Tag: Clinical-Nursing

  • Nursing Leadership Strategy Discussion

    Nursing Leadership Strategy Discussion

    As a nurse, you serve an important role in identifying strategies to effectively manage health care resources and in leading health care quality improvement. You must be able to decide what leadership style or strategy to apply in a given situation to achieve an effective resolution of the issue. Read the following two scenarios and select one to focus on in this Discussion. Consider the leadership style or strategy that might be most effective in the scenario you selected.

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    Scenario 1

    You work in a for-profit nursing home, with about 100 beds, on a 20-bed unit that is largely patients with Alzheimer’s disease. Your patient mix is predominantly Medicare and Medicaid patients. Your nursing home is part of a larger system that includes a major medical center, as well as VNA, outpatient dialysis, and a fully integrated network. Your nurse manager is getting feedback from the hospital that your nursing home is sending too many patients to the ED who really don’t need to go Nursing Leadership Strategy Discussion. How would you go about figuring out what could be done at the nursing home to prevent avoidable ED visits?

    Scenario 2

    You’ve been associated with an outpatient cardiology clinic that is part of a large academic medical center. Your patients are mostly charity care and managed Medicaid. Most have a prescription plan, but none have a “family doctor” and use the clinic (and the ED) regularly. Most are unfamiliar with their medications and do not have the resources for care coordination in their family/social network Nursing Leadership Strategy Discussion. About 25 CHF patients have been “lovingly,” but inappropriately, called “frequent fliers” because of their inability to manage their own care, their frequent visits to the ED, and their “one night stays” paid at the observation rate. As a staff nurse in this clinic, describe the strategies you could devise for you and your fellow staff nurses targeting these 25 patients. Find at least one article from the professional literature to corroborate your recommendations.

    Select one of the scenarios, and post the following:

    Describe the most appropriate leadership style and/or strategy to apply in the scenario you chose in order to implement the recommendations successfully. Justify your selection. Nursing Leadership Strategy Discussion.

    Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.

    Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). Nursing Leadership Strategy Discussion

  • Policy Issue Presentation. NRP/508: Health Policy And Role Of The Advanced Practice Nurse

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

    Week 5 Assignment Instructions

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

    Create a 8- to 10-slide Microsoft® PowerPoint® presentation, with speaker’s notes, communicating the change vision of the policy issue you selected.

    Locate a minimum of three academic articles to support your stance. Two of the three articles can be previous resources used in earlier weeks.

    Include the following in your presentation:

    Summarize the problem statement using relevant background information and supporting details from the articles you located. (15 pts)

    Identify the policy objectives, options, and alternatives. (10 pts)

    Who is directly impacted by the health policy issue? (10 pts)

    Identify the stakeholders who will assist you in implementing the change and define their roles. (10 pts)

    What are the outside influences on the policy issue? (10 pts)

    How has the media’s influence shaped the policy? (10 pts)

    How will the policy change improve health care? (10 pts)

    Are there any cultural or ethical implications to this policy? (10 pts)

    Cite and reference using APA guidelines. There must be at least 3 scholarly works that are peer-reviewed and within the last 5 years. References and in-text citations must be included in APA format. (5 pts) Policy Issue Presentation. NRP/508: Health Policy And Role Of The Advanced Practice Nurse

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    Assignment texts and readings.

    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.

    Chapter 14.

    Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F. D., & East, L. (2014). Addressing issues impacting advanced nursing practice worldwide. Online Journal of Nursing Issues, 19(2), 1-12.

    Week 5 Assignment Instructions
    Policy Issue Presentation.  NRP/508: Health Policy And Role Of The Advanced Practice Nurse

    Create a 8- to 10-slide Microsoft® PowerPoint® presentation, with speaker’s notes, communicating the change vision of the policy issue you selected.

    Locate a minimum of three academic articles to support your stance. Two of the three articles can be previous resources used in earlier weeks.

    Include the following in your presentation:

    Summarize the problem statement using relevant background information and supporting details from the articles you located. (15 pts)

    Identify the policy objectives, options, and alternatives. (10 pts)

    Who is directly impacted by the health policy issue? (10 pts)

    Identify the stakeholders who will assist you in implementing the change and define their roles. (10 pts)

    What are the outside influences on the policy issue? (10 pts)

    How has the media’s influence shaped the policy? (10 pts)

    How will the policy change improve health care? (10 pts)

    Are there any cultural or ethical implications to this policy? (10 pts)

    Cite and reference using APA guidelines. There must be at least 3 scholarly works that are peer-reviewed and within the last 5 years. References and in-text citations must be included in APA format. (5 pts)

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

     

    Assignment texts and readings.

    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.

    Chapter 14.

    Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F. D., & East, L. (2014). Addressing issues impacting advanced nursing practice worldwide. Online Journal of Nursing Issues, 19(2), 1-12. Policy Issue Presentation. NRP/508: Health Policy And Role Of The Advanced Practice Nurse

  • Ethical Decision-Making, NRP/508: Health Policy And Role Of The Advanced Practice Nurse

    Week 4 Assignment Instructions

    Conduct an Internet search for the Core Concepts of Jean Watson’s Theory of Human Caring/Caring Science article.

    Read the article.

    Complete the questions from Box 15-1: Ethics Inventory located on p. 141 in Ch. 15 of Policy & Politics.

    Select an ethical dilemma you would face as an APRN.

    Write a 1,050-word paper addressing the following:

    Identify which provision of the nursing code of ethics would be violated in the ethical dilemma. How can you use the code of ethics to address the issue? (15 pts)

    How can you create an ethical environment in your workplace to bring about awareness for other nurses in this area? (15 pts)

    Explain how you can use Watson’s theory of human caring as a guide when encountering ethical decisions. (15 pts)

    Provide references for all sources cited and format according to APA guidelines. There must be at least one scholarly work that is peer-reviewed and within the last 5 years. References and in-text citations must be included in APA format. (5 pts)

     

    Reading for assignment.  Box 15-1 is included in the reading below.  Box 15-1, page 141, Chapter 15, Policy and Politics in Nursing and Health Care text.

    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.

    Chapter 7 and 13.

     

    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.

    Chapter 8 and 15.

     

    Weber, B. B. (2011). The role of professional nursing organizations in maintaining a healthy workplace. Plastic Surgical Nursing, 31(3), 92-94.

  • Benchmark – Electronic Health Record Implementation Paper

    Benchmark – Electronic Health Record Implementation Paper

    Electronic health records (EHR) is a tool that has received much attention in the health care industry, particularly because of its capacity to track the opportunities for improving health care through the database feature. To be more precise, the database contained in the EHR contains patient registries that indicate the status of the patient, measures taken and results of the care approaches, as well as any relevant warnings or advices. In fact, the registries contain information on all the patient interactions with the…

    This benchmark assignment assesses the following programmatic competencies:

    2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.

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    5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care.

    One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process. Benchmark – Electronic Health Record Implementation Paper

    In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse’s role during this type of scenario:

    What key information would be needed in the database that would allow you to track opportunities for care improvement?

    What role does informatics play in the ability to capture this data?

    Which systems and staff members would need to be involved in the design and implementation process and team?

    What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?

    How would the EHR team ensure that all order sets are part of the new record?

    How would you communicate the changes, including any kind of transition plan?

    What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?

    What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

    You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Benchmark – Electronic Health Record Implementation Paper.

    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.

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

    Benchmark – Electronic Health Record Implementation Paper – Rubric

    No of Criteria: 14 Achievement Levels: 5

    Criteria

    Achievement Levels

    DescriptionPercentage

    Unsatisfactory

    0.00 %

    Less than Satisfactory

    80.00 %

    Satisfactory

    88.00 %

    Good

    92.00 %

    Excellent

    100.00 %

    Content

    70.0

    Key Information Needed in the Database to Track Opportunities for Care Improvement

    10.0

    A discussion of key information needed in the database to track opportunities for care improvement is not included.

    A discussion of key information needed in the database to track opportunities for care improvement is present, but it lacks detail or is incomplete.

    A discussion of key information needed in the database to track opportunities for care improvement is present.

    A discussion of key information needed in the database to track opportunities for care improvement is clearly provided and well developed. Benchmark – Electronic Health Record Implementation Paper

    A comprehensive discussion of key information needed in the database to track opportunities for care improvement is thoroughly developed with supporting details.

    Role Informatics Plays in the Ability to Capture This Data

    10.0

    A discussion of the role informatics plays in the ability to capture this data is not included.

    A discussion of the role informatics plays in the ability to capture this data is present, but it lacks detail or is incomplete.

    A discussion of the role informatics plays in the ability to capture this data is present.

    A discussion of the role informatics plays in the ability to capture this data is clearly provided and well developed.

    A comprehensive discussion of the role informatics plays in the ability to capture this data is thoroughly developed with supporting details.

    The Systems and Staff Members that Would Need to Be Involved in the Design and Implementation Process and Team

    10.0

    A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is not included.

    A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is present, but it lacks detail or is incomplete.

    A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is present.

    A discussion of the systems and staff members that would need to be involved in the design and implementation process and team is clearly provided and well developed.

    A comprehensive discussion of the systems and staff members that would need to be involved in the design and implementation process and team is thoroughly developed with supporting details.

    Professional, Ethical, and Regulatory Standards That Must Be Incorporated Into the Design and Implementation of the System (5.2) Benchmark – Electronic Health Record Implementation Paper

    10.0

    A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is not included.

    A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is present, but it lacks detail or is incomplete.

    A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is present.

    A discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is clearly provided and well developed.

    A comprehensive discussion of professional, ethical, and regulatory standards that must be incorporated into the design and implementation of the system is thoroughly developed with supporting details.

    How the EHR Team Would Ensure That All Order Sets Are Part of the New Record

    5.0

    A discussion of how the EHR team would ensure that all order sets are part of the new record is not included.

    A discussion of how the EHR team would ensure that all order sets are part of the new record is present, but it lacks detail or is incomplete.

    A discussion of how the EHR team would ensure that all order sets are part of the new record is present.

    A discussion of how the EHR team would ensure that all order sets are part of the new record is clearly provided and well developed.

    A comprehensive discussion of how the EHR team would ensure that all order sets are part of the new record is thoroughly developed with supporting details.

    Communication of the Changes, Including Any Kind of Transition Plan

    5.0

    A discussion of how to communicate the changes, including any kind of transition plan, is not included.

    A discussion of how to communicate the changes, including any kind of transition plan, is present, but it lacks detail or is incomplete. Benchmark – Electronic Health Record Implementation Paper

    A discussion of how to communicate the changes, including any kind of transition plan, is present.

    A discussion of how to communicate the changes, including any kind of transition plan, is clearly provided and well developed.

    A comprehensive discussion of how to communicate the changes, including any kind of transition plan, is thoroughly developed with supporting details.

    Measures and Steps to Evaluate the Success of the EHR Implementation

    5.0

    A discussion of measures and steps to evaluate the success of the EHR implementation is not included.

    A discussion of measures and steps to evaluate the success of the EHR implementation is present, but it lacks detail or is incomplete.

    A discussion of measures and steps to evaluate the success of the EHR implementation is present.

    A discussion of measures and steps to evaluate the success of the EHR implementation is clearly provided and well developed.

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    A comprehensive discussion of measures and steps to evaluate the success of the EHR implementation is thoroughly developed with supporting details.

    Leadership Skills, Theories, and Styles to Employ for Collaboration on Interprofessional Teams Participating in the Legislative Process and Providing Evidence-Based, Patient-Centered Care (2.3)

    10.0

    A discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is not included.

    A discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is present, but it lacks detail or is incomplete.

    A discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is present.

    A discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is clearly provided and well developed. Benchmark – Electronic Health Record Implementation Paper

    A comprehensive discussion of leadership skills, theories, and styles to employ for collaboration on interprofessional teams participating in the legislative process and providing evidence-based, patient-centered care is thoroughly developed with supporting details.

    Required Sources

    5.0

    Sources are not included.

    Number of required sources is only partially met.

    Number of required sources is met, but sources are outdated or inappropriate.

    Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

    Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

    Organization and Effectiveness

    20.0

    Thesis Development and Purpose

    7.0

    Paper lacks any discernible overall purpose or organizing claim.

    Thesis is insufficiently developed or vague. Purpose is not clear.

    Thesis is apparent and appropriate to purpose.

    Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    Argument Logic and Construction

    8.0

    Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

    Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

    Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Benchmark – Electronic Health Record Implementation Paper

    Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

    Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    5.0

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

    Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

    Writer is clearly in command of standard, written, academic English.

    Format

    10.0

    Paper Format (Use of appropriate style for the major and assignment)

    5.0

    Template is not used appropriately or documentation format is rarely followed correctly.

    Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

    Template is used, and formatting is correct, although some minor errors may be present.

    Template is fully used; There are virtually no errors in formatting style.

    All format elements are correct.

    Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

    5.0

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    Total Percentage 100

     

    Electronic health record implementation

    What key information would be needed in the database that would allow you to track opportunities for care improvement?

    Electronic health records (EHR) is a tool that has received much attention in the health care industry, particularly because of its capacity to track the opportunities for improving health care through the database feature. To be more precise, the database contained in the EHR contains patient registries that indicate the status of the patient, measures taken and results of the care approaches, as well as any relevant warnings or advices. In fact, the registries contain information on all the patient interactions with the medical facility and personnel (HealthIT, 2019). To maximize its benefits in terms of tracking care improvement opportunities, there is a need for the database to have certain elements as routine features. Benchmark – Electronic Health Record Implementation Paper. The first element is records keepings that makes it possible to track trends across all demographics thus making it possible to monitor care improvement efforts applied as well as inform research into additional improvements. The records should also contain information on how the patients react to the different care approaches and whether the desired objectives were achieved in each care setting. The second element is a clear link between health care approach and outcomes, making use of informatics to support decision making through noting what works to achieve the desired objectives. The final element is the presence of comprehensive indices that collect all the information at a single point and ensure that they are access to the authorized persons thereby supporting inter-professional collaboration and care approaches for the best outcomes (HealthIT, 2019).

    What role does informatics play in the ability to capture this data?

    Informatics is concerned with organization and analyzing health care information with a focus on extracting the useful aspects and assigning logical meaning to the information. It acknowledges that all interactions between medical facilities and personnel produce cumbersome data, and that deliberate processes are needed to make sense of the data. As such, informatics makes sense of the collected data by assigning value and extracting insight to allow the health care systems to reduce the opportunities for errors while improving the odds of achieving the desired outcomes. In fact, it associates the data variables and develops logical correlations to show associations that can support deliberate care improvement and cost reduction efforts (Saba & McCormick, 2015). Given that informatics makes use of data, then it is not hard to imagine that informatics plays a role in the ability to capture data. In this case, informatics influences the data capture process by identifying the determinants and contextual factors that are relevant to the health care objectives, and considering them as variables (Estiri, Patel & Murphy, 2018). In this respect, informatics influences the ability to capture data by identifying the useful data Benchmark – Electronic Health Record Implementation Paper.

    Which systems and staff members would need to be involved in the design and implementation process and team?

    Designing and implementing informatics requires input from systems and staff members. In this case, the systems include the specific technologies that support staff members to perform logical functions. There are a range of systems that are required to complete these functions. Firstly, clinical decision support systems are necessary to support primary care provision through diagnosis, prevention and treatment efforts. They include prediction algorithms, reminders and
    e
    -tools. Secondly, personal health records that contain all the information collected during interactions between patients and medical personnel. Thirdly, telehealth and telemedicine systems that support self-care efforts without placing the patients in unnecessary risks. All the systems must support efforts to secure the information and ensure that only authorized persons can access the information. This is in line with confidentiality and autonomy expectations for patient information (Demiris & Kneale, 2015). Besides the mentioned systems, there are personnel who are needed to complete the logical health care functions. They are identified based on their interactions with informatics and knowledge levels. Firstly, creators who are proficient in programing and mathematics can address the technical needs, such as computer engineers, programmers and system analysts. They are engaged in informatics design and development. Secondly, administrators and operators who operate and manage the informatics systems on a daily basis, determine how they are used and access. They include trainers, help-desk/support analysts, database administrators, and operators. Thirdly, information managers and users who determine what the informatics results will be used for in terms of application. They include the information security officer, project manager, function manager and information officer (McGonigle & Mastrian, 2018).

    What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system?

    Informatics systems have implications for professional, regulatory and ethical standards. That is because they make use of protected health information as inputs. To be more precise, there is an inherent expectation for patient information to be protected. However, informatics systems rely on this information thereby presenting concerns that can be potentially preempted through implementing the standards that act as guides to ensure that information security and confidentiality expectations are not violated. These standards have an overlap with the health care practice standards that are already in use in managing all health care information. In fact, regardless of context, there is an expectation of information integrity, non-maleficence, beneficence, justice, equality, confidentiality, and autonomy. In addition, these standards include an expectation of accountability, legitimate infringement, least intrusive alternative, openness, access, security and privacy for all informatics activities (Davis & LaCour, 2014). In addition, the regulatory standards must be observed, particularly the legislation intention to protect patient information. That is because they have legal implications with possibility of judicial intervention and penalties for violations. Examples of the relevant regulatory regulations include the 21
    st
    Century Cures Act of 2016, Medicare Access & CHIP (Children’s Health Insurance Program) Reauthorization Act of 2015, Food and Drug Administration Safety and Innovation Act (FDASIA) of 2012, Affordable Care Act of 2010, Health Insurance Portability and Accountability Act (HIPAA) of 1996, Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, and Privacy Act of 1974. Benchmark – Electronic Health Record Implementation Paper. In addition, there is a need to observe the regulations presented by the institutional review boards (IRB), Medicare laws, and patient records confidentiality rules (Hoffman 2017).

    How would the EHR team ensure that all order sets are part of the new record?

    The EHR team must ensure that all order sets are part of the new record. These occurs by undertaking deliberate steps. Firstly, the new record must be compatible with the old record. If not compatible, then the old record should be reviewed and integrated into the new record so that all the available information is assimilated into one information database. Secondly, the new record should be implemented in a progressive manner so that users familiarize themselves with its use even as data is transferred from the old record into the new record. This step ensures that the new record performs as intended even as kinks are eliminated with continued use (Davis & LaCour, 2014) Benchmark – Electronic Health Record Implementation Paper.

    How would you communicate the changes, including any kind of transition plan?

    Communicating the changes ensures that all stakeholders are aware of what is taking place, and are well prepared for the change. Successful, efficient and effective can only be achieved through the inclusion of three features. Firstly, ensuring that all the stakeholders are primed to have a shared vision of what the change seeks to address. They must recognize that change is necessary to address an existing problem Benchmark – Electronic Health Record Implementation Paper. Secondly, appointing or assigning effective leadership that has a good understanding of the change and can explain its intentions. This ensures that knowledgeable persons are assigned to lobby for the change and convince other stakeholders to support the change. Thirdly, disturbing the status-quo so that the stakeholders are dissatisfied with the state of affairs and look to the change as a way of achieving a new acceptable status quo (McGonigle & Mastrian, 2018).

    What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective?

    The success of the EHR implementation can be evaluated using two approaches. The first approach is to check if the technical performance of the EHR matches the expectations. In addition, this approach looks at the cost of the implementation and confirms how the actual cost matches to the budgeted costs and whether the implementation wend under or over the budget. The second approach is to engage the stakeholders and collect their perspective on the EHR system. This approach identifies the affected stakeholders, how they were affected, performance evaluation, and whether there is a need for changes (McGonigle & Mastrian, 2018).

    What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care?

    There is a need for leadership between stakeholders to ensure that the best possible care is provided. There are two leadership skills that should be applied. The first skill is supporting co-governance and self-governance so that the stakeholders are encouraged to express their opinions with regards to their expectations. This allows them to point out areas that need improvement, particularly the features that relate to specific disciplines and stakeholder groups. The second skill is applying hierarchical governance that assigns clear authority and responsibility to individuals. In addition to the two skills, leaders should be effective change agents, self-aware, vision, innovation, self-regulation, team building, motivation, strategic planning, decisive, and have integrity. Besides that, they should apply situational leadership theory that requires the leader to always correspond the leadership style to the respective situation through evacuating the relevant variables such as the number of team members, nature of professionals and type of task (Arnold & Boggs, 2019). Benchmark – Electronic Health Record Implementation Paper.

    References

    Arnold, E. & Boggs, K. (2019).
    Interpersonal relationships e-book: professional communication skills for nurses
    (8
    th
    ed.). St. Louis, MO: Elsevier.

    Davis, N. & LaCour, M. (2014).
    Health information technology
    (3
    rd
    ed.). Amsterdam: Elsevier.

    Demiris, G. & Kneale, L. (2015). Informatics systems and tools to facilitate patient-centered care coordination.
    Yearbook of Medical Informatics
    , 10(1), 15-21. DOI: 10.15265/IY-2015-003

    Estiri, H., Patel, C. & Murphy, S. (2018). Informatics can help providers incorporate context into care.
    JAMIA Open
    , 1(1), 3–6. DOI: 10.1093/jamiaopen/ooy025

    HealthIT (2019).
    What information does an electronic health record (EHR) contain?
    https://www.healthit.gov/faq/what-information-does-electronic-health-record-ehr-contain

    Hoffman, S. (2017).
    Electronic health records and medical big data: law and policy
    . New York, NY: Cambridge University Press.

    McGonigle, D., & Mastrian, K. G. (2018).
    Nursing informatics and the foundation of knowledge
    (4
    th
    ed.). Burlington, MA: Jones and Bartlett Learning.

    Saba, V. & McCormick, K. (2015).
    Essentials of nursing informatics
    (6
    th
    ed.). New York, NY: McGraw-Hill. Benchmark – Electronic Health Record Implementation Paper.

  • Practicum Journal: Safe Prescribing

    Week 2 Practicum Journal: Safe Prescribing

    There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications.

    In this Practicum Journal Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state.

    Learning Objectives

    Students will:

    • Analyze roles of the Drug Enforcement Administration

    • Analyze PMHNP responsibilities when issued a DEA number

    • Analyze DEA number application procedures

    • Analyze state requirements for safe prescribing and prescription monitoring

    • Analyze PMHNP responsibilities for safe prescribing and prescription monitoring

    • Analyze Schedule II-V drug levels

    ** Assigned in Week 2 and submitted in Week 4.

    To prepare for this Practicum Journal:

    • Review the Learning Resources.

    In 2-3 pages:

    • Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.

    • Explain your responsibilities when having a DEA number.

    • Explain how you apply for a DEA number.

    • Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements.

    • Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

     

    Every patient has a right to be prescribed the right medication upon visiting a healthcare facility. Getting the correct medication not only ensures that a patient’s chances of better outcomes are increased but it also minimizes the chances of medication errors and adverse effects (Gorgich, Barfrohan, Ghoreshi, et al., 2016). It is, therefore, important that a PMHNP is well versed with the state and federal legislation that guides the use and prescription of controlled drugs. This paper will discuss the role that DEA plays, responsibilities of a person in possession of a DEA number, application of DEA, requirements for the safe prescription of controlled drugs and the role of PMHNP, and lastly some examples of schedule II-Vdrugs will be discussed.

    The Role of DEA

    Kanouse & Compton (2015) point out that the main responsibility of the DEA is to ensure that the circulation of illegal narcotics is controlled. The Department of Justice oversees the activities of the DEA. The DoJ makes sure the federal laws that touch on the manufacturing, sale, use as well as the distribution of controlled drugs adherence. As regards the PMHNP, the role of the DEA is in ensuring that drugs are controlled and that the prescription and supply are done by licensed persons who possess a DEA number (Kanouse & Compton, 2015). This prevents the misuse and abuse of controlled drugs.

    Responsibilities of Possessing a DEA Number

    When a professional possess a DEA number it shows one’s competency in the controlled drugs prescription. A DEA provisional number ought to be given to a person that is licensed prior to attaining the number. Hence, a person is tasked by federal legislation adherence as pertaining to the drug prescription, manufacturing and distribution (Caulkins &Reuter, 2017)

    Application of DEA Number

    The acquisition of a DEA number is necessary for the legalization of controlled drugs prescribed to patients. One has to visit the DEA website to create an order form. Alternatively, a person can visit a DEA field where one gets a form that will fill to acquire the number. After filling out the form and submitting it, one should note the ID number with which a person can check the progress status. After a three day waiting period, a person can contact the DEA to find out if the registration is approved or is yet pending. Additionally, one can make any necessary changes, on the application form. A person needs to first hold a license for practice as well as a permit for controlled substance distribution prior to being issued with a DEA number.

    Requirements for Safe Prescription, PMHNP Responsibility, and Cleveland’s Program on Prescription Monitoring

    The process of manufacturing, distribution, and prescription of controlled substances in Cleveland is governed by several guidance rules. These guidelines aim at eradicating or at least minimizing incidences of drug abuse. A practitioner first has to register with the regional DEA office that heads the drug monitoring program. Once successfully registered, a physician is licensed to prescribe controlled drugs to a patient in need of the same in their treatment process. However, Bao, Pan, Taylor et al., (2016) point out that a physician is required to first consult with the PDMP of a patient before prescribing a controlled drug. Further, upon dispensing a controlled drug, a report should be filed on the same for accountability purposes.

    As a PMHNP, I am expected to prescribed controlled drugs to patients residing in the area in which I practice my profession. I should not for any reason, self-prescribe. Regarding schedule narcotics, I should first check the ILPMP before initial first time prescription of the said drugs. This action ensures that controlled substances are not misused or abused and also medical errors are averted.

    Schedule II-V Drug Examples

    Controlled drugs are classified into schedules in order of their severity in the possibility of abuse and causing harm. They are also categorized based on their usefulness and possibility of dependence. The top of this list is the schedule II drugs. These drugs are likely to cause severe dependence both psychologically and physically with equally high abuse potential. Fentanyl is a schedule II drug that can be prescribed for patients with chronic pain and who have already developed a tolerance for other opioids (Ramos & Lope, 2019). Schedule III drugs have physical reliance that is low while psychological reliance is high. Pentobarbital is an example of a schedule III drug that can be prescribed for treating insomnia (Johnson & Sadiq, 2019). The schedule IV drugs have a lesser chance of abuse compared to the previous two schedules. Benzphetamine is one such drug in the schedule IV list. This drug is an appetite suppressant used in the treatment of obesity and overweight patients (Plodkowski, McGaeve, Reisinger et al., 2016). Schedule V drugs are moderately mild and Lomotil is one such example. Lomotil is used in the treatment of diarrhea (Khan, Asghar, Kanwal, et al, 2019).

    Conclusion

    Controlled drugs need to be administered by licensed professionals. Abuse and misuse of these drugs can cause a lifetime of dependence and in some cases, death. Physicians and NPs that are licensed to prescribe controlled drugs need to be vigilant and perform their due diligence before prescribing the drugs to a first-time patient. Additionally, a PHMNP should be knowledgeable on the correct dosage and prescription and always stay informed on any changes affecting the drugs the one prescribes.

     

    References

    Bao, Y., Pan, Y., Taylor, A., Radakrishnan, S., Luo, F., Pincus, H. A., & Schackman, B. R. (2016). Prescription drug monitoring programs are associated with sustained reductions in opioid prescribing by physicians.
    Health Affairs
    ,
    35
    (6), 1045-1051.

    Caulkins, J. P., & Reuter, P. (2017). Dealing more effectively and humanely with illegal drugs. 
    Crime and justice
    , 
    46
    (1), 95-158.

    Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. 
    Global journal of health science
    , 
    8
    (8), 220.

    Johnson, A. B., & Sadiq, N. M. (2019). Pentobarbital. In 
    StatPearls [Internet]
    . StatPearls Publishing.

    Kanouse, A. B., & Compton, P. (2015). The epidemic of prescription opioid abuse, the subsequent rising prevalence of heroin use, and the federal response. 
    Journal of pain & palliative care pharmacotherapy
    , 
    29
    (2), 102-114.

    Khan, H. R., Asghar, S. A., Kanwal, S., Qadar, L. T., & Qadri, K. H. (2019). Diphenoxylate-atropine (Lomotil) Toxicity in Infantile Diarrhea: A Case Report of Therapeutic Failure. 
    Cureus
    , 
    11
    (10).

    Plodkowski, R. A., McGarvey, M. E., Reisinger-Kindle, K., Kramer, B., Nelson, E., Lee, J., & Nguyen, Q. T. (2016). Obesity Management: Clinical Review and Update of the Pharmacologic Treatment Options. 
    Federal Practitioner
    , 
    33
    (1), 6.

    Ramos-Matos, C. F., & Lopez-Ojeda, W. (2019). Fentanyl. In 
    StatPearls [Internet]
    . StatPearls Publishing.

  • NUR-550 – Benchmark – Population Health Policy Analysis

    NUR-550 – Benchmark – Population Health Policy Analysis

    Course Code

    Class Code

    Assignment Title

    Total Points

    NUR-550

    NUR-550-XO0905XB

    Benchmark – Population Health Policy Analysis

    160.0

    Criteria

    Percentage

    Unsatisfactory (0.00%)

    Less than Satisfactory (80.00%)

    Satisfactory (88.00%)

    Good (92.00%)

    Excellent (100.00%)

    Content

    70.0%

    Financially Sound Health Care Policy That Incorporates the Nursing Perspective and Relevant Ethical, Legal, and Political Factors (2.1)

    20.0%

    A discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is not included.

    A discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is present, but it lacks detail or is incomplete.

    A discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is present.

    A discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is clearly provided and well developed.

    A comprehensive discussion of financially sound health care policy that incorporates the nursing perspective and relevant ethical, legal, and political factors is thoroughly developed with supporting details.

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    Integration of Appropriate State, Federal, and Global Health Policies and Goals Related to Equitable Health Care for Populations (4.2)

    20.0%

    A discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is not included. NUR-550 – Benchmark – Population Health Policy Analysis

    A discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is present, but it lacks detail or is incomplete.

    A discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is present.

    A discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is clearly provided and well developed.

    A comprehensive discussion of appropriate state, federal, and global health policies and goals related to equitable health care for populations is thoroughly developed with supporting details.

    Advocacy Strategies for Improving Access, Quality, and Cost-Effective Health Care for Diverse Populations (2.2)

    10.0%

    A discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is not included.

    A discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is present, but it lacks detail or is incomplete.

    A discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is present.

    A discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is clearly provided and well developed.

    A comprehensive discussion of advocacy strategies for improving access, quality, and cost-effective health care for diverse populations is thoroughly developed with supporting details.

    The Professional and Moral Obligation of Advanced Registered Nurses to Respect Human Dignity and Advance the Common Good Through Working to Promote Health and Prevent Disease Among Diverse Populations from a Christian Perspective (4.3)

    15.0%

    A discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is not included.

    A discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is present, but it lacks detail or is incomplete.

    A discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is present.

    A discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is clearly provided and well developed.

    A comprehensive discussion of the professional and moral obligation of advanced registered nurses to respect human dignity and advance the common good through working to promote health and prevent disease among diverse populations from a Christian perspective is thoroughly developed with supporting details.

    Required Sources

    5.0%

    Sources are not included. NUR-550 – Benchmark – Population Health Policy Analysis

    Number of required sources is only partially met.

    Number of required sources is met, but sources are outdated or inappropriate.

    Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

    Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

    Organization and Effectiveness

    20.0%

    Thesis Development and Purpose

    7.0%

    Paper lacks any discernible overall purpose or organizing claim.

    Thesis is insufficiently developed or vague. Purpose is not clear.

    Thesis is apparent and appropriate to purpose.

    Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    Argument Logic and Construction

    8.0%

    Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

    Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

    Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

    Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

    Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    5.0%

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

    Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

    Writer is clearly in command of standard, written, academic English.

    Format

    10.0%

    Paper Format (Use of appropriate style for the major and assignment)

    5.0%

    Template is not used appropriately or documentation format is rarely followed correctly. NUR-550 – Benchmark – Population Health Policy Analysis

    Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

    Template is used, and formatting is correct, although some minor errors may be present.

    Template is fully used; There are virtually no errors in formatting style.

    All format elements are correct.

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    Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) NUR-550 – Benchmark – Population Health Policy Analysis

    5.0%

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    Total Weightage

    100%

  • Brian Foster Chest Pain Shadow Health Assessment

    Brian Foster Chest Pain Shadow Health Assessment

    Introduction and Pre-brief

    This assignment provides the opportunity to conduct a focused exam on Brian Foster, who presents with recent episodes of chest pain in a non-emergency setting. Interview Mr. Foster and be sure to thoroughly assess the cardiovascular system as well as related body systems in order to compile a list of differential diagnoses. This case study offers you the opportunity to evaluate Mr. Foster’s personal and family history with heart disease and identify lifestyle risk factors. During the physical examination, thoroughly examine the cardiovascular system and carefully evaluate and document the patient’s heart sounds.

    Tips and Tricks

    The sounds in the Shadow Health Concept Labs and Physical Assessment Assignments are medically accurate.

    Distinguishing normal from abnormal heart sounds requires practice and carefully listening for sometimes subtle and easily missed sounds. Be sure to take advantage of the Cardiovascular Concept Lab to sharpen your skills prior to beginning this assignment. Brian Foster Chest Pain Shadow Health Assessment

    Optimize your listening experience by using headphones with your computer and listen to both normal and abnormal sounds multiple times to improve your proficiency with recognizing subtle differences.

    Often patients present with a specific complaint or problem. However, during the history and physical examination, a new problem may be discovered that takes precedence during the visit. Be alert to such a situation with this case study assignment.

    Are you looking for a 100% score?

    WE ARE THE SHADOW HEALTH EXPERTS, LET’S HELP YOU HANDLE YOUR
    ASSESSMENT

    Chat us on the right bottom corner below to order

    Purposes

    The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge.  Brian Foster Chest Pain Shadow Health Assessment.

     

     

    Subjective Data Collection: 30 of 30 (100.0%)

    Hover To Reveal…

    Hover over the 
    Patient Data
     items below to reveal important information, including 
    Pro Tips
     and 
    Example Questions
    .

    Found:

    Indicates an item that you found.

    Available:

    Indicates an item that is available to be found.

    Category

    Scored Items

    Experts selected these topics as essential components of a strong, thorough interview with this patient.

    Patient Data

    Not Scored

    A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

    Chief Complaint

    Finding:

    Established chief complaint

    Finding:

    Reports sporadic chest pain

    (Found)

    Pro Tip: Chest pain can be a sign of many health problems, some serious and some less serious. It is important to follow up with discovery of chest pain by asking about its characteristics and severity. Brian Foster Chest Pain Shadow Health Assessment.

    Example Question:

    Do you have chest pain?

    History of Present Illness

    Finding:

    Asked about onset of pain

    Finding:

    Reports chest pain started appearing in the past month

    (Found)

    Pro Tip: Establishing the onset of a patient’s pain is essential in diagnosing its severity as well as the comfort of the patient.

    Example Question:

    When did your chest pain start?

    Finding:

    Asked about location of pain

    Finding:

    Reports pain is in center of the chest

    (Found)

    Pro Tip: Identifying the location of a patient’s pain is essential in determining which body systems are affected, the underlying cause of the pain, and how best to treat it. Brian Foster Chest Pain Shadow Health Assessment.

    Example Question:

    Where is the pain?

    Finding:

    Reports pain does not radiate

    (Found)

    Pro Tip: Pain radiation is an important symptom that can be helpful in understanding the cause of pain and narrowing the diagnosis.

    Example Question:

    Does the pain radiate?

    Finding:

    Denies arm pain

    (Found)

    Pro Tip: When combined with chest pain, arm pain can be a telling sign that the complaint may be cardiac in nature.

    Example Question:

    Are you experiencing arm pain?

    Finding:

    Denies shoulder pain

    (Found)

    Pro Tip: When combined with chest pain, shoulder pain can be a telling sign that the complaint may be cardiac in nature.

    Example Question:

    Are you experiencing shoulder pain?

    Finding:

    Denies back pain

    (Found)

    Pro Tip: When combined with chest pain, back pain can be a telling sign that the complaint may be cardiac in nature.

    Example Question:

    Are you experiencing back pain?

    Finding:

    Denies neck pain

    (Found)

    Pro Tip: When combined with chest pain, neck pain can be a telling sign that the complaint may be cardiac in nature.

    Example Question:

    Are you experiencing neck pain?

    Finding:

    Asked about duration of pain episodes

    Finding:

    Reports each episode lasted “several” minutes

    (Found)

    Pro Tip: Knowing the duration of a patient’s pain gives you a more complete picture of its severity and potential impact on the patient’s health.

    Example Question:

    How long does your chest pain last?

    Finding:

    Asked about frequency of pain

    Finding:

    Reports 3 episodes in past month

    (Found)

    Pro Tip: Establishing a timeline for a patient’s symptoms can help you to better diagnose his condition and most effectively treat him.

    Example Question:

    How many times in the last month have you had chest pain?

    Finding:

    Reports that episodes did not seem related

    (Available)

    Pro Tip: Asking your patient if the episodes seem associated can point to possible factors that aggravate the episodes or trigger symptoms, and can help narrow your diagnosis. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    Did the episodes seem associated?

    WE ARE THE SHADOW HEALTH EXPERTS, LET’S HELP YOU HANDLE YOUR 
    ASSESSMENT

    Chat us on the right bottom corner below to order

    Finding:

    Asked about severity of pain

    Finding:

    Reports current pain is 0 out of 10

    (Found)

    Pro Tip: For many patients, it is difficult to clearly describe pain. Asking Brian to rate his pain on a scale from 0 to 10 develops a consistent measure of pain severity.

    Example Question:

    How would you rate your pain on a scale of zero to ten?

    Finding:

    Reports pain severity at its worst is 5 out of 10

    (Found)

    Pro Tip: For many patients, it is difficult to clearly describe pain. Asking Brian to rate his pain at its worst gives a clearer picture of the pain’s severity.

    Example Question:

    How would you rate your pain on a scale of zero to ten?

    Finding:

    Asked about character of pain

    Finding:

    Describes pain as tight and uncomfortable

    (Found)

    Pro Tip: Asking Brian to describe his pain helps identify the cause and the severity of his discomfort. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning.

    Example Question:

    Can you describe your pain?

    Finding:

    Denies crushing pain

    (Found)

    Pro Tip: Asking Brian to describe his pain helps identify the cause and the severity of his discomfort. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning.

    Example Question:

    Is the pain crushing?

    Finding:

    Denies gnawing pain

    (Found)

    Pro Tip: Asking Brian to describe his pain helps identify the cause and the severity of his discomfort. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    Is the pain gnawing?

    Finding:

    Denies burning pain

    (Found)

    Pro Tip: Asking Brian to describe his pain helps identify the cause and the severity of his discomfort. Patients may not know how to answer, so you may need to suggest words like sharp, dull, crushing, gnawing, or burning.

    Example Question:

    Is the pain burning?

    Finding:

    Asked about aggravating factors

    Finding:

    Reports pain is aggravated by activity

    (Found)

    Pro Tip: Aggravating factors reveal further information about the nature of the pain and the body systems affected.

    Example Question:

    What makes the pain worse?

    Finding:

    Pain occurred with yard work and taking stairs

    (Found)

    Pro Tip: Determining the activity that may have caused the patient’s complaint is crucial because it may reveal the root cause of the complaint.

    Example Question:

    What activity triggered the pain?

    Finding:

    Pain does not worsen with eating

    (Available)

    Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.

    Example Question:

    Is the pain worse when you eat?

    Finding:

    Pain does not worsen after spicy foods

    (Available)

    Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.

    Example Question:

    Is the pain worse after you eat spicy food?

    Finding:

    Pain does not worsen after high-fat foods

    (Found)

    Pro Tip: It is important to ask about the patient’s diet and its impact on his complaint because cardiac complaints and gastrointestinal pain can be very similar and are frequently conflated. Ruling out one or the other can assist your diagnosis.

    Example Question:

    Is the pain worse after you eat high-fat foods?

    Finding:

    Asked about relieving factors

    Finding:

    Reports pain relief with brief period of rest

    (Found)

    Pro Tip: It’s important to assess the nature of pain by asking about relief. Relieving factors can help narrow the body system and assist in a more accurate diagnosis. Brian Foster Chest Pain Shadow Health Assessment.

    Example Question:

    What relieves your pain?

    Finding:

    Reports no medication to treat chest pain

    (Found)

    Pro Tip: It’s important to assess the nature of pain by asking about relief. Discovering any pain medication Brian takes can help you assess the nature and severity of his pain and avoid any unwanted medication interactions. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    Did you take anything for the chest pain?

    Medical History

    Finding:

    Confirmed use of medications

    Finding:

    Confirms medications

    (Found)

    Pro Tip: Determining what, if any, medications a patient is taking is a crucial element of a thorough health history and will help you avoid unwanted drug interactions.

    Example Question:

    What medications do you take?

    Finding:

    Reports taking hypertension medication

    (Found)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

    Example Question:

    Do you take medication for hypertension?

    Finding:

    Reports taking hyperlipidemia medication

    (Found)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

    Example Question:

    Do you take medication for hyperlipidemia?

    Finding:

    Reports occasional ibuprofen use

    (Available)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

    Example Question:

    Do you take over the counter medications?

    Finding:

    Reports taking fish oil

    (Found)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication or supplements will help you to treat your patient.

    Example Question:

    Do you take any supplements?

    Finding:

    Denies aspirin regimen

    (Available)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication will help you to treat your patient.

    Example Question:

    Do you take aspirin?

    Finding:

    Followed up on hypertension treatment

    Finding:

    Medication is Lopressor

    (Found)

    Pro Tip: Discovering which specific medications a patient takes helps you assess his health conditions, effectiveness of treatment, and guards against unwanted medication interactions.

    Example Question:

    What medication do you take for hypertension?

    Finding:

    Lopressor dose is 100mg

    (Found)

    Pro Tip: The current dose of any patient’s prescription medications is important to learn about because it provides useful information about the patient’s treatment plan as well as potential medication interactions.

    Example Question:

    What dose of medication do you take for hypertension?

    Finding:

    Takes Lopressor once daily

    (Found)

    Pro Tip: The frequency with which a patient takes his medications is an essential element of the complete picture of his medication treatment plan. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    How frequently do you take medication for hypertension?

    Finding:

    Followed up on hyperlipidemia treatment

    Finding:

    Medication is Lipitor

    (Found)

    Pro Tip: Discovering which specific medications a patient takes helps you assess his health conditions, effectiveness of treatment, and guards against unwanted medication interactions. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    What medication do you take for hyperlipidemia?

    Finding:

    Lipitor dose is 20mg

    (Found)

    Pro Tip: The current dose of any patient’s prescription medications is important to learn about because it provides useful information about the patient’s treatment plan as well as potential medication interactions.

    Example Question:

    What dose of medication do you take for hyperlipidemia?

    Finding:

    Takes Lipitor once daily

    (Found)

    Pro Tip: The frequency with which a patient takes his medications is an essential element of the complete picture of his medication treatment plan.

    Example Question:

    How frequently do you take medication for hyperlipidemia?

    Finding:

    Takes Lipitor at bedtime

    (Available)

    Pro Tip: The medication that a patient takes will indicate any relevant health conditions, their treatment plan, and how well they comply with it. Asking about relevant medication information, like at what time of day Brian takes Lipitor, will help you to treat your patient. Brian Foster Chest Pain Shadow Health Assessment

    Example Question:

    What time of day do you take your lipitor?

    Finding:

    Has taken Lipitor for 1 year

     

     

     

    Objective Data Collection: 30 of 33 (90.91%)

     Correct

     Partially correct

     Incorrect

     Missed

     Inspected face

    1 of 1 point

    Appearance 
    (1/1 point)

     No visible abnormal findings

     Rash or lesion

     Cyanosis

     Pallor

     Redness or flushing

     Evidence of trauma (scar, laceration, or bruising)

     Inspected for jugular venous distension

    1 of 1 point

    Height Of Venous Pressure 
    (1/1 point)

     4 cm or less above the sternal angle

     More than 4 cm above the sternal angle

     Inspected chest

    1 of 1 point

    Symmetry 
    (1/2 point)

     Symmetric

     Asymmetric

    Appearance 
    (1/2 point)

     No visible abnormal findings

     Rash or lesion

     AP diameter abnormal

     Intercostal retraction while breathing

     Excessive use of accessory muscles while breathing

     Pectus excavatum

     Skin growths (freckles or moles)

     Evidence of skin trauma (scar, laceration, or bruising)

     Inspected abdomen

    0.67 of 1 point

     Inspected hands and fingernails

    1 of 1 point

    Right: Appearance 
    (1/4 point)

     No visible abnormal findings

     Redness

     Moles or skin tags

     Masses (warts, cysts, or tumors)

     Freckles, birthmark, or other discoloration

     Excessive dry or flaking skin

     Purpura

     Scarring

     Laceration, lesion, or wound

     Bruising

     Rash

    Right: Nail Changes 
    (1/4 point)

     No visible abnormal findings

     Pallor

     Cyanosis

     Splinter hemorrhages

     Clubbing

    Left: Appearance 
    (1/4 point)

     No visible abnormal findings

     Redness

     Moles or skin tags

     Masses (warts, cysts, or tumors)

     Freckles, birthmark, or other discoloration

     Excessive dry or flaking skin

     Purpura

     Scarring

     Laceration, lesion, or wound

     Bruising

     Rash

    Left: Nail Changes 
    (1/4 point)

     No visible abnormal findings

     Pallor

     Cyanosis

     Splinter hemorrhages

     Clubbing

     Inspected lower extremities and toenails

    1 of 1 point

     Inspect lower extremities for edema

    1 of 1 point

     Tested capillary refill time

    1 of 1 point

    Education & Empathy 
    : 5 of 6 (83.3%)

    During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A 
    Model Statement
     is provided as an example of an appropriate response to each opportunity.

    Opportunities marked as 
    Not Encountered
     are opportunities that were not elicited in the interview

    Opportunities marked as 
    Not Followed Up
     are missed opportunities that were present in the interview, but where no statements were made

    Brian Foster Chest Pain Shadow Health Assessment

    Opportunities marked as 
    Followed Up
    were followed up by students, and include the dialogue between student and patient Brian Foster Chest Pain Shadow Health Assessment

     1 Symptoms

    Followed Up

     2 Hypertension and High Cholesterol

    Followed Up

     3 Exercise

    Followed Up

     4 Diet

    Followed Up

     5 Weight Gain

    Not Encountered

     6 Family History

    Followed Up

    Documentation / Electronic Health Record

    Document: Vitals

    Vitals

    Blood Pressure

    Left Arm BP 146/88; Right Arm BP 146/90

    O2 Sat

    98%

    Pulse

    104 BPM

    Resp. Rate

    19

    Temperature

    36.7C

    Document: Provider Notes

    T

    The patient reports to the clinic because of chest pains xxxxx. He reports experiencing xxxxx. He describes the chest pain xxxxx. . He denies heartburn xxxx

    Return to Canvas to complete your SOAP note for this assignment.

    Objective

    General Survey:

    Respiratory: Breathing is xxx.

    Gatrointestital: Round, xx. No xxxx. Tymphanic throughout. xxx palpable xxxx. Neuro: Alert and oriented. xxxx all extremities. Skin: Warm, pink, xxx tenting. EKG: Regular

    Return to Canvas to complete your SOAP note for this assignment.

    Assessment

    Diagnosis; 1. Angina basal pectori xxx

    Self-Reflection
    Activity Time: 8 min

    Explain the clinical reasoning behind your decisions and tasks.

    Student Response:
    xxxthe xxx

    Explicitly describe the tasks you undertook to complete this exam.

    Student Response: xx
     used xxx

    What data did you use to base your decisions on for this patient assessment?

    Brian Foster Chest Pain Shadow Health Assessment

  • Client-Centered Communication and Collaboration- The Case of Mrs. G

    Client-Centered Communication and Collaboration- The Case of Mrs. G

    The case study involves a 75-year-old widow called Mrs. G who is going through feelings of individuality and loneliness, deteriorating health status and aging. Her children are resolute about keeping her safe and ensuring that she receives the best care. It is for this reason that they initiated a conversation with Mrs. G about going to an assisted living facility. Mrs. G is against not only the idea but also gets upset that her children believe that she should go out of her home where she has lived with her husband for 50 years…

    In this written assignment, you have the opportunity to share your thoughts about how to deliver client-centered culturally competent care and work collaboratively with others. Client-Centered Communication and Collaboration- The Case of Mrs. G.

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    The Case of Mrs. G.

    Mrs. G. is a 75 year old Hispanic woman who has been relatively well all of her life. She had been married for 50 years and had five children. Her children are grown with families of their own. All but one of her children live in other states. Mrs. G.’s husband passed away last year, which was devastating for her. She had been very close to him and relied upon him for everything. He was ”the life of the party” she always said and was a loving and caring man. Since his passing, Mrs. G. has continued to live in the house they shared for 35 years. In the last month, Mrs. G. has fallen twice sustaining injuries, though minimal. Her home health nurse comes weekly to check in on her. Mrs. G. likes her very much and wishes she could come more often. Mrs. G.’s daughter who lives in the next town over, has been worried and decided with the urging of her siblings and the doctor to start looking for an assisted living facility for her mother. She found one last week and talked with the Director who said she would be happy to help in whatever way was best. The daughter decided to tell her mother that it was time for her to move, so she can be cared for and be safe. When she told her mother, Mrs. G. cried and said, ”This will not happen ever. I plan to stay in this house of loving memories for the remainder of my life.” Client-Centered Communication and Collaboration- The Case of Mrs. G

    In 3 – 4 pages answer the following questions:

    1.)How would you best describe Mrs. G.’s feelings about her life, her family, her traditions, and her future?

    2.)Did Mrs. G.’s response to her daughter surprise you? Please explain your answer.

    3.)In what way do you believe her culture might be influencing her decision?

    4.)If you were Mrs. G.’s daughter what would you say to her that shows you are caring and have compassion for her situation? What nonverbal communication would support that level of communication?

    5.)Suppose Mrs. G. stands firm about not leaving her house. What resources and collaborations might be available and helpful so the daughter and other healthcare providers can keep her mother safe and make the most effective decision? Client-Centered Communication and Collaboration- The Case of Mrs. G

     

    Overview

    The case study involves a 75-year-old widow called Mrs. G who is going through feelings of individuality and loneliness, deteriorating health status and aging. Her children are resolute about keeping her safe and ensuring that she receives the best care. It is for this reason that they initiated a conversation with Mrs. G about going to an assisted living facility. Mrs. G is against not only the idea but also gets upset that her children believe that she should go out of her home where she has lived with her husband for 50 years.

    How Mrs. G Feels About Her Life, Family, Traditions, and Future

    Mrs. G strongly values family including people she is not related to by blood such as church leaders and immediate community members. Her interest in family surpasses her interest to the extent that she values her husband and children more than she values herself. Besides, she valued the impact she had on her children’s future lifestyle. Rather than having a personality of her own, she integrated with the family’s cultural practices and structure. She respected her husband who was the head of the family unit and had the family authority. Client-Centered Communication and Collaboration- The Case of Mrs. G. It is for this reason that Mrs. G was still grieving the loss of her husband, a situation that can be emotionally devastating.

    According to the traditions of Hispanics, children are expected to relate closely with family and take responsibility for their care when they grow old. The suggestion to go to an assisted living facility is not common in their culture since when parents grow old, children opt to live with their parents or parents usually move in to live with their children. Mrs. G is also influenced by her religious and spiritual beliefs on well-being and illness. According to the Hispanic culture, good health is a reward from God while illness is a punishment for a wrongdoing. It is for this reason that she feels she has done something wrong. Client-Centered Communication and Collaboration- The Case of Mrs. G

    Mrs. G’s Response

    There are mixed reputations about the ability of assisted living facilities to care for elderly people. In most cases, incidences of maltreatment and negligence tend to overshadow the best outcomes and positive tales of those living in assisted living facilities. In this case, Mrs. Gs’ response to her daughter’s suggestion of moving to an assisted living facility with a lot of unwillingness and resentment. Client-Centered Communication and Collaboration- The Case of Mrs. G.  Her response is linked to several reasons. She strongly feels that leaving a home she has spent more than 35 years with her husband will feel like totally losing him. The house brings memories she cherished and shared with her husband. Therefore, even in his physical absence, she still feels his presence.

    Besides, Mrs. G is determined to maintain her independence and adapt to living without her husband. However, she feels that going to an assisted living facility takes away that independence.  Lastly, most seniors think that they are forgotten when taken in an assisted living facility. The majority of those who reside in assisted living facilities involuntarily believe that their care is transferred to other people other than their children who should take responsibility for their care. Therefore, concerning the devastating events that occurred in her life, her reaction to her daughter’s suggestion was not surprising. Client-Centered Communication and Collaboration- The Case of Mrs. G

    How Culture Influences Her Decision

    Mrs. G’s culture probably has a great influence on her decision to continue residing in her house rather than moving to an assisted living facility as proposed by her daughters. The Latino culture values family and that is why Mrs. G feels that she should continue living in her house where she spent most of the time with her husband and children and that her daughters should take responsibility for her care. However, it is also evident that Mrs. G openly welcomes a home nurse who checks and cares for her every week. This means that Mrs. G is determined and willing to allow more frequent care visits than she currently receives. Her willingness to let someone else take care of her illustrates multiculturalism where she has adjusted to the culture of the nation that she currently resides (Catalano, 2015). It is essential to hold on to their culture and personal beliefs although philosophies and values might fail to align with individual views, which increases the complexity of care. Client-Centered Communication and Collaboration- The Case of Mrs. G

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    Communicating With Mrs. G

    A meaningful conversation with Mrs. G requires less aggressiveness from her daughter. Instead, she should be more personal so that Mrs. G does not feel sad and angry. Her daughter should also communicate her fears about her mother’s deteriorating health status and general mental status to help Mrs. G understand her idea of going to reside in an assisted living facility. When communicating, her daughter should express care and compassion by using positive facial expressions, maintain eye contact when talking to her mother, give light touches of reassurance, and love (Campinha-Bacote, 2011) Client-Centered Communication and Collaboration- The Case of Mrs. G. This is the only way Mrs. G will discover that her idea is respectful, mindful and meaningful.

    Resources and Collaborations

    There are wide ranges of resources that can ensure the safety of Mrs. G based on her choice. These resources include meals delivered at home, senior daycares, personal chore and care services, and transport services. Based on the information provided regarding Mrs. G’s preferences, she would benefit a lot from frequent home health services. Home health services will ensure that Mrs. G gets a daytime caregiver. At night when there is no one around, the use of a fall alert device may be considered. Should Mrs. G’s situation worsen, it will be necessary to consider a 24-hour home care service. Client-Centered Communication and Collaboration- The Case of Mrs. G

     

    References

    Catalano, Joseph T. (2015).
    Nursing Now! Today’s Issues, Tomorrow’s Trends, 7th Edition
    .

    Campinha-Bacote, J. (2011). Delivering Patient-Centered Care amid a Cultural Conflict: The Role of Cultural Competence.
    OJIN: The Online Journal of Issues in Nursing,

    16
    (2), 5th ser. doi:10.3912/OJIN.Vol16No02Man05 Client-Centered Communication and Collaboration- The Case of Mrs. G

  • Brian Foster Shadow Health Assessment

    Shadow Health Assessment Assignment

    You will complete all assessment assignments using the 
    Shadow Health
      virtual reality simulation platform.

    Introduction and Pre-brief

    This assignment provides the opportunity to conduct a focused exam on Brian Foster, who presents with recent episodes of chest pain in a non-emergency setting. Interview Mr. Foster and be sure to thoroughly assess the cardiovascular system as well as related body systems in order to compile a list of differential diagnoses. This case study offers you the opportunity to evaluate Mr. Foster’s personal and family history with heart disease and identify lifestyle risk factors. During the physical examination, thoroughly examine the cardiovascular system and carefully evaluate and document the patient’s heart sounds.

    WE ARE THE SHADOW HEALTH EXPERTS, LET’S HELP YOU HANDLE YOUR 
    ASSESSMENT

    Chat us on the right bottom corner below to order

    Tips and Tricks

    The sounds in the Shadow Health Concept Labs and Physical Assessment Assignments are medically accurate.

    Distinguishing normal from abnormal heart sounds requires practice and carefully listening for sometimes subtle and easily missed sounds. Be sure to take advantage of the Cardiovascular Concept Lab to sharpen your skills prior to beginning this assignment. Brian Foster Shadow Health Assessment.

    Optimize your listening experience by using headphones with your computer and listen to both normal and abnormal sounds multiple times to improve your proficiency with recognizing subtle differences.

    Often patients present with a specific complaint or problem. However, during the history and physical examination, a new problem may be discovered that takes precedence during the visit. Be alert to such a situation with this case study assignment.

    Purposes

    The purposes of the Shadow Health Physical Assessment Assignments are to: (a) increase knowledge and understanding of advanced practice physical assessment skills and techniques, (b) conduct focused and comprehensive histories and physical assessments for various patient populations, (c) adapt or modify your physical assessment skills and techniques to suit the individual needs of the patient, (d) apply assessment skills and techniques to gather subjective and objective data, (e) differentiate normal from abnormal physical examination findings, (f) summarize, organize, and appropriately document findings using correct professional terminology, (g) practice developing primary and differential diagnoses, (h) practice creating treatment plans which include diagnostics, medication, education, consultation/referral, and follow-up planning; and (i) analyze and reflect on own performance to gain insight and foster knowledge.

    Due Date

    Sunday 11:59 PM MT
     at the end of 
    each respective week.

    Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Brian Foster Shadow Health Assessment.

    In the event of an emergency that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending.

    Total Points Possible: 75 Points

    Assignment

    Step One: Complete the designated Shadow Health (SH) Assignment on the SH platform.

    Step Two: Document your findings on the  
    Fillable Soap Note Template
     or the 
    Printable Soap Note
    .

    Step Three:  Upload the Lab Pass and completed SOAP Note as separate documents to the same assignment tab in the gradebook.

    Requirements

    NOTE: Before initiating any activity in Shadow Health, complete the required course weekly 
    readings and lessons
     as well as review the 
    introduction and pre-brief.

    Complete the Shadow Health Concept Lab (Weeks 2, 4, and 5) prior to beginning the graded assignment.

    Gather subjective and objective data by completing a focused, detailed health history and physical examination for each physical assessment assignment.

    Critically appraise the findings as normal or abnormal.

    Complete the post activity assessment questions for each assignment .

    Complete all reflection questions following each physical assessment assignment. Brian Foster Shadow Health Assessment.

    Digital Clinical Experience (DCE) scores do not round up. For example, a DCE score of 92.99 is a 92, not a 93.

    You have a maximum of two (2) attempts per Shadow Health assignment to improve your performance. However, you may elect not to repeat any assignment. NOTE: If you repeat an attempt, ONLY the second attempt will be graded, regardless of the DCE score. Please refer to the grading rubric categories for details.

    Download the Lab Pass for the final attempt on the assignment. Brian Foster Shadow Health Assessment.

    On the Canvas Platform:

    Summarize, organize, and appropriately document findings using correct professional terminology on the SOAP Note Template.

    Identify three (3) differential diagnoses and provide ICD-10 codes and pertinent positive and negative findings for each diagnosis.

    Create a comprehensive treatment plan for each assignment. Must address the following components: Diagnostics, Medication, Education, Referral/Consultation, and Follow-up planning. If no interventions for one or more component, document “none at this time” but do not skip over the component.

    Provide rationales and citations for diagnoses and interventions. Brian Foster Shadow Health Assessment.

    Include at least one scholarly source to support diagnoses and treatment interventions with rationales and references on the SOAP note. Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality. Each student is responsible for determining the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.

    Upload the Lab Pass to the appropriate assignment area in Canvas Grades Brian Foster Shadow Health Assessment.

     

    Shadow Health Grading Rubric

    Portions of the rubric are designated with a ***. The following explains those portions of the rubric:

    * 
    Digital Clinical Experience (DCE) Score 
    is automatically translated by Shadow Health based on individual student performance and reflects how student work compares to their peer learners across the country for a particular assignment. The DCE Score is a fair assessment of effort, and therefore is appropriate for use when grading assignments.

    **Scholarly Sources: 
    Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are 
    NOT
     considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality. Each student is responsible for determining the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.

    ***
    Components of a treatment plan include 
    diagnostics
    , 
    medication
    , 
    education
    , 
    consultation/referral
    , and 
    follow-up planning

    ****Insight
     refers to the capacity to gain an accurate and deep intuitive understanding of a concept or thing. For example, one might demonstrate insight by relating a concept to a personal or meaningful experience.

    ASSIGNMENT CONTENT

    Category

    Points

    %

    Description

    Health History Communication, Education, Empathy, and Summary

    (DCE Score
     
    or transcript)

     

    15

    20%

    The Digital Clinical Experience (DCE)Score is automatically translates by Shadow Health based on individual student performance and reflects how student work with data collection, health history communication, education, empathy, and summarization compares to peer learners across the country for a particular assignment. The DCE Score is a fair assessment of effort, and therefore is appropriate for use when grading assignments. Occasionally, performance transcripts may be reviewed for secondary support.

    Assessment, Documentation, Treatment Plan, and Scholarly Sources

    35

    47%

    This category is evaluated on the quality of student’s ability to: Identify pertinent normal and abnormal findings for the assignment, utilize professional terminology, provide comprehensive and detailed subjective and objective findings, identify differential diagnoses, and create a comprehensive treatment plan. Includeat least one appropriate EBP scholarly source and use the SOAP Note format template to document all findings.

     

    Self-Reflection

    15

    20%

    Self-reflection posts must demonstrate the student’s own perspective. The quality of this criterion is based upon responding to all the reflection questions; providing responses that are substantive (add importance, meaningfulness, and relevance to the post); demonstrate analysis of own performance; and demonstrate insight. Brian Foster Shadow Health Assessment. Insight refers to the capacity to gain an accurate and deep intuitive understanding of a concept or thing. For example, one might demonstrate insight by relating a concept to a personal or meaningful experience.Reflection post responses should vary from SH assignment to assignment.

     

    65

    87%

    Total CONTENT Points= 65

    ASSIGNMENT FORMAT

    Category

    Points

    %

    Description

    Grammar, Spelling, Syntax, Mechanics and APA Format

    10

    13%

    Reflection post has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post.

    * APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

    **Direct quote should not to exceed 15 words & must add substantively to the assignment

    10

    100%

    Total FORMAT Points= 10

    ASSIGNMENT TOTAL=
     
    75 points

    Rubric

    NR509 Weeks 2-6 Shadow Health Assignment_Sept19 (3)

    NR509 Weeks 2-6 Shadow Health Assignment_Sept19 (3)

    Criteria

    Ratings

    Pts

    This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 65 Points

    Criterion 1

    Health History Communication, Education, Empathy, and Summary

    (DCE Score or Transcript)

    15.0 pts

    Excellent

    DCE Score > 93

    14.0 pts

    V. Good

    DCE Score 86-92

    12.0 pts

    Satisfactory

    DCE Score 80-85

    8.0 pts

    Needs Improvement

    DCE Score < 79 0.0 pts Unsatisfactory No Assignment 15.0 pts This criterion is linked to a Learning OutcomeCriterion 2 Assessment, Documentation, Treatment Plan, and Scholarly Sources Must demonstrate the following elements: Brian Foster Shadow Health Assessment Identified all pertinent normal and abnormal findings; Used professional terminology; Subjective and objective documentation was detailed and comprehensive; Used the SOAP Note Format template for documentation; Identified three (3) differential diagnoses with ICD-10 codes and pertinent positive/negative findings; Addressed each of the following on the treatment plan: Diagnostics, Medication, Education, Referral/Consultation, and Follow-up Planning; Interventions are detailed and appropriate for the focused assignment; Provided at least one appropriate EBP scholar source (8 Required Elements) 35.0 pts Excellent Demonstrated all elements for this Criterion 32.0 pts V. Good Missing 1 element for this Criterion 29.0 pts Satisfactory Missing 2 or 3 elements for this Criterion 18.0 pts Needs Improvement Missing 4 or 5 elements on for this Criterion 0.0 pts Unsatisfactory Missing 6 or more elements for the criterion Or No Assignment 35.0 pts This criterion is linked to a Learning OutcomeCriterion 3 Self-Reflection Must demonstrate the following elements: Written from the student’s own perspective; Responded to all the reflection questions; Responses were each substantive (added importance, meaningfulness, and relevance to the post); Offer self-analysis of performance and insight; Reflection post responses should vary from SH assignment to assignment. (5 Required Elements) 15.0 pts Excellent Demonstrated all elements for this Criterion 14.0 pts V. Good Missing 1 element for this Criterion 12.0 pts Satisfactory Missing 2 elements for this Criterion 8.0 pts Needs Improvement Missing 3 elements for this Criterion 0.0 pts Unsatisfactory Missing 4 or more elements for the criterion Or No Assignment 15.0 pts This criterion is linked to a Learning OutcomeAssignment Format Possible Points = 10 Points Format Criterion 1 Grammar, Spelling, Syntax, Mechanics and APA Format 10.0 pts Excellent 0-1 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format 9.0 pts V. Good 2-3 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format Brian Foster Shadow Health Assessment 8.0 pts Satisfactory 4-5 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format 5.0 pts Needs Improvement 6-7 errors in grammar, syntax, spelling, punctuation, mechanics, or APA format 0.0 pts Unsatisfactory 8 or more errors in grammar, syntax, spelling, punctuation, mechanics, or APA format Or No assignment 10.0 pts This criterion is linked to a Learning OutcomeLate Penalty Deductions Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy. 0.0 pts Minus Points 0.0 pts Minus Points 0.0 pts Total Points: 75.0 Brian Foster Shadow Health Assessment