Chapter 11: Patient-Centered Care and Professional Nursing Practice

Question 1. 

Characteristics of patient-centered care are respect for patients’ values, preferences, and expressed needs (Masters, 2017). A nurse must respect the patients caring for. Everyone has distinct values, preferences and needs, therefore, nurse should be non-judgmental while caring for a patient.

Each PCC characteristic has its importance. For instance, what’s important to the patient should be respected and accepted by the nurse caring for the patient. The nurse should acknowledge that what may be of valuable means to someone may not be to someone else. Also, preferences have an important role in nursing. Hence, a nurse may encounter a patient preferring to be treated by a nurse of the same gender due to religion.

Lastly, a patient may have specific needs that must be addressed in order to achieve proper care. For instance, a patient with low income and is newly diagnosed with diabetes. Patient is unable to purchase the expensive medication needed for his new condition; therefore, unable to achieve proper treatment. As nurses we must understand patients’ needs and be their advocates.

Question 2. 

First, I would consider age, gender, culture and race to proceed with an appropriate educational method for this patients’ discharge. Although, the patient is being discharged with home health care, I would not disregard that he is the patient and must be informed of discharge. So, I would go over some suggestions of times that he may take his medications and work around his daily activities schedule. In addition, involving the patient in the treatment plan may motivate the elderly to feeling more efficient and useful.

            Furthermore, I would address any medication interactions involved with him. However, I would also hand him documents reinstating the discharge instructions and times discussed considering age related barriers and that the load of information given may be overwhelming. Of course, reassuring him I may answer any questions concerning his new medications and diagnosis. At this point, it is crucial to know if the patient is a visual learner or audio? The nurse may hand out pamphlets or brochures.

Lastly, involving family or home health care nurse in his treatment plan and discharge is an important factor in PCC. Also, I would consult with the patient the importance of taking his medications and sustaining a regimen. Considering, the patient being an elderly male African American he may be resistant at first to proceed with his medical plan and may look for remedy alternatives.

Question 3. 

The goal of the nurse in the process of patient education is to assist the patient in obtaining the knowledge, skills, or attitude that will help the patient develop in obtaining the knowledge, skills, or attitude that will help the patient  develop behaviors to meet needs and maximize the potential for positive health outcomes (Falvo, 2004,2011). It’s a nurse’s job to assure that the information being delivered is delivered correctly. In other words, the patients learning abilities, language barriers, or cultural sensitivity that may impede from treatment collaboration.

Thus, assess the patients comfort level in discussing treatment plan. Also, evaluate the patient’s ability to collaborate and if any barriers. Keeping in mind, Age-related changes in cognitive function occur slowly and are thought to begin at approximately sixty-years of age in healthy adults (Miller, 2004). Depending, I would proceed to ask the patient to reinstate what he understood of the information taught to determine if the information was retained by patient.  

Lastly, the patient needs to be willing to participate in his plan of care to be able to obtain a good health outcome. Therefore, as a nurse my priority would be in assessing any barriers that may impede a behavioral change. Once the patient is collaborating with the nurse should ask open ended questions to promote better communication between nurse and patient.

References

Falvo, D. (2004,2011). Effective patient education: A guide to increased adherence. Sudbury, MA: Jones & Barlett Learning.

Masters, K. (2017). Role Development in Professional Nursing Practice. Burlington, MA.

Miller, C. (2004). Nursing for wellness in older adults: Theory and practice. Philadelphia,PA: Lippincott.

Respond to your colleague providing further suggestions on how their database search might be improved.

At least 2 references in each peer responses! 

PICO(T) Question

Considering the overwhelming amount of research sources now available via the internet, clinicians must utilize a systematic approach while participating in evidence-based practice (EBP) inquiries. The PICO(T) question format is one such method clinicians use to ask a question about a clinical issue one seeks to gather EBP research (Stillwell, Fineout-Overholt, Melnyk, & Williamson, 2010).                                                                                                                   

    The clinical issue I chose to address for this assignment is anxiety in school-age children. As a school nurse, many of the visits to my health room are related to somatic symptoms from anxiety triggers. Anxiety disorders affect 7.1% of children ages 3-17 years old, and sadly only 59% of children age 3-17 years old will receive a formal mental health treatment (CDC, n.d.). The PICO(T) question I chose is: In school-age children with anxiety (P), how does a school-based mental health intervention (I) compared with no intervention (C) affect anxiety symptoms and overall global functioning (O)?

Search Terms and Databases Used for Research

    Based on my PICO(T) question, the terms I initially searched were “anxiety in children” and “school-based mental health”. I later narrowed down these terms further as outlined below to elicit more specific search results. The two databases I utilized for my research were CINAHL with Full-Text and PsycINFO.

Search Results, Articles Returned, and Changes from use of  Boolean Operators

Using CINAHL with Full Text, I searched the term “anxiety in children”, which returned approximately 4,000 results. Then I searched the term “school-based mental health”, which yielded 239 results. After completing the same search using the PsycINFO database, I yielded 10,798 and 571 results, respectively. I then applied the Boolean connector “AND” combining both of the search terms. The search results dramatically decreased the number of articles for each of the databases to generate less than ten results.

Database Strategies to Increase Rigor and Effectiveness

Strategies I implemented to increase the rigorousness and effectiveness of my search were searching synonyms of my keywords. According to Melnyk and Fineout-Overholt (2018), different databases will yield different results depending on the keyword used. Because of this, it is a good idea to utilize single word synonyms related to your original keywords and connect them with the Boolean operator “OR” when searching. For example, for the keyword “children”, I took advantage of the automatic word matching suggestions. I searched the keywords “child OR adolescents OR youth OR teenager”, broadening my search results just “children” since my particular clinical issue related to all school-age children. Databases are programmed to search for exact words. Therefore if you limit your keywords, you may risk potentially restrict your search results too drastically (Walden University Library, n.d.).

Please answer the following questions regarding demand for health care. 

• In your own words use utility analysis to explain why people demand health. How does the Law of Diminishing Marginal Utility fit into the analysis? 
• How would you expect the price elasticity of demand for medical care to vary with health status? Give a specific example. 

ONLY 250-300 words please, excluding sources. No formal formatting. Thanks!

Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.

2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.

3. Consider the discussions and any insights gained from it.

4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

1. Practice Hours: each module has a minimum required practice hours related to your work on the main education project. Practice hours relate to time spent on project work (Discussion Board work does not apply). Document your hours for Module 3 in Project Concert. Access Project Concert. You should have an estimated 10-15 hours for this module. Minimum required hours must be entered into Project Concert for Module 3. Some states/entities require hour logs for certification or employment. It is the student’s professional responsibility to ensure all hours are entered correctly in order to meet these requirements. Please see the Project Concert directions document in the Learning Materials on how to enter hours.
2. Create a PowerPoint presentation to illustrate and explain how the core determinants of health are impacting the health of your target population utilizing the picture below. Note that you should briefly review all of the determinants and then choose the ones that impact your target group to talk about in the assignment.  Be sure to review the link information in the classroom on Core Determinants of Health.  You will then use the power point you created as a visual and record your voice, narrating your power point. 

3. The presentation should be between 5 and 7 minutes in length. Use a recording platform of your choice  (note that screencast o matic is the easiest) and either upload as an mp4 or share the link directly to the video in the drop box.

If you do not know how to create a screen cast, note that there are tutorials on the www.screencast-o-matic.com website and also here is a short webinar link to click with information on how to use screen cast o matic:

https://screencast-o-matic.com/watch/cFioboFk2M

You will be using this sort of recording many times, so be sure that you understand how to use it.    

***Please do not record as voice-over on the PowerPoint platform, because this cannot be saved in mp4 format or a link.*** If you submit your assignment as a PowerPoint with voice over recording you will not receive credit for your assignment (or partial credit as you did not meet the full requirements of the assignment.)

Okay for a conceptual framework but what about a Nursing Theory? Go to https://nursing-theory.org/ and see what would work with your assumptions.