipsychotic medication can be used to address aggression but does not treat the core features of the disorder such as lack of remorse, deceitfulness. Furthermore, the plethora of side effects known to be caused by the medication can increase noncompliance. Psychotherapy can be beneficial, but psychodynamic is not appropriate for this patient because it may require patient to address emotional states. According to Hesse (2010), probing about ‘feeling states’ is unhelpful because the ASPD client may have difficulty accessing such state and may become aggressive when made to confront personal shortcoming.
Decision Three
In decision three, the recommendation is for a group-based cognitive therapy. Latuda an antipsychotic can be used to treat aggression but not the core symptoms of ASPD. Dialectical behavioral therapy will be more appropriate in the client with BPD than in ASPD. The most cited effective psychotherapeutic approach used in ASPD is cognitive behavioral therapy (CBT). This approach helps the client address distorted beliefs about self, others and the world. CBT can be used to enhance social and intrapersonal functioning.
A group setting may be beneficial for these clients as they may be able to learn from others experience or information shared about self. Psychotherapy for ASPD should be met with skepticism, but Hesse (2010) suggested that approaches that includes employing moral reasoning, cognitive behavioral approach, applying a social information processing approach, and planning for relapse prevention should be used. Additionally, the clients need a high level of external structure that includes supervision of the patient and reinforcement of positive social behaviors to yield increased outcomes for ASPD clients (Hesse, 2010).
 
Ethical and Legal Considerations
Due to the clinical manifestation of ASPD, some clinicians believe that it is hopeless to treat ASPD clients due to their clinical manifestation of aggression, deceitfulness and manipulation. Clients tends to be noncompliant, fueling the clinician’s pessimism. Existence of pessimism can hinder practitioners from upholding the ethical principles to do no harm and to do the best for the patient to full capacity. Hatchet (2015), implores clinicians to turn to published studies to become more aware of treatment options and to avoid expert opinions or clinical myths in regards to treating clients with ASPD. For these clients, autonomy may be purposely compromised to prevent harm to the patient and to others. This is seen in cases where patient refuse to comply with treatment plan or ordered into treatment and remain in treatment until deemed fit to come out of treatment.
Conclusion
It is essential for the practitioner to be knowledgeable about personality s disorder to effectively care for the patient. The practitioner should explore various options of medication, used to target accompanied symptoms. Psychotherapy, even though some might argue of its effectiveness, should not be ruled out. Assessment tools should be used to guide the clinicians, in diagnosing, especially with disorders that have overlapping symptoms.

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author.
Khalifa, N., Duggan, C., Stoffers, J., Huband, N., Völlm, B. A., Ferriter, M., & Lieb, K. (2010). Pharmacological interventions for antisocial personality disorder. The cochrane database of systematic Reviews, (8). Doi: 10.1002/14651858.CD007667.pub2
Hatchett, G. T. (2015). Treatment guidelines for clients with antisocial personality disorder. Journal of mental health counseling, 37(1). Retrieved from Walden University Database
Hesse, M. (2010). What should be done with antisocial personality disorder in the new edition of the diagnostic and statistical manual of mental disorders (DSM-V)? Biomed central medicine, 8(66). DOI: 10.1186/1741-7015-8-66
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

WK2 Assgn 1 NRNP 6675

WK2 Assgn 1 NRNP 6675

WK2 Assgn 1 NRNP 6675

WK2 Assgn 1 NRNP 6675

WK2 Assgn 1 NRNP 6675
Insurance coding and billing is complex, but it boils down to how to accurately apply a code, or CPT (current procedural terminology), to the service that you provided. The payer then reimburses the service at a certain rate. As a provider, you will have to understand what codes to use and what documentation is necessary to support coding.
For this Assignment, you will review evaluation and management (E/M) documentation for a patient and perform a crosswalk of codes from DSM-5 to ICD-10.
 
 
The Assignment
 
· Assign DSM-5 and ICD-10 codes to services based upon the patient case scenario.
Then, in 1–2 pages address the following. You may add your narrative answers to these questions to the bottom of the case scenario document and submit altogether as one document.
· Explain what pertinent information, generally, is required in documentation to support DSM-5 and ICD-10 coding.
· Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.
· Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.
 
*******NOTE
The case scenario is inside the sample evaluation template.
The answer goes into the attached sample evaluation template.
(The parts printed in red).
 
REQUIRED READINGS
 
Contol+click the link to access the links below.
 
 
 
American Psychiatric Association. (2020). Updates to DSM–5 criteria, text and ICD-10 codes. /orders/www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm-5
 
American Psychiatric Association. (2013). Insurance implications of DSM-5. /orders/www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Insurance-Implications-of-DSM-5.pdf
· Clicking on this link will initiate the download of the PDF.
 
American Psychiatric Association. (2020). Coding and reimbursement.
/orders/www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement
 
American Psychiatric Association. (2013). Numerical listing of DSM-5 diagnoses and codes (ICD-10-CM). In Diagnostic and statistical manual of mental disorders (5th ed.)./orders/dsm-psychiatryonline-org.ezp.waldenulibrary.org/doi/10.1176/appi.books.9780890425596.ICD10Num_list
 
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
· Chapter 9, “Reimbursement for Nurse Practitioner Services”
 
Centers for Medicare & Medicaid Services. (2020). Your billing responsibilities. /orders/www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/ProviderServices/Your-Billing-Responsibilities
 
Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
· Chapter 15, “Reimbursement for Nurse Practitioner Services”
 
Walden University Academic Skills Center. (2017). Developing SMART goals. /orders/academicguides.waldenu.edu/ld.php?content_id=51901492
 
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
· Chapter 4 “Neuroanatomy, Physiology, and Mental Illness”
Pathways Mental Health
Psychiatric Patient Evaluation

Narrative Answers

 
 
References

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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?

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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.
• 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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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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NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 3 (Very Important For Me Please – Need Only A Work On This)- 12 – 14 Hours At The Max

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 3 (Very Important For Me Please – Need Only A Work On This)- 12 – 14 Hours At The Max

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 3 (Very Important For Me Please – Need Only A Work On This)- 12 – 14 Hours At The Max

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 3 (Very Important For Me Please – Need Only A Work On This)- 12 – 14 Hours At The Max

Discussion: Practicum Project Methodology and Evaluation
Consider the following scenario:
With a clear conception of her Practicum Project goal and objectives, Sandra was optimistic that she was on the right track. Then she started to consider the methodology for her project and realized how much she still needed to figure out. She began to think about the theories and concepts she had examined in her program of study and how they might inform her methodology. The biggest challenge, she discovered, was in mapping the strategies that would help her achieve each objective. How would she decide what would be most effective? What barriers were likely to arise? She also realized that she needed to think about evaluation early in order to establish appropriate criteria and make sure she could assess the evidence related to the process, impact, and outcomes of her project. She wondered how she might use formative evaluation to develop and improve the project, as well as how she could use summative evaluation following the implementation of the project to determine if it had been successful.
Consider the models, theories, and concepts you have examined in your program of study as they relate to your project. Which of these can be applied to the development of methodology to help you achieve the project objectives? Which ones can be used to help you establish criteria and methods of evaluation for your project?
In this Discussion, you examine and propose the methodology for your Practicum Project, as well as evaluation methods. The insights you gain through this Discussion should be integrated into your Practicum Project Plan, which is due in Week 5.
To prepare:
Reflect on the Practicum Project goal and objectives you developed in Week 3.
Refer to the Practicum Project Plan (PPP) Overview document as needed for information related to the assignment.
Consider the models, theories, and concepts you have examined in your program of study as they relate to your project. How can this information be applied to the development of the methodology and evaluation for your project?
Review the information on methodology in the Learning Resources, and conduct additional research to facilitate your analysis for your project. Evaluate the who, what, how, where, and when associated with each objective: Who will make what change, by how much, where, and by when? Consider the methods you could use to meet each objective. Devise your methodology in as much detail as possible to identify how you could meet each objective. For example, identify which professional organizations or regulatory bodies you would consult (by viewing their websites or contacting them directly) to gather evidence.
Review the information on formative and summative evaluation in this week’s Learning Resources, and conduct additional research to facilitate your analysis for your project. How could you evaluate achievement of your Practicum Project objectives using formative and/or summative evaluation? Begin to develop an evaluation plan for your Practicum Project.
Post a brief summary of your Practicum Project focus, including the goal and objectives of your Practicum Project (to serve as a reminder for your colleagues). Explain your selected methodology, and justify your selection. Include a detailed explanation of how you could meet each objective using this methodology. Also explain your evaluation plan, noting at which points during your Practicum Project formative and/or summative evaluation will occur.
Respond to at least two of your colleagues on two different days, using one or more of the following approaches:
Comment on your colleague’s methodology, offering suggestions for improvement as appropriate.
Suggest an alternative evaluation method for your colleague’s project.
Required Readings
Reminder: Review resources from previous courses as necessary.
Black, P. (2010). Formative assessment. In P. Peterson, E. Baker, & B. McGaw (Eds.), International encyclopedia of education (3rd ed., pp. 359–364). St. Louis, MO: Elsevier.
Note: Retrieved from the Walden Library databases.
 
This article outlines the history of formative assessment and its application and use as an evaluation tool.
Duers, L. E., & Brown, N. (2009). An exploration of student nurses’ experiences of formative assessment. Nurse Education Today, 29(6), 654–659.
Note: Retrieved from the Walden Library databases.
 
This article compares formative and summative assessment and presents examples of the application of formative assessment in nursing education.
Gantt, L. T. (2013). The effect of preparation on anxiety and performance in summative simulations. Clinical Simulation in Nursing, 9(1), e25–e33.
Note: Retrieved from the Walden Library databases.
 
This article provides an example of how formative and summative evaluation is used in a nursing simulation lab. The article discusses strategies for improving nurses’ performance on summative evaluations and explores the use of formative evaluation as a strategy for improving performance on summative evaluations.
Pellegrino, J. W. (2010). Technology and formative assessment. In P. Peterson, E. Baker, & B. McGaw (Eds.), International encyclopedia of education (3rd ed., pp. 42–47). St. Louis, MO: Elsevier.
Note: Retrieved from the Walden Library databases.
 
The author discusses the importance of formative assessment and examines how technology can be used to support the assessment process.

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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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Therapy for Clients With Impulsivity, Compulsivity, and Addiction

The Assignment

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
Week 8: Therapy for Clients With Impulsivity, Compulsivity, and Addiction
Impulsivity and compulsivity have a wide range of clinical presentations and often overlap with many other psychiatric disorders. Some individuals act without forethought and have difficulty saying “no” to certain things such as using illicit drugs or spending money, whereas other individuals engage in compulsive behaviors with undesirable consequences. In some cases, these impulsive and compulsive behaviors also fuel issues with addiction. To effectively assess and treat clients, you must understand how these disorders differ, as well as how their symptoms impact clients and their families.
This week, as you examine therapies for individuals with impulsivity, compulsivity, and addiction, you explore the assessment and treatment of clients with these disorders. You also consider ethical and legal implications of these therapies.
Photo Credit: [Apolinar B. Fonseca]/[Moment]/Getty Images
 
Assignment: Assessing and Treating Clients With Impulsivity, Compulsivity, and Addiction
Impulsivity, compulsivity, and addiction are challenging disorders for clients across the lifespan. These disorders often manifest as negative behaviors, resulting in adverse outcomes for clients. In your role as the psychiatric mental health nurse practitioner, you have the opportunity to help clients address underlying causes of the disorders and overcome these behaviors. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with impulsivity, compulsivity, and addiction.
Learning Objectives
Students will:
· Assess client factors and history to develop personalized therapy plans for clients with impulsivity, compulsivity, and addiction
· Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for impulsivity, compulsivity, and addiction
· Evaluate efficacy of treatment plans
· Analyze ethical and legal implications related to prescribing therapy for clients with impulsivity, compulsivity, and addiction
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
 
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
 
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
 
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
· Chapter 14, “Impulsivity, Compulsivity, and Addiction”
Stahl, S. M., & Grady, M. (2012). Stahl’s illustrated substance use and impulsive disorder New York, NY: Cambridge University Press.
 
To access the following chapter, click on the Illustrated Guides tab and then the Substance Use and Impulsive Disorders tab.
· Chapter 10, “Disorders of Impulsivity and Compulsivity”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
 
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
 
Review the following medications:
For insomnia
For obsessive-compulsive disorder
· Citalopram
· clomipramine
· escitalopram
· fluoxetine
· fluvoxamine
· paroxetine
· sertraline
· venlafaxine
· vilazodone
 
For alcohol withdrawal
· chlordiazepoxide
· clonidine
· clorazepate
· diazepam
· lorazepam
· oxazepam
 
For bulimia nervosa and binge eating
· fluoxetine
· topiramate
· zonisamide
For alcohol abstinence
· acamprosate
· disulfiram
 
For alcohol dependence
· nalmefene
· naltrexone
 
For opioid dependence
· buprenorphine
· naltrexone
For nicotine addiction
· bupropion
· varenicline
 
Book Excerpt: Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders. Treatment Improvement Protocol Series, No. 32. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64350/
· Chapter 1, “Substance Use Among Adolescents”
· Chapter 2, “Tailoring Treatment to the Adolescent’s Problem”
· Chapter 7, “Youths with Distinctive Treatment Needs”
University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control in adulthood, study finds. Retrieved from /orders/www.sciencedaily.com/releases/2016/01/160120201324.htm
Note: Retrieved from Walden Library databases.
Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical Pharmacology, 77(2), 375–381. doi:10.1111/j.1365-2125.2012.04457.x
Note: Retrieved from Walden Library databases.
Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10–15. doi:10.3928/00989134-20160314-04
Note: Retrieved from Walden Library databases.
Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual Diagnosis, 8(1), 74–84. doi:10.1080/15504263.2012.648439
Note: Retrieved from Walden Library databases.
Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., & … Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive Psychiatry, 55(6), 1337–1341. doi:10.1016/j.comppsych.2014.04.018
Note: Retrieved from Walden Library databases.
Required Media
 
Laureate Education (2016c). Case study: A Puerto Rican woman with comorbid addiction [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
 
To prepare for this Assignment:
· Review this week’s Learning Resources. Consider how to assess and treat adolescent clients requiring therapy for impulsivity, compulsivity, and addiction.
The Assignment
Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
· Decision #1
· Which decision did you select?
· Why did you select this decision? Support your response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
· Decision #2
· Why did you select this decision? Support your response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
· Decision #3
· Why did you select this decision? Support your response with evidence and references to the Learning Resources.
· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
· Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Note:  Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Co-morbid Addiction (ETOH and Gambling)  53-year-old Puerto Rican Female
 
BACKGROUND
Mrs. Maria Perez is a 53 year old Puerto Rican female who presents to your office today due to a rather “embarrassing problem.”
 
SUBJECTIVE
Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past two years, she has been having more and more difficulty maintaining her sobriety since they opened the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during their grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past two years and she is concerned about the negative effects of the cigarette smoking on her health.
She states that she attempts to abstain from drinking but that she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much” but enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much- she currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight.
Mrs. Perez is quite concerned today because she has borrowed over $50,000 from her retirement account to pay off her gambling debts. She is very concerned because her husband does not know that she has spent this much money.
 
MENTAL STATUS EXAM
The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.
Diagnosis: Gambling disorder, alcohol use disorder
Decision Point One
Select what the PMHNP should do:
Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks
 
Antabuse (Disulfiram) 250 mg orally daily
 
Campral (Acamprosate) 666 mg orally three times/day
 
Co-morbid Addiction (ETOH and Gambling)  53-year-old Puerto Rican Female
 
Decision Point One
 
Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks
RESULTS OF DECISION POINT ONE
·  Client returns to clinic in four weeks
·  Mrs. Perez said that she felt “wonderful” as she has not “touched a drop” to drink since receiving the injection
·  Client reports that she has not been going to the casino, as frequently, but when she does go she “drops a bundle” (meaning, spends a lot of money gambling)
·  Client She is also still smoking, which has her concerned. She is also reporting some problems with anxiety, which also have her concerned
Decision Point Two
Refer to a counselor to address gambling issues
 
RESULTS OF DECISION POINT TWO
·  Client returns to clinic in four weeks
·  Client reports that the anxiety that she had been experiencing is gone
·  Client reports that she has met with the counselor, but did not really like her. She did start going to a local meeting gamblers anonymous. She stated that last week, for the first time, she spoke during the meeting. She reports feeling supported in this group
Decision Point Three
 
Explore the issue that Mrs. Perez is having with her counselor, and encourage her to continue attending the Gamblers Anonymous meetings
 
Guidance to Student
Although controversy exists in the literature regarding how long to maintain a client on Vivitrol, four weeks is probably too soon to consider discontinuation. The psychiatric mental health nurse practitioner should explore the issues that Mrs. Perez is having with her counselor. As you will learn in future courses, ruptures and the therapeutic alliance can result in clients stopping therapy. Clearly, if the client does not continue with therapy, the likelihood of the gambling problem spontaneously remitting is lower (than had the client continued to receive therapy). Recall that there are no FDA approved treatments for gambling addiction, and the mainstay of treatment for this disorder is counseling. Since Mrs. Perez reports good perceived support from the gamblers anonymous meetings, she should be encouraged to continue her participation with this group.
The PMHNP needs to discuss smoking cessation options with Mrs. Perez in order to address the totality of addictions, and to enhance her overall health

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score. Therapy for Clients With Impulsivity, Compulsivity, and Addiction

• 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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NURSING POSTER

I KIND OF FORGOT ABOUT THIS POSTER FOR SCHOOL AND NEED THIS DONE ASAP!!   ANYONE WILLING TO HELP WOULD BE GREAT NEED ASAP*******LMK ASAP IF YOU NEED ANY ADDITIONAL INFORMATION
 
Phi Nu, Walden University Chapter of Sigma Theta Tau the International Nursing Honor Society
Scholarship of Practice Poster Session
The Scholarship and Research committee invites you to submit a Scholarship of Practice Poster for the Phi Nu Scholarship and Induction Ceremony to be held during a Walden University Commencement. This is the Honor Society’s open-house celebration of Walden student scholarly activities.
Call for Posters
You will be notified of the deadlines for abstract submissions for the Annual Scholarship of Practice Poster Session by Walden University School of Nursing.
To be eligible to submit, an applicant must be:

1. A current Walden student or Alumni who is an active Phi Nu Chapter member
2. Able to present her/his poster at a Walden University Commencement
3. Project must be completed by date of poster presentation

Applicants should submit abstracts based on their Scholarship of Practice.
Practicum projects are especially encouraged. This is a great opportunity to showcase your practicum work in a mentored environment.
Please follow the direction on the attached form and submit by the due date (to be determined).
One outstanding poster in each of the three categories per program (BSN, MSN and DNP) will be selected for a $100 award.
Blind reviews will be completed by a panel of Walden University faculty.
Names will be removed from the abstracts to ensure anonymity of the applicant.
Persons who have been selected to participate will be notified.
Abstracts must follow the required format to be considered.
Travel will be at the presenter’s expense.
ABSTRACT SUBMISSION FORM
Nursing Scholarship of Practice Poster Session
Poster presentations submitted should describe innovative projects and lessons learned in the practice of nursing.
1. Authors’ names, credentials, and affiliations (primary and co-authors):
2. Corresponding author’s e-mail address and phone number:
3. Nursing Program or practice Specialization that best fits your poster presentation:
____    A.        Nursing Education
____    B.        Nursing Leadership and Management
____    C.        Nursing Informatics
____    D.        BSN Student Project
_____  E.         DNP Student Project
_____  F          Other Nursing Specialty Project
4.  Title of presentation:
5.  Beginning date of project:  __________            
6.  Ending date of project: __________ (if project is ongoing indicate that here)
Please describe your project by answering items 7–14 below.
Do not exceed 500 words total in your responses.
7.  Setting of project:
8. Problem addressed:
9. Objectives of project:
10. Intervention or change implemented, if any:
11. Actions and methods used to solve the problem and meet the objectives:
12. Evaluation Strategies used to determine whether the objectives were met:
13. Outcomes:
 
14. Lessons learned (conclusions and recommendations for practice):
NURS 6600: Capstone Synthesis Practicum
Student Support and Calendar Information
So you have all key information available to you off-line, it is highly recommended that you print the following items for your reference:
· Syllabus, including the Course Schedule, located below as a linked PDF
· Term Calendar
· Student Support
Credit Hours
5 quarter hours
Walden University assigns credit hours based on the number and type of assignments that enable students to achieve the course learning objectives. In general, each semester credit equals about 42 hours of total student work and each quarter credit equals about 28 hours of total student work. This time requirement represents an approximate average for undergraduate work and the minimum expectations for graduate work. The number and kind of activities estimated to fulfill time requirements will vary by degree level and student learning style, and by student familiarity with the delivery method and course content.
Course Description
Students in this course apply the MSN curriculum experience by translating knowledge into practice through participation in professional activities and the development of a culminating project. Students apply theory, principles, and concepts related to their area of specialization in order to enhance nursing practice and promote positive social change.  Note:  This course requires a minimum of 144 practicum hours.
Course Prerequisites
Students must have completed all Core Courses:
· NURS 6001: Foundations for Graduate Study
· NURS 6050: Policy and Advocacy for Improving Population Health
· NURS 6051: Transforming Nursing and Healthcare Through Technology
· NURS 6052: Essentials of Evidence-Based Practice
· NURS 6053: Interprofessional Organizational and Systems Leadership
Plus area of specialization courses:
Leadership and Management Specialization:
· NURS 6201: Leadership in Nursing and Healthcare
· NURS 6211: Finance and Economics in Healthcare Delivery
· NURS 6221: Managing Human Resources
· NURS 6231: Healthcare Systems and Quality Outcomes
· NURS 6241: Strategic Planning in Health Care Organizations
Nursing Informatics Specialization:
· NURS 6401: Informatics in Nursing and Healthcare
· NURS 6411: Information and Knowledge Management
· NURS 6421: Supporting Workflow in Healthcare Systems
· NURS 6441: Project Management: Healthcare Information Technology
· NURS 6431: Evaluation Methods for Health Information and Technology
Course Outcomes
· Create professional development objectives for the Practicum Experience
· Apply theory as it relates to a practicum and/or practice experiences
· Apply knowledge and expertise to address a health care problem in a practicum setting
· Evaluate Practicum Experiences
· Evaluate the achievement of individualized and Practicum Project objectives
· Apply methods for disseminating outcomes of the Practicum Project
· Evaluate opportunities for continued professional growth
Son Alignment of Learner Outcomes
Click on the following link to access the SON Alignment of Learner Outcomes:  NURS 6600 SON Alignment of Learner Outcomes (PDF)
Course Materials
Students will be provided the following course materials. For missing, incorrect, or damaged materials, please contact the Student Support Team. Contact information for the Student Support Team can be located in the Student Support area of the course navigation menu.
Course Text
There is no course text for this course. However, other readings (journal articles, websites, book excerpts, etc.) are assigned throughout the course and may be found within each week and within the Course Schedule.
Course Readings List
The Course Readings List contains all of the required Walden Library resources for this course. Please click on the following link to access the list:  NURS 6600 Course Readings List
Media
Assigned course media elements may be found in one or more weeks of the course and are available via a streaming media player or a hyperlink to the individual item.
Course Schedule
For full assignment details and directions, refer to each week.
All assignments are due by 11:59 p.m. Mountain Time (MT) on the day assigned (which is 1:59 a.m. Eastern Time (ET) the next day). The time stamp in the classroom will reflect Eastern Time (ET), regardless of your time zone. As long as your submission time stamp is no later than 1:59 a.m. Eastern Time (ET), you have submitted on time.
Click the following link to access the Course Schedule:  NURS 6600 Course Schedule (PDF)
Course Calendar
A printable course calendar is located in the Term Calendar area of the course navigation menu.
Dedicated Support for Course Media
You may use the following e-mail address and toll-free number for any questions or concerns you have about media in the course.
E-mail:  mediasupport@waldenu.edu
Phone: 1-877-238-2963
Primary and Secondary Sources
Review the following information prior to selecting resources for assignments.
Primary: A primary source is an original document that is the first account of what happened. A research report is primary, and you can tell because it includes materials and methods demonstrating how the research was done. Some creative work is also primary, such as poetry, novels, and interviews of people who experienced something firsthand. In nursing, which is an evidence-based discipline, we strive to use primary research that is published in scholarly, peer-reviewed journals.
Scholarly, peer-reviewed journal: Scholarly journals publish papers by professional authors and experts in the field using a peer-review process to review the work and assure quality before publishing. The focus of a scholarly journal is to provide accurate information for scholars and other researchers. The focus is on content rather than advertising, a direct contrast to popular media. Scholarly journals publish both primary and secondary papers, the former usually noted as original research and the latter as reviews and commentaries. Letters to the editor may also be published but should be recognized as opinion pieces.
Note: When selecting articles for course assignments, you are advised (unless you are referencing seminal information) to focus on work published within the past five years.
Secondary: A secondary source is one step removed from the original source. This work interprets and often compiles other work, and it includes review articles, textbooks, fact sheets, and commentaries about a topic. It also includes news reports of original research. Secondary work is more prone to error and bias than primary work because it is being filtered through an additional person or persons. Review papers can be useful to glean information about a topic and to find other sources from the reference list, but it is the original, primary research that should be relied on most heavily in demonstrating scholarship, depth, and validation of factual information.
Course Assignments
1. Participation in weekly Discussions: The exchange of ideas among colleagues engaged in scholarly inquiry is a key aspect of learning and is a requisite activity in this course. You are expected to participate each week by posting a response to a prompt or question in the weekly Discussion area. Discussion topics/questions are provided in the Discussion area under each weekly button. In addition, you are expected to respond to your fellow students’ postings. To count as participation, responses need to be thoughtful; that is, they must refer to the week’s readings, relevant issues in the news, information obtained from other sources, and/or ideas expressed in the postings of other class members. You may ask questions or offer further information or links about the subject. Please pay attention to grammar and spelling, as consistently poorly written posts will receive grade penalties. In grading the required Discussion postings, your Instructor will be using the Formative Evaluative Criteria for Discussion Board Assignments rubric located in the Course Information area of the course navigation menu. Note: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are required to participate in the Discussion on at least three different days. It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner.
2. Application Assignments: The Application Assignments provide you with the opportunity to apply the skills and knowledge gained through the Learning Resources. See the Assignment area of specific weeks for detailed descriptions of the assignments. In grading the required Application Assignments, your Instructor will be using rubrics located in the Course Information area of the course navigation menu.
3. Practicum Journal/Time Log: This course includes a 144-hour practicum. The practicum is an active learning experience that provides you with the opportunity to apply your nursing knowledge in a community or public health setting. You will apply the concepts and skills that you are acquiring in NURS 6600 with guidance from your Instructor under the direction of a mentor. The practicum is a minimum of 144 hours. Students must keep a log of the time they spend related to their practicum experience.  Time Logs are accessed from the Welcome Page of the Meditreck Account. Hours must be inputted daily throughout the term and are reviewed by the instructor in Weeks 3, 7, and 11.
Grading Criteria and Total Components of a Grade
Course grades will be based on participation (postings) and completion of assignments listed below.
Grading Scale
Letter grades will be assigned as follows:

Please see below for the policy on Incomplete (I) grades.
Important Note: This course contains weighted grading. Assignments are weighted differently depending on their type. The total points achieved for each assignment will be weighted based on the percentage values noted in the Weighted Total (%) column of the table that follows.

* Each Discussion requires that you make one initial posting and at least two response postings to colleagues. See the Formative Evaluative Criteria for Discussion Board Assignments Rubric for posting details.
Incomplete Grade Policy
Per University policy, Incomplete grades can be granted only to students who have already met the minimum criteria for active weekly participation in a course (including weekly postings in online courses) and have completed at least 80% of other coursework. Incompletes can be awarded when, because of extenuating circumstances, a student has not met additional course requirements, including but not limited to written assignments, group projects, and research papers, as applicable. All Incomplete grades are awarded at the discretion of the course faculty. (Reproduced from the Student Catalog)
Students who are eligible for an Incomplete must contact the course Faculty Member to request the grade as soon as possible. Students who do not meet the criteria listed above will not be allowed to earn an Incomplete. If the Incomplete is approved, the Faculty Member will work with the student to outline the due date(s) for remaining work. Under no circumstances will the new due dates extend beyond 50 days from the last day of the term. Faculty will then have 10 days to assess the work and post the permanent grade before the University-allotted Incomplete time limit of 60 days expires. All Incomplete grades not resolved within the time allotted will convert to permanent grades of F.
Instructor Feedback Schedule
The Instructor will log in to the course during the week to monitor the weekly Discussion area. Feedback will be provided via comments in the My Grades area, the Discussion area, and/or the Announcements page.
You can expect your weekly assignment grades to be posted within 10 calendar days of a due date. Instructor feedback and explanation is provided whenever full credit is not achieved. Depending on the nature of the feedback, Instructor responses may be posted to the Discussion area or included in the My Grades area. The goal of your Instructor is to act as a discussion and learning facilitator rather than a lecturer. The Instructor will not respond to every posting by every individual, so please feel free to ask your Instructor if you would like some personal feedback on a particular assignment posting or any time you have any questions regarding your assignments or your grade.
Course Procedures
All class Discussions take place in the weekly Discussion areas.
You are encouraged to post course-related questions to the Contact the Instructor area of the course navigation menu, as they may be of interest to all; however, if your question is urgent, it is often best to e-mail the Instructor. If your e-mailed question is thought to be of benefit to all, it may be responded to by the Instructor via e-mail to all or posted as an announcement.
Instructor feedback on content and writing issues that is thought to be of benefit to the entire class may be posted to the Contact the Instructor area; however, most personal critique will be done privately in the My Grades area. Be sure to check the My Grades area for comments every week, even if you received full credit.
Please feel free to use the Class Café to initiate and participate in conversations not directly related to the course. This is an excellent opportunity to get to know other students better. The Instructor will browse theClass Café occasionally, but generally will not respond to conversations posted there unless students have specific questions for him or her.
Check the e-mail account you use for official Walden University business on a regular basis. The expectation is that you are checking this e-mail account daily during the week. If you experience difficulty sending or receiving Walden e-mail, please contact the Student Support Team right away. Contact information for the Student Support Team is located in the Student Support area of the course navigation menu.
Review all materials in the Course Information area, as well as the materials contained under each of the weekly buttons. Please note: There may be Optional Readings located within the Learning Resources section of each week in the course. You are encouraged to explore these readings as needed in order to enhance your understanding of the course content.
Preferred Methods for Delivering Assignments
Be sure that you post to the correct Discussion area each week. Do not e-mail postings to the Instructor. For all initial Discussion postings, make sure that the first sentence of your posting reads Main Question Post. For your responses to others’ response postings, make sure that the first sentence of your response readsResponse. These actions will ensure easily identifiable subject lines for your postings and responses.
Application Assignments are submitted and named according to the week in which the Assignment is submitted. Directions for naming each Application Assignment are included in each week’s Assignment area. Please be sure that all written Application Assignments are saved and submitted as “.doc” files.
All e-mail correspondence must contain in the subject line “NURS 6600-XX-NAME” (XX is the section number) followed by a brief description of the subject. This subject line convention ensures that your e-mail will be easily identified and responded to in a timely manner. It is required that the e-mail contain a signature that matches the official name used in the course.
Late Assignment Policy
Students are expected to submit assignments by the due dates noted in the course. In extenuating circumstances, such as illness, the student must contact the Instructor as soon as possible to discuss the situation. In those circumstances, faculty will determine the appropriate course of action for the student. Depending on the situation, these actions may include recommendations to drop the course (if within the University drop/withdrawal period), acceptance of some or all of the overdue assignments with or without penalties, or refusal to accept assignments.
Assignments submitted late without prior agreement of the Instructor, outside of an emergency absence, or in violation of agreements for late submission, will receive a grade reduction for the assignment amounting up to 20%. After 5 days, the assignment will not be graded. Students should be aware that late assignments may not receive the same level of written feedback as do assignments submitted on time.
Keeping Your Course Work
You will have access to the course and your coursework from the course start date until 60 days after the course ends. After this time, you will no longer be able to access the course or related materials. For this reason, we strongly recommend that you retain copies of your completed assignments and any documents you wish to keep. The University is not responsible for lost or missing coursework.
Course Evaluation
At or near the end of the course, you will receive an e-mail inviting you to submit an online evaluation of the course and instruction. All submitted course evaluations are confidential, and only aggregate data and comments will be shared with the Instructor and Program Director. Your feedback is vitally important to Walden University in its efforts to continuously improve programs.
Classroom Participation
In accordance with U.S. Department of Education guidance regarding class participation, Walden University requires that all students submit at least one of their required Week 1 assignments (which includes posting to the Discussion Board) within each course(s) during the first 7 calendar days of class. For courses with two-week units, posting to the Discussion Board by Day 7 meets this requirement. The first calendar day of class is the official start date of the course as posted on your myWalden academic page.
Assignments submitted prior to the official start date will not count toward your participation.
Financial Aid cannot be released without class participation as defined above.
Students who are taking their first class with Walden and do not submit at least one of their required Week 1 assignments (or at least one Discussion post) by the end of the 7th day will be administratively withdrawn from the university.
Students who have already taken and successfully completed at least one or more class(es) with Walden, and who do not participate within the first 7 days, will be dropped from that class.
If you have any questions about your assignments, or you are unable to complete your assignments, please contact your Faculty Member.

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ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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Part 3:Critical Appraisal Of Research

Assignment: Evidence-Based Project, Part 3: Critical Appraisal of Research
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
To Prepare:
· Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
· Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
· Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
By Day 7 of Week 7
Submit Part 3A and 3B of your Evidence-Based Project.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
· Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.
· Click the Week 7 Assignment Rubric to review the Grading Criteria for the Assignment.
· Click the Week 7 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
 
Required Readings
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
· Chapter 5, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 124–188)
· Chapter 6, “Critically Appraising Qualitative Evidence for Clinical Decision Making” (pp. 189–218)
Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010a). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c
Note: You will access this article from the Walden Library databases.
Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Critical appraisal of the evidence: Part II: Digging deeper—examining the “keeper” studies. American Journal of Nursing, 110(9), 41–48. doi:10.1097/01.NAJ.0000388264.49427.f9
Note: You will access this article from the Walden Library databases.
Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010c). Evidence-based practice, step by step: Critical appraisal of the evidence: Part III: The process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5
Note: You will access this article from the Walden Library databases.
Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207. doi:10.1177/1078390309338733
Note: You will access this article from the Walden Library databases.
 
Preferred articles peer reviewed articles , pls two from this group
#1. Al Danaf, J., Chang, B. H., Shaear, M., Johnson, K. M., Miller, S., Nester, L., & Aboumatar, H. J. (2018). Surfacing and addressing hospitalized patients’ needs: Proactive nurse rounding as a tool. Journal of nursing management, 26(5), 540-547. Retrieved from /orders/doi-org/10.1111/jonm.12580
Article#2. Kirk, K., & Kane, R. (2016). A qualitative exploration of intentional nursing round models in the emergency department setting: Investigating the barriers to their use and success. Journal of Clinical Nursing, 25 (910), 1262-1272.
/orders/doi-org./10.1111/jocn.13150
Article#3 Morgan, L., Flynn, L., Robertson, E., New, S., Forde‐Johnston, C., & McCulloch, P. (2017). Intentional rounding: a staff‐led quality improvement intervention in the prevention of patient falls. Journal of Clinical Nursing, 26(1-2), 115-124. Retrieved from
/orders/doi-.org/10.1111/jocn.13401
Preferred Systemic reviewed articles, please critically appraise two from this group
Article #4 Christiansen. A., Coventry, A., Graham, R., Jacob, E., Twigg. D. & Whitehead, L.(2018).
Intentional rounding in acute adult healthcare settings: A systematic mixed-method review. Journal of Clinical Nursing 27(9-10) p.1759-1792. /orders/doi-org/10.1111/jocn.14370
 
Article #5 Sims, S., Leamy, M., Davies. N., Schnitzier, K., Levenson,,R., Mayer, F., Grant, R., Gourlay, S., Ross,  F., & Harris, R (2018). Realist synthesis of intentional rounding in hospital wards: Exploring the evidence of what works, for whom, in what circumstances and why.  BMJ Quality and Safety 9 (743-752).   /orders/doi-org.10.1136/brmjqs-2017-006757
Article #6Toole, N., Mekuskey, T., & Hall, N. ( 2016). A systemic review :barriers to hourly rounding.
  Journal of Nursing Management 24(3),283-290.   /orders/doi-org/10.1111/jonm.12332  
SAMPLE OF TEMPLATE

( Critical Appraisal Tool Worksheet Template )

Evaluation Table
 
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research
 
 

 
 
* These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide

( Critical Appraisal Tool Worksheet Template )

Evaluation Table
 
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
* These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide
 
· Level I
Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis
 
· Level II
Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis
 
· Level III
Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis
· Level IV
Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence
· Level V
Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence
 
 
**Note on Conceptual Framework
 
· The following information is from Walden academic guides which helps explain conceptual frameworks and the reasons they are used in research. Here is the link /orders/academicguides.waldenu.edu/library/conceptualframework
 
· Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework.
 
· As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.”
 
· Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature.
 
· Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.
 
References
 
 
The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing dvidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019 from /orders/www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf
 
Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your” House”. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.
 
Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. Retrieved October 23, 2019 from /orders/academicguides.waldenu.edu/library/conceptualframework

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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.

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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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NURS 630 Interventions for ADHD

NURS 630 Interventions for ADHD

Case 2: Volume 1, Case #14: The Scatter-Brained Mother Whose Daughter Has ADHD, Like Mother, Like Daughter

To prepare for this Discussion:
Note: To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number. (Already attached with this posting)
 
Case 2: Volume 1, Case #14: The scatter-brained mother whose daughter has ADHD, like mother, like daughter
 
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
 
By Day 3
Post a response to the following:
Provide the case number in the subject line of the Discussion.
List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.
List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s ADHD therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.
Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.
 
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
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Clancy, C.M., Change, S., Slutsky, J., & Fox, S. (2011). Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence, diagnosis, and treatment.  Table B. KQ2: Long-term(>1 year) effectiveness of interventions for ADHD in people 6 years and older.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
 
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 12, “Attention Deficit Hyperactivity Disorder and Its Treatment”
Stahl, S. M., & Mignon, L. (2012). Stahl’s illustrated attention deficit hyperactivity disorder. New York, NY: Cambridge University Press.
 
To access the following chapter, click on the Illustrated Guides tab and then the ADHD tab.
Chapter 4, “ADHD Treatments”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
 
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
 
Review the following medications:
For ADHD
armodafinil
amphetamine (d)
amphetamine (d,l)
atomoxetine
bupropion
chlorpromazine
clonidine
guanfacine
haloperidol
lisdexamfetamine
methylphenidate (d)
methylphenidate (d,l)
modafinil
reboxetine
 
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
 
Optional Resources
Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245–268. doi:10.2165/11599630-000000000-00000
Psychiatric Times. (2016). A 5-question quiz on ADHD. Retrieved from http://www.psychiatrictimes.com/adhd/5-question-quiz-adhd?GUID=AA46068B-C6FF-4020-8933-087041A0B140&rememberme=1&ts=22072016
 
Course Texts
These course texts are available through Stahl Online Resources http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – NURS 630 Interventions for ADHD

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. NURS 630 Interventions for ADHD

• 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

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, affordable, plagiarism-free paper

Evidence Based Assignment

Assignment: Evidence-Based Project

Is there a difference between “common practice” and “best practice”?
When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.
Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: An Introduction to Clinical Inquiry
Create a 4- to 5-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you used keywords to search on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

Assignment: Evidence-Based Project

Is there a difference between “common practice” and “best practice”?
When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.
Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.
Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?
In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.
To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: An Introduction to Clinical Inquiry
Create a 4- to 5-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you used keywords to search on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

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DQ-Week 1: Health Assessment

 Discussion: Building a Health History
Effective communication is vital to constructing  an accurate and detailed patient history. A patient’s health or illness  is influenced by many factors, including age, gender, ethnicity, and  environmental setting. As an advanced practice nurse, you must be aware  of these factors and tailor your communication techniques accordingly.  Doing so will not only help you establish rapport with your patients,  but it will also enable you to more effectively gather the information  needed to assess your patients’ health risks.
For this Discussion, you will take on the role  of a clinician who is building a health history for a particular new  patient assigned by your Instructor.
 
                                               To prepare:
By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. (new patient profile):  14-year-old biracial male living with his grandmother in a high-density public housing complex 
 
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s social determinants of health?
What  risk assessment instruments would be appropriate to use with each  patient, or what questions would you ask each patient to assess his or  her health risks?
Identify  any potential health-related risks based upon the patient’s age,  gender, ethnicity, or environmental setting that should be taken into  consideration.
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

Post a summary of the interview and a  description of the communication techniques you would use with your  assigned patient. Explain why you would use these techniques. Identify  the risk assessment instrument you selected, and justify why it would be  applicable to the selected patient. Provide at least five targeted  questions you would ask the patient.
NOTE: THIS IS THE LINK TO DOWNLOAD THE BOOK YOU NEED TO COMPLETE THE DISCUSSION QUESTION
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.
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 1, “The History and Interviewing Process”
This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.
 
· Chapter 5, “Recording Information”
This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
· Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–29)
Deckx, L., van den Akker, M., Daniels, L., De Jonge, E. T., Bulens, P., Tjan-Heijnen, V. C. G., … Buntinx, F. (2015). Geriatric screening tools are of limited value to predict decline in functional status and quality of life: Results of a cohort study. BMC Family Practice, 16, 1–12. /orders/doi-org.ezp.waldenulibrary.org/10.1186/s12875-015-0241-x
Note: You will access this article from the Walden Library databases.
Wu, R. R., & Orlando, L. A. (2015). Implementation of health risk assessments with family health history: Barriers and benefits. Postgraduate Medical Journal, (1079), 508–513. Retrieved from /orders/search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edsgea&AN=edsgcl.429265076&site=eds-live&scope=site
Note: You will access this article from the Walden Library databases.
Lushniak, B. D. (2015). Surgeon general’s perspectives: Family health history: Using the past to improve future health. Public Health Reports, (1), 3. Retrieved from /orders/search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edsgea&AN=edsgcl.426834285&site=eds-live&scope=site
Note: You will access this article from the Walden Library databases.
Jardim, T. V., Sousa, A. L. L., Povoa, T. I. R., Barroso, W. K. S., Chinem, B., Jardim, L., … Jardim, P. C. B. V. (2015). The natural history of cardiovascular risk factors in health professionals: 20-year follow-up. BMC Public Health, 15(1111), 1–7. /orders/doi-org.ezp.waldenulibrary.org/10.1186/s12889-015-2477-8
Note: You will access this article from the Walden Library databases.
Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation as well as other support resources:
 
Frey, C. [Chris Frey]. (2015, September 4). Student orientation [Video file]. Retrieved from /orders/www.youtube.com/watch?v=Rfd_8pTJBkY
 
Shadow Health. (n.d.). Shadow Health help desk. Retrieved from /orders/support.shadowhealth.com/hc/en-us
 
Document: Shadow Health. (2014). Useful tips and tricks (Version 2) (PDF)
 
Document: Shadow Health Nursing Documentation Tutorial (Word document)

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ADDITIONAL INSTRUCTIONS FOR THE CLASS

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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.
• 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.

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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