This work of HCA 459 Week 1 Discussion Question 2 The Challenge of Change shows the solutions to the following problems:
Change is usually positive but it can also be difficult to embrace at times. Employees can be resistant to change while managers may feel that it is necessary for organizational stability. Discuss the challenge of change as it relates to health care organizations. What is the overall impact of change on the organization its employees and its constituents and what role does the manager play as an agent of change?
In addition to responding to these questions review the examples of successful change in your textbook and choose two examples to discuss in greater detail. What did you learn from these examples? In each case how did the individuals overcome the barriers to change and what were the resulting benefits?

 

In clinical settings, some of the most common questions that patients ask are Why do I have this? What caused this disorder? Will it ever go away? These emotional questions can be difficult to ask and to answer. However, for patients to come to terms with their diagnoses and adhere to treatment plans, they must have an understanding of factors that might have caused, or continue to impact, their disorders. As an advanced practice nurse, it is important that you are able to explain disorders, associated alterations and symptoms, and changes that might occur within your patients’ bodies.
To prepare:
•Review this week’s media presentation. Reflect on the importance of developing an in-depth understanding of pathophysiology.
•Select a disorder from the following list: ◦Adrenal insufficiency (Addison’s disease) ◦Atherosclerosis ◦Cholelithiasis (gallstones) ◦Colon cancer ◦Cystic fibrosis ◦Hemophilia ◦Nephrolithiasis (kidney stones) ◦Osteoporosis ◦Parkinson’s disease ◦Tuberculosis
•Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how that factor might impact your selected disorder, as well as potential associated alterations and symptoms.
•Identify the pathophysiology of the associated alterations, including the normal and altered cellular function. Consider both intra- and extra-cellular changes that occur. Post on or before Day 3 a brief description of a patient scenario involving the disorder and the factor you selected.
Explain how the factor might impact your selected disorder, as well as potential associated alterations and symptoms. Finally, explain the pathophysiology of the associated alterations, including changes in cellular function. Place this order with us and get 18% discount now! to earn your discount enter this code: special18 If you need assistance chat with us now by clicking the live chat button.

 

Each student will conduct an in-depth analysis of a major clinical outcome, which can either be an aggregate or individual health outcome and do the following: Criteria:
1. Conceptual a. Define the outcome, use research literature to support your definition b. What model can be used to describe the relations of the outcome to determinant and process of care.
2. Operational Definition a. What is the operational definition for this outcome? b. How are you going to measure the concept?
3. Measurement Characteristics a. Discuss the methods used to collect data in the system of care versus community population focus. b. Discuss measurement qualities – sensitivity and specificity, reliability and validity, and importance.
4. Relate outcome to: a. Life Span b. Diverse population 0. Cultural variation
5. How does this outcome relate to clinical decisions? a. How will you use the measure? b. When will you use the measure
6. How is the outcome amenable to change by nursing interventions? Under what set of conditions will bring about change?
7. Clinical versus research significance – what would be a meaningful clinical change? How much?
8. How does this outcome fit into the overall health care system? (To whom, for what?)
9. What are the methodological issues using this measure as a systems measure?
10. What is the relevance of outcome to nursing?
11. What are the Policy implications? Up to 10 points will be deducted for grammar and spelling mistakes.

 

Presentations of ADHD
Although ADHD is often associated with children, this disorder is diagnosed in clients across the lifespan. While many individuals are properly diagnosed and treated during childhood, some individuals who have ADHD only present with subsyndromal evidence of the disorder. These individuals are often undiagnosed until they reach adulthood and struggle to cope with competing demands of running a household, caring for children, and maintaining employment. For this Discussion, you consider how you might assess and treat individuals presenting with ADHD.
Learning ObjectivesStudents will:Assess client factors and history to develop personalized therapy plans for clients with ADHDAnalyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for ADHDEvaluate efficacy of treatment plansApply knowledge of providing care to adult and geriatric clients presenting for antidepressant therapyLearning ResourcesNote: 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 ReadingsNote: 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
armodafinilamphetamine (d)amphetamine (d,l)atomoxetinebupropionchlorpromazineclonidineguanfacinehaloperidollisdexamfetaminemethylphenidate (d)methylphenidate (d,l)modafinilreboxetine
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Optional ResourcesHodgkins, 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
To prepare for this Discussion:
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. 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.
Case 1: Volume 1, Case #13: The 8-year-old girl who was naughty
Case 2: Volume 1, Case #14: The scatter-brained mother whose daughter has ADHD, like mother, like daughter
Case 3: Volume 2, Case #21: Hindsight is always 20/20, or attention deficit hyperactivity disorder
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.Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
By Day 3Post 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.

 

Nursing – Leadership, teams and decision making What does leadership in health care mean? Describe the aspects of this in relation to the aged care and disability health care sector. Consider the effect various styles of leadership may have on service delivery and quality care within both the community as well as individual case management. Explore the diversity within Western health care systems and the impact this may have on leadership decisions that may be made.
Explain your answer with examples from your area of work. Use references where required to substantiate potential changes to decision making processes that may affect team management. Demonstrate knowledge of roles, responsibilities, styles and theories of leadership in Western health care, and to critically analyse the distance between the ‘heroic’ concepts of leadership and the present day reality of health care leaders.