Tag: Clinical-Nursing

NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

NURS 6512: Advanced Health Assessment and Diagnostic Reasoning

Week Seven: Assessment of Abdomen and Gastrointestinal System

Review of case study #2

Scenario: A 50-year-old male complains of burning pain starting at the abdomen and rising to the middle of his chest. He describes the pain as a gnawing feeling that begins after meals, especially when lying down.

Episodic/Focused SOAP Note for Throat Exam

Patient Information: V.S.     Age: 50 y.o.        Sex: Male          DOB: 8/7/1967

S
.

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Chief Complaint/Reason for Visit:

The patient reported abdominal discomfort for the past two days that feels like “burning sensation in his chest.”

History of Present Illness:

Mr. V.S. is a 50 y/o Caucasian male with h/o hyperlipidemia, hypothyroidism, hypertension, DM Type II, presenting with c/o abdominal discomfort ranging from 5 to 6 out of 10 for two days. According to the patient, his stomach discomfort has however been ongoing for the past two days and describes it as burning pain starting at the mid-abdomen and rising to the middle of his chest. He reported that the pain usually begins when he eats and worsens when lying down but subsides when he walks. Patient denies constipation or diarrhea. His last meal was at 14:00 today. According to the patient, he recently started taking aspirin once a day as advised by his primary care physician. NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

Current Medications:

Atorvastatin (Lipitor) 40 mg tablet Take 40 mg nightly

Levothyroxine (SYNTHROID) 100 mcg once daily

Metformin (GLUCOPHAGE) 500 mg tablet two times daily (with breakfast & dinner)

Aspirin 81mg once daily

Allergies: No known allergies

PMHx:

Diabetes mellitus (managed by diet and medication)

Diabetes type 2, controlled with diet and medication

Hyperlipidemia (currently on medication)

Hypothyroidism (managed by medication)

Fam Hx: Reported both parents are alive, father with hypertension, mother with diabetes.

Personal/Social History: Drinks ETOH occasionally. Consumes 2-3 cans of beer two times per week. Denies smoking, and illicit drug use.

Review of Systems:

Constitutional:  A&O x4, pleasant and cooperative. Reports abdominal pain 5-6/10. No acute distress. Denies weight loss, weakness, or fatigue.

HEENT:  Denies headache, sore throat or changes in hearing.

SKIN:  No rash or itching.

CARDIOVASCULAR:  Reported burning sensation on his chest when lying down.

RESPIRATORY:  Denies shortness of breath or cough.

GASTROINTESTINAL:  Reported abdominal discomfort for the past two days ranging from 5-6/10. Described as “gnawing” and “burning.” Denies nausea or vomiting. No change in bowel pattern.

GENITOURINARY:  Denies dysuria or hematuria.

NEUROLOGICAL:  Denies focal loss of strength or loss of sensation.

MUSCULOSKELETAL:  Denies focal weakness, facial droop, or joint swelling.

HEMATOLOGIC:  No anemia, bleeding or bruising. NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

LYMPHATICS:  No enlarged nodes. No cervical lymphadenopathy

ALL OTHER SYSTEMS REVIEWED AND NEGATIVE OF PERTINENT FINDINGS

O.

Physical exam: Vital signs: B/P 117/59, Pulse 108 (strong and regular); Temp 98.3F orally; RR 18; non-labored; SpO2: 96% room air;

Height 1.575 m (5′ 2″), weight 73.5 kg (162 lb),

General: A&O x4, pleasant and cooperative. Not in any acute distress.

HEENT: Normocephalic and atraumatic. Sclera anicteric, No conjunctival erythema, PERRLA, oropharynx red, moist mucous membranes.

Neck: Supple. No JVD. Trachea midline. No pain, swelling or palpable nodules.

Chest/Lungs: Clear to auscultation bilaterally. No wheezing, crackles or rhonchi. No accessory muscle use.

Heart/Peripheral Vascular: Regular rate and rhythm noted. No murmurs. No palpitation. No peripheral edema to palpation bilaterally.  NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

ABD: Reports of 5-6/10 pain. Soft, nontender, nondistended. Hyperactive BS. No palpable hepatosplenomegaly

Genital/Rectal: continent of bladder and bowel.

Musculoskeletal: Normal range of motion. Regular muscle mass for age. No swelling or joint deformities.

Neuro: Alert and oriented x4. Strength and sensation intact.

Skin/Lymph Nodes: No cervical lymphadenopathy. No rashes, or erythema. No lesions. NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

Diagnostic results:

EKG: NSR

Laboratory studies:

CBC – WBC 9.4; H/H: 14.3/41.0; PLT: 289.

Chemistry Panel: BUN/Crea: 19/0.52; Glucose: 117*

Pylori serology: negative

Esophageal pH Test: pending

NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

 

A
.

Differential Diagnoses (DD):

Gastroesophageal Reflux Disease (GERD): backward flow of gastric contents, which are typically acidic, into the esophagus (Ball, Dains, Flynn, Solomon, & Stewart, 2015, p. 400).

–    Patient with reports of burning, gnawing pain in the mid-epigastrium that worsens with recumbency (Baumann, Dains, & Scheibel, 2016, p. 27).

–    Risk factors for GERD include obesity, pregnancy, smoking, eating large meals or eating late at night, eating certain foods (triggers) such as fatty or fried foods, drinking certain beverages such as alcohol or coffee, taking certain medications, such as aspirin (Mayo Foundation for Medical Education and Research, 2017).

–    Due to the reported symptoms, alcohol consumption, and recent changes in the patient’s medication, GERD is the primary diagnosis for the patient. NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

Acute coronary syndrome: may have heartburn or a bitter taste in the mouth due to stomach fluid “coming up” which usually occurs after eating and gastroesophageal reflux disease (GERD) is the most common cause of non-cardiac chest pain (The Cleveland Clinic Foundation, 2015).

Peptic Ulcer: associated with reports of burning or gnawing pain that occurs most often with an empty stomach, stress, and alcohol intake which is relieved with food intake (Baumann, Dains, & Scheibel, 2016, p. 27).

Achalasia: a condition where the esophagus is unable to move food into the stomach as the lower esophageal sphincter stays closed during swallowing, back up of food results and symptoms include vomiting undigested food, chest pain, heartburn and weight loss (The Cleveland Clinic Foundation, 2017).

Gastritis: is a constant burning pain in the epigastric area that can be accompanied by nausea, vomiting, diarrhea, or fever and alcohol, nonsteroidal inflammatory drugs and salicylates make the pain worse (Baumann, Dains, & Scheibel, 2016, p. 27).

Hiatal Hernia with esophagitis: is a condition where part of the stomach passes through the esophageal hiatus in the diaphragm and into the chest cavity with symptoms of epigastric pain or heartburn that worsens with lying down and is resolved by sitting up or antacids (Ball, Dains, Flynn, Solomon, & Stewart, 2015, p. 401).

 

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Baumann, L. C., Dains, J. E., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby. NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

Mayo Foundation for Medical Education and Research. (2017, November). Gastroesophageal reflux disease (GERD). Retrieved from https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940

The Cleveland Clinic Foundation. (2015, June). Non-Cardiac Chest Pain: GERD. Retrieved from https://my.clevelandclinic.org/health/diseases/15851-gerd-non-cardiac-chest-pain

The Cleveland Clinic Foundation. (2017, July). Swallowing Problems: Achalasia. Retrieved from https://my.clevelandclinic.org/health/diseases/17534-swallowing-problems-achalasia/symptoms–diagnosis?view=print NURS 6512: Assessment of Abdomen and Gastrointestinal System Episodic/Focused SOAP Note

Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Subjective Data Collection: 20 of 20 (100.0%)

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

 Indicates an item that you found.

Available:

 Indicates an item that is available to be found.

Category

Scored Items

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

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Patient Data

Not Scored

A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Chief Complaint

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Finding:

Established chief complaint

Finding:

Reports cough

(Found)

Pro Tip: Asking about the characteristics of your patient’s cough and voice quality should guide your assessment. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Example Question:

Do you have a cough?

History of Present Illness

Finding:

Asked about onset of cough

Finding:

Reports cough started 5 days ago

(Found)

Pro Tip: Whenever you are assessing a symptom or a health condition, inquiring about onset assesses the severity and the progression of the problem.

Example Question:

How long have you had a cough?

Finding:

Asked about frequency and duration of cough

Finding:

Reports coughing every couple minutes

(Found)

Pro Tip: Establishing a timeline for Danny’s coughing will illustrate how long he has been suffering these particular symptoms and might indicate possible triggers. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Example Question:

How frequently have you been coughing?

Finding:

Asked about character of cough

Finding:

Reports cough is wet

(Found)

Pro Tip: Asking about the characteristics of your patient’s cough and voice quality should guide your assessment. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Example Question:

Is your cough a wet cough?

Finding:

Reports clear sputum with cough

(Found)

Pro Tip: Asking if your patient’s cough is productive should guide your assessment.

Example Question:

Do you produce any phlegm or sputum with your cough? Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Finding:

Asked about aggravating factors for cough

Finding:

Reports cough is worse at night

(Found)

Pro Tip: Establishing a timeline for Danny’s coughing will illustrate how long he has been suffering these particular symptoms and might indicate possible triggers.

Example Question:

Is your cough worse at night?

Finding:

Reports exposure to secondhand smoke

(Found)

Pro Tip: Tobacco use puts the patient at risk for many medical conditions. Asking about all types of tobacco products assesses this risk factor.

Example Question:

Do you smoke?

Finding:

Reports not knowing specific triggers that make the cough worse

(Found)

Pro Tip: Follow-up questions will enable Danny to more fully and specifically describe his condition, experience, or symptoms. Establishing what makes Danny’s cough worse will allow you to more effectively treat his symptoms.

Example Question:

What makes your cough worse?

Finding:

Asked about relieving factors for cough

Finding:

Reports cough “stays the same” with rest

(Available)

Pro Tip: Asking what relieves the patient’s chief complaint will determine the efficacy of possible treatment and may provide important insight into the condition itself.

Example Question:

Does resting help your cough?

Finding:

Reports cough “stays the same” despite drinking water

(Available)

Pro Tip: Asking what relieves the patient’s chief complaint will determine the efficacy of possible treatment and may provide important insight into the condition itself. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Example Question:

Does drinking water help your cough?

Finding:

Asked about nasal symptoms

Finding:

Reports current runny nose

(Found)

Pro Tip: Asking your patient if his nose is running will allow you to determine the symptoms he is experiencing and possible triggers. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Example Question:

Do you have a runny nose?

Finding:

Denies sneezing

(Found)

Pro Tip: Asking your patient if he has been sneezing will allow you to determine the symptoms he is experiencing and possible triggers.

Example Question:

Have you been sneezing?

Finding:

Reports frequent rhinorrhea

(Found)

Pro Tip: Establishing how frequently your patient experiences symptoms, like a runny nose, will most effectively enable you to treat your patient’s symptoms.

Example Question:

Do you get runny noses often?

Finding:

Followed up on nasal discharge

Finding:

Reports nasal discharge is clear

(Found)

Pro Tip: Asking your patient about their specific symptoms and the way that they manifest, like the character of his nasal discharge, will help you to understand his symptoms.

Example Question:

What color is your snot?

Finding:

Reports nasal discharge is thin

(Found)

Pro Tip: Asking your patient about their specific symptoms and the way that they manifest, like the character of his nasal discharge, will help you to understand his symptoms.

Example Question:

Is your snot thin?

Finding:

Asked about ear symptoms

Finding:

Reports pain in right ear

(Found)

Pro Tip: Ear pain can suggest an ear infection, during which the middle of the ear becomes clogged with fluid and mucous, which can affect hearing. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data. Asking Danny if he has ear pain might indicate a possible ear infection and a reason for changes in his hearing.

Example Question:

Do you have any ear pain?

Finding:

Followed up on ear pain

Finding:

Reports ear pain started yesterday

(Available)

Pro Tip: It is important to know how long your patient has suffered pain to determine how urgently treatment is needed.

Example Question:

How long have you had ear pain?

Finding:

Reports pain rating of 3 for ear pain

(Available)

Pro Tip: It is important to determine the severity of your patient’s paint to determine how urgently treatment is needed and how best to address it.

Example Question:

How bad is your ear pain?

Finding:

Denies ear discharge

(Found)

Pro Tip: Asking your patient about their specific symptoms and the way that they manifest, like if he has ear discharge, will help you to understand his symptoms. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data.

Example Question:

Do you have any ear discharge?

Finding:

Asked about throat symptoms

Finding:

Reports sore throat

(Found)

Pro Tip: Asking about the patient’s mouth and throat should guide your assessment.

Example Question:

Is your throat sore?

Finding:

Reports “a little” pain with swallowing

(Found)

Pro Tip: Asking your patient about their specific symptoms and the way that they manifest, like if he has ear discharge, will help you to understand his symptoms.

Example Question:

Does it hurt when you swallow?

Medical History

Finding:

Confirmed use of medications

Finding:

Confirms medications

(Found)

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

Example Question:

What medications do you take?

Finding:

Reports taking a daily vitamin

(Found)

Pro Tip: Asking specifically about vitamin or supplement use is important, because patients don’t always consider these a “medication.”

Example Question:

Do you take vitamins?

Finding:

Reports taking cough medicine

(Found)

Pro Tip: Asking specifically about medications to relieve a condition is a good way to check that a patient is remembering all of his medications Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data.

Example Question:

Are you taking medication for your cough?

Finding:

Followed up on cough medicine

Finding:

Reports cough medicine was purple

(Found)

Pro Tip: Asking about how the patient has been managing their pain assesses their current condition and their approach to self-care. The results of their previous treatment may be helpful in your diagnosis and the development of their new treatment plan, as well as a good opportunity to educate the patient on effective self-care practices.

Example Question:

What color was the cough medicine?

Finding:

Reports taking one spoonful of cough medicine

(Found)

Pro Tip: Asking about how the patient has been managing their pain assesses their current condition and their approach to self-care. The results of their previous treatment may be helpful in your diagnosis and the development of their new treatment plan, as well as a good opportunity to educate the patient on effective self-care practices.

Example Question:

How much cough medicine did you take?

Finding:

Reports mother gave him the medicine

(Found)

Pro Tip: Asking about how the patient has been managing their pain assesses their current condition and their approach to self-care. The results of their previous treatment may be helpful in your diagnosis and the development of their new treatment plan, as well as a good opportunity to educate the patient on effective self-care practices.

Example Question:

Who gave you the cough medicine?

Finding:

Reports cough medicine provided temporary relief

(Available)

Pro Tip: Asking about how the patient has been managing their pain assesses their current condition and their approach to self-care. The results of their previous treatment may be helpful in your diagnosis and the development of their new treatment plan, as well as a good opportunity to educate the patient on effective self-care practices. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data.

Example Question:

Did the cough medicine make you feel better?

Finding:

Asked about allergies

Finding:

Denies seasonal allergies

(Found)

Pro Tip: Seasonal allergies can cause symptoms like runny nose, cough, and discomfort. Asking Danny if he has seasonal allergies can help you to ascertain possible triggers for symptoms.

Example Question:

Do you have seasonal allergies?

Finding:

Denies food allergies

(Found)

Pro Tip: Knowing if your patient has food allergies is important and relevant medical history. Asking your patient about food allergies will allow you to most effectively treat him.

Example Question:

Do you have food allergies?

Finding:

Denies medication allergies

(Found)

Pro Tip: Knowing if your patient has allergies to medicine is important and relevant medical history. Asking your patient about medicine allergies will allow you to most effectively treat him.

Example Question:

Are you allergic to any medicine?

Finding:

Denies allergies to animals

(Available)

Pro Tip: Asking about allergies to animals is important for a child with respiratory problems, because the issue could be caused or exacerbated by a family pet or recent exposure to an animal.

Example Question:

Are you allergic to animals?

Finding:

Denies latex allergy

(Available)

Pro Tip: Confirming absence or presence of a latex allergy is essential in a hospital setting, where some instruments have latex parts.

Example Question:

Are you allergic to latex?

Finding:

Asked about relevant medical history

Finding:

Denies asthma diagnosis

(Found)

Pro Tip: Asthma is a serious medical condition that can be life-threatening if not managed appropriately. Regardless of the patient’s presenting illness, it is critical to identify current medical conditions in order to treat the patient appropriately. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data. Specific questions should be asked about previous medical problems, even if the patient doesn’t notice current symptoms.

Example Question:

Do you have asthma?

Finding:

Reports immunizations as current

(Found)

Pro Tip: A health assessment should include an evaluation of the patient’s immunization status in order to identify diseases to which the patient is vulnerable.

Example Question:

Do you have current immunizations?

Finding:

Reports past pneumonia and frequent coughs

(Found)

Pro Tip: Respiratory conditions extremely limit one’s ability to function in normal life activities. It’s important to identify the patient’s health conditions in order to care for her safely and effectively. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data.

Example Question:

Do you have a history of respiratory problems?

Finding:

Denies past hospitalizations

(Available)

Pro Tip: Asking about previous hospitalizations will give you a broader understanding of the patient’s medical history in addition to guiding your assessment of their chief complaint.

Example Question:

Have you ever been to the hospital?

Social History

Finding:

Asked about exposure to secondhand smoke

Finding:

Reports father smokes cigars

(Found)

Pro Tip: Secondhand smoke puts the patient at risk for many medical conditions may exacerbate breathing problems associated with a respiratory complaint. Knowing about household exposure to irritants such as smoke will help you know about potential sources of Danny’s complaint.

Example Question:

Who smokes at home?

Finding:

Reports father sometimes forgets to take cigars outside

(Available)

Pro Tip: Secondhand smoke puts the patient at risk for many medical conditions may exacerbate breathing problems associated with a respiratory complaint. Knowing about household exposure to irritants such as smoke will help you know about potential sources of Danny’s complaint.

Example Question:

Where does your father smoke?

Review of Systems

Finding:

Asked about general symptoms

Finding:

Reports frequent colds

(Found)

Pro Tip: Asking about the patient’s susceptibility to colds is should guide your assessment.

Example Question:

Do you have unusually frequent colds?

Finding:

Denies fever

(Found)

Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has a fever will illustrate the way his symptoms manifest.

Example Question:

Do you have a fever?

Finding:

Denies chills

(Found)

Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has chills will illustrate the way his symptoms manifest. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

Example Question:

Do you have chills?

Finding:

Reports reports feeling “kind of tired”

(Found)

Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has fatigue will illustrate the way his symptoms manifest.

Example Question:

Do you have fatigue?

Finding:

Denies night sweats

(Found)

Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has night sweats will illustrate the way his symptoms manifest.

Example Question:

Do you have night sweats?

Finding:

Denies weight loss

(Available)

Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny if he has lost weight will illustrate the way his symptoms manifest.

Example Question:

Have you lost weight?

Finding:

Denies appetite loss

(Available)

Pro Tip: Soliciting a shallow history of your patient’s symptoms will help you to most effectively treat him. Asking Danny about his appetite will illustrate the way his symptoms manifest.

Example Question:

Have you lost your appetite?

Finding:

Asked about review of systems for HEENT

Finding:

Denies ear popping or crackling

(Available)

Pro Tip: Asking your patient about their specific symptoms and the way that they manifest, like if he has any ear popping, will help you to understand his symptoms.

Example Question:

Do you hear any popping sounds?

Finding:

Reports history of frequent ear infections

(Available)

Pro Tip: Asking your patient about their specific symptoms and the way that they manifest, like if he has ear infections, will help you to understand his symptoms.

Example Question:

Have you ever had ear infections?

Finding:

Denies ear surgery or ear tubes

(Available)

Pro Tip: It is important to ask your patient about past surgeries to better understand the scope of previous treatment as well as rule out possible complications that may be resulting in the patient’s condition.

Example Question:

Have you ever had surgery on your ears?

Finding:

Denies headaches

(Found)

Pro Tip: Headaches are a common complaint that can be caused by a variety of benign conditions. However, headaches can be an indicator of serious underlying neurological conditions such as cerebral hemorrhage, meningitis, or brain tumors. They may also be a symptom of sinus infection.

Example Question:

Do you get headaches?

Finding:

Denies nosebleeds

(Found)

Pro Tip: Infected sinuses can manifest as nose problems. Asking Danny about his nasal symptoms solicits information about his sinuses and possible sinus problems. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data.

Example Question:

Do you have nosebleeds?

Finding:

Denies vision problems

(Found)

Pro Tip: Eye or vision problems can lower one’s ability to function and can be a major safety risk.

Example Question:

Do you have any problems with your vision?

Finding:

Denies dizziness

(Found)

Pro Tip: Asking about dizziness assesses for inner ear, neurological, or cardiovascular problems.

Example Question:

Do you have any dizziness?

Finding:

Denies watery eyes

(Found)

Pro Tip: Eye or vision problems can lower one’s ability to function and can be a major safety risk.

Example Question:

Do you have watery eyes?

Finding:

Denies eye redness

(Found)

Pro Tip: Eye or vision problems can lower one’s ability to function and can be a major safety risk.

Example Question:

Do you have eye redness?

Finding:

Denies eye pain

(Found)

Pro Tip: Sinusitis can create pressure behind the eyes, causing eye pain. Asking Danny whether he is experiencing eye pain solicits information about possible symptoms.

Example Question:

Do you have any eye pain?

Finding:

Denies sinus pain

(Found)

Pro Tip: Infected sinuses can manifest as nose problems. Asking Danny about his nasal symptoms solicits information about his sinuses and possible sinus problems.

Example Question:

Do you have any sinus pain?

Finding:

Denies hearing problems

(Found)

Pro Tip: Asking your patient about their specific symptoms and the way that they manifest, like if he has hearing problems, will help you to understand his symptoms.

Example Question:

Do you have any hearing problems?

Finding:

Asked about review of systems for respiratory

Finding:

Denies difficulty breathing

(Found)

Pro Tip: It’s important to ask about episodes of shortness of breath because ineffective breathing can be life-threatening. Shortness of breath can be caused by respiratory or cardiac conditions, allergies, or exercise.

Example Question:

Do you have difficulty breathing?

Finding:

Denies chest tightness

(Found)

Pro Tip: Chest pain may indicate cardiac conditions, muscular inflammation, gastric upset, or respiratory distress. If chest tightness is present, asking about its location, characteristics, and related factors helps to determine the cause of the discomfort. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data.

Example Question:

Do you have chest tightness?

Finding:

Denies chest pain

(Found)

Pro Tip: Chest pain may indicate cardiac conditions, muscular inflammation, gastric upset, or respiratory distress. If chest pain is present, asking about its location, characteristics, and related factors helps to determine the cause of the discomfort.

Example Question:

Do you have any chest pain?

Finding:

Reports no history of inhaler use or breathing treatments

(Available)

Pro Tip: Respiratory conditions extremely limit one’s ability to function in normal life activities. It’s important to identify the patient’s health conditions in order to care for her safely and effectively.

Example Question:

Have you ever used a medicine that you inhaled?

Family History

Finding:

Asked about relevant family history

Finding:

Reports not being around anyone ill at home

(Available)

Pro Tip:

Example Question:

Is anyone sick at your house?

Finding:

Reports father had asthma as a child

(Found)

Pro Tip: Medical problems that are present in a patient’s immediate family can represent increased risk factors to many medical conditions for the patient.

Example Question:

Do you have a family history of asthma?

Finding:

Denies family history of allergies

(Found)

Pro Tip: Medical problems that are present in a patient’s immediate family can represent increased risk factors to many medical conditions for the patient. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data.

Example Question:

Do you have a family history of allergies?

Finding:

Denies pets at home

Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data

NR451 – Apply the components of the iCARE concept to interprofessional teams

Title

Your Name

Chamberlain College of Nursing

NR451 RN Capstone Course

Term and Year

ORDER A PLAGIARISM-FREE PAPER HERE

Your title here

This paragraph(s) is to introduce the paper.
Explain the type of work setting you are discussing and whether interprofessional teams are present. If present, indicate a team function that could be improved.  If not present, indicate what type of team you think might work well in this setting and how it might function.
Remember this is a scholarly APA assignment so you cannot use first person. Remember also that you will keep all the bolded headings and just remove the non-bolded content when you start your paper. NR451 – Apply the components of the iCARE concept to interprofessional teams

Compassion

In this paragraph, describe
a nursing action that could contribute to compassion
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Advocacy

In this paragraph, describe
a nursing action that could contribute to advocacy
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes. NR451 – Apply the components of the iCARE concept to interprofessional teams

Resilience

In this paragraph, describe
a nursing action that could contribute to resilience
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Evidence-Based Practice

In this paragraph, describe
a nursing action that could contribute to evidence-based

practice
through interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes. NR451 – Apply the components of the iCARE concept to interprofessional teams

Summary

Provide a clear and concise summary. Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes through nursing actions.  Address how you may be able to influence this process of support for interprofessional teams on your unit or in your organization.

 

References

Select at least one scholarly nursing article from CINAHL as a resource for your paper. Additional scholarly sources can be used but are optional.

 

Purpose

The purpose of the iCARE Paper assignment is to explore the concept of interprofessional teams and patient outcomes. Nursing supportive actions of compassion, advocacy, resilience, and evidence-based practice will serve as a way to apply care concepts.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO1: Applies principles of nursing, theories, and the care philosophies to self, colleagues, individuals, families, aggregates and communities throughout the healthcare system. (PO#1)

CO6: Plans clinical practice activities that integrate professional nursing standards in accordance with the Nursing Code of Ethics and the American Nurses’ Association (ANA) standards of practice. (PO#6) NR451 – Apply the components of the iCARE concept to interprofessional teams

Points

The assignment is worth 200 points.

Due Date

Submit your completed assignment by Sunday end of Week 5 by 11:59 p.m. MT.

Directions

Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity (Links to an external site.)

Getting Started: Interprofessional teams are part of practice trends we see developing in all aspects of care delivery. Consider you own work environment (or recent clinical setting).

• For this assignment, consider the concept of interprofessional teamwork and patient outcomes.

• Look to your current workplace as an example. (If you are not currently employed, look to a past workplace or clinical practice area.) NR451 – Apply the components of the iCARE concept to interprofessional teams

• Apply the components of the iCARE concept to interprofessional teams in a short paper. (Body of the paper to be 3 pages, excluding the title page and references page)

• iCARE components are:

C ompassion

A dvocacy

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R esilience

E vidence-Based Practice (EBP)

• How could you contribute to an interprofessional team and patient outcomes through nursing actions of: compassion, advocacy, resilience, and evidence-based practice?

• Select one scholarly nursing article from CINAHL as a resource for your paper. Additional scholarly sources can be used but are optional. When searching in the CINAHL database, please limit your search word to one component of the paper you wish to emphasize, such as ‘Resilience’. Searching for the term iCARE will not produce the results you need. NR451 – Apply the components of the iCARE concept to interprofessional teams

• Use APA format throughout, particularly in citations and on the References page.

• Please paraphrase throughout. One short quote is permitted.

• The prepared paper template is RECOMMENDED for this assignment.

Download the assignment template here:

iCare Assignment Template (Links to an external site.) – APA 6th edition

iCare Assignment Template (Links to an external site.) – APA 7th edition

A short tutorial with tips for completing this assignment may be viewed here: iCARE Paper Tutorial (Links to an external site.)

Elements of iCARE paper

• Title page

• Below are the headings to be used for this assignment.

• Introduction: (No heading needed here in APA) Explain the type of work setting you are discussing and whether interprofessional teams are currently present. If interprofessional teams are present, indicate a team function that could be improved. If interprofessional teams are NOT present, indicate what type of team you think might be possible in the setting. NR451 – Apply the components of the iCARE concept to interprofessional teams

Describe a nursing action item for each component below that could contribute to: interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

• Compassion

• Advocacy

• Resilience

• Evidence-Based Practice

• Summary: Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes. Address how you may be able to influence this process of support for interprofessional teams overall in your unit or organization.

• References page: List any references used in APA format. NR451 – Apply the components of the iCARE concept to interprofessional teams

Supportive Psychotherapy Versus Interpersonal Psychotherapy

Briefly describe how supportive and interpersonal psychotherapies are similar.

Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor.

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Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature. Supportive Psychotherapy Versus Interpersonal Psychotherapy.

Practicum: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical, as well as mental factors that might impact the client’s diagnosis and treatment. Practicum: Decision Tree

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At each Decision Point stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Practicum: Decision Tree

Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?

Decision #2: Treatment Plan for Psychotherapy

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

Decision #3: Treatment Plan for Psychopharmacology

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Practicum: Decision Tree

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. Practicum: Decision Tree

// A young woman with Depression

Case #2

A young woman with Depression

SUBJECTIVE

Stefanie is a 32-year-old female from Puerto Rico who presents to your office today with complaints of difficulty sleeping. You learn that Stefanie can go for a few days with minimal sleep (about 3 hours/night), but does not seem to be fatigued the next day. Stefanie explains that after 3 days with minimal sleep, she “crashes” and has a good night’s sleep. She states that sleep will be “alright” for a few days, even a few weeks, and then she will have a similar issue with sleep.

You learn throughout the assessment process that Stefanie has had this problem for years. She noticed that it began in college and thought it was just because of the workload and academic demands. However, she found that it persisted after college. She also notices that she has periods where she will engage in increased amounts of goal-directed activity. She states that things will just “pile up” at work and she gets this burst of energy to “make everything right.” She states that these bursts will last most of the day. She states that these periods show up probably every 2 to 3 weeks. Practicum: Decision Tree

Stefanie also confesses to problems with being “down in the dumps.” She states that when she has her episodes in which she endeavors to “make everything right,” she feels fantastic and on top of the world. However, when these periods of energy end, she reports that she feels “depressed”—but then states: “well, maybe not depressed, but I definitely feel sad and empty.” She also endorses feelings of fatigue and a decreased ability to concentrate when she is feeling sad. She finally tells you: “I have lived with this for so long, I have to admit that it is finally a relief to tell someone how I feel!”

OBJECTIVE

Stefanie is dressed appropriately to the weather. She has no gait abnormalities. Physical assessment is unremarkable. Gross neurological assessment is within normal limits.

MENTAL STATUS EXAM

Stefanie is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. Self-reported mood is “sad.” Affect does appear consistent with dysphoria. Eye contact is normal. Speech is clear, coherent, and goal directed. She denies visual or auditory hallucinations. No overt evidence of paranoid or delusional thought processes noted. She denies suicidal or homicidal ideation and is future oriented.

At this point, please discuss any additional diagnostic tests you would perform on Stefanie.

Decision Point One Practicum: Decision Tree

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER (PMHNP) GIVE TO STEFANIE?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis. Practicum: Decision Tree

Bipolar I, current phase, depressed

Bipolar II, current phase, hypomanic

Cyclothymic disorder

Decision Point One

Bipolar I, current phase, depressed

Bipolar I, current phase, depressed

Decision Point Two

BASED ON THIS DIAGNOSIS, SELECT YOUR CHOICE OF ACTIONS:

Begin Latuda 40 mg orally daily

Lamictal 100 mg orally daily

Begin psychotherapy using a psychodynamic approach

Decision Point One

BipBipolar II, current phase, hypomanic

olar II, current phase, hypomanic

Decision Point Two

BASED ON THIS DIAGNOSIS, SELECT YOUR CHOICE OF ACTIONS:

Begin Lithium 300 mg orally twice a day

Begin Olanzapine 10 mg orally at bedtime

Begin Abilify 10 mg orally daily Practicum: Decision Tree

Cyclothymic disorder

Cyclothymic disorder

Decision Point Two

BASED ON THIS DIAGNOSIS, SELECT YOUR CHOICE OF ACTIONS:

Begin Depakote 250 mg orally three times daily

Begin Abilify 10 mg orally daily

Arrange to see Stefanie every 3 months for routine follow-up Practicum: Decision Tree

Create a 3-5-page PICO(T) question essay submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.

PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.

It stands for:

P – Patient/population/problem.

I – Intervention.

C – Comparison (of potential interventions, typically).

O – Outcome(s).

T – Time frame (if time frame is relevant).

The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. PICO(T) question essay.

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You are encouraged to complete the Vila Health PCI(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.

Explain the findings from articles or other sources of evidence.

Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.

Identify sources of evidence that could be potentially effective in answering a PICO(T) question.

Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question PICO(T) question essay.

Competency 3: Apply an evidence-based practice model to address a practice issue.

Define a practice issue to be explored via a PICO(T) approach.

Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Reference

Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Burlington, MA: Jones & Bartlett Learning.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted. PICO(T) question essay.

PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question PICO(T) question essay.

Scenario

For this assessment, please use an issue of interest from your current or past nursing practice.

If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.

Instructions

For this assessment, select an issue of interest an apply the PICO(T) process to define the question and research it.

Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.

If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the ”Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful.

In your submission, make sure you address the following grading criteria:

Define a practice issue to be explored via a PICO(T) approach.

Identify sources of evidence that could be potentially effective in answering a PICO(T) question.

Explain the findings from articles or other sources of evidence.

Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.

Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style PICO(T) question essay.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 3 Example 1 [PDF].

Additional Requirements

Your assessment should meet the following requirements:

Length of submission: Create a 3–5-page submission focused on defining a research question and interpreting evidence relevant to answering it. A title page is not required but you must include a reference list.

Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.

APA formatting: Format references and citations according to current APA style. PICO(T) question essay

The purpose of this PUB 550 Data Management assignment is to practice organizing data through ordering and grouping variables.

Data often appear disordered and it is difficult to see any connections or relationships. Ordering the data by certain variables or grouping variables into specific categories, such as age or sex categories, can help bring clarity to the data. Knowing how to organize data is an important skill to initiate the analytical process.

For this assignment, students will use Excel and SPSS Statistics to order variables. Using the ”Example Dataset,” complete the steps below using both Excel and SPSS Statistics. View the Excel and SPSS tutorials for assistance in completing this assignment. Submit one Word document and include a screen shot of the data after completing the first two steps of Part 1 in Excel and SPSS to compare your results. Use a second Word document to complete Part 2 of the assignment. PUB 550 Data Management.

Part 1: Ordering and Grouping Data Using Excel and SPSS

For Part 1, accomplish the following:

Order (sort) observations according to age.

Group observations by sex and investigate the age and income for males and females.

Create a new variable titled ”Exercise Group” based on the variable ”Minutes Exercise.” Use the following categories to create your groups: 1 = 0-30 minutes; 2 = 31-60 minutes; 3 = 61-90 minutes; 4 = 91-120 minutes; and 5 = 120+ minutes.

 

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Part 2: Data Interpretation

Study the results of the dataset grouping and ordering. Discuss the following in a 500-750 word summary:

Describe the measurement levels for each of the variables in the dataset.

Discuss what you learned from ordering the data by age and why this information is important.

Describe the process you used to group the data in Excel and SPSS.

Describe what you learned by grouping the variables by category of exercise.

Are these data from a correlational study, experimental study, or quasi-experimental (observational) study? Discuss your rationale and identify a study question appropriate for this dataset.

General Requirements PUB 550 Data Management

Submit the Word document to the instructor.

APA style is not required, but solid academic writing is expected.

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

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

Attachments

PUB-550-RS-Example Dataset.xlsx PUB 550 Data Management

HE006: Commitment to Professional Development and Lifelong Learning Assignment Paper

Complete the HumanMetrics personality assessment. Based on your results, write a 3- to 4-page NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue self-reflection as follows:

Analyze your personal and professional strengths. What management, leadership, functional, and interpersonal skills do you consider to be your strengths? Why were these strengths included?

Analyze your personal and professional weaknesses. In what areas do you recognize that improvement is needed if you are to perform as an effective administrator, manager, and leader? Are there areas in which you are interested but feel you need additional knowledge and skills? Explain and justify your rationale for selecting these weaknesses.

Analyze at least three opportunities you have to further your professional growth and development. Include work-related opportunities or those outside the workplace.

Describe at least three ways you would incorporate the practice of lifelong learning in your profession growth.

Describe barriers or challenges that might keep you from achieving what you want. Include work-related barriers or those outside the workplace. Explain which barriers are of most concern and why. HE006: Commitment to Professional Development and Lifelong Learning Assignment Paper.

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Consider the varied opportunities for healthcare administrators, managers, and leaders today: the different settings, positions, and areas of expertise and knowledge that exist in the fast-changing healthcare environment. With insights from your self-reflection in mind, write a 4- to 6-page opportunities analysis as follows:

Describe the roles and responsibilities of four different administrative and or managerial positions in four different healthcare settings (for example, a director of food services in a nursing home; a health information manager in a hospital; or a director of business development, contracting, and sales in a rehabilitation center). Select positions and settings that are of particular interest and relevance to you professionally. Explain why these positions interest you. Describe trends that impact the growth potential of these positions. HE006: Commitment to Professional Development and Lifelong Learning Assignment Paper.

Describe the strengths you would bring to each position as well as the weaknesses you would need to address, including any functional knowledge and skills you bring to the position or would need to gain.

Analyze key unique and specific leadership, knowledge, and competency skills that are needed to be effective and innovative in these healthcare administrative roles. Identify at least four you need to enhance through additional training and mentorship and where skills can be developed.

Describe at least two opportunities you have for expanding personal innovative leadership in the workplace. How and why might those opportunities yield positive results?

There are many paths that lead toward continuing professional development through lifelong learning. All require deliberate and informed thought and planning. Based on insights and information gained from Parts 1 and 2 of this Assessment, develop a 3- to 4-page professional development plan as follows:

Note: If your current place of employment provides a “Professional Development Plan Template,” you are encouraged to use this template. HE006: Commitment to Professional Development and Lifelong Learning Assignment Paper.

Describe which professional organizations you might join. If you are already a member of an organization, discuss how you have benefitted and how you could enhance benefits from your membership. Describe specifically what you can gain from involvement with these organizations and what you can contribute to the organizations.

Describe at least three specific, measurable steps/actions you can take over the next 3–5 years that will enhance your professional career opportunities and help you reach your professional goals. Consider certifications that may better position you to gain new opportunities.

Identify career goals in the context of the dynamic healthcare environment and the specific skills and knowledge needed to maintain a competitive advantage. Consider additional work experiences, even in your current workplace, you might seek that will enhance your opportunities in the future. Also consider what community involvement activities you might engage in that will authentically demonstrate your commitment to a community orientation and social change. Consider managerial and leadership skills you need to enhance. Explain your rationale for each, including how it will specifically help position you for continued growth.

Describe at least five action steps needed for your “Plan for Professional Development.” Using a “Word Table,” break the steps down into specific, measurable steps that include target date, event, and milestone. Provide rationale for each action step HE006: Commitment to Professional Development and Lifelong Learning Assignment Paper.

NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue

Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States

There are many national healthcare stressors or issues affecting and impacting healthcare organizations all over the United States. All of them require addressing, although some are more urgent than others. The healthcare issue chosen in this case and one of the most significant stressors at the moment is the issue of upskilling of healthcare professionals. In this context, these would be the nurses working within the healthcare organization. According to Ross (2019), upskilling is the process of retraining employees so that they can acquire new skills for them to continue practicing in their field with ease NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue. Recent developments (particularly technological) within and around healthcare have necessitated the requirement that workers such as nurses possess skillsets that are upgraded. As a matter of fact, upskilling was identified as one of the six important healthcare issues in 2019 by PwC Health Research Institute (Ross, 2019). Currently, whole healthcare workforces are threatened with redundancy by technologies such as artificial intelligence (AI) if they do not upskill. This includes nurses, who have traditionally not been involved with technology in the course of delivering nursing care (Teague, 2019). NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue

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The impact to my healthcare organization of upskilling as a healthcare issue is immense. This is because emerging healthcare technologies are becoming more and more mandatory in diagnostics, therapeutics, and nursing care. Nurses are therefore finding themselves short of skills to deliver quality patient care. This makes the organization set aside resources to retrain and upgrade the skills of its nurses so that they can cope with the emerging technological changes. This, however, is an inevitably resource-intensive undertaking fir the organization. In my organization, for instance, the policy makers have already had to set aside funds for training of the nurses and other healthcare staff on the use of the recently introduced EHR. NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue. Already, upskilling is happening in the healthcare sector with the now standard requirement for electronic health records or EHR. That said, the hallmark of upskilling in healthcare is predicted to be artificial intelligence-assisted telehealth interventions (Teague, 2019).

Some of the Areas of Concern

Healthcare organizations must invest in the abilities of their workforce if they are to have a competitive advantage over their peers. Not doing so will of course render the organization unable to compete effectively in an ever-changing healthcare marketplace. For instance, AI is more and more used in healthcare at the moment. What this means is that rising sophistication of emerging medical technologies is driving the need for upskilled health workers (Ross, 2019). The advent of digital therapeutics is the other area of concern. This is the treatment of disease using healthcare technologies to complement or replace traditional methods in disease management. The reality is that the clinical validation of these digital therapeutics products and connected medical devices is already being done by the Food and Drug Administration or FDA (Siwicki, 2019). This is an indicator of the urgency with which upskilling of healthcare staff like nurses should be treated. NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue.

Two Articles on the Upskilling of Healthcare Workers as a Healthcare Issue of Concern

           
Rimmer (2018) has posited that doctors have to undergo additional training in order to be successful at using emerging healthcare technologies. This particular article addresses doctors as the healthcare workers of concern, but it has been chosen because the very same situation is true for the nurses. This article talks of a report that states that training is needed by doctors in areas such as artificial intelligence algorithms, genomics, and digital literacy. As mentioned above, that is the same treatment that nurse practitioners should also receive. The article goes ahead to stress that training is a must for healthcare staff in order to cope with emerging healthcare technologies. NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue

Fralic (2013) on her part observes that the American healthcare system is undergoing change that is radical and monumental. She states, correctly, that with change there is need to re-strategise and re-organize to deliver quality healthcare. To do this, upskilling is a must to keep up with healthcare technologies. In other organizations in the healthcare sector, the same situation portends. They, too, are adopting the same approach of retraining to upskill nurses, doctors, and other health workers so that they can cope with the recent technological changes and continue to offer quality and safe patient care.

Strategies to Address the Organizational Impact of Upskilling

Since the reality of upskilling in healthcare organizations is inevitable, it is essential to develop strategies that aim at addressing the organizational impact of this issue. Three strategies are especially helpful. First, the organization needs to introduce new technologies gradually to allow for adaptation and training. Second, upskilling should be made a policy initiative that features in the organization’s goals. Third and last, upskilling should be properly budgeted for like any other expense if it is to succeed (Fralic, 2013; Rimmer, 2018; Teague, 2019). Under no circumstances should upskilling be considered as an afterthought. These strategies impact my organization positively in that they are geared towards giving the organization a competitive advantage. On the negative side, however, budgeting means that this strategy will consume resources that the organization must set aside.

References

Fralic, M.F. (2013). Upskilling for new-era healthcare: Lessons from high impact readings.
Nurse Leader, 11
(4).
http://dx.doi.org/10.1016/j.mnl.2013.05.008

Rimmer, A. (2018). Upskill doctors to make the most of new medical technologies, report says.
BMJ,
361
(k2861). Doi: 10.1136/bmj.k2861

Ross, J.R. (2019).
Upskilling could be an ideal treatment for healthcare’s employment woes
. Retrieved 4 March 2020 from
https://www.cardiovascularbusiness.com/topics/healthcare-economics/upskilling-could-be-ideal-rx-healthcares-employment-woes

Siwicki, B. (2019). Here are 6 major issues facing healthcare in 2019, according to PwC.
Healthcare ITNews
. Retrieved 4 March 2020 from
https://www.healthcareitnews.com/news/here-are-6-major-issues-facing-healthcare-2019-according-pwc

Teague, T. (2019).
Will healthcare employees need to be upskilled or reskilled as technology advances?
Retrieved 4 March 2020 from

Will Healthcare Employees Need to be Upskilled or Reskilled as Technology Advances?

 

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. NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue

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. NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue

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.

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).

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. NURS 6053 week 2 Assignment: Analysis of a Pertinent Healthcare Issue

NURS 6053 week 3 Discussion: Organizational Policies and Practices to Support Healthcare Issues

Discussion: Organizational Policies and Practices to Support Healthcare Issues

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

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

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. NURS 6053 week 3 Discussion: Organizational Policies and Practices to Support Healthcare Issues

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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. NURS 6053 week 3 Discussion: Organizational Policies and Practices to Support Healthcare Issues. NURS 6053 week 3 Discussion: Organizational Policies and Practices to Support Healthcare Issues

 

Organizational Policies and Practices to Support Healthcare Issues

How competing needs may impact the development of a policy

Competing needs, such as the needs of patients, workforce, and resources may impact the development of a policy because the competing needs should align with the agenda that policy is advocating for.   For example, a policy addressing adequate nurse staffing is required to meet the patient and workforce needs while minimizing financial cost.  According to Lopez et al (2015), .the effective utilization and deployment of the workforce are of great importance to ensure efficient delivery of healthcare services in terms of quantity, quality, and cost.

Failure effectively deploys and utilizing the workforce to do so might lead to a shortage or oversupply of clinical staff. For example, an oversupply of clinical staff might result in economic inefficiencies along with misallocated resources under the guise of adequate staffing. The shortage of staff is connected with numerous negative impacts, including lower quality and quantity of care because there are few resources to offer the essential services; work overload of the available nurses leading to burnout, eventually compromising patient safety; and longer waiting times as a result of inadequate staff leading to preventable patient deaths (Lopez et al, 2015).

Specific competing needs that may impact workload

A good fit between nursing staff and patients’ needs are specific competing needs that may impact workload as a national healthcare issue Organizations are exploring schemes of ensuring a good balance amid nursing staff expertise and size and patient needs so as to ensure quality and safe care along with outstanding services to patients while ensuring operating costs are sustainable (van den Oetelaar et al, 2016).

van den Oetelaar et al (2016) claim that nursing capacity should be optimally matched to the needs of patients which is achievable through a sensible and fair distribution of nurses in units, leading to a workload that is equally distributed and manageable for the nursing staff. This necessitates a good balance between nursing staff and patients’ needs. One scheme of ensuring an appropriate balance is the managing workload for nursing staff. This assists balance the needed resources with the available resources, which in turn averts additional costs for overstaffing a unit and averts a decline in employee engagement or patient experiences by understaffing a unit. NURS 6053 week 3 Discussion: Organizational Policies and Practices to Support Healthcare Issues

The impacts and how policy might address these competing needs

Workload has an impact on both patient and staff needs as well as an organization’s resources.  High causes burnout which leads to errors and poor patient outcomes. High workload also has an impact on nurse job dissatisfaction and burnout, and the intention of nurses to leave. High nursing staff turnover resulting in increased costs for using temporary employees or training new nurses (van den Oetelaar et al, 2016).

A policy might address these competing needs by ensuring an optimal nurse to patient ratio which can improve nurse staffing in organizations and improved care outcomes for patients. The policy can outline a particular nurse to patient ratio depending on the type of unit within a healthcare facility.  For instance, the ratio for a surgical and medical unit can be 5: 1, meaning one nurse will be assigned to five patients at most, while in the intensive unit ratio can be 2:1.  As suggested by Livanos (2015), having a staffing policy in a facility can improve the working conditions for the nursing staff as well as the superiority and safety of care.  In turn, costs of adhering to the ratios can be offset by, less need for training new nurses or temporary nurses and reduced turnover of the nursing staff. NURS 6053 week 3 Discussion: Organizational Policies and Practices to Support Healthcare Issues

 

References

Livanos, N. (2018). A Broadening Coalition: Patient Safety Enters the Nurse-To-Patient Ration Debate
. Journal of Nursing Regulation, 9
(1), 68-70.

Lopes, M., Almeida, A., & Almada-Lobo, B. (2015). Handling healthcare workforce planning with care: where do we stand?
Human Resources for Health13
:38.

van den Oetelaar, van Stel, H., Van Rhenen W, et al. (2016).  Balancing nurses’ workload in hospital wards: study protocol of developing a method to manage workload.
BMJ Open, 6
(11), e012148. NURS 6053 week 3 Discussion: Organizational Policies and Practices to Support Healthcare Issues