Instructions: Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide citations/references for your answers in APA format. 

CASE STUDY: Preschool Child: Ricky Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father, who both work full-time, and his infant sister. Their extended family lives in a different state more than 100 miles away. Both parents are of average height and in good health. Ricky’s mother mentions that Ricky often expresses frustration, particularly in regard to food. Conflict over food occurs every day. Mealtime is a battle to get him to eat, unless his mother feeds him. Ricky’s baby sister seems to tolerate all baby foods but requires her mother to spoon-feed. Ricky’s mother is quite frustrated and concerned that he will become malnourished. Reflective Questions 

1. What additional assessment information would you collect?

 2. What questions would you ask, and how would you further explore this issue with the mother?

 3. In what ways does the distance of the extended family influence this family’s approach to health promotion? 

4. What factors would you consider to determine whether malnourishment is a factor in this family? 

In a 2- to 3-page paper, address the following:

• Identify the psychotherapeutic approach that the group facilitator is using and explain why she might be using this approach.
• Determine whether or not you would use the same psychotherapeutic approach if you were the counselor facilitating this group and justify your decision.
• Identify an alternative approach to group therapy for addiction and explain why it is an appropriate option.
• Support your position with evidence-based literature.

http://mym.cdn.laureate-media.com/2dett4d/Walden/SOCW/MSWP/CH/mm/homepage/episodes.html

 Choose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life management. 

Using the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.

Practice

1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.

2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.

3. Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.

4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.

Education

1. Those who practice in secondary or tertiary palliative care will have specialist education and certification.

2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.

3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.

4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.

Research

1. Increase the integration of evidence-based care across the dimensions of end-of-life care.

2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.

3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.

4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.

5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.

Administration

1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.

2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.

3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.

4. Support the development and integration of palliative care services for all in- and outpatients and their families.

  Topics to review: Article: Nurses roles and responsibilities Providing care and support at end of life. https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics /endoflife-positionstatement.pdf 

APA format. At least two references.

1) Briefly describe a Continuous Quality Improvement (CQI) Initiative (actual or anticipated). Identify the task, and discuss the PDSA cycle including the anticipated or target outcome.

2) Discuss the Core Competencies for Interprofessional Collaborative Practice, and incorporate the role of the advanced practice nurse as team leader. Identify elements to improve team effectiveness.

3) Identify the stakeholders and their role as team members for this initiative.

4) What resources are needed to support the team? These may include financial resources, intellectual resources, i.e. field experts, and recognition for team members and rewards.

5) How will you ensure open “safe” team communications?

6) What decision making structure/process will you use?

7) What considerations must be taken into account to incorporate the organization’s culture?

8) What would define success of the team’s effectiveness?

 To address the aforementioned questions, write the assignment in a 4-5 page and include include 2–4 scholarly, peer-reviewed articles.

Discussion  : End of Life initial post.

End-of-Life Care (including advanced directives, palliation) Topics to review: 

Article: Nurses roles and responsibilities Providing care and support at end of life. https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics /endoflife-positionstatement.pdf

choose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life management

Using the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.

Practice

1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.

2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.

3. Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.

4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.

Education

1. Those who practice in secondary or tertiary palliative care will have specialist education and certification.

2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.

3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.

4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.

Research

1. Increase the integration of evidence-based care across the dimensions of end-of-life care.

2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.

3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.

4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.

5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.

Administration

1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.

2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.

3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.

4. Support the development and integration of palliative care services for all in- and outpatients and their families.