Tag: Clinical-Nursing

  • NURS 6512 Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

    NURS 6512 Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

    Case Study Assignment: Assessment Tools and Diagnostic Tests in  Children

    The health and wellbeing of children are critical milestones in the growth and development of children. The Centers for Disease Control and prevention (CDC) and the Health Resources and Services Administration (HRSA) have reported that one in six or 17% of children aged between three and seventeen years had a developmental disability in the 2009-2017 period (Zablotsky et al., 2019). According to Zablotsky et al. (2019), the number of affected children increased from 16.2% in 2009–2011 to 17.8% in 2015–2017. On the other hand, Ford et al. (2017) have found that developmental and behavioral disorders are now among the top-five chronic conditions in the pediatric population. The main concern is that minority children and those living in rural areas carry a disproportionate burden of developmental disabilities. A combination of these issues highlights the critical role that Nurse Practitioners (NPs) play in screening and care management of children. As such, the purpose of this assignment is to explore a case involving a severely underweight 12-year-old Hispanic girl with underweight parents who has been bullied in school just recentlyNURS 6512 Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children.

    Health Issues and Risks

    The patient presented in the case is underweight, which is one of the four broad sub-categories of undernutrition. Nutrition plays a critical role in the adolescence stage of growth and development. According to Burns et al. (2017), adolescence is a unique and crucial stage of development characterized by intense cognitive, physical, and psychosocial development. Burns et al. (2017) has identified malnutrition as a key miscellaneous causes of delayed growth and puberty. Undernutrition particularly causes a short stature with a delayed pattern of growth. The patient has an increased risk of delayed puberty considering that the stage begins early in girls compared to boys. Research findings have shown that severe states of undernutrition impair the normal activity of the reproductive process (Zablotsky et al., 2019). Zablotsky et al. (2019) have found that undernutrition that occurs in late childhood can delay the onset of puberty. Nutrition is vital for the patient since the growth spurt triggered by puberty increases the demand for nutritional needs, including micro and macronutrients NURS 6512 Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children.

    Moreover, macro and micronutrients are also crucial for normal health and wellbeing. Therefore, being underweight has significantly increased the risk of the 12-year-old girl to multiple health issues. Specifically, the girl’s underweight status means that she is not getting enough nutrients to achieve developmental milestones. As such, she has a higher risk of nutritional deficiencies, impaired immunity, and hormonal imbalances. The three expose the patient to a myriad of health problems and complications. For example, lack of calcium and vitamin D increase the risk of fragile bones and osteoporosis while iron, vitamin B12, and foliate deficiencies cause anemia (Ball et al., 2019). On the other hand, underweight increases the risk of infection because of decreased or compromised immune function. A notable example is where underweight individuals often take long to heal wounds compared to the general population. Furthermore, underweight persons have poor general health, including problems related to skin, hair and teeth; general body weakness; and frequent infections (Burns et al., 2017).

    The current information show that the patient is underweight. However, it is crucial to gather additional information about the underlying causes of the patient’s underweight. First, the patient’s parents are also underweight, which highlights the need of assessing any underlying genetic factors. A person’s genetic background has been shown to influence the risk of underweight, overweight, and obesity (Ball et al., 2019). Thus, it is critical to assess the plausibility of this theory through a focused patient history. The second issue to consider is whether the patient has an underlying disease condition. Co-existing diseases, including thyroid disease, digestive problems, and cancer contribute to cases of underweight (Burns et al., 2017). Therefore, examining the patient’s medical history is useful to confirm or rule out co-occurring medical concerns. Third, a comprehensive assessment of the patient’s socioeconomic status could provide valuable clues about the cause of underweight in the family. The assessment will focus on social determinants of health and how they influence the family’s nutritional status. Poverty is a powerful social determinant of health associated with the growing burden of undernutrition in the US (Ball et al., 2019).

    Assessment tools will play a fundamental role in gleaning additional information from the case. The Sexual Maturity Rating (SMR) or Tanner Staging is the first screening to consider to find out if the child’s undernutrition is affecting her sexual development. Tanner Staging will allow the NP to assess whether the patient is achieving her sexual developmental milestones to inform referral decisions. The 24-hour diet recall is another tool that will help the NP to have a general overview of the patient’s diet. The tool provides “list all the food, beverages, and snacks eaten during the past 24 hours” (Ball et al, 2019). The second test is necessary to find out if the patient’s underweight is a consequence of poor nutrition and deprivation. Furthermore, the NP will also measure the patient’s weight and BMI as part of the differential diagnosis for undernutrition. The four broad sub-types of undernutrition include underweight stunting, wasting, and severe weight loss. Thus, assessment/screening tools specific to the child will allow the NP to make the right diagnosis and develop an individualized care plan for the patient NURS 6512 Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children.

    Depression and anxiety are two additional risks to consider for further information. Screening for depression and anxiety is crucial since the patient has been bullied in school most recently. Underweight brings forward concerns about body image and self-esteem, which then exposes the child to the risk of bullying. Research findings have shown that a combination of bullying and weight status are strong predictors of depression and anxiety among children (Ford et al., 2017). The child is also at a high risk of internalizing disorders because she is currently in the adolescence stage of development. A major concern is that an underlying mental health problem is the main cause of suicide in more than 90% of children and teenagers (Burns et al., 2017). Thus, it is of the essence to screen and evaluate the risk of depression, including the presence of comorbid conditions and differential diagnosis. The HEEADSSS psychosocial assessment tool will help the NP to gather comprehensive information about the case. The HEEADSSS will specifically support the collection of comprehensive information on social economic status of the family, including the patient’s risk profile and developmental milestones (Smith & McGuinness, 2017).

    Specific Assessment Questions

    Malnutrition and the risk of depression are the primary concerns for the patient. A detailed patient and medical history is necessary to establish the underlying etiology of malnutrition. Issues of body image and self-esteem underpin the risk of depression and anxiety. However, it is critical to find be sensitive when exploring these issues. The following questions will guide the assessment process.

    Could you describe your eating habits on a normal day, including the food choices?

    Has your daughter been underweight since childhood or it is a recent phenomenon?

    Has your daughter been diagnosed or receiving treatment for a medical condition in the past six months?

    Has your family experienced food insecurity recently?

    Have you sought food assistance from welfare agencies over the past three months?

    Has your family experienced any changes in economic status in the recent past?

    Proactive Strategies

    Patient education will form the hallmark of the care management plan for the family. Patient education will focus on creating awareness about the role that nutrition plays in promoting optimal growth and development NURS 6512 Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children. Both the patient and her parents will verbalize meals and food choices that will terminate the underweight status. The family members will also verbalize the health risks and implications of inadequate nutrition. The second strategy will entail assessing the needs of the family and connecting them to community-based resources. Social and welfare support at the community level is particularly important if the family lives in a deprived community. The best approach is to assess the level of support that the family is getting, including accessibility to available resources. The NP will then identify gaps and areas where support is needed the most. The third strategy is to sustain the family within the healthcare system. Patient follow-up is necessary to access progress in clinical outcomes.

      ORDER A PLAGIARISM FREE PAPER NOW

     

    References

    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.). Elsevier Mosby

    Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017).
    Pediatric primary care
    (6th ed.). Elsevier.

    Ford, S. H., Choi, H., Brunssen, S., & Van Riper, M. (2017). Delays and disabilities: NP screening and care management.
    Journal for Nurse Practitioners, 13
    (2), e67-e73. https://doi.org/10.1016/j.nurpra.2016.11.005

    Smith, G. L, & McGuinness, T. M. (2017). Adolescent psychosocial assessment: The HEEADSSS.
    Journal of Psychosocial Nursing and Mental Health Services, 55
    (5), 24-27. https://doi.org/10.3928/02793695-20170420-03 NURS 6512 Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

    Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A. (2019). Prevalence and trends of developmental disabilities among children in the US: 2009–2017.
    Pediatrics, 144
    (4), e20190811. https://doi.org/10.1542/peds.2019-0811

    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 NURS 6512 Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children.

  • AG is a 54-year-old Caucasian male – NURS 6512 discussion post

    AG is a 54-year-old Caucasian male – NURS 6512 discussion post

    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.

    WK 2 Health Assmt.   Discussion.

    AG is a 54-year-old Caucasian male who was referred to your clinic to establish care after a recent hospitalization after having a seizure related to alcohol withdrawal. He has hypertension and a history of alcohol and cocaine abuse. He is homeless and is currently living at a local homeless shelter. He reports that he is out of his amlodipine 10 mg which he takes for hypertension. He reports he is abstaining from alcohol and cocaine but needs to smoke cigarettes to calm down since he is not drinking anymore AG is a 54-year-old Caucasian male – NURS 6512 discussion post.

    Socio-Economic, Spiritual, Lifestyle and Cultural Factors

    Ball et al. (2019), explain that patients age differently and their knowledge, cognitive abilities, personality, and experience will influence how the interview is conducted by a provider.  There could be a multitude of reasons as to why an older adult can become homeless.  This includes unemployment due to corporate age discrimination as told by Murphy and Eghaneyan (2018).  AG’s drug and alcohol use could be a reason as to why he lost his employment and due to financial constrains, was unable to pay rent or mortgage.  It is the responsibility of the nurse practitioner to gather information from the patient and not make assumptions about situations.  The socioeconomic factors we are looking at are employment, education, and income per Coogle and Owens (2015).

    An individual’s income plays an important role in the determinant of health according to Mullen (2015). Having a higher income enables better nutrition, housing, health care, and recreation per Tsai (2018). On the other hand,  poverty has a strong detrimental effect on health and is normally associated with unhealthy or risky behaviors as reported by Tsai (2018).  People with low income have been observed to have more association with the consumption of unhealthy goods, like tobacco, alcohol and illicit drug use according to Tsai (2018). AG has no income and therefore has fewer chances of seeking healthcare resources or preventative services.  These services could mean the difference between having a manageable health condition versus late stage multiple diagnosis and treatment.   AG smokes, uses drugs and alcohol which shows his lack of health promoting behaviors AG is a 54-year-old Caucasian male – NURS 6512 discussion post.

    Education is one of the focal determinants of health and is an indicator of a person’s socio-economic status per Mullen (2015).  People who are better educated have fewer morbidities than their counterparts according to Hook and Markus (2020).  We do not know AG’s level of education and therefore we cannot draw any conclusions.  AG’s lifestyle is contributing to his present status which is having a negative effect on his health.   From his chosen lifestyle, AG can end up having a heart attack or death from uncontrolled hypertension and the use of illicit drugs.  Cigarette smoking can also increase cardiovascular problems as well as cause cancer.

    AG needs support and education in the management of his illness.  Due to the socioeconomic factors unfolding in his life, he may become depressed and without help, may contemplate suicide.  Inquiring about AG’s mood like depression or anxiety can allow the NP to analyze what resources are appropriate.  There is no mention of any religious preferences and this could be a question that the NP can ask during patient interviews.

    Drug users and homeless individuals experience severe health inequalities and barriers to accessing healthcare.   It is the duty of the healthcare workers to change their perception of others and be receptive to other people’s cultures as O’Donnell et al. (2019) explain.

    Sensitive Issues while Interacting with Patient

    AG may have reservations about speaking about his adversities with a new provider for fear of being judged or prejudice.   As a nurse practitioner, one should be cautious about how questions are posed to the patient as Coogle and Owens (2015) explain.  A tone that is accusatory will not yield pertinent information.   The NP should make sure that they are not passing judgement or being prejudice against any patient that they encounter per Ball et al. (2019).  The nurse practitioner should listen carefully to AG during the information gathering process AG is a 54-year-old Caucasian male – NURS 6512 discussion post.  The nurse practitioner should also be careful of the non-verbal cues they present.  How a clinician controls their emotions is also a strong communication skill that is very important during the interview process.

    AG did not choose a healthy lifestyle and therefore the nurse practitioner can offer AG resources that can aid him in his health quest.  Smoking cessation resources should also be offered when AG is ready to give up the unhealthy habit.  At this time, it is imperative that the clinician offers full support and not force AG to give up any behaviors unwillingly.   The nurse practitioner does not know anything about AG and therefore must use the RESPECT model as adviced by Ball et al. (2019).

    Questions pertaining to why he chose to use drugs and alcohol should be asked respectfully without any preformed notions from the NP per Ball et al. (2019).   A trusting relationship must be formed with AG who may probably be embarrassed about the life choices he has made.  AG is in his early fifties and mid-life crisis is also a concern at this time and therefore the NP must not make him feel like he is a  failure.  Instead AG needs reassurance, support, guidance and with the help of the NP, he can set a goal that is attainable per Coogle and Owens (2015).

    Questions to ask AG

    Part of the information gathering involves asking the patient his allergies and the reactions experienced, the patient’s family history of illnesses, any previous surgeries to name a few.

    Have you had any  other previous hospitalizations including any mental health stay

    Can you please tell me how you ended up staying at the shelter or being homeless

    When did you start using cocaine, alcohol and tobacco substances

    What were your last employment and the duration

    What is your highest level of education

    Do you have any religious or cultural preferences, that we need to put in place AG is a 54-year-old Caucasian male – NURS 6512 discussion post

    Do you ever experience feelings of hopelessness, depression, sadness

    Are there are resources that you would like to have access to

    Is there anything else you think we might be able to assist you with

    AG should have an opportunity to ask any questions or clarify information.  Resources should be offered by the nurse practitioner who can also put AG in contact with a social worker for further commendations.

     

    References

    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.

    Coogle, C., & Owens, M. (2015). Screening and Brief Intervention for Alcohol Misuse in Older Adults: Training Outcomes Among Physicians and Other Healthcare Practitioners in Community-Based Settings. 
    Community Mental Health Journal
    , 
    51
    (5), 546–553. https://doi-org.ezp.waldenulibrary.org/10.1007/s10597-014-9804-x

    Hook, C. J., & Rose Markus, H. (2020). Health in the United States: Are Appeals to Choice and Personal Responsibility Making Americans Sick? 
    Perspectives on Psychological Science
    , 
    15
    (3), 643–664. 
    https://doi-org.ezp.waldenulibrary.org/10.1177/1745691619896252

    Mullen, J. (2015). Living Longer Better: A Call to Action to Promote the Health of Older Adults and Their Communities. 
    Journal of Public Health Management & Practice
    , 
    21
    (4), 410–412. https://doi-org.ezp.waldenulibrary.org/10.1097/PHH.0000000000000280

    Murphy, E. R., & Eghaneyan, B. H. (2018). Understanding the Phenomenon of Older Adult Homelessness in North America: A Qualitative Interpretive Meta-Synthesis. 
    British Journal of Social Work
    , 
    48
    (8), 2361–2380. https://doi-org.ezp.waldenulibrary.org/10.1093/bjsw/bcx163

    O’Donnell, P., Tierney, E., O’Carroll, A., Nurse, D., & MacFarlane, A. (2016). Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study. 
    International Journal for Equity in Health
    , 
    15
    (1), 197.

    Tsai, J. (2018). Lifetime and 1-year prevalence of homelessness in the US population: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. 
    Journal of Public Health
    , 
    40
    (1), 65–74. https://doi-org.ezp.waldenulibrary.org/10.1093/pubmed/fdx034 AG is a 54-year-old Caucasian male – NURS 6512 discussion post

    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.

    response

    Great post! I thought that you addressed a situation that had several layers of difficulty extremely well. It’s clear that you were very aware of the cultural and socioeconomic factors at play. Treating a patient with a history of ETOH abuse is difficult in itself, but given that fact that the patient is currently homeless adds another hurdle for the patient as well as the practitioner. I especially enjoyed your acknowledgment of the sensitivity of the patient’s situation and that you used that knowledge to form well thought out and pointed questions.

    Given the prevalence of mental health and substance abuse in the homeless population, I do think that establishing a timeline will be extremely important in the treatment of this patient. Did the patient begin drinking heavily before or after he was homeless? Had he been diagnosed with any mental health disorder and at what age?

    Research estimates that 38 percent of homeless people are alcohol dependent and that their living conditions made it more difficult to remain sober and achieve stability. That makes appropriate treatment and follow up an important part of ensuring this patient is successful with their sobriety.  Effective communication is always key, but maybe more so in complex and difficult situations. Establishing a positive patient relationship depends on communication built on courtesy, comfort, connection, and confirmation. Building a history is important, of course, but building trust from the start will help to ensure that the patient is open and honest and in turn, or treatment will be more effective.

     

    References

    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.

    Murray, K. (2019). Homeless Alcoholism. Retrieved June 13, 2020 from https://www.alcoholrehabguide.org/resources/homeless-alcoholism/#sources AG is a 54-year-old Caucasian male – NURS 6512 discussion post

    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).

    Photo Credit: Getty Images

    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.

    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.

    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?AG is a 54-year-old Caucasian male – NURS 6512 discussion post

      ORDER A PLAGIARISM FREE PAPER NOW

    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!

    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 AG is a 54-year-old Caucasian male – NURS 6512 discussion post.

    Week 2 Discussion: Diversity

    Case Study 2:

    AG is a 54-year-old Caucasian male who was referred to the clinic to establish care after a recent hospitalization after having a seizure related to alcohol withdrawal. He has hypertension and a history of alcohol and cocaine abuse. He is homeless and is currently living at a local homeless shelter. He reports that he is out of his amlodipine 10 mg which he takes for hypertension. He reports he is abstaining from alcohol and cocaine but needs to smoke cigarettes to calm down since he is not drinking anymore.

     

    The socioeconomic issues affecting AG is homelessness, finances, and lack of adequate health care. During the initial interview, I would assess for financial income and the ability to secure stable long term housing. Establish if any family or friends are involved in his life, ask the patient if he has been to rehab in the past and if he is willing to go to inpatient rehab to stabilize and receive counseling and coping strategies (Cuevas & Whitiney, 2019). Ask the patient what are his plans, and how long he plans to stay at the shelter because accommodation is only temporary and safe housing is to be included in planning (Manning & Greenwood, 2019).

    The patient’s perceived quality of life is based on his current lifestyle which includes substance abuse, lack of stable housing. AG is a 54-year-old caucasian male and sensitivity to cultural differences to avoid miscommunication is to be considered in cultural factors, and history of substance abuse and seizures he should be assessed for cognitive function. Issues I need to be sensitive about are his finances, be sensitive in the questioning line of income, does he have an income from unemployment, SSI, or disability, does he he have health insurance or the ability to pay for medications and food. Family relations can be a source of anxiety to some individuals, I will be sensitive to line of questioning on family, friends, and community relations if he has any support or in contact with any members. Religion and faith-based beliefs can create a barrier to communication and the ability to accept some interventions. As far as his substance abuse I would ask about when last he used, how long he has been using, identify his triggers to reduce relapse. I will be sensitive to his personal space and mode of communication, ask what is his preferred mode of communication, language, what name he wants to be called (Ball, Dains, Flynn, Solomon, & Stewart, 2019) AG is a 54-year-old Caucasian male – NURS 6512 discussion post.

    Targeted questions to the patient to build his health history and to assess his health risks include

    1. Medical and familial history, when was he first diagnosed with hypertension, and family history of cardiac disease. What medications he currently take and when was his last dose. Where did he last seek medical attention?

    2. Level of education and any work skills, this is to assess his level of comprehension and processing of information to be exchanged.

    3. Depression screening tool to assess for level of anxiety, what does he mean he needs a cigarette to calm down, how many does he smoke daily, what are his triggers?

    4. History of substance abuse, what are his substances of choice, did he ever attempt to quit before, did he ever have the professional help to quit. How much money does he usually spend on his habit?

    5. Well- maintenance evaluation, when last did he have physical, including prostrate screening, colorectal screening, diabetes risk assessment, cardiovascular disease risk assessment, and STD risk assessment screening?

    6. Any history of abuse or trauma, any history military service to rule out PTSD

    7. Vaccination history for immunity against community-acquired infections because of his housing disposition.

     

    References

    Ball, J. W., Daines, 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.

    Cuevas, R., & Whitney, G. (2019). Better Together: An Early Head Start Partnership Supporting Families in Recovery Experiencing Homelessness. 
    ZERO TO THREE
    , 
    39
    (4), 29–34.

    Manning, R. M., & Greenwood, R. M. (2019). Recovery in Homelessness: The Influence of Choice and Mastery on Physical Health, Psychiatric Symptoms, Alcohol and Drug Use, and Community Integration. 
    Psychiatric Rehabilitation Journal
    , 
    42
    (2), 147–157. https://doi-org.ezp.waldenulibrary.org/10.1037/prj0000350

    response

    Your post categorically addresses the socioeconomic factors that affect this patient. According to 
    Health People
    (2020), race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health(“Disparities,” n.d.). The targeted questions are structured to provide detailed information that will assist in the patient’s care plan. Numerous studies have shown that the homeless seek treatment late in their disease process; fall out of disease management plan including non-adherence to prescribed medications,  and have a frequent  habit of visiting the Emergency Room and Inpatient services AG is a 54-year-old Caucasian male – NURS 6512 discussion post. It is important for clinicians to inquire about readiness to change and the resources available for this patient. Examples of questions that bring forth the need for change are: What are the benefits of staying sober?; Have you ever thought of committing suicide?”; If you did want to make a change, how would you go about it?” (Cooper, 2016). Such inquiry elicits the individual’s commitment to making change.

    Cooper, D. B. (2016). 
    Intervention in mental health-substance use
    . CRC Press.

    Disparities
    . (n.d.). Healthy People 2020 |. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities AG is a 54-year-old Caucasian male – NURS 6512 discussion post

  • BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion

    BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion

    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.

    Module 2: Functional Assessments and Assessment Tools

    Week 2: Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment

    Discussion: Diversity and Health Assessments

    Initial Post: Patient Profiles – BK is a 16-year-old Caucasian female

    Tanya SchellB   is a 16-year-old Caucasian female – NURS 6512 week 2 discussion

     

    As an Advances Practice Nurse (APN), it is essential to the success of the patient outcomes to become culturally competent. The APN will provide services to many different cultures throughout their career. According to Ball, et al, (2015), each patient should be treated according to their culture religious, socioeconomic, and personal beliefs. A competent and successful healthcare provider will be able to offer competent care to people belonging to other cultures different from their own (Corona, et al, 2017) when educating themselves on the different cultures and their specific needs. Seeking out cultural training is one way to be successful in the delivery of patient-specific healthcare. Culturally competent healthcare providers can adapt to the unique needs of patients from various cultural backgrounds, developing a trusting relationship between the healthcare provider and the patient (Ball, Dains, Flynn, Solomon, & Stewart, 2015). In order to build a trusting provider-patient working relationship, it begins with the provider being knowledgeable of the patient’s specific culture. Avoiding stereotypes is imperative in succeeding in positive patient outcomes BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion.

    In this patient scenario, BK is a 16-year-old Caucasian female, who presents to the clinic for an annual well-child visit. BK doesn’t make eye contact with the APN, she is obese and currently not on medications. BK is accompanied by her Grandmother who has concerns and believes BK is now acting strange, staying in her room all the time, and refusing to do all the things BK use to enjoy like singing in the youth choir at their church. The grandmother is fearful that BK might be using drugs and is requesting a drug screen since BK’s mother has a history of drug use and is currently incarcerated. It appears that BK has lived with the grandmother for some time since the grandmother can see a change in BK.

    Being sensitive on the subjects of her weight, and her views on her mother. Teenage girls are very sensitive about their weight and might have a hard time opening up about their feelings regarding their weight. All teenagers, but especially girls need extra support, guidance, and nurturing from their mothers and fathers. Since BK’s mother is not currently in her life, this may be an emotional trigger for BK to discuss. Asking questions specific to her spirituality will help the APN understand why BK suddenly stopped participating in the youth choir at church. Finding out about how BK feels about living with her grandmother and if they have any socioeconomic issues or concerns that can be addressed by the APN or referred to another source for assistance. Engaging in conversation about BK’s friends, activities, and risky behaviors also helps the APN learn BK’s lifestyle and any cultural issues BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion.

     

    Targeted Questions

    Have you had anything traumatic happen to you? Have you ever participated in counseling?

    How do you feel about your mother not being around and her drug situation? What do you believe is the cause of drug use by your mother? How do you feel about drugs?

    How high is your self-esteem? Do you have thoughts of self-harm? Do you find joy in your life?

    What do you see has changed in your life? Is your life satisfying?

    Do you attend church? Do you feel that you are a spiritual person?

    What do you and your friends do for fun? Have you participated in any risky activities with friends? Drugs, Alcohol, skipping school?

    What do you normally eat during the week? Do you feel that you are at a healthy weight?  What is your goal weight?

    Is there anything else you want to talk about today?

    What else can I help you with today?

    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.

    Corona, R., Rodríguez, V. M., McDonald, S. E., Velazquez, E., Rodríguez, A., & Fuentes, V. E. (2017). Associations between cultural stressors, cultural values, and Latina/o college students’ mental health. Journal of youth and adolescence, 46(1), 63-77

    Lonneman, W. (2015). Teaching strategies to increase cultural awareness in nursing students. Nurse educator, 40(6), 285-288 BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion.

      ORDER A PLAGIARISM FREE PAPER NOW

    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.

     

    response

    I enjoyed reading your post and getting your perspective on treatment of BK. I especially liked how you made sure to focus on her spirituality that you focused on the importance of shying away from things that may be emotional triggers for her, (her weight; her mother). While I think that those issues are of great importance, I believe that it would benefit more to build trust and focus on those issues at a later appointment; possibly at an appointment where she is alone.

    Ensuring that we, as APRNs, address the individual as well as their culture. In this case, the fact that the patient’s mother has a history of drug abuse is definitely a risk factor, but should not be the only piece of the puzzle when evaluating the patient for potential risk behaviors. An individual may belong to many subgroups and that the behaviors and attitudes of a subgroup can override the impact of the cultural values of the larger group (Ball et al, 2019).

    Screening for depression in this particular patient will also be of great importance. When doing so, it is imperative that screening is be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. (Siu, 2016). Treatment of this particular patient should occur over multiple visits and her completed treatment plan should not be based off of the single visit.

     

    References

    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.

    Siu, A.  (2016).  US Preventive Services Task Force Pediatrics.  
    Screening for Depression in Children and Adolescents
    137 (3) e20154467; DOI: 10.1542/peds.2015-4467 BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion

    response 2

    Patients who are in this age group are going through a lot in life. Stressors includes school, part time job, family, hormonal changes, body image disturbance, peer pressure, introduction to substances, etc. It may take a longer time or a few sessions to build rapport with a teenager, especially one of the opposite sexes. During the physical the practitioner would have to examine the patient’s genitalia. So, if the practitioner is a woman and the patient is a male, or visa versa, there will be a chance the patient will feel uncomfortable and not agree with the total health assessment. A teen client can be a master at putting up the invisible force field while pushing our buttons or telling us what we want to hear and side-stepping responsibility. (Selekman, 2020). Once the teen feels pressured or obligated to do something against their will, the patient will shut down and either be untruthful or not answer the question.

    Teens face an especially hard time when the practitioners ask them about their sexual orientation, sexual partners and if they think they have been exposed to any sexual transmitted diseases. As part of the physical, this patient will be asked about her last menstrual cycle, the flow, cramps, and any abnormal discharge. Also, a pelvic exam will be done to test for STDs and possible cervical disease. If the patient has never had any sexual activity, this procedure can be especially traumatic. A speculum is inserted inside her, this procedure is invasive and can be painful. Recent studies show that if the patient is not sexually active, this exam is not deemed necessary. Bimanual pelvic exams and Pap tests used to be standard parts of annual gynecological checkups, but leading professional associations no longer recommend them for most younger patients. (Vaughn, 2020).

    Many teen girls deal with body image disturbance. All they see on television are skinny supermodel like movie stars. Taking this ideal image as something that is normal, so if they differ and especially if they are overweight or obese, they will feel a sense of not belonging to the norm. This female patient is obese, she currently does not have any medical issues and not taking any meds. But, to her grandma she is acting strange and staying in her room and refusing to do extracurricular activities like singing in her youth choir at church. The grandmother disclosed that the patient’s mother has a history of drug use and is currently incarcerated. There can be an arranged of possibility with this patient. She is in a current stage of life where she might feel more comfortable being alone, and this is totally normal. Or, the grandmother is correct, and she may be exposed to illegal substances and is currently using drugs. Ethically and legally a drug test should not be ordered just because the grandma wants it done on the patient. The practitioner needs the consent of the patient, even though she is a minor. We as practitioners cannot force the patient to do the test unless it is an emergency BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion.

    A psych social can also be done if the practitioner deems it is necessary because during this period the patient can develop depression or anxiety related to her many stressors in life. Untreated depression and anxiety can lead to self-harm, self-medicating with substances or worst-case scenario, suicide. The practitioner can refer the patient to a therapist or psychiatrist. Teens sometimes feel like multiple stressors is too much for them to handle and they rather not deal with it. Carefully monitoring the patient and if she exhibits any abnormal behavior is a good indicator of potential self-harm.

     

    References

    Selekman, M. (2020). How to make teen therapy engaging. Retrieved on June 12, 2020 from 
    https://www.psychotherapynetworker.org/blog/details/405/creating-a-therapeutic-alliance-with-the-troubled-teen

    Vaughn, E. (2020). Teen girls do not need routine pelvic exams. Why are doctors doing so many? Retrieved on June 12, 2020 from https://www.npr.org/sections/health-shots/2020/01/09/794991658/teen-girls-dont-need-routine-pelvic-exams-why-are-doctors-doing-so-many BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion

    response 3

    BK being in her teens, the NP must find ways of conversing with her.  During the adolescence period, teens like privacy, and therefore she might not speak freely with the NP.  Forming a trusting relationship is key and can allow BK to confide in the NP on what is presently going on in her life.   The NP should make BK feel comfortable and not ask questions that may be deemed as intrusive per Klein et al. (2020).  An adolescent patient is likely to disclose sensitive information when confidentiality is guaranteed per  Klein et al. (2020) and therefore providers must offer confidential screening and counseling.

    The provider can perform a short psychosocial screening which can include existing stressors, whether BK has a confidant and how her experience is at school.  Teens older than 12 years of age should also be screened for major depressive disorder according to Spithoven et al.(2017).    Klein et al. (2020) also explain that teens with a BMI of 95
    th
     percentile and higher can be referred for a comprehensive behavioral intervention.  It is only after the NP gains the trust of BK, can she then talk about BK’s feelings and how the incarceration of her mother has influenced her life.

    Adolescents have stressors that the NP can focus on during the initial well visit.  Threats to the well being of teenagers can both be experimental and psychosocial stressors per Klein et al. (2020).  According to Klein et al. (2020), this includes school, home, activities, drugs, emotions or eating, sexuality, strengths and safety.    The NP must not only gather a psychosocial history but also emphasize on BK’s strengths to deter the feeling of shame per Klein et al. (2020).    A provider can also talk about digital literacy and how to have boundary settings while online as Klein et al. (2020) advices us.  The NP should not only focus on the patient’s physical being but also in general.  Questions to ask can include what BK likes to do, what she is most proud of, whether she has friends.  More questions include whether she has been feeling stressed, any trouble sleeping, any feeling of being down, sad or depressed, any thoughts of hurting herself, or if she has had any attempts BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion.

    Reference

    Klein, D. A., Paradise, S. L., & Landis, C. A. (2020). Screening and Counseling Adolescents and Young Adults: A Framework for Comprehensive Care. 
    American Family Physician
    , 
    101
    (3), 147–158.

    Spithoven, A., Lodder, G., Goossens, L., Bijttebier, P., Bastin, M., Verhagen, M., & Scholte, R. (2017). Adolescents’ Loneliness and Depression Associated with Friendship Experiences and Well-Being: A Person-Centered Approach. 
    Journal of Youth & Adolescence
    , 
    46
    (2), 429–441. https://doi-org.ezp.waldenulibrary.org/10.1007/s10964-016-0478-2 BK is a 16-year-old Caucasian female – NURS 6512 week 2 discussion

  • EB is a 68-year-old black female with hypertension – NURS 6512 wk 2 Discussion: Diversity and Health Assessments

    EB is a 68-year-old black female with hypertension – NURS 6512 wk 2 Discussion: Diversity and Health Assessments

    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.

    Scenario
    : 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). She brings in her medication bottles and she has some medication bottles from the previous year full of medications. She is missing one medication she had been prescribed and says she may have forgotten it at home. Her BP in clinic today is 182/99 with HR of 84 EB is a 68-year-old black female with hypertension – NURS 6512 wk 2 Discussion: Diversity and Health Assessments.

    Explanation of Factors Associated with the Assigned Patient

    Every patient is a unique individual, and providers need to approach their patients as such to provide patient-centered care. Factors that should be considered in providing patient-centered, quality care include the patient’s culture, age, gender, race or ethnicity, and socioeconomic status, among others. Similar to the individual patient with unique needs and considerations, providers are also unique in their cultures and biases. Barriers, such as language and culture, between providers and patients, interfere with effective delivery of care (Saha, Beach & Cooper, 2008). To ensure safe, quality healthcare delivery, providers need to have cultural awareness as well as the ability to provide culturally competent care. In the above scenario, factors that can affect the patient’s health and which require the provider’s attention include the patient’s age, culture, socioeconomic status, health belief system, and health literacy.

    Given the patient’s profile, being an African American and a minority is a major contributory factor to healthcare disparity in the United States. The racial and ethnic disparity in healthcare is apparent throughout the spectrum of healthcare, including health access, utilization, and healthcare insurance (Watts, 2003). For example, lack of health insurance in the African American population accounts for why a significant percentage of African Americans are less likely to visit providers for preventive services such as annual physical and or screening tests. Riley (2012) explains that the consequences of lack of health insurance include adverse health outcomes, higher rates of mortality and disability, and lost wages due to sickness. Lower socioeconomic status among blacks, compared to their white counterpart, affects medication adherence as many patients cannot afford to pay for their medications. Spirituality and affiliation with the church among African Americans may contribute to how they perceive their health and illness EB is a 68-year-old black female with hypertension – NURS 6512 wk 2 Discussion: Diversity and Health Assessments.

    Sensitive Issues When Interacting With the Patient

    Issues that are considered sensitive can be handled poorly or appropriately based on the provider’s communication. Respectful and culturally competent communication may ease the patient’s tension and allow them to answer questions openly and accurately. As an elderly patient, asking the patient about sexual activity or drug use may be offensive, especially if the provider is the opposite gender. Also, if the patient is a religious person who believes her health can be improved through faith and prayers, asking about spirituality as a way of questioning her beliefs may be misperceived. Addressing these sensitive issues can be handled by establishing a trusting relationship and effective communication.

    Targeted Questions

    Targeted question for the patient may include:

    Can you tell me how you are taking each of your medications?

    How important is it for you to have your blood pressure under control?

    How has your worsening vision affected how you take your medications?

    Is there anything we can do to make remember when and how to take your medications?

    When was the last time you had your vision checked?

     

    Reference

    Riley W. J. (2012). Health disparities: gaps in access, quality and affordability of medical care. 
    Transactions of the American Clinical and Climatological Association
    , 
    123
    , 167–174.

    Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence and healthcare quality. 
    Journal of the National Medical Association
    , 
    100
    (11), 1275–1285. 
    https://doi.org/10.1016/s0027-9684(15)31505-4

    Watts, R. (January 31, 2003). Race Consciousness and the Health of African Americans. 
    Online Journal of Issues in Nursing,
     
    8
    (1), Manuscript 3. www.nursingworld.org//MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume82003/No1Jan2003/RaceandHealth.aspx EB is a 68-year-old black female with hypertension – NURS 6512 wk 2 Discussion: Diversity and Health Assessments

     

    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.

      ORDER A PLAGIARISM FREE PAPER NOW

    response

    The list of questions you have drawn for your patients are important ones, especially the first question. Finding out how the patient is taking medications can help with medication adherence, which can be an issue with patients. Should medication adherence be an issue for your patient, some tips to improve that includes customizing support tools for your patient including apps for her phone and compliance packaging (McCaslin, 2016).

     

    The second question you have formulated for the patient, is also a great one, as it helps to assess what level of knowledge the patient has, regarding their condition. In the event that the patient does not have adequate information, the patient can be given more information. Patient education is a very important part of dealing with patients because it results in better outcomes by helping the patient make informed decisions (Heath, 2016) and adhere to any administered therapies including medication.

     

    References

    Heath, S. (2016). Why Patient Education is Vital for Engagement, Better Outcomes. Patient Engagement. Retrieved from 
    https://patientengagementhit.com/news/why-patient-education-is-vital-for-engagement-better-outcomes#:~:text=Education%20helps%20patients%20make%20informed%20decisions&text=Ensuring%20informed%20decision%2Dmaking%20relies,want%20to%20receive%20their%20healthcare.

    McCaslin, J. (2016). Nine tips for improving medication adherence. AmerisourceBergen. Retrieved from 
    https://www.amerisourcebergen.com/insights/pharmacies/nine-tips-for-medication-adherence

    response 2

    Thank you for your informative post. Your case study is similar to a few of my elderly clients, she lives alone, has worsening vision, hypertensive, and is taking multiple medications. EB brings in her medication bottles for review and reconciliation, however, she has bottles from last year and is missing a current medication and her BP is elevated EB is a 68-year-old black female with hypertension – NURS 6512 wk 2 Discussion: Diversity and Health Assessments. The first question you asked is the top priority, by asking the patient to tell you how she takes her medications to assess for knowledge of her regime. You also addressed her vision, reading the writing on the medication bottles can be challenging, and you want to know when last she had a vision evaluation (Feinberg, Rogers, & Sokol-McCay, 2009).

    After assessing if the patient can identify her medications and read the labels note the mistakes she is making, ask is she needs assistance with methods to remind her when and which medications to take, for example, singles dose med-packs, pillboxes, or color-coding bottles. I would also include asking about nutrition and meals because some people often associate taking medications with a meal, so if meals are missed so are the pills. Ask the patient is she has a BP monitor at home, the use of self-monitoring tools can be incorporated into health education/ literacy when talking BP medications significantly promotes adherence (Delavar, Pashaeypoor, & Negarandeh, 2020).

    References

    Delavar, F., Pashaeypoor, S., & Negarandeh, R. (2020). The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. 
    Patient Education and Counseling
    , 
    103
    (2), 336–342. https://doi-org.ezp.waldenulibrary.org/10.1016/j.pec.2019.08.028

    Feinberg Jl, Rogers PA, & Sokol-McKay D. (2009). Age-related eye disease and medication safety. 
    Annals of Long Term Care
    , 
    17
    (6), 17–22 EB is a 68-year-old black female with hypertension – NURS 6512 wk 2 Discussion: Diversity and Health Assessments.

  • JC 86-year-old Asian male

    JC 86-year-old Asian male

    Week 2 initial post

    Case 1:

    In the case of JC who is 86-year-old and totally dependent on the daughter calls for having a cultural and lifestyle understanding of the patient in order to understand the patient. In a report by US Census Bureau, 70% of non-institutionalized older adults live with their families while the other live alone. Being physically and financially dependent, I would ensure I sympathize with the patient, through making him aware I understand his concerns about being a burden to her daughter. Understanding the background of the patient is important as one can identify the areas the patient is sensitive on (Sahin, 2016). I would ask him what the daughter does for living. Knowing what the daughter does for a living can assist in identifying how well the basic and patient needs are met as well as availing drugs for gastroesophageal reflux disease (GERD) and ahx hypertension. Understanding the people who the patient interacts with in the environment is important as they can influence the health status of the of the patient considering he has hypertension JC 86-year-old Asian male.

    It is important to ask about how long he has been in that condition to identify the intervention that is needed to improve on the outcome. In understanding the lifestyle of the patient, I would ask about dieting to understand the type food they eat and what needs to be recommended as a form of intervention (Elliott, 2016). Environmental safety is an important consideration as most of the patient are affected by the hazards in the environment. Culture affects the patient in many ways. Understanding the patient view on what causes the disease and the ideal health intervention is important in identifying cultural influence on the patient views. During interaction, I would ensure active listening and breaking language barriers as the best approach to a successful health assessment as they ensure the patient is encouraged to speak out the issues he is experiencing for comprehensive health assessment (Williams, 2018) JC 86-year-old Asian male.

    Below are the targeted questions to the patient to assess health risks.

      ORDER A PLAGIARISM FREE PAPER NOW

    When was the last time you visited a doctor? And what was the medical issue?

    What physical normal activities are you unable to perform that requires your daughter’s assistance?

    How often do you experience burning chest pain?

    What are the side effects of the medicine you take?

    Have you experienced any new complications other than the ones in your past physical exams?

    References

    Elliott, D. (2016). Environmental issues: Health, safety and social impacts. 
    Green Energy Futures: A Big Change for the Better
    , 20-38. doi:10.1007/978-1-137-58443-4_2

    Sahin, C. (2016). Assesment of disabled geriatric health council reports. 
    Journal of Clinical and Analytical Medicine
    , 
    7
    (1). doi:10.4328/jcam.3982

    Williams, M. E. (2018). The hospitalized older adult: Communication and physical examination. 
    Hospitalists’ Guide to the Care of Older Patients
    , 5-15. doi:10.1002/9781118674963.ch2 JC 86-year-old Asian male

  • NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment

    NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment

    Portfolio Assignment:

    The Role of the Nurse Informaticist in Systems Development and

     Implementation

    The purpose of this paper is to describe the role description for a graduate-level nurse to guide participants on the implementation team throughout the process. The role description is based on the SDLC stages and tasks. It will clearly define how this individual will participate in and impact each of the following steps: planning and requirements definition, analysis, design of the new system, implementation, and post-implementation support.

    The nursing professions’ impact on communication and information technology utilization possibilities are boundless. The systems development life cycle (SDLC) is a continual development process through planning and implementing advancement (McGonigle & Mastrian, 2018). The systems development life cycle (SDLC) is the model specifically useful in project management for the improvement of health information technology (HIT) systems (2018) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

    Role Description

    The nurse leader, usually the nurse manager in this role, needs to scrutinize the problems and what profits become connected with engaging the nurse leader in the health information system’s implementation process. The nurse leaders’ involvement safeguards that the system will be applicable and adequate for the nurses’ using the system. The nurse leaders’ inclusion on the SDLC team is conducive to informatics in health care. The role of informatics in health care integrates information providing evidence of how technology strengthens care quality (McKay & Vanaskie, 2018) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

    Planning and requirements definition

    The planning stage is of utmost importance for the SDLC project as it prepares for the steps to follow and fundamentally will determine the results of subsequent actions (Rehani, n.d.). The planning phase is where the nurse leader participates with the interdisciplinary team representatives to identify the breadth of the obstacles, examine potential solutions, gather needed resources, and plan a schedule for the project and itinerary to commence the project (n.d.). The nurse leaders’ clinical insight into the system and practice with the concurrence of critical thinking skills grants nurses’ superior ability to determine goals for the project. And establish expectations that can be realistically reached (n.d.). The evolution of the health care technology project will be successful with the nurse leader fully participating in the SDLC planning phase.

      ORDER A PLAGIARISM FREE PAPER NOW

    Analysis

               
    The analysis phase involves the nurse leader role to assist in setting up the project’s requirements, developing and examining feasible back-up plan recommendations (Weckman & Janzen, 2009). The lack of back-up plans may delay the project with errors, loss of data, and disintegration in communication between team members. Analysis of the process entails evaluating tools used for decision making, communication, and function processes (Rojas & Seckman, 2014). The analysis also includes examining the technical, hardware, software, staffing, and determining if additional space is needed (Rehani, n.d.). The nurse leaders’ input in this phase includes assessing the organization’s policies to determine if changes are necessary to have the new health care technology system (Darvish et al., 2014) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.
                                                                        

     
                                                                          Design

    The design phase requires the nurse leaders’ full engagement to inform the SDLC team to establish that the software’s configuration clearly and correctly is described and to regulate the operation of the system (Rehani, n.d.) Included in the system’s operation requiring regulation are hardware, software, user interface, archiving and use, retrieval of data, networking, and processes (n.d.). The nurses’ role in design includes emphasizing the system’s vital goal is to improve patient safety (n.d.). The nurse leader will collaborate to design the system to support clinical decisions to integrate various specialties (n.d.) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

                                                                Implementation   

    During the implementation phase, the nurse works jointly with the team to facilitate specialization, evaluate by testing, and install the system (Rehani, n.d.). The nurse leader role continues to be vital now with the need to educate and train staff, maintain the system, and communicate results to the information technology (IT) department (n.d.). The nurse leaders’ role remains essential for establishing communication between themselves and the staff to promote evaluation for use in the system’s redesign to improve results (n.d.). The staff evaluation is necessary for modification of the system for tailoring to enhance healthcare technology capability ultimately. Furthermore, the nurse leader will need to make rounds to ensure safety and to assess for problems in the workflow, and identify

    system glitches for significant problem solving (n.d.)

                                                                Maintenance

               
    The nurse leader maintains involvement in the maintenance phase by providing ongoing support and sufficient training (Rehani, n.d.). The nurse leader needs to recognize how the system works and the importance of promoting cooperation and submission (n.d.).  The nurse leaders’ engagement in this process will also improve approval and encourage evidence-based practice (n.d.). The nurse informaticist involvement in the SDLC maintenance phase is crucial to minimize technical issues (n.d.). During the maintenance phase, the nurses’ role informs IT of glitches requiring problem-solving to improve the system (n.d.) NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

                                                               
    Conclusion

    The nurse leader, including nurse informaticist importance in full engagement in the SDLC, cannot be understated. The nurse is the backbone of health care organizations. Without the nurses’ participation in the SDLC team phases, improvement in patient safety would be missing. The nurses and other staff using the health care systems would be frustrated and disgruntled due to the lack of logical and smooth functioning of the system meant to improve such and safety. The nurse leaders’ role is crucial to the system being useful to the health care organizations improved safety results NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment.

    References

    Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014).
    The role of nursing

    informatics in promoting the quality of health care and the need for appropriate education. Global Journal of Health Science,
    6(6), 11-18. DOI:10.5539/gjhs.v6n6p11

    McGonigle, D., & Mastrian, K. G. (2018).
    Nursing informatics and the foundation of
    (4
    th
    ed.).

    Burlington, MA: Jones and Bartlett Learning.

    McKay, C. & Vanaskie, K. (2018).
    Partnering for success: The role of the nurse leader in

    Health information technology implementation for coordination of care. Nurse Leader,
    16(6), 385-388.
    https://doi-org.ezp.waldenulibrary.org/10.1016/j.mnl.2018.07.012

    Rehani, N. (n.d.
    ). Using SDLC methodology to implement HIT.
    https://pdfs.semantic

    scholar.org/7fbd/35017b7085209694cd56373e8eab62b84b2a.pdf

    Rojas, C., & Seckman, C. (2014).
    The informatics nurse specialist role in electronic health

    record usability evaluation. Computers, Informatics, Nursing
    , 32(5). 221-222. DOI: 10.1097/CIN.0000000000000042

    Weckman, H., Janzen, S. (2009).
    The critical nature of early nursing involvement for

    Introducing new technologies. The Online Journal of Issues in Nursing, 14(2), 1-13. DOI: 10.3912/ojIN.Vol14No02Man02

    new technologies. The Online Journal of Issues in Nursing
    , 14(2), 1-13. DOI:103912/OJN.Vol14No02Man02 NURS 5051/ 6051 The Role of the Nurse Informaticist in Systems Development and Implementation Portfolio Assignment

  • NRNP 6565 Discussion: Certification and Licensure

    NRNP 6565 Discussion: Certification and Licensure

    Discussion: Certification and Licensure

    Now that you are in your final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass a national AGPCNP certification exam.  Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state NRNP 6565 Discussion: Certification and Licensure.

    Photo Credit: Getty Images/iStockphoto

    Although there is a movement called the APRN Consensus Model to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.

    Another important area to consider and plan for is prescriptive authority. Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the medical board, state board of pharmacy, or nursing board for the appropriate state licensure being pursued. The authority to write for a 
    controlled substance
     is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

      ORDER A PLAGIARISM FREE PAPER NOW

    Finally, the legal landscape for NPs is constantly changing as the status of NPs as providers improves on a national level. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a nurse practitioner NRNP 6565 Discussion: Certification and Licensure.

    For this Discussion, you examine professional issues for your state, including certification and licensure, scope of practice, independent practice, prescriptive authority, and legislative activities.

    To prepare:

    Review practice agreements in your state.

    Identify whether your state requires physician collaboration or supervision for nurse practitioners and, if so, what those requirements are.

    Research the following:

    How do you get certified and licensed in your state?

    What is the application process for certification in your state?

    What is the primary nurse licensure office resource website in your state?

    How does your state define the scope of practice of a nurse practitioner?

    What is included in your state’s practice agreement?

    How do you get a Drug Enforcement Agency (DEA) license?

    How does your state describe a nurse practitioner’s controlled-substance prescriptive authority and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

    In what legislative and advocacy activities are your state nurse practitioner organization(s) involved?

    By Day 3

    Post
     a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.

    Read
    a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues on 
    2 different days
     in one or more of the ways listed below.

    Share an insight from having viewed your colleagues’ posts.

    Suggest additional actions or perspectives.

    Share insights after comparing state processes, roles, and limitations.

    Suggest a way to advocate for the profession.

    Share resources with those who are in your state NRNP 6565 Discussion: Certification and Licensure.

  • NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

    NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

    Informatics Week 3 discussion

        
     
    When electronic records came to the Iowa Department of Corrections, Ill be honest, I was very skeptical, and everyone resisted the change from “how we do business.” According to Gaines (2020), nursing informaticist is a specialty area that combines nursing and technology to help with electronic records and other varies health technology areas.
     
    (Gaines, 2020)
     
    In reading another discussion post, I am quite jealous that they have a Nurse Informaticist. Our system was developed by an outside technology company and did have a “help desk.” Unfortunately, we have to go through other management to be able to call and get assistance. It cost money every time they are called. From my understanding, it would be cost-effective to have a Nurse Informaticist working for the IDOC NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.
     

                  
     
    Another frustrating issue with not having a NI is that nurses that use the program every day do not get a say in what needs added or taken out of the medical record program or the medication administration record. Some of these decisions are made at nurse manager meetings, which many are not as familiar with using the program as nurses at the forefront of patient care. If we had a NI, those ideas could be developed into more efficient ways of documenting and possibly decrease medication errors. Medical errors cost nearly $40 billion every year in healthcare, and many can be prevented from having an NI in the healthcare system.
     
    (Rupp, 2016) 
     
    The NI could visit every institution and listen to the concerns of nurses, which would decrease stress and make the program better. It is incredibly frustrating to have a program that assessment and plan of care are sometimes inaccessible together without consulting a physician to write as orders.
     

       
     
    By having an NI, new employees can be trained on the system by that nurse instead of a line staff nurse that is trying to care for patients as well as train a new nurse. That new nurse would learn the program much quicker and correctly by having NI do training.
     

        
     
    I’m excited to see how using nurses in this role in the future helps develop and improve patient care! There are so many places that NIs can be of benefit. Base salaries for informatics nurses are increasing to be a pretty substantial wage at sometimes 100,000. One excellent concept of this up and coming career option is that these nurses can be developing programs that still advocate for the bedside nurse. I can be supportive and educate older nurses that may not be “technically inclined” yet teach the newer nurses how to use to use the technology efficiently.
     
    (Rupp, 2016) NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists    
     

    References

    Gaines, K. (2020, July 22).
     
    nurse.org Career Guide Series: Nursing informatics
    . nurse.org.
     
    http://nurse.org

    Nelson, T. L. (2019, March 12).
     
    Nursing informatics: The EHR and beyond
    . American Nurse.com.
     

    Home – American Nurse Journal

    Rupp, S. (2016). How Nurses Are Using Health Informatics to Improve Patient Care.
     
    Electronic Health Reporter
    .
     
    https://doi.org/http://electronic health reporter.com

     
    Whenever there is a change in computer systems, even something as simple as an upgrade, there is bound to be push back and difficulties with the change. At my current place of employment there are nursing super users with each change. The managers, coordinators, and floor educators are automatically put in super user classes. The management can then ask 3-4 floor nurses to become super users as well. These super users are expected to attend a longer more in-depth class with the IT teams. These classes are set up by management as well as the higher-level informatics officers. One of the informatics officers is a nurse, she is also management of IT. This setup is similar to the framework of decision making in informatics proposed by
     
    Mosier et al (2019), in that there is a defined timeline and defined roles of all those involved NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.
     

     
    This system is important because management is not on the floor at all times. Having super users from both shifts available is a very useful asset. We upgraded the computer system last month and there was a large change in the care plan section. There was required online training, but everyone still had a really hard time adjusting. The super users were able to help and their helpful tricks filtered through the floor like a ripple effect. This made the transition much more-smoothly for everyone. Nurses are knowledge workers, and this is evident at a time of new technology
     
    (McGonigle & Mastrian, 2017). Nurses tend to be great learners; they catch on fast and teach each other well NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.
     

     
    One informatics change I would like to see implemented is a further use of the mobile devices. There are a handful of things we can complete on the iPhone we use for texting physicians, charting vitals, and printing lab slips. As discussed by Ng et al (2018), mobile devices have a huge benefit for population in health. There is so much we can do with mobile devices now related to healthcare. There should also be a nursing portion of the health reminders. These could be flags for medications, or reminders for vitals rechecks, or some sort of integration with the new computer system we have started. There could be a way to progressively chart the care plan section as the day goes by, on a mobile device. There is no reason mobile device advancements should only be for patients and the population. Decreasing the amount of time nurses need to sit at a desk to chart, would increase the time patients are able to see them. This is a benefit to hospitals. I am hopeful for advancement in our mobile charting soon, with the further advancement of other healthcare apps NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.
     

    References

    McGonigle, D., & Mastrian, K. (2017). 
    Nursing Informatics and the Foundation of Knowledge
    . Jones & Bartlett Learning.

    Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions. 
    JONA: The Journal of Nursing Administration
    , 
    49
    (11), 543–548. https://doi.org/10.1097/nna.0000000000000815

    Ng, Y. C., Alexander, S., & Frith, K. H. (2018). Integration of Mobile Health Applications in Health Information Technology Initiatives. 
    CIN: Computers, Informatics, Nursing
    , 
    36
    (5), 209–213. https://doi.org/10.1097/cin.0000000000000445NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

    Discussion: Interaction Between Nurse Informaticists and Other Specialists

    Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

    Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

    In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

    To Prepare:

    Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.

    Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    By Day 3 of Week 3

    Post
     a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

    By Day 6 of Week 3

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
    , offering one or more additional interaction strategies in support of the examples/observations shared or by offering further insight to the thoughts shared about the future of these interactions.

     

    Collaboration with Nurse Informaticists

    I can honestly say I have never seen the nurse informaticist that works within my healthcare organization. I have heard that there is one that works down in information technology (IT) and occasionally makes changes in the electronic health record (EHR) but I have never interacted with her. I feel that there needs to be more nurse informaticists and more professional collaboration between them and the rest of the hospital. Nobody really talks about nursing informatics at my hospital and that is starting to become a problem. I currently work in the heart and vascular ICU where we have been overburdened with high-acuity patients and a significant shortage of staff. One strategy I offer for improvement is to simply have the nurse informaticist come up to the unit and start interacting with the staff. Another strategy is to increase training and education for nurses in the field of informatics. Sipes (2016) states that nurse informaticists must be competent in over 200 skills now. This will require an increase in training and education programs to better prepare them to improve clinical practice (Sipes, 2016). Now is a better time than ever to implement these changes. Ideally, they will benefit interprofessional collaboration and, ultimately, improve patient outcomes NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    Informatics, technology, and Professional Interaction

    Technology has made dramatic progress in the past four decades and has forever changed the way that healthcare is delivered (Elsayed et al., 2016). The field of nursing informatics has also come a long way considering that it has only been a specialty since 1992 (Cummins et al., 2016). Technological advancements in nursing informatics have benefited the way we interact with other professionals as well as the patients we aim to serve. Advancements include the electronic health record (EHR), handheld digital devices, upgrades in computer systems, and much more (Elsayed et al., 2016). It is estimated that nurses spend about 50% of their time at work documenting and charting (Elsayed, 2016). That being said, informatics has come to their rescue with the above advancements in technology such as the EHR. As technology continues to improve, collaboration with other professionals will benefit as well. Advancements in hands-free devices, telecommunications, and telehealth could forever change the way nursing is done (Fathi et al., 2017). As nursing informatics and technology continue to make strides, the end goals will be to enhance the delivery of healthcare, increase interprofessional collaboration, and improve the clinical outcomes of the patients NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    References

    Cummins, M. R., Gundlapalli, A. V., Murray, P., Park, H. A., Lehmann, C. U., & Gundlapalli, A. V. (2016). Nursing Informatics Certification Worldwide: History, Pathway, Roles, and Motivation. 
    Yearbook of Medical Informatics
    , 
    25
    (01), 264–271. 
    https://doi.org/10.15265/iy-2016-039

    Elsayed, I. A., El-Nagger, N. S., & AzimMohamed, H. A. (2016). Evolution of Nursing Informatics: A key to Improving Nursing Practice. 
    Research Journal of Medicine and Medical Sciences
    , 
    11
    . 
    https://www.academia.edu/29974363/Evolution_of_Nursing_Informatics_A_key_to_Improving_Nursing_Practice
    .

    Fathi, J. T., Modin, H. E., & Scott, J. D. (2017). Nurses Advancing Telehealth Services in the Era of Healthcare Reform. 
    The Online Journal of Issues in Nursing
    , 
    22
    (2). 
    https://10.3912/OJIN.Vol22No02Man02   

    Sipes, C. (2016). Project Management: Essential Skill of Nurse Informaticists. 
    Nursing Informatics 2016
    , 
    225
    . 
    https://doi.org/10.3233/978-1-61499-658-3-252

    Recently this writer has spent a great deal of time reflecting on my experiences and interactions with Information’s Technology and those who make it all happen. Early on in this writer’s career, I was exposed to the emergence of new software, programs, and even the implementation of electronic medical records for the first time in a facility or agency NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    When beginning a career as an RN at Beaufort Memorial Hospital (BMH), a rural hospital in Beaufort, SC, I was asked to participate as a “Superuser” when BMH went electronic, less than a year into my working there. According to Bullard (2016), a superuser is vital to the implementation, upkeep, and affordability of any electronic health record (EHR) system. As this writer progressed in my career, I have found myself in the center of every committee or orientation process related to health information technology. Reflecting on the implementation of the EHR at BMH, specifically the excellence of care that now, after experiencing other hospital systems was greatly influenced by the presence of bedside computers in every patient room. The electronic version of the flow chart and head to toe assessment including the timely documentation, the ability to quickly access information for the patient including evidenced-based practice (EBP) standards, education materials, and the ability to print these documents for the patients later use were all elements that shaped the nurse I am today NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    As a Certified Nurse Assistant (CNA) and then a Licensed Practical Nurse (LPN) for a grand total of only eighteen months prior to graduating to the novice Registered Nurse (RN), this writer can attest to the difference in a new graduate-level of skills including presence, versus those of the seasoned nurse as discussed by (McGonigle, 2017). However, many years of bedside charting and then a transition to home care and eventually hospice care gave this writer a different perspectives regarding the presence and documenting in an (EHR) in the home. This the writer now understands the perspective of the executive leader as discussed by Mosier et al., (2019). A while later this writer landed in the middle of a complete software revamp when the company to which employed agreed to be the pilot agency for software designed for homecare but also being implemented in hospice. At the executive level, this writer spent many hours, at least 50% of my day either building workarounds or  literally working on the necessary changes to the software needed to not only qualify for reimbursement form insurers but also to pass a state survey NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    A strategy proven to improve patient outcomes as well as employee morale and financial stability within an organization is to include the nurse in the design and decision making of your EHR (Bullard, 2016). Many frustrations this writer experienced at a Long-Term Acute Care (LTAC) assignment recently could have been avoided. The lack of acknowledgment of nurse feedback regarding much-needed changes to the EHR, especially regarding lack of presence and an incredible amount of time spent documenting redundantly rather than caring for the patient were discovered to be cultural. This writer intended to share ideas and proven improvement learned throughout my career and the evolution of technology, but it was not reciprocated. As Nursing Informatics evolves into a specialty all its own, this writer believes the culture mentioned earlier will have to change.

    After the recent interactions or lack thereof at that last assignment and taking a heap of assessments on various job boards, this writer was actually a bit surprised to find that the only areas in which I am more than “very proficient” is in areas that include IT and Management, all scoring in the “excellent” category. Long story short, as of last Friday, I have changed my concentration of major to HIT. This is my strategy NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

      ORDER A PLAGIARISM FREE PAPER NOW

    References

    Bullard, K. L. (2016). Cost-Effective Staffing for an EHR Implementation. Nursing Economic$, 34(2), 72–76.

    McGonigle, D.  (20170317). Nursing Informatics and the Foundation of Knowledge, 4th Edition. [[VitalSource Bookshelf version]].  Retrieved from vbk://9781284142990

    Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership. JONA: The Journal of Nursing Administration, 49(11), 543-548.

     

    NURS_5051_Module02_Week03_Discussion_Rubric

    Excellent

    Good

    Fair

    Poor

    Main Posting

    45 
    (45%)
     – 50 
    (50%)

    Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

    Supported by at least three current, credible sources.

    Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

    40 
    (40%)
     – 44 
    (44%)

    Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

    At least 75% of post has exceptional depth and breadth.

    Supported by at least three credible sources.

    Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

    35 
    (35%)
     – 39 
    (39%)

    Responds to some of the discussion question(s).

    One or two criteria are not addressed or are superficially addressed.

    Is somewhat lacking reflection and critical analysis and synthesis.

    Somewhat represents knowledge gained from the course readings for the module.

    Post is cited with two credible sources.

    Written somewhat concisely; may contain more than two spelling or grammatical errors.

    Contains some APA formatting errors.

    0 
    (0%)
     – 34 
    (34%)

    Does not respond to the discussion question(s) adequately.

    Lacks depth or superficially addresses criteria.

    Lacks reflection and critical analysis and synthesis.

    Does not represent knowledge gained from the course readings for the module.

    Contains only one or no credible sources.

    Not written clearly or concisely.

    Contains more than two spelling or grammatical errors.

    Does not adhere to current APA manual writing rules and style.

    Main Post: Timeliness

    10 
    (10%)
     – 10 
    (10%)

    Posts main post by day 3.

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    Does not post by day 3.

    First Response

    17 
    (17%)
     – 18 
    (18%)

    Response exhibits synthesis, critical thinking, and application to practice settings.

    Responds fully to questions posed by faculty.

    Provides clear, concise opinions and ideas that are supported by at least two scholarly sources NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    Demonstrates synthesis and understanding of learning objectives.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are fully answered, if posed.

    Response is effectively written in standard, edited English.

    15 
    (15%)
     – 16 
    (16%)

    Response exhibits critical thinking and application to practice settings.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are answered, if posed.

    Provides clear, concise opinions and ideas that are supported by two or more credible sources.

    Response is effectively written in standard, edited English.

    13 
    (13%)
     – 14 
    (14%)

    Response is on topic and may have some depth.

    Responses posted in the discussion may lack effective professional communication.

    Responses to faculty questions are somewhat answered, if posed.

    Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

    0 
    (0%)
     – 12 
    (12%)

    Response may not be on topic and lacks depth.

    Responses posted in the discussion lack effective professional communication.

    Responses to faculty questions are missing.

    No credible sources are cited.

    Second Response

    16 
    (16%)
     – 17 
    (17%)

    Response exhibits synthesis, critical thinking, and application to practice settings.

    Responds fully to questions posed by faculty.

    Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

    Demonstrates synthesis and understanding of learning objectives.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are fully answered, if posed.

    Response is effectively written in standard, edited English.

    14 
    (14%)
     – 15 
    (15%)

    Response exhibits critical thinking and application to practice settings.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are answered, if posed.

    Provides clear, concise opinions and ideas that are supported by two or more credible sources.

    Response is effectively written in standard, edited English.

    12 
    (12%)
     – 13 
    (13%)

    Response is on topic and may have some depth.

    Responses posted in the discussion may lack effective professional communication.

    Responses to faculty questions are somewhat answered, if posed.

    Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

    0 
    (0%)
     – 11 
    (11%)

    Response may not be on topic and lacks depth.

    Responses posted in the discussion lack effective professional communication.

    Responses to faculty questions are missing.

    No credible sources are cited.

    Participation

    5 
    (5%)
     – 5 
    (5%)

    Meets requirements for participation by posting on three different days.

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    Does not meet requirements for participation by posting on 3 different days.

    Total Points: 100

    Name: NURS_5051_Module02_Week03_Discussion_Rubric

    The purpose of this discussion is to gain insight into aspects of interdisciplinary informatics in healthcare. Informatics in healthcare is the exchange of digital information utilizing technology across a multitude of medical disciplines in order to facilitate a continuum of care NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists. The digital age of informatics has advanced since the creation of the Office of the National Coordinator for Health Information Technology (ONC) within the US Department of Health and Human Services (Desalvo et al., 2015). Further advancing informatics was the passage of the e-Health Information Technology for Economic and Clinical Health (HITECH) Act, which prioritized financial allocations for the advancement of healthcare technology development (Desalvo et al., 2015). This funding allowed for the creation of the Meaningful Use (MU) Act, designed to completely digitize the healthcare record (Desalvo et al., 2015). This digitization allows for the scrutinization of the healthcare delivery landscape, enabling for identification of poorly performing processes, thus enabling the proficient delivery of patient-center, evidenced-based, quality healthcare delivery.  The following is a discussion pertaining to the role of informatics in interdisciplinary collaboration.

    The Emergency Department is a unique setting in that it allows for data to be simultaneously accessed and utilized across a number of independent patient care areas.  Information regarding patients presenting must be accessed by lab technicians, imaging technologists, radiologists, ED physicians, intensivists, and other ancillary staff.  The information available across these disciplines represents the patient and their acute and chronic health status.  Interventional decisions can then be directed to allow for evidenced-based care.  These decisions are made by utilizing the Foundation of Knowledge, which is the base for (Marstrian & McGonigle, 2019). The Foundation of Knowledge is the base healthcare providers use to make appropriate interventions based on empirical evidence and evidenced-base practice NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.  Below are strategies designed to allow informatics to function in an interdisciplinary healthcare environment (Marstrian & McGonigle, 2019).

    In order for biomedical informatics to be effectively utilized across the vast array of interdisciplinary demands present in the clinical setting, the focus must be on both the members of the interdisciplinary team and the health systems’ ability to maintains the technological infrastructure utilized to access clinical data. Team members must possess leadership quality, maintain a clear vision and goal, focus on efficient time management, and excel in prioritizing initiatives to continually improve the delivery of patient-centered care (Holden et al., 2018).  It is also essential to have defined roles for informaticians across the interdisciplinary team and ensure informatics education supports the established defined interdisciplinary decision process (Holden et al., 2018).

    Predictive medicine is believed to the future of healthcare and is affords it’s attainability to the advancement of biomedical informatics (Jen, 2019).  Intercollarborative practice success will be destined to parallel the advancement of biometric informatics.  Visual analytic tools and informatic collection systems will continue to evolve, with the dissemination and subsequent analyzation of patient data allowed to be more concisely presented (Wu et al., 2019) NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.  New evaluation tools will provide us with more data that will allow insight into the acute and future health of our patients (Wu et al., 2019).  Another future component of healthcare delivery that will is deep learning of health informatics (Ravì et al., 2019).  Deep learning aims to accelerate algorithm calculations in order to hasten diagnostic intervention and prescriptive medicine by analyzing data and learning from patterns represented in the clinical informatics (Ravì et al., 2019). The promise for more effective healthcare delivery is bright for both providers and patients utilizing informatics and interdisciplinary collaboration NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    References

    DeSalvo, K. B., Dinkler, A. N., & Stevens, L. (2015). The US Office of the National Coordinator for Health Information Technology: progress and promise for the future at the 10-year mark. Annals of emergency medicine, 66(5), 507-510. 
    http://doi.org/10.1016/j.annemergmed.2015.03.032

    Holden, R. J., Binkheder, S., Patel, J., & Viernes, S. H. P. (2018). Best practices for health informatician involvement in interprofessional health care teams. Applied clinical informatics, 9(1), 141. 
    https://doi.org/10.1055/s-0038-1626724

    Jen, M. Y., & Teoli, D. (2019). Informatics. In StatPearls [Internet]. StatPearls Publishing. 
    https://www.ncbi.nlm.nih.gov/books/NBK470564/

    Mastrian, K., & McGonigle, D. (2019). Informatics for health professionals. Jones & Bartlett Learning.

    Ravì, D., Wong, C., Deligianni, F., Berthelot, M., Andreu-Perez, J., Lo, B., & Yang, G. Z. (2016). Deep learning for health informatics. IEEE journal of biomedical and health informatics, 21(1), 4-21. 
    https://doi.org/10.1109/JBHI.2016.2636665

    Wu, D. T., Chen, A. T., Manning, J. D., Levy-Fix, G., Backonja, U., Borland, D., … & Kandaswamy, S. (2019). Evaluating visual analytics for health informatics applications: a systematic review from the American Medical Informatics Association Visual Analytics Working Group Task Force on Evaluation. Journal of the American Medical Informatics Association, 26(4), 314-323. 
    https://doi.org10.1093/jamia/ocy190 NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

              Nursing informatics is a field of nursing that incorporates nursing, computer, and information sciences to maintain and develop medical data and systems to support the practice of nursing, and to improve patient care outcomes (Whithers, 2020). As a Nurse, I see data and technology on a daily basis. We utilize nursing informatics in almost everything we do. Staying up-to-date with this growing concept is vital in ensuring patient safety.

    Nurses aren’t the only profession to utilize and benefit from data and technology. From my observation, nurse informatics have a great impact in the interaction with other professions. The mental health hospital where I currently work has new technology of electronic health records. The EHR allows those healthcare providers designated by the patient to obtain healthcare information related to past episodes of healthcare. It is hoped that such a record will eventually be a birth-to-death electronic healthcare record (Vasilescu, 2015).The IT department works with all professions within the workplace, which includes Nurses, Doctors, Clinicians, Therapists, Secretaries, and so forth.

    A strategy on how the interaction between IT and these professions can improve is by continuous education of the electronic healthcare records. Learning the HER can be complicated, but with the right training, the system can and should run smoothly. IT must be aware of the healthcare staff’s level of computer competency in order to effectively educate. Super users can assist with this training. Super Users answer questions, help end users navigate through the system, and report issues to the project team to support prompt resolution (
    Epic@UNC
    2015) NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists.

    Whithers, F. (2020, May 08). What is Nursing Informatics & How to Become a Nurse Informaticist. Retrieved September 15, 2020, from 
    https://www.registerednursing.org/nursing-informatics/

    Vasilescu, A. (2015). Informatics: The Electronic Health Record: Will Nursing Be on Board When the Ship Leaves? Retrieved September 16, 2020, from 
    http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Health-IT/ElectronicHealthRecord.html

    Epic@UNC. (2015, December 22). Retrieved September 16, 2020, from http://news.unchealthcare.org/epic/training/super-user-responsibilities NURS-6051N Discussion: Interaction Between Nurse Informaticists and Other Specialists

  • Nursing Certification and Licensure in South Carolina Essay

    Nursing Certification and Licensure in South Carolina Essay

    Week 1 Main Discussion Post—

    NRNP – 6565 –
    Synthesis in Advanced Nursing Practice of Patients in Primary Care Settings

    Summary of findings

          Laws that govern nurse practitioner (NP) definition, scope of practice, and prescriptive authority, along with any requirements for physician collaboration, are governed by state legislature (Buppert, 2021).  In South Carolina, the state Board of Nursing (BON) has the authority to govern NP practice. Requirements for becoming certified and licensed in SC include holding an active RN license, obtaining a graduate-level degree in an NP role, and passing a national certification exam (American Association of Nurse Practitioners [AANP], 2020). The application process is managed by the state board of nursing online through the state’s labor, licensing, and regulation (LLR) website found at llr.sc.gov Nursing Certification and Licensure in South Carolina Essay.

    The South Carolina Legislature (South Carolina Legislature, n.d., 40 section) defines the scope of practice for a nurse practitioner in the Nurse Practice Act as “ (5) “Advanced Practice Registered Nurse” or”APRN” means a registered nurse who is prepared for an advanced practice registered nursing role by virtue of additional knowledge and skills gained through an advanced formal education program of nursing in a specialty area that is approved by the board. The categories of APRN are nurse practitioner, certified nurse-midwife, clinical nurse specialist, and certified registered nurse anesthetist. An advanced practice registered nurse shall hold a doctorate, a post-nursing master’s certificate, or a minimum of a master’s degree that includes advanced education composed of didactic and supervised clinical practice in a specific area of advanced practice registered nursing. APRNs must achieve national certification within two years post-graduation. An APRN may perform those activities considered to be the practice of registered nursing or advanced practice consisting of nonmedical acts, such as population health management; quality improvement or research projects within a health care system; and analysis of data and corresponding system recommendations, revisions, developments, or informatics Nursing Certification and Licensure in South Carolina Essay. An APRN also may perform specified medical acts pursuant to a practice agreement as defined in item (45). (40) “Nurse Practitioner” or “NP” means a registered nurse who has completed an advanced formal education program at the master’s level or doctoral level acceptable to the board, and who demonstrates advanced knowledge and skill in assessment and management of physical and psychosocial health, illness status of persons, families, and groups. Nurse practitioners who perform medical acts must do so pursuant to a practice agreement as defined in item (45).”

         The state of South Carolina has an in-depth Nurse Practice Act which covers many aspects of practice including definitions, criminal records, license requirements and renewal, initial certification exam, demonstration of continued competency, and code of ethics (South Carolina Legislature, n.d.). The state’s practice agreement is a written agreement developed by an NP and collaborating physician to establish the medical aspects of care that are to be provided by the NP and must contain a way for evaluation to ensure patient safety and quality of care in accordance with state and federal laws (Buppert, 2021) Nursing Certification and Licensure in South Carolina Essay.

         A DEA license is required for healthcare providers who prescribe controlled substances. The DEA will assign an NP a DEA number as a mid-level practitioner if the NP has a practice site, if state law permits, and the NP has no felony on record (Buppert, 2021). South Carolina requires physician collaboration and poses restrictions for prescribing controlled substances. Schedule II nonnarcotic substances can be prescribed for up to 30 days and schedule II narcotic substances must not exceed a 5-day supply with exceptions being hospice or palliative care instances not exceeding a 30-day supply (South Carolina Legislature, n.d.).

         Recent legislative and advocacy activities include a senate bill which passed in May 2021 passed which authorizes APRNs and Pas the ability to issue orders for home health care (AANP, 2020). The Myrtle Beach, SC, area has a nurse practitioner advocacy and continuing education group that meets monthly called
    Grand Strand Advance Practice Nurse Association
    which offers membership to APRNs in the area along with NP students who are close to graduation Nursing Certification and Licensure in South Carolina Essay.

      ORDER A PLAGIARISM FREE PAPER NOW

    Regulations/Barriers

         South Carolina is a restricted practice state and requires physician delegation, supervision, and collaboration for NP practice. The state board of medical examiners must review cases when a supervising physician has more than three NPs practicing under their license (AANP, 2020). A specific barrier in South Carolina is the lack of access to medical care and health professionals in rural areas along with a short supply of statewide primary care physicians. Adopting full scope of practice in SC can be associated with improved access to care, especially in rural areas (Kandrack et al., 2019). If the growing supply of NP practitioners in the workforce is optimally utilized, access to health care especially for racial and ethnic minorities can be improved dramatically (Poghosyan & Carthon, 2017). Additional research is needed surrounding the heated debate on policy reform that grants full state-level NP scope of practice in all states and additional work is needed to align practice and policy efforts with healthcare accessibility (Patel et al., 2018).

    Surprising Research Findings

         The lack of consistency state to state regarding APRN scope of practice is alarming and surprising, as well as the lack of a clear scope of practice in some states. Clarity is essential for an NP to practice safely and confidently. With the aging population in the United States along with the challenges of rising healthcare costs and growing disease burden, NPs bring high-quality care and have a strong potential to vastly increase access to care and help address the healthcare challenges of the future Nursing Certification and Licensure in South Carolina Essay.

    References

    American Association of Nurse Practitioners. (2020, October 15).
    AANP state fact sheet: South Carolina
    . statepolicy@aanp.org. Retrieved August 31, 2021, from
    https://www.aanp.org/advocacy/south-carolina

    Buppert, C. (2021).
    Nurse practitioner’s business practice and legal guide
    (7th ed.). Jones & Bartlett.

    Kandrack, R., Barnes, H., & Martsolf, G. R. (2019). Nurse practitioner scope of practice regulations and nurse practitioner supply.
    Medical Care Research and Review
    ,
    78
    (3), 208–217.
    https://doi.org/10.1177/1077558719888424

    Patel, E. Y., Petermann, V., & Mark, B. A. (2018). Does state-level nurse practitioner scope-of-practice policy affect access to care?
    Western Journal of Nursing Research
    ,
    41
    (4), 488–518.
    https://doi.org/10.1177/0193945918795168

    Poghosyan, L., & Carthon, J. (2017). The untapped potential of the nurse practitioner workforce in reducing health disparities.
    Policy, Politics, & Nursing Practice
    ,
    18
    (2), 84–94.
    https://doi.org/10.1177/1527154417721189

    South Carolina Legislature. (n.d.).
    South Carolina code of laws: Nurse practice act
    . scstatehouse.gov. Retrieved August 31, 2021, from https://www.scstatehouse.gov/code/t40c033.php Nursing Certification and Licensure in South Carolina Essay

  • Wisconsin nursing practice Certification and Licensure

    Wisconsin nursing practice Certification and Licensure

    Summarize nurse practitioner certification and licensure processes

    Certification of a nurse practitioner (NP) includes applying for an exam with the American Academy of Nurse Practitioners Certification Board (AANPCB) or the American Nurses Credentialing Center (ANCC) by graduating from an accredited master’s, postgraduate, or doctorate degree program and possessing an active registered nurse (RN) license (Leik, 2021). NP licensure is governed by the state of residence or practice and information can be quite difficult to find. In Wisconsin, you must submit an application and fee, provide evidence of current registered nurse licensure, current NP certification by a certifying body, master’s or doctoral degree, and completion of 45 contact hours in clinical pharmacology (Wisconsin Department of Safety and Professional Services, 2021) Wisconsin nursing practice Certification and Licensure.

    Explain state-specific scope of practice for family practice nurse practitioners and restrictions or limitations for practice

    Wisconsin NPs do not have a separate scope of practice from RNs and LPNs. Wisconsin NPs must have a collaboration with a medical doctor or doctor of osteopathic medicine to practice and prescribe no more than schedule II drugs. A Wisconsin NP can never practice independently and never be named a primary care provider (NCLS, n.d.).

    Explain nurse practitioner prescriptive authority and DEA registration processes

    As stated above the prescriptive authority of a Wisconsin NP is limited to schedule II drugs. Any NP that prescribes controlled substances needs a Drug Enforcement Administration (DEA) number. To apply for a number an NP must either apply online, call DEA Headquarters, or mail DEA Form 222a (American Associated of Nurse Practitioners, n.d.).

    Explain legislative and advocacy activities related to nurse practitioner practice

    For several years NPs have been fighting for updating legislation in Wisconsin including independent practice, being labeled advanced practice registered nurses (APRN), and providing a definition and scope of practice (Wisconsin Nurses Association, 2021). Hearings are currently being held in Wisconsin legislation.

    Identify key concepts of professional issues related to nurse practitioner practice

    A few issues related to nurse practitioner practice includes the presumed lack of education, experience, and knowledge to care for patients. However, studies show that NPs provide holistic, safe, and cost-effective care and when complex patients arise an NP utilizes resources to assist with the needed care (Buttaro et al., 2021; Moldestad et al., 2020) Wisconsin nursing practice Certification and Licensure.

    References

    American Association of Nurse Practitioners. (n.d.). How to get information about obtaining a DEA number. Retrieved August 31, 2021, from https://www.aanp.org/practice/practice-management/business-resources-for-nurse-practitioners/how-to-order-a-dea-number

    Buttaro, T. M., Polgar-Bailey, P., Sandberg-Cook, J., & Trybulski, J. (2021).
    Primary care: Interprofessional collaborative practice
    (6th ed.). Elsevier.

      ORDER A PLAGIARISM FREE PAPER NOW

    Leik, M. T. C. (2021). Adult-gerontology nurse practitioner certification: Intensive review (4th ed.). Springer Publishing Company

    Moldestad, M., Greene, P. A., Sayre, G. G., Neely, E. L., Sulc, C. A., Sales, A. E., Reddy, A., Wong, E. S., & Liu, C. (2020). Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states. 
    Journal of Advanced Nursing
    , 
    76
    (11), 3092–3103. https://doi-org.ezp.waldenulibrary.org/10.1111/jan.14501

    NCSL. (n.d.) State overview: Wisconsin. Retrieved August 31, 2021, from https://scopeofpracticepolicy.org/states/wi/

    Wisconsin Department of Safety and Professional Services. (July 2021). Board of nursing. Retrieved August 31, 2021 from https://dsps.wi.gov/Credentialing/Health/fm2124.pdf

    Wisconsin Nurses Association. (August 2021). APRN modernization act 2021. Retrieved August 31, 2021, from https://www.wisconsinnurses.org/aprn-modernization-act-2021/ Wisconsin nursing practice Certification and Licensure