Student report

Read the Met call Transcript bellow, prepare a written report (~1000

words) including:

• Identification of four (4) examples of effective or ineffective teamwork

and/or communication in the scenario. This can be presented in a table

or as dot points.

• Discussion, using the literature, about how each identified example of

effective/ineffective teamwork and/or communication can impact on the:

◦ Patient (approx. 300 words, informed by 2-3 references)

◦ Staff (approx. 300 words, informed by 2-3 references)

Organisation (approx. 300 words, informed by 2-3 references).

Read the transcripts bellow and uses these resources as your

references to answer the report.

Starting references are provided below to assist you with beginning your

student report/CAP. Please note, however, that you are expected to find

and include additional references in your report.

Other Requirements

Do not write an introduction or conclusion.

Provide a reference list at the end of your report for all in-text

references.

Aitkin, L., & Eagar, S. (2013). Collegial relationship breakdown: A

qualitative exploration of nurses in acute care settings. Collegian, 20(2),

115-121. doi: 10.1016/j.colegn.2012.04.008

Al Sayah, F., Szafran, O., Robertson, S., Bell, N., & Williams, B., (2014).

Nursing perspectives on factors influencing interdisciplinary teamwork in

the Canadian primary health care setting. Journal of Clinical Nursing,

3(19-20), 2968-2979. doi: 10.1111/jocn.12547

Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J.

(2015). Structured nursing communication on interdisciplinary acute

care teams improves perceptions of safety, efficiency, understanding of

care plan and teamwork as well as job satisfaction. Journal of

Multidisciplinary Healthcare, 8, 33-37. doi: 10.2147/JMDH.S72623

Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional

communication in healthcare: an integrative review. Nurse Education in

Practice, 19, 36-40. doi: 10.1016/j.nepr.2016.04.005

Manias, E., Geddes, F., Watson, B., Jones, D., & Della, P. (2015).

Perspectives of clinical handover processes: a multi-site survey across

different health professionals. Journal of Clinical Nursing, 25, 80-91. doi:

10.1111/jocn.12986

Mitchell, R., Parker, V., Giles, M., & Boyle, B. (2013). The ABC of health

care team dynamics: understanding complex affective, behavioral, and

cognitive dynamics in interprofessional teams. Health Care

Management Review, 39(1), 1-9. doi: 10.1097/HCM.0b013e3182766504

Polis, S., Higgs, M., Manning, V., Netto., & Fernandez, R. (2015)

Factors contributing to nursing team work in an acute care tertiary

hospital, Collegian. doi: http://dx.doi.org/10.1016/j.colegn.2015.09.002

The case of the MET call – transcript

Katie: How are you feeling Dolly?

Dolly: I don’t feel well.

Katie: No, ok. I’m a bit worried. I’ve just done your blood pressure. It’s

90 systolic at the moment. It’s come down quite a bit from what it was,

actually.

Dolly: Yeah.

Katie: Yeah. Are you feeling light headed or anything?

Dolly: I feel dizzy.

Katie: Ahh. Ok. Um. Heart rate has also come up to 115. It feels a little

bit on the thready, weak side. You’ve got a temperature as well. 38.6

this morning, which is a quite high.

Dolly: Yes.

Katie: Yep, but your breathing and your oxygen levels and everything

seem to be alright.

Dolly: Yes.

Katie: You look really dry?

Dolly: Yes, I’m thirsty.

Katie: Alright. I’m a bit worried, I think I need to actually go and get some

help to be able to sort this out.

Dolly: Ok.

Katie: Ok, so I’m just going to find some help. Urm, and I’ll be back. Ok?

[Calls to colleague] Monica?

Monica: Yes? Hi Katie.

Katie: Yes, um… I’m just…

Monica: How’re you going Dolly?

Dolly: I’m not good.

Monica: Not good – what’s the problem?

Katie: She’s not great. I’m quite concerned about her now. Her blood

pressure has come down to 90 systolic…

Monica: Yes.

Katie: You can see it’s sort of trended down…

Monica: Yep.

Katie: And her heart rate’s come up to 115..

Monica: Yep

Katie: Her respiratory rate and oxygen sats are 99 and that’s all ok.

Monica: Yep, ok.

Katie: Her temperature’s 38.6 as well..

Monica: Right.

Katie: So… And she feels kind of a bit light headed, did you say Dolly?

Dolly: Yes, I did, yeah.

Katie: A bit dizzy.

Monica: I think we’re in the criteria for a MET call, Katie…

Katie: Yeah…

Monica: So I’m just going to call…

Katie: That’s what I thought. I just didn’t feel confident enough to call it

myself… Talking over each other

Monica: Oh, ok, I understand, being a student nurse. I’m going to go and

get that… organise that right now. We’ll be right back with some help

Dolly. Ok, Katie?

Katie: Shall I stay here?

Monica: If you can stay there and just keep an eye…

talking over each other

Katie: I’ll wait for you to come back.

Monica: I’ll be back with the team…

Katie: Alright, ok… [to Dolly] So Monica will be back in a moment. She’s

gone to call the MET team – that’s another doctor and a nurse who are

going to come and help us.

Dolly: Ok.

Katie: Ok, alright, good. Have you got any pain anywhere, Dolly?

Dolly: Just a little bit…

Katie: Just a little bit.

Monica: I’ve called the team, so they’re going to be coming now, so I’m

going to…

Talking over each other

Katie: Ok.

Monica: …get the trolley

Katie: Can I… is there anything I can do to help, Monica?

Monica: Can you just do another blood pressure?

Katie: Yes, sure, sure.

Monica: That would be great.

Katie: Yeah, ok…

Monica: …and we’ll get the trolley ready, and they should be coming

now. The doctors are going to come now, Dolly.

Katie: ok.

Monica: …and we’ve got everything ready to go.

Katie: We’ll check your blood pressure again Dolly…

Doctor Kelli and MET nurse Chanika arrive.

Kelli: Good morning, hello, [to Dolly] hello there, what’s your name?

Dolly: Dolly.

Kelli: Hello Dolly, I’m Kelli, I’m the registrar with the MET team.

Chanika: Hi, I’m Chanika, I’m the nurse.

Monica: Ok, so…

Kelli: Sorry, can I just… what was your name?

Monica: Oh, sorry! Monica! I’m Katie’s preceptor.

Katie: Hi

Kelli: Lovely! Nice to meet you both. [To Dolly] Just going to have a chat

for a minute Dolly.

Dolly: Ok.

Monica: Ok, so we’ve… Dolly’s post-op three days. She had her right

hip done. Her obs have been stable this morning. The doctors did the

rounds. However, now her blood pressure has come right down as you

can see…

Kelli: Yes.

Monica: It’s down within… quite low.

Kelli: Hmmm.

Monica: Her heart rate’s actually a little bit elevated. And her resp rate

has gone up…

Talking over each other

Kelli: And this is a recent temperature?

Monica: And she’s spiking a temp as well…

Talking over each other

Kelli: Right, yeah.

Monica: So we’re not sure where you want to go from here.

Kelli: How are you feeling dolly?

Dolly: I’m not good.

Kelli: You’re not good?

Dolly: Not good at all.

Kelli: Ok. Can we… Katie, can you get me some fluids, some normal

saline.

Monica: Yep.

Katie: More saline? Yep.

Monica: I’ll get that for you Katie.

Katie: Ok.

Chanika: [to Kelli] Pain medication?

Kelli: Oh yeah, when did we last have pain… Have you got pain?

Dolly: Yes, yes I do.

Kelli: You do?

Dolly: In my hip.

Kelli: Katie, can you tell me if she had pain relief this morning?

Katie: She has had pain relief this morning, but she’s just got endone

written up, and she’s had her endone, paracetamol. I feel like she needs

something, sort of, slow release. It seems to wear off quite quickly.

Kelli: Ok.

Monica: Chanika, can you check this with me please?

Katie: I’m a bit worried ‘cos she hasn’t passed any urine since, I don’t

think, yesterday afternoon… She looks a bit dry in the mouth as well.

At the same time: Monica and Chanika check Dolly’s ID and the

medications. Chanika asks for Dolly’s chart from Kelli, who apologises

and hands it to her.

Katie: She looks a bit dry in the mouth as well.

Kelli: Yes, we’ll get those fluids… and we’ll get some… do you feel like

you need some pain relief Dolly?

Chanika and Monica continue checking the medication

Dolly: Yes, yes, I think so.

Kelli: Ok, right. So Katie, I think maybe we’ll give some slow release…

let me write that up. So if you can organise that. Has she got any allergis

that you know of?

Monica: [to Dolly]: Ok Dolly, so I’m just going to put this IV in here for

you.

Katie: No allergies. No allergies Dolly?

Dolly: No

At the same time

Monica: No, she’s got no allergies.

Kelli: Katie, can you organise that for me please?

Katie: Ok, yep. Will that be ok with her blood pressure?

Kelli: Yes, well we’ll give her some fluids.

Katie: Ok, so I can give her this…?

Kelli: We’ll check it again before with give it. That would be good.

Katie: Ok, right. Cool, so I’ll let you know…

Chanika: Katie, do you want to come and check this with me?

Katie: I need to get some pain relief for Dolly, so…

Chanika: I’ve got it here.

Katie: Oh, ok.

[[Everyone speaking over each other]]

Kelli: Monica, when you’ve got some [inaudible – everyone speaking at

once] antibiotics. She hasn’t been on any… and I think that’s maybe…

Have we had a look at her wound this morning?

Monica: No, we haven’t actually. We haven’t got her out of bed for a

shower yet, so…

Kelli: Right.

Monica: Do you want us to have a look at her wound?

Kelli: Yeah, we need to look at the wound to see what’s happening now.

Monica: Ok, no problem. So I’m just going to get this IV going.

Kelli: [to Dolly] This is no good, Dolly, is it?

Dolly: No.

Kelli: I think you should be heading on the way home now, not getting

worse.

Monica: We need a new IV, it’s actually [bunged] so we need a new IV.

Kelli: Ok, right. I’ll put that in. Would you grab me the trolley for that

please? That would be good.

Talking over each other.

Monica: Yep, sure. Yep.

Kelli: Great, so Dolly, we’re just getting you some more antibiotics

again…

Dolly: Ok

Kelli: And we’re getting you a bit of fluid. I think you’re a bit dry, aren’t

you?

Dolly: Yes, I’d love a cup of tea.

Kelli: You’d love a cup of tea! You’re a cup-of- tea girl are you? How do

you have your tea?

Dolly: With one sugar.

Kelli: Ok. I think maybe when we get this sorted we might be able to get

you a cup of tea.

Dolly: Ok.

Kelli: Alright.

Monica: [returning with trolley] What side would you like it in doctor?

Kelli: We’ll go this side.

Monica: Ok, cool.

Kelli: And that way…

Monica: [to Chanika] Can I just get the IV out of this trolley here?

Chanika and Katie continue checking the medications

Kelli: So, Dolly, I need to pop another drip in.

Dolly: Alright.

Kelli: I know they’re a bit uncomfortable, but we need to give you this

fluid. It’ll make you feel a lot better.

Dolly: Ok.

Kelli: Where do you live, Dolly?

Dolly: I live in a retirement home.

Kelli: Oh, lovely.

Monica: [returns with the new IV] Ok

Kelli: Very good.

Katie: So, just letting you know, we’ve got the pain relief ready. We just

need to wait ‘til…

Kelli: Excellent. I’m going to pop that in now. So we’ve got fluids ready to

go, we’ve got pain relief, and we’ve got someone getting antibiotics.

Katie: And someone getting antibiotics, ok.

Kelli: Lovely. Excellent. I think Monica was going to do that? Are you

going to do the antibiotics next, Monica?

Monica: Yes, yes. So I’ve got that here for you.

Katie: Do you want me to do anything else? Want me to check the

pressure again?

Kelli: Yes, we’ll need to take the obs again.

Katie: Yeah.

Kelli: Katie, you could do that for me?

Katie: Yep.

Monica: Where’s the other nurse? Chanika? Can you check this with me

please?

Kelli: Oh, Monica, remember that IV’s not working on that side. So just

give me a moment and I’ll pop this one in.

[Talking over each other]

Monica: Oh, yes, that’s right. [to Chanika] Can you just check this with

me?

Chanika: Yes, that’s already been checked…

Everyone talking at once.

Monica: Ok, we’ll get the IV in and then we’ll do that.

Dolly: Very busy.

Kelli: Very busy! Always busy these days!

[end of scene]

Community Level Interventions

The windshield survey summary will require you to apply what you have learned through your basic windshield survey of Sentinel City® to a target population of your choosing. You will complete your project by comparing data from Sentinel City® with similar data from the city where your target population lives.

Your presentation will include 9 parts, which are described in detail below and include details in the speaker notes.

I. Introduction

Provide a brief introduction that identifies the demographics for the city where your target population lives.

II. Description of Your Target Population

Compose a detailed description of your chosen target population. In this section, you will describe the demographic characteristics of your chosen target population, including the population’s socioeconomic status, vital statistics, education level, religion, and occupations. Include a table, graph, and/or figure display that includes relevant demographic data for your target population.

III. Comparison of Sentinel City Demographic Data

Compare the demographic data of Sentinel City® with the demographic data from the city where your target population is located. You should present this information in a clear to understand table.

IV. Key Health Concerns or Issues

Present a list of the top 3 health concerns for your target population. Provide a brief description of these concerns and include data from your target population city that supports the rationale for selecting these health concerns. Select one of the 3 health concerns you identified and state why you decided to develop an intervention that addresses these particular health concerns/issues. Include the Healthy People 2020 objective that relates to your identified health concerns.

V. Community Health Nursing Diagnosis

Develop a community health nursing diagnosis based on your analysis of the demographic and health status data that you gathered.

Your community health nursing diagnosis should be written using the following format (Nies & McEwen, 2011, p. 101):

Increased risk of (disability, disease, etc.) among (community or population) related to (disability, disease, etc.) as demonstrated in or by (health status indicator, or etiological/causal statement).

Examples:

Increased risk of obesity among school age children related to lack of safe outdoor play areas for children as demonstrated by above average BMI rates.

Increased risk of depression among persons with a physical disability related to the lack of handicap accessible facilities and social isolation as demonstrated by high suicide rate

VI. A & B. Intervention to Address the Diagnosis

Describe your proposed intervention that will address the community health nursing diagnosis for your target population. You may choose to develop your own intervention or modify one that was recommended by the Task Force on Community Preventive Services (TFCPS).

To view recommended interventions, visit the TFCPS website and select the topic you plan on addressing for your intervention. (Note: at the bottom of most topic pages on the TFCPS website there is a sample on how to cite the webpage. After reviewing the topics, click the “Resources” tab then click “Fact Sheets”. Here you may find fact sheets to share with your mentor at your practice learning site.)

Whether you modify an existing intervention or develop one of your own, you must discuss why this intervention will or why you needed to modify it because it would not work for your target population. Include advantages, population fit, and barriers in use of the intervention. You should include the long-term goals, two measurable objectives, and the required resources such as: time, equipment, finances, etc. [Note: you are not required to carry out your intervention]

VII. Evaluation Plan

Describe your method for evaluating the objectives of your intervention (for example, pre/post-test, survey, questionnaire, phone interview).  Include one long term goal and two short-term measurable objectives.

Example of goals and measurable objectives:

Goal – To increase my potential for promotion at my place of employment

Objective – Complete all undergraduate nursing courses with a B+ or higher

Objective – Complete the American Sentinel University BSN program before 2020

Goal – To learn about public health nursing

Objective – Describe community health levels of prevention

Objective – List the 8 subsystems of a community

VIII. Summary of Sentinel City®

Summarize the assets (strengths) in Sentinel City® pertaining to the 8 community subsystems. In addition to the “people” (the core) of the community, there are eight subsystems that come together to form the assessment data for your windshield survey, which will contribute to your overall community assessment of Sentinel City®. The eight subsystems within every community include: 1) physical environment, 2) safety and transportation, 3) health and social services, 4) education, 5) recreation, 6) politics and government, 7) communication, and 8) economics.

Include your recommendations for improving/strengthening specific subsystems in Sentinel City®.  Discuss other recommended changes or additions needed to improve the health of the population living in Sentinel City®.

IX. Reference List

Include references that were used as you developed your plan.

For the purpose of this assessment cite the Sentinel City® demographic data as follows:

U. S. Census Bureau. (2010). American FactFinder fact sheet:  Sentinel City, USA Retrieved January 31, 2014, from https://factfinder.census.gov/servlet/

Reading and Resources

Harkness & DeMarco (2016) Read Chapter 9 (p. 154-161, 163-168)

Visit the Task Force on Community Preventive Services (TFCPS). The Community Guide.

Additional Instructions:

• All submissions should have a title page and reference page.
• Utilize a minimum of two scholarly resources.
• Adhere to grammar, spelling and punctuation criteria.
• Adhere to APA compliance guidelines.
• Adhere to the chosen Submission Option for Delivery of Activity guidelines.

Submission Options

Instructions:

Microsoft PowerPoint Presentation

• 14 to 20 slides. Add title and reference slides.
• Follow Rules of 7.

The Assignment:

Examine Case Study: A Caucasian Man With Hip Pain. 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?
Also include how ethical considerations might impact your treatment plan and communication with clients.

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.

Complex Regional Pain Disorder

White Male With Hip Pain

BACKGROUND

This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”

SUBJECTIVE

The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said, “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!”

The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”

He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it.”

During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation, and is future oriented.

Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)

Decision Point One:

Select what the PMHNP should do:

Savella 12.5 mg once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter

RESULTS OF DECISION POINT ONE:

Client returns to clinic in four weeks

Client comes into the office to without crutches but is limping a bit. The client states that the pain is “more manageable since I started taking that drug. I have been able to get around more on my own. The pain is bad in the morning though and gets better throughout the day”. On a pain scale of 1-10; the client states that his pain is currently a 4. When asked what pain level would be tolerable on a daily basis, the client states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.”. When questioned further, the PMHNP asks what makes the pain on a scale of 1-10 different when comparing a level of 9 to his current level of 4?”. The client states that since using this drug, I can get to a point on most days where I do not need the crutches. ” The client is also asked what would need to happen to get his pain from a current level of 4 to an acceptable level of 3. He states, “If I could get to the point everyday where I do not need the crutches for most of my day, I would be happy.”

Client states that he has noticed that he frequently (over the past 2 weeks) gets bouts of sweating for no apparent reason. He also states that his sleep has “not been so good as of lately.” He does complain of nausea today

Client’s blood pressure and pulse are recorded as 147/92 and 110 respectively. He also admits to experiencing butterflies in his chest. The client denies suicidal/homicidal ideation and is still future oriented

Decision Point One

Complex Regional Pain Disorder

White Male With Hip Pain

Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day

RESULTS OF DECISION POINT ONE

Client returns to clinic in four weeks

Client comes to the office still using crutches. He states that the pain has improved but he is a bit groggy in the morning

Client’s pain level is currently a 6 out of 10. The PMHNP questions the client on what would be an acceptable pain level. He states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.” He states that his pain level normally hovers around a 9 out of 10 on most days of the week before the amitriptyline was started. The PMHNP asks what makes the pain on a scale of 1-10 different when comparing a level of 9 to his current level of 6?” The client states, “I’m able to go to the bathroom or to the kitchen without using my crutches all the time. The achiness is less and my toes do not curl as often as they did before.” The client is also asked what would need to happen to get his pain from a current level of 6 to an acceptable level of 3. He states, “Well, that is kind of hard to answer. I guess I would like the achiness and throbbing in my right leg to not happen every day or at least not several times a day. I also could do without my toes curling in like they do. That really hurts.”

Client denies suicidal/homicidal ideation and is still future oriented

Decision Point Two:

Select what the PMHNP should do next:

Continue with current medication but lower dose to 25mg twice a day

RESULTS OF DECISION POINT TWO:

Client returns to clinic in four weeks

Client comes to office today with use of crutches. He states that his current pain is a 7 out of 10. “I do not feel as good as I did last month.”

Client states that he is sleeping at night but woken frequently from pain down his right leg and into his foot

Client’s blood pressure and heart rate recorded today are 124/85 and 87 respectively. He denies any heart palpitations today

Client denies suicidal/homicidal ideation but he is discouraged about the recent slip in his pain management and looks sad

Decision Point Three:

Select what the PMHNP should do next:

Change Savella to 25mg orally in the MORNING and 50 mg orally at BEDTIME

Guidance to Student

The client has a complex neuropathic pain syndrome that may never respond to pain medication. Once that is understood, the next task is to explain to the client that pain level expectations need to realistic in nature and understand that he will always have some level of pain on a daily basis. The key is to manage it in a manner that allows him to continue his activities of daily living with as little discomfort as possible. Next, it is important to explain that medications are never the final answer but a part of a complex regimen that includes physical therapy, possible chiropractic care, heat and massage therapy, and medications. Savella is a SNRI that also possesses NMDA antagonist activity which helps in producing analgesia at the site of nerve endings. It is specifically marketed for fibromyalgia and has a place in therapy for this gentleman. Tramadol is never a good option along with other opioid type analgesics. Agonists at the Mu receptors does not provide adequate pain control in these types of neuropathic pain syndromes and therefore is never a good idea. It also has addictive properties which can lead to secondary drug abuse. Reductions in Savella can help control side effects but at a cost of uncontrolled pain. It is always a good idea to start with dose reductions during parts of the day that pain is most under control. The addition of Celexa with Savella needs to be done cautiously. Both medications inhibit the reuptake of serotonin and can, therefore, lead to serotonin toxicity or serotonin syndrome.

White Male Wit https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/07/mm/complex_regional_pain_disorder/1.html#option1h Hip Pain

Benchmark – Effective Approaches in Leadership and Management

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

1. Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
2. Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
3. Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
4. Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
5. Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
6. Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

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. Refer to the LopesWrite Technical Support articles for assistance.

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1:       Exemplify professionalism in diverse health care settings.

1.3:       Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care.

3.4:       Demonstrate professional standards of practice.

RUBRIC

Attempt Start Date: 05-Aug-2019 at 12:00:00 AM

Due Date: 11-Aug-2019 at 11:59:59 PM

Maximum Points: 150.0

Benchmark – Effective Approaches for Leadership and Management

No of Criteria: 10 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory0.00 %Less Than Satisfactory75.00 %Satisfactory79.00 %Good89.00 %Excellent100.00 %Content80.0     Selected Issue, Setting, and Impact on Patient Safety15.0The issue described does not meet the assignment criteria. The description of the issue and its impact to quality of care and patient safety is omitted.A partial summary of the issue is presented. How it impacts quality of care and patient safety is unclear. There are omissions of key information.A general description of the issue is presented. A summary of how it impacts quality of care and patient safety is presented; more information is needed. There are some inaccuracies.A description of the issue is presented. How the issue impacts quality of care and patient safety is presented. Some detail is needed for clarity or accuracy.A clear description of the issue is presented. How the issue impacts quality of care and patient safety is detailed and accurate.Professional Standards of Practice to Rectify Issue or Maintain Professional Conduct (D3.4)15.0How professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is not discussed.A summary of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. The summary is incomplete. More information is needed. There are significant inaccuracies.A general discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. There are some gaps in the discussion; some information is needed. There are minor inaccuracies. Rationale is needed for support.A discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. Minor detail is needed for clarity or accuracy. Rationale provides adequate support.A through discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. An understanding of the importance of professional standards of practice in resolving issues and maintaining professional conduct is demonstrated. Strong rationale supports discussion.Differing Roles and Approaches of Nursing Leaders and Nursing Managers (C1.3)15.0Explanation of the differing roles and approaches for nursing leaders and nursing managers is omitted.A partial explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. It is unclear how the roles and approaches relate to the selected issue, or how they would promote patient safety and quality care. Rationale using theories, principles, skills, and nursing manger or nursing leader roles is not used.A general explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. A general summary of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Some rationale using theories, principles, skills, and nursing manger or nursing leader roles is used.An explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. An explanation of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Rationale using theories, principles, skills, and nursing manger or nursing leader roles is used. Some detail is needed for accuracy or clarity. More rationale is needed in some areas. The explanation demonstrates a general understanding of the of nursing leadership and management roles in the promotion of patient safety and quality care.A detailed explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. A well-developed explanation of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Rationale using theories, principles, skills, and nursing manger or nursing leader roles is used. The explanation demonstrates insight into exercising the roles of professional nursing leadership and management in the promotion of patient safety and quality care.Ensuring Professionalism Through Diverse Health Care Settings (C1.1)20.0Discussion on what additional aspects mangers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is omitted. The discussion fails to meet the assignment criteria.A partial summary on what additional aspects mangers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. The summary contains significant omissions. There are inaccuracies.A general discussion on what additional aspects mangers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. It is unclear how some of the aspects continue to address the selected issue, or the aspects do not appear to relate to a diverse health care setting.A discussion on what additional aspects mangers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. Overall, the aspects presented address the selected issue and relate to a diverse health care setting. The items proposed in the discussion generally support professionalism in diverse health care settings.A detailed discussion on what additional aspects mangers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. The aspects presented clearly continue to address the selected issue and relate to a diverse health care setting. The items proposed in the discussion support the exemplification of professionalism in diverse health care settings.Leadership Style to Address Issue15.0A leadership style to address the chosen issue is omitted. The proposed item is not a leadership style.A leadership style to address the chosen issue is partially summarized. The characteristics of the leadership style are vaguely presented. It is unclear why this style could be successful in this setting.The characteristics of the identified leadership style are described. A general explanation of why this style could be successful in this setting is presented. There are some gaps in the explanation. More information or rationale is needed.The characteristics of the identified leadership style are described. An explanation of why this style could be successful in this setting is presented. Some rationale is needed for support.The characteristics of the identified leadership style are clearly described. A detailed explanation of why this style could be successful in this setting is presented. Strong rationale is provided for support.Organization, Effectiveness, and Format20.0     Thesis Development and Purpose5.0Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction5.0Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use)5.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.Writer is clearly in command of standard, written, academic English.Paper Format (use of appropriate style for the major and assignment)2.0Template is not used appropriately, or documentation format is rarely followed correctly.Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.Appropriate template is used. Formatting is correct, although some minor errors may be present.Appropriate template is fully used. There are virtually no errors in formatting style.All format elements are correct.Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)3.0Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct.Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Percentage  100

Respond to your colleagues’ posts by sharing your thoughts on their specialty, supporting their choice or offering suggestions if they have yet to choose. 

At least 2 references in each peer responses!

Evidence-Based Practice is critical to make decisions about how to promote health or provide care (Laureate Education Producer, 2018). Since 2010 this has been the gold standard of nursing and healthcare. The purpose of using EBP is that it has been shown that it leads to the highest quality of care and the best patient outcomes (Melnyk & Overholt,2018, p. 12). Modern medicine has shifted to relying on data, analytics, and reproducible test that lead to collaborated results.

For my website, I have decided to review the American Psychiatric Nurses Association (APNA) website. This website provides an opportunity for utilizing research, continuing education, and access to publications. While browsing the website, you can find that the vision of the APNA is to use EBP in recovery-focused assessments, diagnosis, treatment, and evaluations of persons with mental illness and substance use disorders (APNA.org, 2020). According to the website, sixty percent of their members are advanced practicing nurses. This shows that EBP is a major part of their organization.

The APNA also distributes the Journal of the American Psychiatric Nurses Association (JAPNA). This journal promotes state of the art information and is backed by EBP (APNA.org, 2020).  On top of an online database, a journal, and an electronic newsletter, the APNA also holds conferences twice a year. These are both focused on expanding the role of the mental health nurse through EBP.

After reviewing the website and sifting through the information, I have not changed my mind of this organization. The APNA states and continues to prove that EBP is at the forefront of its mission. This is proven by a journal that focuses on EBP techniques, and conferences that spread new information that has been proven by EBP. The APNA is grounded in evidence-based practice. I look forward to getting to know this organization better as I progress with my education.