Client Questions

Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course mentor that you will take into consideration for your own change project.

Please make a reply to this student post adding something extra of what the student already did. APA references and less than 20 % similarity . Minimum 3 paragraph wit at least 3 sentences.     Discussion question The purpose of literature review provides an overview of a chosen topic to allow for critical evaluation, classification, and comparison of already published knowledge. Literature review involves putting a chosen topic in context of a broad field of research so as to identify current knowledge on a chosen field. Literature review helps in synthesizing and placing a topic into context and map different approaches to reveal patterns of understanding a topic (Polit & Beck, 2017). Another purpose of literature review is to justify the significance of investigating a topic. Through literature review, gaps in a field are identified that provides the need for the further research. The major situation where a nurse requires literature review is during research. Literature review also helps arrange thoughts and ideas in cases when a nurse is practicing based on evidence based research. There are a number of challenges that nursing researchers face when conducting literature research. The process of literature review involves first the validation of different studies to ensure that they meet the criteria of quality required (Chen et al., 2016). This is a tedious and challenging work for nurses especially if they are trying to find literature on relatively unstudied work. There are also errors such as accidental inclusions and exclusion of studies that do not meet criteria and duplication of references. Another challenge of developing literature review is the inability to concentrate on the details of the text. In literature review, one has to look for relevant results which are not always easy to find. Moreover, one will have to continue to sort information to avoid redundancies and opposite conclusions from research. Having a review of literature that supports the needs and gaps of research often becomes hard. References Chen, D. T. V., Wang, Y. M., & Lee, W. C. (2016). Challenges confronting beginning researchers in conducting literature reviews. Studies in Continuing Education, 38(1), 47-60. Polit, D. & Beck, C. (2017). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer Health.

After you have read chapter 20 of the class textbook and review the PowerPoint presentation, choose a family in your community and conduct a family health assessment addressing the questions below.  1. Family composition.  Type of family, age, gender and racial/ethnic composition of the family. 2. Roles of each family member. Who is the leader in the family? Who is the primary provider? Is there any other provider? 3. Do family members have any existing physical or psychological conditions that are affecting family function? 4. Home (physical condition) and external environment; living situation (this must include financial information). How the family support itself.  For example, working parents, children or any other member 5. How adequately have individual family members accomplished age-appropriate developmental tasks? 6. Do individual family member’s developmental states create stress in the family? 7. What developmental stage is the family in? How well has the family achieve the task of this and previous developmental stages?  8. Any family history of genetic predisposition to disease? 9. Immunization status of the family? 10. Any child or adolescent experiencing problems 11. Hospital admission of any family member and how it is handled by the other members? 12. What are the typical modes of family communication? It is affective? Why? 13. How are decisions make in the family? 14. Is there evidence of violence within the family? What forms of discipline are use? 15. How well the family deals with crisis? 16. What cultural and religious factors influence the family health and social status? 17. What are the family goals? 18. Identify any external or internal sources of support that are available? 19. Is there evidence of role conflict? Role overload? 20. Does the family have an emergency plan to deal with family crisis, disasters? Identify 3 nursing diagnosis and develop a short plan of care using the nursing process. Please present your assessment in an APA required font, word document attached to the forum in the discussion tab of the blackboard and in the SafeAssign exercise title “family assessment”.   4 evidence-based practice references besides the class textbook are require and must be quoted in the assignment.  A minimum of 1000 words are required, excluding the first and reference page (Websites can be used but will not count toward grading).  2 replies to any of your peer’s assessment/posting are required sustained with the proper reference. You must identify two family problems and present a nursing care plan using the nursing process addressing the problems. The assignment must be posted in the discussion tab of the blackboard for your peers to review and reply and in the SafeAssign Exercise in the assignment tab of the blackboard to verify originality.  Due date: Sunday, July 19, 2020 at 11:59 PM to be posted in both forum and for replies on Wednesday, July 22, 2020 at 11:59 for replies only. I will not accept assignments posted in the reply’s forum.

Respond  by providing one alternative therapeutic approach. Explain  why you suggest this alternative and support your suggestion with  evidence-based literature and/or your own experiences with clients.                                       Main Post   Therapy for Clients with Personality Disorders According  to the American Psychiatric Association (2013b) there are six types of  personality disorders: borderline personality disorder,  obsessive-compulsive personality disorder, avoidant personality  disorder, schizotypal personality disorder, antisocial personality  disorder, and narcissistic personality disorder. The DSM-5 has them  listed under section III in Specific Personality Disorders  (American Psychiatric Association, 2013a, p 763). All patients should be  assessed for “personality functioning” and traits because personality  disorders can affect other mental disorders (American Psychiatric  Association, 2013a, p 763). Diagnosing a patient with a personality  disorder can be difficult because they usually have traits that  “overlap” with other personality disorders (American Psychiatric  Association, 2013a, p 761). The purpose of this post is to consider  therapeutic approaches to use for clients with a personality disorder.  This discussion will describe borderline personality disorder (BPD),  explain a therapeutic approach I might use to treat a client with BPD,  and discuss how I would tell the patient the diagnosis without damaging  our therapeutic relationship. I often hear that patient has cluster B personality traits. That can include “antisocial  personality disorder, borderline personality disorder, histrionic  personality disorder, and narcissistic personality disorder” (Mayo Clinic, 2016). For this assignment, I decided to focus on BPD because I see it more often.  According  to the Mayo Clinic (2019), BPD causes and risk factors may stem from  genetics, brain abnormalities, and/ or a stressful childhood. Persons  with BPD have a maladaptive schema of “abandonment/instability” that  cause them to have negative beliefs about themselves and situations  (Wheeler, 2014, p 326). Their fear abandonment and issues with trusting  others, causes them to sabotage relationships (Wheeler, 2014, p 243).  This also makes it difficult when attempting to establish a therapeutic  relationship (Wheeler, 2014, p 243). Another  concern is persons with BPD have problems with intense emotions and  self-regulation (NAMI, 2017). They are prone no injurious behavior or  self-harm when stressed or feeling rejected (Howe, 2013). According to  Dr. Edmund Howe (2013), “on average”, these patients will “attempt  suicide 3.3 times” in their life and as many as 10% complete suicide. Therapeutic Approach              Psychodynamic psychotherapy and dialectical behavior therapy (DBT) are  the therapies of choice for BPD (Wheeler, 2014, p 242). DBT being the  “gold standard” for BPD, is the approach I would use (Greenstein, 2017).  For BPD patients, DBT is used to teach “behavioral” and coping skills  to deal with symptoms (Greenstein, 2017). Therapy teaches mindfulness,  distress tolerance, interpersonal effectiveness, and emotion regulation  (Greenstein, 2017). Each skill set is in its own module and it takes a  “year to go through all four modules” (Greenstein, 2017). One study  boasts that DBT has a 77% success rate (Greenstein, 2017). Telling the Patient              There was a time, practitioners were reluctant to tell a patient they  have BPD due to fears of patient reactions (Howe, 2013). Stigmas against  BPD because it was believed to be a condition somewhere between  psychosis and neurosis and lacked any real treatment options, making it  more difficult to discuss (Howe, 2013). The current belief is that being  open with the patient and explaining the diagnosis can benefit  treatment and help the patient process what they are going through  (Howe, 2013).               I would tell the patient their diagnosis and over the diagnosis  criteria with them. Doing this allows the patient to relate the criteria  with their symptoms (Howe, 2013). It may also give them peace of mind  that they are not to blame and being diagnosed means they can now start  treatment and hopefully get better.                                   References: American Psychiatric Association. (2013a). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.  American Psychiatric Association. (2013b). Personality Disorders. file:///C:/Users/1Insignia5/Downloads/APA_DSM-5-Personality-Disorder.pdf Greenstein, L. (2017). Treating Borderline Personality Disorder. NAMI. https://www.nami.org/Blogs/NAMI-Blog/June-2017/Treating-Borderline-Personality-Disorder Howe  E. (2013). Five ethical and clinical challenges psychiatrists may face  when treating patients with borderline personality disorder who are or  may become suicidal. Innovations in clinical neuroscience, 10(1), 14–19. Mayo Clinic. (2016). Personality disorders.  https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463 Mayo Clinic. (2019). Borderline personality disorder. https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237 NAMI. (2017). Borderline Personality Disorder. https://nami.org/About-Mental-Illness/Mental-Health-Conditions/Borderline-Personality-Disorder Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). Springer Publishing Company.

Write a 3–4 page evidence-based resourcing plan for one component of the Heart Failure Clinic.    Instructions Deliverable: Develop one component of an evidence-based resourcing plan. Scenario: The hospital leadership team has already allocated the major capital expenditures for the heart failure clinic, such as the facility, legal services, IT, and security services. However, as a member of the nurse team, you have been asked to develop onecomponent of a resourcing plan for the next leadership meeting. You may use any combination of documents (for example, a spreadsheet or a table) in addition to explanatory information to convey information clearly and succinctly. Choose one of the following: Budget: Apply evidence-based management strategies and best practices for resourcing health care services. Identify the business plan budget categories and subcategories (not necessarily the actual cost) to establish a new clinic. Start-up expenses. Examine fixed and variable costs. Capital budget items. Examples: salary and benefits, staffing mix, specialized equipment or materials, et cetera. Contingency fund and parameters. Apply legal and professional standards for resourcing outpatient services. Explain the alignment to best practices and professional standards for cost effective outpatient services. How will uninsured or underinsured patients be managed? Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes. What data resources and tools analyze costs, health insurance, and hospitalization services? How will billing be handled? How will you determine if outpatient management is cost-effective? How does transparency impact the consumer? Staffing Plan: Apply evidence-based management strategies and best practices for resourcing health care services. Identify the disciplines and skill mix needed for appropriate staffing. Estimate staffing requirements by discipline and staffing ratios (evidence-based). Develop a sample staffing schedule. How will you staff to meet corporate diversity goals or the needs of diverse patients? Explain how delegation, collaboration, negotiation will affect staffing plan. How does a union contract affect the staffing plan or schedule? Examine the Nurse Practice Act for your state. How does the Nurse Practice Act affect your staffing plan? Apply legal and professional standards for resourcing outpatient services. Align your staffing plan to best practices, the Nurse Practice Act for your state, scope of practice, and the Joint Commission standards for outpatients. Describe management and accountability tools and procedures used to manage health delivery services and patient outcomes. How will you know if staffing is cost-effective? How will you know if staffing mix or schedule impacts patient outcomes? Additional Requirements Written communication: Written communication should be free of errors that detract from the overall message. APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting. Length: The plan should be 3–4 pages in content length, double-spaced. Font and font size: Times New Roman, 12 point. Number of resources: Support your plan with a minimum of three peer-reviewed resources, in addition to professional standards Grading rubric attached**

ITS IMPORTANT TO MEET THE COMPETENCES ! In 3–5 pages, develop recommendations for a team charter and provide communication and collaboration strategies for a new interprofessional team that will work together on challenging cases. By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: Competency 1: Explain strategies for effective interprofessional teamwork and collaboration in health care delivery.             (IMPORTANT) -Explain methods to establish ground rules and set expectations for interprofessional team collaboration. (IMPORTANT) -Describe best practices for interprofessional team collaboration. (IMPORTANT) -Explain the benefits and limitations of different forms of communication for an interprofessional team. Competency 3: Develop evidence-based nursing interventions to address specific problems and enable systemic change.             (IMPORTANT) -Describe evidence-based conflict resolution strategies for interprofessional teams. Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations of a nursing professional.             (IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, and mechanics. Use correct APA format. Assessment Instructions  Preparation Use the Capella library and the Internet to research examples of interprofessional team charters, communication strategies and conflict resolution strategies for teams, and methods and technologies used in team communication. Requirements You have been charged with facilitating the launch of an interprofessional team that will work together on a number of challenging cases. The team members will come from several different areas within the organization. The team is expected to have its orientation meeting in two weeks and then work together collaboratively for the next six months. Your first task is to develop recommendations for a team charter that will help the group establish ground rules and decide who will lead the team. You also need to help the team with communication and collaboration strategies. This assessment has two distinct sections: Team Charter Recommendations and Communication and Collaboration Strategies. Provide thorough and detailed recommendations and support your recommendations using examples, references, and citations from your research. For the Team Charter Recommendations: Explain methods to establish ground rules and set expectations. How might differences in personality, expectations, and experience affect team efficiency? Describe conflict resolution strategies for interprofessional teams. Identify effective ways to address issues of team leadership. How will the team decide who will lead them? What happens if the team leader is ineffective? For the Communication and Collaboration Strategies: Describe best practices for effective interprofessional collaboration. What types of technology can be used to support collaboration? Explain the benefits and limitations of different communication strategies such as e-mail, text, voice mail, and face-to-face. When is it appropriate to use each type of communication? This assessment should be 3–5 pages in length, not including the title page and reference page. Use at least three resources to support your recommendations, and follow APA guidelines for style and format. Additional Requirements Include a title page and reference page. Reference at least three current scholarly or professional resources. Use APA format. Use Times New Roman font, 12 point.

What are the methods a nurse can use to gather cultural information from patients? How does cultural competence relate to better patient care? Discuss the ways in which a nurse demonstrates cultural competency in nursing practice.

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment. Communicable Disease Selection Chickenpox Tuberculosis Influenza Mononucleosis Hepatitis B HIV Ebola Measles Polio Influenza Epidemiology Paper Requirements Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc. Describe the social determinants of health and explain how those factors contribute to the development of this disease. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population? Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.  A minimum of three peer-reviewed or professional references is required.

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society. Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape. To Prepare: Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA). Consider who benefits the most when policy is developed and in the context of policy implementation.

PICOT is an acronym used to help develop clinical research questions and guide you in your search for evidence: P = Patient population I = Intervention or issue of interest C = Comparison of interventions or comparison of interests O = Outcome T = Time frame For example, you may wish to research the effects of interrupted sleep on cognition of ICU patients 65 or older. Using this PICOT model, In _________(P), how does __________ (I) compared to _________ (C) influence _________ (O) over ________ (T)? In ICU patients who are 65 or older, how does interrupted sleep (awakened one time or more in four hours) as compared to uninterrupted sleep influence the patient’s cognitive ability over 5 days? Assignment Directions Begin by selecting a topic in nursing or medicine that is of interest to you. Next, use PICOT to format possible research questions about that topic. Provide 3 possible PICOT research questions. Include the following: Title page Provide a brief description of the topic and background information. Explain the significance of the topic to nursing practice. Provide 3 clearly stated PICOT questions. Your paper should:  Be 2–3 pages (not including the title page and reference page) Use current APA format to style your paper and to cite your sources.