Tag Archive for: nursing

Peer Responses/Participation

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Ms. Brown comes into the emergency department to secure treatment for a head injury, plus minor bruises and abrasions she reportedly received during an assault that happened about 20 hours ago. Ms. Brown is 34 years old and accompanied by her boyfriend, Roy. She indicates they were sleeping in a protected entrance to an elevator in the city parking garage when two young men began beating and kicking them. The two men took Ms. Brown’s purse, a sack of food she and Roy had accumulated, and Roy’s wallet which contained $5.00.

Ms. Brown indicates she has been homeless for more than a year. She occasionally stays in city shelters but spends most of her time roaming the city and walking to procure meals at the various programs that feed the poor. She is tall and thin, with a variety of skin lesions. She came to the hospital due to dizziness that prevented her from walking to the church, where she could eat. She and Roy occasionally work odd jobs but use the bulk of their income to support Roy’s drug habit. She is trying to get Roy to quit using.

The nurse practitioner (NP) cleans Ms. Brown’s scalp and tapes the traumatic lesion. A contusion is suspected, and the NP suggests Ms. Brown rests for a few days and goes to the neurological clinic if the dizziness worsens. Ms. Brown points out that she has no place to rest and cannot get to the clinic without public transportation. The NP realizes this but indicates it is beyond her control. Because the contusion is not definitively diagnosed, the NP must discharge Ms. Brown with follow-up orders to seek help if things get worse.

Using the Resolution Guidelines with the mnemonic ETHICAL, consider the following questions:

  • E—Examine what other data are needed to make informed choices.
  • T—Think about who should be involved in the decision-making process and who should make the ultimate decision. Should Roy be involved? What agencies are available in your community to assist Ms. Brown?
  • H—Humanize Reflect on all the possible options with resulting consequences and humanize them by constructing a decision tree.
  • I—Incorporate the ethical principles (autonomy, beneficence, nonmaleficence, veracity, confidentiality, fidelity, and justice) when appropriate. Are there any legal statutes that apply? What standards of care should be incorporated
  • C—Choose an option.
  • A—Act on your ethical choice.
  • L—Look back and evaluate your option to see if you need to make any other choices. This also will be a guide for the next time a similar situation arises.

Peer Responses/Participation [Due Sunday]

  • Make sure to respond to at least two of your fellow classmates postings as well and challenge each other to go beyond just the surface.
  • Share your thoughts on how you support their ideas and explain why.
  • Present new references that support your opinions.

Family Planning

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You are working in a rural Family Planning Health clinic and a 16 y/o presents with complaints of vaginal pain, discharge, odor x 4 days. Pain is getting worse. Her mother relates she has a cognitive learning delay and has tried to talk to her about her consensual sexual behavior with multiple partners. She tells you she has “felt some ‘bumps’ down there.” She relates multiple sexual partners because she is now popular and it is part of the ‘game’ to stay popular with her new friends. Diagnosis: HPV with several condyloma lesions, a vaginal yeast infection, and chlamydia.

She is given a prescription for Chlamydia, and the vulvar lesions, told to follow up in 2 weeks.

How do you approach her and begin the conversation regarding safe sexual practices? What are your thoughts about this young lady? How do you feel about her game? How would you proceed to give her education?

Problem      statement

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In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

  1. Background
  2. Problem      statement
  3. Purpose      of the change proposal
  4. PICOT
  5. Literature      search strategy employed
  6. Evaluation      of the literature
  7. Applicable      change or nursing theory utilized
  8. Proposed      implementation plan with outcome measures
  9. Identification      of potential barriers to plan implementation, and a discussion of how      these could be overcome
  10. Appendix      section, if tables, graphs, surveys, educational materials, etc. are      created

Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Journal Entry

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Assignment: Practicum – Week 1 Journal Entry

 

As a future advanced practice nurse, it is important that you can connect your classroom experience to your practicum experience. By applying the concepts, you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.

Learning Objectives

Students will:

· Analyze nursing and counseling theories to guide practice in psychotherapy*

· Develop goals and objectives for personal practicum experiences*

· Create timelines for practicum activities*

In preparation for this course’s practicum experience, address the following in your Practicum Journal:

· Review the media Clinical Interview: Intake, Assessment, & Therapeutic Alliance in your Learning Resources.

· Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.

Note: For guidance on nursing and counseling theories, refer to the Wheeler textbook in this week’s Learning Resources.

· Explain why you selected these theories. Support your approach with evidence-based literature.

· Develop at least three goals and at least three objectives for the practicum experience in this course.

· Create a timeline of practicum activities based on your practicum requirements.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

Required Readings

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 1, “The Nurse Psychotherapist and a      Framework for Practice” (pp. 3–52)

Required Media

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Clinical interview: Intake, assessment, & therapeutic alliance [Video file]. Mill Valley, CA: Psychotherapy.net.

PLEASE SEE THE ATTACHED Practicum Journal Template AND JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATION

sensory inputs

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Write a 4–6-page examination of three different kinds of architecture that impact your daily life.

This assessment allows you to demonstrate your understanding architecture’s influence on personal experience.

 

For this assessment, complete the following:

  • Select three different kinds of spaces with which you are familiar in everyday life: places where you live, work, play, exercise, socialize, meditate, or worship.
    • Describe these spaces in detail, explaining what you observe, feel, think, and do when you are in each. Let your observation include lots of sensory inputs; you may first notice visual elements, but look for characteristic smells or sounds as well.
    • Examine your thoughts and feelings with the same degree of attention; is this a place that uplifts you or drags you down?
    • Consider the activities you pursue here, whether they are unique to this space or associated with it in your memory.
  • List the theoretical principles of architecture and apply those principles to the spaces you have described.
    • How do the architectural features of the space help to shape the variety of experiences you have when inhabiting it? Reflect on the traditional forms of architecture and assess how they contribute to what you observe, feel, think, and do in these spaces.
Additional Requirements
  • Written communication: Should be free of errors that detract from the overall message.
  • APA formatting: Your paper should be formatted according to APA (6th edition) style and formatting.
  • Length: 4–6 typed and double-spaced pages.
  • Font and font size: Times New Roman, 12 point.

health care organization,

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Review the performance dashboard for a health care organization, as well as relevant local, state, and federal laws and policies. Then, write a report for senior leaders in the organization that communicates your analysis and evaluation of the current state of organizational performance, including a recommended metric to target for improvement.

Maintaining standards and promoting quality in modern health care are crucial, not only for the care of patients, but also for the continuing success and financial viability of health care organizations. In the era of health care reform, health care leaders must understand what quality care entails and how quality in health care connects to the standards set by relevant federal, state, and local laws and policies. An understanding of relevant benchmarks that result from these laws and policies, and how they relate to quality care and regulatory standards, is also vitally important.

· Health care is a dynamic, complex, and heavily regulated industry. For this reason, you will be expected to constantly scan the external environment for emerging laws, new regulations, and changing industry standards. You may discover that as new policies are enacted into law, ambiguity in interpretation of various facets of the law may occur. Sometimes, new laws conflict with preexisting laws and regulations, or unexpected implementation issues arise, which may warrant further clarification from lawmakers. Adding partisan politics and social media to the mix can further complicate understanding of the process and buy-in from stakeholders.

How many health care laws can you name that affect your practice in your current or future workplace? How do they impact your daily work? How many regulatory agencies oversee the types of services your health care organization provides? Which regulatory agencies apply to your workplace setting? Are you familiar with the process of complying with those agencies in order to maintain certification? You might be overwhelmed as you consider these broad questions.

· As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend or family member, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

What local, state, or federal health care policies or laws set benchmarks and standards reflected in performance dashboards common in your professional area of practice?

· What are the potential challenges or opportunities for health care organizations or interprofessional teams in meeting prescribed performance benchmarks and standards? Factors you might consider include the organization’s mission, its size and resources, operational policies and procedures, and the population the organization serves.

· Preparation

For this assessment, you may choose one of the following three options for a performance dashboard to use as the basis for your benchmark evaluation.

Option 1: Dashboard and Health Care Benchmark Evaluation Simulation

If you decide to use one of the simulation dashboards for your evaluation, review both dashboards, as well as the relevant local, state, and federal laws and policies linked in each dashboard. Choose one of the dashboards and consider the metrics within it  that are falling short of the prescribed benchmarks.

Option 2: Actual Dashboard From a Professional Practice Setting

If you choose an actual dashboard from a professional practice setting for your evaluation, be sure to add a brief description of the organization and setting that includes:

· The size of the facility that the dashboard is reporting on.

· The specific type of care delivery.

· The population diversity and ethnicity demographics.

· The socioeconomic level of the population served by the organization.

Note: Ensure that your data is Health Insurance Portability and Accountability Act (HIPAA) compliant. Do not use any easily identifiable organization or patient information.

Option 3: Hypothetical Dashboard Based on a Professional Practice Setting

If you have a sophisticated understanding of dashboards that are relevant to your own practice, you may also construct a hypothetical dashboard for your evaluation, based on that setting. Your hypothetical dashboard must present at least four different metrics, at least two of which must be under-performing the relevant benchmark set forth by a federal, state, or local laws or policies. In addition, be sure to add a brief description of the organization and setting that includes:

· The size of the facility that the dashboard is reporting on.

· The specific type of care delivery.

· The population diversity and ethnicity demographics.

· The socioeconomic level of the population served by the organization.

Note: Ensure that your data is HIPAA compliant. Do not use any easily identifiable organization or patient information.

Report Requirements

Structure your report in such a way that it would be easy for a colleague or supervisor to locate the information they need. Be sure to cite relevant local, state, or federal health care laws or policies when evaluating metric performance against prescribed benchmarks. Cite an additional 2–4 credible sources to support your analysis and evaluation of the challenges in meeting the benchmarks, the potential for performance improvement, and your advocacy for ethical action.

Note: The tasks outlined below correspond to grading criteria in the scoring guide.

In your report, be sure to:

· Evaluate dashboard metrics against the benchmarks set by local, state, or federal health care laws or policies.

9. Which metrics are below the mandated benchmarks in the organization? Evaluate weaknesses within the entire set of benchmarks.

9. What are the local, state, or federal health care laws or policies that set these benchmarks?

. Analyze challenges that meeting prescribed benchmarks can pose for the organization or for an interprofessional team.

10. What are the specific challenges or opportunities that the organization or interprofessional team might have in meeting the benchmarks? For example, consider:

1. The strategic direction of the organization.

1. The organization’s mission.

1. Available resources:

3. Staffing.

3. Operational and capital funding.

3. Physical space.

3. Support services (any ancillary department that supports a specific care unit in the organization, such as a pharmacy, cleaning services, and dietary services).

1. Cultural diversity in the organization.

1. Cultural diversity in the community.

1. Organizational processes and procedures.

10. How might these challenges be contributing to benchmark underperformance?

. Evaluate a benchmark underperformance in the organization or interprofessional team that has the potential for greatly improving overall quality or performance.

11. Which metric is underperforming its benchmark by the greatest degree?

11. Which benchmark underperformance is the most widespread throughout the organization or interprofessional team?

11. Which benchmark affects the greatest number of patients?

11. Which benchmark affects the greatest number of staff?

11. How does this underperformance affect the community the organization serves?

11. Where is the greatest opportunity for improvement in the overall quality or performance of the organization or interpersonal team—and ultimately in patient outcomes?

. Advocate for ethical action in addressing the benchmark underperformance that has the potential for greatly improving overall quality or performance.

12. At which group of stakeholders should your advocacy be directed? Which group could be expected to take the appropriate action to improve the benchmark metric?

12. What are some ethical actions that the stakeholder group could take that support improved benchmark performance?

12. Why should the stakeholder group take action?

. Communicate your findings and recommendations in a professional and effective manner.

13. Ensure that your report is well organized and easy to read.

13. Write clearly and logically, using correct grammar, punctuation, and mechanics.

. Integrate relevant sources to support your arguments, correctly formatting source citations and references using current APA style.

14. Did you cite relevant local, state, or federal health care laws or policies when discussing the mandated benchmarks?

14. Did you cite an additional 2–4 credible sources to support your analysis, evaluation, and advocacy?

Effective communication

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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:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

This is your case:

38-year-old  Native American pregnant female living on a reservation

  • 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.

Rubric:

Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.   Supported by at least three current, credible sources.  Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

References:

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)

References has to be 3 or more

Health promotion

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Purpose

Community health nurses practice in a variety of settings. The purpose of this paper is to describe the community setting and analyze the role of a nurse in the assigned setting. Health promotion nursing interventions and a professional nursing organization related to this role will also be examined.

The topic for this paper is the role of a nurse in a correctional setting. 

Course Outcomes

This assignment enables the student to meet the following Course Outcomes.

  • CO5: Analyze the nursing roles in providing comprehensive care in a variety of community health settings. (PO 1)
  • CO6: Utilize a systems-based and collaborative approach to address factors that influence the health of a community and population health problems. (PO 2)

This APA paper is expected to be no more than four pages in length (not including the title page and reference list). Below are the requirements for successful completion of this paper. Please use the recommended APA Template linked below, which incorporates the following categories as the first level headings on your paper. APA formatting helps you to organize your paper in a professional manner and provides consistent methods for citing your sources and completing your reference page. See the documents in the APA category in Resources for assistance with APA formatting. The Student Success Strategies resource has great sections on writing scholarly papers and APA formatting.

  1. The community health setting for this paper must be a correctional setting such as a jail or prison (state, federal, men’s, women’s, juvenile, psychiatric, military, etc.).
  2. Click to view and download the NR443 Community Settings APA Template (Links to an external site.) to complete your paper. The template is formatted with the appropriate running head, title page, page numbers, paragraph formatting, and most of the headings. Please edit the headers and title page with your specific information. You are also encouraged to view the Week 4 assignment tutorial found at the end of the Academic Integrity Reminder.
  3. Read the chapter of your textbook on the  assigned community health setting and take notes based on the outline below.
  4. Locate and read at least one scholarly peer-reviewed journal article that is not assigned in the course related to a nurse’s role in health promotion in this setting. Go to the Chamberlain library at http:/library.chamberlain.edu (Links to an external site.). Search peer reviewed journals to find a scholarly article on this topic. The article must be less than 10 years old (less than 5 years is best).
  5. Thoroughly address the following categories using the APA Template that is provided.
  • Introduction (one paragraph):
    • The introduction should be interesting and capture the reader’s attention.
    • Introduce the assigned community setting
    • Briefly identify CHN role(s) in this setting
    • Identify vulnerable population(s) served in this setting
    • Include a purpose statement
  • Community Setting (two to three paragraphs)
    • Describe the assigned community setting, including vulnerable population(s) served.
    • Discuss three health services provided by the a CHN in the assigned setting.
    • Use your textbook or an outside scholarly source to address these sub-points.
  • Health Promotion Nursing Intervention (two to three paragraphs) 
    • Describe in detail health promotion intervention(s) that a CHN could implement in the assigned community setting.
    • Identify people/organizations/community members this CHN role may collaborate with in health promotion interventions.
    • Utilize at least one peer-reviewed scholarly article related to a health promotion intervention.
  • Professional Nursing Organization (two paragraphs)
    • Provide a detailed description of a professional nursing organization related to the assigned community setting. Search the text, your article, or the Internet for one professional organization that supports nurses in this role. If you can’t find an organization specific to this group, search the American Nurses Association (ANA) website for information on this role. Cite the organization in the body of the text with (organization name, year), and include a complete reference on the reference page.
    • Discuss one professional issue that this organization is addressing related to the assigned community setting.
  • Summary (one paragraph)

The summary reiterates key points about:

  • The community setting and the CHN role(s)
  • Health promotion intervention
  • Professional organization
  • Includes a concluding statement.
  • Reference Page: The reference page should start on a new page (insert a page break). All references should be cited within the body of the paper as (author or organization, year), and the full reference should be included in APA format on the reference page. A URL link alone is not an adequate reference. See the Chamberlain Guidelines for Professional Writing in the APA Folder in Resources for examples of properly formatted references.

digital information tools and technologies.

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In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.

To Prepare:

  • Reflect on the Resources related to digital information tools and technologies.
  • Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
  • Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.

Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.

3 to 5 References less tha 5 years

Quadruple Aim

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Write a brief analysis (no longer than 2 pages) of the connection between evidence-based practice and the Quadruple Aim.

· Define the Quadruple Aim and explain its application to evidence-based practice.

Your analysis should address how evidence-based practice might (or might not) help reach the Quadruple Aim, including each of the four measures of:

o Patient experience (2–3 paragraphs)

o Population health (2–3 paragraphs)

o Costs (2–3 paragraphs)

o Work-life of healthcare providers (2–3 paragraphs)

Provide a citation for each resource you used to write your response to this Assessment. The following citation has been provided as an example: