Respond to at least two of your  colleagues who were assigned to a different case than you. Explain how  you might apply knowledge gained from your colleagues case studies to  you own practice in clinical settings. 

                                       Main Post

      Case #13 the 8-year-old girl who was naughty  

         

This  case study will examine an 8-year-old girl who initially presents to  the pediatrician’s office with complaints of a fever and sore throat.  After further examination, the client is diagnosed with attention  deficit hyperactivity disorder (ADHD) and oppositional defiant disorder  (ODD). According to Ghosh, Ray, & Basu (2017), characteristics of  ODD include persistent anger or irritable mood, argumentativeness,  defiance, and vindictiveness for at least 6 months. ADHD is  characterized by a pattern of inattention, hyperactivity, and  impulsivity that interferes with daily functioning or development  (American Psychiatric Association, 2013). 

3 Additional Assessment Questions for the Client:

1.  I would ask the client and her mother how often her daughter displays  symptoms that are congruent with ODD and? According to the authors  Ghosh, Ray, & Basu (2017), the occurrence of ODD symptoms must be  disproportionate to the child’s developmental stage and age. 

2. I  would ask the client if she had trouble learning in class when she was  younger. The onset of ADHD symptoms usually occurs before a child  reaches age 12, and in some children, these symptoms are noticeable at  age 3 (Sibley, Rohde, & Swanson, 2017). 

3. A  final question that I would ask the client is if she interrupts her  classmates when they are speaking. Children suffering from ADHD feel the  need to be constantly active and struggle with controlling impulsive  behaviors (American Psychiatric Association, 2013).  

Feedback From the Client’s Loved Ones

The  first person in this client’s life that I would like to further  interview is the client’s mother. According to Stahl (2019), the  client’s mother is 26 years old and is a single parent of two children,  ages 8 and 6. I would want to ask the client’s mother more about her  daughter’s academic performance in earlier grades. Identifying the  precise onset of the client’s ADHD symptoms will assist the provider in  creating the most appropriate treatment for the client (Stahl, 2014). I  would also like to interview the client’s teacher in order to gain  another perspective on the client’s behavior in the classroom. The  client’s teacher did use an ADHD rating scale, but scales of that nature  are very broad and do not elaborate on the child’s specific classroom  behaviors. A third person that I would interview is the client’s  6-year-old sister. According to Stahl (2019), the client began  displaying signs of anger and resentfulness when her sister was born. I  would ask the client’s sister if she felt safe at home and if she and  her sister fought often, in order to determine if the home environment  is safe for both children. 

Physical Exams and Diagnostic Tests

The  physical assessment of the client is essential for developing an  appropriate diagnosis and treatment plan. Visual assessment of the  client’s behaviors during the physical assessment will be extremely  useful to the provider. The provider would also want to obtain and  review the client’s report cards along with any behavior reports, and  attendance records from the client’s school (Adesman, 2011). The  healthcare provider should also review the client’s pediatric health  records to see if her symptoms are congruent with a learning disability,  auditory processing disorder, signs of language delay, spacial  orientation confusion, and complete a more thorough family history  involving learning disabilities (Adesman, 2011). A complete blood count  should be down to rule out physical illness as a causetive factor for  the client’s ODD symptoms. The client is currently suffering from a  fever and sore throat, which could be an indicator of PANDAS (pediatric  autoimmune neuropsychiatric disorder associated with streptococcal  infections). Since  the client does have a current sore throat, a rapid strep test should  be ordered. If the client does test positive for strep, it could explain  the client’s symptomologies impulsivity, temper tantrums, and aggressiveness.  

Differential Diagnoses

Autism Spectrum Disorder: there  are deficits in social-emotional reciprocity, ranging from an abnormal  social approach and failure to communicate in a standard back-and-forth  conversation (American Psychiatric Association, 2013). There is also a  reduced sharing of interests, emotions, or affect, along with a failure  of the patient to initiate or respond during social interactions (American Psychiatric Association, 2013). The client’s history does not show any indication of impaired communication. 

Conduct Disorder:  characterized by behavior that violates either the rights of others or  major societal norms, the symptoms must be present for at least 3 months  with one symptom having been present in the past 6 months. The symptoms  of conduct disorder must cause significant impairment in social,  academic or occupational functioning (American Psychiatric Association,  2013). Per the client’s medical record, her symptoms fit the time frame  for conduct disorder, however, her behavior is not this severe in  nature. 

ADHD with Co-occurring ODD: The authors Ghosh, Ray, & Basu (2017), describe the characteristics  of ODD as persistent anger or irritable mood, argumentativeness,  defiance, and vindictiveness for at least 6 months. ADHD is  characterized by a pattern of inattention, hyperactivity,  and impulsivity that interferes with daily functioning or development  (American Psychiatric Association, 2013). The client’s behavior is  congruent with ADHD with co-occurring ODD.

Pharmacological Agents for ADHD/ODD Therapy: 

Risperdal  is the first pharmacological agent that I would choose for this client.  This medication is not listed on the suggested medication list of the  case study, however, the medication list does list “other” as a possible  choice. According to Stahl (2014), Risperidone  is also used to treat behavior problems such as aggression,  self-injury, and sudden mood changes in teenagers and children 5 to 16  years of age. Risperidone  is in a class of medications called atypical antipsychotics. It works  by changing the activity of certain natural substances in the brain. The  second medication that was chosen for this client is Vyvanse.  Vyvanse increases norepinephrine and dopamine actions by blocking their  reuptake and creating an environment that allows their release (Stahl,  2013). Vyvanse also causes an enhancement of dopamine and  norepinephrine in specific areas of the brain that may improve  attention, concentration, executive dysfunction, and wakefulness (Stahl,  2013). According to Stahl (2014), it is thought that the increased  dopamine action caused by Vyvanse, may help with hyperactivity. I would  initially start this client on Vyvanse due to its efficacy in treating  symptoms of ADHD. If the child’s academic performance and classroom  behavior improve, perhaps ODD symptoms will improve. 

   

CheckPoints: 

According  to Stahl (2019), the closest child psychotherapist is an hour away,  therefore the client did not receive therapy. I would refer the client  and her mother to case management in order to connect the client with  resources that are closer to her home. I would also ask the client’s  school what type of resources are available in terms of psychotherapy.

Lessons Learned: 

Through  this case study I have learned that co-occurring childhood disorders  can be difficult to treat. Pediatric clients can respond differently to  medication dosages than adults, so careful dose titration is essential.  Pediatric clients also rely on their parents or caregivers to provide  them with their prescribed medications and transportation to medical  appointments. It is essential that the healthcare provider conveys how  important treatment regime compliance is to both the client and their  caregiver.

Adesman, A. R. (2011). The Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in 

    
           Pediatric Patients. Primary care companion to the Journal of clinical psychiatry, 3(2), 66-77. 

    
           https://doi.org/10.4088/pcc.v03n0204 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC: Author.

Ghosh, A., Ray, A., & Basu, A. (2017). Oppositional defiant disorder: current insight. Psychology 

    
 research and behavior management, 10, 353-367. https://doi.org/10.2147/PRBM.S120582 

Sibley, M. H., Rohde, L. A., & Swanson, J. M. (2017). Late-Onset ADHD Reconsidered with 

    
            Comprehensive Repeated Assessments between Ages 10 and 25. American journal of psychiatry, 

    
 175(2), 140-149. https://doi.org/10.1176/appi.ajp.2017.17030298 

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

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

Stahl Online. (2019). Volume 1 case #5: The sleepy woman with anxiety. (PDF file). 

Retrievedfrom 

age=csEP_05.pdf                

  

Respond to your colleagues post by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.

at least 2 references in each peer responses! 

Much like in the nursing process, the step of evaluation is very important in implementing any change. Deciding how the policy will be evaluated should be done as the policy is being created (Laureate education). The Institute of Medicine wants nurses to be at the forefront of healthcare change. This also contributes to the fourth aim of the quadruple aim which is to fight healthcare worker fatigue (Milstead & Short, 2019). When nurses have a say in the changes, they will be more likely to help implement them.

Nursing input was asked for in evaluating the Affordable Care Act (ACA) (Milstead & Short, 2019). They were, urged to engage in the evaluation process, advocate for cost transparency, campaign for patient education regarding enrollment in subsidized health insurance plans, and assist with the dissemination of accurate evaluation results (Milstead & Short, 2019, pp. 121). With nurses being at the forefront of healthcare and the largest group of healthcare workers, their input is critical in evaluating how a new policy is working and they are also able to identify problems. 

Nursing professional organizations, such as the American Nurses Association (ANA) and the American Association of Nurse Practitioners (AANP), among many others, were asked to provide formative data to lawmakers while the ACA was being evaluated (Milstead & Short, 2019). In addition to assisting with data collection, they were also asked to help disseminate evaluation data among peers, stakeholders, and patients (Milstead & Short, 2019). By being highly involved in a nursing organization, a nurse can have an excellent opportunity to review policies.

There are some challenges that exist in evaluating health policies. One factor is public opinion (Milstead & Short, 2019). This played a huge role in reviewing the ACA. Members of the public were constantly being manipulated by the press to think it was either bad or good and their opinions affected congress members’ decisions since they rely on votes to stay in office. A policy that might be overall beneficial to the public, could die by public opinion. To combat that, nurses need to make sure that they advocate for policies they believe in. This could make a difference since they are a trusted profession. 

Another challenge is the rapid pace of policy changes (Milstead & Short, 2019). Some policies take time to truly see the effect they will have, but constituents and stakeholders want results overnight. This challenge might be met by establishing evaluation criteria from the start and asserting that time will be needed to fully know the impact. 

Laureate Education (Producer). (2018). The Importance of Program Evaluation [Video file]. Baltimore, MD: Author.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurses guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

      

Episodic/Focused   SOAP Note Exemplar (pls use this template)
 

Focused   SOAP Note for a patient with chest pain

 S.
  CC: Chest pain
 

  HPI: The patient is a 65 year old AA male who developed sudden onset of   chest pain, which began early this morning.  The pain is described as   crushing and is rated nine out of 10 in terms of intensity. The pain is   located in the middle of the chest and is accompanied by shortness of breath.   The patient reports feeling nauseous. The patient tried an antacid with   minimal relief of his symptoms.
 

  PMH: Positive history of GERD and hypertension is controlled
 

  FH: Mother died at 78 of breast cancer; Father at 75 of CVA.  No   history of premature cardiovascular disease in first degree relatives.
 

  SH : Negative for tobacco abuse, currently or previously; consumes   moderate alcohol; married for 39 years
 

  ROS   
General–Negative for fevers,   chills, fatigue
Cardiovascular–Negative for   orthopnea, PND, positive for intermittent lower extremity edema
Gastrointestinal–Positive for   nausea without vomiting; negative for diarrhea, abdominal pain
Pulmonary–Positive for   intermittent dyspnea on exertion, negative for cough or   hemoptysis  

 

O.

VS:   BP 186/102; P 94; R 22; T 97.8; 02 96% Wt 235lbs; Ht 70

General–Pt appears diaphoretic and anxious

Cardiovascular–PMI is in the 5th inter-costal   space at the mid clavicular line. A grade 2/6 systolic decrescendo murmur is   heard best at the

second   right inter-costal space which radiates to the neck.

A   third heard sound is heard at the apex. No fourth heart sound or rub are   heard. No cyanosis, clubbing, noted, positive for bilateral 2+ LE edema is   noted.

Gastrointestinal–The abdomen is symmetrical   without distention; bowel

sounds   are normal in quality and intensity in all areas; a

bruit   is heard in the right para-umbilical area. No masses or

splenomegaly   are noted. Positive for mid-epigastric tenderness with deep palpation.

Pulmonary— Lungs are clear to   auscultation and percussion bilaterally 

Diagnostic   results: EKG, CXR, CK-MB (support with evidenced and guidelines)

A.

Differential   Diagnosis:

1)   Myocardial Infarction (provide supportive documentation with evidence based   guidelines).

2)   Angina (provide supportive documentation with evidence based guidelines).

3)   Costochondritis (provide supportive documentation with evidence based   guidelines).

Primary   Diagnosis/Presumptive Diagnosis: Myocardial Infarction

P. This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

Case #2: 

CASE STUDY 2: Numbness and Pain A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

To Prepare

 You will be assigned to a specific case study for this Case Study Assignment (Please see Above)

Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format( as in exampler above) rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

 

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided ( ABOVE). Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 

Resource for references

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 7, Mental Status

       This chapter revolves around the mental status evaluation of an      individuals overall cognitive state. The chapter includes a list of      mental abnormalities and their symptoms.

• Chapter 23, Neurologic System

       The authors of this chapter explore the anatomy and physiology of the      neurologic system. The authors also describe neurological examinations and      potential findings.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

• Chapter 2, “The Comprehensive History      and Physical Exam” (“Cranial Nerves and Their Function” and      “Grading Reflexes”) (Previously read in Weeks 1, 2, 3, and 5)

This article reviews the use of electrocenographs (EEG) to assist in differential diagnoses. The authors provide differential diagnostic scenarios in which the EEG was useful.

Prepare an 4-5 page paper on the importance of nursing-sensitive quality indicators.

As you begin to prepare this assessment you are encouraged to complete the Conabedian Quality Assessment Framework activity. Quality healthcare delivery requires systematic action. Completion of this will help you succeed with the assessment as you consider how the triad of structure (such as the hospital, clinic, provider qualifications/organizational characteristics) and process (such as the delivery/coordination/education/protocols/practice style or standard of care) may be modified to achieve quality outcomes.

The American Nursing Association (ANA) established the National Database of Nursing Quality Indicators (NDNQI) in 1998 to track and report on quality indicators heavily influenced by nursing action.

NDNQI was established as a standardized approach to evaluating nursing performance in relation to patient outcomes. It provides a database and quality measurement program to track clinical performance and to compare nursing quality measures against other hospital data at the national, regional, and state levels. Nursing-sensitive quality indicators help establish evidence-based practice guidelines in the inpatient and outpatient settings to enhance quality care outcomes and initiate quality improvement educational programs, outreach, and protocol development.

The quality indicators the NDNQI monitors are organized into three categories: structure, process, and outcome. Theorist Avedis Donabedian first identified these categories. Donabedians theory of quality health care focused on the links between quality outcomes and the structures and processes of care (Grove, Gray, Jay, Jay, & Burns, 2015).

Nurses must be knowledgeable about the indicators their workplaces monitor. Some nurses deliver direct patient care that leads to a monitored outcome. Other nurses may be involved in data collection and analysis. In addition, monitoring organizations, including managed care entities, exist to gather data from individual organizations to analyze overall industry quality. All of these roles are important to advance quality and safety outcomes.

The focus of Assessment 4 is on how informatics support monitoring of nursing-sensitive quality indicator data. You will develop an 810 minute audio (or video) training module to orient new nurses in a workplace to a single nursing-sensitive quality indicator critical to the organization. Your recording will address how data are collected and disseminated across the organization along with the nurses role in supporting accurate reporting and high quality results.

Reference

Grove, S. K., Gray, J. R., Jay, G.W., Jay, H. M., & Burns, N. (2015). Understanding nursing research: Building an evidence-based practice (6th ed.). St. Louis, MO: Elsevier.

Demonstration of Proficiency

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

• Competency 1: Describe nurses and the interdisciplinary teams role in informatics with a focus on electronic health information and patient care technology to support decision making. 
  • Describe the interdisciplinary teams role in collecting and reporting quality indicator data to enhance patient safety, patient care outcomes, and organizational performance reports.
• Competency 3: Evaluate the impact of patient care technologies on desired outcomes. 
  • Explain how a health care organization uses nursing-sensitive quality indicators to enhance patient safety, patient care outcomes, and organizational performance reports.
• Competency 4: Recommend the use of a technology to enhance quality and safety standards for patients. 
  • Justify how a nursing-sensitive quality indicator establishes evidence-based practice guidelines for nurses to follow when using patient care technologies to enhance patient safety, satisfaction, and outcomes.
• Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies. 
  • Deliver a professional and effective audio tutorial on a selected quality indicator that engages new nurses and motivates them to accurately report quality data in a timely fashion.
  • Follow APA style and formatting guidelines for citations and references.

Preparation

This assessment requires you to prepare a 4-5 page paper on the importance of nursing-sensitive quality indicators. To successfully prepare for your assessment, you will need to complete the following preparatory activities:

• Select a single nursing-sensitive quality indicator that you see as important to a selected type of health care system.
• Conduct independent research on the most current information about the selected nursing-sensitive quality indicator.
• Interview a professional colleague or contact who is familiar with quality monitoring and how technology can help to collect and report quality indicator data. You do not need to submit the transcript of your conversation, but do integrate what you learned from the interview into the audio tutorial. Consider these questions for your interview: 
  • What is your experience with collecting data and entering it into a database?
  • What challenges have you experienced?
  • How does your organization share with the nursing staff and other members of the health care system the quality improvement monitoring results?
  • What role do bedside nurses and other frontline staff have in entering the data? For example, do staff members enter the information into an electronic medical record for extraction? Or do they enter it into another system? How effective is this process

Instructions

For this assessment, imagine you are a member of a Quality Improvement Council at any type of health care system, whether acute, ambulatory, home health, managed care, et cetera. Your Council has identified that newly hired nurses would benefit from comprehensive training on the importance of nursing-sensitive quality indicators. The Council would like the training to address how this information is collected and disseminated across the organization. It would also like the training to describe the role nurses have in accurate reporting and high-quality results.

The Council indicates a recording is preferable to a written fact sheet due to the popularity of audio blogs. In this way, new hires can listen to the tutorial on their own time using their phone or other device.

As a result of this need, you offer to create an audio tutorial orienting new hires to these topics. You know that you will need a script to guide your audio recording. You also plan to incorporate into your script the insights you learned from conducting an interview with an authority on quality monitoring and the use of technology to collect and report quality indicator data.

You determine that you will cover the following topics in your audio tutorial script:

Introduction: Nursing-Sensitive Quality Indicator

• What is the NDNQI?
• What are nursing-sensitive quality indicators?
• Which particular quality indicator did you select to address in your tutorial?
• Why is this quality indicator important to monitor? 
  • Be sure to address the impact of this indicator on quality of care and patient safety.
• Why do new nurses need to be familiar with this particular quality indicator when providing patient care?

Collection and Distribution of Quality Indicator Data

• According to your interview and other resources, how does your organization collect data on this quality indicator?
• How does the organization disseminate aggregate data?
• What role do nurses play in supporting accurate reporting and high-quality results? 
  • As an example, consider the importance of accurately entering data regarding nursing interventions.

Additional Requirements

• References: Cite a minimum of three scholarly and/or authoritative sources.
• APA: Submit along with the recording a separate Reference page that follows APA style and formatting guidelines. For an APA refresher, consult the page on Campus.

 

The student will visit

The student will answer the following questions related to the website.  

1.  Summarize eligibility for the Medicaid program.

2.  Explain how the Medicaid program works.

3. Describe how the Medicaid program is financed.

The paper should be no more than 2 paragraphs.  Use APA format.

Select a community organization or group that you feel would be interested in learning about ethical and policy issues that affect the coordination of care. Then, develop and record a 10-12-slide, Create a detailed narrative script for your presentation, 4-5 pages in length.

As coordinators of care, nurses must be aware of the code of ethics for nurses and health policy issues that affect the coordination of care within the context of the community. To help patients navigate the continuum of care, nurses must be proficient at interpreting and applying the code of ethics for nurses and health policy, specifically, the Affordable Care Act (ACA). Being knowledgeable about ethical and policy issues helps ensure that care coordinators are upholding ethical standards and navigating policy issues that affect patient care.

This assessment provides an opportunity for you to develop a presentation for a local community organization of your choice, which provides an overview of ethical standards and relevant policy issues that affect the coordination of care. Completing this assessment will strengthen your understanding of ethical issues and policies related to the coordination and continuum of care, and will empower you to be a stronger advocate and nursing professional.

It would be an excellent choice to complete the Vila Health: Ethical Decision Making activity prior to developing the presentation. The activity provides a helpful update on the ethical principles that will help with success in this assessment.

Demonstration of Proficiency

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

• Competency 4: Defend decisions based on the code of ethics for nursing. 
  • Assess the impact of the code of ethics for nurses on the coordination and continuum of care.
• Competency 5: Explain how health care policies affect patient-centered care. 
  • Explain how governmental policies related to the health and/or safety of a community affect the coordination of care.
  • Identify national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination.
• Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care. 
  • Communicate key ethical and policy issues in a presentation affecting the coordination and continuum of care for a selected community organization or support group. Either speaker notes or audio voice-over are included.

Preparation

Your nurse manager at the community care center is well connected and frequently speaks to a variety of community organizations and groups. She has noticed the good work you are doing in your new care coordination role and respects your speaking and presentation skills. Consequently, she thought that an opportunity to speak publicly about contemporary issues in care coordination would be beneficial for your career and has suggested reaching out to a community organization or support group to gauge their interest in hearing from you, as a care center representative, on a topic of interest to both you and your prospective audience.

You have agreed that this is a good idea and have decided to research a community organization or support group that might be interested in learning about ethical and policy issues related to the coordination of care. Your manager has suggested the following community organizations and support groups, but acknowledges that the choice is yours.

• Homeless shelters.
• Local religious groups.
• Nursing homes.
• Local community organizations (Rotary Club or Kiwanis Club).

To prepare for this assessment, you may wish to:

• Research your selected community organization or support group.
• Review the Code of Ethics for Nurses With Interpretive Statements and associated health policy issues, specifically, the ACA.
• Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete.
• Allocate sufficient time to rehearse your presentation before recording the final version for submission.

Note: Remember that you can submit all, or a portion of, your draft presentation to for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 2448 hours for receiving feedback.

Instructions

For this assessment:

• Choose the community organization or support group that you plan to address.
• Develop and record a presentation, with typed speaker notes (the script for your voice recording) and audio voice-over recording, intended for that audience. Video is not required.

Note: PowerPoint has a feature to type the speaker notes directly into the presentation. You are encouraged to use that feature or you may choose to submit a separate document. See for technical support about the use of PowerPoint, including voice recording and speaker notes.

Note: For this assessment, develop your presentation slides and speaker notes, then record your presentation. You are not required to deliver your presentation to an actual audience but you certainly could if you chose to.

Presentation Format and Length

You may use PowerPoint (recommended) or other suitable presentation software to create your slides and add your voiceover. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues. You can also record your presentation using Kaltura or similar software.

Be sure that your slide deck includes the following slides:

• Title slide. 
  • Presentation title.
  • Your name.
  • Date.
  • Course number and title.
• References (at the end of your presentation).

Your slide deck should consist of 1012 slides, not including a title and references slide with typed speaker notes and audio voice over. Your presentation should not exceed 20 minutes.

Create a detailed narrative script for your presentation, approximately 45 pages in length.

Supporting Evidence

Cite 35 credible sources from peer-reviewed journals or professional industry publications to support your presentation. Include your source citations on a references page appended to your narrative script.

Grading Requirements

The requirements outlined below correspond to the grading criteria in the Ethical and Policy Factors in Care Coordination Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

• Explain how governmental policies related to the health and/or safety of the community affect the coordination of care. 
  • Provide examples of a specific policy affecting the organization or group.
  • Refer to the assessment resources for help in locating relevant policies.
  • Be sure influential policies include the Health Insurance Portability and Accountability Act (HIPPA).
• Identify national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination. 
  • What are the implications and consequences of specific policy provisions?
  • What evidence do you have to support your conclusions?
• Assess the impact of the code of ethics for nurses on the coordination and continuum of care. 
  • Consider the factors that contribute to health, health disparities, and access to services.
  • Consider the social determinants of health identified in Healthy People 2020 as a framework for your assessment.
  • Provide evidence to support your conclusions.
• Communicate key ethical and policy issues in a presentation affecting the coordination and continuum of care for a selected community organization or support group. Either speaker notes or audio voice-over are included. 
  • Present a concise overview.
  • Support your main points and conclusions with relevant and credible evidence.

 

Sensation and Perception

Sensations involve one of your five senses and perception involves the brains capacity to interpret, analyze, and integrate the stimuli presented.  We cannot tune into everything our senses come in contact with or we would be overloaded with sensory stimuli.  Read and respond to the following: 

You are the president of a corporation that owns several large department stores. A board member has a plan for preventing shoplifting: In each store, play musical soundtracks containing subaudible and consciously imperceptible verbal messages such as don’t steal and shoplifting is a crime. Carefully discuss your reasons for supporting or rejecting this proposal to engage in subliminal persuasion. You should offer at least one citation to support your work.

 

Watch the “Diary of Medical Mission Trip” videos dealing with the catastrophic earthquake in Haiti in 2010. Reflect on this natural disaster by answering the following questions:

1. Propose one example of a nursing intervention related to the disaster from each of the following levels: primary prevention, secondary prevention, and tertiary prevention. Provide innovative examples that have not been discussed by previous students.
2. Under which phase of the disaster do the three proposed interventions fall? Explain why you chose that phase.
3. With what people or agencies would you work in facilitating the proposed interventions and why?

Submit an evidence-based practice paper about cultural competency in mental health nursing. An evidence-based practice paper allows you to explore best practice and help improve client outcomes on a psychiatric unit. Your paper should describe how you, as a nurse, will include – or have included – cultural awareness in a client diagnosed with a mental illness. The person you describe could be someone in your clinical setting, someone you have worked with in the past, or a theoretical client. 

Remember that culture can also include gender equality, sexual orientation, and other cultures besides race and religion – including cultures unique to one particular family. Your paper should be at least 3 pages (double-spaced, not including the title or reference pages) in APA Format and include:

• Assessment: Discuss what you would assess in regard to a client’s culture. For example, are there specific dietary requirements? Are schedule changes necessary to avoid conflicts with religious practices? Who is the spokesperson for the family? What would you assess?
• Diagnosis: List any mental health nursing diagnoses this person has or may be at risk for. Include at least one cultural diagnosis.
• Planning: What planning needs to be done to ensure the cultural and emotional safety of the client? 
• Implementation: What are interventions that would ensure the safety of your client in regard to culture? Include at least two interventions. For example, if your client has religious beliefs that affect the ability to take medications, what interventions would you create to ensure the client’s safety? What can you do to make sure the client’s cultural needs are met?
• Evaluation: How will you evaluate whether your implementation was effective? Make sure the parameters are objective and measurable.
• In your summary, discuss whether any completed interventions were successful. What could be done differently in the future? If the interventions have not yet been carried out, you might discuss some institutional changes that could be made to ensure cultural safety for all clients in that setting.

 What spiritual considerations surrounding a disaster can arise for individuals, communities, and health care providers? Explain your answer in the context of a natural or manmade disaster. How can a community health nurse assist in the spiritual care of the individual, community, self, and colleagues?