Tag: Clinical-Nursing

Analysis of Mental Health Disparities – Mental Health Disparities Essay

Introduction

Disparities in mental health remain persistent especially among racial/ethnic groups which results into poor mental health outcomes. Factors such as inadequate access to care, discrimination and inadequate information contribute to the disparities. Understanding the causes goes far in identifying efforts and strategies to reduce these disparities. This paper aims to discuss the issue of mental health disparities, the causative factors, potential solutions, and ethical concerns to consider when implementing the solution.

Mental Health Disparities and Possible Causes

Mental health disparities are defined as differences in mental health outcomes that persistently affect disadvantaged populations. Mental health disparities impede the attainment of mental health equity, and result in increased disease burden for patients and their families. Multiple factors have been identified as primary causes of the existing disparities. First, individual-level factors including mental health literacy, provider shortage, and health preference may explain the existing disparities in outcomes. A recent focus on the role of socioeconomic and structural factors on mental health outcomes has been used to explain the existing disparities. Deferio et al. (2019) suggest that populations that encounter food and housing insecurity, adverse childhood experiences, racism and discrimination, employment barriers, and hostile environment experience are more likely to experience mental health illnesses. Minority groups are more likely to encounter the determinants identified to contribute to mental illness prevalence and therefore greatly affected by the disparities compared to their white counterparts.

Analysis of Mental Health Disparities

According to Barksdale et al. (2022), mental health disparities are prevalent among populations that encounter health disparities and those who are greatly disadvantaged in accessing mental health services. In addition, racial/ethnic groups, low socioeconomic and underserved rural populations significantly encounter disparities in mental health compared to their white counterparts. Among the minority groups, Blacks and Hispanics are more likely to be diagnosed with a mental disorder compared to non-Hispanics. In addition, the prevalence in mental health disorders is more persistent among individuals in rural areas compared to their counterparts in urban areas (Barksdale et al., 2022). The differences in mental prevalence among racial/ethnic minority groups is attributed to factors such as sociocultural, socioeconomic, cultural, and access to mental health care differences. Mental health disparities are associated with increased suicidal and death rates, health inequalities and increased disease burdens for patients and their families. As such, identifying and implementing solutions to address the risk factors helps bridge the gap of existing disparities and mitigate the associated complications.

GET HELP HERE

Potential Solution to Mental Health Disparities

Several solutions can be implemented to help reduce mental health disparities. Disparities in access to mental health services is a major factor that contributes to existing mental health disparities. As such, implementing policies that focus in improving access to mental health services among minority and underserved groups may help bridge the existing gaps. For example, policies that aim to increase universal coverage for mental health care would help improve access to mental care for racial/ethnic and marginalized groups ultimately reducing the disparities. Similarly, implementing policies that aim to improve mental health services, appropriate education and support, as well as regular screening would help mitigate the disparities.

Factors such as access to care, service user preference, and provider behavior have been associated with mental health disparities. As such, Hall et al. (2021) suggest possible solutions such as having a diverse workforce and training providers on providing culturally competent care may help in addressing the disparities. Providing culturally competent care involves addressing contextual concerns such as poverty, discrimination, inadequate access to resources, and other factors addressing patient outcomes. This ultimately ensures that patients receive culturally relevant treatment while ensuring factors that impact health outcomes are addressed. Mental health literacy is also a factor associated with mental health disparities. Potential solution to help address this factor involves educating patients on mental health risk factors and potential interventions to help create awareness among minority and disadvantaged populations.

The Solution to Mental Health Disparities

An effective solution that could help reduce mental health disparities involves implementing policies that address key areas contributing to existing disparities. The efficacy of policy in addressing mental health disparities has been documented in several studies. In a study by Zabelski et al. )2024), the authors established that implementing policies that enhance access to care such as Medicaid expansion to community mental health services in North Carolina helped address the access gap to community health services ultimately mitigating the disparities. As such policies that address key elements contributing to disparities may help bridge the gap. Policies that address psychosocial needs that impact mental health could mitigate mental health disparities. For example, governments should implement state and federal programs that provide financial support to minority and socially disadvantaged groups. Secondly, policies that aim to improve access to mental services could be crucial in mitigating the existing disparities. For example, policies that provide coverage for mental care and also regular screening among minority and disadvantaged populations may help address the mental health gaps. Ultimately, implementing these policies could be beneficial in mitigating mental health disparities and its associated impacts.

Ethical implications of implementing the solution

Policies implemented to address mental health disparities must meet the ethical principles of autonomy, beneficence, equity, and justice. Autonomy requires that health providers educate patients on alternative treatment options to ensure informed decision-making in their treatment intervention (Varkey, 2020). In this case, policies implemented must ensure they empower patients through education for them to make informed decisions. The principle of equity and justice involves ensuring that all patients are treated fairly by health professionals (Varkey, 2020). In this context, it’s important to ensure that policies implemented promote equal access to health services for all populations including minority, underserved, and disadvantaged groups, who may encounter barriers to mental health access due to socioeconomic factors. Lastly, the principle of beneficence requires that providers act in a patient’s best interest. As such, policies implemented must promote the well-being of patients by improving access to healthcare services.

Implementation of the Solution

The solutions identified to mitigating mental health disparities require effective planning and identifying keys stakeholders involved in the implementation process. First, defining clear goals and objectives is the first stage of the implementation process. The goals may involve identifying key areas to address that contribute to mental health disparities. In addition, its important to identify measurable outcomes to evaluate the effectiveness of a solution. The next step is to engage stakeholders such as nurses, providers, legislators, and other stakeholders in implementing the intervention to gather their input and also train members to supporting the implementation of the policy. Lastly, allocating resources that support healthcare facilities and programs is the last step in implementing the identified solutions.

Conclusion

In conclusion, mental health disparities have worsened in the past decade and are associated with disparities in socioeconomic factors. Racial, underserved, and marginalized groups encounter significant disparities in mental health outcomes compared to their white counterparts. Social determinants of health that contribute to the disparities include food and housing insecurity, adverse childhood experiences, racism and discrimination, employment barriers, and hostile environment experiences. Mental health disparities increase the disease burden for patients and their families and impede the healthcare system towards achieving health equity. As such, implementing solutions such as policies to address SDOH that contribute to the disparities can help mitigate the issue. The policies should focus on improving access to mental health services for minority, underserved, and marginalized groups and providing support at the community level that helps individuals mitigate the risk factors.

References

Barksdale, C. L., Pérez-Stable, E., & Gordon, J. (2022). Innovative Directions to advance mental health disparities research.
American Journal of Psychiatry
,
179
(6), 397–401. https://doi.org/10.1176/appi.ajp.21100972

Deferio, J. J., Breitinger, S., Khullar, D., Sheth, A., & Pathak, J. (2019). Social Determinants of health in Mental Health Care and research: A case for greater inclusion.
Journal of the American Medical Informatics Association
,
26
(8–9), 895–899. https://doi.org/10.1093/jamia/ocz049

Hall, G. C., Berkman, E. T., Zane, N. W., Leong, F. T., Hwang, W.-C., Nezu, A. M., Nezu, C. M., Hong, J. J., Chu, J. P., & Huang, E. R. (2021). Reducing mental health disparities by increasing the personal relevance of interventions.
American Psychologist
,
76
(1), 91–103. https://doi.org/10.1037/amp0000616

Varkey, B. (2020). Principles of clinical ethics and their application to practice.
Medical Principles and Practice
,
30
(1), 17–28. https://doi.org/10.1159/000509119

Zabelski, S., Hollander, M., & Alexander, A. (2024). Addressing inequities in access to Mental Healthcare: A policy analysis of community mental health systems serving minoritized populations in North Carolina.
Administration and Policy in Mental Health and Mental Health Services Research
,
51
(4), 543–553. https://doi.org/10.1007/s10488-024-01344-8

Communication Plan Example

Scenario

You are a project manager on a team for the implementation of a computerized physician order entry (CPOE) system in a nationally owned hospital. Your team is implementing the CPOE system in a large academic medical center in California and in a small community hospital in Virginia. You are reporting to stakeholders in both locations, and they are requesting weekly status checks. After an initial meeting with senior leadership, it seems clear to you that the stakeholder expectations do not align with the agreed-upon project plan. They are pushing to meet an aggressive schedule, and you have concerns that it could allow personal health data to be compromised. Also, each state has regulatory and policy mandates that demand different requirements for project implementation.

Create a 4- to 5-page communication plan to address managing client expectations based on the scenario. Include the following in your plan:

Stakeholder communication requirements

Information to be communicated

Method of presentation

Frequency and time frame of communication

Sender responsible for communication

Constraints and assumptions of the communication plan

Methods for addressing sensitive or proprietary information

Methods for addressing regulatory differences

Budget associated with communication activities

In addition to the communication management plan, include a 1- to 2-page letter that senior leadership can adopt to communicate project scope with a consistent message. Be specific and include at least 4 references to scholarly resources.

Communication Plan Example

Managing Expectations and Project Communications

Stakeholder communication requirements

Stakeholders in California and Virginia require transparent, consistent updates on project status, specifically regarding timelines, regulatory compliance, and data security measures. The communication plan will consider regulatory differences in each state, with tailored information addressing these requirements to ensure clarity and support decision-making. Additionally, stakeholders are concerned with project progress, data integrity, and alignment with health data protection standards.

Information to be communicated

Weekly reports will include updates on key milestones, current status relative to the timeline, potential risks, and mitigation strategies—specifically addressing any impacts on data privacy and state regulatory requirements. Reports will highlight progress at both the academic medical center in California and the community hospital in Virginia, with emphasis on compliance steps and how the project adheres to each state’s mandates. Any delays or proposed timeline adjustments due to data security concerns will also be addressed.

ORDER A HUMAN-WRITTEN, PLAGIARISM-FREE PAPER HERE

Method of presentation

Updates will be delivered through concise weekly reports and a bi-weekly virtual meeting to discuss key issues, address concerns, and align expectations. To ensure all details are accessible, a shared project management portal will be established for real-time updates, supporting documents, and access to regulatory compliance information.

Frequency and time frame of communication

Weekly status reports will be issued every Friday by 12:00 PM PST, with bi-weekly virtual meetings scheduled on Mondays. Any urgent issues affecting data security or timeline will trigger ad-hoc communications. The overall communication plan will be reassessed monthly to ensure it meets stakeholder needs and aligns with project progress.

Sender responsible for communication

The project manager will serve as the primary communicator for this CPOE implementation project. As the central point of contact, the project manager will be responsible for all outgoing communications with stakeholders in both California and Virginia, ensuring that updates are consistently clear and thorough. This role involves not only crafting and sending reports but also coordinating closely with team leads in both states, alongside compliance and IT teams, to ensure that all project details meet required standards, particularly those related to security and regulatory compliance. The project manager will also facilitate feedback loops with stakeholders, addressing concerns promptly and adjusting communication as needed to align with stakeholder expectations.

Constraints and assumptions of the communication plan

Constraints
: The communication plan must navigate distinct regulatory requirements in California and Virginia, HIPAA privacy standards limiting data-sharing methods, and an aggressive timeline with high stakeholder expectations, which may restrict time for addressing issues.

Assumptions
: Stakeholders will adhere to the communication structure, participate in scheduled meetings, and provide feedback. Necessary resources for security, compliance, and training are assumed to be available to support project needs and timelines.

Methods for addressing sensitive or proprietary information

Given the sensitive nature of the data involved in this project, especially related to personal health information and system security protocols, special methods are required for communicating proprietary information. Sensitive updates will be shared using encrypted communication channels, or a secure project management portal will be implemented with role-based access to ensure only authorized personnel have visibility into sensitive content. During meetings, particularly virtual ones, sensitive data will be discussed at a high level to protect data integrity and security, with details disclosed only when necessary and under secure meeting protocols to prevent unauthorized access.

Methods for addressing regulatory differences

To manage the regulatory differences between California and Virginia effectively, the communication plan will include separate sections in each status update and report, dedicated to addressing compliance activities specific to each state. The project manager will coordinate directly with compliance officers in California and Virginia to ensure that all updates reflect the necessary legal requirements of each state. By doing so, stakeholders can receive assurance that regulatory mandates are being met, with details on actions taken in each location. Compliance updates will be provided in each communication cycle to confirm that alignment with state-specific regulations is maintained throughout the project’s lifecycle.

Budget associated with communication activities

The budget for communication activities in the CPOE implementation project will encompass various costs, including personnel, materials, tools, and meeting expenses. Below is a brief overview along with a budget template:

Item

Description

Cost

Personnel Investments

Project Manager’s guiding light (40 hours)

$2,000

Compliance Officer’s wisdom (20 hours)

$1,000

Communication Materials

Eye-catching reports and presentations

$500

Secure platform for crystal-clear dialogue

$300

Engaging Meetings

Virtual meeting software for seamless talks

$400

Travel costs for face-to-face synergy

$600

Empowering Training

Interactive training resources for stakeholders

$700

Total Investment in Communication

$5,100

 

Add a letter that senior leadership can adopt to communicate project scope with a consistent message.

Dear Team,

As we embark on the implementation of the Computerized Physician Order Entry (CPOE) system at our academic medical center in California and our community hospital in Virginia, I want to take this opportunity to clarify the project scope and outline our commitment to effective communication throughout this process. The primary objectives of this initiative are to enhance efficiency in order entry, ensure compliance with state-specific regulatory requirements, and foster collaboration among all stakeholders.

To achieve these objectives, we will provide weekly status reports detailing project progress, key milestones, and any challenges we encounter. Additionally, bi-weekly virtual meetings will be held to address stakeholder concerns and facilitate open dialogue. A secure project management portal will also be established, allowing for real-time access to updates and important resources, including information related to regulatory compliance.

Your engagement and support are vital as we work towards this significant transformation in our healthcare delivery. Together, we can ensure that the CPOE implementation not only meets the needs of our patients and providers but also upholds the highest standards of care and compliance. Thank you for your dedication to this important initiative.

Best regards,

 

References

Bahadorestani, A., Naderpajouh, N., & Sadiq, R. (2020). Planning for sustainable stakeholder engagement based on the assessment of conflicting interests in projects. 
Journal of Cleaner Production
, 
242
, 118402.
https://doi.org/10.1016/j.jclepro.2019.118402

Lauff, C. A., Knight, D., Kotys-Schwartz, D., & Rentschler, M. E. (2020). The role of prototypes in communication between stakeholders. 
Design Studies
, 
66
, 1-34.
https://doi.org/10.1016/j.destud.2019.11.007

Rowe, S. F. (2020). 
Project management for small projects
. Berrett-Koehler Publishers. Communication Plan Example

THE ASSIGNMENT:

Succinctly, in 1–2 pages, address the following:

• Briefly describe the personality disorder you selected, including the DSM-5-TR diagnostic criteria.

• Explain a therapeutic approach and a modality you might use to treat a client presenting with this disorder. Explain why you selected the approach and modality, justifying their appropriateness.

• Next, briefly explain what a therapeutic relationship is in psychiatry. Explain how you would share your diagnosis of this disorder with the client in order to avoid damaging the therapeutic relationship. Compare the differences in how you would share your diagnosis with an individual, a family, and in a group session.

Support your response with specific examples from this week’s Learning Resources and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

Submit your
Assignment
. Also attach and submit PDFs of the sources you used.

Borderline Personality Disorder DSM-5-TR Essay

 
Personality Disorder DSM-5-TR Overview

Borderline Personality Disorder (BPD) is a type of personality disorder that involves an unstable and disturbed pattern of mood and interpersonal relationships, as well as irresponsible behavior. The DSM-5-TR diagnostic criteria for BPD include sudden panic, the absence of a stable and secure attachment figure in their childhood, a constantly shifting sense of self, suicidal tendencies when overwhelmed by negative emotions, bipolar disorder-like tendencies, pervasive and persistent existential depression, rage reactions, brief psychotic episodes that manifest as paranoia, and split-off ego states (Leichsenring et al., 2024). According to DSM 5, the patient requires at least five of these characteristics are necessary for diagnosing the disorder. Interpersonal conflicts and perceived abandonment significantly increase emotional sensitivity, impulsivity, and self-harm in BPD. The sooner the diagnosis is made and treatment commenced, the better the prognosis.

ORDER HERE

Therapeutic Approach for Managing Borderline Personality Disorder

Dialectical Behavioral Therapy (DBT) is an efficient treatment method for managing BPD. DBT utilizes cognitive-behavioral approaches, but it is based on the principles of mindfulness. This modality aims to equip BPD clients with skills to control their emotions, cope with stress, and enhance their relational capabilities, making it suitable for treating the aspect of BPD that involves poor emotion regulation (Kujovic et al., 2024). This structure of DBT may be useful for clients with BPD, as it encourages the replacement of self-harming behaviors with better coping skills over time (Leichsenring et al., 2023).  Behavioral skills training further incorporates group and individual therapies to establish an organizational format to elicit healthier emotional reactions and improve Interpersonal communication skills Borderline Personality Disorder DSM-5-TR Essay.

Therapeutic Relationship in Psychiatry

In psychiatry, a therapeutic relationship can be described as a working partnership between the therapist and the client that involves trust, helpful communication, and participation in the therapeutic process. It is underpinned by empathy, respect, and positive regard for the client; they are encouraged to discuss their problems in this therapeutic alliance. Developing this trust is vital as it facilitates communication and compliance with the stipulated therapy regimes (Kujovic et al., 2024). Thus, therapists should be aware of possible power relations that impact the process and be open about this to foster a constructive relationship during the therapeutic process Borderline Personality Disorder DSM-5-TR Essay.

Sharing Diagnosis with the Client

The nurse practitioner should provide details on the patient, ensuring an understanding of the condition and the treatment plan that should be implemented. Therefore, when explaining BPD to a patient, concerns should be presented non-judgmentally, emphasizing positive qualities. I would describe the symptoms in basic language, noting how these characteristics may affect feelings and interpersonal connections and stressing the potential for recovery through medication. I emphasize that the diagnosis is driven by explaining the symptoms, prognostication, and treatment strategies (Wheeler, 2020). Applying this strategy could help the client gain more control over the process. It would not compromise the therapeutic alliance that personality disorder diagnoses often produce feelings of stigma or alienation.

 
Individual vs. Family vs. Group Session Disclosure

In the individual context, it would be critical for the nurse practitioner to explain the diagnosis, emphasizing the individual impacts of the disease and approaches for enhancing recovery. On the other hand, in the family setting, the approach should focus more on enhancing the family’s understanding of the diagnosis and the existing needs associated with the condition. The family setting interventions focus on empowering the patient and the family to understand their roles in managing the condition and address any myths and misconceptions that may affect the management of the condition. However, a group setting offers optimal opportunities for sharing experiences where patients can learn from one another and develop resilience in managing their conditions and needs (Wheeler, 2020). These settings require managing individual needs and preferences and maintaining privacy to help build trust, maintain therapeutic relationships, and foster mutual support.

References

Kujovic, M., Benz, D., Riesbeck, M., Mollamehmetoglu, D., Becker-Sadzio, J., Margittai, Z., Bahr, C., & Meisenzahl, E. (2024). Comparison of 8-vs-12 weeks adapted dialectical behavioral therapy (DBT) for borderline personality disorder in routine psychiatric inpatient treatment: A naturalistic study.
Scientific Reports
,
14
(1), 11264.
https://doi.org/10.1038/s41598-024-61795-9

Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024). Borderline personality disorder: A comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies.
World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
,
23
(1), 4–25.
https://doi.org/10.1002/wps.21156

Leichsenring, F., Heim, N., Leweke, F., Spitzer, C., Steinert, C., & Kernberg, O. F. (2023). Borderline personality disorder: A review.
JAMA
,
329
(8), 670–679.
https://doi.org/10.1001/jama.2023.0589

Wheeler, K. (2020).
Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
(3rd ed.). Springer Publishing Company Borderline Personality Disorder DSM-5-TR Essay

American Foreign Policy During the Cold War

In preparation for the initial post, consider two (2) of the following American Foreign policies:

Marshall Plan

Berlin Airlift

Containment

Anti-Communist Freedom Fighters

Vietnam (conflict) War

Détente’

SALT I & SALT II

Camp David Accords

Strategic Defense Initiative (nicknamed “Star Wars”)

Then, in one (1) to two (2) paragraphs, address one (1) of the following:

Explain how each of your choices was an effective policy to thwart international communist expansion.

Based on your selections, analyze if the United States should have feared international communist subversion during the Cold War era (1945–1991).

American Foreign Policy During the Cold War

Introduction

The United States implemented several foreign policies during the Cold War (1945–1991) to stop the expansion of communism, which was viewed as a danger to both American interests and world democracy. The Marshall Plan and containment were two noteworthy initiatives that were crucial in halting the spread of communism around the world. This paper discusses these two policies.

ORDER A PLAGIARISM-FREE PAPER HERE

Marshall Plan

The Marshall Plan, formally the European Recovery Program, was launched in 1948 to help the war-ravaged Western European countries. It was developed to try to restore the economics of war-devastated regions and to stabilize governments while discouraging the spread of communism by encouraging economic growth. The United States felt that Europe remained poor and filled with despair, and then communist movements would be propagated. The Marshall Plan forged $12 billion in aid, totally disproving the Soviet Union’s grip on Europe; the nations that received aid did not pledge allegiance towards communism (McGlinchey, 2009). On the same note, the program boosted America’s relations with the Europeans, giving Western Europe a check against communism.

Containment

The containment policy proposed by George Kennan in 1947 presupposed the stoppage of the communist expansion by confronting the Soviets in areas of crucial significance. Containment framed American policies in foreign affairs for the extent of the Cold War. It was used in one way or another in Korea, Vietnam, and other places where the U.S. got militarily involved to prevent further advancement of communism. The policy was grounded on the prognosis that if communism itself were to be isolated to its domains, confined within geographical extremities, communism itself would disintegrate due to its inherent contradictions (Roberts et al., 1972). Although it was not always effective, containment proved to be a vital component in ensuring that communism did not spread to certain areas.

Conclusion

In conclusion, during the Cold War, both containment and the Marshall Plan were successful in preventing the spread of communism. The United States was able to slow the expansion of Soviet hegemony by stabilizing Europe with economic assistance and stepping in to protect areas under communist threat. However, given the Soviet Union’s severe internal problems that constrained its global influence, the concern of an international communist takeover may have been exaggerated. Nevertheless, during a critical time, these policies were essential to preserving world stability.

 

 
References

McGlinchey, S. (2009). The Marshall plan, the Truman Doctrine, and the division of Europe. E-International Relations, 1-5.

Roberts, C. M., Harriman, W. A., Krock, A., & Acheson, D. (1972). How Containment Worked. Foreign Policy, (7), 41-53. American Foreign Policy During the Cold War

Iowa Model Essay

In the early 1990s, a team of nurses from the University of Iowa Hospitals and Clinics (UIHC) and College of Nursing devised a framework known as The Iowa Model of Research-Based Practice to Enhance Quality Care (Buckwalter et al., 2017). Its purpose was to assist clinicians in assessing and integrating research findings into patient care. It was crafted by nurses who drew from their successful experiences in research utilization projects. Over time, as research utilization transitioned into Evidence-Based Practice (EBP), incorporating various levels of evidence became paramount. Consequently, the Iowa Model underwent revisions to accommodate this expansion and offer more comprehensive guidance on implementing transformative changes (Buckwalter et al., 2017).

ORDER HERE

The Iowa Model comprises several integral steps to facilitate evidence-based practice. Firstly, it involves the identification of a specific clinical issue necessitating attention (Henson & Jeffrey, 2024). Healthcare professionals systematically review existing literature to unearth pertinent research findings concerning the identified problem. Subsequently, these findings are synthesized and meticulously evaluated to ascertain their validity, relevance, and applicability within the clinical setting. Upon evaluation, strategies are devised to integrate the evidence into clinical practice seamlessly. Implementing evidence-based practice interventions follows suit, marking a pivotal phase. Evaluation of outcomes ensues to gauge the effectiveness of the implemented interventions in addressing the clinical problem. Finally, continuous monitoring and evaluation of outcomes are undertaken to ensure the sustainability and efficacy of evidence-based practices over time (Henson & Jeffrey, 2024) Iowa Model Essay.

The Iowa Model is notable for its heuristic nature, offering flexibility and adaptability to diverse clinical environments (Tucker et al., 2021). Its comprehensive approach spans problem identification to outcome evaluation, promoting thoroughness and accountability. Moreover, the model prioritizes sustainability through continuous outcome monitoring, ensuring enduring improvements in patient care.

Science, philosophical tenets, and EBP models like the Iowa Model have advanced nursing knowledge. EBP models guide nurses in identifying clinical problems, reviewing literature, and implementing evidence-based interventions (Melnyk & Fineout-Overholt, 2019). Evidence-based nursing integrates patient needs, practical problem-solving, and nursing expertise (Wang & Ma, 2013). Philosophical tenets, such as ethical and empirical frameworks, ensure patient rights are upheld. Science allows nurses to conduct research and apply findings to practice (Lauzon, 1995).

Theories and theorizing are crucial for understanding and implementing EBP models. Theories, grounded in logical positivism, explain why practices are effective (Robinson & Bender, 2023). For instance, the Iowa Model incorporates change management and organizational behavior theories. Theorizing involves developing and refining explanations (Meza et al., 2023). Nurses theorize effective EBP interventions based on new research and clinical experience.

The Iowa Model, Stetler Model, and Clinical Scholar Model all focus on integrating research evidence into practice to improve outcomes, offering structured frameworks. Differences include focus areas: the Iowa Model emphasizes organizational change, the Stetler Model targets individual decision-making, and the Clinical Scholar Model develops nurses as EBP leaders (Melnyk & Fineout-Overholt, 2015) Iowa Model Essay.

Analyzing Group Techniques

 

Student Name:

Department and Institutional Affiliation

Course Code and Name

Professor

Date

 

Analyzing Group Techniques

Nurse practitioners apply both pharmacological and non-pharmacological interventions to manage the underlying mental health issues and needs affecting patients. These interventions are tailored to support the individual needs of the client and help them cope with the underlying issues and needs. Group therapy is one of the key techniques that healthcare professionals often apply to establish a supportive environment to clients, ensuring that they share their experiences, feelings, and support one another in coping with the underlying issues. In group therapy sessions, the nurse practitioner may explore the group strengths and develop strategic measures in which every individual can benefit and work towards addressing their mental health needs. Therefore, the therapist or the nurse practitioner acts as the team leader, supporting each individual to work towards attaining the targeted outcomes and enhancing the overall healthcare outcomes for patients and populations. This paper uses a group therapy video, “Psychotherapy for Schizophrenia,” to explore the components of group therapy and develop appropriate mechanisms for managing the underlying issues and needs.

ORDER A PLAGIARISM-FREE PAPER HERE

Alternative Group Therapy Techniques Demonstrated

During the group therapy session, the therapist applies cognitive-behavioral therapy (CBT) to achieve the targeted session goals. In this session, the therapist acted as facilitators who supported patients manage their fears and cope with the underlying issues. For instance, the healthcare provider encouraged clients to share their fears and describe some of the strategies that they are using to manage them. Research by Moloud et al. (2022) indicates that incorporating CBT sessions during group therapy allows patients to develop individualized strategies for managing their stressors and fears. Thus, the approach makes patients more resilient, adaptive, and compliant to the prescribed treatment plan. In this case, the patient recognizes their experiences and fears as a collective issue, enhances individual responsibility, and supports the patient in working collaboratively with the rest of the team members in managing them. One of the key strategies that the session uses is to empower patients and enhance their self-esteem despite having the underlying condition. This resource is considered scholarly because it is written by health experts and subjected to a review process to ensure the accuracy of the information. Thus, utilizing the resource to recommend various strategies may enhance the best outcomes.

What the Therapist did Well

In the video scenario, the therapist focused on the group goals while helping every individual manage their mental health issues and needs. The leader achieved this by developing goals that were shared among the group members and offering opportunities for each group member to participate in enhancing the group activity. In addition, the therapist created a conducive and supportive work environment where all patients could contribute their opinions, fears, and stressors to the group. This approach boosted the morale of individuals and the group as a whole, promoting acceptance of their conditions and motivating them to actively engage in managing these issues and needs. Research by Marmarosh et al. (2022) demonstrates that the group leader must establish unique opportunities and strategies where the group’s collective activities address the individual needs of group members. Therefore, in this session, I believe the leader motivated every group member to contribute individual roles and responsibilities in managing the underlying needs and enhancing the overall quality of care. However, if I were to design the session, I would assign each group member an assignment or a role to play during the session so that group members have shared accountability and responsibility in carrying out group assignments, unlike the random assignment during the session.

Insights Gained from Watching the Therapist

After watching the group therapy video, I developed an in-depth understanding of the group therapy session. Each group member has a unique role to play, and the collective roles of the individual members contribute to attaining the group’s effectiveness. In addition, I learned that during these sessions, the nurse practitioner or the therapist is the facilitator of the sessions. Therefore, the therapist’s role is to guide the team members through the group activities, initiate the process of developing shared goals, and provide the needed resources for achieving the desired performance (Di Lorenzo et al., 2023). Furthermore, the session must be guided by clear rules and regulations, which every group member must comply with to promote the group’s success.  The resource is considered scholarly because it collects real-time data from patients over one year to initiate evidence-based approaches for managing and addressing the issues associated with group therapy.

Handling a Disruptive Group Member

The nurse practitioner is the team leader and is in charge of the group, ensuring that the group works towards achieving the targeted goals. In this case, the nurse practitioner should enforce rules and regulations and clarify the roles and responsibilities of group members. In this case, the healthcare provider must ensure that the group members understand that they have a collective responsibility for attaining the group’s success. Therefore, in the event of a disruptive or temperament group member, it is vital to remind the member of the need to respect the opinions and ideas of other group members and offer them alternative activities to discharge their energy. For instance, the nurse practitioner may assign the disruptive member the responsibility of writing the group’s minutes, discussions, and plans (Marmarosh et al., 2022). In this case, the group member will remain calm, listen, and document what is being discussed, allowing the group to continue smoothly. Furthermore, it is vital to ensure that the group members understand the limits and personal boundaries of other patients and respect one another.  The article is considered scholarly because it reviews relevant literature surrounding group therapy, providing high-quality research that allows evaluation of group therapy sessions.

Conclusion

Group therapy sessions offer opportunities where patients can share resources to attain the specific targeted goals. In this case, patients engage one another in handling their stressors, managing their fears, and enforcing their ability to manage these issues and needs in a timely and effective manner. When working with these groups, the mental health and psychiatric nurse must initiate strategies that ensure that every group member benefits from the session and attains the targeted healthcare outcomes. The approach also allows the practitioner to combine various treatment approaches and effectively allows group members to share resources and strategies for enhancing the best outcomes.

 

 

References

Di Lorenzo, R., Damore, J. F., Amoretti, S., Bonisoli, J., Gualtieri, F., Ragazzini, I., Rovesti, S., & Ferri, P. (2023). Group therapy with peer support provider participation in an acute psychiatric ward: 1-Year analysis.
Healthcare
,
11
(20), 2772–2772.
https://doi.org/10.3390/healthcare11202772

Marmarosh, C. L., Sandage, S., Wade, N., Captari, L. E., & Crabtree, S. (2022). New horizons in group psychotherapy research and practice from third wave positive psychology: a practice-friendly review.
Research in Psychotherapy: Psychopathology, Process and Outcome
,
25
(3).
https://doi.org/10.4081/ripppo.2022.643

Moloud, R., Saeed, Y., Mahmonir, H., & Rasool, G. A. (2022). Cognitive-behavioral group therapy in major depressive disorder with focus on self-esteem and optimism: An interventional study.
BMC Psychiatry
,
22
(1), 1–11.
https://doi.org/10.1186/s12888-022-03918-y

 

 

      

      NRNP-6645-3 WEEK 3 ASSIGNMENT INSTRUCTIONS

 
TOPIC:
Analyzing Group Techniques

Group therapy can alleviate feelings of isolation and foster a supportive and collaborative environment for sharing difficult feelings in order to facilitate healing. For many people, being part of a group that has a shared understanding of a struggle provides a unique opportunity to gain understanding of their own experiences.

As you examine one of the group therapy demonstrations from this week’s Learning Resources, consider the role and efficacy of the leader and the reasons that specific therapeutic techniques were selected.

 

To prepare:

Select one of the group therapy video demonstrations from this week’s required media Learning Resources
(
BELOW
).

REQUIRED READING:

American Psychiatric Association. (2022). 
Diagnostic and statistical manual of mental disorders
Links to an external site.
(5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787

“Culture and Psychiatric Diagnosis”

Wheeler, K. (Ed.). (2020). 
Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
(3rd ed.). Springer Publishing.

Chapter 12, “Group Therapy”

Yalom, I. D., & Leszcz, M. (2005). The therapeutic factors. In 
The theory and practice of group psychotherapy
Download The theory and practice of group psychotherapy
(5th ed.) (pp. 1–18). Basic Books.

Credit: The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, I. D., & Leszcz, M. Copyright 2005 by Basic Books. Reprinted by permission of Basic Books via the Copyright Clearance Center.

Yalom, I. D., & Leszcz, M. (2005). Interpersonal learning. In 
The theory and practice of group psychotherapy
Download The theory and practice of group psychotherapy
(5th ed.) (pp. 19–52). Basic Books.

Credit: The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, I. D., & Leszcz, M. Copyright 2005 by Basic Books. Reprinted by permission of Basic Books via the Copyright Clearance Center.

Yalom, I. D., & Leszcz, M. (2005). Group cohesiveness. In 
The theory and practice of group psychotherapy
Download The theory and practice of group psychotherapy
(5th ed.) (pp. 53–76). Basic Books.

Credit: The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, I. D., & Leszcz, M. Copyright 2005 by Basic Books. Reprinted by permission of Basic Books via the Copyright Clearance Center.

Select one of the group therapy video demonstrations from this week’s required media Learning Resources
(
BELOW
).

REQUIRED MEDIA:

Cats Cats. (2016, September 29). 
Interpersonal group therapy for addiction recovery demonstration
Links to an external site.
[Video]. YouTube. https://youtu.be/szS31h0kMI0

Gerber, B. (2013, November 21). 
Psychotherapy group for schizophrenia
Links to an external site.
[Video]. YouTube. https://www.youtube.com/watch?v=t8Dzus8WGqA

Henson, B. A. (2017, April 27). 
Role play: Group counseling for adolescents with anxietyLinks to an external site.
[Video]. YouTube. https://www.youtube.com/watch?v=h6CF09f5S1M

(2009, May 6).
 
Irvin Yalom inpatient group psychotherapy videoLinks to an external site.
 [Video]. YouTube. https://www.youtube.com/watch?v=05Elmr65RDg

(2009, May 7).
 
Irvin Yalom outpatient group psychotherapy videoLinks to an external site.
 [Video]. YouTube. https://youtu.be/PwnfWMNbg48

 

ASSIGHNMENT:

In a 3- to 4-page paper, identify the video you selected and address the following:

What group therapy techniques were demonstrated? How well do you believe these techniques were demonstrated?

What evidence from the literature supports the techniques demonstrated? 

What did you notice that the therapist did well?

Explain something that you would have handled differently.

What is an insight that you gained from watching the therapist handle the group therapy?

Now imagine you are leading your own group session. How would you go about handling a difficult situation with a disruptive group member? How would you elicit participation in your group? What would you anticipate finding in the different phases of group therapy? What do you see as the benefits and challenges of group therapy?  

Support your reasoning with at least three peer-reviewed, evidence-based sources, and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

 

Submit
your Assignment. 

Reminde
rLinks to an external site.
The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

 

The assignment is under the section NRNP-6645-3 PSYCHOTHERAPY WITH MULTIPLE MODALITIES, WEEK 3 ASSIGNMENT.  THE VIDEOS ARE UNDER LEARNING MEDIA RESOURCES. CHOOSE ONE OF THE VIDEOS. Please let me know if you have any questions. Please, follow the rubric. Thank you.

 

NRNP_6645_Week3_Assignment_Rubric

NRNP_6645_Week3_Assignment_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeDevelop a 3- to 4-page paper considering the role and efficacy of the leader of a group therapy demonstration. Be sure to address the following: ·   Describe the group therapy techniques that were demonstrated and evaluate how well they were demonstrated. . Include evidence from the literature that supports the use of the demonstrated techniques.

25 to >22.0 pts

Excellent 90%–100%

The response accurately and thoroughly describes and evaluates the efficacy of the group therapy techniques that were demonstrated in the video…. The response includes accurate, clear, and detailed evidence from the literature that supports the use of the demonstrated techniques.

22 to >19.0 pts

Good 80%–89%

The response accurately describes and evaluates the efficacy of the group therapy techniques that were demonstrated in the video…. The response includes evidence from the literature that supports the use of the demonstrated techniques.

19 to >17.0 pts

Fair 70%–79%

The response includes a somewhat vague or inaccurate description and evaluation of the group therapy techniques that were demonstrated in the video…. The response includes somewhat vague or inaccurate evidence from the literature to support the use of the demonstrated techniques.

17 to >0 pts

Poor 0%–69%

The description and evaluation of the group therapy techniques that were demonstrated in the video are vague and inaccurate, or missing…. The response includes vague and inaccurate evidence from the literature to support the use of the demonstrated techniques, or is missing.

25 pts

This criterion is linked to a Learning Outcome·   Identify what the therapist did well. ·   Explain something that you would have handled differently. ·   Identify an insight that you gained form watching the therapist handle the group therapy.

25 to >22.0 pts

Excellent 90%–100%

The response accurately and thoroughly explains in detail what the therapist did well…. The response accurately and thoroughly explains something that could have been handled differently…. The response accurately and thoroughly explains an insight gained from watching the therapist handle the group therapy.

22 to >19.0 pts

Good 80%–89%

The response accurately explains in detail what the therapist did well…. The response accurately explains something that could have been handled differently…. The response accurately explains an insight gained from watching the therapist handle the group therapy.

19 to >17.0 pts

Fair 70%–79%

The response somewhat vaguely or inaccurately explains in detail what the therapist did well…. The response somewhat vaguely or inaccurately explains something that could have been handled differently…. The response somewhat vaguely or inaccurately explains an insight gained from watching the therapist handle the group therapy.

17 to >0 pts

Poor 0%–69%

The response vaguely or inaccurately explains in detail what the therapist did well, or is missing…. The response vaguely or inaccurately explains something that could have been handled differently, or is missing…. The response vaguely or inaccurately explains an insight gained from watching the therapist handle the group therapy, or is missing.

25 pts

This criterion is linked to a Learning OutcomeImagine that you are leading your own group session. ·   Describe how would you go about handling a difficult group member. ·   Explain how you would elicit participation in your group. ·   Describe what you would anticipate to find in different phases of the group therapy. ·   Explain the benefits and challenges of group therapy.

25 to >22.0 pts

Excellent 90%–100%

The response includes a detailed and accurate description of how to handle a difficult group member…. The response accurately and thoroughly explains how to elicit participation in group therapy…. The response thoroughly and accurately describes anticipated findings in different phases of group therapy…. The response includes a thorough and accurate explanation the benefits and challenges of group therapy.

22 to >19.0 pts

Good 80%–89%

The response includes a description of how to handle a difficult group member…. The response explains how to elicit participation in group therapy…. The response describes anticipated findings in different phases of group therapy…. The response explains the benefits and challenges of group therapy.

19 to >17.0 pts

Fair 70%–79%

The response includes a somewhat vague or inaccurate description of how to handle a difficult group member…. The response somewhat vaguely or inaccurately explains how to elicit participation in group therapy…. The response somewhat vaguely or inaccurately describes anticipated findings in different phases of group therapy…. The response includes a somewhat vague or inaccurate explaination of the benefits and challenges of group therapy.

17 to >0 pts

Poor 0%–69%

The response includes a vague or inaccurate description of how to handle a difficult group member, or is missing…. The response vaguely or inaccurately explains how to elicit participation in group therapy, or is missing…. The response vaguely or inaccurately describes anticipated findings in different phases of group therapy, or is missing…. The response includes a vague or inaccurate explaination the benefits and challenges of group therapy, or is missing.

25 pts

This criterion is linked to a Learning Outcome• Support your reasoning with at least three peer-reviewed, evidence-based sources, and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

10 to >8.0 pts

Excellent 90%–100%

Three peer-reviewed, evidence-based sources are used to support the assignment. Resources selected provide strong justification for reasoning and represent the latest in standards of care. PDFs are attached.

8 to >7.0 pts

Good 80%–89%

Three peer-reviewed, evidence-based sources are used to support the assignment. Resources selected to provide appropriate justification for reasoning and represent the latest in standards of care. PDFs are attached.

7 to >6.0 pts

Fair 70%–79%

Two peer-reviewed, evidence-based sources are used to support the assignment. Resources selected to provide appropriate justification for reasoning and represent the latest in standards of care. Or, three scholarly resources are used to support the assignment, but provide only weak support for reasoning or do not represent the latest in standards of care. PDFs may not be attached.

6 to >0 pts

Poor 0%–69%

Resources selected are not peer-reviewed and evidence-based, or provide poor justification for reasoning; or resources are missing.

10 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 to >4.0 pts

Excellent 90%–100%

Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineates all required criteria.

4 to >3.5 pts

Good 80%–89%

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3.5 to >3.0 pts

Fair 70%–79%

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic.

3 to >0 pts

Poor 0%–69%

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided. 5 pts This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 to >4.0 pts

Excellent 90%–100%

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.5 pts

Good 80%–89%

Contains 1 or 2 grammar, spelling, and punctuation errors.

3.5 to >3.0 pts

Fair 70%–79%

Contains 3 or 4 grammar, spelling, and punctuation errors.

3 to >0 pts

Poor 0%–69%

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent 90%–100%

Uses correct APA format with no errors.

4 to >3.5 pts

Good 80%–89%

Contains 1 or 2 APA format errors.

3.5 to >3.0 pts

Fair 70%–79%

Contains 3 or 4 APA format errors.

3 to >0 pts

Poor 0%–69%

Contains many (≥ 5) APA format errors.

5 pts

Total Points: 100

Previous
Next

Strategies to promote academic integrity and professional ethics

Add to the assignment template added. Complete Part 2 section 1 and 2. Please make sure it is in APA format, she is strict and cited. Also us at least 2 resources your argument. I work in oncology as it references past work and have not declared any future ideas of work scope except as a nurse practice which is what I am pursuing now.

 

Module 2 | Part 2:
Strategies to Promote Academic Integrity and Professional Ethics

I have analyzed the relationship between academic integrity and writing, as well as the relationship between professional practices and scholarly ethics. I have also identified strategies I intend to pursue to maintain integrity and ethics of my academic work while a student of the MSN program or PMC, as well as my professional work as a nurse throughout my career. The results of these efforts are shared below.

 

Directions: In the space below craft your analysis/writing sample, including Part 1 (The Connection Between
Academic and Professional Integrity) and Part 2 (Strategies for Maintaining Integrity of Work).

 

 

Part 1: Writing Sample: The Connection Between Academic and Professional Integrity

 

In the space below write a 2- 3-paragraph analysis that includes the following:

 

Explanation for the relationship between academic integrity and writing

 

There is a close relationship between academic integrity and writing. The relationship focuses on originality in dividing the writer’s voice from others, rephrasing ideas in one’s own words and understanding, and crediting the source of ideas. Academic integrity is an essential concept in writing as it guarantees the knowledge pool of the academic field is not contaminated with unsubstantiated or incorrect information. It ensures that the written work is original, accurate, and distinct from the writing of others. Every writing must have support from scholars who have tackled similar topics or are currently actively tackling them, along with their meaningful original work. At the same time, the writer assures that the referenced original information is carefully selected and applied (Lancaster, 2020).

The relationship between academic integrity and writing matters because exceptional ethical academic and professional conduct standards are demanded. Persons engaging in academic writing activities, whether as faculty, students, or professionals, are expected to conduct themselves professionally while refraining from misconduct, including plagiarism, cheating, or dishonesty. Any substantiated writing violations of academic integrity may result in disciplinary action, including suspension from the course and expulsion from the university (Eaton, 2021).

 

Explanation for the relationship between professional practices and scholarly ethics

 

Scholarly ethics plays an important role in guiding professional practice. In this case, ethics takes on a participatory role that guides professionals without constraining them. It helps professionals to figure out how to do the right thing. There may be more than one way to get things right, and ethics relies on the lived experience and advice of professionals already in the field to figure out how professionals should act. In scholarly work, ethics is guided by a profoundly respectful partnership between the professional’s and other stakeholders’ aims. Scholarly ethics in professional practice ensures that writing is about fairness and accuracy. Any dishonest activity, such as failure to adequately credit a source of information, would only distance the writing from the truth, thereby making it less useful.  Aspiring for scholarly ethics ensures that writing accurately contextualizes its contributions to professional knowledge and the wider world of scholarship (Kearney-Nunnery, 2024).

ORDER A PLAGIARISM-FREE PAPER HERE

Explain how Grammarly, Turnitin, and paraphrasing contributes to academic integrity

 

Grammarly and Turnitin are programs to improve writing, while paraphrasing is an approach that avoids plagiarism and uses one’s own words to retain ideas and present unique understanding. Grammarly is a grammar-checking tool that helps writers avoid routine grammar mistakes, punctuation errors, and spellchecks. It identifies writing issues, from checking punctuation and spelling to detecting readability, wordiness, and improper tone and suggesting changes to improve the writing. Using Grammarly helps to maintain academic integrity by checking errors and producing quality writing (Lanning & Gerrity, 2022).

Turnitin is a plagiarism-checking tool that helps inspect writing to determine if the content is plagiarized from an unquoted source. It contains algorithms that compare the writing to other archives content on the internet to identify similarities in word combinations and sentences. Once plagiarism is identified, the writer can place the text in quotes and cite the source or apply paraphrasing to retain the idea while using an original combination of words (Lanning & Gerrity, 2022).

Applying paraphrasing helps to present original writing. It is an alternative to using quotes and shows that the writer has understood the source well enough to write in their own words. It empowers the writer to convey ideas and concepts more clearly while seamlessly integrating sources. This catalyzes a more profound comprehension of the source as the writer must dissect the source, analyze the concepts it presents, and skillfully rephrase them in their own words. This process fosters a deeper comprehension of the subject matter, allowing the writer to effectively internalize and synthesize the information (Lanning & Gerrity, 2022). All these help to support academic integrity Strategies to promote academic integrity and professional ethics.

 

PART 2: Strategies for Maintaining Integrity of Work

 

Expand on your thoughts from Part 1 by:

 

Identifying and describing strategies you intend to pursue to maintain integrity and ethics of your 1) academic work while a student of the MSN program or PMC, and 2) professional work as a nurse throughout your career. Include a review of resources and approaches you propose to use as a student and a professional.

 

Five strategies
are identified for maintaining integrity and ethics of academic work as a student. First, being clear about the guidelines and instructions for writing. Second, use tools like Grammarly and Turnitin to improve writing and avoid plagiarism. Third, properly citing and referencing sources and utilizing support tools to ensure sources are appropriately acknowledged. Fourth, ensure that all writing submissions are own work, original presentation, except where cited. Fifth, acknowledge and attribute content to the source. The library and writing center are useful resources for maintaining academic integrity as a student as they help identify credible sources, maintain the recommended writing format, and improve writing language and presentation (Lancaster, 2020).

Six strategies are identified for maintaining integrity and ethics of professional work as a nurse. First, treating everyone with integrity is about wholeness, honesty, and being the same with everyone and in all situations. Every workmate is treated with the same level of respect and professionalism regardless of seniority. Every patient is given the best treatment, regardless of the level of service the patient pays for. Second, rewarding honesty even when mistakes are made. Third, admitting mistakes and apologizing when wrong. Fourth, encouraging free speech and honest conversation that is respectful and open-minded. Fifth, conducting periodic self-assessments to identify areas that may need improvement. Sixth, keeping commitments and developing a reputation as someone who delivers on promises. Finally, putting in maximum effort demonstrates commitment and a strong work ethic (Grace & Uveges, 2023).

 

References

Eaton, S. E. (2021).
Plagiarism in Higher Education: Tackling Tough Topics in Academic Integrity
. ABC-CLIO.

Grace, P. J., & Uveges, M. K. (2023).
Nursing Ethics and Professional Responsibility in Advanced Practice
(4th ed.). Jones & Bartlett Learning.

Kearney-Nunnery, R. (2024). 
Advancing Your Career: Concepts of Professional Nursing
(8th ed.). F.A. Davis.

Lancaster, T. E. (2020).
Avoid Plagiarism
. SAGE Publications, Inc.

Lanning, S. & Gerrity, C. (2022). 
Concise Guide to Information Literacy
. ABC-CLIO.

Homelessness Community Health Reasoning – George Mayfield is a 68-year-old African American male

 

Homelessness

Community Health Reasoning

 

 

George Mayfield, 68 years old

 

Primary Concept

Health Promotion

Interrelated Concepts
(In order of emphasis)

•   Collaboration

•   Patient Education

•   Communication

•   Addiction

•   Clinical Judgment

 

History of Present Problem:
 

George Mayfield is a 68-year-old African American male with a past history of hypertension, but has not taken his meds the past year because it was too much bother and he felt fine. He is seen at a clinic that serves the homeless in a large metropolitan community.

George came to the clinic because of a headache that has been persistent the past week and blurred vision. His clothing is dirty and he has a strong body odor as well as smelly feet. His shoes are shabby and he has lots of callouses on his feet. George is missing many teeth and those that remain are yellow and brown with dental decay. When the nurse reviewed the health screening questions, George admitted that he has had a productive cough with occasional blood tinged yellow mucus the past couple weeks. His initial BP is 188/96.

ORDER A PLAGIARISM-FREE PAPER HERE

Personal/Social History: 

George is veteran who served in Vietnam. He has struggled with alcohol abuse in the past but denies ETOH use in the past year. He has been homeless since he lost his job as a mechanic ten years ago and currently lives in his car, a 1980 Cadillac, with Milo, his white poodle.

He has never married and has no close friends or relatives with whom he stays in contact. He smokes one pack of cigarettes a day.

 

What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?

RELEVANT Data from Present Problem:

Clinical Significance:

       i.          Blurred vision and persistent headaches.

 

ii.          Productive cough with blood-tinged yellow mucus

iii.          A blood pressure of 188/96

 

 

       i.          Could be a possible indicator of hypertensive crisis or uncontrolled hypertension.

 

ii.          Could be a potential TB, Lung infection and chronic bronchitis.

 

iii.          A possibility of poorly managed hypertension
.

RELEVANT Data from Social History:

Clinical Significance:

       i.          Past history of alcohol abuse.

ii.          Homelessness and living in a car.

 

iii.          Smoking a pack per day

 

 

 

       i.          Could possibly be a liver disease or other complications.

ii.          Being at a risk of poor hygiene, inadequate healthcare access and limited access to resources.

   iii.         
Increases the risks of COPD, lung cancer, and cardiovascular diseases.

 

Patient Care Begins:

Current VS:

P-Q-R-S-T Pain Assessment:

T:
97.6 F/36.4 C (oral)

P
rovoking/Palliative:

Nothing/nothing

P:
90
(
regular)

Q
uality:

Dull ache

R:
18 (regular)

R
egion/Radiation:

head

BP:
182/90

S
everity:

7/10

O2 sat:
90% room air

T
iming:

continuous

 

What VS data are RELEVANT and must be interpreted as clinically significant by the nurse?

RELEVANT VS Data:

Clinical Significance:

       i.          BP: 182/90

 

ii.          O2 sat: 90% on room air

       i.          Signifies poorly managed hypertension hence being at a risk of stroke and other heart diseases.

     ii.         
Indicate Borderline hypoxia, possibly due to lung disease infection. Homelessness Community Health Reasoning – George Mayfield is a 68-year-old African American male

 

Current  Objective Assessment:

GENERAL

APPEARANCE:

Clothing soiled, hair and beard unkept. Has foul body odor, shabby shoes and smelly feet with callouses. Teeth are yellow stained and many are missing with obvious poor dentition

RESP:

Breath sounds clear bilaterally upon inspiration, coarse rhonchi heard in bases bilaterally upon expiration, occasional harsh productive cough with blood-tinged yellow mucus

CARDIAC:

Pink, warm & dry, no edema, heart sounds regular with no abnormal beats, pulses strong, equal with palpation at radial/pedal/post-tibial landmarks

NEURO:

Alert & oriented to person, place, time, and situation (x4)

GI:

Abdomen flat, soft/nontender, bowel sounds audible per auscultation in all four quadrants

GU:

Voiding without difficulty, urine clear/yellow  Voids three times during the night

SKIN:

Dirt on hands and under fingernails, fungal toenails present on both feet, feet persistently itch, are swollen, macerated and moist with peeling of the skin layers between toes on both feet.

 

 

Current Subjective Assessment:

 

SUICIDAL RISK:

 

Assessment:
George did not demonstrate the presence of suicidal ideation but as a homeless man with no family or friends he may well be at risk. It would be imperative to perform a mental health checkup to ensure that there is no possibility of suicidal thoughts.
Clinical Significance:
For individuals in his situation, depression and suicidal thoughts are more common, which means that constant supervision and psychological counseling are essential.

SLEEP ASSESSMENT:

Assessment:
George is currently homeless and resides in his car, and this can have negative impacts such as poor sleeping habits and lack of cleanliness. It is possible to experience loss of sleep or interrupted sleep because of discomfort and stress.

Clinical Significance:
Lack of sleep affects total health, memory, learning capacity and worsens some psychological illnesses.

NUTRITIONAL ASSESSMENT:

Assessment:
In this case George is a homeless man which means he doesn’t always have proper meals and thus can be malnourished. Other oral health issues which include the absence of teeth and dental caries also impede his capacity to consume adequately.

Clinical Significance:
Apart from deterioration of his general well-being, he can develop different health issues associated with malnutrition such as decreased immunity and emerging complications linked to chronic diseases, such as hypertension.

ETOH ABUSE:

 

Assessment:
Although George does not admit having used alcohol within the past year, he has featured in alcohol abuse. Prolonged sexual abstinence should be established, he requires periodic examination for other liver related illnesses.

Clinical Significance:
His history of excessive alcohol intake in the past increases the chances of developing liver disease and could be the reason for developing additional health problems even if he does not consume alcohol at present time.

DEPRESSION

ASSESSMENT:

Assessment:
Despite George not coming out and saying he is depressed, he is at a very high risk because of the lack of support, being homeless, and lonely, as seen from his history. His living environment, unclean appearance, and overall apparent abandonment may indicate that he experiences some degree of depression.

Clinical Significance:
Homeless patients especially those with depression are less likely to report their condition or receive treatment and this results in neglect of personal health care, higher risks and low quality of life. Both screening and mental health intervention are essential.

 

What assessment data is RELEVANT and must be interpreted as clinically significant by the nurse?

RELEVANT  Assessment Data:

Clinical Significance:

       i.          BP: 182/90

 

 

 

ii.          Productive cough with blood-tinged mucus

 

iii.          O2 saturation: 90% on room air

 

 

iv.          Poor dentition (yellow, decayed teeth)

       i.          Reveals poorly controlled hypertension, which further poses George for heart attack, stroke or heart failure. His past non-adherence to medications worsens the situation.

 

ii.          A possible indicator of TB, Respiratory infections, and other pulmonary issues.

 

iii.          Suggest a possible hypoxia or an underlying respiratory problem, that requires further investigation, especially in terms cough and mucus.

    iv.         
Poor oral hygiene increases risk for systemic infections and malnutrition. It also complicates proper food intake and contributes to poor health.

RELEVANT SUBJECTIVE

Assessment Data:

Clinical Significance:

       i.          Blurred vision and persistent headaches

ii.          Being homelessness and living in a car

iii.          Prior history of not adhering to hypertension medication

iv.          Smoking a pack of cigarettes daily.

v.          Past alcohol abuse history

       i.          Could be a possible indicator of hypertensive crisis or uncontrolled hypertension.

ii.          Being at a risk of poor hygiene, inadequate healthcare access and limited access to resources.

iii.          Increases the risk of further complications such as stroke and kidney failure.

iv.          Increases the risks of COPD, lung cancer, and cardiovascular diseases.

v.          Could possibly be a liver disease or other complications.

 

List the physical and psychosocial problems that are adversely impacting his health? What are the physiological OR psychosocial causes of the problem?

Physical Problem(s)

Cause and/or Pathophysiology

Hypertension

 

 

 

Productive cough with hemoptysis

 

 

Fungal and skin infections

 

 

 

 

Poor dentition

 

 

 

 

Blurred vision and headache

 

 

Malnutrition

 

 

A Blood Pressure of (182/90) is likely due to non-adherence to antihypertensive medications for the past year.

 

Possible causes might be respiratory infection, chronic bronchitis, or tuberculosis (TB). It can impact lung cancer when one lives in poor conditions such as in his car.

 

Fungal infections and maceration between the toes are as a result of bad hygiene practices, tight shoes, and wet environment. Additionally, he is likely to get further infections and experience complications with his mobility.

 

Failing to clean the teeth results in tooth decay, decreasing the chances of getting well-nourished and free from body infections. It may also affect his ability to take proper meals to worsen his health.

 

Perhaps because of high blood pressure, which may affect blood vessels in the eyes (hypertensive retinopathy) and lead to headaches due to increased pressure.

 

Lack of proper nutrition could have resulted from poor access to food and dental problems in George’s case. This increases his overall frailty and decreases immunity, as well as other associated diseases such as hypertension Homelessness Community Health Reasoning – George Mayfield is a 68-year-old African American male.

Psychosocial Problem(s)

Cause and/or Pathophysiology

Homelessness and isolation

 

 

Mental health (possible depression)

It impacts poor self-care, lack of access to healthcare, and deteriorating health.

 

These are lack of social interaction, loss of job, and homelessness are some of the causes of depression.

 

Is there a
RELATIONSHIP
between his social history and
physical/psychosocial problems
that may have contributed to the development of another problem?

Physical Problem(s)

What then Developed?

Uncontrolled hypertension

 

Smoking a pack per day

 

Poor hygiene and fungal infection

 Headaches, Blurred vision and risk of cardiovascular diseases.

 

Issues in respiratory system such as hypoxia, chronic cough and possible COPD.

 

Fungal infection on the feet could affect mobility due to infections.

Psychosocial Problem(s)

What then Developed?

Homelessness

 

 

Past alcohol abuse history

 

 

Social isolation

 

Lack of access to healthcare.
 

 
It contributes to malnutrition, poor hygiene, poor access to healthcare and worsening of conditions such as hypertension.

 

Potential long-term damage to his kidney and the liver, hence affecting his general health.

 

Contributes to development of depression.

 

Contribute to long-term untreated chronic diseases such as hypertension.

 

What are the priority physical/psychosocial problems and resultant assessments?

PRIORITY Problems:

PRIORITY Nursing Assessments:

Hypertension

 

 

productive cough and hypoxia

 

 

Malnutrition

 

Poor hygiene and fungal infection on the feet

 

 

Psychosocial issues such as isolation

Regular monitoring of BP and assessment of its signs such as headaches and vision changes.

 

Lung sounds assessment, oxygen saturation, and monitoring respiratory infections.

 

Assess his diet, body weight and dental health.

 

Inspection of the feet for a possible infection sign, mobility assessment and provision of hygienic care.

 

Screening for suicidal thoughts and depression. Assessment of mental health

 

What are the nursing interventions at the primary, secondary and tertiary level of care?  

(Nursing roles to consider are the following: educate, advocate, manage, collaborate, leadership)

Primary Prevention Level: 

Keep disease or injury from occurring.  (Educate)

Primary prevention for George entails using health promotion strategies whereby George is informed on the health behaviors that might further decline his health status. This includes anti-smoking campaigns, learning how smoking affects the respiratory system, and where to get help to quit this behavior. Ensuring that nurses collaborate in monitoring his blood pressure is instrumental, hence the need to educate him on the importance of taking medications as prescribed and the need to take a healthy diet. Hygiene education is also of extreme importance and includes foot care, where George is to be educated on how to dry and clean his feet besides being encouraged to wear shoes as a way of avoiding getting infections.

 

Secondary Prevention Level:
 

Detect and treat existing disease or injuries. (Screen and treat)

At secondary level, the main nursing interventions include assessment and management of known chronic disorders. Blood pressure measurement is required to identify hypertension and its treatment with medication and dietary modifications. Screening tests should then be performed on a regular basis to check for such new diseases as tuberculosis or chronic bronchitis. Finally, they entail mental health examination in order to rule out depression or suicidal thoughts, as well as refer George to mental health care that may be required to support him throughout the process of recovery.

 

Tertiary Prevention Level: 

Reduce the disease or injury to lowest level to minimize disability. (Rehabilitation).

Tertiary prevention seeks to reduce the chances of developing complications from the two chronic health conditions of George. Respiratory rehabilitation aims at looking into chronic respiratory illnesses like COPD, ensuring that appropriate treatment is taken and encouraging lung wellness. Nutrition is also important as referring George to sources that help him work on his nourishment and making sure he gets the dental work that will aid in his eating is essential. There should also be continuous, consistent foot care, with regards to the fungal infections, the ulcers, and consistent assessment of the conditions that could worsen and affect George’s mobility and independence.

 

High Incidence Problems in Homeless Population:

Start by considering all the information you have regarding this client who is homeless.  What are the problems most frequently seen in a homeless population?

       i.          Malnutrition

ii.          Respiratory infections such as TB

iii.          Chronic conditions such as hypertension

iv.          Poor hygiene that might impact infections.

v.          Substance abuse such as alcohol abuse

Homelessness Community Health Reasoning – George Mayfield is a 68-year-old African American male

 

Practice Settings/Community Resources:

Pick the practice settings that might offer resources to the patient.  Describe the resources offered and/or the nursing role for the selected settings. Only choose the relevant practice settings.

Practice Setting

Community Resources

Role of Nurse

Public Health

Immunization programs, public health clinics, and the mobile health units.

Offering vaccinations, providing health related education, and screening for chronic diseases.

Forensic

 

 

 

 

Clinic

Free clinics and Federally Qualified Health Centers (FQHC).

 

Chronic disease management, offering primary care and provision of referrals to social services.

School

 

 

 

 

Occupational

 

 

 

 

Faith-Based

Food pantries and faith related shelters.

 

Provision of holistic type of care that include spiritual support, counselling and mental health services.

Home Health/hospice

 

 

 

 

Senior Center

 

 

 

 

Homeless shelter

Offering of free shelters, services of managing substance abuse and other outreach programs.

Connection o housing services, conducting health assessments to patients and educating on proper measures of hygiene and selfcare.

 

Transcultural:  

Describe how the cultural factors relate to the care of this patient in the categories listed below.

Race/Ethnicity:

 It means that when consulting for a patient, one must be sensitive to his or her origin, ethnicity, and gender; in this case, George is an African-American male. Hypertension and smoking related diseases are predominant in the black individuals and these should help in the development of his care plan.

Environmental Health

He has been living in his car and has probably made his respiratory conditions and general hygienic conditions are worse, hence requiring health treatments with emphasis on his unstable housing status.

Vulnerable Population:

 To begin with, George is homeless elderly and he belongs to the category of the vulnerable people. His inconsistent utilization of health care and social services must inform nursing care, directing him to community resources, including elderly’s services and housing support services. Homelessness Community Health Reasoning – George Mayfield is a 68-year-old African American male

Politics and the Patient Protection and Affordable Care Act Essay 

Politics and the Patient Protection and Affordable Care Act

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.

Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).

Consider who benefits the most when policy is developed and in the context of policy implementation.

By Day 3 of Week 3

Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.

By Day 6 of Week 3

Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

 

Politics and the Patient Protection and Affordable Care Act Essay

Politics and the Patient Protection and the “Affordable Care Act” (ACA)

           
Political leaders collaborate with policymakers to improve the healthcare sector by enacting new policies or laws. Upon resuming office, President Barack Obama was interested in improving the US healthcare industry. This goal could only be achieved by reducing the number of uninsured Americans, which was significantly high compared to other developed countries. According to Glied et al. (2020), a relatively high number of low-income families living in the US were uninsured before the introduction of the ACA. For this reason, President Obama enacted the ACA (Obama Care) to boost medical coverage, especially among low-income earns across the US. However, present-day Obama’s successors have different views regarding the ACA, with some proposing alternative health policies. This paper presents the cost-benefit analysis of the ACA.

ORDER A PLAGIARISM-FREE PAPER HERE

Repealing the ACA and replacing it with the AHCA

In May 2017, the Congress attempted to repeal and replace the ACA for the first time. The House of Representatives passed the “American Health Care Act” (AHCA) during this time (Gluck & Scott-Railton, 2019). Republican legislators led by President Trump expressed their interest in repealing Obamacare and replacing it with AHCA. Nonetheless, the AHCA would disadvantage citizens since approximately 24 million Americans would lose their medical insurance coverage if the ACA was replaced (Goldman & Sommers, 2020). Americans would be taxed based on age rather than income following the enactment of the proposed AHCA. As a result, most Americans would be exposed to high healthcare costs. Specifically, Americans with pre-existing medical issues would incur higher treatment costs. Additionally, several regulations currently in the ACA would be suspended if the ACA were replaced with AHCA (Gluck & Scott-Railton, 2019). Consequently, Americans undergoing continuous treatment for chronic illnesses would pay higher premium rates for medical insurance coverage.

The Impact of Voters’ Views on Legislative Leaders’ Decision Regarding the ACA Repeal/Replace

Voters’ perception of the repeal process would impact legislative leaders significantly. Most Americans (voters) value the ACA since it enhances access to quality healthcare services across the US through increased medical insurance coverage and its current provisions (Goldman & Sommers, 2020). Therefore, the legislators, particularly Republicans, conducted a cost-benefit analysis to guide their repeal/replace decisions. Analysis results indicated that Republicans risked not being re-elected if they advocated for ‘repeal and replace’ due to the negative aspect of this action, especially a rise in the cost of medical care across the US. Thus, the new AHCA policy would limit access to affordable and quality healthcare services to most Americans, especially low-income households, the elderly, and persons with chronic illnesses. Therefore, it is evident that citizens would not vote for leaders who expose them to problems that Obamacare has addressed.

The primary goal of legislators is to be re-elected. Thus, elective legislators consider voters’ interests when supporting proposed policies. Cost analysis revealed that these legislators were likely to lose their positions in the government if they continued to support the ACA repeal effort. As a result, most legislators in the Senate and House of Representatives withdrew their support for the repeal effort. This decision would please the voters, increasing legislators’ possibility of being re-elected Politics and the Patient Protection and Affordable Care Act Essay.

 

References

Glied, S. A., Collins, S. R., & Lin, S. (2020). Did The ACA Lower Americans’ Financial Barriers to Health Care? A review of evidence to determine whether the Affordable Care Act was effective in lowering cost barriers to health insurance coverage and health care. 
Health Affairs
, 
39
(3), 379-386.
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2019.01448

Gluck, A. R., & Scott-Railton, T. (2019). Affordable Care Act Entrenchment. 
Geo. LJ
, 
108
, 495.
https://heinonline.org/HOL/LandingPage?handle=hein.journals/glj108&div=19&id=&page=

Goldman, A. L., & Sommers, B. D. (2020). Among Low-Income Adults Enrolled in Medicaid, Churning Decreased After the Affordable Care Act: This study examines whether the Affordable Care Act’s expansion of Medicaid eligibility impacted coverage disruptions–known as “churning”–among Medicaid enrollees.
Health Affairs
, 
39
(1), 85-93.
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00378