You have been selected as the Team Lead for your department. Management has asked you for a report on the following topics. Research each topic and summarize in an executive summary. Cite your sources in an appendix on the last page of your document.

Make sure that your research has information from at least 2 sources other than your textbook. 2 page minimum

• The role of managers and technology
• Ways to improve healthcare outcomes and reduce cost through new  technology
• Deficiencies in clinical use of technology
• Technology and medical errors
• Concentration on profit margins

Reading Research Literature (RRL) Worksheet ***see attached form

Read over each of the following directions, the required Reading Research Literature worksheet, and grading rubric.

Download and complete the required Reading Research Literature (RRL) worksheet*** see attached

 

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Download or access the required article. The required article must be used.  ***see attached

O’Connor, M., Tanner, P. , Miller, L.,  Watts, K., & Musiello, T. (2017). Detecting distress: Introducing routine screening in a gynecological cancer setting. Clinical Journal of Oncology Nursing, 21(1), 79-85. Retrieved from  https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?

 

You are required to complete the worksheet

Purpose of the Study

Using information from the required article and mostly your words, thoroughly summarize the purpose of the study. Describe what the study is about. Provide details

Reading Research Literature

Summarize why it is important for you to read and understand research literature. Summarize what you learned from completing the reading research literature activity worksheet. Provide details.

Respond  on two different days who selected different factors than you, in the following ways:

Share insights on how your colleague’s factors impact the pathophysiology of pain.

Suggest alternative diagnoses and treatment options for acute, chronic, and referred pain.

Main Post

Pain is both an easy and complex symptom to diagnose and treat due to its subjective nature. As future practitioners, we are diagnosing pain in the era of the opioid crisis will only add to the complexity of analyzing all of the signs and symptoms while trying to provide comfort to our patients. Pain confronts us with basic questions such as the tension between an objective and a subjective approach, the concept of brain disease, human consciousness, and the relationship between body and mind (Dekkers, 2017).

Pain

According to the National Library of Medicine (2018), pain is a signal activated within the nervous system signaling to an individual that something may be wrong; it is an unpleasant feeling that can be described as burning, stinging, aching, tingling, etc. It ranges from dull to severe, can be treated in a variety of ways, or can dissipate on its own. Every individual reacts differently to pain; pain can present differently in genders despite being the same disease process.

Acute Pain

Acute pain is brief and can last several seconds or up to three months; acute pain occurs in an attempt to protect the body from harm by causing withdrawal from painful stimuli and encourages individuals to avoid painful stimuli in the future (Huether & McCance, 2017). The damage to the tissue is usually easily seen, with the naked eye or imaging that can reveal the source. Acute pain also involves biological functions that protect against further injury. For example, pain produces protective reflexes, including an unconscious withdrawal from the noxious stimulus, muscle spasms, and other autonomic reactions such as flight (Rodriguez, 2015). Noxious stimulation in the periphery leads to activation of nociceptors and the transmission of signals to the central nervous system, which will lead to the perception of acute pain (Berger & Zelman, 2016).

Chronic Pain

Chronic pain persists for at least three months or greater, despite intervention to relieve the injury, surgical, holistic, or medicinal, when the treatment does not control the original issue. Chronic pain is disruptive to sleep patterns and activities of daily living, and as a pain syndrome, it serves no protective or adaptive function (Rodriguez, 2015). Anwar (2016) acknowledges that there are three ascending pathways: the first-order neuron; start from the periphery (skin, bone, ligaments, muscles, and other viscera) travels through the peripheral nerve reaches the dorsal horn of the spinal cord, second-order neuron: start at the dorsal horn cross over to the contralateral side and then ascend in the spinal cord to the thalamus, and other brain areas like dorsolateral pons and third order neuron: starts at the thalamus and then terminates in the cerebral cortex. The descending pathway begins in multiple areas of the brain, sending signals across nerve fibers.

Referred Pain

Referred pain is felt in an area removed or distant from its point of origin-the area of referred pain is supplied by the same spinal segment as the actual site of pain (Huether & McCance, 2017). Making the diagnosis difficult for practitioners, referred pain also presents differently in men and women. It is fairly common in some conditions, such as heart attacks and osteoarthritis (Ungvarsky, 2019). Impulses from many cutaneous and visceral neurons converge on the same ascending neuron, and the brain cannot distinguish between the different sources of pain (Huether & McCance, 2017).

Impact of Gender and Age on Pain

Focusing on the factors of age and gender and the effects on the experience of pain showed the importance of understanding different factors relating to pain. Persistent pain affects the elderly disproportionally, occurring in 50 % of elderly community-dwelling patients and 80 % of aged care residents (Veal & Peterson, 2015). In the United States, the fastest growing population is the baby boomers generation, and in ten years they will represent one out of five citizens. Pain is also increasingly difficult to manage in the elderly patient population as drug interactions, absorption rates and drug clearances begin varying as a result of the aging process. With the opportunity of placing a high fall risk population in even more danger, dosing for the elderly population can become difficult for a  practitioner. Petrini, Matthiesen, and Arendt-Nielsen (2015) acknowledged that the experience of pain in the elderly may differ from the experience in younger populations on multiple dimensions (sensory, affective, and cognitive). As the body physically wears down, so does the nervous system. In many patients seeking pain relief, the number of neurotransmitter cell receptors decreases with age-associated cortical and subcortical atrophy of brain tissue (Kaye et al., 2014). The practitioner must take into account all of the aging population’s comorbidities plus, fully assess the patient to determine if they are accurately representing their pain description.

Females have always been associated with a higher threshold for pain, and I can attest to this as I would gladly take an open heart female patient over a male patient but, this is not fair to assume those female patients have a higher tolerance for pain. Practitioners must still assess their patients, monitor their vital signs, and ask questions that can reveal answers that patient may not know themselves until the question is asked. Women do have more difficulty when attempting to have their pain managed. The tendency to underdiagnose and undertreat the pain of certain groups of patients, especially women, is greater when patients present with symptoms that are less objective and more grounded in complaints of pain (coronary artery disease, collagen vascular disease, nonspecific abdominal or pelvic pain) (Becker & Mcgregor, 2017). While pain does not differentiate between genders, male masculinity has taught generations of men to accept pain as normal while at the same time, women who complain of pain are frequently underdiagnosed.

Conclusion

Pain can be acute or chronic, and it can be referred or direct, practitioners must take into account all the factors that can mask or enhance the pain experience of their patients. Understanding the role the pain experience has can vary due to age or gender and pain is whatever the individual states it is or in some cases, fail to state. High-quality physical assessments and asking the appropriate questions can help practitioners manage their pain, taking into account the aging process and comorbidities that present throughout life.

 

References

Anwar, K. (2016). Pathophysiology of pain. Disease-a-Month, 62(9), 324–329. https://doi-org.ezp.waldenulibrary.org/10.1016/j.disamonth.2016.05.015

Becker, B., & Mcgregor, A. J. (2017). Article Commentary: Men, Women, and Pain. Gender and the Genome, 1(1), 46-50. https://doi-org.ezp.waldenulibrary.org/10.1089/gg.2017.0002

Dekkers, W. (2017). Pain as a Subjective and Objective Phenomenon. Handbook of the Philosophy of Medicine, 1-15. doi:10.1007/978-94-017-8706-2_8-1

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Kaye, A. D., Baluch, A. R., Kaye, R. J., Niaz, R. S., Kaye, A. J., Liu, H., & Fox, C. J. (2014). Geriatric pain management, pharmacological and nonpharmacological considerations. Psychology & Neuroscience, 7(1), 15–26. https://doi-org.ezp.waldenulibrary.org/10.3922/j.psns.2014.1.04

National Library of Medicine – National Institutes of Health. (2018). Retrieved June 7, 2019, from https://www.nlm.nih.gov/

Petrini, L., Matthiesen, S. T., & Arendt-Nielsen, L. (2015). The Effect of Age and Gender on Pressure Pain Thresholds and Suprathreshold Stimuli. Perception, 44(5), 587–596. https://doi-org.ezp.waldenulibrary.org/10.1068/p7847

Rodriguez, L. (2015). Pathophysiology of Pain: Implications for Perioperative Nursing. AORN Journal, 101(3), 338–344. https://doi-org.ezp.waldenulibrary.org/10.1016/j.aorn.2014.12.008

Ungvarsky, J. (2019). Referred pain (reflective pain). Salem Press Encyclopedia of Health. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=ers&AN=133861288&site=eds-live&scope=site

Veal, F., & Peterson, G. (2015). Pain in the Frail or Elderly Patient: Does Tapentadol Have a Role? Drugs & Aging, 32(6), 419–426. https://doi-org.ezp.waldenulibrary.org/10.1007/s40266-015-0268-7

Describe the scenario you selected.

Describe the transformational behaviors or actions the leader exhibited. Be specific and provide examples.

Explain how these behaviors or actions produce the best care and environment for excellence in nursing practice and a healthy workplace environment that leads to quality patient outcomes.

For each behavior or action, provide an example of how excellence in nursing practice is taking place.

Explain how the leader’s behaviors and actions contribute to a healthy workplace culture.

Explain the relationship among transformational leadership, communication, and collaboration with other teams and how this promotes excellence in nursing practice.

Week 12 Case Study III

 

Use APA 6th Edition Format and support your work with at least 3 peer-reviewed references within 5 years of publication. Remember that you need a cover page and a reference page. All paragraphs need to be cited properly. Please use headers.  All responses must be in a narrative format and each paragraph must have at least 4 sentences. Lastly, you must have at least 2 pages of content, no greater than 4 pages, excluding cover page and reference page.

Due 11/25/2019 by 12 Midnight. If submitted after 11/27/2019,

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Case Study #3: Insomnia and Sleep Disorders 

S.H., age 47, reports difficulty falling asleep and staying asleep. These problems have been ongoing for many years, but she has never mentioned them to her health care provider. She has generally “lived with it” and selftreated the problem with OTC Tylenol PM. Currently, she is also experiencing perimenopausal symptoms of night sweats and mood swings. Current medical problems include hypertension controlled with medications. Past medical history includes childhood illnesses of measles, chickenpox, and mumps. Family history is positive for diabetes on the maternal side and hypertension on the paternal side. Her only medication is an angiotensinconverting enzyme inhibitor and diuretic combination for hypertension control. She generally does not like taking medication and does not take any other OTC products.

Diagnosis: Insomnia

1. List specific goals of therapy for S.H.

2. What drug therapy would you prescribe? Why?

3. What are the parameters for monitoring the success of the therapy?

4. Discuss specific patient education based on the prescribed therapy

5. List one or two adverse reactions for the selected agent that would cause you to change therapy.

6. What would be the choice for second-line therapy?

7. What OTC and/or alternative medicines might be appropriate for this patient?

8. What dietary and lifestyle changes might you recommend?

9. Describe one or two drug–drug or drug–food interactions for the selected agent.