REPLY1

Great response Maria. Thank you for sharing further details as they relate to the concepts behind Hildegard Peplau’s theory of Interpersonal Relations. I too find that building a trusting relationship between nurse and patient to be quite beneficial when working towards optimizing patient outcomes. Within your response you mentioned, “First, I have come to appreciate the importance of applying the principle of human relations in my nursing practice. I always ensure I bond with my patients in a way that they feel open to open up to me about what they are going through.” In what ways are you able to apply elements from Peplau’s theory into practice, what are the strategies implemented? Also, what impact has this had on patient outcomes and satisfaction?

Professor Hanson

REPLY2

The Watson theory of caring is one that appeals most to my nursing philosophy. The theory argues that caring is the fundamental pillar of the nursing profession. The changing health care system has affected the ability of nurses to engage in a caring and develop a meaningful relationship with the patients that enhances healing. Among the reasons for the change is the use of technology as well as the increasing workload. Technology has been adopted as an alternative to primary care in most organizations. This is especially the reality as health care organizations try to save on costs which has led to a reduction of the personal engagement with the patients. The increased workload has also affected the ability of the nurses to set aside the needed time with the patients. Some nurses have to juggle several tasks and are forced to spend the minimal time possible with some of their patients. The Watson theory of caring calls for authentic presence and recognize the importance of the same in facilitating healing (Norman et al., 2016). Therefore, it is important that nurt5ses and nursing organizations remember that the core pillar of the profession is caring. Therefore, the use of technology as a substitute for primary care should be limited and there is a need to provide authentic presence to help the patients during the healing process. 

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2 references

Main Discussion Post

The Clinical Global Impression Scale (CGI) is one of the most widely used brief rating scales in mental health and pharmaceutical trials. The CGI is a standardized assessment tool that allows the clinician to rate the severity of illness, change over time, and efficacy of medication; while taking into account the client’s clinical condition and the severity of side effects. The CGI Scale is widely used in clinical psychopharmacology trials as an outcome measure. The CGI consists of three domains; Global Severity, Global Improvement, and Therapeutic Index. The Global Severity domain of the CGI is a single overall rating of severity of illness, which is rated on a seven-point scale rated from no mental illness to severely ill clients and change over time.  The CGI-Improvement is rated 1-7 from very much improved to very much worse (Jones et al., 2019).   This rating is based upon observed and reported symptoms, behavior, and function in the past seven days.  Symptoms and behaviors can fluctuate over a week; the score should reflect the average severity level during the seven days. The clinicians have many parameters to judge the severity of mental illness for clients in different settings.   However, the CGI is known for its ease of use and ability to track progress through time and is as effective as other more lengthy and tedious instruments (Jones et al., 2019). 

The CGI was developed as a simplified global measure to reflect the clinician’s view of the client’s condition before and after initiating medication.  The CGI tool is used to measure mental illness (medical history, psychosocial circumstances, symptoms, behaviors, and impact on functioning) to diagnose clients and measure the client’s response to treatment. For example, the CGI correlates well to scales such as the Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale to name a few (Jones et al., 2019).  

The CGI is well established and may be used for all psychiatric disorders in all FDA-regulated and most CNS trials; and the non-researcher clinician can easily use it in practice. The CGI is appropriate for use in depression, schizophrenia, anxiety, other mental disorders, regardless of the population, drug, or study measures. The CGI tool may also be used for other disorders such as sleep apnea (Dieltjens et al., 2019). The CGI is a brief and easy tool that may be administered by the practicing clinician to study the progression of treatment while using professional clinical judgment regarding the illness severity over the clinical experience. 

In conclusion, the Clinical Global Impression (CGI) is one of the most useful clinical tools available for monitoring outcomes across multiple clinically relevant domains, over time.  The CGI is valid, reliable, and easy to use. The CGI can be effectively and efficiently used across cultures, for clients of all ages and across socio-economic locations, and mental disorders.  The CGI scale allows the APPN to provide a more comprehensive treatment plan by creating a quantifiable measurement of symptoms and treatment efficacy. The clinician can monitor symptoms and improvement or lack of, to determine if the client is getting better or not throughout treatment.  Therefore, allowing the client and provider to make an informed decision providing patient-centered treatment utilizing evidence-based practice. 

You have been hired by a large law enforcement agency to analyze the images used on advertising billboards in both urban and suburban regions. The billboards visually display a new campaign message to improve neighborhood safety.

During your analysis, you find that the images used on billboards in the urban areas are exactly the same as the images used in the suburban areas. Both images show parents happily talking with law enforcement officers while children run over green lawns having a fun balloon fight. You decide that these images are not sending proper perceptual messages. You decide to create a visual analysis video for the law enforcement agency to share with the administration

For the video visual analysis, you realize you will need to find two new images that are quite different from one another. One image will be used on the urban billboard, and the other image will be used on the suburban billboard. In your video presentation, you will compare and contrast how each image utilizes the following:

1. Compare and contrast the visual elements of cultural familiarity. Explain why it is important to use culturally familiar visuals that are quite different in the urban and suburban billboard images. Include specific visuals in your visual analysis.
2. Identify specific visual examples of the following cognitive elements: memories, experiences, and expectation. Compare and contrast how urban and suburban viewers may be affected differently by those specific cognitive visual elements.
3. Explain the difference between urban and suburban viewers’ emotionally engagement with each of the billboard images.
4. Identify visual semiotic codes in both images: metonymic, analogical, displaced, and condensed. Discuss the importance of using these codes. Include specific visuals in each part of your visual analysis.

As you outline your ideas for the video, you decide to record your verbal analysis while analyzing the two visuals in less than seven minutes for added clarity.

Define basic methods of payment for healthcare firms.