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Discussion: Developing a Culture of Evidence-Based Practice NURS 6052

Discussion: Developing a Culture of Evidence-Based Practice NURS 6052

Dissemination is the targeted distribution of information and intervention materials to a specific public health or clinical practice audience. (AHRQ, 2012). It is used to spread knowledge and evidence-based practice on a wide scale within or across geographic locations, practice settings, social media, or other networks for the benefit of patients and health care providers.

The two dissemination strategies I would be most inclined to use are social media and mass communication. The reason being, we live in a social media world, everyone is on some type of social media platform, and they find out information very quickly. If a specific topic is trending, it is most likely going to reach the masses of people in a matter of seconds. Social media helps facilitate to most recent and most relevant information.

Mass communication is another great way to exchanging information on a large scale to a wide range of people. It has brought information to people that otherwise could not be reached and has increased awareness among people about what is happening in other parts of the world. Websites and healthcare applications are great in delivering mass communications on topics that need to be discussed to a particular population an also keep the community up to date and in the know. (Krohn et al, 2022).

I would be least likely to distribute program materials, such as flyers, guides, pamphlets and DVDs because most of the time, they end up in the trash. Having a phone or tablet to search for information is more convenient and less clutter for humans. It will take more time to find the pamphlet and scan for the information as opposed to searching online.

The barriers I might encounter when using social media and mass communication are social anxiety, depression, and exposure to content that is not age appropriate. (Dalomba, 2022). People tend to believe everything on social media, it is not always a good thing, and people do not talk about what they read but tend to internalize it.

Ways to overcome these barriers are to display some type of public service announcement or disclaimer after the information. Sometimes, people need to be reminded about things they just read, and know that there is help, or someone here to further explain and answer questions.

References

Agency for Healthcare Research and Quality. (AHRQ). (2012). Communication and Dissemination Strategies To Facilitate the Use of Health-Related Evidence. https://effectivehealthcare.ahrq.gov/products/medical-evidence-communication/research-protocol

Links to an external site.

Dalomba, F. (2022). Lifespan: Pros and Cons of social media. https://www.lifespan.org/lifespan-living/social-media-good-bad-and-ugly

Links to an external site.

Krohn, Kristina M. MD1; Crichlow, Renee MD2; McKinney, Zeke J. MD3; Tessier, Katelyn M. MS4; Scheurer, Johannah M. MD5; Olson, Andrew P.J. MD6 (2022). Introducing Mass Communications Strategies to Medical Students: A Novel Short Session for Fourth-Year Students. Academic Medicine 97(7):p 999-1003 https://journals.lww.com/academicmedicine/Fulltext/2022/07000/Introducing_Mass_Communications_Strategies_to.42.aspx

Great post! I love going to conferences and hearing colleagues discussed new information or experiences they have encountered at their organization. These conferences provide education, sharpen skills, gives us the ability to interact with peers, and try new equipment which leads to improvement in health-care delivery, and patient outcomes. (Mishra, S, 2016).

Sometimes, we may think that our place of work is the only one going through an issue, when, it happens more often, but not discussed. At conferences, I learn about issues, or techniques that are being used or no longer in use and the nurses elaborate as to why. Their input is valuable, and gives us as a whole a much clearer understanding.

Publishing an article is another great dissemination strategy. Writing for a publication allows you to contribute to nursing practice and help build nursing and healthcare knowledge. Clinical articles aim to help nurses understand the clinical presentation and progression of a disease or health issue and the subsequent care for a specific patient population.

The nursing literature serves as a primary means of communicating new knowledge to nurses and should provide some discussion about the nursing perspective and nurses’ contributions to these health care initiatives. It is important not to lose our nursing perspective. (Oerman et al, 2019). Journal articles, websites, books, and other publications provide our primary means of communicating this knowledge and new information to others.

I concur with you about forcefully implementing the evidence-based practice intervention in the organization without informing or involving the other organizational stakeholders. This is a recipe for disaster, lack of support, an unwillingness to learn and implement, and dissatisfaction among leaders, nurses and other stakeholders.

 References 

Mishra S.(2016). Do medical conferences have a role to play? Sharpen the saw. Indian Heart J. 68(2):111-3. doi: 10.1016/j.ihj.2016.03.011. PMID: 27133315; PMCID: PMC4867024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867024/Links to an external site.

Oermann, M, Chinn, P, Carter-Templeton, H, Nicoll, L. (2019). The Importance of Nursing in Nursing Publications. https://doi.org/10.1111/j.1750-4910.2019.tb00043.xLinks to an external site.

As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

• Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
  • This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
• Reflect on which type of dissemination strategy you might use to communicate EBP.

By Day 3 of Week 10

Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified. Discussion: Developing a Culture of Evidence-Based Practice NURS 6052

Dissemination Strategies

Evidence-based practice (EBP) is an essential competency for healthcare professionals to provide better patient outcomes (Newhouse et al., 2007). In order to promote changes that are found to have solid evidence, there are multiple dissemination strategies that can be used, including: publishing in nursing journals, sharing information through social media or website, creating pamphlets and flyers, presenting at national conferences, promoting at health fairs, and more (Rural Health Information Hub, n.d.).

One dissemination strategy I am most inclined to use is work email. Emails are a quick and easy way to send information to multiple parties at a given time. They are efficient in relaying information to the intended recipient(s) and can be opened at the convenience of the recipient.

Another strategy I would be inclined to use is creating informative flyers. I have always had a passion for art, and I enjoy creating projects that are beneficial to improving workflow and organization. Furthermore, I believe both appeal and presentation have a huge impact on the impressions of leaders.

The dissemination strategy I would be least inclined to use is speaking at national-level conferences. I have always struggled with public speaking, and this would be an amplified version of what I might consider being a typical public audience.

Barriers and Overcoming Barriers

Although most individuals in the healthcare system likely already realize the importance of promoting evidence-based practice (EBP), there are barriers as well. For instance, if using email as a dissemination technique, one might encounter a lack of response as not everyone keeps up with checking their emails daily. Another lack of response could be from an email that happened to go to the wrong email address. To overcome these issues, I would triple check email addresses for accuracy as well as encourage staff to check their emails regularly.

Another barrier could potentially be the lack of support from the manager. If the manager does not envision a successful outcome, he or she may be less likely to support the intervention. If this becomes the issue at hand, I would reach out to doctors and nurse practitioners within the workplace to gather their thoughts and opinions considering their medical knowledge. After all, being a role model, empowering others, and encouraging others to reach their full potential are all characteristics of an evidence-based leader (Melnyk & Fineout-Overholt, 2018).

By Day 6 of Week 10

Respond to at least two of your colleagues on two different days by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 10 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 10

To participate in this Discussion:

Week 10 Discussion

Assignment: Evidence-Based Capstone Project, Part 6: Disseminating Results

The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP. Discussion: Developing a Culture of Evidence-Based Practice NURS 6052

To Prepare:

• Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course.
• Consider the best method of disseminating the results of your presentation to an audience.

To Complete:

Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.

• Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
• Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

By Day 5 of Week 11

Submit Part 6, your revised PowerPoint presentation of your Evidence-Based Project.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.
• Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 11 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 11 Assignment draft and review the originality report.

Submit Your Assignment by Day 5 of Week 11

To submit your Assignment:

Week 11 Assignment

Assignment: Development Markers Based on the CDC (2020)

Assignment: Development Markers Based on the CDC (2020)

Reply 19-month old development markersBased on the CDC (2020), a 9-month-old baby should be able to do at least these things listed below as examples:Social and Emotional – May be afraid of strangers and attached with those familiar to themLanguage/Communication – Understands “no” and makes different sounds that seem like “mama” or “dada”Cognitive – plays peek-a-boo, can hold cereal between pointer finger and thumbPhysical Development – sits by themselves without support, crawlsRecommendations with EBPThere are so many assessments that would need to be made to ensure the baby is growing properly. If the baby’s birth weight, height, and head circumference were in the 5th percentile when born and developing on schedule, then the baby may just be small. If on the other hand, the infant was born in the 60% percentile and is now in the 20% for weight, that would be of concern. If that were the case, I would go over the infant’s daily intake and feeding schedule; also assessing if the mother is breastfeeding. If she is breastfeeding, it would be important to recommend foods that are nutritious for the baby and ensuring she is feeding often enough and producing enough milk. Not eating enough or the right foods could delay the baby’s growth and by 9 months, the infant should be eating baby foods and if drinking juice it should be 100% fruit juice (Green, 2018). If the mother was unable to produce enough milk, refer her to an appropriate formula and even information to have food supplement if the family is unable to afford. The WIC program is helpful to provide healthy choices. Based on the American Academy of Pediatrics (AAP) (n.d.) suggests that babies at age 9 months eat less fruits and vegetables because the baby can start feeding themselves and snack on non-nutritive snacks (baby cookies, etc.) instead of fruits and vegetables. “After 9 months, offer 2-3 healthy and nutritious snacks per day” consisting of fruits and vegetables (AAP, n.d.). I would also provide information and websites to access for more information.References American Academy of Pediatrics (AAP). (n.d.) Infant food and feeding. Retrieved from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/Age-Specific-Content/Pages/Infant-Food-and-Feeding.aspx Centers for Disease Control and Prevention (CDC). (2020). Important milestones: Your baby by nine months. Retrieved from https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html Green, S.Z. (2018). Health assessment: Foundations for effective practice.Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/ Reply 2Consider the following patient scenario:A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).Describe the developmental markers a nurse should assess for a 9-month-old female infant.Developmental markers are physical, communicational, emotional, and cognitive. ( Centers for Disease Control and Prevention, 2020) Physical markers such as height, weight, and head circumference are measurements of development. Average weight of a 9-month-old girl should be between 18-19 lbs., height should be around 27-28 inches, and head circumference around 44cm. ( Centers for Disease Control and Prevention, 2020) Other physical markers include the 9 month old being able to complete tasks such as crawling, sitting without support, pulling self to standing, stands while holding a support, and making stepping motions. (Green, 2018) Understanding of the word no, makes sounds such as mama and dada, copying sounds, and using fingers to point, are typical communication for a 9 month old. ( Centers for Disease Control and Prevention, 2020) Emotional markers include being afraid of strangers, being clingy to familiar adults, and having favorite toys. ( Centers for Disease Control and Prevention, 2020) A 9 month old with normal development in cognition will watch the path of falling items, looks for others when they hide, plays peek-a-boo, puts things in mouth, moves things from one hand to the other smoothly, and is able to pick up small items between thumb and index finger. ( Centers for Disease Control and Prevention, 2020) Another developmental marker is assessing dental health and the impact of teething.Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.Recommendations to the mother would depend on the answers to the other developmental questions. Assessment of nutritional intake would be key in understanding why the child is lacking in weight. A thorough evaluation of the patient’s history and overall health would be needed to make appropriate recommendations. With the information provided this patient could be referred to the WIC program for assistance with access to food if that is an issue for the patient. Another recommendation would be to start the child on solid foods if they have not started them already. “First solid should be a single-grain iron-fortified baby cereal, such as rice with breastmilk, formula, or water via spoon.” (Green, 2018) By the age or 8 months on the child can eat small pieces of more solid type foods such as crackers, noodles, cooked vegetables, and more. (Green, 2018) If the child is teething and that is causing a lack of interest in food. The nurse can suggest items to ease the child’s teething pain such as a frozen teething ring or cool soft foods. Ensuring proper diet and care for the child are very important to maintain overall health and wellness.ReferencesCenters for Disease Control and Prevention. (2020, June 9). Retrieved from CDC 24/7: Saving Lives, Protecting People: https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.htmlGreen, S. Z. (2018). Grand Canyon University. Retrieved from Health Assessment Foundations for Effective Practice: https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/1

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Assignment: Presсrіption Drug Addiction

Assignment: Presсrіption Drug Addiction

Here is what the rubric for the essay included. The Topic I am doing is Presсrіption Drug

addiction. It has to be APA style, and this professor is VERY strict about essay level,

paragraph level, and sentence level. If the essay is not structure as he provided below he

grades it poorly. You do not have to worry about the title page I can fill that out, but if you

include the abstract and sources you have used that would be great. 1. Intro: Tell me about

your chosen discipline and present your chosen topic. End with a thesis that tells me who

this problem hurts and who it benefits. 2. Definition/Setup a. Describe your topic: Explain

what your topic is and why it’s a problem for society today. What are some of the ways that

this impacts the world? b. Explain the source: When did this problem begin? What caused it?

Has it gotten better or worse over time? 3. Group 1 – Those the problem hurts a. Explain

who the group is: Explain who this problem impacts most. Pay special attention to people

with differing racial/ethnic identities, socioeconomic classes, gender expressions, sexualities,

religions, ages, political beliefs, etc. Consider which career groups or interest groups would

be most hurt by the problem. Why does the problem affect these groups more than others?

b. Explain how it hurts them: Does it affect them financially/economically? Does it impact

their mental/physical/emotional health and wellness? Does it hurt their social standing? Does

it impact their access to politics/power? Why is this the case? 4. Group 2 – Those who

benefit from the problem a. Explain who the group is: In this section, consider what groups

would benefit from this problem. Why might these groups have something to gain? Consider

all of the same types of groups as above. b. Explain how it benefits them: Why might these

groups want this problem to continue existing? Do they benefit financially/economically? Is

there a social incentive? Do they have anything to gain politically? Would they do anything to

make sure that this problem isn’t solved? Could this problem exist on purpose? Why is this

the case? 5. Outro: Conclude by reinforcing what you’ve said above – tell me who the

biggest victims are and tell me who the biggest beneficiaries are. Do we learn something

interesting about the problem if we compare these two groups? Does this help us

understand why the problem exists in the first place? Or maybe why it hasn’t been solved?

Tips for this Assignment o Spend some time thinking about which discipline you’d like to

explore first and foremost. This may be the field of study you’re currently in, or it could be

something totally new to you. After you’ve selected a discipline, spend some time thinking

about social issues and other newsworthy topics. Late-night shows like Last Week Tonight

with John Oliver can be a great way to get introduced to topics you might not have otherwise

considered. o Your introduction should provide me with some information about the

discipline you’ve chosen (consider mentioning specific majors or careers in your discipline),

and it should briefly cover the topic you’re considering in your paper. Your thesis should tell

me about the victims and the beneficiaries – consider why that might be the case. o As you

write your essay, pay special attention to the outline I’ve given you. Your topic sentences

should make it very clear that you’re following this structure. Answer the questions provided

in each bullet point, and support your ideas with information from outside sources (using

APA to avoid plagiarism of course). o The tone for this assignment is especially important to

consider. You should remain unbiased in how you present your information. You should

choose a topic that resonates with you, and write about it fairly. o You will be able to use this

essay for some of your later assignments, so make sure you take your time with it. Being

lazy now can hurt you when it comes time to do your second paper and even when you start

working on the final research project. This paper must be 4-5 pages long, and it must be

written using APA Style. You must use at least 3 outside sources (one for each section). You

must have a title page, abstract, and references page for this assignment

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Discussion Questions: Psychiatric Care and Mental Health in the Community

Discussion Questions: Psychiatric Care and Mental Health in the Community

Week 14 lecture and discussion questions

Psychiatric Care and Mental Health in the Community

Read chapter 24 of the class textbook and review the attached PowerPointpresentation. Once done answer the following questions;

Explain and give some examples of the concepts of community mental health and discuss the importance of community mental health promotion in special populations.
Describe the biological, social, and political factors associated with mental illness.
Describe different types of evidence-based treatment for mental disorders, including the use of psychotropic medication management, community case management, and crisis intervention. Give at least one example.
Describe the role of mental health nurses in the community.
INSTRUCTIONS:

As stated in the syllabus present your assignment in anAPA format word document,APA requiredfont attached to the forum in the discussion tab of the blackboard titled “Week 14 essay” and theSafeAssignexercise in the assignment tab of the blackboard which is a mandatory requirement.A minimum of 2 evidence-based references (besides the class textbook) no older thanfive years must be used. You must post two replies on different dates to any of your peers sustained with the proper references no older than five years as well and make sure the references are properly quoted in your assignment.The replies cannot be posted on the same day; I must see different dates in the replies.A minimum of 800 words are required and not exceeding 1,000 words (excluding the first and reference page). Please make sure to follow the instructions as given and use either spell-check orGrammarlybefore you post your assignment.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

• Grid View

Discussion: Interprofessional Organizational and Systems Leadership

Discussion: Interprofessional Organizational and Systems Leadership

Organizational health has a significant effect on its performance and competitiveness. Healthy organizations with supportive culture, leadership, and management have excellent performance and highly motivated workforce. Organizational assessment is important in practice, as it provides an accurate picture of the organization’s health and its ability to address its stakeholder needs. Therefore, this paper examines the implications of the completed work environment assessment. It explores the results of the work environment assessment and their implications and recommends evidence-based strategies that can be adopted to address the identified issues and improve performance.

Work Environment Assessment

My workplace environment scored 60 per the Clark Healthy workplace Inventory, meaning it is “barely healthy” (Clark, 2015). The organization scored poorly in encouraging the free expression of ideas, employee wellness, valuing employees, employee satisfaction, and employee engagement in decision-making. However, reasonable workload and effective conflict resolution were the areas with the best scores. The overall results of 60 surprised me. I did not know that my workplace is uncivil to that extent. There is no joint decision-making in my organization. I just realized that we are often given instructions about new projects, policies changes but we as nurses are never asked to be part of the decision-making. Taking this assessment also made me realize that I have never seen any employee wellness initiative at my organization, implying it does not emphasize self-care. Before the assessment, I thought my workplace is civil enough but that has been proven wrong with the scores.

The other aspect that surprised me about the results is that there is a low level of trust between and among formal leadership and other members in the workplace. Most of the employees reported a lack of trust towards the organizational leadership and other members of the organization. Initially, I believed that employees had a high level of trust towards the organizational leadership. They have never raised any concerns about their relationship with the management. However, based on the assessment result, it could be argued that their minimal involvement by the leadership and management could have contributed to this attitude. Organizational leadership should promote the adoption of interventions that motivate the staff to achieve their personal and professional goals in undertaking their roles. They should also act as role models for best practice interventions in the organization. This is not the case in our organization, hence, the poor score in this aspect during the organizational assessment.

One of the ideas that I believed before conducting the assessment that was confirmed is the fact that the organizational management and leadership do not view employees as assets and valued partners in the organization. Often, the organizational leadership and management make rules and policies that are imposed on the employees. The employees have minimal roles in assessing, planning, implementing, monitoring, and evaluating organizational strategic initiatives. The management and leadership also use one-way communication where the employee input on the organization’s strategies is not considered. The consequences of this lack of employee consideration include a low level of job satisfaction and morale among the staff (Titlestad et al., 2018). The assessment results confirmed the ideas, as seen from the lowest score in the statement that focused on whether the employees are viewed as assets and valued partners within the organization.

The assessment results show my organization as unhealthy and with low civility. The organization does not prioritize the needs of its employees as an approach to achieving its performance goals. It does not implement strategies that address the actual and potential employee needs. For example, the organization does not provide its staff with the opportunities to express their issues, concerns, and views on how to meet their needs and those of the organization. The assessment results also demonstrate ineffective leadership and management in the organization, making it an unhealthy and uncivil workplace. Organizational leadership and management are expected to promote excellence among staff. Interventions such as teamwork, interprofessional collaboration, and open communication should be adopted to enhance employee performance and job satisfaction (Clucas et al., 2019). However, this is not the case in my organization since the management and leadership do not prioritize the needs of their staff. As a result, the staff perceives their workplace as unhealthy and less civilized in promoting their optimal health, wellbeing, and functioning. Therefore, interventions that aim at improving an organization’s health and civility should be embraced.

Laureate Education (Producer). (2018). The Leader in You [Video file]. Baltimore, MD: Author.

Required Readings

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)
Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)
Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194)
Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3

Resources for the StrengthsFinder Assessment Tool

Rath, T. (2007). Strengths Finder 2.0 – with Access Code.

Purchase the access code from the Walden bookstore. Then follow the instructions in the document “How to Access the Strengths Finder 2.0.

Document: How to Access Strengths Finder 2.0 (PDF)

Required Media

Laureate Education (Producer). (2014). Leadership [Video file]. Baltimore, MD: Author.

Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Moore Foundation. (n.d.). Nurses share lessons in leadership. Retrieved from https://www.youtube.com/playlist?list=PLopRJPO6GaifsYPGP_jcWXZzU10H3AaX7

Discussion 1: Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

To Prepare:

Review the Resources and examine the leadership theories and behaviors introduced.
Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
Reflect on the leadership behaviors presented in the three resources that you selected for review.
By Day 3 of Week 4

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

NURS 6521 Discussion: Decision Making When Treating Psychological Disorders

Generalized Anxiety Disorder Middle-Aged White Male With Anxiety NURS 6521

Decision Point One 

Select what you should do:

Begin Zoloft 50 mg po daily

Begin Imipramine 25 mg po BID

Begin Buspirone 10 mg po BID

Decision Point One

Begin Zoloft 50 mg orally daily

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• Client informs you that he has no tightness in chest, or shortness of breath
• Client states that he noticed decreased worries about work over the past 4 or 5 days
• HAM-A score has decreased to 18 (partial response)

Decision Point Two

Select what you should do next:

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Client reports an even further reduction in his symptoms
• HAM-A score has now decreased to 10. At this point- continue current dose (61% reduction in symptoms)

Increase dose to 75 mg orally daily

Increase dose to 100 mg orally daily

No change in drug/dose at this time

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Client reports an even further reduction in his symptoms
• HAM-A score has now decreased to 10. At this point- continue current dose (61% reduction in symptoms)

Decision Point Three

Maintain current dose

Guidance to Student
At this point, it may be appropriate to continue client at the current dose. It is clear that the client is having a good response (as evidenced by greater than a 50% reduction in symptoms) and the client is currently not experiencing any side effects, the current dose can be maintained for 12 weeks to evaluate full effect of drug. Increasing drug at this point may yield a further decrease in symptoms, but may also increase the risk of side effects. This is a decision that you should discuss with the client. Nothing in the client’s case tells us that we should consider adding an augmentation agent at this point as the client is demonstrating response to the drug. Avoid polypharmacy unless symptoms cannot be managed by a single drug.

Discussion Week 8

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Discussion Depression

A 70-year-old Hispanic male suffering from depression from a lot of sources needs to be addressed. There are several types of antidepressant drugs and we should choose according to history of previous response. But if there is no history of previous response then it is better to start the patient on Sertraline (Zoloft) 25 mg orally daily and increasing gradually to 200 mg depending on response and side effects. So, I started the patient on Sertraline 25 mg orally daily.

After four weeks the client returns to the clinic with 25 % reduction in symptoms but has new onset of erectile dysfunction. Erectile dysfunction is one of the symptoms of this medication and he would probably stop taking the pill because of this. So, I’m adding an augmenting agent Wellbutrin IR 150 mg to help with depression and relieve erectile dysfunction. After starting bupropion, symptoms gradually decrease over a period of weeks (NAMI, n.d.). Bupropion is the AD for which there is the most scientific evidence for a low incidence of treatment sexual dysfunction (TESD) and could therefore be the first option in the sexually active population. While other non-serotoninergic drugs are also associated with a low incidence of TESD (Montejo, et al., 2019).

After four weeks, the client returns to the clinic in four weeks. Client states that depressive symptoms have decreased even more, and his erectile dysfunction has abated, which is a good sign. But client reports that he has been feeling” jittery” and “nervous”. The feeling of jittery maybe due to the fast release of Wellbutrin so, I’m changing to Wellbutrin XL 150 mg orally daily in am.

There were case reports that acute dystonia due to bupropion SR occurred when an escalated dose from 150 to 300 mg daily was administered.

Seizure has been reported as a dose related side effect. The risk of seizure as an adverse effect increases with dose and particularly in vulnerable subjects like the history of head injury, past history of seizure, bulimia ,anorexia,  and alcohol intake (Mishra, Sardesai, Rastogi & Ramghulam, 2017).

 

The physicians caring for these patients should be aware adverse effects associated with bupropion and should know the proper management of the dangerous side effect. Actions may include stopping the agent or reducing the dose.  Caution must be used when prescribing bupropion. It is important to take precaution to avoid prescribing potential culprit drugs, especially those that have the same effect on serotonin reuptake.

 

 

References

Mishra, D.K., Sardesai, U., Rastogi, P., and Ramghulam, (2017). Seizure secondary to Bupropion extended release preparation: A report. American Journal of Psychiatry, Volume 30, https://doi.org/10.1016/j.ajp.2017.08.006Get rights and content

Montejo, A.L., Prieto, N., Alarcon R., Casado-Espada, N., de la Iglesia, J., and Montejo, L. (2019). Management Strategies for Antidepressant -Related Sexual Dysfunction: A Clinical Approach. Journal of Clinical Medicine, Vol 8, Issue 10, p 1640

National Alliance on Mental Illness (NAMI). Bupropion (Wellbutrin). https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Bupropion-(Wellbutrin)

Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.

 

Photo Credit: Getty Images/iStockphoto

For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology.

To Prepare

• Review this week’s interactive media pieces and select one to focus on for this Discussion.
• Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.

By Day 3 of Week 8

Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.

By Day 6 of Week 8

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 of Week 8 and Respond by Day 6 of Week 8

To Participate in this Discussion:

Week 8 Discussion

NURS 6521 Discussion: Decision Making When Treating Psychological Disorders

Attention Deficit Hyperactivity Disorder A Young Girl With ADHD NURS 6521

Decision Point One 

Select what you should do:

Begin Wellbutrin (bupropion) XL 150 mg orally daily

Begin Intuniv extended release 1 mg orally at BEDTIME

Begin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNING

Decision Point One

Begin Wellbutrin (bupropion) XL 150 mg orally daily

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• Katie’s parents inform you that they stopped giving Katie the medication because about 2 weeks into the prescription, Katie told her parents that she was thinking about hurting herself. This scared the parents, but they didn’t want to “bother you” by calling the office, so they felt that it would be best to just stop the medication as they would be seeing you in two weeks

Decision Point Two

Educate the parents that Bupropion sometimes causes suicidal ideation in children and that this is normal, and re-start the drug at the previous dose

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Katie’s parents again report that after about a week of treatment with the Bupropion, Katie began telling her parents that she wanted to hurt herself and began having dreams about being dead. This scared her parents and they stopped giving her the medication
• At this point, they are quite upset with the results of their daughter’s treatment and are convinced that medication is not the answer

Decision Point Three

Select what you should do next:

Refer the parents to a pediatric psychologist who can use behavioral therapy to treat Katie’s ADHD

Do nothing, and explain to the parents that Katie’s ADHD will most likely improve with age as her prefrontal cortex grows and matures

Discuss the use of a medication such as Adderall and its evidence for treating ADHD

Decision Point Three

Refer the parents to a pediatric psychologist who can use behavioral therapy to treat Katie’s ADHD

Guidance to Student
Bupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant.

At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie.

In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues.

You should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow you to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

NURS 6521 Discussion: Decision Making When Treating Psychological Disorders

Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.

 

Photo Credit: Getty Images/iStockphoto

For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology.

To Prepare

• Review this week’s interactive media pieces and select one to focus on for this Discussion.
• Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.

By Day 3 of Week 8

Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.

By Day 6 of Week 8

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 of Week 8 and Respond by Day 6 of Week 8

To Participate in this Discussion:

Week 8 Discussion

NURS 6521 Discussion: Decision Making When Treating Psychological Disorders

NURS 6521 Bipolar Therapy Client of Korean Descent/Ancestry

Decision Point One 

Select what you should do:

Begin Lithium 300 mg orally BID

Begin Risperdal 1 mg orally BID

Begin Seroquel XR 100 mg orally at HS

Decision Point One

Begin Lithium 300 mg orally BID

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• Client informs you that she has been taking her drug “off and on” only when she “feels like she needs it”
• Today’s presentation is similar to the first day you met her

Decision Point Two

Increase Lithium to 450 mg orally BID

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Client returns reports that she is still taking the medication when she feels that she needs it
• She remains quite manic and reports that her family is getting really upset because she likes to play her new guitar at night

Decision Point Three

Assess for rationale for non-compliance and educate client

Guidance to Student
You should further assess for dangerousness to self or others. The client should be assessed for self-care, to including hygiene, eating, sleeping, etc. Hospitalization may be indicated if the client remains non-compliant and is a danger to self. If the client is not a danger to self, and hospitalization is not indicated, you needs to assess for rationale for non-compliance. Many clients enjoy mania as it is a nice feeling to be consistently happy. When clients are successfully treated for mania, they often describe themselves as feeling ‘down’ or ‘flat.’ You need to assess for depression at this point as opposed to normalization of mood. Abilify is also FDA approved as monotherapy for mania and mixed presentations, but at a dose of 15 mg. day., so although you may be tempted to begin Abilify- be certain to use correct dose. Also, because it can be “activating” you need to dose this drug in the morning. However, the client is non-compliant and therefore, eliciting reasons for non-compliance is essential to the care of this client.

Bipolar Therapy Client of Korean Descent/Ancestry

NURS 6521 Discussion: Decision Making When Treating Psychological Disorders

Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.

 

Photo Credit: Getty Images/iStockphoto

For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology.

To Prepare

• Review this week’s interactive media pieces and select one to focus on for this Discussion.
• Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.

By Day 3 of Week 8

Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.

By Day 6 of Week 8

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 of Week 8 and Respond by Day 6 of Week 8

To Participate in this Discussion:

Week 8 Discussion

Begin Risperdal 1 mg orally BID

Decision Point Two

Discontinue Risperdal and start Lithium sustained release 300 mg orally BID

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Client no longer lethargic after the end of the first week
• Client has a slight decrease in her Young Mania Rating Scale (from 22 to 19)
• Client reports that her sleep is again decreasing, but that overall, she is happy

Decision Point Three

Increase Lithium SR to 450 mg orally BID

Guidance to Student
Recall that the client is of Korean descent and is positive for CYP2D6*10 allele. As a result, she may be demonstrating slower clearance of Risperdal from her system, resulting in higher than normal levels of Risperdal in the blood, resulting in sedation. The client responded well to the discontinuation of Risperdal and after about a week of drug cessation, she was no longer lethargic/sedate. However, in the following 3 weeks, she had experienced increased symptoms, although a slight improvement in YMSR score was noted. You could make no changes at this time and allow the lithium to remain at its current dose for an additional 4 weeks and reassess. Conversely, you can increase the lithium to 450 mg orally BID and then reassess in 4. The additional milligrams may hasten mood stabilization. Risperdal 0.5 mg orally BID may be appropriate if the clients’ symptoms are worsening, however, you would need to have the client return to the office sooner than 4 weeks for an interim visit to assess effects of drug and presence of somnolence/lethargy.

Potential Allied Health Careers Discussion

Potential Allied Health Careers Discussion

Reflection

ExploreHealthCareers.org has a partial listing of potential allied health careers. Medical Administrative Assistants, entry level Medical Billing and Coding, Medical Assistant, Electronic Health Records Specialist are all entry level positions. In 1-2 pages reflect on where you might like your career to go.

Include the following aspects in the assignment:

Ø Convey two careers listed in either the link above or other links pertaining allied health careers.

Ø Expand on the job outlook, responsibilities, and education requirements.

Ø Demonstrate what skills you personally have that would make you successful in the field of Allied Health.

Ø Explore your short and long-term goals in reference to Allied Health.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.