Tag Archive for: nursing

Intraprofessional collaboration

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

You must place them in one document, but you can break it up in weeks.

  1. New practice approaches
  2. Intraprofessional collaboration
  3. Health care delivery and clinical systems
  4. Ethical considerations in health care
  5. Population health concerns
  6. The role of technology in improving health care outcomes
  7. Health policy
  8. Leadership and economic models
  9. Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric.

You are required to submit this assignment to LopesWrite.

Rubric

  • New practice approaches are present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10%
  • Intraprofessional collaboration information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10%
  • Health care delivery and clinical systems information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10%
  • Ethical considerations in health care information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10%
  • Population health concerns information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10%
  • Information on the role of technology in improving health care outcomes is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10%
  • Health policy information content is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10%
  • Information on leadership and economic models is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10%
  • Information on health disparities is present, complete, and incorporates additional relevant details and critical thinking to engage the reader 10%
  • The work is well presented and includes all required elements. The overall appearance is neat and professional. 5%
  • Writer is clearly in command of standard, written, academic English. 5%

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antipsychotic therapy

I want this assignment asap -PLAGIARISM MUST BE LESS THAN 10%

sychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.

Learning Objectives

Students will:
  • Assess client factors and history to develop personalized plans of antipsychotic therapy for clients
  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy
  • Evaluate efficacy of treatment plans
  • Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan

 

To prepare for this Assignment:

  • Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

The Assignment

Examine Case Study: Pakistani Woman with Delusional Thought Processes. 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?
  • SAMPLE  ONLY

 

NURS 6630

WEEK SEVEN

Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady

Introduction

Briefly, this is a scenario of a 42 year- old woman with a complex psychiatric history extending from depression, posttraumatic stress disorder, insomnia, visual hallucinations (little man)and impaired behavior with aggression. In the course of more than 36 months, the client was treated with Paroxetine (SSRI), Bupropion ( NDRI), Tiagabine, Ramelteon and , but finally a combination of Lexapro, Bupropion and quetiapine was able to decrease her symptoms . The client’s medical history includes diabetes, hypertension, CAD, hyperlipidemia, COPD, OSA, GERD, Glaucoma, overweight and a remote history of substance abuse.

Related Professional Questions

Certain medications or supplements can cause symptoms of mental illness and also due to her extensive medical history and usage of multiple medications I would ask the following questions:

1. Do you take any over -the – counter, herbal supplements or remedies and I would check for interactions with current medication regimen?

2. When and how often do you use your albuterol inhaler ? Some of the side effects of albuterol include anxiety, nervousness, and insomnia ( Cunha, 2016)

Sleep Hygiene: Do you keep regular sleep schedule ? Do you drink caffeine beverages close to bedtime?

Patient History

The patient may not be a reliable source of information, particularly that she has a significant mental illness that affects her functioning, hence verifying her responses with her direct family members, and mental social workers to get clues to the underlying or precipitating causes of mental crisis. Also checking facility records from previous encounters, or any psychiatric hospitalizations would be useful.

Diagnostics Testing

1. Thyroid Stimulating Hormone (TSH). Based on recent evidence, the prevalence of depressive symptoms in hypothyroidism was nearly 50%, and clinical depression occurs in more than 40% of people suffering from hypothyroidism ( Bhagwat, 2017)

2. Electrocardiogram (ECG) The client has cardiovascular diseases ( HTN, CAD), with risks of cardio complications. In the setting of taking antidepressants and antipsychotics, baseline ECG and possibly every three to six months would be appropriate.  Several atypical antipsychotics including quetiapine (Seroquel) are known to cause prolongation of the QT interval, hypothesized to occur via direct inhibition of the cardiac delayed potassium rectifier channel, which extends the ventricular repolarization process (Zhai et al., 2017)

Differential Diagnoses

1. Posttraumatic Stress Disorder ( PTSD)_

2. Major Depressive Disorder  (MDD)

3. Insomnia Disorder.

Pharmacotherapy Options for Sleep/ Wake cycle

1. Zolpidem (Ambien) 5mg oral at bedtime for Seven days.

Zolpidem is nonbenzodiazepine hypnotic, it works by enhancing GABA inhibitory actions that provide sedative hypnotic effects more selectively than other actions of GABA (Stahl, 2017). With its side effects of sedation,  low dose prescribed as the client has respiratory problems (sleep apnea OSA)).  Studies have shown that Zolpidem did not significantly worsen OSA as measured by the numbers and duration of pauses in breathing during sleep, but in one trial, it significantly lowered minimum oxygen levels during the night when compared with placebo ( Mason & Smith, 2015).

2. Trazadone 25 mg oral at bedtime for Thirty days.

Trazadone is a serotonin 2 antagonist/reuptake inhibitor, used in management of depression and insomnia. It is absorbed well, metabolized by CYP 450 3A4 with average half life of 6hrs. It has less side sedative effects compared to zolpidem (Stahl, 2017)

The best choice for the client would be Trazadone as there is no reliable evidence of dependence or withdraws and it can also work for the client’s depression.

Conclusion

The case was a perfect example how it is sometimes difficult to find effective pharmacological treatments of psychiatric illnesses. In the course of four years, the client was prescribed 5-6 medications targeting different neurotransmitters to improve the symptoms. Client’s polypharmacy increased risks of drug-drug interactions, and her medical comorbidities increased risks of adverse reactions. Lesson learned from this study was  that treatment  should be optimally initiated after diagnosis, and augment or switching to a new agent must be carefully  done in consideration of possible  side effects and better outcomes.

References

Bhagwat, N., Tayde, P., Sharma, P., Sharma, B., Dalwadi, P., Sonawane, A., … Varthakavi, P. (2017). Hypothyroidism and depression: Are cytokines the link? Indian Journal of Endocrinology and Metabolism21(6), 886. Retrieved from https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=7&sid=aeb79c1d-68dc-40a4-bd10-f956796bc9e8%40sessionmgr101

Cunha, J. (2016). Common Side Effects of Ventolin HFA (Albuterol Sulfate Inhalation Aerosol) Drug Center – RxList. Retrieved from https://www.rxlist.com/ventolin-hfa-side-effects-drug-center.htm

Mason, M., & Smith, I. (2015). Effects of opioid, hypnotic and sedating medications on obstructive sleep apnoea (OSA) in adults with known OSA | Cochrane. Retrieved from http://www.cochrane.org/CD011090/AIRWAYS_effects-opioid-hypnotic-and-sedating-medications-obstructive-sleep-apnoea-osa-adults-known-osa

Zhai, D., Lang, Y., Dong, G., Liu, Y., Wang, X., Zhou, D., … Zhang, R. (2017). QTc interval lengthening in first-episode schizophrenia (FES) patients in the earliest stages of antipsychotic treatment. Schizophrenia Research179, 70-74. Retrieved from https://resolver-ebscohost-com.ezp.waldenulibrary.org/openurl?ID=pmid%3a27727006&genre=article&atitle=QTc+interval+lengthening+in+first-episode+schizophrenia+(FES)+patien

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adolescent pregnancy.

Adolescent pregnancy is viewed as a high-risk situation because it poses serious health risks for the mother and the baby. Describe various risk factors or precursors to adolescent pregnancy. Research community and state resources devoted in adolescent pregnancy and describe at least two of these resources. Research the teen pregnancy rates for the last 10 years for your state and community. Has this rate increased or decreased? Discuss possible reasons for an increase or decrease.

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Ethical Principles

Read “The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research” (1979):  http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html  Write a 1,250-1,500 word paper that addresses the significance of autonomy, patient advocacy, and informed consent. Your paper should include: 1.A description of the concepts of autonomy, patient advocacy, and informed consent. 2.A discussion of the Nuremberg Code and the Declaration of Helsinki and a summary of the events that led up to the development of ethical guidelines for conducting human clinical trials, including Institutional Review Boards (IRB). 3.Three examples of ways “The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research” works to protect special populations (e.g., minors, prisoners, persons with mental illness).  A minimum of three references are required.

Original work only!  Free of many grammatical errors and on time.

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New technology

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

  • Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
  • Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

  • Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

Resources:

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 14, “The Electronic Health Record and Clinical Informatics” (pp. 267–287)
  • Chapter 15, “Informatics Tools to Promote Patient Safety and Quality Outcomes” (pp. 293–317)
  • Chapter 16, “Patient Engagement and Connected Health” (pp. 323–338)
  • Chapter 17, “Using Informatics to Promote Community/Population Health” (pp. 341–355)
  • Chapter 18, “Telenursing and Remote Access Telehealth” (pp. 359–388)

Rao-Gupta, S., Kruger, D. Leak, L. D., Tieman, L. A., & Manworren, R. C. B. (2018). Leveraging interactive patient care technology to Improve pain management engagement. Pain Management Nursing, 19(3), 212–221. doi:10.1016/j.pmn.2017.11.002

Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. doi:10.3390/informatics4030032

https://www.healthit.gov/faq/what-electronic-health-record-ehr

https://www.himss.org/library/ehr/

https://class.waldenu.edu/bbcswebdav/institution/USW1/201970_27/MS_NURS/NURS_5051_WC/artifacts/USW1_NURS_5051_Dykes.pdfhttps://class.waldenu.edu/bbcswebdav/institution/USW1/201970_27/MS_NURS/NURS_5051_WC/artifacts/USW1_NURS_5051_Dykes.pdf

Rurbic:

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

·   Properly identify 5 peer-reviewed articles selected.
·   Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.–

Levels of Achievement:  Excellent 77 (77%) – 85 (85%)    Good 68 (68%) – 76 (76%)    Fair 60 (60%) – 67 (67%)    Poor 0 (0%) – 59 (59%)

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

Levels of Achievement:  Excellent 5 (5%) – 5 (5%)    Good 4 (4%) – 4 (4%)    Fair 3.5 (3.5%) – 3.5 (3.5%)    Poor 0 (0%) – 3 (3%)

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therapy model

For this assignment, you will be developing a family therapy plan for a family dealing with a substance use disorder.

Part 1: Write a 300-700-word counseling scenario for a family dealing with a substance use disorder. Please note the scenario should be hypothetical and lend itself to one of the brief substance use disorder therapy models discussed in CSAT TIP #34. Include information about his/her life circumstances and add family members with descriptive information about each family member and about the family’s interactions to the scenario.

Part 2: Write a 750-1,250-word paper to provide brief therapy to the hypothetical client and his/her family using one of the brief therapy models described in CSAT TIP #34.

Your plan should include the following:

  1. The therapy model you will implement with the family and rationale for the selected model.
  2. Two to four initial counseling goals that you hope to achieve using this model.
  3. Planned frequency and duration of counseling.
  4. A description of three counseling activities, exercises, or homework assignments that you will use (one in the initial session, one in a subsequent session, and one at termination) that are consistent with the model you have selected.

While APA style is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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 Turnitin. Please refer to the directions in the Student Success Center.

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Developing a Strategic Plan

Course Project: Developing a Strategic Plan

 

Section 5: Proposed Core Team of Change Champions

 

In Week 4, you examined the benefits of stakeholder involvement and the negative consequences that may arise if this is not sufficiently addressed during strategic planning. This week you have been considering how to leverage the influence of change champions and facilitate team building to promote the successful implementation of a proposed change.

How would you create a core team of change champions for the change you are proposing through your Course Project?

 

To prepare:

 

Reflect on the results of your SWOT analysis (submitted in Week 7) and other elements of your strategic plan.

Think about how effective stakeholder involvement would promote the successful adoption and implementation of your proposed change.

 

Consider the following:

 

What strategies would help you to develop a core team to generate buy-in for this change?

Which stakeholders should be included in the process as change champions? How and when should they become involved?

Begin to write a 1- to 2-page description of your core team of change champions.

 

Section 6: Evaluation Plan

 

Creating an evaluation plan is a critical part of developing a strategic plan. How would evaluation allow you to determine the cost benefits and effectiveness of your proposed change?

 

To prepare:

 

Reflect on the elements of your Course Project that you have developed thus far. Review the information on evaluation presented in the Learning Resources, and reflect on any insights you have gained from this week’s Discussion. (Week 11 Discussion)

How would you evaluate the implementation of your strategic plan? Develop an evaluation plan that includes a timeline for evaluation. Be sure to incorporate refreezing.

 

To complete:

 

Write a 1- to 3-page explanation of your evaluation plan. Include the timeline for evaluation, and explain how you will incorporate refreezing.

Note: This will be submitted as part of your Course Project this week.

 

Section 7: Executive Summary

 

As your development of a strategic plan comes to a conclusion, it is time to develop foundational pieces for your Course Project, including an executive summary.

An executive summary provides an overview of your proposed change and allows your target audience to become acquainted with the essential elements of the strategic plan. Your executive summary should be informative and persuasive, delineating the business case for your proposed change.

 

To prepare:

 

Review the information in the Learning Resources related to developing an executive summary.

Craft an executive summary that appeals to your target audience and presents key information related to your strategic plan. Be sure to describe the unmet need you are addressing and convey the urgency or significance of this problem. Clearly state your proposed change and substantiate your recommendation.

 

To complete:

 

Write an executive summary for your strategic plan.

Note: This will be submitted as part of your Course Project this week.

 

Section 8: References

 

The inclusion of a reference list not only allows you to credit others’ work appropriately but also provides the information readers would need to read resources of interest to them and learn more about the underpinnings of your strategic plan.

 

To prepare:

 

Develop and/or refine the list of the resources cited in your strategic plan.

 

To complete:

 

Create your reference list to accompany your strategic plan.

 

 

Comprehensive Course Project: Developing a Strategic Plan

 

Over the past several weeks of this course, you have been developing elements of a strategic plan. As you prepare to submit your Course Project, reflect on what you have learned throughout this process. Also think about how you would like to convey the results of your analysis and planning to your target audience.

 

Your Course Project must include information related to each section of the Course Project assigned in Weeks 6–11; however, you have some flexibility in terms of how you present it. You may wish to compare strategic plans from various groups and organizations and then develop a format that best suits your plan.

Note: Your comprehensive Course Project serves as your Portfolio Assignment for this course.

 

To complete:

 

Create a strategic plan that includes essential information related to the following:

Section 1: Summary of the Issue

Section 2: SWOT Analysis

Section 3: Balanced Scorecard

Section 4: Budgeting and Timeline Tools

Section 5: Proposed Core Team of Change Champions

Section 6: Evaluation Plan

Section 7: Executive Summary

Section 8: References

 

SECTION 1 – 2 – 3 – 4 are attached.

 

PLEASE COMPLETE OTHER SECTIONS and need one comprehensive project submitted including each section.

 

THis paper is worth 500 points and depending on this paper is my pass or fail.

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hospital or public health agency

Play this week’s games to familiarize yourself with the prefixes, suffixes, and word roots related to this week’s topic.Imagine you are an official in a hospital or public health agency.Write a memo, at least 350 words in length, to a fictional colleague in which you use 5 words from the Summary Tables in this week’s chapters.Be sure to use the words in such a way that it is clear to the reader that you know the exact meaning of each of the 5 words.

Use  this word:

 

pneumonic

bronchiole

 

•respiratory

•normoventilation

 

•inspiration

•normoxia

 

•ventilation

•hyperventilation

 

•hemoptysis

•hypoxia

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ventilator-associated pneumonias

  • Imagine you are the CEO of a 200-bed community hospital and have heard that Medicare hospital payments will continue to be trimmed for patients who experience harms considered to be largely preventable, such as blood clots, surgical infections, ventilator-associated pneumonias, and others. You want to make sure that your hospital prevents all possible avoidable harms to patients.

    Your assistant summarizes the issues for you: denied payments focus exclusively on additional care required to treat the injury (e.g., when a second procedure is required to retrieve a surgical instrument). To date, the denied payments are for hospital care only, but some analysts have recommended that the same policy be applied to physician payments.

    One measure your hospital has already taken is to require that all workers who interact with patients wash their hands, to prevent hospital-acquired infections. Although this would seem a simple and obvious initiative, it has met with limited success. In response to additional queries, you learn that the hospital’s patient safety department does not track the kinds of events for which it may be financially penalized.

    You also learn that the ACA will affect hospital payment in another way: trimming reimbursements for potentially avoidable hospital readmissions. Your hospital serves an older population, and many patients currently have multiple admissions for acute exacerbations of chronic illnesses, such as congestive heart failure and diabetes. In the future, these multiple admissions may be very costly.

    Your hospital’s margin last year was razor thin; the combination of the economic downturn and any decreased reimbursements could result in closure.

    • Refer to your text readings and resources to answer the following questions in a 1- to 2-page paper:
      • Who on your senior team should lead this effort?
      • Who else should be involved?
      • What precisely are you charging the team to do?
      • Who will help communicate this effort to all frontline staff?
      • What kinds of systems need to be created to track progress?
      • What external resources could be utilized?
    • Cite evidence to support your conclusions.
    • Click the Submit Assignment link in the upper right corner to upload your assignment.

Rubric

Case Study Rubric (2)Case Study Rubric (2)CriteriaRatingsPtsThis criterion is linked to a Learning OutcomePaper fully addresses the following questions: Who on your senior team should lead this effort? Who else should be involved? What precisely are you charging the team to do? Who will help communicate this effort to all frontline staff? What kinds of systems need to be created to track progress? What external resources could be utilized?6.0 pts
This criterion is linked to a Learning OutcomePaper is 1 to 2 pages, is formatted based on APA guidelines, and includes in-text citations and a reference page.2.0 pts
This criterion is linked to a Learning OutcomePaper meets basic writing standards including grammar, usage, spelling, punctuation, and organization.2.0 pts
Total Points: 10.0

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qualitative research studies.

Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide rationale, include examples, and reference content from the studies in your responses.

Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

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.

AttachmentsNRS-433V-RS2-ResearchCritiqueGuidelinesPart I.docx

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