Tag: Clinical-Nursing

  • Long Term Goals for Nurse Practitioner Student

    NURS 6565 Week 1: Short and Long-Term Professional Goals

    Long Term Goals for Nurse Practitioner Student example essay

    Short term and long terms goals help the individual to motivate towards meetings the professional goals and gives a long term vision where one wanted to be. Nurse Practitioner education is highly competitive, and it is imperative to be motivated throughout during the school term, and after once one becomes a nurse practitioner. SMART acronym tools are often used to set the goals, and it stands for S specific, M measurable, A attainable, R realistic and T timely. SMART goal setting tools helps to set the goal within the reasonable limits and helps the individual to prepare for the challenges that help to achieve the goal (Massachusetts Institute of Technology Human Resources, n.d.) Long Term Goals for Nurse Practitioner Student.

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    Short Terms Goals

    As a Nurse Practitioner student, I have following three short terms and long terms goals that prepare my transition towards Nurse Practitioner Practice from the RN.

    Short terms Goal:

    My first short term goal is to be prepared for this semester so that my preparation will help me to towards fulfilling my long terms goals of passing the Nurse Practitioner Board certification.

    The second short term goal is to learn the skill sets required to serve the particular population I am intended to work as a future Family nurse practitioner. As a family nurse practitioner student, one get training towards the range of entire ages: however mostly I work with adult population as a Nurse and so far my desire e is to serve the same population as a Nurse practitioner.

    The third goal is to understand the legal implication like state laws that define the nurse practice during this period so that before applying for the job I have the fair knowledge of the scope of practice that defines nurses’ roles, articulate oversight requirements, and govern practice and prescriptive authorities Long Term Goals for Nurse Practitioner Student.

    Long terms goal

     

    As I mentioned earlier, my first long term goal is to get the certification through the American Academy of Nurse Certification Program as soon as I complete my degree. I have to keep this in my mind as accreditation can take weeks to months, so my goal is to start the application process as soon as I can.

     

    There is no denying the fact that as soon as one started for NP school, getting a good decent job is something always the first thing in the mind. With this course I am a very close get my degree and my certification, so my 2nd  goal is to get a decent job that I always intend to. I live in Quad cities and the market for Family Care Practitioner Jobs is not very promising. However, I am lucky enough to get an offered from one of the preceptor offices. Although, nothing is confirmed, but I am trying to be very proactive looking the jobs with the help of social networking and on job listing websites.

    The third goal is something actually I will say both come under long and short goals is to continue to update the knowledge and technological skill based on current evidence-based practice through a focus on continuing education so that I can provide based patient outcomes every time.

     

    References:

    Goal Setting. (n.d.). Retrieved from
    https://hr.mit.edu/performance/goals

    Family Nurse Practitioner Career Guide. (n.d.). Retrieved from
    https://nurse.org/resources/family-nurse-practitioner/

    Poje, K. (2016). Smoothing your transition from RN to NP. Retrieved from https://americannursetoday.com/wp-content/uploads/2016/07/ant7-Focus-On-CAREER-621.pdf

     

    NURS 6565 Week 1: Short and Long-Term Professional Goals example essay

    Family nurse practitioner students (FNPS) need to develop realistic and professional goals because they are critical to guide our careers and make the transition from the role working as registered nurses to the advanced practice registered nurses (APRN) successful.  As new APRN, we will be a novice again the same way as we were when coming out of nursing school and we need to do everything that we can to make the transition simple and uncomplicated.  New APRN sometimes set unrealistic expectations making their role change more difficult and increasing their anxiety (Poje, 2016) and risk for failure in their new occupation.  The purpose of writing this paper is to identify at least three short and three long term goals, describe why I selected them and how they relate to my professional career development, and create a strategic plan that describes how I might achieve each of those goals.

    Three Short and Three Long-term Goals, why I Selected Them, and how They Relate to my Professional Career Development

    FNPS need to come up with goals that certainly describes what they want to achieve or learn and they must be specific, measurable, achievable, appropriate and time-limited (College of Nurses of Ontario [CNO], 2014).  They need to create and ensure that their goals are focused and present a clear idea of what they want to accomplish or want to master (CNO, 2014), and they include:

    I have to learn to identify the different illnesses so that all patients will be protected from harm by knowing the sign and symptoms, causes, how to diagnose and manage their condition by the end of 2018 as measured by less number of misdiagnosis. I selected this goal because the majority of APRN coming out of school have so much to learn which it is essential and connected to the development of their professional career.  Nurse practitioners (NP) have to be knowledgeable, so they can become excellent providers and be able to deliver safe, effective, and high quality of care for their patients (Flinter, 2012).  If they do not have the knowledge to do their job, they can lose their license and not be able to work in this profession again.

    I have to learn to manage time wisely so that I can do my job appropriately and will be able to go home on time by August 2018 as measured by having some free time after work to enjoy life. I selected this goal because many new APRN that I know have a problem with time management.  They go to work for about 8-12 hours per day and have to stay over or go home to finish documenting on all the clients that they saw because the lack of time to do it during the office visit.  If the problem continues for a long time, the APRN’s stress level goes up, and their career satisfaction goes down (Flinter, 2012) affecting their professional career development and making them want to quit their job.

    I have to learn the necessary skills so that I can perform the proper procedures needed and will be able to take care of the patients correctly by the end of 2018 as measured by the number of successful procedures. I carefully chose this goal because I noticed that many APRN have to review the clinic’s policies and procedures manual or look up information on the internet frequently due to their lack of experience.  Having the necessary skills can help APRN become competent providers (Flinter, 2012) which are associated with the development of a better professional career.  If providers are not skilled, clients will not want to return and see them negatively impacting their career.

    I have to develop the confidence to educate patients so that they can and will learn what they need to about their medications and conditions by the end 2020 as measured by not having to look up information all the time. I selected the goal because it is important that APRN know everything about the different prescription drugs and disorders affecting people and be able to teach them to prevent complications.  When NP have confidence, patients will feel more comfortable having them as primary care providers (Flinter, 2012) which are associated with the advancement of their professional career.

    I plan to work hard so that I can save money and will be able to have my own business by the middle of 2022 as measured by having my place of employment. I selected this goal because I would like to have my own business one day, be able to help patients, and not have to be in such a hurry to make money instead of taking care of clients like most clinics are doing nowadays.  The United States has a shortage of health care providers (Flinter, 2012) due to the challenges affecting APRN’s occupation and the discontent with the duties and responsibilities impacting the advancement of the professional career.  There are some things that I do not agree with, and by owning a business, some of those elements can be changed or improved.

    I have to continue my education so that I will be able to obtain the doctor of nursing practice (DNP) degree by 2020 as measured by completing the program and getting a document to prove it. I picked this goal because that is what I want to do in the future and believe that it can be attainable when individuals work hard to get what they want in life.  The DNP is not going to give me extra money for getting it in many places, but it will help me move forward with my professional career and open new opportunities.

    NURS 6565 Week 1 – Strategic Plan Explaining how I Might Attain the Goals

    One way to accomplish all of those goals is by creating an individualized plan that can assist me to achieve them.  The goals number 1, 2, 3, 4, and 6, which are about learning, gaining skills and confidence, and obtaining the DNP can be within the person’s reach and be achieved.  APRN have to start going to clinical case conferences or workshop, taking online or in the classroom classes, reading journal articles, completing online training courses, reviewing case studies, going through a practice simulation, being mentored, and attending webinars (Thabault, Mylott, & Patterson, 2015 and CNO, 2014).  Others include working as a team with medical assistants, nurses, NP, doctors, physician assistants, and shared personnel resources such as dieticians, managers, pharmacist, behavioralists, and diabetes educator (Flinter, 2012).  Managing my time better by becoming regimented with it, adopting strategies that increase productivity (Perkel, 2015), keeping and redirecting patients to the task at hand, staying focus, establishing a routine and making changes as necessary, and not wasting time getting distracted.

    The goal of having my own business can be reachable by working hard, stop wasting so much money on unnecessary things and buying what I need only, not going out as much to save money, eating at home and taking my lunch, and others.  Doing those few things work great and save money because I am about to complete this program and I am debt free.  APRN tend to make good money, but I noticed that the more money individuals make, the more that they tend to spend and that has to change to accomplish the goal.

    Another Long Term Goals for Nurse Practitioner Student example essay

    Short-term goals

    The short-term goals chosen are; obtaining board certification, choosing the preferred patient population, and evaluating potential employers. The Massachusetts Institute of Technology Human Recourses states that goals should be specific, measurable, achievable, relevant to performance and professional development, and be time specific (Massachusetts Institute of Technology Human Recourses).

    My first goal; to obtain board certification, state requirements varies widely (Buppert, 2018). All states require that Nurse Practitioners are licensed Registered Nurses; my current licensures are active in two states Wisconsin and Illinois (Buppert, 2018). In Illinois the RN must complete a master’s program and sit for an examination based determination from the American Academy of Nurse Practitioners Certification Program or American Nurses Credentialing Center, Wisconsin requires the same (NursingLicensure.org). Prior to be allowed to schedule an examination you have to show proof of program completion.

    The second goal is choosing a preferred patient population. As a family nurse practitioner you are trained to care for the entire range of ages: however my background is mostly in Women’s health so it would be tempting to accept a position a gynecology office, but is that something that would be desirable for me?

    The third goal is evaluation of potential employers: when evaluating an organization there is more than compensation that needs to be considered, things such as travel distance from home, benefits, hours available to work, expectations and support for new nurse practitioners are all important considerations. Lack of support and understanding of the scope of practice of nurse practitioner’s is a barrier to professional success (Freenstra, 2014). It may cause increased difficulty adjusting to a new role as provider if the position was accepted into an organization that is new to having nurse practitioners.

    Long-term Goals

    First; find an organization to work with that supports my professional growth; develop care relationships with patients, and collaborating providers. Second; consider if returning to school to achieve a doctorate degree is a feasible option five years after completion of Advanced Degree Nurse.

    Strategic Planning

    As soon as I complete my degree; complete the online application to sit for examination with American Academy of Nurse Practitioners Certification Program. Accreditation can often take several weeks to months to complete; the sooner an applicant starts to gather needed forms and information the better. Begin evaluation and applications with potential employers as soon as possible so that ample time to evaluate any offers before accepting is allowed. List all pros and cons of accepting any positions in a specialty area verses a general practice area before deciding to specialize with any population.

    Short term goals will be achievable reasonably quick while long term goals will need evaluation after a period f time adjusting to the new role as a Nurse Practitioner.

    References:

    Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

    Freenstra, R. (2014). SMART Goals- Quick Overview. Retrieved from

    Massachusetts Institute of Technology Human Recourses (n.d.). SMART Goals. Retrieved from
    http://hrweb.mit.edu/performance-development/goal-setting-planning/smart-goals

    NursingLicensure.org, retrieved on August 27
    th
    , 2018 from: https://www.nursinglicensure.org/np-state/illinois-nurse-practitioner.html

    NURS 6565 Week 1 – Summary

    FNPS need to develop realistic and professional goals because they are critical to guide our careers and make the transition from the role working as registered nurses to the APRN successful.  As a new APRN, we will be a novice again the same way as we were when coming out of nursing school and we need to do everything that we can to make the transition simple and uncomplicated.  New APRN sometimes set unrealistic expectations making their role change more difficult and increasing their anxiety (Poje, 2016) and risk for failure in their new occupation.  The three short and three long-term goals consist of learning about the different conditions, managing time wisely, developing confidence, having own business, and completing the DNP program within 1-5 years which are related to the development of my professional career.  The goals can be achievable by coming up with the right strategic plan, evaluating, and making changes as needed to get them done.

    NURS 6565 Week 1 Primary Care Journal

    NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

    Professional Goals

    Short-term goals and their impact

    The short-term goals that I will set include; becoming a certified board member, choosing the patient population to serve as well as evaluating potential employers carefully. Becoming a certified board member will help me become more confident as a nursing practitioner, as well as boost my marketability in the competitive industry. In an effort to ensure that I become a certified board member in record time, I will undertake to apply for the exams before I leave RN and ensure that I am able to sit for them within three or four months after application.

    The selection of the patient population encompasses the finding of the perfect position from which I will be able to grow and I will thus have to decide on a specific population that I will serve such as cardiac or the old age people. This will help ensure I am able to easily network within that given specialty area. The third goal that I will set is critical evaluation of the potential employers in which I will undertake to ask about job expectations, such as work hours, patients to be served as well as growth opportunities such as training programs. This will help ensure I land an employer that offers growth opportunities as well as an enabling environment to hone my skills as a nursing practitioner (Masters, 2017).

    Long-term Goals and Their Impact

    These goals include; get my name out there, engaging in research as well as advancing my qualifications. In an effort to increase my marketability, I will ensure that I stay in touch with the various individuals that I completed my practice with and who are likely to help with recommendations in the event I decide to advance career-wise. I will also ensure that I engage other nursing practitioners who are in the field whether older or even younger and who might help in giving advice as well as recommending career opportunities that might help in my growth. The engagement in research will help advance my understanding of contemporary issues and nursing topics while also giving me the chance to increase my marketability (Masters, 2017). This will add more value on my portfolio and thus increases my chances of advancing in the field. Academic qualifications will play a crucial role in ensuring I continuously hone my skills as well as improve my employability standings; it will also help me improve my leadership skills thus prepare me for a role as a nursing leader.

    Strategic Plan

    In an effort to ensure that I am able to achieve these goals I will set in place a strategic plan that will address the short-term as well as the long-term goals. In an effort to ensure that I meet all these goals I will start by cultivating a social change in my personal life and which will help prompt me to no longer think as a RN but a NP who has career goals and ambitions to fulfill. The social change that will be set in place will encompass modeling of ethical guidelines to help guide my conduct not only with my peers but also in my private social life (Catalano, 2015). This will help ensure that I remain focused on my goals, with all distractions been slowly stemmed out. I will also become an active participant in both work forums and social forums, as a means of ensuring that I do not get distracted and engaged in vices that can easily deter me from meeting the goals through procrastination. I will lastly develop a personal mission statement and communicate the same to my parents who I will ask to evaluate the progress I am making from time to time, as a means of ensuring that I stay on course and do not deviate.

    References

    Catalano, J. T. (2015). Nursing now!: Today’s issues, tomorrow’s trends. Philadelphia, PA: F.A. Davis.

    Masters, K. (2017). Role development in professional nursing practice. Burlington, MA: Jones & Bartlett Publishers.

     

    NR510  Advanced Practice Nurse Personal Development Plan

    Advanced Practice Nurse Professional Development Plan

    It is important that a Master’s degree trained Nurse Practitioner (NP) have the opportunity to discover the different roles of the Advanced Practice Nurse (APN) and subsequently use that knowledge to develop a professional development plan (PDP). The PDP should have certain considerations including education, licensure, and governing requirements specific to geographic location. This paper will describe those considerations as they apply to the NP in the state of Florida. Moreover, the paper will include a personal assessment including weaknesses, strengths, and goals. Prospective national and local professional organizations that provide employment for NP’s and networking/marketing strategies will be discussed. Lastly, a Curriculum Vitae will be reviewed to provide an in-depth view of the NP’s abilities, skills, and accomplishments.

    Advance Practice Nurse Scope of Practice

    Each state varies in its guidelines for defining the licensure, accreditation, certification, and education (LACE) for nurse practitioners. This can have an effect on the experience NP’s have when working in their chosen field. In the state of Florida, it is required that to receive certification as an Advanced Registered Nurse Practitioner (ARNP), the candidate must first hold a valid nursing license in the state of Florida. The applicant must have graduated on or after October 1
    st
    1998 shall have completed a masters or post master’s degree (Advanced Registered Nurse Practitioner, 2016).  If the applicant graduated with a certificate or closed program then documentation supporting their compliance with the board guidelines needs to be submitted through the appropriate channels.

    There are three ways in which an NP can practice within the United States. Full practice which is total independent practice where the NP is responsible exclusively to a state board of nursing, reduced practice which is a collaborative practice agreement with a physician that specifies the scope of practice allowed, and restricted practice where there a physician is required to oversee all care provided by the NP (Bartol, 2014). Florida is a state there exercises restricted practice. The NP must have the above noted written agreement that states the participation of each party, the medications the NP can prescribe, procedures that the NP can perform, and the circumstances in which the NP must call the physician. Currently in the state of Florida NP’s are not allowed to write prescriptions for controlled substances under any circumstances.

    Personal Assessment

    Before a new NP enters the workforce, he/she will need to perform a thorough personal assessment to determine their strengths, weaknesses, goals, and objectives. This type of assessment requires deep self-evaluation.  Self-evaluation helps organize the above stated areas so that potential employers can have insight into the potential employee’s accomplishments, objectives, and personal evaluation. Constructing a personal assessment allows the NP to explore their interests, passions, and explore what area or specialty would be their best fit.

    Strengths

    In order to care for others, one must first know who they are and what they stand for. Identifying strengths is a main component of that understanding. Having solid communication is essential in any career, especially a career as a NP. Listening and speaking are the most important aspects when caring for a patient. Valuable information must be retrieved from the patient. The information heard helps develop the patient’s diagnoses, plan of care, and treatment. The message that is transmitted to the patient is as equally important. The patients understanding of the intended message affects the way they will care for themselves. This includes how they will comply with treatments, follow up, and lifestyle changes.

    Every decision made in the medical field can have extensive consequences. The NP must pay great attention to detail. This includes all aspects of care, from reviewing a patient’s chart to ordering the correct medication. In this field errors have great repercussions. Paying attention to details can mean the difference between life and death.

    Weaknesses

    Ralph Waldo Emerson put it best, “Our strength grows out of our weaknesses” (Ralph Waldo Emerson Quotes, 2016). While everyone has their strengths, everyone also has subsequent weaknesses. Weaknesses can be improved upon until they are no longer considered as such. The biggest weakness that the newly trained NP will have is that they will again be at the novice level of their career. According to Benner’s Stages of Clinical Competence, one who is a novice lacks confidence and practice can be prolonged (Benner’s stages of Clinical Competence, 2011). However so, this will not always be the case. The new NP will become more confident in their role and should quickly learn the ropes. As time goes by, the NP will work their way through the various levels of Benner’s Stages of Clinical Competence.

    As the career of the NP grows, these traits will be continually evolving. An identified weakness in newly trained NP’s is the need to want to complete all tasks themselves. This sounds good in theory, but it is not how today’s healthcare system is designed. Certain tasks should be delegated to assistive personal such as, medical assistants, phlebotomists, and other interdisciplinary team members. Allowing others to participate in patient care allows the NP to spend more time face to face with patients and further enhances the patient experience.

     

    Goals

    Establishing and developing career goals is one of the most important tasks a NP can do to improve professional development. Goals should be evaluated and revised to ensure that they are moving their career forward. One short term personal goal for the newly certified NP is to seek employment as a full time nurse practitioner in their area of study. This will allow them to gain the experience and skills that will allow them to continue to grow. Another longer term goal would be to be an educator and /or preceptor for other NP students. Being a mentor for novice and experienced practitioners is vital because the success of all rests on the success of each (Practitioner Network, 2016). An additional long term goal would be to enhance patient care by advancing knowledge. The Master’s degree prepared NP can continue their education by pursuing a Doctorate in Nursing Practice (DNP).  The DNP prepared nurse would be able to implement the science developed by nurse researchers prepared in PhD, DNSc, and other research based nursing doctorates into daily patient care (DNP Fact Sheet, 2016).

    Objectives

    Nurse Practitioners should have objectives to help meet their intended goals. There are objectives that should be in place when seeking employment. The NP should network as a means to seek employment. People usually hire individuals they already know therefore the NP would be a face and a personality, not just a name on a resume. An objective that should be in place when mentoring another professional is to foster a nurturing environment. A preceptor gives other professionals resources to ready themselves for situations and challenges that may occur on the job. This means they should be comfortable to ask questions and ask for help as issues arise. An accepting environment is the best way to enhance the preceptees learning experience. Lastly, when a NP is looking to further their education, they should do extensive research. Accreditation, pass rates, cost, and curriculum should all be reviewed. Education is an investment into ones future and all components should be evaluated.

    Networking and Marketing Strategies

    In order to become employed after certification the NP must properly network and look at appropriate places for employment. At the local level Florida has several websites that are advertising employment opportunities. The Florida Nurse Practitioner Network (FNPN) has a website that provides tools for educational and professional development, including employment opportunities. Their mission is to “encourage networking between members throughout the state” (Florida Nurse Practitioner Network, 2016). Additionally, they are a resource tool for NP’s, patients, and other health care consumers. Another local website that has resources for NP’s seeking employment is the Florida Nurses Association (FNA). The FNA is a constituent of the American Nurses Association which is the only nursing organization that represents all of the nursing field regardless of specialty or practice area (About the Florida Nurses Association, 2016).They advertise employment opportunities for various healthcare systems in different counties throughout Florida. The employment page is powered by a third party company and is not run directly by the FNA.  The FNFP is a The FNA is an organization that many new student nurses are members of.

    If a NP is looking for a career in an area to which they are not local, there are also employment tools available online. These are national organizations that provide resources to enhance NP’s search for employment. The American Association of Nurse Practitioners (AANP) is the biggest and only full service national professional membership organization for nurse practitioners of any specialty (American Association of Nurse Practitioners, 2016). In addition to information on employment, they offer education, policy updates, and career related conference information. They have a link for the job center that gives both members and non-members access to the available job opportunities. However, they give members an exclusive five day preview for new career posts. Another resource that the NP can utilize to search for employment on the national level is NP central. NP Central’s goal is to help NP’s succeed in their chosen field. They are not for profit and also have a particular focus on development, advancement, and educational support for the NP (NP Central, 2016). Both the AANP and NP Central are both on the top 75 organizations for nurse practitioners list (75 Top Professional Organizations for Nurse Practitioners, 2016).

    Conclusion

    The certified NP has the opportunity to practice in a variety of settings and roles. In order to make promote their skills and abilities, the NP should have a professional develop plan (PDP). The PDP should always be a work in progress because the NP is continually learning and growing. Areas that were once a weakness can grow into strengths and new weaknesses will come to light. That growth can be defined by Benner’s Stages of Clinical Competence. If the NP is seeking employment, there are a variety of reputable organizations that have resources that can assist NP’s in finding employment. With the proper tools and guidance, the new NP has a bright future that can touch the lives of many.

    xxx

    Contact

    xxxStreet

    xxx

    E-mail: xxx

    Phone: xxx

    Certification

    Licensed RN in the state of xxx

    CPR/BLS certified

    Will sit for ONCxxx

    Education

    Masters of Science in Nursing – Family Nurse Practitioner January 2015 — Present

    Chamberlain College of Nursing

    Current GPA 3.87

    Bachelors of Science in Nursing March 2012 — April 2015

    Keiser University

    Associates of Science in Nursing July 2010 — December 2011

    Keiser University

    Graduated with perfect attendance

    Work experience

    Health First May 2012 — Present

    Registered Nurse·         Care of surgical patients pre and post operatively as well as medical patients

    ·         Receive post-operative patients from PACU, monitor vital signs, administration of IV fluids and antibiotics, review and implementation of post-operative orders

    ·         Monitor patients closely for changes in condition and advocate as needs arise

    ·         Educate patients on precautions associated with surgical procedure and signs/symptoms of  potential complications

    ·         Management of various drains  (Jackson Pratt, hemovac, accordion, and constavac)

    ·         Work within best practice guidelines

    ·         Manage pain effectively with pharmacologic and non-pharmacologic measures

    Set up and maintain various equipment: PCAs, SCDs, Bux traction and trapeze·         Insertion and management of nasogastric tubes·         Preceptor to new graduates, students, and new hires·         Part of the fall committee and the Skin Committee

    Wuesthoff Health System January 2012 — May 2012

    Registered Nurse

    ·         Care of patients with severe and enduring mental illness

    ·         Administering medications

    ·         Coordinating and running group therapy sessions while maintaining a therapeutic millieu

    ·         Liaising with social workers, psychiatrist, and other healthcare professionals

    Interests

    Volunteering.
    Currently a volunteer at my daughter’s elementary school for the third consecutive school year. Served as a chaperon on field trips and office/clerical work. Prior volunteer work done for Habitat for Humanity, Ascension Catholic Church, and Stone Middle School.

    Educating.  
    As a volunteer I had the opportunity to educate my daughter’s aftercare classmates on the importance of hand washing and proper respiratory etiquette. As a volunteer at Stone Middle School, I worked with a student who had just moved Middle East. He knew little English but spoke fluent French. I tutored him once a week using the French language as common ground. I also am always looking for ways to educate myself, whether it is speaking to a rep about the new product they are demonstrating or precepting others, there is always something to learn or to teach.

    References

    75 Top Professional Organizations for Nurse Practitioners. (2016). Retrieved from https://onlinenursepractitionerprograms.com/professional-organizations/

    About the Florida Nurses Association. (2016). Retrieved from Florida Nurses Association website: http://www.floridanurse.org/aboutFNA/

    Advanced Registered Nurse Practitioner. (2016). Retrieved from State of Florida website:
    http://floridasnursing.gov/licensing/advanced-registered-nurse-practitioner/

    American Association of Nurse Practitioners. (2016). Retrieved from American Association of Nurse Practitioners website: https://www.aanp.org

    Bartol, T. (2014). Impact of Nurse Practitioners on Health Outcomes of Medicare and Medicaid Patients. Medscape, Retrieved from
    http://www.medscape.com/viewarticle/832738

     

    Benner’s Stages of Clinical Competence. (2011). Retrieved from Ministry of Health website:
    http://www.health.nsw.gov.au/nursing/projects/Documents/novice-expert-benner.pdf

    DNP Fact Sheet. (2016). Retrieved from American Association of Colleges of Nursing website:
    http://www.aacn.nche.edu/media-relations/fact-sheets/dnp

    Florida Nurse Practitioner Network. (2016). Retrieved from ENP Network website:
    https://fnpn.enpnetwork.com/

    NP Central. (2016). Retrieved from http://www.npcentral.net/

    Practitioner Network. (2016). Retrieved from University of Maryland Medical Center website: http://umm.edu/professionals/nurse-practitioners/practitioner-network

    Ralph Waldo Emerson Quotes. (2016). Retrieved from
    https://www.goodreads.com/quotes/206329-believe-in-yourself-our-strength-grows-out-of-our-weakness

     

    Nurs 6565N Week 2 Board Vitals Exam

    1. A young nursing student is interviewing a nurse practitioner about her profession. Which of the following is true?

    The first nurse practitioners were family practitioners

    The first nurse practitioner program was started in 2001

    A nurse practitioner derives the legal right to practice from federal law

    NP practice is not regulated by the Department of Health and Human Services

    2. A nurse practitioner enters a contract with a physician. What branch of law governs this type of transaction?

    Administrative law

    Civil law

    Rules and regulations

    Criminal law

    3. What was the major impetus for the creation of the nurse practitioner role?

    Need for expert nurse clinician

    Shortage of primary care physicians

    Trend for specialized nurses to diagnose and manage unstable acute and chronic conditions

    Movement of graduate nursing education to diagnosis and treatment of major illnesses

    4. Who started the first nurse practitioner program?

    Hildegard Peplau

    Mary Breckenridge

    Agnes Mcgee

    Loretta Ford

    5. When the NP is paid directly by the patient’s payer who agrees to pay the NP for providing care for a specific population, this is called a:

    Contracted service system

    Second party system

    Third party system

    Fee for service system

    6. Which of the following practices constitutes a barrier to safe and effective healthcare

    Input from multiple team members

    Raising an objection about quality of care to a team member with a higher level of health profession education

    Use of informatics to inform team discussion

    Inadequate disclosure of errors to patients and families

    7.

    Nurs 6565N Week 2 Board Vitals Exam

     

    Nurs 6565 Week 3 Board Vitals Exam questions with answers

    A nurse practitioner is seeing patients in a clinic. Which of the following requirements must the NP meet to satisfy Medicare’s coverage requirements

    The services must be provided under direct supervision

    The services must be provided subject to restrictions and supervision requirements of the state

    The services must be billed through a clinic that is directed by a physician or through a hospital or health agency

    Services must be provided in a federally qualified health center (FQHC) or rural health clinic (RHC)

    When advocating for the profession of nursing, a nurse practitioner knows that responsibility for interrupting scope of practice parameters rests with which of the following

    The state medical licensure board

    The state board of nursing

    The state legislature

    The individual NP

    The NP knows that his or her legal right to practice is derived from

    The laws of the state where he or she practices

    The nurse practice act of the state where he or she practices

    The federal medicare laws

    The board of nursing in the state where he or she practices

    Your nursing license may be in jeopardy if

    You appropriately delegate medication administration to a trusted RN employee who administers a fatal dose

    You delegate client assessment tasks to an LPN who has been floated to your outpatient clinic for the day

    You provide nursing care services consistent with established standards of practice in your jurisdiction

    The medical assistant in your supervising physician’s office exceeds the scope of her authority but you take prompt action to correct the problem

    The NP delegates a task to an unlicensed person. The person(s) responsible for outcomes in this case is

    The NP

    The unlicensed person who performs the task

    Both the NP and the unlicensed person

    The physician responsible for the NP

    According to the institute of medicine which of the following defines healthcare performance

    How things are done now

    The efficiency and outcome of care by an organization including patient satisfaction

    Healthcare delivery system inputs

    Activities within a healthcare organization

    Which of the following is true of advanced practice registered nurses

    Half of the states in the US license Nurse practitioners

    Designated titles by which nurse practitioners are known vary by state

    Only two states currently require NPs be certified by a national certifying organization for nurses

    An APRN employed by the VA must have separate licenses for each state in which she works in a VA facility

    Nurs 6565 Week 3 Board Vitals Exam

     

    NURS 6565 Week 3 Discussion: Quality and Cost Measurements

    Week 3 Discussion

    As nurse practitioners continue to expand their role in health care, it is important to provide the data and evidence to demonstrate the impact of NP care on patient outcomes. There are several challenges that advanced practice nurses face to provide quality care and meet productivity goals of an organization.  Quality measures seek to measure the degree to which evidence-based treatment guidelines are followed, where indicated, and assess the results of care. The use of quality measurement helps strengthen accountability and supports performance improvement initiatives at numerous levels.  The performance measures used in the article we read are quality, patient satisfaction, professional participation, and training.

    AANP and the National Nurse-Led Care Consortium (NNCC) are administering an NP SAN for the Transforming Clinical Practice Initiative (TCPi).  This is a new program supported by the Centers for Medicare & Medicaid Services (CMS). CMS offers several technical assistance programs to help clinicians successfully participate in one of the two payment tracks under the Quality Payment Program (QPP).

    The TCPi is a four-year technical assistance program designed to help clinicians expand their quality improvement capacity, engage in greater peer-to-peer learning and utilize health data to determine gaps and target intervention needs. The NP SAN promotes NP participation in this quality improvement initiative by providing free education, technical assistance and training and access to specialized evidenced-based tools. NPs in either nurse-led or physician-led health care settings are eligible to…

     

    NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    Nurse Practitioner’s Business Plan Development – Elizabeth Jones, FNP-BC, has been an NP for 8 years. She has worked in the primary care setting, as well as the urgent care setting. She is considering relocating to a state that allows for unrestricted independent practice and opening her own primary care clinic. There are multiple benefits to owning an independent practice. However, owning a practice requires extensive knowledge and support. For an NP to establish independent practice, an appropriate plan must be developed. For this Assignment, you will create a Business Plan for your potential future business. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    ORDER A PLAGIARISM-FREE PAPER NOW

    Write
     a 2-3 page paper Business Plan that addresses the following:

    Identify and explain your chosen business structure (owning a private practice)

    Estimate monthly cost for establishing your own independent practice in Texas, including:

    Clinical site expenses

    Employee structure and expenses

    Supplies

    Utilities and other overhead expenses

    Malpractice insurance

    Continuing education expenses

    Accounting fees

    Services identified that you will provide (e.g., primary care services, drug screens, DOT exams)

    Projected monthly income necessary to support your independent practice. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay Long Term Goals for Nurse Practitioner Student

    References

    American Association of Nurse Practitioners (2016). State Practice Environment. Retrieved from 
    https://www.aanp.org/legislation-regulation/state-…

    Buppert, C. (2018). 
    Nurse practitioner’s business practice and legal guide
     (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

    Appendix 11-A: A Checklist for Setting Up a Practice (pp. 383-394)

    Appendix 11-C: Sample NP Business Plan (pp. 400-412)

    Chapter 11, “Practice Ownership: Legal and Business Considerations for the Nurse Practitioner Owner” (pp. 353- 381)

    Buppert, C. (2015). Appendix 11-C: Sample NP Business Plan. 
    In Nurse Practitioner’s Business Practice and Legal Guide 
    (5th ed.). (402-416). Burlington, MA: Jones & Bartlett. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    Buppert, C. (2015). Practice Ownership: Legal and Business Considerations for the Nurse Practitioner Owner. 
    In Nurse Practitioner’s Business Practice and Legal Guide 
    (5th ed.). (315-383). Burlington, MA: Jones & Bartlett.

    Ford, L. C.. & Gardenier, D. (2015). Fasten your seat belts – it’s going to be a bumpy ride. 
    The Journal for Nurse Practitioners, 11(6),
     575-577.

    Kao, Y. S. (2015). Nephrology advanced practice registered nurse health policy: Where are we? What is our future? 
    Nephology Nursing Journal, 42
    (3):289-93.

    Kostas-Polston, E. A., Thanavaro, J., Arvidson, C., & Taub, L. M. (2015). Advanced Practice Nursing: Shaping Health Through Policy. 
    Journal of the American Association of Nurse Practitioners, 27
    (1), 11-20. doi:10.1002/2327-6924.12192

    , C. (2018). 
    Nurse practitioner’s business practice and legal guide
     (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

    Appendix 11-A: A Checklist for Setting Up a Practice (pp. 383-394)

    Appendix 11-C: Sample NP Business Plan (pp. 400-412)

    Chapter 11, “Practice Ownership: Legal and Business Considerations for the Nurse Practitioner Owner” (pp. 353- 381)

    Buppert, C. (2015). Appendix 11-C: Sample NP Business Plan. 
    In Nurse Practitioner’s Business Practice and Legal Guide 
    (5th ed.). (402-416). Burlington, MA: Jones & Bartlett. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    Buppert, C. (2015). Practice Ownership: Legal and Business Considerations for the Nurse Practitioner Owner. 
    In Nurse Practitioner’s Business Practice and Legal Guide 
    (5th ed.). (315-383). Burlington, MA: Jones & Bartlett.

    Ford, L. C.. & Gardenier, D. (2015). Fasten your seat belts – it’s going to be a bumpy ride. 
    The Journal for Nurse Practitioners, 11(6),
     575-577.

    Kao, Y. S. (2015). Nephrology advanced practice registered nurse health policy: Where are we? What is our future? 
    Nephology Nursing Journal, 42
    (3):289-93.

    Kostas-Polston, E. A., Thanavaro, J., Arvidson, C., & Taub, L. M. (2015). Advanced Practice Nursing: Shaping Health Through Policy. 
    Journal of the American Association of Nurse Practitioners, 27
    (1), 11-20. doi:10.1002/2327-6924.12192

    NURS 6565 Practicum Journal Wk 10

    Each week you will complete a Practicum Journal entry and Time Log that prompts you to reflect on and document your Practicum Experiences. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay Long Term Goals for Nurse Practitioner Student

    Practicum Journal

    Continue documenting your Practicum Experiences in your Practicum Journal. Reflect on your practicum experiences and relate them to your Professional Goals and Self-Assessment of Clinical Skills that you identified in Week 1.

    Follow journal entry format and choose any illness or patient…..

    E.g

    Reflect on a patient who presented with a disease. Describe key signs and symptoms that were consistent with this disease. If you diagnosed the patient with the disease, describe your experience in telling the patient that she had the disease, as well as the patient’s reaction to the diagnosis. Explain how the diagnosis might impact the patient’s life short-term and long-term. Include an explanation of the patient’s medical history, drug therapy and treatments, and follow-up care. If you did not have an opportunity to evaluate a patient with this background during the last four weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

    Cover Letter, Resume, and Portfolio Assignment Guide

    Your professional cover letter, resume, and portfolio are due by Day 7 of Week 10. It is highly recommended that you begin planning and working on this Assignment as soon as it is viable. The following checklists outline all of the items you should include in your cover letter, resume, and portfolio. Additionally, the resources below have been provided to assist you in developing your professional cover letter, resume, and portfolio. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    Also, refer to the Walden University Career Center website for resources and develop your cover letter and resume with the assistance of the Walden University Career Center website for resources and make your cover letter, resume, and portfolio accessible online to your faculty and potential employers.

    Checklist for Cover Letter (S/U grade)

    Your Cover Letter should be:

    • Presented and formatted in professional business manner • Addressed properly • Clear and concise and include:

    o Content Introduction o Content Body o Content Conclusion

    • Written in a professional style and include: o Correct spelling, punctuation, and grammar o Clear and accurate sentence structure. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    Checklist for Resume (S/U)

    • Your Resume should be clear, concise and well-organized and it should also include your: • Name, address, business phone number, and email address (top center of resume) • Profile: 2-3 sentences describing goal and positive attributes/characteristics • Certifications & Licensure • Education • Professional Experience • Honors/Awards • References Long Term Goals for Nurse Practitioner Student

    © 2016 Laureate Education, Inc. 2 of 3

    Checklist for Portfolio (S/U)

    • Your Portfolio should be clear, concise and well-organized and it should also include your: • Personal Philosophy Statement • Self-Assessment • Personal goals (short term and long term) • Achievements • Cover Letter • Resume • Diplomas for formal education • Letters of Recommendation  References (list names, affiliation and contact

    information) • Certifications • Certificates of attendance for continuing education • Transcripts (Note: You do NOT need to submit an official transcript. Including an

    unofficial transcript will meet this requirement.) • Publications • Oral Presentations and/or Poster Presentations

    Learning Resources. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    Resume, Portfolio, and Cover Letter Resources:

    • Cover Letter Advice (n.d.). Nurse practitioner cover letter sample 1. Retrieved from http://www.coverletter.us/nurse-practitioner-cover-letter/

    • Dahring, R. (2013). Cover letter caveats. Retrieved from http://nurse-practitioners-and- physician-assistants.advanceweb.com/Columns/Career-Coach/Cover-Letter-Caveats.aspx

    • NP Career Coach (n.d.). NP career coach resume tip sheet. Retrieved from http://www.nursepractitionerjobsearch.com/nurse-practitioner-resume-tips.pdf

    • Porche, D. J. & Danna, D. (2015). Cover letter & resume preparation: Every detail is important when applying for a job. Advance healthcare network for NPs & PAs. Retrieved from http://nurse-practitioners-and-physician- assistants.advanceweb.com/Features/Articles/Cover-Letter-Resume-Preparation.aspx

    • Walden University Career Services (n.d.). Resumes & CVs: Home Retrieved from

    http://academicguides.waldenu.edu/careerservices/resumesandcvs

    Portfolio Resources: NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    http://www.coverletter.us/nurse-practitioner-cover-letter/

    http://nurse-practitioners-and-physician-assistants.advanceweb.com/Columns/Career-Coach/Cover-Letter-Caveats.aspx

    http://nurse-practitioners-and-physician-assistants.advanceweb.com/Columns/Career-Coach/Cover-Letter-Caveats.aspx

    http://www.nursepractitionerjobsearch.com/nurse-practitioner-resume-tips.pdf

    http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/Cover-Letter-Resume-Preparation.aspx

    http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/Cover-Letter-Resume-Preparation.aspx

    http://academicguides.waldenu.edu/careerservices/resumesandcvs

    © 2016 Laureate Education, Inc. 3 of 3

    • Dennison, R. D. (2007). What goes into your professional portfolio and what you’ll get out of it: Advance your nursing career with a professional portfolio. American Nurse Today 2(1). Retrieved from http://www.americannursetoday.com/assets/0/434/436/440/4352/4354/4368/4376/1b04d64f- 8cb0-4af6-adb6-7e3474d2603d.pdf

    • Ferrara, S. (2013, October 31). Professional portfolio – A must have for NP students. [Blog message]. Retrieved from http://onlinenursepractitionerprograms.com/2013/professional- portfolio-a-must-have-for-np-students/

    • Hayes, E., Chandler, G., Merriam, D., & King, M. C. (2002). The master’s portfolio: Validating a career in advanced practice nursing. Journal of the American Academy of Nurse Practitioners, 14(3), 119. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    • Walden University Career Services (2015). Quick start: Getting started with Optimal 2015. Retrieved from https://youtu.be/Ir-B4MCuAvU

    • Walden University Career Services (2015). Quick start: Getting started with Optimal

    Resume: Presentation slides. Retrieved from http://academicguides.waldenu.edu/ld.php?content_id=10634421

    • Walden University Career Services (2015). Getting started with Optimal Resume: Tutorial.

    Retrieved from http://academicguides.waldenu.edu/ld.php?content_id=10634430 • Walden University Career Services (2015). Getting started with Optimal Resume: Transcript.

    Retrieved from http://academicguides.waldenu.edu/ld.php?content_id=10634440

    • Weber, S. (2006). Developing nurse practitioner student portfolios. Journal of the American Academy of Nurse Practitioners, 18(7), 301-302. doi:10.1111/j.1745-7599.2006.00134.x. NURS 6565 Week 10: Nurse Practitioner’s Business Plan Development Business Plan Development Essay

    NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

    Cover Letter, Resume, and Portfolio Assignment Guide

    Your professional cover letter, resume, and portfolio are due by Day 7 of Week 10. It is highly recommended that you begin planning and working on this Assignment as soon as it is viable. The following checklists outline all of the items you should include in your cover letter, resume, and portfolio. Additionally, the resources below have been provided to assist you in developing your professional cover letter, resume, and portfolio.

    Also, refer to the Walden University Career Center website for resources and develop your cover letter and resume with the assistance of the Walden University Career Center website for resources and make your cover letter, resume, and portfolio accessible online to your faculty and potential employers. Long Term Goals for Nurse Practitioner Student

    Checklist for Cover Letter (S/U grade)

    Your Cover Letter should be:

    • Presented and formatted in professional business manner • Addressed properly • Clear and concise and include:

    o Content Introduction o Content Body o Content Conclusion

    • Written in a professional style and include: o Correct spelling, punctuation, and grammar o Clear and accurate sentence structure

    Checklist for Resume (S/U)

    • Your Resume should be clear, concise and well-organized and it should also include your: • Name, address, business phone number, and email address (top center of resume) • Profile: 2-3 sentences describing goal and positive attributes/characteristics • Certifications & Licensure • Education • Professional Experience • Honors/Awards • References

    © 2016 Laureate Education, Inc. 2 of 3

    Checklist for Portfolio (S/U)

    • Your Portfolio should be clear, concise and well-organized and it should also include your: • Personal Philosophy Statement • Self-Assessment • Personal goals (short term and long term) • Achievements • Cover Letter • Resume • Diplomas for formal education • Letters of Recommendation  References (list names, affiliation and contact

    information) • Certifications • Certificates of attendance for continuing education • Transcripts (Note: You do NOT need to submit an official transcript. Including an

    unofficial transcript will meet this requirement.) • Publications • Oral Presentations and/or Poster Presentations

    Learning Resources

    Resume, Portfolio, and Cover Letter Resources:

    • Cover Letter Advice (n.d.). Nurse practitioner cover letter sample 1. Retrieved from http://www.coverletter.us/nurse-practitioner-cover-letter/

    • Dahring, R. (2013). Cover letter caveats. Retrieved from http://nurse-practitioners-and- physician-assistants.advanceweb.com/Columns/Career-Coach/Cover-Letter-Caveats.aspx

    • NP Career Coach (n.d.). NP career coach resume tip sheet. Retrieved from http://www.nursepractitionerjobsearch.com/nurse-practitioner-resume-tips.pdf

    • Porche, D. J. & Danna, D. (2015). Cover letter & resume preparation: Every detail is important when applying for a job. Advance healthcare network for NPs & PAs. Retrieved from http://nurse-practitioners-and-physician- assistants.advanceweb.com/Features/Articles/Cover-Letter-Resume-Preparation.aspx

    • Walden University Career Services (n.d.). Resumes & CVs: Home Retrieved from Long Term Goals for Nurse Practitioner Student

    http://academicguides.waldenu.edu/careerservices/resumesandcvs

    Portfolio Resources:

    http://www.coverletter.us/nurse-practitioner-cover-letter/

    http://nurse-practitioners-and-physician-assistants.advanceweb.com/Columns/Career-Coach/Cover-Letter-Caveats.aspx

    http://nurse-practitioners-and-physician-assistants.advanceweb.com/Columns/Career-Coach/Cover-Letter-Caveats.aspx

    http://www.nursepractitionerjobsearch.com/nurse-practitioner-resume-tips.pdf

    http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/Cover-Letter-Resume-Preparation.aspx

    http://nurse-practitioners-and-physician-assistants.advanceweb.com/Features/Articles/Cover-Letter-Resume-Preparation.aspx

    http://academicguides.waldenu.edu/careerservices/resumesandcvs

    © 2016 Laureate Education, Inc. 3 of 3

    • Dennison, R. D. (2007). What goes into your professional portfolio and what you’ll get out of it: Advance your nursing career with a professional portfolio. American Nurse Today 2(1). Retrieved from http://www.americannursetoday.com/assets/0/434/436/440/4352/4354/4368/4376/1b04d64f- 8cb0-4af6-adb6-7e3474d2603d.pdf

    • Ferrara, S. (2013, October 31). Professional portfolio – A must have for NP students. [Blog message]. Retrieved from http://onlinenursepractitionerprograms.com/2013/professional- portfolio-a-must-have-for-np-students/

    • Hayes, E., Chandler, G., Merriam, D., & King, M. C. (2002). The master’s portfolio: Validating a career in advanced practice nursing. Journal of the American Academy of Nurse Practitioners, 14(3), 119.

    • Walden University Career Services (2015). Quick start: Getting started with Optimal 2015. Retrieved from https://youtu.be/Ir-B4MCuAvU

    • Walden University Career Services (2015). Quick start: Getting started with Optimal

    Resume: Presentation slides. Retrieved from http://academicguides.waldenu.edu/ld.php?content_id=10634421

    • Walden University Career Services (2015). Getting started with Optimal Resume: Tutorial.

    Retrieved from http://academicguides.waldenu.edu/ld.php?content_id=10634430 • Walden University Career Services (2015). Getting started with Optimal Resume: Transcript.

    Retrieved from http://academicguides.waldenu.edu/ld.php?content_id=10634440

    • Weber, S. (2006). Developing nurse practitioner student portfolios. Journal of the American Academy of Nurse Practitioners, 18(7), 301-302. doi:10.1111/j.1745-7599.2006.00134.x

    http://www.americannursetoday.com/assets/0/434/436/440/4352/4354/4368/4376/1b04d64f-8cb0-4af6-adb6-7e3474d2603d.pdf

    http://www.americannursetoday.com/assets/0/434/436/440/4352/4354/4368/4376/1b04d64f-8cb0-4af6-adb6-7e3474d2603d.pdf Long Term Goals for Nurse Practitioner Student

    http://academicguides.waldenu.edu/ld.php?content_id=10634421

    http://academicguides.waldenu.edu/ld.php?content_id=10634430

    http://academicguides.waldenu.edu/ld.php?content_id=10634440

     

    NR510  Advanced Practice Nurse Personal Development Plan

    Advanced Practice Nurse Professional Development Plan

    It is important that a Master’s degree trained Nurse Practitioner (NP) have the opportunity to discover the different roles of the Advanced Practice Nurse (APN) and subsequently use that knowledge to develop a professional development plan (PDP). The PDP should have certain considerations including education, licensure, and governing requirements specific to geographic location. This paper will describe those considerations as they apply to the NP in the state of Florida. Moreover, the paper will include a personal assessment including weaknesses, strengths, and goals. Prospective national and local professional organizations that provide employment for NP’s and networking/marketing strategies will be discussed. Lastly, a Curriculum Vitae will be reviewed to provide an in-depth view of the NP’s abilities, skills, and accomplishments.

    Advance Practice Nurse Scope of Practice

    Each state varies in its guidelines for defining the licensure, accreditation, certification, and education (LACE) for nurse practitioners. This can have an effect on the experience NP’s have when working in their chosen field. In the state of Florida, it is required that to receive certification as an Advanced Registered Nurse Practitioner (ARNP), the candidate must first hold a valid nursing license in the state of Florida. The applicant must have graduated on or after October 1
    st
    1998 shall have completed a masters or post master’s degree (Advanced Registered Nurse Practitioner, 2016).  If the applicant graduated with a certificate or closed program then documentation supporting their compliance with the board guidelines needs to be submitted through the appropriate channels.

    There are three ways in which an NP can practice within the United States. Full practice which is total independent practice where the NP is responsible exclusively to a state board of nursing, reduced practice which is a collaborative practice agreement with a physician that specifies the scope of practice allowed, and restricted practice where there a physician is required to oversee all care provided by the NP (Bartol, 2014). Florida is a state there exercises restricted practice. The NP must have the above noted written agreement that states the participation of each party, the medications the NP can prescribe, procedures that the NP can perform, and the circumstances in which the NP must call the physician. Currently in the state of Florida NP’s are not allowed to write prescriptions for controlled substances under any circumstances.

    Personal Assessment

    Before a new NP enters the workforce, he/she will need to perform a thorough personal assessment to determine their strengths, weaknesses, goals, and objectives. This type of assessment requires deep self-evaluation.  Self-evaluation helps organize the above stated areas so that potential employers can have insight into the potential employee’s accomplishments, objectives, and personal evaluation. Constructing a personal assessment allows the NP to explore their interests, passions, and explore what area or specialty would be their best fit.

    Strengths

    In order to care for others, one must first know who they are and what they stand for. Identifying strengths is a main component of that understanding. Having solid communication is essential in any career, especially a career as a NP. Listening and speaking are the most important aspects when caring for a patient. Valuable information must be retrieved from the patient. The information heard helps develop the patient’s diagnoses, plan of care, and treatment. The message that is transmitted to the patient is as equally important. The patients understanding of the intended message affects the way they will care for themselves. This includes how they will comply with treatments, follow up, and lifestyle changes.

    Every decision made in the medical field can have extensive consequences. The NP must pay great attention to detail. This includes all aspects of care, from reviewing a patient’s chart to ordering the correct medication. In this field errors have great repercussions. Paying attention to details can mean the difference between life and death.

    Weaknesses

    Ralph Waldo Emerson put it best, “Our strength grows out of our weaknesses” (Ralph Waldo Emerson Quotes, 2016). While everyone has their strengths, everyone also has subsequent weaknesses. Weaknesses can be improved upon until they are no longer considered as such. The biggest weakness that the newly trained NP will have is that they will again be at the novice level of their career. According to Benner’s Stages of Clinical Competence, one who is a novice lacks confidence and practice can be prolonged (Benner’s stages of Clinical Competence, 2011). However so, this will not always be the case. The new NP will become more confident in their role and should quickly learn the ropes. As time goes by, the NP will work their way through the various levels of Benner’s Stages of Clinical Competence.

    As the career of the NP grows, these traits will be continually evolving. An identified weakness in newly trained NP’s is the need to want to complete all tasks themselves. This sounds good in theory, but it is not how today’s healthcare system is designed. Certain tasks should be delegated to assistive personal such as, medical assistants, phlebotomists, and other interdisciplinary team members. Allowing others to participate in patient care allows the NP to spend more time face to face with patients and further enhances the patient experience. Long Term Goals for Nurse Practitioner Student

     

    Goals

    Establishing and developing career goals is one of the most important tasks a NP can do to improve professional development. Goals should be evaluated and revised to ensure that they are moving their career forward. One short term personal goal for the newly certified NP is to seek employment as a full time nurse practitioner in their area of study. This will allow them to gain the experience and skills that will allow them to continue to grow. Another longer term goal would be to be an educator and /or preceptor for other NP students. Being a mentor for novice and experienced practitioners is vital because the success of all rests on the success of each (Practitioner Network, 2016). An additional long term goal would be to enhance patient care by advancing knowledge. The Master’s degree prepared NP can continue their education by pursuing a Doctorate in Nursing Practice (DNP).  The DNP prepared nurse would be able to implement the science developed by nurse researchers prepared in PhD, DNSc, and other research based nursing doctorates into daily patient care (DNP Fact Sheet, 2016).

    Objectives

    Nurse Practitioners should have objectives to help meet their intended goals. There are objectives that should be in place when seeking employment. The NP should network as a means to seek employment. People usually hire individuals they already know therefore the NP would be a face and a personality, not just a name on a resume. An objective that should be in place when mentoring another professional is to foster a nurturing environment. A preceptor gives other professionals resources to ready themselves for situations and challenges that may occur on the job. This means they should be comfortable to ask questions and ask for help as issues arise. An accepting environment is the best way to enhance the preceptees learning experience. Lastly, when a NP is looking to further their education, they should do extensive research. Accreditation, pass rates, cost, and curriculum should all be reviewed. Education is an investment into ones future and all components should be evaluated. Long Term Goals for Nurse Practitioner Student

    Networking and Marketing Strategies

    In order to become employed after certification the NP must properly network and look at appropriate places for employment. At the local level Florida has several websites that are advertising employment opportunities. The Florida Nurse Practitioner Network (FNPN) has a website that provides tools for educational and professional development, including employment opportunities. Their mission is to “encourage networking between members throughout the state” (Florida Nurse Practitioner Network, 2016). Additionally, they are a resource tool for NP’s, patients, and other health care consumers. Another local website that has resources for NP’s seeking employment is the Florida Nurses Association (FNA). The FNA is a constituent of the American Nurses Association which is the only nursing organization that represents all of the nursing field regardless of specialty or practice area (About the Florida Nurses Association, 2016).They advertise employment opportunities for various healthcare systems in different counties throughout Florida. The employment page is powered by a third party company and is not run directly by the FNA.  The FNFP is a The FNA is an organization that many new student nurses are members of.

    If a NP is looking for a career in an area to which they are not local, there are also employment tools available online. These are national organizations that provide resources to enhance NP’s search for employment. The American Association of Nurse Practitioners (AANP) is the biggest and only full service national professional membership organization for nurse practitioners of any specialty (American Association of Nurse Practitioners, 2016). In addition to information on employment, they offer education, policy updates, and career related conference information. They have a link for the job center that gives both members and non-members access to the available job opportunities. However, they give members an exclusive five day preview for new career posts. Another resource that the NP can utilize to search for employment on the national level is NP central. NP Central’s goal is to help NP’s succeed in their chosen field. They are not for profit and also have a particular focus on development, advancement, and educational support for the NP (NP Central, 2016). Both the AANP and NP Central are both on the top 75 organizations for nurse practitioners list (75 Top Professional Organizations for Nurse Practitioners, 2016).

    Conclusion

    The certified NP has the opportunity to practice in a variety of settings and roles. In order to make promote their skills and abilities, the NP should have a professional develop plan (PDP). The PDP should always be a work in progress because the NP is continually learning and growing. Areas that were once a weakness can grow into strengths and new weaknesses will come to light. That growth can be defined by Benner’s Stages of Clinical Competence. If the NP is seeking employment, there are a variety of reputable organizations that have resources that can assist NP’s in finding employment. With the proper tools and guidance, the new NP has a bright future that can touch the lives of many. Long Term Goals for Nurse Practitioner Student

    xxx

    Contact

    xxxStreet

    xxx

    E-mail: xxx

    Phone: xxx

    Certification

    Licensed RN in the state of xxx

    CPR/BLS certified

    Will sit for ONCxxx

    Education

    Masters of Science in Nursing – Family Nurse Practitioner January 2015 — Present

    Chamberlain College of Nursing

    Current GPA 3.87

    Bachelors of Science in Nursing March 2012 — April 2015

    Keiser University

    Associates of Science in Nursing July 2010 — December 2011

    Keiser University

    Graduated with perfect attendance

    Long Term Goals for Nurse Practitioner Student

    Work experience

    Health First May 2012 — Present

    Registered Nurse·         Care of surgical patients pre and post operatively as well as medical patients

    ·         Receive post-operative patients from PACU, monitor vital signs, administration of IV fluids and antibiotics, review and implementation of post-operative orders

    ·         Monitor patients closely for changes in condition and advocate as needs arise

    ·         Educate patients on precautions associated with surgical procedure and signs/symptoms of  potential complications

    ·         Management of various drains  (Jackson Pratt, hemovac, accordion, and constavac)

    ·         Work within best practice guidelines

    ·         Manage pain effectively with pharmacologic and non-pharmacologic measures

    Set up and maintain various equipment: PCAs, SCDs, Bux traction and trapeze·         Insertion and management of nasogastric tubes·         Preceptor to new graduates, students, and new hires·         Part of the fall committee and the Skin Committee

    Wuesthoff Health System January 2012 — May 2012

    Registered Nurse

    ·         Care of patients with severe and enduring mental illness

    ·         Administering medications

    ·         Coordinating and running group therapy sessions while maintaining a therapeutic millieu

    ·         Liaising with social workers, psychiatrist, and other healthcare professionals Long Term Goals for Nurse Practitioner Student

    Interests

    Volunteering.
    Currently a volunteer at my daughter’s elementary school for the third consecutive school year. Served as a chaperon on field trips and office/clerical work. Prior volunteer work done for Habitat for Humanity, Ascension Catholic Church, and Stone Middle School.

    Educating.  
    As a volunteer I had the opportunity to educate my daughter’s aftercare classmates on the importance of hand washing and proper respiratory etiquette. As a volunteer at Stone Middle School, I worked with a student who had just moved Middle East. He knew little English but spoke fluent French. I tutored him once a week using the French language as common ground. I also am always looking for ways to educate myself, whether it is speaking to a rep about the new product they are demonstrating or precepting others, there is always something to learn or to teach.

    References

    75 Top Professional Organizations for Nurse Practitioners. (2016). Retrieved from https://onlinenursepractitionerprograms.com/professional-organizations/

    About the Florida Nurses Association. (2016). Retrieved from Florida Nurses Association website: http://www.floridanurse.org/aboutFNA/

    Advanced Registered Nurse Practitioner. (2016). Retrieved from State of Florida website:
    http://floridasnursing.gov/licensing/advanced-registered-nurse-practitioner/

    American Association of Nurse Practitioners. (2016). Retrieved from American Association of Nurse Practitioners website: https://www.aanp.org

    Bartol, T. (2014). Impact of Nurse Practitioners on Health Outcomes of Medicare and Medicaid Patients. Medscape, Retrieved from
    http://www.medscape.com/viewarticle/832738

     

    Benner’s Stages of Clinical Competence. (2011). Retrieved from Ministry of Health website:
    http://www.health.nsw.gov.au/nursing/projects/Documents/novice-expert-benner.pdf

    DNP Fact Sheet. (2016). Retrieved from American Association of Colleges of Nursing website:
    http://www.aacn.nche.edu/media-relations/fact-sheets/dnp

    Florida Nurse Practitioner Network. (2016). Retrieved from ENP Network website:
    https://fnpn.enpnetwork.com/

    NP Central. (2016). Retrieved from http://www.npcentral.net/

    Practitioner Network. (2016). Retrieved from University of Maryland Medical Center website: http://umm.edu/professionals/nurse-practitioners/practitioner-network

    Ralph Waldo Emerson Quotes. (2016). Retrieved from
    https://www.goodreads.com/quotes/206329-believe-in-yourself-our-strength-grows-out-of-our-weakness

    Long Term Goals for Nurse Practitioner Student

  • LEIK FNP review

    LEIK FNP review

    ANTIBIOTIC STUDY GUIDE

    CEPHALOSPORINS (Category B)

    1st Generation: cephalexin (Keflex)

    2nd Generation: cefprozil (Cefzil), cefuroxime (Ceftin), cefaclor (Ceclor).

    3rd Generation: IM ceftriaxone (Rocephin),

    cefdinir (Omnicef), cefixime (Suprax)

     

    NOTE:
    Penicillin-allergic patients may be allergic to cephs. (cross-sensitivity). All antibiotics can cause Clostridium difficile overgrowth, pseudomembranous colitis,CDAD. Used for: strep throat, cellulitis, pneumonia, sinusitis, otitis media, secondary infection COPD, GC (Suprax, Rocephin)

    ORDER A PLAGIARISM-FREE PAPER HERE

    PENICILLINS (Category B)

    1st Generation: po penicillin V (Veetids), IM benzathine penicillin (Bicillin L-A). 2nd Generation: dicloxacillin (Dynapen)

    NOTE: Penicillin-allergic, can use macrolides, cephalosporins, newer quinolones (age >18 years), preferred for strep throat. Also cellulitis, AOM, sinusitis

     

    MACROLIDES (most are Cat. B and two are Cat. C)

    *There are 2 macrolides that should be avoided during pregnancy (both are Cat. C)

    erythromycin estolate (Ilosone) 2. clarithromycin

    Category B macrolides:

    Erythromycin (Ery-Tab, E-mycin), azithromycin (Zithromax, Z-Pack), clarithromycin (Biaxin)

    Macrolides may: Increased risk of arrythmias, prolong the QT interval, nausea/GI upset, diarrhea, etc.

     

    NOTE
    : This drug class has more drug-drug interactions compared with the other classes of antibiotics.

     

    Warfarin (Coumadin – increase risk bleeding), theophylline, carbamezapine (Tegretol), benzodiazepines (alprazolam, midazolam – slows down clearance so last longer), cisapride (risk extrasystoles, prolongs QT interval), HMG-CoA reductase inhibitors (lovastatin, simvastatin -increased risk rhabdomyolysis ,quinidine (risk arrythymias) LEIK FNP review

     

    Tetracyclines (Category D)

    Tetracycline, doxycycline, minocycline (Minocin)

    Stains actively growing tooth enamel. Used for: chlamydia STDs, atypical pneumonia, UTIs, otitis media, PCP in AIDs, Lyme disease

     

    SULFONAMIDES (Cat. C 1st & 3rd trimester)

    Trimethoprim-sulfamethazole (Bactrim, Septra),

    sulfadiazine, sulfisoxazole. Nitrofurantoin also has sulfa and should be avoided in the last month of pregnancy (hyperbilirubinemia). Avoid sulfas with G6PD anemia (hemolysis/jaundice).

     

    NOTE: Avoid combining sulfas with warfarin (increases INR).

    Avoid sulfas in pregnant women in the 1st trimester (folate antagonist) and 3rd trimester (hyperbilirubinemia).

    G6PD anemia (hemolysis). Rash (Stevens-Johnson syndrome). Monitor INR if on warfarin (bleeds). Used for: UTIs, pyelonephritis, toxoplasmosis, AOM, etc.

     

    FLOUROQUINOLONES (Category D)

    Older forms: ciprofloxacin (Cipro), ofloxacin (Floxin). For gram-negatives, pseudomonas, some atypical bacteria. Best antipseudomonal antibiotic is ciprofloxacin.

    Newer forms: levofloxacin (Levaquin), gemifloxacin (Factive), gatifloxacin (Tequin).

     

    NOTE
    : Careful, this drug class has a lot of drug interactions and causes prolongation of QT interval.

     

    Warning: Achilles & other types of tendon rupture. Interacts with theophylline, phenytoin, anticoagulants.

    Avoid using in pregnancy, lactation, & children <18 years (affects cartilage development) . If on Coumadin (Cat. X), monitor INR.   Used for: UTIs, pyelonephritis, pneumonia, sinusitis, otitis media (newer forms), anthrax, bone infections, joint infections, GI, prostatitis, epididymitis   Stimulant/Sympathomimetic Contraindications Examples: decongestants (Sudafe), cold meds, amphetamines (Ritalin, Adderall), cocaine   Avoid stimulants/sympathomimetics with: Avoid with hypertension, arrhythmias, post-MI, etc. Avoid with stroke/CVA or TIAs Avoid if hx of seizures LEIK FNP review   Caffeine will increase the effects of stimulants Phenylephrine eye drops (mydriatic): avoid in acute narrow- angle glaucoma Be careful: BPH since may cause urinary retention   SAMPLE EXAM QUESTIONS   1) The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination with meningococcal conjugate vaccine (Menactra) to all of the following groups except: Entering college freshman who plan on residing in dormitories Pre-teen to teenagers aged 11 and 18 years Persons with sickle cell disease or splenectomy Adults aged 65 years or older who reside in nursing homes   2) The cones of the retina are responsible for what type of vision: peripheral vision and night vision central vision and 20/20 vision peripheral vision night vision LEIK FNP review   3) All of the following are correct statements about G6PD anemia except: It is classified as a hemolytic anemia The intake of sulfa-containing drugs should be avoided These patients are at higher risk of autoimmune disorders Foods such as fava beans can precipitate hemolysis in these patients.   4) A 35 year old male with a BMI of 28 is seen for a routine PE. Vital signs are: BP 134/80, Pulse 80/min., Resp. 20/min. The lipid profile results are: HDL 35, LDL 120. FBS is 120 mg/dL. What is the best initial treatment plan to follow for this patient: 1) Advise the patient that he needs to loose 40 pounds 2) Recommend moderate exercise for at least 30 minutes for most days of the week 3) Initiate a prescription of Zocor 20 mg daily 4) Refer the patient to a cardiologist for a stress test   Answer Key: (1) 4; (2) 2; (3) 3; (4) 2   EXAM TIPS: Non-Clinical Topics   Licensure: According to the U.S. Department of Health, Education and Welfare (1971), what is the definition of licensure? It is a process by which an agency of the state government grants permission to individuals accountable for the practice of a profession to engage in the practice of that profession and prohibits all others from legally doing so.   Certification: Voluntary process by which a professional or non-governmental agency (ie: ANCC, AANP) certifies that a practitioner has met predetermined standards specified by that profession. LEIK FNP review.   Per the ANCC – what is the value of certification? Certification protects the public by enabling anyone to identify competent people more readily aids the profession by encouraging and recognizing professional achievement and enhances professionalism. (http://www.nursecredentialing.org/Certification/Policies Services accessed 9/1/10)   HIPAA There will be several questions that address HIPAA on the ANCC exam. The questions will assess whether you know how HIPAA rules are “applied” in the real world.   Updated/New Notes Hospice  Expected lifespan of 6 months or less. If patient does not want to participate in hospice care, can’t force. Patient does not fit criteria if refuses (even if terminally ill). LEIK FNP review.   Palliative Care Follows palliative care model (quality of life is goal). Pain management, physical and psychological counseling if needed. Patient must agree not to pursue curative treatment   LEIK review

  • PUB-550 Benchmark – Analyzing and Reporting Data in Nursing

    The purpose of this PUB-550 Benchmark – Analyzing and Reporting Data in Nursing assignment is analyze a dataset and report findings to relevant stakeholders.

    Read the Topic Material “Analyzing and Reporting Data – Overview” prior to beginning the assignment.

    For this assignment, you will use IBM SPSS Statistics and one of the three datasets to conduct a basic statistical analysis and report the results by creating a scientific poster. MPH students can use this assignment as an introduction to the option of a larger secondary data analysis for their capstone project.

    Select a public health topic that is of interest to you and complete the following using the “GCU MPH Poster Template.”

    ORDER A PLAGIARISM-FREE PAPER HERE

    Review the three datasets provided in the Topic Materials and brainstorm at least one potential research question that could be answered by one of the datasets. The question should be based on a topic that is of interest to you and is supported by existing literature. PUB-550 Benchmark – Analyzing and Reporting Data in Nursing

    Select the dataset and organize the data to complete the analysis.

    Provide descriptive statistics that summarize the sample.

    Select an appropriate statistical test and conduct the analysis.

    Interpret the results of your analysis.

    Prepare your poster presentation putting the results in the context of the larger story surrounding the purpose for the analysis. Consider the data source, assumptions, hypotheses, decision rule, and interpretation.

    In addition to the poster, write a 1,000-word summary of the analysis that addresses the questions below. The summary should include additional discussion notes you would include for each section if you were presenting your poster at a professional conference. Typically, a poster presentation involves presenting your poster to small groups and providing an oral explanation as the audience reviews your poster.

    Summary of the data source.

    Variables used in the analysis.

    The six steps of hypothesis testing.

    Prepare and submit the PowerPoint poster and summary as two separate documents.

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. PUB-550 Benchmark – Analyzing and Reporting Data in Nursing

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are required to submit this assignment to LopesWrite. Refer to the
    LopesWrite Technical Support articles
    for assistance.

    Attachments

    PUB-550-RS-National-Health-Interview-Survey-Dataset.sav

    PUB-550-RS-Analyzing-and-Reporting-Data-Overview.docx

    PUT-550-RS-Demographhic-and-Health-Survey-Dataset.sav

    PUB-550-RS-Youth-Risk-Behavior-Surveillance-System-Dataset.sav

    PUB-550-RS-GCU-MPH-Poster-Template.pptx

    Analyzing and Reporting Data – Overview

    The purpose of this assignment is to give you experience conducting a basic secondary data analysis using real-world surveillance data. Secondary data analysis is faster and cheaper to conduct compared to primary data collection. However, there are also significant limitations. The data were likely collected for a different purpose, and may not include the specific variables required to answer your question. The sampling strategy might not be random and may not be representative of your target population. These are examples of such limitations you should be aware of as you work with existing data. PUB-550 Benchmark – Analyzing and Reporting Data in Nursing.

    A key question is whether the data should determine the research question, or if the research question should determine the type of data you use. In practice, you would want your research question or hypothesis to determine the dataset you select. In this assignment, you are limited to three datasets and may need to adjust your initial research question to accommodate one of the three datasets. Avoid “mining” for significant results and stick to your initial research question as much as possible. PUB-550 Benchmark – Analyzing and Reporting Data in Nursing. For this project, you will select one of the three example datasets to complete a basic analysis and communicate your findings through a scientific poster presentation.

    These steps will help you get started:

    Review the websites for each of the three datasets listed below. Be sure to understand the purpose of the survey, the sample used in the survey, and the main focus areas of each survey. Review the documentation provided on the websites to get to know the story behind the data and understand the population before reviewing the data.

    Select the dataset that is most appropriate for your interest area.

    Open the data in SPSS and get to know the data by reviewing the variables in “Variable View” mode. This view will allow you to read the variable labels and response labels for each variable.

    Based on your research interest and question, select variables that will help increase your understanding about that topic.

    Arrange the data as needed to organize and clean data, allowing you to focus on your specific question. Remember to save your analytic data file as a new file in case you need to go back to the original file. It is good practice to continually save new versions of the data file as you work with and manipulate the data.

    Follow the hypothesis testing steps to carry out your secondary data analysis. PUB-550 Benchmark – Analyzing and Reporting Data in Nursing.

    For additional information on conducting a secondary data analysis, read the Topic Material, “Conducting High-Value Secondary Dataset Analysis: An Introductory Guide and Resources.”

    Dataset Documents

    Demographic and Health Survey

    The Demographic and Health Survey is a global monitoring survey administered by USAID. The sample dataset is the model data set put together by USAID to explore DHS data. The sample data is not from a specific country or year, but it gives you an idea of what can be obtained from various countries through these datasets. The datasets are free and publically available once you register with USAID to access the DHS data. For the purpose of this assignment, treat this dataset as coming from a country of your choice. Access to the Model Questionnaire, Recode Manual, and Data Video Tutorials, including a video on the sampling strategy, is found at
    http://dhsprogram.com/data/model-datasets.cfm
    .

    Note:
    You do not need to worry about weighting strategies for this PUB-550 Benchmark – Analyzing and Reporting Data in Nursing assignment.

    Use the
    http://dhsprogram.com/data/Using-DataSets-for-Analysis.cfm
    link to review the “
    Step-by-Step Introduction to Analyzing DHS Data”
    for tips on how to access your own dataset for future use and to see what resources are available to help you navigate the model dataset for this assignment:

    Youth Risk Behavior Surveillance System (YRBSS)

    The Youth Risk Behavior Survey is a national survey monitoring health behaviors among youth and young adults. It is administered by the Centers for Disease Control and Prevention. The example dataset for this assignment comes from the National Survey (not combined) dataset for 2015. General information about the survey is found at
    https://www.cdc.gov/healthyYouth/data/yrbs/index.htm
    .

    Documentation and questionnaires can be found by accessing the “YRBSS Data and Documentation: website at
    https://www.cdc.gov/healthyyouth/data/yrbs/data.htm
    .

    Please read the
    2015 YRBS Data User’s Guide,
    listed in the “National YRBS Datasets and Documentation” page at
    https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2015/2015_yrbs-data-users_guide_smy_combined.pdf
    .

    The dataset includes calculated variables not found in the questionnaire that you might find helpful in determining your analysis for this assignment. PUB-550 Benchmark – Analyzing and Reporting Data in Nursing. The crosswalk to match the questions with the dataset can be found by viewing the “YRBS Questionnaire Content – 1991-2017” found at
    https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/yrbs_questionnaire_content_1991-2017.pdf
    .

    National Health Interview Survey (NHIS)

    The NHIS began in 1957, and has been used to monitor the health of the United States ever since. It is a household-level survey administered by the U.S. Census Bureau. Key topics in the survey include doctor’s visits, medical conditions, health insurance, and health behaviors. General information about the survey, including the sample design and data collection procedures, can be found at
    https://www.cdc.gov/nchs/nhis/about_nhis.htm
    .

    A
    Survey Description
    of the 2015 National Health Interview Survey can be found at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/srvydesc.pdf
    .

    The sample dataset is from the 2015 adult survey at
    https://www.cdc.gov/nchs/nhis/nhis_2015_data_release.htm
    .

    Some of the variables have been deleted to decrease the size of the file, but none of the observations have been dropped. Please review the “2015 National Health Interview Survey (NHIS) Public Use Data Release” document at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/readme.pdf
    .

    Review the “2015 NHIS Public Use Variable Summary” at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/samadult_summary.pdf
    .

    After you identify a few variables you are interested in, review the complete description of the variable in the variable layout document at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/samadult_layout.pdf
    .

    Checking the variable frequencies will help you determine the range of answers for each variable of interest, including the number of missing observations. If the number missing is high, consider using another variable. Variable frequencies can be found at
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2015/samadult_freq.pdf
    .  PUB-550 Benchmark – Analyzing and Reporting Data in Nursing

  • PUB-550 Topic 8: Analyzing and Reporting Results

    PUB-550 Topic 8: Analyzing and Reporting Results

    Objectives:

    Apply hypothesis testing steps to a data set.

    Communicate scientific information for public health practice.

    Select quantitative and qualitative data collection methods appropriate for a given public health context.

    Analyze quantitative and qualitative data using biostatistics, informatics, computer-based programming, and software, as appropriate. PUB-550 Topic 8: Analyzing and Reporting Results

    Interpret results of data analysis for public health research, policy, or practice.

    Benchmark – Analyzing and Reporting Data

    The purpose of this assignment is analyze a dataset and report findings to relevant stakeholders.

    Read the Topic Material “Analyzing and Reporting Data – Overview” prior to beginning the assignment.

    For this assignment, you will use IBM SPSS Statistics and one of the three datasets to conduct a basic statistical analysis and report the results by creating a scientific poster. MPH students can use this assignment as an introduction to the option of a larger secondary data analysis for their capstone project. PUB-550 Topic 8: Analyzing and Reporting Results

    ORDER A PLAGIARISM-FREE PAPER HERE

    Select a public health topic that is of interest to you and complete the following using the “GCU MPH Poster Template.”

    Review the three datasets provided in the Topic Materials and brainstorm at least one potential research question that could be answered by one of the datasets. The question should be based on a topic that is of interest to you and is supported by existing literature.

    Select the dataset and organize the data to complete the analysis.

    Provide descriptive statistics that summarize the sample.

    Select an appropriate statistical test and conduct the analysis.

    Interpret the results of your analysis. PUB-550 Topic 8: Analyzing and Reporting Results

    Prepare your poster presentation putting the results in the context of the larger story surrounding the purpose for the analysis. Consider the data source, assumptions, hypotheses, decision rule, and interpretation.

    In addition to the poster, write a 1,000-word summary of the analysis that addresses the questions below. The summary should include additional discussion notes you would include for each section if you were presenting your poster at a professional conference. Typically, a poster presentation involves presenting your poster to small groups and providing an oral explanation as the audience reviews your poster.

    Summary of the data source.

    Variables used in the analysis.

    The six steps of hypothesis testing.

    Prepare and submit the PowerPoint poster and summary as two separate documents.

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. PUB-550 Topic 8: Analyzing and Reporting Results

    You are required to submit this assignment to LopesWrite. Refer to the
    LopesWrite Technical Support articles
    for assistance.

    Attachments

    PUB-550-RS-National-Health-Interview-Survey-Dataset.sav

    PUB-550-RS-Analyzing-and-Reporting-Data-Overview.docx

    PUT-550-RS-Demographhic-and-Health-Survey-Dataset.sav

    PUB-550-RS-Youth-Risk-Behavior-Surveillance-System-Dataset.sav

    PUB-550-RS-GCU-MPH-Poster-Template.pptx

     

    Topic 8 DQ 1

    Reporting public health information requires a clear understanding of the various statistical methods used to draw conclusions. These methods are then communicated within the larger story surrounding the public health issue. Identify a public health report or article and discuss what you would do differently to improve understanding and application if you were the author. Post the permalink to your article or report in the Main Forum.

    Topic 8 DQ 1

    Chen & Wang (2014)study found the following: Public health is “the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts” [
    1
    ]. The ultimate goal of public health is to improve health at the population level, and this is achieved through the collective mechanisms and actions of public health authorities within the government context [
    1
    ,
    2
    ]. Three functions of public health agencies have been defined: assessment of health status and health needs, policy development to serve the public interest, and assurance that necessary services are provided [
    2
    ,
    3
    ]. Since data, information and knowledge underpin these three functions, public health is inherently a data-intensive domain [
    3
    ,
    4
    ]. High quality data are the prerequisite for better information, better decision-making and better population health [
    5
    ](p.5170). PUB-550 Topic 8: Analyzing and Reporting Results

     

    Braveman & Gottlieb(2014) study found the following: A number of studies have attempted to assess the impact of social factors on health. A review by McGinnis et al. estimated that medical care was responsible for only 10%–15% of preventable mortality in the U.S.;
    45
    while Mackenbach’s studies suggest that this percentage may be an underestimate, they affirm the overwhelming importance of social factors.
    25
    ,
    26
    McGinnis and Foege concluded that half of all deaths in the U.S. involve behavioral causes;
    18
    other evidence has shown that health-related behaviors are strongly shaped by social factors, including income, education, and employment.
    46
    ,
    47
    Jemal et al., studying 2001 U.S. death data, concluded that “potentially avoidable factors associated with lower educational status account for almost half of all deaths among working-age adults in the U.S.(p.19)

    Braveman & Gottlieb(2014) study found the following: Despite challenges, controversies, and unanswered questions, the tremendous advances in knowledge that have occurred in the past 25 years leave little room for doubt that social factors are powerful determinants of health. The consistency and reproducibility of strong associations between social (including socioeconomic) factors and a multitude of health outcomes in diverse settings and populations have been well documented, and the biological plausibility of the influence of social factors on health has been established. It is not surprising that exceptional examples of health indicators, settings, and subgroups in which health does not necessarily improve with greater social advantage can be found. There may be thresholds above which a higher degree of a given social factor (e.g., income) no longer yields better health. Exceptions would also be expected as the effects of any given factor are contingent upon the presence of myriad other factors—social, economic, psychological, environmental, genetic, and epigenetic (p.31).

    Braveman & Gottlieb(2014) study found the following: Public health workers and clinicians also can develop health-promotion strategies that reach beyond individual clinical and social services to communities, to influence living and working conditions that are generally the strongest determinants of whether people are healthy or become sick in the first place.
    143
    They can participate in or promote research adding to the understanding of the mechanisms by which social factors influence health, and test which strategies appear most effective and efficient (p.31). PUB-550 Topic 8: Analyzing and Reporting Results

     

    Reference

     

    Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it’s time to consider the causes of the causes.
    Public health reports (Washington, D.C. : 1974)
    ,
    129 Suppl 2
    (Suppl 2), 19–31. doi:10.1177/00333549141291S206

     

    Chen, H., Hailey, D., Wang, N., & Yu, P. (2014). A review of data quality assessment methods for public health information systems.
    International journal of environmental research and public health
    ,
    11
    (5), 5170–5207. doi:10.3390/ijerph110505170 PUB-550 Topic 8: Analyzing and Reporting Results

  • Application of the Pearson Correlation Coefficient and the Chi-Square Test in nursing

    Application of the Pearson Correlation Coefficient and the Chi-Square Test in nursing

    PUB-550: Application and Interpretation of Public Health Data

    Topic 7: Correlation and Nonparemetric Tests

    Objectives:

    Evaluate the application of the Pearson correlation coefficient.

    Evaluate the application of nonparametric statistical tests such as the chi-square test.

    Explain the differences between parametric and nonparametric tests.

    Application of the Pearson Correlation Coefficient and the Chi-Square Test

    The purpose of this assignment is to practice calculating and interpreting the Pearson correlation coefficient and a chi-square test of independence.

    For this assignment, complete Problems 13.132 and 15.88 in the textbook. Include your process for conducting the calculations. You can complete the calculations by hand or using Excel or SPSS. If you use Excel or SPSS, copy and paste your output results into a Word document. Application of the Pearson Correlation Coefficient and the Chi-Square Test in nursing.

    ORDER A PLAGIARISM-FREE PAPER HERE

    When addressing each textbook problem, provide a response for each of the six steps of hypothesis testing listed below.

    Pick a test.

    Check the assumptions.

    List the hypotheses.

    Set the decision rule.

    Calculate the test statistic.

    Interpret the results. (What was done? What was found? What does it mean? What suggestions exist for future research?)

    Submit a Word document with your problem answers to each of the six steps. If Excel or SPSS was used to complete the assignment, submit the second Word document containing the screenshots to the instructor.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite. Application of the Pearson Correlation Coefficient and the Chi-Square Test in nursing

  • NRP/508 Professional Organization Evaluation

    NRP/508: Health Policy And Role Of The Advanced Practice Nurse

    Wk 3 Assignment – Professional Organization Evaluation

    Use your selected health policy issue as the basis for completing this assignment. Issue chosen:
     
    Improve Medicare Patient Access to Home Health Services.
      APRN’s are not able to document the face to face assessments/visits, sign home health plan of cares for their patients, sign additional orders to modify their patients plan of cares for home health services, or sign re-certification for home health services and plan of care for their patients. NRP/508 Professional Organization Evaluation

    Research a professional organization with influence over the health policy issue.

    Locate at least one academic article focusing on the professional organization’s efforts to effect change on the health policy issue. The article must be current (
    within 6 years
    ) and must be a scholarly work (
    peer-reviewed
    ).

    Contact the organization and ask at least two specific questions regarding the health policy issue that neither their website nor the article answered.

    Prepare a marketable visual presentation (i.e., flyer, brochure, infographic, pamphlet, poster, etc.) on the organization. Include the following in your presentation:

    The role and mission of the organization (15 pts)

    The benefits of the organization to its members and the APRN community as a whole. (10 pts)

    How will networking with this organization and with others in the industry help drive change in the area of your selected health policy issue? (10 pts)

    Based on the article you selected and your research on the organization, how can the organization be used as a guiding coalition to address your health policy issue. (15 pts)

    Write a 350- to 525-word summary analyzing three of the core competencies of advanced practice nursing and how they relate to professional organizations and professional development.

    Consider the following questions in your summary: (20 pts)

    Why are the selected competencies important?

    How will mastery of the competencies improve your practice?

    How can you continue to develop the competencies after graduation?

    Use APA guidelines. Utilize correct grammar and punctuation and use of article as outlined above. 3 minimum scholarly (peer-reviewed) references less than 6 years old. (10 pts)

    Required reading and/or texts for assignment: NRP/508 Professional Organization Evaluation

     

    Hamric, A. B., Hanson, C. M., Tracy, M.F., & O’Grady, E.T (2019). Hamric and Hanson’s advanced practice nursing: an integrative approach (6th ed.). St. Louis, MO: Elsevier.

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    Chapters 8, 10, 16

    Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016). Policy & politics in nursing and health care, 7th ed. St. Louis, MO: Elsevier.

     

    Chapters 3, 59, 64, 75

     

    Health Policy and Role of the Advanced Practice Nurse

    The selected three core competencies of advanced practice nursing include quality, policy, and independent practice. Quality competency is important in ensuring that an advanced nurse practitioner provides high-quality care and adheres to the required professional knowledge and standards to ensure the provision of high-quality care. A nurse practitioner should use the latest research evidence to apply in the clinical practice to improve the quality of care (Hamric et al; 2014). Mastering the quality competency significantly improves practice by ensuring that the best and latest research findings are applied to clinical practice. In addition, research is used to assess the organizational operations and inform policies and thus facilitating the implementation of the relevant improvements and implementation of health policies (Sastre-Fullana et al; 2017) NRP/508 Professional Organization Evaluation. I will continue to develop quality competency by always engaging in research to ensure my practice is informed by the best and latest research findings.

    The second selected competency is policy. A nurse practitioner can influence the implementation of policies that support better care delivery. For example, a nurse practitioner should support the implementation of policies that support improved access to care, affordable healthcare and better quality of care. ANPs should use the best and latest evidence available to influence decisions that lead to a better quality of care, better access to care, and improved work environment for nurses (Arabi et al; 2014) NRP/508 Professional Organization Evaluation. In the future, I plan to always use the best evidence available to advocate for the implementation of policies that support increased access to healthcare for vulnerable groups such as the poor and people with mental disorders. I will also support professional organizations that advocate for the implementation of policies supporting health improvement for all and a better working environment for the nursing workforce.

    The independent practice competency ascertains that nurse practitioners can work as licensed independent practitioners. Nurse practitioners can deliver care without being supervised. This includes the ability to assess, diagnose, and treat patients independently (Sastre-Fullana et al; 2017). Being able to practice independently as an ANP improves access to care and addresses the issue of workforce shortage because ANPs can provide similar services provided by physicians. I will develop this competency by ensuring that I continually improve my clinical skills when it comes to the assessment, diagnosis, as well as treatment of patients. This will make me competent to practice independently as an NP and according to the state laws.

     

     

    References

    American Nurses Association (ANA). (2020).
    Health Policy
    .  https://www.nursingworld.org/practice-policy/health-policy/

    Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis.
    Iranian journal of nursing and midwifery research
    ,
    19
    (3), 315–322.

    Hamric, A. B., Hanson, C. M., Tracy, M.F., & O’Grady, E.T (2019). Hamric and Hanson’s advanced practice nursing: an integrative approach (6th ed.). St. Louis, MO: Elsevier. NRP/508 Professional Organization Evaluation

    Landers, S., Madigan, E., Leff, B., Rosati, R. J., McCann, B. A., Hornbake, R., MacMillan, R., Jones, K., Bowles, K., Dowding, D., Lee, T., Moorhead, T., Rodriguez, S., & Breese, E. (2016). The Future of Home Health Care: A Strategic Framework for Optimizing Value.
    Home health care management & practice
    ,
    28
    (4), 262–278.
    https://doi.org/10.1177/1084822316666368
    .

    Sastre-Fullana, P., Morales-Asencio, J. M., Sesé-Abad, A., Bennasar-Veny, M., Fernández-Domínguez, J. C., & De Pedro-Gómez, J. (2017). Advanced Practice Nursing Competency Assessment Instrument (APNCAI): clinimetric validation.
    BMJ open
    ,
    7
    (2), e013659. https://doi.org/10.1136/bmjopen-2016-013659. NRP/508 Professional Organization Evaluation

  • USW1 NURS 6050 Global Health Comparison Grid Template

    USW1 NURS 6050 Global Health
    Comparison Grid
    Template

    Global Health Comparison Grid Template

     

    Use this document to complete the Module 6 Assessment
    Global Healthcare Comparison Matrix
    and Narrative Statement.

     

     

     

    Global Healthcare Issue

     

    HIV/AIDS

    Description

     

    HIV/AIDS is a global epidemic that has continued to ravage the lives of approximately a million people annually. Different countries apply different ways to cope with the disease. This comparison template seeks to analyze the approaches that the US and which will be

     

    Country

    United States

     

    Haiti

    USW1 NURS 6050 Global Health Comparison Grid Template

    Describe the policy in each country related to the identified healthcare issue

    The Office of National AIDS policy works to reduce the number of HIV infections in the US through prevention, care and treatment methods in the country (Meier, Back, Berman, Block, Corrigan & Morrison, 2017)

     

    The Pacific Sports Haiti SA policy that seeks to provide practices that can be undertaken for HIV prevention and anti-discriminatory ways to handle people living with the disease (Gupta, Small & Kershaw, 2016).

    What are the strengths of this policy?

     

    It directs the national government in carrying out assessments on the progress in the programs that manage HIV/AIDS in the country.

    The policy helps in the anti-stigmatization of HIV/AIDS infected individuals in the workplace.

    What are the weaknesses of this policy?

    The policy does not provide a satisfactory estimation of the population in the country, which causes failure in the offering of services to some of the affected citizens.

     

    It is only centered on the workplace influence of HIV/AIDS measures in the workplace.

    Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)

     

    The status in society, economic situation, employment status, and level of education play a huge part in the determinants of the spread of HIV/AIDS.

     

    The societal level, employment status, the youth, sexual orientation are some determinants in the HIV/AIDS issue that is faced in Haiti.

    Also, the norm in young women sexually associating with older men plays a large part in the spread of AIDS in the country.

    How has each country’s government addressed cost, quality, and access to the selected global health issue?

     

    The United States government has created health care centers that exclusively deal with issues concerning HIV/AIDS.

    Access to healthcare services has been made less complicated through a reduction in costs, and quality of treatment has been improved.

     

    The cost of accessing HIV/AIDS care has been reduced significantly, with some of the public care being provided for free.

    The quality and facilities have, however, been run down due to a lack of resources in the government.

    How has the identified health policy impacted the health of the global population? (Be specific and provide examples)

    The plan has aided in the worldwide improvement of sensitizing the public on the issues that concern HIV/AIDS.

    The policy has also helped the government engage in a stigma-free society health watch that has helped in the continuous monitoring of the disease. USW1 NURS 6050 Global Health Comparison Grid Template

     

    The Pacific Sports S>A policy has helped reduce the stigma that was often associated with AIDS through public education incentives on the illness.

    The policy also provides for the protection of workers infected with HIV/AIDS in the workplace.

    Describe the potential impact of the identified health policy on the role of a nurse in each country.

    The policy has influenced the role of the nurse in the US as it provides for patients to receive personalized services. This dictates that nurses receive additional training to be in a better position to handle the patient.

     

    The nurse in Haiti is overwhelmed with the increased workload due to the high number of infections that are experienced in the country.

    Additional training should also be carried out to help nurses learn ways through which they should deal with HIV infected patients.

    Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)

    The global health issues help ensure that all departments in the United States government are integrated to work together in the prevention, care, and treatment systems that concern the HIV/AIDS pandemic.

    They ensure that the government is always actively working towards making the required changes in laws to meet the demands that arise in the pandemic efficiently.

     

    The Pacific Sports SA policy has played a considerable part in ensuring that the rights of an HIV/AIDS infected individual in the workplace are not interfered with.

    It also undertakes in society education on the ways through which the diseases can be fought.

    General Notes/Comments

     

    The United States government has made conscious efforts in the fight against HIV/AIDS.

    It is continually making advancements in handling AIDS, and with more investments being injected into the sector, a cure for the illness will likely be arrived at in the foreseeable future.

     

    Just like in the United States, the fight against HIV/AIDS is ongoing in Haiti. More efforts should, however, be made by the government to inject more resources into the policy to achieve more positive results. USW1 NURS 6050 Global Health Comparison Grid Template

     

     

     

     

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    A Plan for Social Change

    The many trends that are being experienced in the current world play a huge role in my nursing career. There are a couple of ways through which I can assimilate the global perspective into my position to ensure that all patients receive quality medical care. First, I would take the initiative to learn more about the different aspects and ways of life that exist in the lives of my patients. I would approach patients with empathy to understand their diversity. I would then do my best to explain the ways of the changing world and the benefits that can be gained from using advanced medical care in treatment. My nursing role should be unnoticeably and quickly assimilated into the use of the policy to ensure that all my patients receive the quality care that is stipulated.

    A comprehensive aspect of the stated policies requires me to incorporate the international perspectives in my career. This is possible through advanced learning classes that I will purposely attend to gain more knowledge and skills that will be useful in the treatment and care of patients infected with HIV/AIDS. Through these classes, my leadership skills will improve in a way that will help me have a better ability to interact with the various people I will meet during my career as a nurse.  Additionally, I will acquire skills that will help me teach the public a better understanding of the issues involved with HIV/AIDS. Lastly, the incorporation of the global health angle will also enable me to merge advancements made in HIV/AIDS prevention, care, and treatment in the United States with those in Haiti to ensure that the number of cases of infection reduces. This will help in the fight and eradication of the pandemic. USW1 NURS 6050 Global Health Comparison Grid Template.

     

     

    Works Cited

    Gupta, J., Small, M. J., & Kershaw, T. (2016). Gender and HIV/AIDS in Haiti: women’s lack of power as an overarching vulnerability. In 
    Gender and HIV/AIDS
     (pp. 85-100). Routledge.

     

    Meier, D. E., Back, A. L., Berman, A., Block, S. D., Corrigan, J. M., & Morrison, R. S. (2017). A national strategy for palliative care. 
    Health affairs
    , 
    36
    (7), 1265-1273. USW1 NURS 6050 Global Health Comparison Grid Template

  • l23.7 allergic reaction soap note

    HPI: 59 y/o patient came into the office today c/o:

    24-year-old male presents with itchy rash to both arms, neck and face. He first noticed the rash two days ago after returning from a camping trip with friends. The rash is spreading and did not improve with over-the-counter itch cream or Benadryl. l23.7 allergic reaction soap note.

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    Review of systems:

    General:
    No fever, chills, or weight changes or sweating or general weakness.

    Eyes:
    No blurred or double vision or pain or redness.

    Ears:
    No pain or decrease in hearing.

    Nose:
    No runny nose or blockage or bleeding.

    Throat:
    No sore throat.

    Head:
    No headache.

    Chest:
    No chest pain or cough or shortness of breath or wheezing.

    Prostate:
    No urinary frequency or dysuria or uretheral discharge or pain on sitting.

    Heart:
    No irregular heart beat or palpitations or chest pain.

    Gastrointestinal:
    No abdominal pain or nausea or vomiting or diarrhea or constipation or difficulty swallowing or rectal bleeding or bloating or distension or hemorrhoids. l23.7 allergic reaction soap note.

    Genitourinary:
    No dysuria or uretheral discharge or pain on sitting.

    Musculoskeletal:
    No joint or back pain or muscle problems or weakness.

    Skin:
    Diffuse rashes spread across the trunk, arms, neck, head, and face..No bruises or skin masses or other skin complaints.

    Neurologic:
    No weakness or headache or seizures or numbness or tingling.

    Psychiatric:
    No anxiety or depression or suicidal/homicidal thoughts.

    Endocrine:
    No excessive thirst or excessive urination or excessive heat or cold.

    Immunologic:
    No tuberculosis or hepatitis or HIV or recurrent infections.

    Hematologic:
    No anemia or easy bruising or bleeding.

     

    PMHx
    : none

    FamilyHx
    : none

    SocialHx
    : Pt is a student.

    Allergies
    : NKA

     

    Objective:

    General:
    Normotensive, in no acute distress.

    Head:
    Normocephalic, no lesions.

    Eyes:
    PERRLA, EOM’s full, conjunctivae clear, fundi grossly normal.

    Ears:
    EAC’s clear, TM’s normal.

    Nose:
    Mucosa normal, no obstruction.

    Throat:
    Clear, no exudates, no lesions.

    Neck:
    Supple, no masses, no thyromegaly, no bruits.

    Chest:
    Lungs clear, no rales, no rhonchi, no wheezes.

    Heart:
    RR, no murmurs, no rubs, no gallops.

    Abdomen:
    Soft, no tenderness, no masses, BS normal.

    Back:
    Normal curvature, no tenderness.

    Extremities:
    FROM, no deformities, no edema, no erythema.

    Neuro:
    Physiological, no localizing findings.

    Skin:
    No lesions noted. Diffuse rashes spread across the trunk, arms, neck, head, and face.

    l23.7 allergic reaction soap note

    ORDER A PLAGIARISM-FREE PAPER HERE

    Assessment:

    Differential Dx:

    Rash and other nonspecific skin eruption. R21

    Pruritus, unspecified. L29.9

    Actual Dx:

    Poison ivy, oak, sumac or other plant dermatitis L23.7 (allergic) (contact)

    ICD-10-CM Codes. (2019). Retrieved from https://www.icd10data.com/ICD10CM/Codes/

    Plan:

    Education I would discuss with and provide to the pt.

    Rubbing alcohol

    Rubbing alcohol can remove the urushiol oil from the skin, helping to minimize discomfort.

    People should do this as soon as possible after contact with poison ivy, particularly within the first 10 minutes of exposure. If going camping or hiking, it is a good idea to carry alcohol wipes at all times.

    The 
    U. S. Food and Drug Administration (FDA)
     advise that urushiol can remain on the surface of most items that come into contact with poison ivy, sometimes for years, unless treated with rubbing alcohol or water.

     

    Shower or bathe

    Thoroughly wash the skin, and under the fingernails, with plain soap and lukewarm water to remove plant oils. Water can be used instead of rubbing alcohol, although it is best to use alcohol first and then shower or bathe.

    It’s believed that showering within 60 minutes of exposure may help limit the spread and severity of the rash.

    Wash anything that comes into contact with the plant. People should wear rubber gloves when doing this.

    Cold compress

    Cool, wet compresses can help to reduce itching and 
    inflammation
    .

    To make a compress, run a clean washcloth under cold water. Wring off excess water. Apply to the skin for 15 to 30 minutes. Repeat this several times a day as needed.

    Some people find relief by soaking the compress in an astringent liquid to further reduce swelling and itching. Examples of astringent liquids include aluminum acetate, apple cider vinegar, and chilled black tea.

    Resist scratching the skin

    Scratching the skin can lead to an infection. It may also cause blisters to burst, which may then become infected.

    Blisters that do open should be left alone, as the skin covering the wound can provide protection and reduce the risk of infection. l23.7 allergic reaction soap note

    Unscrubbed fingernails may also contain traces of urushiol, which can be transmitted to the skin through scratching. This can lead to further itching and a more severe poison ivy rash.

    5. Topical lotions and creams

    Several lotions that can help relieve the symptoms of a mild poison ivy rash are available without a prescription.

    Hydrocortisone creams and calamine lotion are two products commonly used to reduce itching and swelling.

    The 
    FDA advise
     that products containing zinc acetate, zinc carbonate, and zinc oxide treat the oozing and weeping caused by poison ivy. Users should always apply these products as per the instructions on the label.

    Aloe vera gel, taken from the aloe vera plant, is another soothing topical poison ivy remedy.

    Oatmeal bath

    According to 
    research
    , oatmeal has 
    antioxidant
     and anti-inflammatory properties that benefit a variety of inflammatory skin conditions.

    Adding oatmeal or an oatmeal-based product to a lukewarm bath is a simple poison ivy remedy. Soaking in the tub for up to 30 minutes may provide symptom relief.

    Bentonite clay

    Bentonite clay is a popular natural clay used in a variety of beauty and personal care products.

    Some people report relief from poison ivy rash after applying a paste of bentonite clay and water to the affected area.

    Research
     suggests that using a modified version of bentonite clay (quaternium-18 bentonite) effectively prevents or reduces the allergic contact dermatitis caused by poison ivy and poison oak.

    Baking soda

    Also known as sodium bicarbonate, baking soda is a salt that is mainly used in baking. However, it is also used as a natural cleaning agent and as a home remedy for various ailments.

    Adding a cup of baking soda to the tub is recommended by the 
    American Academy of Dermatology
     for relief from poison ivy rash.

    Leonard, J. (2019). Poison ivy: Home remedies and how to recognize it. Retrieved from https://www.medicalnewstoday.com/articles/318059.php

    Prescription:

    OTC Pramoxine-Calamine medicated lotion. Apply to affected areas every 6 to 8 hours as needed.

    Medication instructions and educatio9n for the pt.

    Calamine is for external use only. Do not swallow it and do not use it on the eyes or mucous membranes such as the inside of the mouth, nose, genital (sex organs), or anal areas.

    To use calamine lotion:

    Shake the lotion well before using.

    Moisten a pledget of cotton with the lotion.

    Use the moistened pledget to apply the lotion to the affected skin area(s).

    Allow the medicine to dry on the skin.

    l23.7 allergic reaction soap note

    WebMD. (2019). Calamine Medicated Topical : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing. Retrieved from https://www.webmd.com/drugs/2/drug-20796/calamine-medicated-topical/details l23.7 allergic reaction soap note

  • NURS 6053 Wk3 Discussion: Organizational Policies and Practices to Support Healthcare Issues Essay

    NURS 6053 Wk3 Discussion: Organizational Policies and Practices to Support Healthcare Issues Essay

    Discussion: Organizational Policies and Practices to Support Healthcare Issues

    Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

    For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care? NURS 6053 Wk3 Discussion: Organizational Policies and Practices to Support Healthcare Issues Essay

    In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

    To Prepare:

    Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.

    Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

    Post
    an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples. NURS 6053 Wk3 Discussion: Organizational Policies and Practices to Support Healthcare Issues Essay

     

    Discussion: Organizational Policies and Practices to Support Healthcare Issues

    Competing needs such as the needs of resources workforce and patients may impact the development of the policy by requiring the nurse leader to strike a balance between these competing needs.  Workforce consumes the greater part of the financial resources of the organization; thus it is the responsibility of the nurse to make sure that the organization remains financially healthy while ensuring that nurses provide quality and safe patient care.  As Hunt (2018) indicates, it is always vital to have sufficient nurses with the appropriate expertise to offer quality care cost-effectively. NURS 6053 Wk3 Discussion: Organizational Policies and Practices to Support Healthcare Issues Essay.  For example, when developing a policy, the nurse leader must try to find the appropriate balance between staff satisfaction, quality and safety of patient care and fiscal sustainability of a staffing policy is to be effective.

    The competing needs that may impact nursing shortage include the requirement for nurses to attend to the increasing patient health needs which makes nurses face burnout and negative outcomes on the health of the nurses. This influences the quality of care that nurses give to patients.  When nurses work under stressful work environments often typified by heavy workloads and subsequent burnout, they are dissatisfied with their jobs, making them leave the organization or change to another career (Heidari et al; 2017) NURS 6053 Wk3 Discussion: Organizational Policies and Practices to Support Healthcare Issues Essay.

    A policy can address the needs of nurses to work in less stressful and supportive environments and the need for patients to receive quality nursing care. An organization can increase the retention of nurses by creating a supportive work environment to lessen the vulnerability of workplace fatigue, and eventually reduce turnover intentions.  A minimum nurse to patient ratio policy can empower nurses to create staffing plans that will be specific to every unit. This strategy will allow healthcare organizations to determine flexible staffing levels.   According to Griffiths et al (2020), the capability to establish the appropriate number of nurses to deploy on a given shift can improve the work conditions for nurses as well as the efficiency and quality of care.

     

    References

    Griffiths, P., Saville, C., Bal, J et al. (2010). Nursing workload, nursing staff methodologies and tools: A systematic scoping review and discussion.
    International Journal of Nursing Studies. 103
    :103487.
    doi.org/10.1016/j.ijnurstu.2019.103487

    Heidari, M., Seifi, B., & Gharebagh, Z. (2017). Nursing staff retention: Effective factors.
    Annals of Tropical Medicine and Public Health, 10
    (6), 1467-1473. DOI:
    10.4103/ATMPH.ATMPH_353_17

    Hunt P. (2018). Developing a staffing plan to meet inpatient unit needs.
    Nursing Management 49
    (5) 24-31. doi: 10.1097/01.NUMA.0000532326.62369.9b. NURS 6053 Wk3 Discussion: Organizational Policies and Practices to Support Healthcare Issues Essay

  • Lower back pain soap note examples

    Lower back pain soap note examples

    CC:
    lower back pain x 1 week

     

    HPI:
    42-year-old obese female presents with complaints of lower back pain for the past week that feels worse today. The pain is constant and intermittently radiates down her left leg. It is not improved with ibuprofen. She works as a grocery store clerk.

    ORDER A PLAGIARISM-FREE PAPER HERE

    Review of systems:

    General:
    No fever, chills, or weight changes or sweating or general weakness.

    Eyes:
    No blurred or double vision or pain or redness.

    Ears:
    No pain or decrease in hearing.

    Nose:
    No runny nose or blockage or bleeding.

    Throat:
    No sore throat.

    Head:
    No headache.

    Chest:
    No chest pain or cough or shortness of breath or wheezing.

    Breasts:
    No pain or tenderness or noticeable lump.

    Heart:
    No irregular heart beat or palpitations or chest pain.

    Gastrointestinal:
    No nausea or vomiting or constipation or difficulty swallowing or rectal bleeding or bloating or distension or hemorrhoids or diarrhea or abdominal discomfort.

    Genitourinary:
    No vaginal discharge or bleeding or dysuria or vaginal problems.

    Musculoskeletal:
    No muscle problems or weakness.
    Lower back pain that radiates down left leg.

    Skin:
    No rashes or bruises or skin masses or other skin complaints.

    Neurologic:
    No weakness or headache or seizures or numbness or tingling.

    Psychiatric:
    No anxiety or depression or suicidal/homicidal thoughts.

    Endocrine:
    No excessive thirst or excessive urination or excessive heat or cold.

    Immunologic:
    No tuberculosis or hepatitis or HIV or recurrent infections.

    Hematologic:
    No anemia or easy bruising or bleeding.

    Lower back pain soap note examples

     

    PMHx
    : none

    FamilyHx
    : none

    SocialHx
    : Pt works as a grocery store clerk

    Allergies
    : NKA

    Objective:

    66 in

    275 lb

    44.4

    122/75 mmHg

    78 bpm

    14 bpm

    97.6 °F

    99 %

     

    General:
    Normotensive, in no acute distress.

    Head:
    Normocephalic, no lesions.

    Eyes:
    PERRLA, EOM’s full, conjunctivae clear, fundi grossly normal.

    Ears:
    EAC’s clear, TM’s normal.

    Nose:
    Mucosa normal, no obstruction.

    Throat:
    Clear, no exudates, no lesions.

    Neck:
    Supple, no masses, no thyromegaly, no bruits.

    Chest:
    Lungs clear, no rales, no rhonchi, no wheezes.

    Heart:
    RR, no murmurs, no rubs, no gallops.

    Abdomen:
    Soft, no tenderness, no masses, BS normal.

    Back:
    Normal curvature, no tenderness.

    Extremities:
    FROM, no deformities, no edema, no erythema.

    Neuro:
    Physiological, no localizing findings.

    Skin:
    Normal, no rashes, no lesions noted.

    Lower back pain soap note examples

    ORDER A PLAGIARISM-FREE PAPER HERE

    Assessment:

    Actual Dx:

    (E66.0) Obesity, body mass index (bmi 40-44.9).

    (M54.5) Dorsalgia, acute low back pain.

    ICD-10-CM Codes. (2019). Retrieved from https://www.icd10data.com/ICD10CM/Codes/

    Plan:

    – begin medications listed below as needed.

    – pt educated on importance of weight loss and dietary modification to reduce back strain

    – RTC for follow up in 30 days if symptoms persist

    Ultram (tramadol) 100 MG Oral Tablet Sig: Take 1 tablet (100 mg) by mouth every 6 hours as needed for pain. #40, no refills.

    Flexeril (cyclobenzaprine) 10 MG Oral Tablet Sig: Take 1 tablet (10 mg) by mouth every 8 hours as needed. Take at bedtime if drowsiness occurs. #30, no refills.

    Ultram, Flexeril: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing. (2019). Retrieved from https://www.webmd.com/drugs

    Education:

    Provide education to pt on importance of dietary modification and exercise in order to lose weight and reduce strain on her back. Stress importance of establishing goals and the health benefits associated with a healthy BMI. If necessary and pt continues to struggle in 30 days will refer to dietician for additional support on nutrition and increasing her level of physical activity (UpToDate, 2019).

     

    History & Physical Examination

     

    Patient Demographics
    :

    Name: T.H.

    Age/race/sex: 26 Hispanic Female

    Clinical site: Primary Care clinic; Presents for sick visit.

     

     

    SUBJECTIVE DATA

     

    Chief Complaints
    :
        “My lower back has been hurting for about 2 weeks now”.

     

    History of Present Illness
    :  

    Mrs. H is a 26 y/o Hispanic female with a six year history of depression-controlled on Sertraline, who presents to the clinic today complaining of spontaneous occurring acute low back pain to lumber region that started about 2 weeks ago after wearing heels to a party. Reports it has been very difficult to dress lower body and to bend. She reports the pain is constant but has intermittent intensities of aching and soreness throughout the day. The pain is localized to the lumber area, described as aching and soreness with no radiation, rated a 5/10 in office today with 3/10 being the lowest amount of pain experienced and 8/10 being the worst pain she has experienced. Reports the pain is worse in the mornings when getting out of bed after lying down all night. She hasn’t tried any pharmacological or non-pharmacological therapies. She reports no heavy lifting, strenuous exercise, current injuries, nor feelings of anxiety or depression. However, about 5 years ago she was riding her bike, went down a ramp and flipped head first over the handle bars of the bike. At which time she experienced this same low back pain, went to the ER and had X-rays that showed some inflammation and swelling. She was then prescribed a muscle relaxant, Ibuprofen, and physical therapy for 8 weeks, which helped tremendously. At today’s visit, she hopes to find out where the pain is coming from and what she can do to prevent it from returning. Lower back pain soap note examples

     

    Past Medical History:

    Depression-active- diagnosed 6 years ago after mom passed in a MVA

    Low back pain-active-diagnosed about 5 years ago after previous back injury.

     

     

    Past Surgical History:

    No surgeries to date

     

    Allergies:

    NKA to food, dust, mold, environment, or medications.

     

    Medications:

    Sertraline 150 mg by mouth daily for depression

     

    Health Maintenance:

    Influenza Vaccine-October 2017 at CVS.

    All other immunizations are up-to-date including TDaP, MMR, and Varicella.

    Last Pap smear- June 2016-normal

    Performs MSBE

    Depression screen positive for PHQ2; on meds and see Psychologists regularly.

    CAGE 0/4

     

    Personal & Social History:

    Lives alone in a one bedroom apartment.

    Works at a nursing home as a Certified Nursing Assistant 4 days/week. She loves her job and has a dependable car.

    Denies any smoking, illicit drug abuse, or alcohol misuse.

    Previously did cross fit in high school. However, do to work she hasn’t had much time to get the amount of exercise she needs.

    Patient is sexually active with only one sex partner, her boyfriend.

    24 hour diet recall: B- one bowl of Chex cereal; L- a turkey sandwich, chips, and a diet coke; S-about 1-2 cups of cheese-it crackers and a diet coke; D- Meatloaf, veggies, mashed potatoes from Boston Market, and a bottled water. Lower back pain soap note examples

     

    Family History:

    Grandparents

    Paternal:      Paternal grandfather 81, HTN, DM; Paternal grandmother 76 history of DM

    and MI.

    Maternal:     Maternal grandfather died at 82 from MI, maternal grandmother 79, history

    of diabetes and arthritis.

     

    Parents

    Father:         Father 59, history of HTN, Diabetes, Depression, and Stroke.

    Mother:        Mother 52, died in a MVA.

     

    Siblings

    Siblings:      Only child.

     

    Children

    Children:     No children.

     

    Review of Systems:
     

    General

    Denies any fever, chills, night sweats, weight loss or weight gain in the past year.

    Skin

    Denies dry skin and itching. Denies abnormal lesions or new nevi/moles

    Head

    Previous head injury, denies any masses, lesions and headache

    Eyes

    Denies any discharge, itchy, blurred vision, vision loss or vision changes, eye pain or injection.

    Ears

    Denies any itching, fullness, vertigo, ear pain or drainage, hearing loss or changes in quality of hearing.

    Nose/Sinuses

    Denies epistaxis, PND, maxillary or frontal sinus pain, or changes in smell

    Mouth/Throat

    Denies sore throat and dysphagia. Denies gum disease, has all original teeth, last dental exam was in July of this year, sees the dentist annually.

    Neck/Lymph Nodes

    Denies swollen /painful lymph nodes, denies any neck pain or stiffness. Lower back pain soap note examples

    Breasts

    Denies masses, pain, or nipple discharge. Does perform regular SBE.

    Thorax/Respiratory

    Denies any SOB, DOE, or wheezing.

    CVS

    Denies CP, palpitations, denies peripheral edema, Orthopnea

    GI/Abdomen

    Denies dyspepsia, nausea, vomiting, diarrhea, constipation, bloating, hematemesis, hematochezia, or abdominal pain. No recent changes in bowel habits. Last bowel movement was this morning, which is consistent with her regular bowel habits and was normal.

    GU

    Denies any pain on urination, frequency, urgency, or vaginal discharge.

    Musculoskeletal

    See HPI.

    Neurologic

    Denies memory loss, numbness, tingling, or burning pains or weakness.

    Endocrine

    Denies known glucose abnormalities, heat or cold intolerance

    Psychiatric

    Reports a history of depression but denies any anxiety.

     

     

    OBJECTIVE

    Physical Examination:

    Vital Signs/HT/WT

    T: 98.2F, P: 72 readily palpable, RR: 16, BP 110/64 on right, 110/68 on the left SaO2 on RA: 100% HT: 5’8”, WT: 128lbs (toned-physique, stable with no gains or losses within the last 6 months), BMI: 19.46, normal for ht. and wt.

    General

    26 y/o Hispanic female, pleasant appears her stated age sitting on the examination table in moderate distress as evidenced by arms tensed on elbows as she’s guarding pain. Well groomed, well developed, AAOx3

    Skin

    Warm, moist, no rashes or suspicious moles, +turgor

    Head/Scalp

    ATNC, thick black hair, no dandruff, no lesions/masses.

    Eyes

    External examination without ptosis, strabismus or exophthalmos. Conjunctiva pink. Rest of exam deferred.

    Ears

    Auricles symmetrical, no lesions or tophi; Rest of exam deferred.

    Nose

    Bilateral nasal turbinates’ pink, moist. Rest of exam deferred.

    Sinuses

    Deferred

    Mouth

    Lips pink, moist mucous membrane, tongue protrudes in midline.

    Pharynx/Throat

    Deferred. Lower back pain soap note examples

    Neck/Lymph nodes

    Trachea midline with full AROM without pain.

    CVS

    RRR, normal S1, S2, no murmurs, rubs, or extra systole, JVD 3cm at 30 degrees, no carotid bruits, no cyanosis or vascular lesions. No chest wall deformity. PMI at 5
    th
    ICM MCL. Non-tender without heaves or thrill. Auscultation of the abdomen without bruit. Palpation without pulsatile masses

    Lungs/Thorax

    Chest symmetrical without deformity, respirations even and unlabored throughout anterior and posterior lung fields. Palpation without tenderness.  Tactile fremitus present. Resonance heard on percussion throughout anterior and posterior lung fields. Vesicular breath sounds auscultated throughout anterior and posterior peripheral lung fields.

    Breasts

    Deferred

    Abdomen

    Deferred

    GU

    Deferred

    Musculoskeletal

    Mandible moves in midline TMJ palpation without clicks or tenderness. Neck and cervical spine have no noted deformities or signs of inflammation. Curvature of cervical, thoracic and lumbar spine within normal limits. Bony features of shoulders and hips are of equal height bilaterally and non-tender. Posture is slumped and gait is smooth but guarded. Palpation of spinous processes of C7-L5 are palpable, midline, and tender to deep palpation right below L5. Discomfort noted with lying flat on exam table. Patient can bend to touch toes but experiences discomfort at about 90 degrees from the upright position. Although patient can actively perform such maneuvers as bending her knees to her chest while lying flat, flex, extend, and rotate the spine there is some mild discomfort and pain noted throughout the maneuvers.

    Extremities/Pulses

    No edema, erythema or cyanosis to upper or lower extremities. Pulses 2/4 to bilateral femoral, popliteal, posterior tibial, and dorsalis pedis pulses.

    Neurologic

    AA O X3. Slumped posture while sitting and walking. Gait steady and intact. Sensation intact to light, deep, and sharp touch. gait and balance intact. CN II- XII intact.  Memory and cognition intact for present and past medical history.

    Psych

    Appropriate mood and affect

     

    Evidence Based Assessment/Plan

    Clinical Decision Making:
     26 y/o Hispanic female presents to the primary care clinic with a two week history of constant low back pain worse when ambulating and dressing. The pain is non-radiating and has intermittent intensities of aching and soreness consistent with acute non-specific low back pain. She has experienced these symptoms before after a biking accident 5 years ago. Given Mrs. H’s presenting signs and symptoms there is a need to differentiate between the diagnosis of acute non-specific low back pain and low back pain with radiculopathy. Mrs. H is an otherwise healthy young female with a history of depression controlled on antidepressant. She has no other co-morbidities or health issues.

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    Differential Diagnosis:

    CHARACTERISTICS OF DIFFERENTIAL DIAGNOSIS

    SIGNS AND SYMPTOMS

    PHYSICAL EXAM FINDINGS

    Non-specific Acute Low Back Pain

    Nonspecific or nonradicular low back pain is not associated with neurologic symptoms or signs. In general, the pain is localized to the spine or paraspinal regions (or both) and does not radiate into the leg. In general, nonspecific low back pain is not associated with spinal nerve root compression. Nonspecific low back pain might or might not be associated with significant pathology on magnetic resonance imaging (MRI) and is often a result of simple soft tissue disorders such as strain, but it can also be caused by serious medical disorders arising in the bony spine, parameningeal, or retroperitoneal regions.

     

    Risk factors:

    Smoking, obesity, older age, female gender, physically strenuous work, sedentary work, a stressful job, job dissatisfaction and psychological factors such as anxiety or depression.

     

    Diagnosis:

    Diagnosis is based on physical exam findings. Routine spine radiographs are of limited value because they visualize only bony structures. Guidelines from the U.S. Agency for Health Care Policy and Research (AHCPR) indicated value of routine spine radiographs for acute low back pain in the following settings: acute major trauma, minor trauma associated with risk of osteoporosis, risk of spinal infection, pain that does not respond to rest or recumbency, and history of cancer, fever, or unexplained weight loss. They may also be of value in assessing spinal alignment and rheumatologic disorders of bone. The American Academy of Neurology guideline recommends nonsurgical therapy before CT and MRI are used in patients with uncomplicated acute low back pain of less than 7 weeks’ duration.

    www.aafp.org

     

    Pain areas: in the low back, muscles and bones, hip, or leg.

     

    Sensory: leg numbness or pins and needles.

     

    Back joint dysfunction or muscle spasms.

     

    Slumped gait due to pain on standing upright.

     

     

     

     

     

     

     

     

    Some physical exam findings of low back pain may include the following;

     

    Superficial tenderness over the lumbar region to light touch

     

    Nonanatomic tenderness

     

    Exacerbation of pain by applying a few pounds of pressure with the hands to the top of the head

     

    Exacerbation of pain by simulated rotation or flexion of the spine

     

    Ability to sit up straight from a supine position, but intolerance of the straight-leg-raising test

     

    Nonanatomic distribution of sensory changes

     

    http://www.clevelandclinicmeded.com

     

    Acute lumbosacral radiculopathy

    Low back pain accompanied by spinal nerve root damage is usually associated with neurologic signs or symptoms and is described as 
    radiculopathy.
     There is usually pathologic evidence of spinal nerve root compression by disk or arthritic spur, but other intraspinal pathologies may be present and are often apparent on an MRI scan of the lumbosacral spine.

    Risk factors:

    Traumatic injury

    Lumbar sprain or strain

    Postural strain

    sitting, standing or walking >2hrs per day

    frequent moving or lifting >25 lbs.

    strength <50% depression obesity poor health prior LBP poor back endurance Osteoarthritis Rheumatoid Arthritis www.aafp.org Diagnosis: After the initial examination, the diagnosis of lumbar radiculopathy can be supported by electrodiagnosis, MRI, CT scans, and/or contrast myelography. Treatment of lumbar radiculopathy will vary depending on the actual cause of the radiculopathy. These treatments can include the use of back supports, medication, physical therapy, steroid injection in the spine, and even surgery. http://www.aanem.org   Radiculopathy  — A common feature of low back pain is radiculopathy, which occurs when a nerve root is irritated by a protruding disc or arthritis of the spine. Radiculopathies usually cause radiating pain, numbness, tingling, or muscle weakness in the specific areas related to the affected nerve root, usually the lower leg. Most people with these conditions improve with limited or no treatment, described below. Lower back pain soap note examples Sciatica  — Sciatica refers to the most common symptom of radiculopathy. It is a pain that occurs when one of the five spinal nerve roots, which are branches of the sciatic nerve, is irritated, causing a sharp or burning pain that extends down the back or side of the thigh, usually to the foot or ankle. You may also feel numbness or tingling. Occasionally, the sciatica may also be associated with muscle weakness in the leg or the foot. If a disc is herniated, sciatic pain often increases with coughing, sneezing, or bearing down. Neurogenic claudication  — Neurogenic claudication is a type of pain that can occur when the spinal cord is compressed due to narrowing of the spinal canal from arthritis or other causes. The pain runs down the back to the buttocks, thighs, and lower legs, often involving both sides of the body. This may cause limping and weakness in the legs. Pain usually gets worse when extending the lower spine (e.g., when standing or walking), and gets better when flexing the spine by sitting, stooping, or leaning forward.   The onset of symptoms in patients with lumbosacral radiculopathy is often sudden and includes LBP. Some patients state the preexisting back pain disappears when the leg pain begins. Sitting, coughing, or sneezing may exacerbate the pain, which travels from the buttock down to the posterior or posterolateral leg to the ankle or foot. Radiculopathy in roots L1-L3 refers pain to the anterior aspect of the thigh and typically does not radiate below the knee, but these levels are affected in only 5% of all disc herniations. When obtaining a patient’s history, be alert for any red flags (i.e., indicators of medical conditions that usually do not resolve on their own without management). Such red flags may imply a more complicated condition that requires further workup (e.g., tumor, infection).   The presence of fever, weight loss, or chills requires a thorough evaluation. Patient age is also a factor when looking for other possible causes of the patient’s symptoms. Individuals younger than 20 years and those older than 50 years are at increased risk for more malignant causes of pain (e.g., tumor, infection).   POC LABS to Review No POC labs to review   Diagnosis 1-Guidelines for Treatment for Non-Specific Acute Low Back Pain (most likely dx): There is general agreement that patients with acute nonspecific spine pain or nonlocalizable lumbosacral radiculopathy (without neurologic signs or significant neurologic symptoms) require only conservative medical management. Patients should abstain from heavy lifting or other activities that aggravate the pain. Bed rest is not helpful and has been shown to delay recovery. Bed rest may be recommended for the first few days for patients with severe pain with movement. Recommended medications include nonsteroidal anti-inflammatory drugs such as ibuprofen or aspirin. If there are complaints of muscle spasm, muscle relaxants such as cyclobenzaprine may be used in the acute phase of pain. Narcotic analgesia should be avoided, in general, but it can be prescribed in cases of severe acute pain. A study by Cherkin and coworkers compared standard physical therapy maneuvers and chiropractic spinal manipulation for the treatment of acute low back pain and found that both provide small short-term benefits and improve patient satisfaction. Nonpharmacologic treatment, including superficial heat, massage, acupuncture, or spinal manipulation, should be used initially for most patients with acute or sub-acute low back pain, as they will improve over time regardless of treatment. When pharmacologic treatment is desired, nonsteroidal anti-inflammatory drugs (NSAIDs) or skeletal muscle relaxants should be used. Avoid imaging in cases of uncomplicated low back pain (unless there are specific clinical indications). Medications prescribed today;   Diclofenac Sodium 50 mg 1 by mouth twice daily for pain for 2 weeks. Flexeril (Cyclobenzaprine) 10 mg 1 tab by mouth three times a day as needed for muscle spasms for 2 weeks. www.aafp.org   Diagnostic test needed: No further diagnostic test needed at this time. Diagnosis was based on clinical presentation, history, and physical exam.   Referrals/Consults: Referral for physical therapy to evaluate and treat for low back pain and spasms.   Patient Education : Remaining active  — many people are afraid that they will hurt their backs further or delay recovery by remaining active. However, remaining active is one of the best things you can do for your back. In fact, prolonged bed rest is not recommended. Studies have shown that people with low back pain recover faster when they remain active. Movement helps to relieve muscle spasms and prevents loss of muscle strength. Although high-impact activities should be avoided, it is fine to continue doing regular day-to-day activities and light exercises, such as walking. If certain activities cause the back to hurt too much, it is fine to stop that activity and try another. If back pain is severe, bedrest may be necessary for a short period of time, generally no more than one day. When in bed, the most comfortable position may be to lie on the back with a pillow behind the knees and the head and shoulders elevated, or to lie on the side with the upper knee bent and a pillow between the knees.   Heat  — using a heating pad can help with low back pain during the first few weeks. It is not clear if cold packs help as well.   Work  — most experts recommend that people with low back pain continue to work so long as it is possible to avoid prolonged standing or sitting, heavy lifting, and twisting. Some people need to stay home from work if their occupation does not allow them to sit or stand comfortably. While standing at work, stepping on a block of wood with one foot (and periodically alternating the foot on the block) may be helpful. Pain medications  — Take medications on a regular basis for two weeks for it to be effective, rather than using the medication only when the pain becomes unbearable. If needed, take muscle relaxant before bedtime. Do not take this medication while driving or operating machinery.   Exercise — a program of exercises can help to increase back flexibility and strengthen the muscles that support the back. Although starting back exercises or stretching immediately after a new episode of low back pain might temporarily increase the pain, the exercise may reduce the total duration of pain and prevent recurrent episodes. Lower back pain soap note examples Recommended activities include those that involve strengthening and stretching, such as walking, swimming, use of a stationary bicycle, and low-impact aerobics. Avoid activities that involve twisting, bending, are high-impact, or make the back hurt more. Some specific exercises may help strengthen the muscles of the lower back. People with frequent episodes of low back pain should continue these exercises indefinitely to prevent new episodes.   Mattress choice – The benefit of a firm mattress in preventing or treating low back pain has not been proven. In one study, medium-firm mattresses were more likely to improve chronic back pain compared with firm mattresses https://www.uptodate.com/contents/low-back-pain-in-adults   Diagnosis 2-Guidelines for Treatment for Acute Lumbosacral Radiculopathy: The initial treatment of the patient with lumbosacral radiculopathy presenting with sensory symptoms and pain without significant neurologic deficits is not different from the approach for the patient with uncomplicated low back pain. However, such patients require observation for possible worsening of their neurologic status. For patients with acute lumbosacral radiculopathy, the objectives of treatment are to ameliorate pain (symptomatic treatment) and to address the specific underlying process (mechanism-specific treatment) if necessary http://www.clevelandclinicmeded.com   Diagnostic test needed: If signs and symptoms of radiculopathy, sciatica, or neurogenic claudication exists the patient may require one or more of test including Spinal Radiography, CT scan, MRI, contrast myelography, or electrodiagnosis. http://www.aanem.org   Referrals/Consults: Referral to an orthopedic surgeon or neurosurgeon is recommended under the following circumstances: Increasing neurologic problems (measurable weakness) Loss of sensation (e.g., numbness) or bladder and bowel symptoms Failure to improve after four to six weeks of nonsurgical management, with persistent and severe sciatica and evidence of nerve root involvement https://www.uptodate.com/contents/low-back-pain-in-adults   Patient Education : Most people with radiculopathy improve with conservative treatment such as medication and PT. Surgery is recommended for some people with radiculopathy. They, too, usually improve after a recovery period. Following treatment, most people are able to work and take part in other daily activities. Patient education would include education to prevent acute non-specific low back pain in addition to reducing chances of developing radiculopathy by maintaining good posture and a healthy weight. Using safe techniques when lifting heavy objects to prevent injuries to your back. Remembering to lift with your knees. That means you should bend your knees, not your back. Also asking for help when moving heavy or bulky objects and when doing repetitive tasks, take frequent breaks. https://www.healthline.com   Prevention : There are a number of ways to prevent low back pain from returning. Perhaps the most important are exercise and staying active. Regular exercise that improves cardiovascular fitness can be combined with specific exercises to strengthen the muscles of the hips and torso. The abdominal muscles are particularly important in supporting the lower back and preventing back pain. It is also important to avoid activities that involve repetitive bending or twisting and high-impact activities that increase stress in the spine.   Bend and lift correctly  — People with low back pain should learn the right way to bend and lift. As an example, lifting should always be done with the knees bent and the abdominal muscles tightened to avoid straining the weaker muscles in the lower back (p   Take a break  — People who sit or stand for long periods should change positions often and use a chair with appropriate support for the back. An office chair should be readjusted several times throughout the day to avoid sitting in the same position. Taking brief but frequent breaks to walk around will also prevent pain due to prolonged sitting or standing. People who stand in place for long periods can try placing a block of wood on the floor, stepping up and down every few minutes. https://www.uptodate.com/contents/low-back-pain-in-adults   Healthcare Maintenance/Recommendations :   Annual Influenza vaccine education provided-Received in October of 2017 Depression screen-positive- Recommended to continue Sertraline and visits to Psychologists as scheduled. CAGE-0/4 STI and STD education Sex behavioral counseling Reinforced recommendations for MSBE Cervical Cancer screen and HPV education-Recommended continuing routine Pap testing every 3 years. Diet and exercise education- Recommended to exercise at least 3 days/week; with exercises to help strengthen the core muscles. Continue eating a healthy diet and stay hydrated during workouts. Recommended using a back brace while at work to help with support with lifting and to call for lifting help instead of trying lift alone.   The USPSTF also recommends high blood pressure, depression, and alcohol misuse screening in this age group. Screening for HIV, Syphilis, HBV, HCV, and STI screening and behavioral counseling is also recommended in all sexually active females in this age group. Although, Mrs. H has a toned physique I think it’s important to counsel her on the importance of daily exercise and physical activity to help reduce pain and on healthful diet practices such as the DASH diet, which is high in grains, fruits, vegetables, and low in fat to help prevent future co-morbidities especially since her family history is so significant for such severe co-morbidities and mortalities.   Follow-up: Follow up in 2 weeks for evaluation of pain management or as needed if pain becomes worse or changes in presentation.     References American Academy of Family Physicians. (2017). Diagnosis and Treatment of Low Back Pain; Clinical Practice Guidelines. Retrieved from: http://www.aafp.org/patient-care/clinical-recommendations/all/back-pain.html American Association of Neuromuscular & Electrodiagnostic Medicine. (2017). Lumbar Radiculopathy. Retrieved from: http:www.aanem.org/Patients/Disorders/Lumbar-Radiculopathy Cleveland Clinic Center for Center for Continuing Education. Published by; Levin, Kerry. M.D. (2010). Low Back Pain. Retrieved from: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/low-back-pain/#top Healthline. (2017). Radiculopathy (Pinched Nerve). Retrieved from: https://www.healthline.com/health/radiculopathy#overview1 Lower back pain soap note examples Scientific Electronic Library Online by Ladeira, Carlos (2011). Evidence based practice guidelines for management of low back pain: physical therapy implications. Retrieved from: http://www.scielo.br/pdf/rbfis/v15n3/04.pdf U.S. Preventive Services Task Force. (2017). Grade A and B Recommendations. https://www.uspreventiveservicestaskforce.org/Search UpToDate. (2017). Patient Education. Low Back Pain in Adults (Beyond the Basics). Retrieved from: https://www.uptodate.com/contents/low-back-pain-in-adults-beyond-the-basics Lower back pain soap note examples