Tag: Clinical-Nursing

NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

Topic 2 DQ 1

Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Child abuse can occur in different forms, such as physical or emotional. Whenever such abuse occurs, it leaves the child emotionally disturbed. It takes the intervention of a professional for the child to get back to their normal self. School-age children are prone to the two types of child abuse. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child. The abuse could range from mistreatment to sexual abuse. Regardless of the type of abuse the child is subjected to, it can have a great emotional impact on their lives.

Among the emotional signs of an abused child is social withdrawal, delayed emotional development, and low self-esteem. The child could also avoid a situation that used to be fun for them. For instance, if the child is no longer excited about going to school or hanging out with friends, it could indicate abuse. The physical warning signs that the nurse can identify is the poor growth rate and injury marks on the child’s body. If the child is not willing to talk about their emotions with the nurse, it could indicate abuse (Hoft & Haddad, 2017).

One of the cultural practices that might seem to be a form of child abuse is circumcision without the use of anesthesia. The practice is carried out to show the child’s strength and perseverance. Failure to cry during the process indicates how strong the child would be in the future. Crying is a sign of weakness. If the nurse notices any signs of abuse, they should notify a physician as soon as possible. The examination should also be carried out in the absence of the suspected victim. Such would allow the child to express their feelings without the fear of being victimized. Once abuse has been proven, the child is given the necessary help.

 Reference

Hoft, M., & Haddad, L. (2017). Screening children for abuse and neglect: a review of the literature. 
Journal of forensic nursing
, 
13
(1), 26-34. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

 

 

Objectives:

Demonstrate clinical reasoning in conducting a child health assessment.

Apply Erikson’s stages of child development to health assessment.

Examine factors that increase the vulnerability of a child.

Compare the physical assessment of a child to that of an adult.

 

The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.

Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.

Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

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.

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

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

Topic 2 DQ 1

 
NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

Topic 2 DQ 2

 

Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.

“Health assessment of young and middle-aged adults extends beyond physical examination. The nurse uses a holistic outlook with consideration for mental, physical, emotional, and spiritual aspects of the individuals” (Falkner, 2018). An adult would receive a head to toe assessment and may receive a more focused cardiac or respiratory assessment. The adult would be asked about medical history and current medications being taken. With an adult you could speak more plainly than you can with a child. You may need to give examples or comparisons to a child. You should still instruct the patient as to what you are doing during the assessment. You could also give the adult patient handouts to learn more about their assessment. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

A child assessment would be done differently than an adult. The child more than likely would be more apprehensive than an adult. Before the assessment started the nurse should interact with the child’s parent that way the child would be more apt to interact with the nurse and this would also begin a trusting rapport. The nurse should get eye level with the child and explain in terms the child can understand while the nurse is explaining what is being done. The nurse would start with less invasive assessments first. The parent may hold the child during the assessment. The nurse may have to ask the parent instead of the child about some of the problems the child may be having. Another thing the nurse would do is let the child see the equipment before using it. Before I take a temporal temperature on a child, I run the thermometer over my forehead first. This lets the child know what I’m about to do to them and that it doesn’t hurt. I tell the child what I’m doing every step of the way. I reassure them and speak kindly to them.

In both assessments, I would inform the patient as to what part of the assessment would be performed next. I would ask questions (if possible) to both of the patients as well. I would be compassionate and attentive while the patient spoke and these strategies would encourage engagement. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

References

Falkner, A. (2018). Adult Health Assessment. 
In Health assessment: Foundations for effective practice
. Retrieved from 
https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/4

NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

Discussion: Organizational Policies and Practices to Support Healthcare Issues

The cost of healthcare in the US has continued to elicit concerns and debates towards healthcare system reforms. The ensuing debates have culminated into unanimity for an affordable and quality healthcare system. The realization of policy reforms towards this direction is a lengthy and complex process characterized by competing demands that require careful consideration due to subverting influence they may have on the policy process.  Oliver (2006) terms policy processes as being political, characterized by power, control, and influence which determine the translation of evidence-based solutions into policy actions. As the process involves multiple stakeholders, multiple interests come into play. Based on how they are affected, they will exert influence and power in support of or against the policy which could ultimately result in abandonment of a policy or its fast-tracking. Political institutions also play a crucial role Discussion: Organizational Policies and Practices to Support Healthcare Issues. When there is political good will from federal and state governments, policy development process gunner support and is faster. Further, the financial affordability of a policy determines its potential to sail through as it involves fiscal ability of government to take additional responsibilities (Oliver, 2006).

A healthcare system is characterized by multiple stakeholders whose interest and power on a policy significantly influence policy development process and outcome. Patients are keen on accessing affordable quality healthcare services while hospitals, care providers, pharmaceuticals, and drug manufacturers struggle to balance between offering the best care at affordable costs while meeting their business interests. Balancing such needs put policy developers at a dilemma. The Affordable Care Act for instance has elicited different reactions from different stakeholders depending on who benefits and who loses. Among the critics has been the insurance industry whose business has been severely affected with 37.9% decline in their application for Medicaid and Medicare Services enrollment. Discussion: Organizational Policies and Practices to Support Healthcare Issues. Some have had to close their businesses while others have had to opt for mergers. This has created an uncompetitive environment resulting in increased premium rates not favorable for patients (Patterson, 2018). On the other hand, are the pharmaceutical manufacturers that have been blamed for increasing costs of healthcare costs. Campbell (2019), noted that prescription drugs in US costed 56% less in developed countries resulting in 8% of Americans attaining their drugs from Canada while others have had to cut on their prescriptions which have been fatal. To address these concerns, a single-payer system is proposed which will replace private insurers as well as promote price negotiations with drug manufacturers reducing cost of healthcare and of drugs respectively. According to
Himmelstein
 and 
Woolhandler
(2020), this model would also save doctors the expense and agony of contract negotiations and billing bureaucracies while reducing hospitals’ administrative costs related to billing estimated at $ 401 billion as at 2017. Discussion: Organizational Policies and Practices to Support Healthcare Issues.

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Political institutions are the regulators and administrators of health policies and therefore, alignment of policy reform proposes to political agenda facilitates buy in, ownership and support. For example, the need for value-based care has received unmatched support from US Department of Health and Human Services as well as from five State Governors of Ohio, Nevada, Colorado, Alaska and Pennsylvania and has thus been widely adopted with several strategies towards its implementation developed (Karapiperis, 2018). As proposed, the value-based model offers the current administration opportunity to offer affordable healthcare that is quality-based and aligned to the current price and quality transparency (HHS, 2019). Moreover, it facilitates healthcare organizations to be more cost-effective and affordable hence being more competitive. Discussion: Organizational Policies and Practices to Support Healthcare Issues

Anticipated costs of policy implementation often determine the successful development of a policy. The cost considerations include cost justification against benefits, opportunity costs, and availability of finances. For instance, the current government healthcare expenditure particularly Medicaid and Medicare Services has been heavily criticized. The basis of criticism has been among others increased cost of healthcare expenditure and failure for such investments to translate to better health outcomes, with US healthcare outcomes lagging behind those of comparable countries (Karapiperis, 2018). Shift to single-payer system is anticipated to result in $600 in cost savings (
Himmelstein
 and 
Woolhandler
, 2020).

 

References

Campbell, K. (2019, August 6). 
Trump Administration’s Plan to Lower Healthcare Costs.
 Retrieved from MedPageToday: https://www.medpagetoday.com/blogs/campbells-scoop/81446

HHS. (2019, November 15). 
Trump Administration Announces Historic Price Transparency Requirements to Increase Competition and Lower Healthcare Costs for All Americans.
Retrieved from HHS: https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html Discussion: Organizational Policies and Practices to Support Healthcare Issues

Himmelstein, D., & Woolhandler, S. (2020). Single-Payer Reform: Heed the Evidence, Not the Soothsayers. 
American Journal of Public Health
.

Karapiperis, D. (2018). A Brief Exploration of Rising Health Care Costs. 
The Centre for Insurance Policy and Research
.

Oliver, T. (2006). The Politics of Public Health Policy. 
Annual Review Public Health
, 175-233.

Patterson, L. (2018). The Pricing Impact of Decreasing Competitiveness of the Health Insurance Market. 
University of Tennessee Honors Thesis Projects
. Retrieved from https://trace.tennessee.edu/utk_chanhonoproj/2202

Discussion: Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations. Discussion: Organizational Policies and Practices to Support Healthcare Issues

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

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

To Prepare:

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

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

By Day 3 of Week 3

Post
 an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

By Day 6 of Week 3

Respond
 to at least 
two
 of your colleagues 
on two different days
by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described. Discussion: Organizational Policies and Practices to Support Healthcare Issues

 

I enjoyed reading your post and likewise believe that health care in the United States presents itself as a rather confusing conundrum. On the one hand, you are told you must have insurance of be fined at the end of each year, but on the other hand many individuals say they can’t afford the required payments each month for insurance coverage Discussion: Organizational Policies and Practices to Support Healthcare Issues. So, the question becomes how to provide healthcare for everyone at an equitable rate, but even more so, how do you reach the uninsured? For example, something I see in my daily practice as an ER nurse is uninsured individuals coming into the ER because they couldn’t pay the out-of-pocket cost a primary care physician would charge to see them. These individuals are not denied health care outright, but the offices require all or most of a visit cost upfront for uninsured patients as a way to protect themselves, but oftentimes an individual cannot afford the out-of-pocket expensive of even a routine or simple health care visit. So, they leave the office and drive a few miles to the ER to be seen, the bill is then paid over time or is not paid at all, and ultimately this does not benefit the individual or the health care system. One specific example, my daughter had to see a podiatrist for custom orthotics- normal office visit, meet the doctor, x-ray her feet, make a mold for her feet, go over exercises and stretches for her feet, and then out the door. The breakdown of her medical bill was pretty outlandish I feel like. Discussion: Organizational Policies and Practices to Support Healthcare Issues. Just the billing to her insurance for the visit- none of the casting and x-rays, just the visit to see the podiatrist was $2,500. Yes, $2,500. Now again, insurance will pay the bulk of that fee, but the point is when you broke down the billing cost for each thing the podiatrist charged for, her 1-hour doctor visit equated to over $4,000. We will have to pay a few hundred out of that total, but what if she didn’t have insurance? What then? If a person in uninsured they more than likely do not have the funds for insurance, but may not qualify for Medicare, so how do they receive treatment? Could you afford a $4,000 out-of-pocket office visit for a visit to the podiatrist, and more importantly, even if you could would you want to? I feel like for most people the answer is no (if not to the first question then most certainly the last). So, then what happens? You don’t go to the appointment, you don’t get the custom orthotics, your feet give you more and more problems, maybe you are in pain all of the time, maybe you can’t work because it becomes debilitating, maybe you just can’t do things like run or walk for exercise- things that are good for your body. The point is the way uninsured individuals have to interact with the healthcare system is a problem, and is a relatively silent problem since their voices are often overlooked and not considered- it’s easy to forget and leave out those whom you don’t see receiving medical care.
Discussion: Organizational Policies and Practices to Support Healthcare Issues.

One step in the right direction was President Obama’s Affordable Care Act, which was signed into existence in 2010 right are the peak of the Great Recession (Blumenthal, Abrams, & Nuzum, 2015). The Affordable Care Act sought to lower medical costs for individuals and provided a longer time in which children could be carried on parental insurance, letting many young adults, recent college graduates, and those working their way through various career fields a few additional years to be financially secure and to cover themselves for insurance. Remarkably, in an analysis of the Affordable Care Act Blumenthal, Abrams, and Nuzum (2015) demonstrate the ACA creating a decline in the need for federal funding to cover health-expenditures, specifically demonstrating federal funding for health care at an all-time low “3.2% annually as compared with 5.6% annually over the previous 10 years” (p. 2456). Discussion: Organizational Policies and Practices to Support Healthcare Issues.

Another potential to limit the cost of these visits is to work with more and more remote technologies and to do simple things such as paramedicine and have licensed medical workers go to patients, take bloodwork, conduct a physical, and act as an intermediary for physicians. The technology exists, and costs could be lessened with the use of current medical professionals and expertise, without necessarily accruing a large medical bill for an office visit (Laureate Education Producer, 2012 [Video File]).
 

 

References

Bulmenthal, D,. Abrams, M., & Nuzum, R. (2015). The affordable care act at 5 years.
 
The New
 
   
 
England Journal of Medicare, 372(25), 2451-2458.
 

 
doi:http://dx.doi.org.ezproxy.gardner-webb.edu/10.1056/NEJMhpr1503614

 

Laureate Education (Producer). (2012). Ethical, Moral, and Legal Leadership [Video file].
 

 
Baltimore, MD: Author.
Discussion: Organizational Policies and Practices to Support Healthcare Issues.

NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay

Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse.

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Research indicates that infants under 12 months old are at the most risk for serious physical abuse (Cannel & Holick, 2018). The warning signs for physical abuse in infants include a non-ambulatory infant with any injury; injury inconsistent with the infant’s physical abilities; bruises on the torso, ear, or neck; burns to genitalia; caregiver being unconcerned about the injury; an unexplained delay in seeking care, as well as inconsistencies in histories provided (Cannel & Holick, 2018). NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay Physical assessment findings that may indicate child abuse in infants include bruising in non-ambulatory infants especially in the face, head, or genitals. Retinal hemorrhages and subdural hematomas may be suggestive of abusive head trauma, a form of child abuse with the highest mortality rate (more than 20 percent). Also, fractures such as posterior and lateral rib fractures, sternal, spinal, and scapular fractures in non-ambulatory infants may indicate abuse (Cannel & Holick, 2018) NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay.

Cupping and coining are ancient healing practices still being practiced today, especially by Russian immigrants and Vietnamese Americans, respectively (Killion, 2017). Cupping typically involves applying a heated cup to the back reportedly to draw out the ailment. Cupping leaves circular burns and bruises from the heat and suction effect which can be mistaken for abuse NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay. Coining, on the other hand, involves rubbing the edge of a coin on oiled skin which results in linear patches that may be interpreted as abuse.

Since they are in frequent contact with children, nurses are mandatory reporters under the North Carolina State Law. They must report cases of suspected child abuse or neglect immediately or within 24 hours to the local Department of Social Services (DSS) in the county where the child resides or is found. This should be followed by filling a mandated reporter form online (Kids Place Incorporated, 2013). NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay

 

References

Cannell, J. J., & Holick, M. F. (2018). Multiple unexplained fractures in infants and child physical abuse. 
The Journal of Steroid Biochemistry and Molecular Biology
, 
175
, 18-22.

Kids Place Incorporated. (2013). How to make a child abuse report. https://www.kidsplacecac.org/how-to-make-abuse-report/

Killion, C. M. (2017). Cultural healing practices that mimic child abuse. 
Annals of Forensic Research and Analysis, 4
(2), 1042. NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay

NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Developing Organizational Policies and Practices on Mental health stigmatization

 
The U.S. healthcare system has improved over the years. Technology has dramatically helped improve healthcare systems in many ways. However, the quality of care delivered to patients is still largely dependent on the ability of healthcare professionals to provide adequate care by employing critical thinking, problem-solving skills, and evidence-based approaches. Therefore, when healthcare workers are overwhelmed by the increased workload, increased hours, and mandatory overtime, the ability to provide safe care is depreciated and leads to nurse burnout and a potential danger to patients (Cuff & Forstrag 2019). Burnout among healthcare professionals is now recognized as a problem by many in the healthcare system, hence the addition of a fourth agenda to the “Triple Aim,” which promotes the positive mental health of healthcare providers in the work environment (Fitzpatrick, Bloore, & Blake 2019) NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment. However, not enough research has been done to find evidence-based solutions to address the problem. The lack of sufficient healthcare personnel including nurses, physicians, and other caregivers, as well as the increased workload, hours, and physical, emotional and psychological demands has placed a significant burden on the sparsely available healthcare professionals left caring for a growing number of patients (Costa & Moss, 2018). This paper aims to address the issue of burnout in healthcare systems, identify the competing needs impacting burnout, and evaluate policies that influence staffing and prevent burnout

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Competing Needs Impacting Nurse Burnout

One approach by which healthcare organizations can address burnout is by creating policies that support work-life balance of their staff, promote job satisfaction, improve staffing, and increase nurse retention. However, competing needs and limited resources can potentially create a substantial barrier to implementing any effective policies in decreasing nurse burnout. One of these competing needs is cost. The cost of healthcare delivery for both human and material resources in the United States is a major hindrance to addressing the issue of burnout among healthcare workers and is a major factor contributing to the common practice of understaffing healthcare facilities
 
across the nation (Costa & Moss, 2018). The perceived cost of implementing policies such as mental health time off, appropriate staffing ratios, and employee compensation and appreciation may prevent some organizations from implementing these policies. Therefore, policy proponents need to educate stakeholders on using a cost-benefit analysis of how the implementation of these policies affect cost and revenue in relation to how burnout and high turnover rates also affect cost and revenue. According to Rivas (2018), the estimated cost of nurse burnout related turnover is $14 billion in the U.S. this is money that can be spent in improving the health care delivery system.

The nursing shortage is another competing need that may restrict institutional efforts to address nurse burnout. The introduction of the Affordable Care Act (ACA) has provided millions of Americans with access to healthcare, thus increasing the number of Americans seeking care (Glied, Ma, & Borja, 2017). There has also been an increase in the average life expectancy in the U.S., leaving a growing aged population with chronic conditions needing care (World Health Organization (2020). These are some of the factors that have created a gap between the number of patients needing care and the number of healthcare professionals available to care for them, thus enhancing the nursing shortage. The lack of a standardized staffing ratio is detrimental to the health care system because it leaves organizations to decide policies regarding nurse-patient ratios (Blitchok, 2018).  
Unbalanced staffing ratios increase nurse burnout, which further worsens the unsafe staffing ratios by increasing turnover rates and absenteeism devolving into a repetitive toxic cycle
.
Organizations in these cycles may want to implement policies to address understaffing but find it difficult due to the shortage of nurses to replace nurses who quit or retire.

Policy influencing Nurse Burnout in my Organization

The organization where I work has policies in place to help address nurse burnout. An example of such a policy includes a mandatory break with other nurses as “buddies” to help cover a nurse’s assignments during breaks. This practice helps ensure that nurses can take a 30-minute lunch break and two 15 minutes breaks that can be taken if the unit is not busy. Another policy that could prevent nurse burnout is the use of a matrix for staffing. The matrix helps determine the maximum number of patients that can be assigned to nurses and nursing assistants.

Policy Critique and Ethical Considerations of the Policy

Research has shown that Safe staffing ratios improve patient outcomes and increase patient and staff satisfaction (American Nurses Association, 2019). The use of a staffing matrix at my organization is a policy that guides the nurse-patient matrix. However, there are loopholes that prevent strict adherence to staffing ratios; the matrix is based on the number of patients in the units, and acuity is not considered. Also, the organizational policy allows for a maximum of eight patients to one nurse; however, the matrix only allows for four nurses when the census is 32-35, meaning some nurses end up with nine patients without consideration for new admits that may arrive in the middle of the shift. The matrix also does not account for lack of nursing assistants, so sometimes nurses may end up with eight patients, four of which do not have a nursing assistant assigned to them thereby. Increasing the workload. This policy is lacking ethical standards due to another policy that prevents nursing managers from making discretional decisions based on a given situation. The policy also prevents nurses from questioning their patient assignments, thereby making it difficult for nurses to refuse an unsafe assignment.

Strength of the Policy and Challenges in Promoting Ethic

The strength of this policy is its ability to ensure adequate staffing for this organization, appropriate staffing is one of the most challenging tasks in a healthcare organization, this matrix helps the staffing coordinator plan ahead to ensure a safe staffing ratio. Although policies and procedures are essential and implemented to provide guidance and structure in an organization, the policies should have ongoing evaluation to ensure they do not have adverse effects and that they continue to produce positive outcomes. One challenge in promoting ethical consideration of this policy is the use of a nonclinical staffing coordinator who is unable to make appropriate clinical and ethical decisions relating to staffing problems. Nurses are directly affected by staffing decisions, and their inability to be involved in the decision making regarding staffing and patient care can lead to negative outcomes. Nurses should be involved in making staffing decisions as they have the knowledge to determine ethical issues that may affect staff and patients (Registerednursing.org, 2020).

Policy or Practice Suggestions to Balance Competing Needs of Resources, Workers, and Patients

The healthcare system holds healthcare professionals accountable for the delivery of quality and safe care. Accountability in healthcare is essential to ensure the quality and safety of care and prevent adverse outcomes to patients and the community at large. However, this accountability needs to be inclusive of all aspects of healthcare. In addition to holding healthcare professionals accountable, healthcare organizations and healthcare leaders need to be held to a higher standard of accountability for how healthcare organizations are run. Healthcare organizations need to employ a safety-first culture in how policies are drafted and implemented.

Developing and adhering to safe staffing ratios is an example of employing a safety-first culture. A study by Driscoll et al. (2017), found that safer nurse staffing ratios are associated with a decreased mortality rate in an in-patient hospital.

The ability to balance competing needs and still provide safe care is crucial in health care, healthcare organizations can utilize a policy review committee that involves all stakeholders. For example, staffing decisions should not be made by managers and employers alone. Nurses should also be allowed to voice their concerns and hold their employers accountable for a safe working environment as well as participate in decision making. A study by Kutney-Lee et al. (2016) indicated that engaging nurses in shared decision-making promote positive patient and nursing outcomes; it also improves nurse performance and nurse retention and increases the organization’s profit.

Conclusion

The United States is a nation that values healthcare outcomes and public health, must continue to create an awareness of the emerging trends regarding healthcare personnel shortage and its effect on care delivery and burnout. We must continue to advance our strategies to achieve balanced staffing ratios to prevent burnout in the workforce, decrease the occurrence of adverse events to patients due to this burnout, and promote continuity in the delivery of quality care.

 

 

 

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

 

 

References

American Nurses Association. (2019). Staffing ratios. Retrieved from 
https://www.nursingworld.org/practice-policy/nurse-staffing/

Blitchok, A. (2018). Proposed federal RN ratios- What you can do about it. Retrieved from

https://nurse.org/articles/federal-staffing-ratios/

Costa, D. K. & Moss, M. (2018). The Cost of Caring: Emotion, Burnout, and Psychological Distress in Critical Care Clinicians. 
AnnalsATS Journal 15(7). 787-790.
 Retrieved from 
https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201804-269PS

Cuff, P. & Forstag, E. H. (2019). A Design Thinking, Systems Approach to Well-Being Within Education and Practice: The Importance of Well-Being in the Health Care Workforce. Retrieved from 
https://www.ncbi.nlm.nih.gov/books/NBK540859/

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyoombwe, T., & Astin, F. (2017). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular nursing. Retrieved from

Glied, S. A., Ma, S., & Borja, A. (2017). Effect of the affordable care act on health care access. Retrieved from 
https://www.commonwealthfund.org/publications/issue-briefs/2017/may/effect-affordable-care-act-health-care-access

Kutney-Lee, A., Germack, H., Hatfield, L., Kelly, S., Maguire, P., Dierkes, A., Guidice, D. M., &Aiken. (2016). Nurse Engagement in Shared Governance and Patient and Nurse Outcomes. 
The journal of nursing administration 46
(11). 605-612. Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117656/

Registerednurisnig.org. (2020). Ethical Practice: NCLEX-RN. Retrieved from 
https://www.registerednursing.org/nclex/ethical-practice/

Rivas, R. (2018). Turning the Lever Down on Burnout and Turning up Resilience, Well-being, and Joy (Part 3). Retrieved from 
https://www.healthcareexcellence.org/2018/05/18/turning-lever-down-on-physician-burnout-cost-turnover-burnout/

World Health Organization. (2020). Global Health Observatory (GHO) data. Life expectancy. Retrieved from 
https://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/

 

Assignment: Developing Organizational Policies and Practices

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

To Prepare:

Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.

Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.

Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

By Day 7 of Week 3

Submit your revised paper.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.

Click the 
Week 3 Assignment Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 3 Assignment 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
button to complete your submission. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

NURS_6053_Module02_Week03_Assignment_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

Add a section to the paper you submitted in Module 1. In 4–5 pages, address the following:

·   Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

23 
(23%)
 – 25 
(25%)

The response accurately and clearly identifies at least two competing needs impacting the healthcare issue/stressor selected.

20 
(20%)
 – 22 
(22%)

The response identifies at least two competing needs impacting the healthcare issue/stressor selected.

NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

18 
(18%)
 – 19 
(19%)

The response identifies at least two competing needs impacting the healthcare issue/stressor selected that is vague or inaccurate.

0 
(0%)
 – 17 
(17%)

The response describes at least two competing needs impacting the healthcare issue/stressor selected that is vague and inaccurate, or is missing.

·   Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

·   Critique the policy for ethical considerations and explain the policy’s strengths and challenges in promoting ethics.

27 
(27%)
 – 30 
(30%)

The response accurately and thoroughly describes in detail a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.

The response accurately and thoroughly critiques in detail the policy for ethical considerations and explains in detail the policy’s strengths and challenges in promoting ethics.

24 
(24%)
 – 26 
(26%)

The response accurately describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.

The response accurately critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics.

21 
(21%)
 – 23 
(23%)

The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague or inaccurate.

The response critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics that is vague or inaccurate.

0 
(0%)
 – 20 
(20%)

The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague and inaccurate, or is missing.

The response critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics that is vague and inaccurate, or is missing.

·   Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

·   Cite evidence that informs the healthcare issue/stressor and/or the policies and provide two scholarly resources in support of your policy or practice recommendations.

27 
(27%)
 – 30 
(30%)

The response provide one or more accurate, clear, and thorough recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.

Specific and accurate examples are provided.

Accurate and detailed evidence is cited that informs the healthcare issue/stressor selected and a specific synthesis of at least two outside scholarly resources in full support of the policy or practice recommendations is provided. The response integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the healthcare issue/stressor selected.

24 
(24%)
 – 26 
(26%)

The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.

Specific examples may be provided.

Evidence is cited that informs the healthcare issue/stressor selected and a synthesis of at least one outside scholarly resource that may support the policy or practice recommendations is provided. The response integrates at least 1 outside resource and 2 or 3 course-specific resources that may support the healthcare issue/stressor selected.

21 
(21%)
 – 23 
(23%)

The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague or inaccurate.

Examples may be provided.

Vague or inaccurate evidence is cited from 2 or 3 resources that informs the healthcare issue/stressor selected and may support the policy or practice recommendations provided.

0 
(0%)
 – 20 
(20%)

The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague and inaccurate, or is missing. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Examples are missing.

Vague and inaccurate evidence is cited that informs the healthcare issue/stressor and may include at least 1 scholarly resource that vaguely and inaccurately supports the policy practice recommendations is provided, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 
(5%)
 – 5 
(5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 
(4%)
 – 4 
(4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3.5 
(3.5%)
 – 3.5 
(3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

0 
(0%)
 – 3 
(3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3 or 4) APA format errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6053_Module02_Week03_Assignment_Rubric NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

Analysis of Nurse Burnout in Healthcare

Introduction

Nurses play a vital role in healthcare delivery; nursing education includes a broad scope of practice, which places them as an essential part of the healthcare team with many tasks and responsibilities, including direct patient care. However, this broad scope of education comes with even greater responsibility, including decision-making (Nursing.org, 2020). Although rewarding, nursing comes with lots of stress, and when that stress is not addressed, excessive, continuous, or ignored, it may lead to burnout. Nurse burnout is prevalent in the U.S such that a 2017 study by RN’SRN’S network pustulated that about half the population of nurses working in the U.S. have considered leaving the profession, due to feelings of lack of job satisfaction and being overworked (Nursing.org, 2020). Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue. The purpose of this paper is to describe burnout, its impact in my organization, and strategies to address burnout. It will also include a summary of two articles that discusses burnout and strategies that are being used in other organizations to address burnout.

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Nurse Burnout

Nurse burnout is a state of decreased physiological and psychological energy related to lack of job satisfaction due to being overworked and understaffed. In addition to lack of support, it is often evident by emotional exhaustion, feeling frustrated and poor motivation (Mudallal et al., 2017). Burnout can also be due to increased workloads and demands, long hours, and a lack of flexible schedule (Nursinglicensure.org, 2020). Nursing is a profession at high risk for burnout. It is due to the complex duty to ensure patient safety, the emotional burden in caring for patients, and the demanding and stressful work environment in which they must perform these duties. In addition, the shortage of healthcare workers and increasing demand to increase patient satisfaction scores increased the pressure and rate of burnout amongst nurses. According to Reith (2018), burnout is a major problem in the U.S. healthcare sector. It harms the healthcare delivery system and contributes to the shortage of healthcare workers.

Impact of Burnout in the Organization

The effect of nurse burnout has the capability to impact organizations, including the one where I work negatively. Nurse burnout has the potential to impact patient safety and patient outcomes negatively, it is one of the leading causes of patient safety and quality concerns in the U.S. healthcare system (Nurse.org, 2020). Burnout has generally been found to lead to a high turnover rate and increased absenteeism for nurses. The organization is evidently impacted by nurse burnout. Nurses at this organization have increasingly shown signs of burnout. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue. This is evidenced by frequent absenteeism, refusal to work any days other than assigned shifts, and a high turnover rate, which the constant hiring does not solve due to the repeated cycle. As a relief charge nurse, a meeting was recently held with the Human resources manager and unit managers who wanted to understand the reason why the turnover rate for nurses and nursing aides were that high for a new hospital branch less than one year. The organization also does quality measurement by tracking the number of falls, incident reports, and errors. An upward trend has now been noted over time, which is associated with understaffing and overworked staff.

Summary of Articles Related to Burnout and its Prevention Strategies

Article 1: 

This article titled occupational stress management and burnout interventions in nursing and their implications for healthy work environments
 
is a literature review of articles aimed at analyzing workplace interventions associated with providing a healthy work environment and improving the quality of work-life for nurses. The study by Nowrouzi et al. (2015), examined occupational stress and burnout for nurses, they also suggested strategies on how to prevent burnout. A survey aimed at understanding the reasons behind nurses leave their nursing job in a rural area in Canada highlighted reasons such as higher level of self-reported occupational stress, decreased job satisfaction, and little control over their work schedule, being on call and making clinical decisions (Nowrouzi, 2015). Understanding the reasons and feedback from nurses can help organizations make better plans and strategies to improve the work environment for nurses and decrease burnout (Nowrouzi et al., 2015).

Some of the articles reviewed in this study suggested strategies such as mindfulness-based stress reduction and psychosocial intervention training. Participants showed a significant decrease in perceived stress and burnout (Nowrouzi et al., 2015). One article indicated that more psychiatric nurses in a rural environment reported an increased job satisfaction level associated with management support and their ability to be involved in their unit’s decision-making (Nowrouzi et al., 2015). Furthermore, the authors suggested that organizations adopt policy and practice changes that will address issues such as staffing and workload for nurses as well as strategies to decrease stress and improve the recruitment and retention of nurses (Nowrouzi et al., 2015) Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue.

Article 2: 

The second article titled burnout, and resiliency in peri anesthesia nurses is a study that aimed at analyzing a national pool of nurses who are members of the American Society of peri anesthesia nurses. This study’s objective was to determine the prevalence and factors affecting nurses’ burnout, examining the effects of external activities such as hobbies and mindfulness practice on personal feelings of lack of job satisfaction (Card et al., 2019). The study also aimed to understand the effect of burnout on physical and mental wellbeing, as well as develop strategies that organizations and management can implement to create a healthy work environment and decrease burnout (Card et al., 2019). Findings from the study indicated that burnout is related to fatigue as well as poor physical and mental health, which leads to absenteeism, lack of job satisfaction, and increased call-ins, which negatively affects the team left to work shorthanded (Card et al., 2019).

The study indicated a link between employees’ perception of the organization and burnout, an employees’ positive perception of leadership support, economic satisfaction, acknowledgment of workload, acknowledgment of work accomplishment, and opportunity for growth and advancement decreases the occurrence of burnout (Card et al., 2019). The study results identified strategies such as improving the relationship between organizations and employees, providing opportunities for career advancement, providing opportunities for and supporting employee engagement in extracurricular activities as effective strategies for decreasing nurse burnout in healthcare organizations (Card et al., 2019). The authors further suggested that organizations invest in providing a healthy work environment, uses evidence-based guidelines for staffing, and provide opportunities for social connection. Furthermore, the author also suggested that the organization also acknowledge employees’ hard work and contribution, promote shared decision making between employees and management, and set reasonable expectations and respect employees limit (Card et al., 2019). They reiterated the need for nurses to set boundaries, engage in physical activities and hobbies, and establish a personal support system (Card et al., 2019).

Strategies Used to Address the Organizational Impact of burnout

Various strategies to help decrease nurse burnout were identified in the two articles summarized above. The strategies included reflected the need for a joint effort between organizations, management, and employees to work together and find lasting solutions. Some of the strategies that could be applied to my current organization include the involvement of employees in decision-making, the use of evidence-based guidelines for staffing, and providing employees the opportunity to engage in extracurricular activities. The implementation of these strategies will improve work-life balance for employees, increase their level of job satisfaction and confidence in the organization as well as decrease burnout.

How Burnout Prevent Strategies Impact the Organization

Implementing these strategies in this organization may be difficult due to their long-standing negative attitude towards change. The management may perceive some of these strategies as counterproductive towards their goals, for example, staffing; it would be challenging to adopt evidence-based guidelines for adequate staffing and respecting employees’ limits due to the perceived financial implications. Therefore, education about the relationship between nurse burnout patient safety, medical errors, and low patient satisfaction scores is imperative (Hall et al., 2016). In addition to education, the organization needs to be open to accepting and implementing change, commit to building a better relationship between staff and management. Although not immediate, this will help them work together to decrease the rate of burnout and decrease the high turnover rate with a minimal financial burden as possible. Nurses also need to advocate for themselves by practicing self-care, identifying stressors, and utilizing coping methods such as mindfulness-based stress reduction. These are some of the ways nurses can improve physical and psychosocial wellbeing and decrease burnout (Penque, 2019).

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Conclusion

Nursing is a rewarding but tough profession making it prone to burnout. Nurse burnout affects U.S. healthcare delivery and predisposes patients to preventable harm. Therefore, healthcare organizations, healthcare leaders, and nurses must collaborate to provide a safe work environment for nurses by finding lasting solutions to ensure that nurses maintain a positive outlook on their job, prevent burnout, and increase nurse retention and job satisfaction.

References

Card, E. B., Hyman, S. A., Wells, N., Shi, Y., Shotwell, M. S., & Weinger, M. B. (2019). Burnout and Resiliency in Peri anesthesia Nurses: Findings and Recommendations from a National Study of Members of the American Society of Peri anesthesia Nurses. 
Journal of Peri Anesthesia Nursing, 34(
6), 1130–1145. 
https://doi-org.ezp.waldenulibrary.org/10.1016/j.jopan.2019.05.133

Gaines, K. (2020). Joint commission tackles burnout in a new report. Retrieved from 
https://nurse.org/articles/joint-commission-tackles-nurse-burnout/

Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor D. B. (2016). Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938539/

Mudallal, R., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798741/

Nowrouzi, B., Lightfoot, N., Larivière, M., Carter, L., Rukholm, E., Schinke, R., & Belanger-Gardner, D. (2015). Occupational Stress Management and Burnout Interventions in Nursing and Their Implications for Healthy Work Environments: A Literature Review. Workplace Health & Safety, 63(7), 308–315. 
https://doi-org.ezp.waldenulibrary.org/10.1177/2165079915576931

Nursing.org. (2020). Nurse burnout. Retrieved from 
https://www.nursing.org/resources/nurse-burnout/

NursingLincensure.org. (2020). Nurse Burnout: Epidemic, or Mendable Malady? Retrieved from 
https://www.nursinglicensure.org/articles/nurse-burnout.html

Penque, S. (2019). Wellness series part 1: Open Mindfulness to promote nurses’ wellbeing. 
Nursing Management
, 
50
(5), 38–44. 
https://doi-org.ezp.waldenulibrary.org/10.1097/01.NUMA.0000557621.42684.c4

Reith, T. P. (2018). Burnout in United States Healthcare Professionals: A Narrative Review. Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367114/

 

NURS 6053: INTERPROFESSIONAL ORGANIZATIONAL AND SYSTEMS LEADERSHIP – Assignment: Analysis of a Pertinent Healthcare Issue

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.

Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.

In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.

To Prepare:

Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.

Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization). Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.

Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

NURS_6053_Module01_Week02_Assignment_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing the selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

·   Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).

23 
(23%)
 – 25 
(25%)

The response accurately and thoroughly describes in detail the national healthcare issue/stressor selected and its impact on an organization.

The response includes accurate, clear, and detailed data to quantify the impact of the national healthcare issue/stressor selected.

20 
(20%)
 – 22 
(22%)

The response describes the national healthcare issue/stressor selected and its impact on an organization.

The response includes accurate data to quantify the impact of the national healthcare issue/stressor selected. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

18 
(18%)
 – 19 
(19%)

The response describes the national healthcare issue/stressor selected and its impact on an organization that is vague or inaccurate.

The response includes vague or inaccurate data to quantify the impact of the national healthcare issue/stressor selected.

0 
(0%)
 – 17 
(17%)

The response describes the national healthcare issue/stressor selected and its impact on an organization that is vague and inaccurate, or is missing.

The response includes vague and inaccurate data to quantify the impact of the national healthcare issue/stressor selected, or is missing.

·   Provide a brief summary of the two articles you reviewed from outside resources, on the national healthcare issue/stressor and explain how the healthcare issue/stressor is being addressed in other organizations.

27 
(27%)
 – 30 
(30%)

A complete, detailed, and specific synthesis of two outside resources reviewed on the national healthcare issue/stressor selected is provided. The response fully integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the summary provided.

The response accurately and thoroughly explains in detail how the healthcare issue/stressor is being addressed in other organizations.

24 
(24%)
 – 26 
(26%)

An accurate synthesis of at least one outside resource reviewed on the national healthcare issue/stressor selected is provided. The response integrates at least 1 outside resource and 2 or 3 course-specific resources that may support the summary provided.

The response explains how the healthcare issue/stressor is being addressed in other organizations.

21 
(21%)
 – 23 
(23%)

A vague or inaccurate summary of outside resources reviewed on the national healthcare issue/stressor selected is provided. The response minimally integrates resources that may support the summary provided. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

The response explains how the healthcare issue/stressor is being addressed in other organizations that is vague or inaccurate.

0 
(0%)
 – 20 
(20%)

A vague and inaccurate summary of no outside resources reviewed on the national healthcare issue/stressor selected is provided, or is missing.

The response fails to integrate any resources to support the summary provided.

·   Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected and explain how they may impact your organization both positively and negatively. Be specific and provide examples.

27 
(27%)
 – 30 
(30%)

A complete, detailed, and accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.

The response accurately and thoroughly explains in detail how the strategies may impact an organization both positively and negatively, with specific and accurate examples.

24 
(24%)
 – 26 
(26%)

An accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.

The response explains how the strategies may impact an organization both positively and negatively. May include some specific examples.

21 
(21%)
 – 23 
(23%)

A vague or inaccurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.

The response explains how the strategies may impact an organization both positively and negatively that is vague or inaccurate. May include some vague or inaccurate examples.

0 
(0%)
 – 20 
(20%)

A vague and inaccurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided, or is missing.

The response explains how the strategies may impact an organization both positively and negatively that is vague and inaccurate, or is missing. Does not include any examples.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 
(5%)
 – 5 
(5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 
(4%)
 – 4 
(4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3.5 
(3.5%)
 – 3.5 
(3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

0 
(0%)
 – 3 
(3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3 or 4) APA format errors. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6053_Module01_Week02_Assignment_Rubric Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

.

NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

Comprehensive SOAP Template

Patient Initials: AC                             Age: 68                                   Gender: Male

 

SUBJECTIVE DATA: “
About a week ago, I noticed some rash on my right chest, back, and neck. I thought it would get better, but the rash is itchy and painful, it has also gotten worse. I also feel a little feverish.” NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

Chief Complaint (CC): 
The patient reported noticing skin abnormality about a week ago, “I have an itchy rash on my neck, chest, and back that is peeling and getting worse.” The rash is swollen with clear liquid and painful.

History of Present Illness (HPI):  
Mr. Alexander Cortez is a 58-year-old Hispanic male. Presents with a patchy rash on the neck, chest, and back region. He states that the rash started about two weeks ago and has progressively gotten worse. He denies changing skin routine or location within the last two weeks, no history of environmental allergies, no known allergy to dye, or latex. Mr. Cortez states he has not tried any treatment for the rash, no worsening, or alleviating factors noted. He complained of pain level 7 on a scale of 1-10. He describes the pain as sharp and states Tylenol 1000mg has helped relieve the pain. He is worried about the rash getting worse and states that the rash and its associated pain interferes with his daily activities and quality of life. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

Medications:  

– Acetaminophen 1000mg

PO Q 6 HRS for pain

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

– Metformin 500mg daily for diabetes

– Atorvastatin 40mg at bedtime for high cholesterol

– Hydralazine 10mg BID for Hypertension

– Amlodipine 5mg daily for hypertension

Allergies: 

– Penicillin Reaction (itching)

Past Medical History (PMH): 

Hypertension-diagnosed at 43 years old

Hyperlipidemia- diagnosed at 45 years old

Diabetes Mellitus Type 2 diagnosed at 38 years old

Chickenpox: 7 years old

Appendicitis – hospitalization at 28 years old

Past Surgical History (PSH): 

Appendectomy 1992

Sexual/Reproductive History: 

Currently sexually active with his wife, he denies sexual/reproductive issues. Heterosexual and currently using no barrier methods, no past history of STDs.

Personal/Social History: 

The patient is a non-smoker, never smoked. His wife smokes 1pack/day. Mr. Cortez drinks alcohol occasionally, about 1-2 drinks a week. He denies the use of recreational drugs.

Immunization History: 

Received flu shot last season

Received pneumococcal vaccine 8/12/2019 during the annual check-up

He does not remember the last tetanus vaccination.

Significant Family History:

-Mother had diabetes mellitus type 2 and died from diabetes complication at 81

-Father had chronic hypertension and died at the age of 78 from a stroke

-Patient does not recall the medical history of grandparents

-Denies any noted illness for his siblings and children.

Lifestyle: 
Mr. Cortez runs a small family construction business, which he runs with his son. He is a Christian and attends church with his family every Sunday. The highest level of education is high school with certifications in HVAC and plumbing. He lives at home with his wife, daughter, who is a single mother and grandson. His wife works full time as a secretary, and his health coverage is through his wife’s job. He states he is too busy to exercise, and his diet comprises mainly of heavy meals due to his job. Reports drinking socially, about 2-3 drinks weekly, mostly beer. Never smoked, denies the use of recreational or illicit drugs

Review of Systems

General: 
Mr. Cortez appears well dressed and well-nourished. Denies weakness and fatigue. No recent weight changes or changes in appetite. No apparent signs of distress.

HEENT: 
The patient uses glasses, denies vision changes, discharge from eyes, tinnitus, hearing loss, and discharge from ears. Denies loss or decreased sense of smell, nasal drainage, or congestion.

Neck: 
The patient denies any injury to the neck, swelling, or history of compression. Rash currently present in the neck region.

Breasts: 
denies lump, discharge, or rash

Respiratory: 
denies shortness of breath, denies cough or respiratory distress, no history of respiratory disorders except occasional seasonal allergies

Cardiovascular/Peripheral Vascular: 
Denies chest pain, reports history of hypertension and high cholesterol. He denies history of stroke, edema or heart failure.

Gastrointestinal: 
Denies nausea or vomiting, and diarrhea. Reports consistent bowel movement every two days.
 
He also reported that his wife occasionally gives him prune juice to aid his
 
occasional constipation.

Genitourinary: 
Pt denies any feeling of urgency or urinary retention. No history of UTI or incontinence denies burning sensation when urinating, denies frequency, and urgency.

Musculoskeletal: 
The patient reported a history of fall six months ago when he woke up and could not find his cane at the bedside. The patient stated that he takes 30 mins to walk in the evenings three times per week with his wife.

Psychiatric: 
The patient denies any history of mental illness, no suicidal or homicidal ideations. Reports no history of mental illness in his family.

Neurological: 
The patient reported feeling lightheaded after his fall 6 months ago but was seen by the ER doctor and has not had any dizziness episodes since then. Denies any headaches or sudden/abnormal movements.

Skin: 
The patient reports a red rash with blisters filled with clear fluid on his right torso and neck. Patient denies any other skin issues, a history of chickenpox when he was eight years old

Hematologic: 
Denies any abnormal bleeding. Denies any history of bleeding disorder in his family. Never been diagnosed with anemia, no history of incidents with significant blood loss.

Endocrine: 
Denies any use of hormonal therapies, denies a history of thyroid disorders.

Allergic/Immunologic: 
Patient denies any history of allergies, reported that he and his children often have seasonal allergies but usually resolves within a few days

OBJECTIVE DATA:

Physical Exam:

Vital signs:

– Blood Pressure: 148/93 mmHg -Weight.: 285 lbs

– Pulse: 76 BPM -Height: 170 cm

– Respiratory Rate: 18 – Blood glucose: 148 mg/dl

– Temperature: 98.9 F

General: 
The patient is alert and oriented, able to communicate clearly, posture, and gesture appropriately, maintains eye contact. Well dressed and groomed, appropriate affect, and reaction. Ambulates independently, gait even and steady

HEENT: 
Head, Face is symmetrical, bilateral eyes, ears, and nose symmetrical. No drainage or foul odor noted, no discoloration noted.

Neck: 
No swelling or deviation was noted. No Jugular Vein Distention noted that the carotid artery is palpable bilaterally, rash noted on the right side, and able to move from side to side.

Chest: 
Equal rise and fall of chest noted. Clear to auscultation Anterior, Posterior and Lateral

Lungs: 
Lung sounds clear, bilaterally anteriorly, posteriorly, and laterally. The respiratory pattern regular, the chest wall is symmetrical, no cough is noted.

Heart: 
No murmurs or palpitations noted

Peripheral Vascular: 
symmetrical, No edema or discoloration noted in extremities, Pulse regular 2+ pulse in the bilateral pedal, and 2+ in bilateral radial.

Abdomen:  
Abdomen soft, flat, and non-tender, no distention noted, no organomegaly noted.

Genital/Rectal: 
External genitalia intact, no swelling or discoloration noted

Musculoskeletal: 
Uneven gait noted; the patient uses a cane for balance.

Neurological:  
Alert and oriented to person, place, time, and situation. CN I – XII intact

Skin: 
Patients’ skin is generally warm, intact, and dry. Red raised vesicles with clear fluids on the right chest, underarms, neck, and back. Site warm to touch. No other skin abnormality was noted.

Clinical Terminology for Skin Condition in Graphic five

The skin condition in graphic five presents as a rash, which is red in color. The rash is present on the right lateral side of the patient’s chest and back. Some of the rashes are fluid-filled and appears blistering.

Differential Diagnosis

Contact Dermatitis
: Contact dermatitis is a common skin disorder that occurs after exposure to allergens or irritants (World, Allergy Organization, 2015). Irritants such as soaps, detergents, stool, and urine trigger irritant contact dermatitis while cosmetics, drugs, food, or dye in people genetically predisposed or sensitized triggers allergic contact dermatitis.

The skin condition is characterized by red vesicles that are itchy (World, Allergy Organization, 2015). The location of the rash depends on the exposure to allergens. It is often diagnosed with history and physical (American Academy of Allergy Asthma & Immunology, 2019).

Psoriasis
: Psoriasis is an autoimmune skin condition characterized by dry, red, and scaly rash (Nair & Badri, 2018). There are different types of psoriasis, however, psoriasis in general, is often seen with red scales covered with silver scales (Nair & Badri, 2018). The exact etiology of psoriasis is unknown; however, it has been seen to be genetically transmitted (Nair & Badri, 2020). the rash can appear anywhere in the body, including the eyes and scalp; it is also commonly seen in the knees and elbows; thus, the rash location and progression are often used when diagnosing the condition (Nair & Badri, 2020).

Shingles
: Shingles is a skin condition also called Herpes Zoster caused by the varicella-zoster virus; it usually occurs in a patient who has previously had chickenpox virus or people older people with weakened immunity. The shingles rash are blistering red vesicles that usually appear in the face and torso (Carter, 2020). The rash may be itchy and painful with a burning or stinging sensation. It commonly affects one side of the body. It is usually diagnosed by the characteristics of the rash (National Institute of Neurological Disorders and Stroke, 2020).

Most Likely Diagnosis

Like many other conditions, diagnosing skin conditions starts with a good assessment, history, and physical (Ball, 2019). Assessment of Certain criteria is critical in helping a provider diagnose a skin disorder. For example, location, color, shape, measurement, surrounding skin, and texture of skin disorders will provide insight and help with accurate diagnosis (Ball, 2019). Other presenting symptoms, including systemic symptoms, are also used to identify and diagnose skin conditions (Ball, 2019) NURS-6512 Differential Diagnosis for Skin Conditions SOAP note. When collecting history and physical for skin conditions, it is important to collect a focused history that helps in diagnosing the skin conditions for example, the onset of skin condition, changes, presence of itch or discharge are some of the histories that help to diagnose skin conditions (Ball, 2019). Diagnostic tests can also help providers rule out certain conditions when diagnosing skin disorders. For example, shingles can be identified by testing for herpes or varicella-zoster virus. (Centers for Disease Control and Prevention, 2019).

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

The skin condition presented in this graphic is seen on the torso’s right lateral side; the rash appears to be red, fluid-filled, and blistering. Mr. Cortez states that the rash began about a week ago and is present only on his right side; he denies change in routine or exposure to irritants that could suggest allergic or irritant contact dermatitis. Also, the rash seen in contact dermatitis is scaly (Dains et al., 2019). Psoriasis rash, in this case, is unlikely because while psoriasis rash is red, it is also scaly and often appears on the knees, elbows, lower back, and scalp (Roland, 2018). Also, psoriasis is characterized by unique systemic symptoms such as swollen and painful joints, which Mr. Cortez denies (Davis, 2020). Shingles are the most likely diagnosis in this case because the rash, in this case, is red vesicles clustered together, appears in a linear arrangement, and is located on the right side of the torso without crossing the midline. According to Carter (2020), shingles rash are red lesions that are usually unilateral. During history, Mr. Cortez denies systemic symptoms that may suggest psoriasis; he also denies history, suggesting contact dermatitis. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

 

References

American Academy of Allergy Asthma & Immunology (2019). Contact dermatitis overview. Retrieved from 
https://www.aaaai.org/conditions-and-treatments/library/allergy-library/contact-dermatitis

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

Carter, T. M. (2020). Shingles: Not Just a Rash. Journal for Nurse Practitioners, 16(2), 111–115.

https://doi-org.ezp.waldenulibrary.org/10.1016/j.nurpra.2019.10.013

Centers for Disease Control and Prevention (2019). Laboratory Testing for VZV. Retrieved from 
https://www.cdc.gov/shingles/lab-testing/index.html

Conceicao, V. (2018). Prevention and management of shingles and associated

complications.
Journal of Community Nursing, 32
(6), 40–43. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and

clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Nair, P. A. & Badri, T. (2020). Psoriasis. Retrieved from 
https://www.ncbi.nlm.nih.gov/books/NBK448194/

National Institute of Neurological Disorders and Stroke (2020). Shingles Information Page. Retrieved from 
https://www.ninds.nih.gov/Disorders/All-Disorders/Shingles-Information-Page

Roland, J. (2018). Shingles vs. psoriasis: What’s the difference? Retrieved from  
https://www.healthline.com/health/psoriasis/shingles-vs-psoriasis#symptoms

World, Allergy Organization (2015). Contact dermatitis: Synopsis. Retrieved from 
https://www.worldallergy.org/education-and-programs/education/allergic-disease-resource-center/professionals/contact-dermatitis-synopsis

 

 

Assignment 1: Lab Assignment: Differential Diagnosis for Skin Conditions

Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

To Prepare

Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.

Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?

Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.

Consider which of the conditions is most likely to be the correct diagnosis, and why.

Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.

Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.

The Lab Assignment

Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of 
three to five 
possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

By Day 7 of Week 4

Submit
 your Lab Assignment.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK4Assgn1+last name+first initial.(extension)” as the name.

Click the 
Week 4 Assignment 1 Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 4 Assignment 1
 link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK4Assgn1+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
 button to complete your submission.

NURS_6512_Week_4_Assignment_1_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

Using the SOAP (Subjective, Objective, Assessment, and Plan) note format:

·  Create documentation, following SOAP format, of your assignment to choose one skin condition graphic (identify by number in your Chief Complaint). ·   Use clinical terminologies to explain the physical characteristics featured in the graphic.

30 
(30%)
 – 35 
(35%)

The response clearly, accurately, and thoroughly follows the SOAP format to document one skin condition graphic and accurately identifies the graphic by number in the Chief Complaint. The response clearly and thoroughly explains all physical characteristics featured in the graphic using accurate terminologies.

24 
(24%)
 – 29 
(29%)

The response accurately follows the SOAP format to document one skin condition graphic and accurately identifies the graphic by number in the Chief Complaint. The response explains most physical characteristics featured in the graphic using accurate terminologies.

NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

18 
(18%)
 – 23 
(23%)

The response follows the SOAP format, with vagueness and some inaccuracy in documenting one skin condition graphic, and accurately identifies the graphic by number in the Chief Complaint. The response explains some physical characteristics featured in the graphic using mostly accurate terminologies.

0 
(0%)
 – 17 
(17%)

The response inaccurately follows the SOAP format or is missing documentation for one skin condition graphic and is missing or inaccurately identifies the graphic by number in the Chief Complaint. The response explains some or few physical characteristics featured in the graphic using terminologies with multiple inaccuracies.

·   Formulate a different diagnosis of three to five possible considerations for the skin graphic.    ·   Determine which is most likely to be the correct diagnosis, and explain your reasoning using at least three different references from current evidence-based literature.

45 
(45%)
 – 50 
(50%)

The response clearly, thoroughly, and accurately formulates a different diagnosis of five possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained clearly, accurately, and thoroughly using three or more different references from current evidence-based literature.

39 
(39%)
 – 44 
(44%)

The response accurately formulates a different diagnosis of three to five possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained accurately using at least three different references from current evidence-based literature.

NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

33 
(33%)
 – 38 
(38%)

The response vaguely or with some inaccuracy formulates a different diagnosis of three possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained vaguely and with some inaccuracy using three different references from current evidence-based literature.

0 
(0%)
 – 32 
(32%)

The response formulates inaccurately, incompletely, or is missing a different diagnosis of possible considerations for the skin graphic, with two or fewer possible considerations provided. The response vaguely, inaccurately, or incompletely determines the most likely correct diagnosis with reasoning that is missing or explained using two or fewer different references from current evidence-based literature.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 
(5%)
 – 5 
(5%)

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

4 
(4%)
 – 4 
(4%)

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

3 
(3%)
 – 3 
(3%)

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

0 
(0%)
 – 2 
(2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) APA format errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6512_Week_4_Assignment_1_Rubric NURS-6512 Differential Diagnosis for Skin Conditions SOAP note

Discussion: Diversity and Health Assessments

May 2012, Alice Randall wrote an article for 
The New York Times
on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012) Discussion: Diversity and Health Assessments.

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity. Discussion: Diversity and Health Assessments.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.

To prepare:

Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

By Day 1 of this week, you will be assigned a case study by your Instructor. 
Note
: Please see the “Course Announcements” section of the classroom for your case study assignment.

Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you. Discussion: Diversity and Health Assessments

Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

By Day 3 of Week 2

Post
 an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

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

Read
 a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond on or before Day 6
 
on 2 different days
 to at least
 two
of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why. Discussion: Diversity and Health Assessments

Use of Prostate-Specific Antigen Test in Healthcare Essay

The Use of Prostate-Specific Antigen Test in Healthcare

Introduction

Various diagnostic tests are performed by healthcare personnel to confirm or determine a disease’s presence in patients suspected to have it. Diagnostic tests protect patients by finding potential health problems in their early stages of development that are easily treatable and prevent health complications that result from the later stages of disease development. Also, diagnostic tests help patients minimize their healthcare spending by finding potential ailments sooner, which can be treated under minimal costs. Some of the diseases whose negative impact can be considerably reduced if identified in their early development stages include various forms of cancer. Prostate cancer is the second most common type of cancer among men in the world. Use of Prostate-Specific Antigen Test in Healthcare Essay Screening performed using the Prostate-Specific Antigen Test is used to detect prostate cancer at an early stage where treatment can efficiently intervene and reduce mortality among male patients. This purpose of this paper is to describe how the Prostate-Specific Antigen test is used in healthcare.

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

The Purpose of the Prostate-Specific Antigen Test

The Prostate-Specific Antigen Test is primarily used to confirm prostate cancer in men in its early stages of development. The Test is used to measure the amount of Prostate-Specific Antigens [PSA] in the blood. PSA refers to proteins made by normal and malignant tissues of the prostate gland. High levels of Protein-Specific Antigens in the blood may suggest the presence of prostate cancer (Tikkinen et al., 2018). Prostate-Specific Antigen tests can also be used to identify other prostate gland problems, including inflammation and enlargement of the prostate. Besides, Prostate-Specific Antigen tests can be used to monitor prostate cancer treatment and find out whether the disease is under control or reoccurring (Lawrenson, et al., 2015). Prostate cancer is usually treated through radiation, surgery, chemotherapy, and hormone therapy. These treatments make the amounts of protein-specific Antigens circulating in the bloodstream significantly. Physicians perform regular testing to determine the level of Protein-Specific Antigens circulating in the bloodstream to determine whether cancer has reoccurred. If the disease reoccurs, additional screening using protein-specific Antigen tests are performed to make recommendations that will aid in the additional treatment and control of the disease. Use of Prostate-Specific Antigen Test in Healthcare Essay

How the Test is conducted

The Prostate-Specific Antigen test is performed by removing some blood from the patient, usually from the arm. The blood samples are then taken to the laboratory to determine the amount of PSA in the blood. The diagnostic test results may take several days, such as one week, before the results come out. Healthcare personnel reports the Test results as the ratio of nanograms of PSA per milliliters of blood [ng/ml]. Even though Prostate-Specific Antigen tests are used to screen for prostate cancer, their results cannot indicate an absolute confirmation of prostate cancer’s presence or absence (Ilic et al., 2018). Consequently, male patients who have high PSA amounts are required to undertake a prostate biopsy to make the absolute confirmation for prostate cancer. Prostate biopsy refers to the procedure of removing small samples of prostate tissues and observing them using a microscope to confirm whether the patient has or lacks prostate cancer. If it is confirmed the patient has prostate cancer, the biopsy also reveals the likelihood of the cancer growing and spreading rapidly.

Reliability and Validity

The use of PSA tests to perform prostate cancer screenings is not highly reliable or valid. Even though most people with prostate cancer have high PSA levels in their bloodstream, other non-malignant conditions might also contribute to the increase in the levels of PSA. Consequently, the PSA test does not provide precise information concerning prostate cancer disease in individuals. At best, using PSA tests to perform prostate cancer screenings results in a small reduction in the mortality risks caused by prostate cancer. Screening using PSA tests might help people detect prostate cancer in the early stages of development. The diagnosis of cancer at an early stage might make it easy to treat and cure, unlike in the later developed stages of the disease. However, prostate cancer screening using PSA tests does not affect the disease’s overall mortality rates (Martin et al., 2018). Prostate cancer develops slowly over many years. Consequently, people may have prostate cancer that does not reveal any symptoms or cause health problems during their lifetimes.

Also, the harms of conducting prostate cancer screenings using PSA tests outweigh the benefits. Male patients who partake PSA tests for prostate cancer screenings risk getting over-diagnosed and over-treated (Ilic et al., 2018). Patients might be over-diagnosed when the PSA tests detect tumors that lack symptoms during their lifetime. Due to over-diagnosis, these harmless tumors might be subjected to various cancer treatments such as chemotherapy and radiation. These treatments have accompanying complications and harmful side effects, including pain, incontinence, bleeding, infections, and erectile dysfunction. Use of Prostate-Specific Antigen Test in Healthcare Essay. Again, PSA tests can make some people experience negative psychological effects. For instance, people with high PSA levels in their blood might suffer from anxiety and distress if they conduct biopsy tests that fail to confirm the presence of prostate cancer (Biddle et al., 2017). Besides, some patients might experience anxiety because of knowing they have slow-growing tumors even though they are harmless.

Conclusion

In conclusion, PSA tests are used to perform prostate cancer screenings and enable early detection of the disease. The early detection of prostate cancer makes it easy for the disease to be treated and eliminate more healthcare spending that might have taken place in the later developed stages. PSA tests can also detect other prostate gland related problems such as inflammation and enlargement. Besides, PSA tests are used to monitor the treatment and recurrence of prostate cancer. The PSA tests are conducted by removing blood, especially from the arm of the patients. The blood samples are tested in the labs for about one week. The results reveal PSA’s level in the blood and are used to indicate whether the patient might have prostate cancer. Since the PSA tests are not precise, further tests such as a prostate biopsy to confirm the presence of the disease. The PSA tests are not reliable in reducing the overall mortality rates of people having prostate cancer. At best, they help people detect cancerous tumors’ growth at an early stage, enabling them to get interventional treatment. However, these tumors grow at a slow rate and might lack to show any symptoms. Besides, these tumors might be harmless and fail to affect the patients in their lifetime. The PSA tests might result in more harm than good by over-diagnosing and over-treating patients, making them experience harmful side effects and complications such as erectile dysfunctions, infections, and pain. Use of Prostate-Specific Antigen Test in Healthcare Essay.

 

References

Biddle, C., Brasel, A., Underwood III, W., & Orom, H. (2017). Experiences of uncertainty in men with an elevated PSA. 
American journal of men’s health
, 
11
(1), 24-34.

Ilic, D., Djulbegovic, M., Jung, J. H., Hwang, E. C., Zhou, Q., Cleves, A., & Dahm, P. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. 
bmj
, 
362
, k3519.

Lawrenson, R., Lao, C., Obertová, Z., Brown, C., Holmes, M., Tyrie, L., … & Laking, G. (2015). Management and characteristics of patients with metastatic prostate cancer in a cohort of New Zealand men. 
Oncology
, 
88
(3), 157-163.

Martin, R. M., Donovan, J. L., Turner, E. L., Metcalfe, C., Young, G. J., Walsh, E. I., … & Sterne, J. A. (2018). Effect of a low-intensity PSA-based screening intervention on prostate cancer mortality: the CAP randomized clinical trial. 
Jama
, 
319
(9), 883-895.

Tikkinen, K. A., Dahm, P., Lytvyn, L., Heen, A. F., Vernooij, R. W., Siemieniuk, R. A., … & Junod, N. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline. 
Bmj
, 
362
, k3581. Use of Prostate-Specific Antigen Test in Healthcare Essay
 

 

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results. Use of Prostate-Specific Antigen Test in Healthcare Essay

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

Photo Credit: Getty Images/Hero Images

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To Prepare

Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.

By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). 
Note:
 Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.

Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?

Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.

If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.

Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment

Assignment
 (3–4 pages, not including title and reference pages)
:

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:

Include the following:

A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.

What is its purpose?

How is it conducted?

What information does it gather?

Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

Assignment Option 2: Child Health Case:

Include the following:

An explanation of the health issues and risks that are relevant to the child you were assigned.

Describe additional information you would need in order to further assess his or her weight-related health.

Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.

Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

By Day 6 of Week 3

Submit
 your Assignment.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK3Assgn1+last name+first initial.(extension)” as the name.

Click the 
Week 3 Assignment 1 Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 3 Assignment 1 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK3Assgn1+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
 button to complete your submission.

NURS_6512_Week_3_Assignment_1_Rubric_Option_1

 

Excellent

Good

Fair

Poor

In 3–4 pages, address the following:

A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.

o What is its purpose?

o How is it conducted?

o What information does it gather?

30 
(30%)
 – 35 
(35%)

The response clearly, accurately, and with specific detail describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.

24 
(24%)
 – 29 
(29%)

The response accurately describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.

18 
(18%)
 – 23 
(23%)

The response vaguely and/or with some inaccuracy describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.

0 
(0%)
 – 17 
(17%)

The response is inaccurate or missing descriptions of how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.

Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values.

45 
(45%)
 – 50 
(50%)

The response accurately and thoroughly evaluates the test or tool’s validity and reliability, and explains any issues with clear sensitivity, reliability, and predictive values. Student’s research is clear, accurate, and appropriate for the evaluation.

39 
(39%)
 – 44 
(44%)

The response accurately evaluates the test or tool’s validity and reliability, and explains any issues with sensitivity, reliability, and predictive values. Student’s research is somewhat clear, accurate,and appropriate for the evaluation.

33 
(33%)
 – 38 
(38%)

The response vaguely and/or with some inaccuracy evaluates the test or tool’s validity and reliability, and explains any issues with some sensitivity, reliability, and predictive values. Student’s research is vague or inaccurate for the evaluation.

0 
(0%)
 – 32 
(32%)

“The response is inaccurate and/or missing evaluations of the test or tool’s validity and reliability, with explanations of any issues missing or lacking sensitivity, reliability, and predictive values. Student’s research is missing, inaccurate, or lacking for the evaluation.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 
(5%)
 – 5 
(5%)

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

4 
(4%)
 – 4 
(4%)

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

Use of Prostate-Specific Antigen Test in Healthcare Essay

3 
(3%)
 – 3 
(3%)

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

0 
(0%)
 – 2 
(2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) APA format errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) APA format errors. Use of Prostate-Specific Antigen Test in Healthcare Essay Total Points: 100 Name: NURS_6512_Week_3_Assignment_1_Rubric_Option_1 NURS_6512_Week_3_Assignment_1_Rubric_Option_2 Grid View List View Excellent Good Fair Poor In 3–4 pages, address the following: An explanation of the health issues and risks that are relevant to the child you were assigned. 20  (20%)  – 25  (25%) The response clearly, accurately, and in detail explains the relevant health issues and risks for the assigned child. 19  (19%)  – 24  (24%) The response accurately explains the relevant health issues and risks for the assigned child. 18  (18%)  – 23  (23%) The response vaguely and with some inaccuracy explains the relevant health issues and risks for the assigned child. 0  (0%)  – 17  (17%) The response is inaccurate and/or missing explanations of the relevant health issues and risks for the assigned child. Describe additional information you would need in order to further assess his or her weight-related health. 20  (20%)  – 25  (25%) The response clearly and accurately describes detailed additional information needed to further assess the child’s weight-related health. 19  (19%)  – 24  (24%) The response accurately describes additional information needed to further assess the child’s weight-related health. 18  (18%)  – 23  (23%) The response vaguely and with some inaccuracy describes additional information needed to further assess the child’s weight-related health. 0  (0%)  – 17  (17%) The response is inaccurate and/or missing a description of additional information needed to further assess the child’s weight-related health. Identify and describe any risks, and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion. 18  (18%)  – 20  (20%) The response clearly and accurately identifies and describes in detail any risks to the child’s health. The response clearly and accurately identifies and describes in detail further information needed to gain a full understanding of the child’s health, with a detailed explanation of how to gather that information in a way that is sensitive to the child. 16  (16%)  – 17  (17%) The response accurately identifies and describes any risks to the child’s health. The response accurately identifies and describes further information needed to gain a full understanding of the child’s health, with a clear explanation of how to gather that information in a way that is sensitive to the child. Use of Prostate-Specific Antigen Test in Healthcare Essay 14  (14%)  – 14  (14%) The response vaguely and with some inaccuracy identifies and describes any risks to the child’s health. The response vaguely identifies and describes further information needed to gain a full understanding of the child’s health, with a vague explanation of how to gather that information in a way that is sensitive to the child. 0  (0%)  – 13  (13%) The response identifies inaccurately and/or is missing descriptions of any risks to the child’s health. The response identifies inaccurately and/or is missing descriptions of further information needed to gain a full understanding of the child’s health, with an inadequate or missing explanation of how to gather that information in a way that is sensitive to the child. Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information. 10  (10%)  – 10  (10%) The response clearly and accurately lists three or more specific questions that would gather more information about the child. Specific questions are carefully worded to clearly demonstrate sensitivity to the parent(s) or caregiver(s) of the child. 9  (9%)  – 9  (9%) The response lists three specific questions that would gather more information about the child. Specific questions are worded to demonstrate sensitivity to the parent(s) or caregiver(s) of the child. 8  (8%)  – 8  (8%) The response lists three questions with wording that is vague and lacking specificity for gathering more information about the child. Some wording of the questions lacks sensitivity to the parent(s) or caregiver(s) of the child. 0  (0%)  – 7  (7%) The response lists two or fewer confusing or inadequate questions, or is missing questions, for gathering more information about the child. Wording of questions provided lacks sensitivity to the parent(s) or caregiver(s) of the child. Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight. 5  (5%)  – 5  (5%) The response clearly describes two or more detailed strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight. 4  (4%)  – 4  (4%) The response describes at least two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight. 3  (3%)  – 3  (3%) The response vaguely describes two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight. 0  (0%)  – 2  (2%) The response inadequately describes one strategy or is missing strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. 5  (5%)  – 5  (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4  (4%)  – 4  (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3  (3%)  – 3  (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. Use of Prostate-Specific Antigen Test in Healthcare Essay 0  (0%)  – 2  (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) APA format errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6512_Week_3_Assignment_1_Rubric_Option_2 Use of Prostate-Specific Antigen Test in Healthcare Essay

NURS 6512 Diversity and Health Assessments Discussion Essay

Module 2: Functional Assessments and Assessment Tools

Health disparities affect just a segment of the population differently. Attitudes toward health care and treatment can also vary among different populations. Therefore, nurse practitioners, as well as medical professionals, need to provide custom care that acknowledges and recognizes these differences in order to serve its diverse patient population. Nurse practitioners becoming more self-aware of themselves can help them realize new things about their own culture which in turn, can open their eyes to appreciating cultural differences. NURS 6512 Diversity and Health Assessments Discussion Essay. Medical teams’ understanding of patients’ beliefs and values, will aid in providing a better care because when a patient cannot find providers that resemble them, their beliefs, their culture, or other facets of their life, it may delay or prevent them from seeking care. As a health care team, it is important that we are diverse in large part just like our patients are diverse. A lack of cultural understanding increases negative attitudes towards cross-cultural care and affects healthcare professionals’ perceived preparedness to take care of culturally diverse patients. Anxiety when combined with uncertainty, can further decrease effective communication leading to increased use of stereotypes. Nurse practitioners need to have an increased awareness about the sociocultural. NURS 6512 Diversity and Health Assessments Discussion Essay.

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

I choose the case study number one; EB is a 68-year-old black female who comes in for follow-up of hypertension. She has glaucoma and her vision has been worsening during the past few years. She lives alone and is prescribed four hypertension medications (Hydralazine 50 mg PO Q8H, Metoprolol XL 200 mg PO Q12H, Lisinopril 40 mg PO daily, and HCTZ 25mg PO daily) NURS 6512 Diversity and Health Assessments Discussion Essay. Poor adherence to antihypertensives has been shown to be a significant factor in poor blood pressure (BP) control. A good communication with patients about her medication-taking behavior may be central to improving adherence “A patient-centered approach in which the provider engages the patient in a process of shared decision making has been identified as an important factor in improving patient adherence” (Kaihlanen, Hietapakka & Heponiemi, 2019). Example, the use of “Open-Ended Strategies” and your patients feel comfortable and address them by their preferred names. Hypertension (HTN) affects more than 29% of the adult population and increases the risk for adverse outcomes. Poorly controlled or managed HTN can lead to stroke, kidney damage, vision loss, fluid in the lungs, memory loss, and erectile dysfunction (AHA, 2010) . Research studies have consistently shown that” most patients with established HTN have poorly controlled blood pressure (BP) and that 30% to 70% of patients do not take their BP medications as prescribed” as seen in the case of this patient (Bokhour, Berlowitz, Long  & Kressin, 2006). NURS 6512 Diversity and Health Assessments Discussion Essay.

The nurse practitioner understanding that development of hypertension is related to both genetic and lifestyle factors such as genetic, age, gender, body shape, and family history, and lifestyle factors of excessive drinking, smoking, poor eating habits, and reduced physical activity will help in the management of this patient problems. As health care team, it is important that we are diverse in large part just like our patients are diverse “A lack of cultural understanding increases negative attitudes towards cross-cultural care and also affects healthcare professionals’ perceived preparedness to take care of culturally diverse patients” (Kaihlanen, Hietapakka & Heponiemi, 2019). Also, research shows that African Americans are genetically more at risk for glaucoma, making early detection and treatment more important. Early diagnosis and treatment and medication adherence are key in preventing vision loss from glaucoma “High BP could increase intraocular pressure (IOP)  by increased production of aqueous humor by means of elevated ciliary blood flow and capillary pressure and decrease of aqueous outflow as a result of increased episcleral venous pressure” (Leeman & Kestelyn, 2019) NURS 6512 Diversity and Health Assessments Discussion Essay.

A low BP, whether spontaneous or secondary to antihypertensive therapy, can play a part in reducing OP intraocular pressure (IOP). Therefore, antihypertensive treatment has shown have a preventive effect on the development of glaucoma and both high BP and low BP having been associated with an increased risk of glaucoma (Leeman & Kestelyn, 2019). Patients with high BP should be screened for glaucoma, and patients with glaucoma should be screened for arterial hypertension. Patients with coexisting glaucoma and high BP should undergo closer ophthalmologic examinations. This patient requires close ambulatory BP monitoring be performed with the deterioration her vision and a referral to an eye doctor initial and then every six months subsequently will be recommended for treatment and management of her glaucoma.

In the case of this 68-year-old AA female who presented to the clinic with elevated BP in clinic with a BP of 182/99 with HR of 84. When developing strategic measures for medication adherence and planning for this patient findings suggestive should include barriers due to self-efficacy, time with hypertension diagnosis, medication inefficiency and age are critical factors to consider “Racial-ethnic minorities are less often engaged in decision on their treatment than white adults, which may be a contributing factor to lower adherence in the former” (Bokhour, Berlowitz, Long, & Kressin, 2006). Some patients do not accept the diagnosis, which is obviously a major impediment to adherence as well. Lack of knowledge about hypertension and its consequences are logically linked to suboptimal adherence. Diversity in health care goes far beyond a language barrier “It’s about understanding the mindset of a patient within a larger context of culture, gender, sexual orientation, religious beliefs, and socioeconomic realities” (Bokhour, Berlowitz, Long, & Kressin, 2006).

As a future nurse practitioner, I can empower this patient to take her medications as Prescribed by doing effective two-way communication to doubles the odds of taking her medications properly. Try to understand the barriers and address them honestly to build that trust. I will develop simple method and directions to help improve medication adherence by simplify the regimen. Talk to her, show empathy and address her concerns or fears. Encourage the use of adherence tools, like day-of-the-week pill boxes or mobile apps such that will work to match the action of taking medications on daily routine example, mealtime or bedtime.  To help impart knowledge, I will write down prescription instructions clearly, and reinforce them verbally. Modify patients’ beliefs and behavior by providing positive reinforcement such as offering incentives when medications are taken successfully. Always ask for patients’ input when discussing recommendations and making decisions and remind patient to call the office with any questions or concerns “Interventions to promote adherence require several components to target these barriers, and health professionals must follow a systematic process to assess all the potential barriers” (Burnier & Egan, 2019).  Also, a healthy lifestyle modification example, healthy eating habits, engaging in enough physical activity, abstaining from tobacco use, and limiting alcohol intake can help with blood pressure control.

Using multiple strategies, the nurse practitioner can assess the patients’ medication-taking behavior, and to identify potential reasons for the lack of BP control, and plan intervention accordingly. NURS 6512 Diversity and Health Assessments Discussion Essay

What Are Your Medical and Surgical Histories?

What Prescription and Non-Prescription Medications Do You Take? …

What Allergies Do You Have? …

What Is Your Smoking, Alcohol, and Illicit Drug Use History?

Did you take all your pills?

When was the last time you see eye doctor?

Socioeconomic, lifestyle, religion and other cultural factors especially religious doctrine among African American community has a lengthy traditional belief. This is because, spiritual or religious experiences of African Americans may shape beliefs about the causes of illness, as well as treatment decisions. There is also a tendency for religious faith and prayer to be having substantial potential for healing and may serve as an alternative to medical care for serious illnesses. Among African Americans, it is generally expected that family members, including extended family members, will play an important role in treatment decisions.  With this patient, it is critical to increase family education about disease states and the benefits of compliance in achieving successful outcomes (Purnell, & Fenkl, 2019).

Conclusion.

Patient poor adherence may be partially due to problems of access and cost of medication, however, patients’ beliefs about HTN and medication may also play a significant role. Not all patients treated for hypertension follow their health care professional’s advice especially when it comes to long-term medication therapy. Medication adherence is very important and non-adherence increases patients risks for death. Most patient stooped taking their prescription drugs they believed that they were cured or thought that they had been advised to stop by their provider.  Some nonadherence to medications has been attributed to both intentional meaning a conscious decision not to take medications and unintentional, a failure to take medications due to poor understanding or forgetfulness. Socioeconomic, lifestyle, religion and other cultural factors especially religious doctrine among African American community has a lengthy traditional belief. This is because, spiritual or religious experiences of African Americans may shape beliefs about the causes of illness, as well as treatment decisions. Medical teams understanding of patients belief and values, will aid in providing a better care  because when a patient cannot find providers that resemble them, their beliefs, their culture, or other facets of their life, it may delay or prevent them from seeking care.

 

References

Bokhour, B. G., Berlowitz, D. R., Long, J. A., & Kressin, N. R. (2006). How do providers assess antihypertensive medication adherence in medical encounters? Journal of General Internal Medicine, 21(6), 577-583. doi:10.1111/j.1525-1497.2006. 00397.x

Burnier, M., & Egan, B. M. (2019). Adherence in Hypertension. Circulation Research, 124(7), 1124-1140. doi:10.1161/circresaha.118.313220

Kaihlanen, A., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: Qualitative study of nurses’ perceptions about cultural competence training. BMC Nursing, 18(1). doi:10.1186/s12912-019-0363-x

Leeman, M., & Kestelyn, P. (11 mar 2019). AHA, 73, NO. 5. doi: https://doi.org/10.1161/HYPERTENSIONAHA.118.11507

Purnell, L. D., & Fenkl, E. A. (2019). Barriers to Culturally Competent Health Care. Handbook for Culturally Competent Care, 19-26. doi:10.1007/978-3-030-21946-8_3 NURS 6512 Diversity and Health Assessments Discussion Essay