Concept, symptoms, treatment, medications, manifestation, complications, nursing interventions

 This week you participate in the second of three clinical discussions called grand rounds. In one of these 3 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.

 Develop a 5-9 page problem statement that presents information related to the problem-intervention-comparison-outcome-time (PICOT) approach to nursing research.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

For the first section of your final capstone project you will develop a proposal for an intervention plan to fulfill a need within a specific population. This assessment is meant to capture your initial thoughts about the need and impacting factors to help focus your in-depth analysis later on in the course.

First you will brainstorm and crystallize some of your ideas for this assessment, specifically ideas around needs, a target population, and some initial support from the literature and other sources of evidence. The problem statement is an important part of your capstone project as it will help illustrate the importance of your project, as well as help to clarify your project’s scope.

Preparations

• Read Guiding Questions: Problem Statement (PICOT) [DOC]. This document is designed to give you questions to consider and additional guidance to help you successfully complete this assessment.
• As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
  • As you reflect on your work in the field, what population do you feel has the greatest need? Why? Is the need across the population, or within a specific setting?
  • What interventions already exist for the selected population? Are they effective? Why or why not?
  • How will site support from your practicum and your preceptor support your goals and objectives?

Instructions

Note: The assessments in this course are sequenced in such a way as to help you build specific skills that you will use throughout your program. Complete the assessments in the order in which they are presented.

Your problem statement will focus on presenting information related to the problem-intervention-comparison-outcome-time (PICOT) approach to nursing research. You will also present a brief literature review that supports the need you identified in your problem statement and the appropriateness of your broad intervention approach. Provide enough detail so that the faculty member assessing your problem statement will be able to provide substantive feedback that you will be able to incorporate into the other project components in this course, as well as into the final draft of your project.

At minimum, be sure to address the bullet points below, as they correspond to the grading criteria. You may also want to read the scoring guide and the Guiding Questions: Problem Statement (PICOT) document (linked above) to better understand how each criterion will be assessed.

Reminder: these instructions are an outline. Your heading for this this section should be titled Problem Statement and not Part 1: Problem Statement.

Your Problem Statement (PICOT) should be structured as follows:

PART 1: PROBLEM STATEMENT (2–3 PAGES)

Need Statement (1 paragraph).

• Analyze a health promotion, quality improvement, prevention, education or management need.

Population and Setting (1–2 paragraphs).

• Describe a target population and setting in which an identified need will be addressed.

Intervention Overview (1–2 paragraphs).

• Explain an overview of one or more interventions that would help address an identified need within a target population and setting.

Comparison of Approaches (1–2 paragraphs).

• Analyze potential interprofessional alternatives to an initial intervention with regard to their possibilities to meet the needs of the project, population, and setting.

Initial Outcome Draft (1 paragraph).

• Define an outcome that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education, or management need.

Time Estimate (1 paragraph).

• Propose a rough time frame for the development and implementation of an intervention to address and identified need.

PART 2: LITERATURE REVIEW (10–15 RESOURCES, 3–6 PAGES)

• Analyze current evidence to validate an identified need and its appropriateness within the target population and setting.
• Evaluate and synthesize resource from diverse sources illustrating existing health policy that could impact the approach taken to address an identified need.

ADDRESS GENERALLY THROUGHOUT

• Communicate problem statement and literature review in way that helps the audience understand the importance and validity of a proposed project.

Additional Requirements

• Length of submission: 5–9 double-spaced pages.
• Number of resources: 10–15 resources. (Your final project summation will require 12–18 unique sources across all sections.)
• Written communication: Written communication is free of errors that detract from the overall message.
• APA formatting: Resources and citations are formatted according to current APA style. Header formatting follows current APA levels.
• Font and font size: Times New Roman, 12 point.

Competencies Measured

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

• Competency 1: Lead organizational change to improve the experience of care, population health, and professional work life while decreasing cost of care.
  • Explain an overview of one or more interventions that would help drive quality improvement related to an identified need within a target population and setting.
• Competency 2: Evaluate the best available evidence for use in clinical and organizational decision making.
  • Analyze a health promotion, quality improvement, prevention, education, or management need.
  • Analyze current evidence to validate an identified need and its appropriateness within the target population and setting.
• Competency 3: Apply quality improvement methods to impact patient, population, and systems outcomes.
  • Describe a quality improvement method that could impact a patient, population, or systems outcome.
• Competency 4: Design patient- and population-centered care to improve health outcomes.
  • Propose a rough time frame for the development and implementation of an intervention to address an identified need.
• Competency 5: Integrate interprofessional care to improve safety and quality and to decrease cost of care.
  • Analyze potential interprofessional alternatives to an initial intervention with regard to their possibilities to meet the needs of the project, population, and setting.
• Competency 6: Evaluate the ability of existing and emerging information, communication, and health care technologies to improve safety and quality and to decrease cost.
  • Evaluate and synthesize resources from diverse sources illustrating existing health policy, health care technologies, or other communications that could impact the approach taken to address an identified need.
• Competency 7: Defend health policy that improves the experience of care, population health, and professional work life while decreasing cost of care.
  • Define an outcome that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education, or management need.

Note: You will also be assessed on two additional criteria unaligned to a course competency:

• Communicate problem statement and literature review in a way that helps the audience to understand the importance and validity of a proposed project.
• Demonstrate completion of hours toward the practicum experience.

GRADING SCALE:

1)  Analyze a health promotion, quality improvement, prevention, education, or management need.

Passing Grade:  Analyzes a health promotion, quality improvement, prevention, education, or management need, and identifies assumptions on which the analysis is based.

2)  Describe a quality improvement method that could impact a patient, population, or systems outcome.

Passing Grade:  Describes a quality improvement method that could impact a patient, population, or systems outcome, and identifies potential challenges of working on the identified need with the target population and setting.

3)  Explain an overview of one or more interventions that would help drive quality improvement related to an identified need within a target population and setting.

Passing Grade:  Explains an overview of one or more interventions that would help drive quality improvement related to an identified need within a target population and setting, impartially acknowledging weaknesses in each intervention.

4)  Analyze potential interprofessional alternatives to an initial intervention with regard to their possibilities to meet the needs of the project, population, and setting.

Passing Grade:  Analyzes potential interprofessional alternatives to an initial intervention with regard to their possibilities to meet the needs of the project, population, and setting, impartially acknowledging weaknesses in each alternative.

5)  Define an outcome related to a health policy that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education, or management need.

Passing Grade:  Defines an outcome related to a health policy that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education, or management need, and identifies criteria that could be used to evaluate achievement of the outcome.

6)  Propose a rough time frame for the development and implementation of an intervention to address an identified need.

Passing Grade:  Proposes a rough time frame for the development and implementation of an intervention to address an identified need, and identifies areas of uncertainty or knowledge gaps that could affect the time frame.

7)  Analyze current evidence to validate an identified need and its appropriateness within the target population and setting.

Passing Grade:  Analyzes current evidence to validate an identified need and its appropriateness within the target population and setting, and evaluates the relevance, currency, sufficiency, and trustworthiness of the evidence.

8)   Evaluate and synthesize resources from diverse sources illustrating existing health policy, health care technologies, or other communications that could impact the approach taken to address an identified need.

Passing Grade:  Evaluates and synthesizes resources from diverse sources illustrating existing health policy, health care technologies, or other communications that could impact the approach taken to address an identified need, and identifies missing information related to health policy.

9)  Communicate problem statement and literature review in a way that helps the audience to understand the importance and validity of a proposed project.

Passing Grade:  Communicates problem statement and literature review in a way that helps the audience to understand the importance and validity of a proposed project. Grammar, punctuation, spelling, and citations are error-free.

10)   Demonstrate completion of hours toward the practicum experience.

Passing Grade:  Demonstrates completion of hours toward the practicum experience, and provides a clear and concise description of the focus of the clinical hours and alignment to the capstone project.

THE ASSIGNMENT: FOCUSED SOAP NOTE 

Personality and Paraphilic Disorders

To prepare:

• Select a child/adolescent      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.
• Your presentation should      include objectives for your audience, at least three possible discussion      questions/prompts for your classmates to respond to, and at least five      scholarly resources from 2018-2022 to support your diagnostic      reasoning and treatment plan.
• Be succinct in your presentation,      and 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-TR 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.  Discuss an       identified social determinate of health impacting this patient’s mental       health status and provide your recommendation for a referral to assist       this patient in meeting this identified need (students will need to       conduct research on this topic both in the literature and for community       resources).
  • 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.
  • Case Formulation

   

REQUIRED LEARNING RESOURCES

Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.

• Chapters      31, “Assessing Personality Disorders”
• Chapter      32, “How to Educate Your Patient”

https://health.gov/healthypeople/priority-areas/social-determinants-health

https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bpd.pdf

https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bpd-watch.pdf

https://www.youtube.com/watch?v=YOV61lKxqxY

https://www.youtube.com/watch?v=0TtryBLokZc

Review your problem or issue and the study materials to formulate a PICOT (Patient, Intervention, Comparison, Outcome and Time) question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process. Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In  of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Step 1: Create PICOT question; A PICOT question is presented and provides a clear framework for the capstone project change proposal. Your PICOT question should clearly outline all of these elements: patient, intervention, comparison, outcome and time.

Step 2: PICOT Problem:   Identify the PICOT problem, what clinical problems or issues may arise from clinical care? The PICOT problem as it relates to evidence-based solution, nursing intervention, patent care, health care agency, and nursing practice is thoroughly described.

Step 3: Describe nursing intervention: A nursing intervention used to address the problem. Compare the nursing intervention to a patient population not currently receiving the nursing intervention, and timeframe needed to implement the change process.

Step 4: Summarize Clinical Problem and Patient Outcome: The clinical problem and how it can result in a positive patient outcome.

Prepare this  according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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

You are required to submit this  to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.