Assignment 2: Comprehensive Psychiatric Evaluation Note and Patient Case Presentation

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Psychiatric notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Comprehensive psychiatric evaluation notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

For this Assignment, you will document information about a patient that you examined at your practicum site, using the Comprehensive Psychiatric Evaluation Note Template provided. You will then use this note to develop and record a case presentation for this patient.

To Prepare

· Review this week’s Learning Resources and consider the insights they provide about impulse-control and conduct disorders.

· Select a patient for whom you conducted psychotherapy for an impulse control or conduct disorder during the last 6 weeks. Create a Comprehensive Psychiatric Evaluation Note on this patient using the template provided in the Learning Resources. There is also a completed template provided as an exemplar and guide. All psychiatric evaluation notes must be signed, and each page must be initialed by your Preceptor. When you submit your note, you should include the complete comprehensive evaluation note as a Word document and pdf/images of each page that is initialed and signed by your Preceptor. You must submit your 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 Grading Policy.

· Then, based on your evaluation of this patient, develop a video presentation of the case. Plan your presentation using the Assignment rubric and rehearse what you plan to say. Be sure to review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.

· Include at least five scholarly resources to support your assessment and diagnostic reasoning.

· Ensure that you have the appropriate lighting and equipment to record the presentation.

The Assignment

Record yourself presenting the complex case study for your clinical patient. In your presentation:

· Dress professionally with a lab coat and present yourself in a professional manner.

· Display your photo ID at the start of the video when you introduce yourself.

· Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information).

· Present the full complex case study. Be succinct in your presentation, and do not exceed 8 minutes. Include subjective and objective data; assessment from most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; current psychotherapeutic plan (include one health promotion activity and one patient education strategy you provided); and patient progress toward treatment goals.

· Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What was 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 the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses in order of highest to lowest priority and explain why you chose them. 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 (including one health promotion activity and one patient education strategy)? What was your plan for treatment and management, including alternative therapies? Include 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?

 

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Physical Assessment General survey

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General Survey Form

Objective: Conduct a General survey on a person of your choice. The purpose of this interaction is observation only.

1. Physical Appearance/Hygiene:

a. General appearance:

b. Gender

c. Apparent age

d. Ethnic group

e. Appears overall healthy

f. Well-groomed or disheveled (Note the general color of skin and hygiene)

2. Body Structure and Movement (Observe general stature):

a. Height appropriate for apparent age

b. Appears well nourished

c. Weight suitable for the height

d. Position or posture (comfortable and relaxed)

e. Obvious deformities

f. Walks with ease

g. Gait balanced and smooth

h. Limitations to range of motion

i. Involuntary movements

j. Using assistive devices

3. Emotional/Mental Status and Behavior:

Level of alertness

Appear well rested or tired

Converse appropriately

Behavior appropriate for the situation

Dress suitable for the weather

4. Document observations with detailed responses in a narrative format. For example, if a client appears tired provide a description adequate for the reader to visualize the client, “Client is alert and appears tired, slumped in a chair with eyes half closed.”

5. Describe two actual or potential risk factors for the client based on the assessment findings with description or reason for selection of them.

Write from nursing perspective

No consideration for plagiarism

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Protection of Human Subject Participants in Nursing Research

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– Protection of Human Subject Participants in Nursing ResearchTop of Form

 

Discussion Prompt

In Melnyk & Fineout-Overholt (2019) textbook Box 23.1 on page 682, select one of the Fifteen Ethical Principles of the Universal Declaration on Bioethics and Human Rights.

State the principle and describe the importance of the selected principle to ethical research. In addition, describe how a researcher would ensure that this principle would be protected for human subjects in a research study.

Expectations

Initial Post:

APA format with intext citations

Word count minimum of 250

References: 2 high-level scholarly references within the last 5 years in APA format.

Turnitin receipt.

 

Plagiarism free.

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Assignment 2: Clinical Skills Self-Assessment

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Assignment 2: Clinical Skills Self-Assessment

 

 

Before embarking on any professional or academic activity, it is important to understand the background, knowledge, and experience you bring to it. You might ask yourself, “What do I already know? What do I need to know? And what do I want to know?” This critical self-reflection is especially important for developing clinical skills such as those for advanced practice nursing.

 

The Psychiatric-Mental Health Nurse Practitioner (PMHNP) Clinical Skills List and Clinical Skills Self-Assessment Form provided in the Learning Resources can be used to celebrate your progress throughout your practicum and identify skills gaps. The list covers all necessary skills you should demonstrate during your practicum experiences.

Just as you have in previous practicum courses, for this Assignment, you assess where you are now in your clinical skill development and make plans for this practicum. Specifically, you will identify strengths and opportunities for improvement regarding the required practicum skills. In this practicum experience, when developing your goals and objectives, be sure to keep assessment and diagnostic reasoning in mind.

To Prepare

· Review the resources and clinical skills in the PMHNP Clinical Skills List document. It is recommended that you print out this document to serve as a guide throughout your practicum.

· Review the “Developing SMART Goals” resource on how to develop goals and objectives that follow the SMART framework.

· Review the resources on nursing competencies and nursing theory, and consider how these inform your practice.

· Download the Clinical Skills Self-Assessment Form to complete this Assignment.

The Assignment

Use the PMHNP Clinical Skills Self-Assessment Form to complete the following:

· Rate yourself according to your confidence level performing the skills identified on the Clinical Skills Self-Assessment Form.

· Based on your ratings, summarize your strengths and opportunities for improvement.

· Based on your self-assessment and theory of nursing practice, develop 3–4 measurable goals and objectives for this practicum experience. Include them on the designated area of the form.

 

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Health Promotion Discussion Outline

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Responsibilities and Duties of Community Health Nurses (The Nurses Rol)
• Community health nursing revolves around various concepts such as healthy living promotion, disease prevention, and health problems, rehabilitation, medical treatment, care delivery evaluation, and systems of prevention as well as research on in-depth health of the community and wellness.
• A community nurse can necessitate various aspects such as the provision of direct care, educating members of the public, advocating for improvements in health, and performing community health research
 Direct Care Provider/ Clinician Role
 Educator Role
 Advocate Role
 Managerial Role
 Collaborator Role
 Leader Role
 Research Role

Responsibilities and Duties of Community Health Nurses
Community health nursing revolves around various concepts such as healthy living promotion, disease prevention, and health problems, rehabilitation, medical treatment, care delivery evaluation, and systems of prevention as well as research on in-depth health of the community and wellness. A community nurse can necessitate various aspects such as the provision of direct care, educating members of the public, advocating for improvements in health, and performing health research at the community level. Therefore, it is the work of a community nurse in health in ensuring control of the community health
Clinician
For the community nurse, the clinician role implies they facilitate services in health, for families and individuals as well as for the community’s populations and groups. The clinician role for the community health nurses revolves around specific emphasis in contrast to the nursing at the basic level for instance skill expansion, health promotion, and holism.
Educator
Its recognized globally that teaching in health forms a vital element of excellent practice in nursing and also a crucial role for a community health nurse. There is an assessment of the stage of change, practices, behaviors, beliefs, values, attitudes, knowledge, and skills of people in the community and the provision of health education based on the level of knowledge.
Advocacy
The client’s right issue is crucial in today’s health care. Every client or patient has the right of receiving humane or just equal treatment. A community health nurse, therefore, advocates for the care as well as the patient’s rights. They encourage people in taking the food that is required for health maintenance, the right treatment drugs, and required services when it is needed. Adequate information is henceforth provided by community health nurses in making health care decisions that are necessary and the promotion of awareness in the community for significant health problems.
Managerial
The nurse, as a manager, enhances administrative direction in the accomplishment of the specified goal through the assessment of the needs of the client, planning and organizing to meet such needs, providing direction and control as well as evaluation of the progress to assure meeting the goal.
Collaborator
The community health nurse hardly performs their practice in isolation. They will always ensure to work with a large number of people inclusive of social workers, other nurses, psychologists, biostatisticians, patients, physicians, nutritionists, therapists, epidemiologists, legislators, and, community leaders being part of the health team.
Leadership
There are an increasingly active nature of the community health nurses within the leader role. The nurse as a leader provides instruction that persuades or influences other people to effect the right change which has a positive impact on other individuals’ health. The primary function of the leadership role is using a health policy change centered upon the health of the community people; in that case, the nurse develops into a change agent.
Researcher
The community nurse within the research role ensures engagement in the systematic investigation, analysis, and data collection in solving problems and enhancing the nursing practice of community health. Following the results of the research, the service quality gets improved by the community nurse as well as improving community people’s health.

References
Kawai, C., Betriana, F., Tanioka, T., Yasuhara, Y., Ito, H., Tanioka, R., … & Locsin, R. (2019). The intermediary roles of public health nurses (PHNs) in utilizing communication robots (CRs) in community health care practice. Health, 11(12), 1598-1608.
Stanhope, M., & Lancaster, J. (2019). Public health nursing e-book: Population-centered health care in the community. Elsevier Health Sciences.

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Locating Credible Databases and Research

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Assessment 1 Instructions: Locating Credible Databases and Research

 

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· Create a 2-4 page resource that will describe databases that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP.

Introduction

Evidence-based practice (EBP) integrates the best evidence available to guide optimal nursing care, with a goal to enhance safety and quality. EBP is crucial to nursing practice because it incorporates the best evidence from current literature, along with the expertise of the practicing nurse. The concern for quality care that flows from EBP generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise. To gain the knowledge, you require a good understanding of how to search for scholarly resources, as well as identify which databases and websites are credible for the purposes of implementing evidence-based changes in practice.

Your Online e-Portfolio

Creating an ePortfolio is not required in the BSN program, but you may find it helpful to create one to attach to your professional resume while job hunting. Online ePortfolios serve two key purposes: 1) to support learning and reflection, and 2) to be used as a showcase tool. Your learning journey can be documented, and ePortfolios contribute to lifelong learning and growth through reflection and sharing. Online ePortfolios can also be shared with employers and peers to present artifacts that demonstrate your accomplishments at Capella.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for providing patient-centered, competent care based on current evidence-based best practices. You will be required to do research, analysis, and dissemination of best evidence to stay abreast of these best practices. Understanding where to go to find credible sources and locate evidence, as well as which search terms to use, is the foundation of incorporation of best practices.

Scenario

You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the Capella University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments and you have all participated in shift report. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse to find research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.

You may choose the diagnosis for the patient in this scenario or health care issue/diagnosis of your choice. Or you may choose something you would find interesting to research or that applies to a clinical problem/diagnosis you would be interested in addressing. Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, journal article, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.

Preparation

To help ensure you are prepared to complete this assessment, review the following resources related to the Capella library. These resources will provide you an overview of the types of tools, resources, and guides available in the library. This may be useful in forming a better understanding of the library to apply to the hypothetical situation laid out in the scenario of this assessment.

· BSN Program Library Research Guide.

· Evidence-Based Practice in Nursing & Health Sciences.

· Databases A-Z: Nursing & Health Sciences.

· Get Critical Search Skills.

Remember, it is also appropriate to look toward databases and resources outside of the Capella library, such as organizational policies, professional organizations, and government health care resources.

You are encouraged to complete the Evaluating the Credibility of Evidence activity. This activity offers an opportunity to practice evaluating the credibility of evidence. These skills will be necessary to complete Assessment 1 successfully and is for your own practice and self-assessment. Completing this activity is also a way to demonstrate course engagement.

Instructions

The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.

For this assessment:

· Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.

· Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to this scenario or clinical practice issue/diagnosis and describe to which of these you would direct a nurse colleague to search for evidence.

· Describe where you might go in the work place to complete this research and how you would access the desired, relevant research within research databases or other online sources.

Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.

. Describe communication strategies to encourage nurses to research the diagnosis/practice issue, as well as strategies to collaborate with the nurses to access resources.

. Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis/health care issue within the context of a specific health care setting.

. Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis/practice issue.

. Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis/health care issue.

. Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Note: While you are not selecting and evaluating specific evidence to help with the clinical diagnosis/practice issue, you should still be citing the literature and best practices to support your description of your communication and collaboration approach. Additionally, it is appropriate to cite best practices related to EBP and evaluating databases to support your explanation as to why you selected the five sources of online information that you did.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

. Assessment 1 Example [PDF].

Additional Requirements

Your assessment should meet the following requirements:

. Length of submission: 2-4 pages (not including the title page or the reference page) description of communication, collaboration, and evidence location process, including a list of databases or other sources with description of why they are appropriate for clinical scenario diagnosis/health care issue (that is, something that would be useable in professional practice for other nurses). Be sure to include an APA-formatted reference page at the end of your submission.

. Number of references: Cite a minimum of three sources of scholarly or professional evidence that supports your findings and considerations. Resources should be no more than five years old.

. APA formatting: References and citations are formatted according to current APA style.

Competencies Measured

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

. Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.

. Explain why the sources selected should provide the best evidence for the chosen diagnosis/health care issue.

· Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision within the context of a specific health care setting.

. Describe the best places to complete research within the workplace environment and what types of resources one would want to access to find pertinent information for the diagnosis/health care issue.

· Competency 4: Plan care based on the best available evidence.

. Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a diagnosis/health care issue and three out of five should be specific to the diagnosis/health care issue.

· Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

. Describe communication strategies to encourage nurses to research a diagnosis/health care issue, as well as strategies to collaborate with the nurses to access resources.

. Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

. Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

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Lit Review

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Developing a Clinical Question and Selecting a Framework

Nursing research and evidence-based practice are generated from clinical problems identified in practice, often in search of a solution to the problem. Once a problem is selected, practice in asking and writing the right question about the problem is needed. Distinguishing between a background and a foreground question is the first step in this process.  In general, nurses with less experience begin with a background question, but as experience increases, foreground questions become prominent.  A focused foreground question in a Population, Intervention, Comparison, Outcome and Time (PICOT) framework provides the components of an answerable, searchable question.  The language used in the question represents the purpose of the question.  For example, research questions generally have a directional outcome. (i.e., to reduce or improve); clinical questions gather the evidence related to an outcome (i.e., who, what, and where); and quality improvement questions are focused on processes influencing the outcomes (i.e., why) (Fineout-Overholt & Stillwell, 2019).  Once a clinical question is drafted, a literature search is conducted using key search terms, and a framework or model from which to develop a method for answering the question should follow.

As a doctorally prepared nurse, the ability to understand how to ask the clinical question, search the literature, appraise the information obtained, and organize it is imperative. The purpose of this course module is to practice building the skill for these critical features. This module is an exercise in asking an answerable, searchable question for study, performing a scholarly literature search, appraising the publications selected and creating an organized evidence (evaluation) table for easy reference when drafting the introduction and literature review for a clinical scholarship project.  An evidence-based framework or model will also be selected to guide the draft of the clinical scholarship project.

 Module Objectives

 At the end of this learning module, the student will be able to:

· Identify a clinical problem of interest.

· Create a study question about the clinical problem.

· Perform a literature search to answer the study question.

· Appraise the factors impeding and facilitating the adoption of the evidence.

· Develop an evidence (evaluation) table or matrix highlighting the attributes and limitations of the literature selected from a scholarly literature search.

· Select an evidence-based practice framework or model from which to build a clinical scholarship project.

 

 

Assignments

Literature Search (25 points)

Directions:  Identify a clinical issue or problem.  Develop a study question to answer the question.  Perform a literature search (consider working with a librarian on this).   Complete the following items on the word document (.docx) provided in the module (download the document, complete it, then upload into the assignment area).

Name (1 point deducted if missing)

Date (1 point deducted if missing)

Clinical Issue or Problem (3 points) (e.g., there is a high number of pediatric needlesticks in an Emergency Department)

Problem Statement (3 points) (e.g., the average number of needlesticks for children in an Emergency Department is 2.2 needlesticks per visit [author & author, 2021)

Study Question (5 points)

· PICO(T) format (e.g., Melnyk & Fineout-Overholt, 2019, Appendix A, pp. 706-7)

Key Search Terms (5 points) (include Boolean operators)

Search Engines Used (3 points) (e.g., PubMed, CINAHL, etc.)

Number of Initial Publications Generated (2 points) (matching the search terms and phrases)

Refined Search:  Inclusion and Exclusion Criteria (2 points)

Number of Publications Generated and Number Selected the Literature Review (2 points)

Literature Appraisal (25 points)

Directions:  Select a research publication (not an evidence-based practice guideline) from the literature search to critically appraise.  Complete the following items on the word document (.docx) provided in the module (download the document, complete it, then upload into the assignment area).  (adapted from Polit & Beck, 2017, p. 100).

 

Evidence (Evaluation) Table/Matrix (100 points)

Directions:  The evidence table/matrix should include all studies which will be included in the draft of the introduction and literature review for the clinical scholarship project due at the end of the semester.  At least 10 studies should be included and in alphabetical order according to the author. Complete the following items on the word document (.docx) provided in the module (download the document, complete it, then upload into the assignment area).  (adapted from Melnyk & Fineout-Overholt, 2019, p. 724).  Each section is worth 10 points (10 sections x 10 points = 100 points)

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discuss week3

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Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the votes views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria. APA format ANd 3 references https://www.congress.gov https://www.nursingoutlook.org/article/S0029-6554(17)30262-2/fulltext https://www.senate.gov/senators/leadership.htm Then respond to two students on apa format and two references each by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example. Student 1 For very many American citizens, the fight over repealing Obamacare on the “Affordable Care Act (ACA)” isn’t about electoral strategy or vote counting, whether or not they will indeed be able to pay for their hospitalization and medications once the issues have passed is a major concern for many families. (Willison & Singer 2017). Regarding healthcare practitioners, this is about being able to service all of their consumers without being overburdened by the expenses of uninsured patients. In addition to protecting employment and companies, states must have the resources to deal with the opioid issue and other health care crises, such as the Ebola outbreak. Therefore, it is essential to look at the “repeal and replacement of the affordable care act” through legislators. There’s no doubt that the “Obama administration’s Patient Protection and Affordable Care Act of 2010 (ACA)” was a ground-breaking piece of legislation. (Thompson et al. 2018). A significant endeavor was made for the first time to address healthcare equity in the US. With Republican members publicly opposing the measure, the policy was plagued from the beginning by political connotations. When Trump took office, one of his top priorities was repealing, defunding and replacing the “Affordable Care Act.” The Senate approved a motion in the beginning of 2017 by a majority of 51-48, a move to begin discussing the budget measure. (Thompson et al. 2018). Budget and tax-related provisions of the ACA were suggested for removal in the budget resolution. The final law was anticipated to abolish measures that gave tax credits for low-income persons to purchase health insurance, mandated all individuals to have insurance, and compelled companies to provide insurance to their workers to repeal these provisions. In a vote taken on July 25, 2017, the Senate approved a move to advance to the passed repeal and replace measure, the “American Health Care Act of 2017 (AHCA).”  The vote was 51-50 in favor of the proposal. Senators Murkowski and Collins voted against the proposal, as did all Senate Democrats. It was Vice President Pence’s voting that broke the 50-50 tie. In spite of his recent diagnosis with brain cancer, Republican Senator McCain came to Congress to vote in support of the measure. In the absence of his vote, the proposal would have been defeated. Finally, there was a tax reform budget to be reviewed and the bill was not voted on.

The impact of re-election prospects on the ACA repeal and replacement effort It quickly became clear to the lawmakers, both Republican and Democrat, that ‘repeal and replace’ was not going to help them win re-election because of its wide-ranging negative effects. (Willison & Singer 2017). Legislators quickly realized that the new ‘repeal and replace’ ideas would have a negative impact on the average American voter. A growing number of Republican lawmakers began to realize that their prospects of re-election were diminishing as a result of their support for repealing and replacing Obamacare. According to research, the “repeal of the Affordable Care Act” would save the central government $91 billion in 2021 plus $930 billion from 2017 and 2026, which seems to be among the aims of those favoring repeal. That’s a drop of 21 percent, which is a significant change. (Willison & Singer 2017) The new approach, as shown above, would have left many Americans without access to affordable medical care. (Jacobs et al 2021).  The “American Academy of Family Physicians,” for example, criticized the AHCA’s measures because they increased health vulnerability for Americans. Because of their age, health, or socioeconomic condition, the AAFP says that this new policy is driving up expenses and denying coverage to people. (Jacobs et al 2021).  Additionally, the expected effects on budgetary allocations and the entire employment market show just how essential the health care industry to our economy is. The research encourages us to look for unforeseen repercussions in whatever changes we contemplate making. Student 2 A cost-benefit analysis is a systematic approach to estimating the strengths and weaknesses of alternatives (2021). Many companies across the world use cost-benefit analysis to make decisions. Congress also sometimes allows cost-benefit analysis to be taken into consideration by legislators. The first job of a legislator is to be re-elected, and to be re-elected, the legislator must consider the wishes of their constituents.  Cost-benefit analysis is considered a decision helping, not a decision-making tool by legislators. The risks, costs, and benefits under scrutiny are usually difficult to establish with precision (2021). The cost-benefit analysis turns all outcomes into a monetary value, allowing lawmakers multiple options to ensure the best results for the lowest cost (2022).  As some legislators talk about repealing or replacing the Affordable Care Act, the cost-benefit analysis could come into play. When the ACA was passed, it was meant to expand affordable health care to all Americans, lower costs and improve quality and care coordination (Management, 2015). Less than 50% of Americans statistically support the Affordable Care Act. Many Americans oppose the government’s role in healthcare and have little trust in the government. Republicans posted many negative television ads against the ACA in 2012, which skewed Americans’ knowledge of what the ACA truly is. Almost 60% of Americans say what they know about the Affordable Care Act is from television (JS).   Although there are many positives to the Affordable Care Act, health insurance markets can only stay afloat because of federal subsidies, and middle-income families without employer-provided insurance and small businesses have increased healthcare costs. ACA has damaged the individual market for healthcare insurance (Blase, 2022). National policy is affected by a legislator’s conservative versus liberal viewpoint and by the desire to be re-elected by their constituents.   The ACA is complex, and there has been no reasonable alternative to repeal and replace it. Alternatives mentioned are health care savings accounts and working with individual companies to lower costs. Repealing the Affordable Care Act without replacing it is not an option due to leaving millions without healthcare.

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Week 3 _ Assignment: Analyzing Group Techniques

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Assignment: Analyzing Group Techniques

 

Group therapy can alleviate feelings of isolation and foster a supportive and collaborative environment for sharing difficult feelings in order to facilitate healing. For many people, being part of a group that has a shared understanding of a struggle provides a unique opportunity to gain understanding of their own experiences.

As you examine one of the group therapy demonstrations from this week’s Learning Resources, consider the role and efficacy of the leader and the reasons that specific therapeutic techniques were selected.

 

To prepare:

· Select one of the group therapy video demonstrations from this week’s required media Learning Resources. (See Transcript – attached and video link below)

 

https://www.youtube.com/watch?v=szS31h0kMI0

 

 

INSTRUCTIONS – The Assignment

 

In a 4- to 5 page paper, identify the video you selected and address the following:

 

· What group therapy techniques were demonstrated? How well do you believe these techniques were demonstrated?

· What evidence from the literature supports the techniques demonstrated?

· What did you notice that the therapist did well?

· Explain something that you would have handled differently.

· What is an insight that you gained from watching the therapist handle the group therapy?

· Now imagine you are leading your own group session. How would you go about handling a difficult situation with a disruptive group member? How would you elicit participation in your group? What would you anticipate finding in the different phases of group therapy? What do you see as the benefits and challenges of group therapy?

· Support your reasoning with at least three peer-reviewed, evidence-based sources, and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

 

Reminde r  The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. APA 7 Format

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Weekly questions

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 1) What is the Christian concept of the imago Dei? How might it be important to health care, and why is it relevant.

2)According to your worldview, what value does a human person have? How does your position affect your stance on controversial bioethical issues, such as abortion, designer babies, and stem cell research?

3) Based on “Case Study: Fetal Abnormality” and the required topic Resources, write a 750-1,000-word reflection that answers the following questions: a)What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity? b)Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected? c)How does the theory determine or influence each of their recommendations for action? d)What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

Need question 1 on Tuesday and question 2 on Thursday. Question 3 on Sunday

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