respond 

 Hello Group – as you have discussed possible solutions to the system-wide issues of the increase in medication errors, what role does accountability play within the ad hoc committee as solutions to the problem are sought? Yes, everyone in a multidisciplinary group must hold each other accountable for group decisions and any solutions that are found to the identified problems. What areas of conflict might arise within the ad hoc group and how can individual personal leadership profiles play a role in resolving the conflicts and bringing the group to consensus? 

Sleep/Wake Disorders

Case 2 : Volume 2, Case #11: The figment of a man who looked upon the lady

To prepare

· Review this week’s Learning Resources and reflect on the insights they provide.

· Go to the Stahl Online website and examine the case study you were assigned( Case # 11 )

· Take the pretest for the case study.

· Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

· Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

· Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

· Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

· Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.

The Assignment

· Provide the case number in the subject line of the Discussion.

· List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.

· Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

· Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.

· List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.

· List two pharmacologic agents and their dosing that would be appropriate for the patient’s sleep/wake therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.

· If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.

· Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.

Resources ( Need 3 + references)

Required Readings

Note: All Stahl resources can be accessed through this link provided.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

• Chapter 10, “Chronic Pain and Its Treatment”

Stahl, S. M., & Ball, S. (2009a). Stahl’s illustrated chronic pain and fibromyalgia. New York, NY: Cambridge University Press.

To access the following chapter, click on the Illustrated Guides tab and then the Chronic Pain and Fibromyalgia tab.

• Chapter 5, “Pain Drugs”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Assignment 2: Practicum – Assessing Client Progress

Learning Objectives

Students will:

· Assess progress for clients receiving psychotherapy

· Differentiate progress notes from privileged notes

· Analyze preceptor’s use of privileged notes

To prepare:

· Reflect on the client you selected for the Week 3 Practicum Assignment( See attached)

· Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.

The Assignment

Part 1: Progress Note

Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):

· Treatment modality used and efficacy of approach

· Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)

· Modification(s) of the treatment plan that were made based on progress/lack of progress

· Clinical impressions regarding diagnosis and/or symptoms

· Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)

· Safety issues

· Clinical emergencies/actions taken

· Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)

· Treatment compliance/lack of compliance

· Clinical consultations

· Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)

· Therapist’s recommendations, including whether the client agreed to the recommendations

· Referrals made/reasons for making referrals

· Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)

· Issues related to consent and/or informed consent for treatment

· Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported

· Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment( See attached)

· The privileged note should include items that you would not typically include in a note as part of the clinical record.

· Explain why the items you included in the privileged note would not be included in the client’s progress note.

· Explain whether your preceptor uses privileged notes, and if so, describe the type of information he or she might include. If not, explain why.

Resources for reference ( Need 3+references). 

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

• Standard 4 “Planning” (pages 50-51)

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

• Chapter 5, “Supportive and      Psychodynamic Psychotherapy” (pp. 238–242)
• Chapter 9, “Interpersonal Psychotherapy” (pp.      347–368)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Abeles, N., & Koocher, G. P. (2011). Ethics in psychotherapy. In J. C. Norcross, G. R. VandenBos, D. K. Freedheim, J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), History of psychotherapy: Continuity and change (pp. 723–740). Washington, DC: American Psychological Association. doi:10.1037/12353-048

Cameron, S., & Turtle-Song, I. (2002). Learning to write case notes using the SOAP format. Journal of Counseling and Development, 80(3), 286-292.

Nicholson, R. (2002). The dilemma of psychotherapy notes and HIPAA. Journal of AHIMA, 73(2), 38–39. Retrieved from http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4

U.S. Department of Health & Human Services. (n.d.). HIPAA privacy rule and sharing information related to mental health. Retrieved from http://www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/

Required Media

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.

Stuart, S. (2010). Interpersonal psychotherapy: A case of postpartum depression [Video file]. Mill Valley, CA: Psychotherapy.net.

Advanced Pharmacology  

Fast Track is a new designation by the FDA which is intended to fasten the approval process of a drug or drugs that may treat a terminal disease and completely eliminate an unmet medical need (Emergo, 2018). 

Launched earlier this year, manufacturers of drugs have until the end of September to submit their applications so that they are vetted and found eligible to participate in the program (Emergo, 2018). The program is open to companies which are already in the market as well as new manufacturers. Once the manufacturers’ application is accepted, their technology and devices will undergo thorough underwriting before they are accepted.  

For a fast trucked drug to be approved, it must show certain benefits when compared to the existing drug. Benefits include being most effective, little to no side effects, improve the diagnosis of a serious disease and address public health issue (Johnson, 2018). 

Fast Track drugs can only be used to treat a serious condition or an unmet medical need. A serious condition is a health condition which if left untreated, it will progress to a more severe condition. An unmet medical need is a disease or condition whose therapy or treatment has not been tried. For such conditions, the type of drug used will be a preventative drug (Johnson, 2018) 

References

EMERGO. (2018, June 7). US FDA Attempts to Spur Development of Medical Devices Targeting Opioid Addiction. Retrieved from https://www.emergobyul.com/blog/2018/05/us-fda-attempts-spur-development-medical-devices-targeting-opioid-addiction

Johnson, S. B. (2018). Regulatory Considerations. Handbook of Neuroemergency Clinical Trials, 329-359. doi:10.1016/b978-0-12-804064-5.00017-5

1) DQ 8: 

Purpose: To provide students with the opportunity to understand the role FLORIDA’s state Board of Nursing (BON) and explore how it protects the welfare and safety of citizens and regulates the practice of nursing. For this week’s discussion read chapters 70, 72, and 74, then provide simple and short answers to the following questions:

1. What is the structure and authority of the BON?
2. What is the code of conduct as described in the Nurse Practice Act?
3. How is professional misconduct defined?
4. What are the sanctions for misconduct?
5. How do nurses remain in good standing?
6. Name three (3) OTHER nursing organizations (include at least one APRN organization)

https://floridasnursing.gov/

Reminder: 1)  250 words post. 2) All questions must be answered to receive full grade. 3)  Your original post by Wednesday 3/11/2020 and reply to ONE peer by 3/14/2020. 4) DO NOT forget your references.

2) REFLECTION #3 :Complete this week’s assigned readings, chapters 86 & 87. After completing the readings, post a short reflection, approximately 1 paragraph in length, discussing your thoughts and opinions about one or several of the specific topics covered in the textbook readings. pertaining to politics in associations and interest groups. Identify which one MSN Essential most relates to your selected topic in your discussion.