Nursin informatics nurse practioner

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Please no more than 10 % plagerize

lactmed is the website that is my birth month that has to be used

Due Date

This assignment is due no later than the Sunday of Week 6 by 11:59 PM MT.

Total Points Possible: 200 Points

Preparation and Paper Outline:

PART 1: The medical application selection for this assignment is contingent upon the month of your birthday. Use the table below to identify the Medical App for this assignment.

Your Birth Month

Medical App for Assignment

 

LactMed

 

PART 2: Answer the Medical App Critical Appraisal questions thoughtfully and comprehensively. Use the criteria headings on this outline as the headings on your properly APA- formatted paper.

NAME: What is the name of the app?

AUTHOR: Who created, developed, or maintains the app? Explain.

ENDORSEMENT: Is the app licensed by the Food and Drug Administration, other government agency, or endorsed by an academic institution or medical professional organization? Explain.

OPERATION: Which platform (mobile or web-based) is suitable for the app and why?

AESTHETICS: Is the information displayed in a way that is easy to navigate? Is it easy to use? Can you use it without instructions? Explain.

PURPOSE: What is the intended purpose or use of the app?

CLINICAL DECISION MAKING: What influence does the app have on clinical decision making? Explain.

SAFETY: Is there potential for patient harm? Explain.

PRIVACY/SECURITY: Does the app have privacy statement or setting? Is there a clear privacy policy stating information will be encrypted and not shared with third parties? Does the app share information on social networks? Are users notified in the event of a breach of privacy and health information? Explain.

USER: For whom is the app intended (providers, patients, or others)? Explain.

DISTRIBUTION: Is it designed for local use or wider distribution? Explain.

CREDIBILITY: How credible are the sources of information? How do you know? Explain.

RELEVANCE: How current is the information in the app? When was the last update? Is the content consistent with evidence-based literature or best practices/standards of care? Explain.

PART 3: Provide one example of an appropriate patient or clinical scenario for this app. The example should include the following details:

Patient Age-population (Pediatric, Adult, Geriatric)

Clinical Setting (Hospital, Private Practice, Extended Living Facility)

History of Present Illness and Diagnosis or Condition

Provide a detailed description of the app in your example. When will the app be implemented (at the Point-of-care or elsewhere)? Who will use the app? What potential impact will it have on the scenario? Incorporate the critical appraisal information from Part 2. Provide one evidence-based scholarly article as a reference to support clinical decision making.

This assignment will be graded on the quality of the information, inclusion of one evidence-based scholarly resource, use of citations, use of Standard English grammar, and organization based on the required components (see the paper headings and content details in Part 1).

The length of the paper is to be between 1,000 and 1,500 words, excluding title page and reference list.

Create this assignment using Microsoft (MS) Word. You can tell that the document is saved as a MS Word document because it will end in “.docx.”

APA format (6th edition) is required in this assignment, explicitly for in-text citations and the reference list. Use 12-point Times New Roman font with 1-inch margins and double spacing. See the APA manual for details regarding proper citation. See resources under Course Resources, “Guidelines for Writing Professional Papers” for further clarification.

* Scholarly Sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.

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Summary and Descriptive Statistics

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There is often the requirement to evaluate descriptive statistics for data within the organization or for health care information. Every year the National Cancer Institute collects and publishes data based on patient demographics. Understanding differences between the groups based upon the collected data often informs health care professionals towards research, treatment options, or patient education.

Using the data on the “National Cancer Institute Data” Excel spreadsheet, calculate the descriptive statistics indicated below for each of the Race/Ethnicity groups. Refer to your textbook and the Topic Materials, as needed, for assistance in with creating Excel formulas.

Provide the following descriptive statistics:

  1. Measures of Central Tendency: Mean, Median, and Mode
  2. Measures of Variation: Variance, Standard Deviation, and Range (a formula is not needed for Range).
  3. Once the data is calculated, provide a 150-250 word analysis of the descriptive statistics on the spreadsheet. This should include differences and health outcomes between groups.

APA style is not required, but solid academic writing is expected.

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

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NR533 week7 -B

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Requirements

  1. Address all components of the business plan as outlined in Preparing the Paper.
  2. Refer to the Business Plan Worksheet, available for download above.
  3. This paper will be graded on quality and completeness of information, accuracy of any required calculations, use of citations, use of standard English grammar, sentence structure, and organization based on the required components.
  4. Create this assignment using Microsoft Word, which is the required format for all Chamberlain documents. You can tell that the document is saved as an MS Word document because it will end in .docx.
  5. Turn It In is used for this assignment and is part of the submission into the assignment portal. See the Turn It In guidelines provided in the Program Resources via the Resources tab on the left.
  6. Submit the final paper to the assignment area by Sunday 11:59 p.m. MT. Any questions about this paper may be discussed in the weekly Q & A Forum under Discussions. Any submission after the deadline will be assessed a penalty per policy.
  7. The length of the paper is to be no greater than seven pages including the appendices, but excludes title page and reference page. Extra pages will not be read nor graded by the instructor. Content beyond the page limit will not be considered part of the paper. Your business plan worksheet should be included after the reference page.
  8. APA format (6th edition) is required in this assignment, including a title page and a reference page. Use headings for the sections of the paper according to APA format. Remember that the introduction does require a heading. See the APA manual for details of formatting. You may also refer to Guidelines for Writing Professional Papers found in Program Resources via the Resources tab on the left.
  9. A complete paper will contain all components outlined under Preparing the Paper.

Preparing the paper

A business plan is a detailed plan for a proposed program, project, or service.

The following sections should be clearly present with headings and complete. Use the headings provided in the outline below.  Remember, there is no heading used for the introduction section.

  1. Introduction/Overview
    1. Purpose of assignment
    2. PICOT
    3. Purpose of business plan
    4. What will be included
  2. Proposal
    1. Cover letter
    2. Executive Summary
  3. Detailed Abstract
    1. Two types analyses
    2. Marketing and financial plans
  4. Appendices
    1. Financial tables
    2. Graphs/charts
  5. Conclusion
    1. What was covered in the plan
    2. Strengths and weaknesses of the plan
    3. Approach for approval
  6. Clearly introduce your business-plan assignment in the Overview section. This should be no longer that one paragraph. Include purpose of your assignment, PICOT as basis for and purpose business plan, and what will be covered in the assignment.
  7. Include a clearly articulated cover letter written in business letter format, active voice, and exactly as it would be read by leadership. Include overview of issue, proposed solution, and action request.  There should be no other content on this page except for the business letter.
  8. Present a captivating executive summary that is interesting and captures the interest of leadership and draws them in to read further. Content includes (1) a description of the proposed project, program, or service, (2) why it is being proposed, and (3) what outcomes are most likely to occur as a result.
  9. Detailed Abstract expands the three areas of the executive summary.
    1. Expand description of project purpose
    2. Issue/problem defined; supportive evidence for project
    3. Expected outcomes and project timeline
    4. Marketing/needs analyses and plans at least two strategies
    5. Fit with mission of organization
    6. Fit with current services
    7. Financial plan including budgetary needs
    8. Financial impact on stakeholders (organization, patients, unit of service, community)
    9. Break-even analysis and cost/benefit analysis results with reference to actual budget and analysis in appendices
  10. Appendices should include any financial tables, charts, or graphs, or other supporting documents referred to in the detailed abstract.  The business plan worksheet should be included in the appendices.
  11. Conclusion for the paper includes an overview of what was covered in the paper, strengths and weaknesses of the plan, and plan for seeking proposal approval.
  12. The paper length will be seven pages maximum including the appendices and excluding title and reference page(s).Note: If you go over the paper length, the additional information will not be read nor considered for part of you grade by the instructor.
  13. Title and reference page(s) must be in APA format (6th edition).
  14. Use 12-point Times New Roman font and one-inch margins on all sides of the paper.
  15. Note: After submitting your assignment to Files, please upload your completed executive summary into the Week 8 designated Discussion to share with your peers.

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Critical Appraisal of Jean Watson’s Theory of Human Caring 1

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Jean Watson’s Theory of Human Caring is a conceptual thread in the USU College of Nursing’s curriculum framework. The purpose of this assignment is to offer students the opportunity to be exposed to Human Caring Science while providing students with the skills of critical appraisal of evidence.

  1. Students will select one nursing research article that focuses on a study that used Jean Watson’s Theory of Human Caring as a theoretical framework.
  2. Students should use as a guide, an appropriate Rapid Critical Appraisal Checklist found in Melnyk & Fineout-Overholt (2019; pp. 708-722).
  3. The critiques are to be informal, although correct grammar, spelling, etc., are expected. The critique should include a brief description of the study that was reviewed and should address elements of the study relevant to critique.
  4. Students will provide a written critique on a critical appraisal of the elements relevant to the nature of the research study such as type of study, design, quality of the study; and rationale, as well as implications for practice and further research and/or evaluation.

The grade will be based on accuracy, level of content and structure of the document.

please use these Examples of research articles incorporating Jean Watson’s theory  in USU online library:

Durgun Ozan, Y., & Okumus, H. (2017). Effects of nursing care based on

Watson’s theory of human caring on anxiety, distress, and coping when

infertility treatment fails: A randomized controlled trial. Journal of Caring

Sciences, 6(2), 95-109.

Rossillao, K. (2018).  Caritas education: Theory to practice…2018

National Teaching Institute research abstracts presented at the AACN

National Teaching Institute, Boston, Massachusetts, May 21-24, 2018.

American Journal of Critical Care, 27(3), e 14 – e15.

Expectations

  • Length: 4-5 pages (including title and reference pages)
  • Format: Formal paper in APA 6th ed format
  • Citations: If used (not required) cite references according to APA 6th ed.

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Spss descriptive statistics

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Week 4 Descriptive Statistics

Review all documents in the Week 4 tab. The SPSS output is provided so you can check your answers. Turn in this document with the title: WkAssn_LastnameFirstInitial_DATE. Do not submit as a paper, no APA ciattions or refernce list is required. Do not submitt SPSS output (tables) as answers to the questions.

Part I

Using the Polit2SetA data set, run descriptive statistics on the following variables: respondent’s age (age) and highest school grade completed (higrade). Create a frequency distribution for the variables: race and ethnicity (racethn) and currently employed (worknow). Create a table, example given, (in APA format) summarizing the results, using the below table shell as a model. The numbers in the table below are “dummy varaibles” and should be replaced with the numbers from the SPSS ouput. Write a paragraph summarizing the information in the table.

Table 1. Demographic Data (N = 30)

n % M (SD)

Age (in years) 30 15(2.4)

Highest School Grade Completed 29 11(1.2)

Race and Ethnicity

Black, Not Hispanic 14 (46.67)

Hispanic 8 (26.67)

White, Not Hispanic 6 (20.0)

Other 2 (6.66)

Currently Employed

Yes 27 (90)

No 3 (10)

Note. Differences in sample size are due to missing data.

Follow these steps when using SPSS:

1. Open Polit2SetA data set.

2. Click on Analyze, then click on Descriptives Statistics, then Descriptives.

3. Click on the first continuous variable you wish to obtain descriptives for (respondent’s age), and then click on the arrow button and move it into the Variables box. Then click on highest school grade completed and then click on the arrow button and move it into the Variables box.

4. Click on the Options button in the upper-right corner. Click on mean, standard deviation, minimum, maximum, and skewness.

5. Click on Continue and then click on OK.

To run the frequency distribution in SPSS, do the following:

1. Click on Analyze, then click on Descriptive Statistics, then Frequencies.

2. Click on the first categorical variable you wish to obtain a frequency for (race and ethnicity), and then click on the arrow button and move it into the Variables box. Then click on currently employed, and then click on the arrow button and move it into the Variables box. Click on the Statistics button in the upper-right corner, then in the Dispersion box click on Minimum and Maximum.

3. Click on Continue and then click on OK.

4. Check your work with the SPSS Week 4 Descriptive Statistics SPSS Output document.

Assignment: Create a table (in APA format) summarizing the results, using the below table shell as a model. Write a paragraph summarizing the information in the table.

 

Part II

For the variables respondent’s age (age) and highest school grade completed (higrade) create a histogram with a normal curve displayed over the histogram. Do not submit the SPSS output (tables) as the answer.

To create a histogram for respondent’s age in SPSS, do the following:

1. Click on Graphs, then on Legacy Dialogs, then Histogram.

2. Click on the variable respondent’s age and then click on the arrow button and move it into the Variables box. Click on the Display Normal Curve button, which is right below the Variables box.

3. Click on OK.

To create a histogram for highest school grade completed in SPSS, do the following:

1. Click on Graphs, then on Legacy Dialogs, then Histogram.

2. Click on respondent’s age in the Variable box and click the arrow to move it back to the box on the left that contains all the variables.

3. Click on the variable highest school grade completed and then click the arrow button and move it into the Variables box. The Display Normal Curve button should alredy be on.

4. Click on OK.

5. Check your work with the SPSS Week 4 Descriptive Statistics SPSS Output document.

 

Assignment: Using the data obtained when you ran the descriptives and the histograms, determine whether the data skewed. If so, is it a positive, negative or neutral skew?

1. ______________________ skew

2. ______________________ skew

 

Part III

Using the Polit2SetA data set, run descriptive statistics on the variable “Family Income Prior Month, all sources” (Income).

Follow these steps when using SPSS:

1. Click on Analyze, then click on Descriptives Statistics, then Descriptives.

2. Click on Family Income Prior Month, all sources, and then click on the arrow button and move it into the Variables box.

3. Click on the Options button in the upper-right corner. Click on mean, standard deviation, minimum, maximum, S.E. Mean (standard error of the mean), and skewness.

4. Click on Continue and then click on OK.

5. Check your work with the SPSS Week 4 Descriptive Statistics SPSS Output document.

Assignment: Using the descriptive statistics for Family Income Prior Month, all sources (Income), answer the following questions:

1. What is the mean income in this sample?

2. What is the standard deviation (SD)?

3. What is the standard error of the mean?

4. Compute a 95% confidence interval around the mean. (Use 1.96 for the 95% CI and get the standard error from the descriptive statistics table). You should get a range (2 numbers) for the salary. The formula is as follows:

95% CI = [mean ± (1.96 SE)]

5. Compute a 99% confidence interval around the mean. (Use 2.58 for the 99% CI and get the standard error from the descriptive statistics table). You should get a range (2 numbers) for the salary. The formula is as follows:

99% CI = [mean ± (2.58 SE)]

6. Which interval is wider? Explain.

Review the corresponding Week 4 Descriptive Statistics Exercises SPSS Output document that has the SPSS output for the above problems. Compare your output with the output in the file.

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Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

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Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

· Identify and briefly describe your chosen clinical issue of interest.

· Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

· Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

· Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.

· Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

To Prepare:

· Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

· Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.

· Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.

· Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

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Analyze and Apply Dashboard Data

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Create a presentation (maximum of 20 slides with detailed speaker notes) for senior leadership in which four organizational leaders analyze the impact of a health care organization’s new safety and quality dashboard. Include an analysis of what the new metrics mean and how they will inform departmental activities for the next quarter.

“Being in a position of leadership is the most important job of any health professional anywhere along the continuum of care” (Ledlow & Coppola, 2013, p. 3). Leaders and ultimately the boards of directors of health care organizations are accountable for the safety of those they serve.” National quality organizations and regulatory bodies … are growing in their emphasis on leadership accountabilities for safe, reliable care as well as excellence in the experience of care” (Youngberg, 2013, p. 39).

With this emphasis on leadership accountability for the delivery of safe, high-quality health care services, health care leaders need to be able to drill down on what exactly safety and quality mean in the health care environment. Likewise, they also need to be able to design measures that help to ensure their organizations are able to deliver those kinds of outcomes. Read Measurement Perspectives attached to question [PDF]to examine key elements related to this issue.

In this final course assessment, you will have a unique opportunity to examine a health care organization’s safety and quality dashboard from the perspective of four organizational leaders. You will explore each leader’s specific interests regarding patient safety and quality. In particular, you will have the opportunity to perform a more in-depth analysis of the dashboard, the type of analysis a quality director might perform to further the organization’s safety and quality objectives.

References

Ledlow, G. R., & Coppola, M. N. (2013). Leadership for health professionals (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Youngberg, B. J. (2013). Patient safety handbook (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 1: Analyze the quality and performance improvement activities within the health care organization.
    • Recommend evidence-based actions to improve a selected measure on a health care organization’s safety and quality dashboard.
  • Competency 2: Explain the risk management function in the health care organization.
    • Analyze areas of a safety and quality dashboard of concern to a risk manager.
  • Competency 3: Analyze the importance of patient safety in health care.
    • Describe how a health care organization chooses the metrics to include in its safety and quality dashboard.
    • Analyze areas of a safety and quality dashboard of concern to a patient safety officer.
  • Competency 4: Apply leadership strategies to quality improvement in a health care organization.
    • Assess senior leadership’s role in setting a health care organization’s strategic safety and quality objectives.
  • Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
    • Create a clear, organized, persuasive, and generally error-free presentation on a leadership team’s assessment of an organization’s safety and quality dashboard that is reflective of professional communication in the health care field.
    • Provide citations and title and reference pages that conform to APA style and format.

Preparation

To help prepare for successfully completing this assessment:

  • Download the Sample Presentation Guide [PPTX]. Use this as a starting point or guide as you develop your presentation.

Instructions

Your organization has just updated its safety and quality dashboard. Please review the Vila Health Mercy Hospital Safety and Quality Dashboard Attached to this question [PDF]. Note: You do not need to create a dashboard for this assessment. You are simply being asked to work with the one provided.

The CEO has asked each of the organizational leaders below to prepare a joint PowerPoint presentation. In it, they are to prepare a set of slides outlining their analysis of how the new numbers will inform their particular activities for the next quarter. The organizational leaders include:

  • The quality director.
  • The patient safety officer.
  • The risk manager.
  • Senior leadership.

Because of the quality director’s critical role in implementing the organization’s safety and quality strategic objectives, this individual will open the presentation and provide additional background about how the new dashboard was developed. This individual will also close the presentation. Use the following outline to organize your presentation. Be sure to include the introduction and conclusion and address all the questions listed under these headings. Also be sure to address each role and the corresponding questions.

Introduction (3–4 slides)
  • What is a safety and quality dashboard?
  • What role do safety and quality dashboards play in helping health care organizations drive their strategic safety and quality objectives?
  • How do health care organization determine what they want to measure? Be sure to consider:
    • Pressures from regulators, payors, and the industry.
    • Self-identified improvement areas. For example, one organization’s safety and quality dashboard may highlight patient falls because its rate of falls is higher than the national average. This may also have resulted in increased costs to the organization.
  • What CQI tools did the organization use to obtain, measure, and report data?
  • What was the quality improvement team’s role in addressing the reported measures?
Quality Director (2–3 slides)
  • Which metric on the dashboard would draw the quality director’s attention the most?
  • What does this dashboard metric mean and why is it important?
  • What three recommendations to leadership would help to address this metric?
  • What (if any) quality models could be used to increase the quality of patient care and outcomes for this metric? Consider PDCA, Six Sigma, Lean, Hoshin Kanri planning, et cetera.
Patient Safety Officer (2–3 slides)
  • Which metric on the dashboard would draw the patient safety officer’s attention the most?
  • What does this dashboard metric mean and why is it important?
  • What role does the patient safety officer play in improving this metric?
Risk Manager (2–3 slides)
  • Which metric on the dashboard would draw the risk manager’s attention the most?
  • What does this dashboard metric mean and why is it important?
  • What role does the risk manager play in improving this metric?
Senior Leader (1 slide)
  • What is the role of senior leadership (for example, CEO, COO, president, senior VP) in driving safety and quality improvement initiatives?
  • What next steps might senior leadership take given the dashboard findings and the quality director’s three improvement recommendations?
Conclusion (2–3 slides)
  • Which regulatory agency(ies) may be concerned about the findings in this dashboard?
  • Why would regulators be concerned about these findings?
  • Why are safety and quality dashboards important for monitoring key metrics in health care organizations?

Your slides need to be concise and offer main ideas in bulleted format. Use the speaker notes to expand upon your findings as if they were the transcript of your presentation for the leadership team.

In the health care environment, it is unlikely for a presentation and speaker notes to be in APA style. Do make sure they are concise, organized, clear, and free of errors in grammar, punctuation, and spelling. Do make sure they address all the required headings and all of the questions under each heading.

Your senior leaders will want to know the sources of your information. Be sure to cite your sources in APA style in your speaker notes.

Additional Requirements

  • Presentation length: Your presentation should be a maximum of 20 slides, including title and reference slides. Format your title and reference slides according to APA format.
  • Speaker notes: Be sure to include these with your slides. They provide an opportunity for you to expand on the information you are highlighting in your slides.
  • Number of references: Cite a minimum of two references.
  • Scoring Guide: Please read the scoring guide for this assessment so you understand how your faculty member is going to evaluate your work.

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week 7 assign 6630

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Assignment: Assessing and Treating Patients With Psychosis and Schizophrenia

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

To prepare for this Assignment:
  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with schizophrenia-related psychoses.
The Assignment: 5 pages

Examine Case Study: Pakistani Woman With Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Freudenreich, O., Goff, D. C., & Henderson, D. C. (2016). Antipsychotic drugs. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 72–85). Elsevier.

American Psychiatric Association. (2019). Practice guideline for the treatment of patients with schizophrenia. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Clinical%20Practice%20Guidelines/APA-Draft-Schizophrenia-Treatment-Guideline.pdf

Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

Funk, M. C., Beach, S. R., Bostwick, J. R., Celano, C. M., Hasnain, M., Pandurangi, A., Khandai, A., Taylor, A., Levenson, J. L., Riba, M., & Kovacs, R. J. (2018). Resource document on QTc prolongation and psychotropic medications. American Psychiatric Association. https://www.psychiatry.org/File%20Library/Psychiatrists/Directories/Library-and-Archive/resource_documents/Resource-Document-2018-QTc-Prolongation-and-Psychotropic-Med.pdf

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. https://doi.org/10.1093/schbul/13.2.261

Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. Chest, 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/

McClellan, J. & Stock. S. (2013). Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry, 52(9), 976–990. https://www.jaacap.org/article/S0890-8567(09)62600-9/pdf

Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649–659. https://doi.org/10.2165/00023210-200923080-00002

Delusional Disorders
Pakistani Female With Delusional Thought Processes

BACKGROUND

The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her when she was 9 years old). She presents following a 21-day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month.

Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control,” which resulted in his calling the police and her subsequent admission to an inpatient psych unit.

During today’s assessment, she appears quite calm and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She says she knows this because the television is telling her so.

She currently weighs 140 lbs., and she is 5’ 5.

SUBJECTIVE

Client reports that her mood is “good.” She denies auditory/visual hallucinations but believes that the television talks to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards you but then calms down.

A review of her hospital records shows that she received a medical workup from physician, who reported her to be in overall good health. Lab studies were all within normal limits.

Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman.

MENTAL STATUS EXAM

The client is alert and oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and, at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect is constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.

You administer the PANSS which reveals the following scores:

-40 for the positive symptoms scale

-20 for the negative symptom scale

-60 for general psychopathology scale

Diagnosis: Schizophrenia, paranoid type

RESOURCES

PANSS Scale. Available at: http://egret.psychol.cam.ac.uk/medicine/scales/PANSS

§ Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. doi:10.1093/schbul/13.2.261

https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

§ Clozapine REMS Program. (n.d.). Clozapine REMS: A guide for healthcare providers. Retrieved September 7, 2016, from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

http://www.ima.org.il/FilesUpload/IMAJ/0/40/20149.pdf

§ Paz, Z., Nalls, M., and Ziv, E. (2011). The genetics of benign neutropenia. Israel Medical Association Journal, 13(10), 625–629. Retrieved from http://www.ima.org.il/FilesUpload/IMAJ/0/40/20149.pdf

Decision Point One

Start Zyprexa (olanzapine) 10 mg orally at BEDTIME

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Her PANSS decreases to a partial response (decrease in positive symptoms by 25%)
  • She comes in today with a reported weight gain of 5 pounds. When questioned further on this point, she states that she can never seem to get full from her meals, so she is snacking constantly throughout the day

Decision Point Two

Decrease Zyprexa to 7.5 mg orally at BEDTIME

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Result of next decision (what happened): Client worsens (her positive symtpoms scale increased by 25% and her negative symptom scale score decreased by 10% indicating improved negative symptoms), but her weight becomes stabilized and excessive hunger abates
  • Husband explains that she is becoming less manageable at home, and he has to take time off from work because he is fearful of leaving her alone

Decision Point Three

Increase Zyprexa 10 MG orally at BEDTIME

Guidance to Student
Weight gain is a significant problem with Zyprexa. Next to Clozaril (clozapine), Zyprexa causes the most weight gain of all the atypical antipsychotics. This is a side effect that a significant number of clients will experience. There also appears to be an increased association of newly diagnosed diabetes mellitus in clients treated with Zyprexa. Although this can be disease related in this population, Zyprexa is above what would be considered coincidental.
Risperdal is a good option, although it is dosed twice daily and compliance in this population can be problematic. There is evidence that shows giving Risperdal all at once can be efficacious and therefore could be an option down the road should compliance become an issue. Weight gain is also possible with Risperdal, but it is not as great as that seen with Zyprexa. If compliance does become an issue with this client, Risperdal has a long-acting injectable formulation, Risperdal Consta, that could be used. Remember, Risperdal Consta has to be given every 2 weeks at the provider’s office, and therapeutic blood levels take time to achieve (on average 3–6 weeks or 2–3 injections). Oral overlapping therapy is required to bridge this period of time. Another option in someone who responds to Risperdal would be Invega Sustenna (paliperidone palmitate), which is the first metabolite of Risperdal and has greater activity at the D2 receptor than Risperdal. An advantage of Invega Sustenna over Risperdal Consta is that therapeutic blood levels are attained within the first 4–7 days, and overlapping oral therapy is usually not necessary. A disadvantage is that during the initiating phase of medication, the first two doses need to be given within 4–7 days of one another. This is followed by monthly injections. There is another product on the market called Invega Trinza, which is given once every 3 months. This product is for clients who have been stabilized on Invega Sustenna for at least 4 months where the last two doses were the same strength (two months of 156 mg injections).
Increasing Zyprexa to 15 mg at bedtime will only worsen the weight gain side effect. While additional benefits from increasing the dose may be possible from an efficacy standpoint, side effects always need to be taken into consideration. “First, do no harm.” Qsymia is a weight loss medication that is a combination of phentermine and topiramate. It is only indicated to treat obesity. This client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35, Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity). There are two things wrong with this therapy option. First, there are only a few occasions where add-on therapy to treat a side effect is acceptable, and weight gain is not one of those scenarios. Secondly, phentermine has a lot of cardiovascular toxicities (such as elevated BP, HR, and increased workload on the heart).PLEASE USE 6 REFERENCES FROM SCHOOL RESOURCES.

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Leadership week 3 chapter 4

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Read Chapter 4

1-which of the following behaviors may be (1) ethical but illegal, (2) legal but unethical, (3) illegal and unethical, and (4) legal and ethical.

A. Working in a clinic that performs abortions

b. Respecting the wishes of a client suffering from ALS that he be permitted to die with dignity and not placed on “breathing machines”

c. Respecting the health surrogate’s wishes regarding termination of life support of her friend

d. Observing a coworker take out two tablets of oxycodone as ordered for pain management for his patient but keeping one for himself, administering only one tablet to the patient.

2-differentiate among the following: deontological theories, utilitarianism, and principlism.

3-what do you think about health-care professionals disclosing information to clients about a poor prognosis, even though the information may cause severe distress.

4-What do they think about health-care professionals disclosing information to clients against family wishes?

5. You see a colleague use another nurse’s password to access the medication administration system and take out a narcotic. What would you do?

6.Your colleague’s child fell and was brought to the emergency department. She comes back up to the unit and tells you that they cleaned and debrided the wound, and she needs to change the dressings twice a day using a wet to dry method. You see her go into the supply system and remove the dressings and saline using a patient’s identification number. What would you do?

7. You are caring for a patient who has a terminal disease. He asks you if he is dying. Would you tell him? If yes, how? If no, what might you say? .

8-You are administering hydromorphone to a patient. The patient asks you what you are administering. Would you tell the patient about the medication?

APA style including presentation page and references page. INCLUDE IN TEXT CITATIONS

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nursing assignment.

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Grand Rounds Discussion: Complex Case Study Presentation

 

Photo Credit: [RGtimeline]/[iStock / Getty Images Plus]/Getty ImagesIn Weeks 4, 7, and 9 of the course, you will participate in clinical discussions called grand rounds. In one of these three weeks, you will be a presenter as well as help facilitate the online discussion; in the others you will be an active discussion participant. When it is your week to present, you will create a Focused SOAP note and a short didactic (teaching) video presenting a real (but de-identified) complex patient case from your practicum experience.

You should have received an assignment from your Instructor letting you know which week of the course you are assigned to present.

To prepare:
  • Review this week’s Learning Resources and consider the insights they provide. Also review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.
  • Select a child/adolescent or adult patient from your clinical experience that presents with a significant concern. Create a focused SOAP note for this patient using the template in the Resources. All SOAP notes must be signed, and each page must be initialed by your Preceptor. When you submit your SOAP note, you should include the complete SOAP note as a Word document and PDF/images of each page that is initialed and signed by your Preceptor. You must submit your SOAP Note using SafeAssign.
    Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Late Policies.
  • Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice what you will say beforehand, and ensure that you have the appropriate lighting and equipment to record the presentation.
  • Your presentation should include objectives for your audience, at least 3 possible discussion questions/prompts for your classmates to respond to, and at least 5 scholarly resources to support your diagnostic reasoning and treatment plan.
  • State 3–4 objectives for the presentation that are targeted, clear, use appropriate verbs from Bloom’s taxonomy, and address what the audience will know or be able to do after viewing.
  • Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management.
  • Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.
  • Pose three questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video.
  • Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide.
    • Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
    • Objective: What observations did you make during the psychiatric assessment?
    • Assessment: Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and is supported by the patient’s symptoms.
    • Plan: What was your plan for psychotherapy (include one health promotion activity and patient education)? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
    • Reflection notes: What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow-up, discuss what your next intervention would be.

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