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NURS 6003 Academic Success and Professional Development Plan Part 2 Example

NURS 6003 Module 2 | Part 2: Strategies to Promote Academic Integrity and Professional Ethics

I have analyzed the relationship between academic integrity and writing, as well as the relationship between professional practices and scholarly ethics. I have also identified strategies I intend to pursue to maintain integrity and ethics in my academic work while a student of the MSN program, as well as my professional work as a nurse throughout my career. The results of these efforts are shared below.

Directions: In the space below, craft your analysis/writing sample, including Part 1 (The Connection Between Academic and Professional Integrity) and Part 2 (Strategies for Maintaining Integrity of Work).

Part 1: Writing Sample: The Connection Between Academic and Professional Integrity

In the space below, write a 2- 3-paragraph analysis that includes the following:

• Explanation for the relationship between academic integrity and writing
• Explanation for the relationship between professional practices and scholarly ethics
•  Cite at least 2 resources that support your arguments, being sure to use proper APA formatting.
• Use Grammarly and SafeAssign to improve the product.
• Explain how Grammarly, Safe Assign, and paraphrasing contributes to academic integrity

Answer:

One of the most important principles in nursing is honesty, and it is imperative that this value be upheld in all situations. This is something that should come easily, and if you do it right, it will indicate that your nursing identity is genuine. The dedication of a learning institution to upholding academic standards guarantees that its students will receive an excellent education that will adequately equip them for rewarding professions in the disciplines in which they want to work (Bloomfield et al., 2021). 

Maintaining one’s professionalism requires continually pushing oneself to become better, as well as adhering to a set of rigorous ethical rules. Students should get encouragement and assistance, satisfy their requirements, and be provided with the resources necessary for academic achievement. It is essential to make the classroom a place where everyone feels safe to speak openly and honestly, to create an environment devoid of cheating and unethical behavior, and to maintain that environment. Students should be honest in their writing and avoid any forms of cheating or unethical behavior.

To have imposed integrity in this field and to be able to set the standards for sustaining morality and ethics is a mark of respectability in any educational system across the world. Plagiarism and cheating are unacceptable forms of academic behavior, as they encourage dishonesty and a perverted approach to education (Ruddy & Ponte, 2019). It fails to appreciate the hard work of its subjects. There are no shortcuts through the learning process because it is so intricate. While discussing works of literature, it is essential to give credit where credit is due and to acknowledge the expertise of one’s teachers and advisors. It is crucial for the success of the institution and the quality of its education that all students maintain their academic integrity.

Both Grammarly and Turnitin contribute to academic integrity in various ways. Grammarly also has a free plagiarism detector to review your writing to see if anything has been stolen. Plagiarism can be detected in one’s work with the help of these programs; some of them will even underline the offending phrases and provide a link to the original source (Brown et al., 2019). In addition, by comparing submitted writing to other works in their database and on the web, the online tool Turnitin can assist in detecting and preventing plagiarism. When users generate an originality report, they can examine the matched sources and verify whether or not they were properly cited.

PART 2: Strategies for Maintaining Integrity of Work

Expand on your thoughts from Part 1 by:

• Identifying and describe strategies you intend to pursue to maintain integrity and ethics of your 1) academic work while a student of the MSN program and 2) professional work as a nurse throughout your career. Include a review of resources and approaches you propose to use as a student and a professional.

Answer:

As a student in the MSN program, I have to maintain high levels of integrity and ethics in both my academic work and professional work. Keeping one’s word and doing one’s best are two ways to act with integrity and honesty. Building trusting relationships with others is essential for success in this line of work, so we should always do what we say we will do.

In addition, Grammarly, Turnitin, and other paraphrasers are only two of several options for ensuring that students’ work is presented as their own and can be used to demonstrate its originality (Brown et al., 2019). Such websites serve as plagiarism checkers and are essential in limiting misconduct and unethical actions in academic writing.

Upholding one’s moral principles is essential in a nurse’s professional role. Nurses should put in their utmost effort to provide patients with the highest quality care possible. Better patient outcomes will result from caregivers who are trustworthy and who prioritize patient safety. Another approach to implementing this principle in nursing is to be courteous and helpful to everyone, regardless of their background or ability level (Haar et al., 2020).

Treating your superiors, colleagues, and patients with the same respect will demonstrate your honesty and professionalism. Being truthful to yourself and other people is essential. Lastly, nurses should not take the chance of lying just because they are afraid the audience will not appreciate the truth, as this is considered unethical.

References

Bloomfield, J. G., Crawford, T., & Fisher, M. (2021). Registered nurses understanding of academic honesty and the perceived relationship to professional conduct: Findings from a cross-sectional survey conducted in Southeast Asia. Nurse Education Today, 100, 104794. https://doi.org/10.1016/j.nedt.2021.104794

Brown, T., Bourke-Taylor, H., Isbel, S., Gustafsson, L., McKinstry, C., Logan, A., & Etherington, J. (2019). Establishing similarities and differences among the self-reported academic integrity of Australian occupational therapy undergraduate and graduate-entry Master’s students. The Open Journal of Occupational Therapy, 7(3), 1–16. https://doi.org/10.15453/2168-6408.1558

Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing Ethics, 27(1), 258–272. https://doi.org/10.1177/0969733019832941

Ruddy, C., & Ponte, F. (2019). Preparing students for university studies and beyond A micro-credential trial that delivers academic integrity awareness. Journal of the Australian Library and Information Association, 68(1), 56–67. https://doi.org/10.1080/24750158.2018.1562520

Assignment: Academic Success and Professional Development Plan Part 2: Strategies to Promote Academic Integrity and Professional Ethics Instructions

Nurse-scholars have a significant obligation to their community as well. Their work must have academic and professional integrity. Their efforts are designed to add to the body of knowledge, advance the profession, and ultimately help in the care of patients. Work that lacks integrity is subject to erode quickly or worse.

Fortunately, there are strategies and tools that can help ensure integrity in academic and professional work. This Assignment asks you to consider these tools and how you might apply them to your own work.

In this Assignment you will continue developing your Academic Success and Professional Development Plan by appending the original document you began in the previous assignment.

To Prepare:

• Reflect on the strategies presented in the Resources for this Module in support of academic style, integrity, and scholarly ethics.
• Reflect on the connection between academic and professional integrity.

The Assignment:

Part 2, Section 1: Writing Sample: The Connection Between Academic and Professional Integrity

Using the Academic and Professional Success Development Template you began in Module 1, write a 2- to 3-paragraph analysis that includes the following:

• Explanation for the relationship between academic integrity and writing
• Explanation for the relationship between professional practices and scholarly ethics
• Cite at least two resources that support your arguments, being sure to use proper APA formatting.
• Use Grammarly and SafeAssign to improve the product.
• Explain how Grammarly, Safe Assign, and paraphrasing contributes to academic integrity.

Part 2, Section 2: Strategies for Maintaining Integrity of Work

Expand on your thoughts from Section 1 by identifying and describing strategies you intend to pursue to maintain integrity and ethics of your:

1. academic work as a student of the MSN program and
2. professional work as a nurse throughout your career. Include a review of resources and approaches you propose to use as a student and a professional.

Note: Add your work for this Assignment to the original document you began in the Module 1 Assignment, which was built from the Academic Success and Professional Development Plan Template.

Acute Respiratory Distress Syndrome Paper

Diagnosis

The clinical features point to acute respiratory distress syndrome (ARDS). The clinical condition is characterized by severe hypoxemia resulting from failure in pulmonary gas exchange (Diamond et al., 2020). Other features are acute onset and presence pulmonary infiltrates, with potential life-threatening.

Reason for Diagnosis

The patient has tachypnea of 30 breaths per minute and is hypoxic with oxygen saturation of 89%, which is low. The temperature of 390 C points to a fever. Besides, the symptoms of worsening cough, fever and dyspnea have presented within 7 days, which marks the cut-off for acute respiratory distress syndrome (Diamond et al., 2020). The fact that the hypoxemia is severe and progressive in absence of cardiogenic pulmonary edema further reinforces the diagnosis of acute respiratory distress syndrome.

Whereas the cough, fever and tachypnea in the presence of leukocytosis of 20000 cells/mm3 point to infectious/inflammatory pulmonary pathology, the conditions would resolve on initiation of antibiotics in the case of pneumonia and ventilation. Thus, failure of resolving points to a non-infectious cause. Acute respiratory distress syndrome would form a more appropriate diagnosis since the symptoms result from capillary endothelial injury and diffuse alveolar damage (Diamond et al., 2020). The condition fails to resolve on antibiotics since the primary pathology in the patient has not been dealt with. Capillary endothelial injury and diffuse alveolar damage in ARDS result in progressive dyspnea and hypoxia.

The worsening symptoms are caused by the increasing damages to the pulmonary architecture, ending in sustained low arterial blood oxygen levels and increasing infiltrates bilaterally on chest x ray. The most current criteria for ARDS is the Berlin definition that characterizes ARDS as “respiratory failure within 1 week of a known insult or new/worsening respiratory symptoms, with evidence of non-cardiogenic pulmonary edema and progressive bilateral opacities on the radiograph plus a hypoxemia of PaO2/FiO2 less than 300 mmHg on at least Positive End-Expiratory Pressure (PEEP) or Continuous Positive Airway Pressure of greater than or equal to 5 cm H2O” (Diamond et al., 2020). The patient meets all the Berlin criteria.

The patient’s x ray exhibits infiltrates in both lower lobes. The film also shows progression of infiltrates throughout both lung fields. ARDS comprises bilateral opacities on chest radiograph or computed tomography that are unexplained by other conditions such as lobar or lung collapse, pleural effusions and pulmonary nodules.

Etiology of the Diagnosis

The cause for ARDS may be pulmonary or extra-pulmonary. Whereas both etiologies have similar incidence, pulmonary causes are more common than extra-pulmonary causes (Rawal, Yadav & Kumar, 2018). The suitable pulmonary cause in this patient would be pneumonia, as evidenced by cough and fever that point to an infective pathology. Pneumonia consists of inflammation of lung parenchyma, causing capillary vasodilatation at the level of the alveolar with subsequent exudation of material into the alveolar space. Persistence of the inflammation and the causative organism culminates in destruction of alveolocapillary membrane, interfering with the gaseous exchange mechanisms that underlie the pathophysiology of ARDS (Rawal, Yadav & Kumar, 2018).  The resultant effect is persistent hypoxia and dyspnea that is non-responsive to the management, with poor prognosis.

The condition progresses via various phases, commencing with alveolar-capillary damage, proliferative phase consisting of improved lung function and healing, and the last stage is the fibrotic phase that marks the end of the acute disease process. The pulmonary epithelial and endothelial cellular damage is marked inflammation, apoptosis, necrosis, and increased alveolar-capillary permeability, with resultant edema into alveolar spaces and proteinosis (Micheal et al., 2019). Alveolar edema limits gaseous exchange, resulting in hypoxemia. The lung bases may be more involved than the apices.

Histopathological lab features may include injury to vascular endothelium and pneumocyte type I. The mentioned factors cause leakage of proteinaceous fluid and blood into the alveolar airspace (Micheal et al., 2019). Other findings are pulmonary capillary congestion, alveolar hemorrhage, hyaline membrane formation and interstitial edema, which are all non-specific.

Common Causes of ARDS

The etiology of ARDS comprises both pulmonary and extrapulmonary causes. Within the lungs, ARDS follows pneumonia, particularly viral and bacterial pneumonia that are non-treated or under-treated (Curtis et al., 2017). For patients with altered levels of consciousness, aspiration of orogastric and esophageal contents has been implicated as causative of pneumonia, besides major trauma to the chest and inhalational burns. Other causes include transfusion associated acute lung injury (TRALI) and acute graft rejection following lung transplant.

Extrapulmonary causes of ARDS include systemic sepsis with foci from urinary, soft tissue or peritoneal sites. These factors culminate in a cytokine storm that negatively affects the functioning of exchange mechanisms in the lung by increasing the permeability of alveolocapillary membrane, with subsequent exudation and accumulation of pulmonary infiltrates (Curtis et al., 2017). The resultant effect is acute respiratory distress syndrome.

Acute pancreatitis is another known cause of ARDS. Pancreatic inflammation causes leakage of pancreatic enzymes into the bloodstream, which damage the alveoli wall and impede production of surfactant (Curtis et al., 2017). Alveoli damage and impaired surfactant production cause faulty alveoli functioning, disrupting the gaseous exchange process. Other proven causes of ARDS are drug overdose, drowning, hemorrhagic shock and inhalation of toxic fumes. Worth-noting, special risk factors to developing ARDS include alcohol consumption, smoking, advanced age, female gender, cardiovascular surgery and traumatic brain injury (Zayed & Askari, 2020). The pathophysiology of ARDS in the mentioned risk factors is varied, but in all cases, the lung function is altered.

A-a Gradient

The A-a gradient is the alveolar-arterial gradient that measures the difference between oxygen concentration in the alveoli and arterial system. Its significance is helping to narrow down differential diagnoses for hypoxemia. Its calculation follows the formula PAO2 – PaO2 where PAO2 is the oxygen concentration in the alveoli and PaO2 is oxygen concentration in the capillary (Handtzidiamantis & Amaro, 2020). The A-a gradient in this patient would increase, owing to dysfunction of the alveolar capillary unit.

Complications

Notwithstanding its life-threatening implications, no known drug is effective in preventing or managing ARDS. Thus, management is primarily supportive care, with focus on reducing shunt fraction, increasing oxygen delivery, decreasing oxygen consumption and preventing further injury. The patient is put on mechanical ventilation, given diuretics to protect against fluid overload and given nutritional support until the care provider observes evidence of improvement. Caution while ventilating is mandatory to prevent exacerbating alveolar damage and perpetuating lung injury in ARDS.  Other complications that must be avoided are barotraumas (damage due to extreme plateau pressures), volutrauma (damage due to large tidal volumes) and atelectrauma (damage due to atelectasis) (Diamond et al., 2020). The goals to reduce lung injury include the following: tidal volume of between 4 and 8 mL/kg of ideal body weight, respiratory rate of up to 35 bpm, plateau pressure of below 30 cm H20, SpO2 from 88 % to 95 %, pH of between 7.30 to 7.45, and inspiratory-to-expiratory time ratio of below 1 (Diamond et al., 2020).

Lung compliance may be improved by introducing neuromuscular blockade. Institution of neuromuscular blockers within the first 48 hours in ARDS improved the 90-day survival and increased the time off the ventilator. Alleviation of lung compliance should include assessing for other causes of reduced lung compliance, including hemothorax, pneumothorax, thoracic compartment syndrome and intraabdominal hypertension (Micheal et al., 2019). The prone position is proven to be beneficial in 50 to 70 % of patients in a recent study. The dangers of prone position include accidental dislodgment of tubes and lines. The benefits consist of recruitment of dependent lung zones, improved diaphragmatic excursion and increased functional residual capacity (Micheal et al., 2019). Maintenance in the prone position for a minimum of 8 hours daily would maximize the benefits. Additonal management strategies include conservative fluid management after resuscitation is attained and extracorporeal membrane oxygenation.

During hospitalization, frequent changes in position would prevent the development of bedsores and deep venous thrombosis (Micheal et al., 2019). The mentioned approach would be beneficial, considering ARDS patients are bed-ridden.

The patient’s prognosis is expected to be good. While ARDS had high mortality rates, recent advances in mechanical ventilation and early antibiotic administration and selection have resulted in a decline in mortality, particularly severe ARDS. The main causes of death were sepsis and multi-organ failure in the 1990s (Rawal, Yadav & Kumar, 2018). Notwithstanding, the effects of long hospitalization following ARDS include poor muscle function, weight loss and functional impairment. Hypoxia in the illness may culminate in diverse cognitive changes which may persist for several months after the patient is discharged (Rawal, Yadav & Kumar, 2018). Complete returning to normal life may be challenging post-treatment since the majority of patients report feelings of decreased exercise tolerance and feelings of dyspnea on exertion.

Postoperative Care and Rehabilitative Care

The majority of patients diagnosed with ARDS will require a tracheostomy and a percutaneous feeding tube during the recovery period. Tracheostomy improves the effectiveness of weaning from the ventilator, easing clearing of secretions and providing more comfort for the patient (Rawal, Yadav & Kumar, 2018). The tracheostomy would be recommendable at between 2 and 3 weeks after diagnosis, followed closely by the percutaneous feeding tube.

Worth-noting, a large proportion of ARDS patients experience difficulty eating, leading to muscle wasting. Parenteral or enteral feeding would be appropriate in their management plan, considering the gastrointestinal tract’s condition (Rawal, Yadav & Kumar, 2018). Starting the patients on low-carbohydrate diet may be beneficiary due to its anti-inflammatory and vasodilating effects.

References

• Cutts, S., Talboys, R., Papsula, C., Prempeh, E., Fanous, R. & Ail, D. (2017). Adult Respiratory Distress Syndrome. US National Library of Medicine National Institutes of Health, 99 (1): 12-16 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392788/
• Diamond, M., Peniston F., Sanghavi, D.  & Sidharth, M. (2020). Acute Respiratory Distress Syndrome. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK436002/
• Hantzidiamantis, P. J., & Amaro, E. (2019). Physiology, Alveolar to Arterial Oxygen Gradient (Aa Gradient). StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK545153/#:~:text=The%20A%2Da%20gradient%2C%20or%20the,the%20differential%20diagnosis%20for%20hypoxemia.
• Micheal, A., Zemans, R., Zimmerman, G., Arabi., Y. Beitler, J., Mercat., Herridge, M., Randolph, G. & Calfee, C. (2019). Acute Respiratory Distress Syndrome. Nature Public Health Emergency Collection, 5(1), 18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709677/
• Rawal, G., Yadav, S., & Kumar, R. (2018). Acute respiratory distress syndrome: an update and review. Journal of Translational Internal Medicine, 6(2), 74-77. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032183/
• Zayed, Y. and Askari, R. (2020). Respiratory Distress Syndrome. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538311/

Accountability Of Healthcare Providers Sample Paper

Accountability is a broad term that means taking responsibility for someone or some event. It could also mean owning up to mistakes that occur during the provision of care. Involves providing effective, safe, quality, and affordable healthcare. The focus of accountability in healthcare is the delivery of quality patient care. Accountability is thus crucial and indispensable. Inadequate accountability may result in substantial organizational damage. The benefits of accountability in healthcare include proper utilization of resources, provision of quality safe care, and building trust in the doctor-patient relationship (Kaufman et al., 2019) .

Defining Accountability Care Organization (ACO) and their impacts on health care providers:

Health care providers (specialists, surgeons, doctors, and nurses), hospitals, and other healthcare facilities can form networks that care for a specific patient population to optimize resources for improved care delivery. These networks are referred to as Accountable Care Organization (ACO). Provider cooperation, improved productivity, coordinated care, improved health outcomes, and improved patient health care experiences are the main goals of ACOs (Kaufman et al., 2019). ACOs advocate for health care providers’ financial accountability in specific populations by impacting traditional payment and delivery systems through incentives. ACOs play other various essential roles in influencing healthcare providers. ACOs inform healthcare coordination and thus facilitate better health outcomes and patients’ healthcare experiences. ACOs foster doctor-patient relationships and doctor-families relationships, which enhances the provision of holistic care with family inclusion (Kaufman et al., 2019). ACOs also promote the provision of affordable, high-quality care.

How ACOs differ from the health maintenance organizations (HMOs)

            There are significant differences between the ACOs and HMOs. The ACOs focus on risk-sharing and quality performance through the provision of financial incentives and improved payment structures. Efficiency, effectiveness, and quality performance in-patient care are not accounted for in the HMOs. ACOs provide monetary rewards to the healthcare providers for the quality care they provide. However, they are sensitive to misuse and wastage of resources and focus on providing quality care as opposed to being profit-oriented (Heider and Mang, 2020).

On the other hand, HMOs do not pay attention to the quality of care provided but to profit realized from health care provision. ACOs are also distinguished from HMOs because they provide care without demanding patients to enroll in the organization. HMOs restrict their care to the specific populations that have enrolled in these organizations. The HMOs also tend to deal with complex health care settings that are often unmanageable, unlike the ACOs, which deal with local, simple, and manageable health care settings (Falkson and Srinivasan, 2020). The results are that the ACOs are more effective in delivering safe, quality, and affordable care than HMOs.

Roles of health information technology (HIT) in the newer models of care

EHRs, which are technological advances in health care, have been instrumental in detecting threats specific to patient diagnosis and alerting the health care providers accordingly. Integration of EHRs has helped improve patient care and promote patient safety. Medication errors have been a notorious cause of patient mortality, and with EHRs, medication errors and subsequent patient mortality are reduced. Paperwork has been dramatically reduced with the integration of EHRs in health care, saving time and energy wasted in retrieving patient records (Adjerid, Adler-Milstein & Angst, 2018). The use of technology has enhanced care delivery to patients even when they are at home.

Patients can schedule meetings with their doctors and benefit from consultation services while at the comfort of their homes. The use of HIT in health care promotes patient-centered care as it provides information to both patients and the care providers and provides means of communication between the care providers and the patients. Patients can access their online medical records and crucial information about their conditions. This has a significant bearing in health care because it improves patient awareness, patient cooperation in care provision and helps patients make informed decisions. HIT improves patient-doctor interactions and care coordination which promotes patient safety and delivery of quality patient care.

Benefit of hospitals accrue by partnering with primary care providers.

The integration of primary care and hospital care confer several benefits to patients. One such benefit is that the patients received informed standard care that is safe and of high quality. The patient’s healing is thus enhanced. The patients are hence less frequently readmitted therefore, they incur less health care costs. The use of EHRs is instrumental in improving communication between the hospital, patient, and primary care providers and, hence, fosters collaboration and, subsequently, delivering quality patient care.

Bundling payments and hiw they contain healthcare costs.

Bundling payments is instrumental in controlling and managing health care costs. Studies reveal that bundling payments lead to a substantial decrease in total health care costs (Wilcock et al., 2020). For example, health care in the United States usually accounted for 18% of the total government expenditure. With the introduction of bundling payments, these costs have markedly decreased. In addition to monetary gains, medical and other expenses that arise from the delivery of poor quality care were also reduced, and the overall quality of health care improved. Bundling payments are thus instrumental in controlling and containing health care costs. Bundled payments also help minimize unnecessary health care costs. For example, the bundled payments cut costs on the treatment of conditions that can be managed through changes in patients’ behaviors such as sedentary lifestyles and risky health behaviors. Saving money leads to a reduction in the health care costs, and thus, the bundling payments are helpful in containing health care costs.

Pay for performance (P4P) and how they improve quality care

Arguably, the pay for performance approach tends to improve health care through negative and positive reinforcements. In positive reinforcement, the health care providers are provided with monetary incentives as rewards for good performance. The incentive acts as a source of extrinsic motivation to the healthcare provider, who in turn adheres to quality healthcare practices leading to improved patient care. In negative reinforcement, penalties are introduced in cases of poor performance.  Health care providers can be penalized for delivering sub-quality care or errors such as wrong medications. The penalties can include taking responsibility for total patient care costs. The healthcare providers are thus keen on providing safe and quality care to avoid penalties. This has the effect of improving the efficacy and efficiency of healthcare. Positive or negative reinforcements that include financial interventions can thus be essential in enhancing the quality of care.

Value-based purchasing program.

The value-based purchasing program (VBPP) is a program under the Centers for Medicaid and Medicare Services. The program is tailored to effectively equate Medicare payment systems to the quality of care offered in the in-patient department. The VBPP assesses the value of reimbursement systems that account for the most significant percentage of Medicare expenditure (Jha, 2017). The hospitals are ranked depending on the effectiveness and quality of care they provide rather than the quantity of services they offer. The aim is to ensure hospitals focus on the provision of adequate and quality care as opposed to delivering many services. The VBPP aims to improve patient health outcomes and create a positive patient experience during care delivery (Ryan et al., 2017). One of the significant interventions of VBPP is providing incentives to hospitals to enhance effective and efficient care by eradicating possible health care errors (Ryan et l., 2017). The VBPP minimizes errors and inappropriate practices in healthcare and also reinforces healthcare providers’ good performance.

Effects of value-based purchasing (VBP) programs on hospital reimbursements.

VBPP determines the amount collected by hospitals through Medicare compensations under IPPS (Inpatient Prospective Payment System). The IPPS disbursements are dependent auon the value of care delivered. The programs affect the in-patient healthcare payments.

Beneficiaries of value-based reimbursements.

The VBP program uses financial incentives to encourage the provision of high-quality care to the patients. The healthcare providers are compensated for their efforts, and the patients, on the other hand, receive quality care (Wilcock et al., 2020). Here, the patients and the healthcare providers’ organizations benefit from the VBPPs, but the healthcare providers’ organizations reap more benefits.

Measuring hospital performance using VBP program.

As mentioned earlier, the VBPPS are a function of the Centers for Medicare and Medicaid systems (CMS). The CMS collects and compares generated data from various hospitals for the periods in which the VBPPs were in progress. A hospital’s performance is analyzed and categorized as successful or failure from the scores determined from the analysis.

Conclusion

Accountability is an integral role of all health care providers. Healthcare providers should ensure that they provide holistic, quality, and safe care to the patients. They should make rational decisions that only convey the benefits to the patients and own up mistakes when they occur during care delivery. They should also be aware that they are responsible for safeguarding the patients from all the health risks that surround them. They must uphold and maintain quality patient care that addresses patients’ needs effectively. The government and other stakeholders also play a significant role in enhancing accountability. Accountability in healthcare is essential as it informs practice and improves the performance of health care practitioners.

References

• Adjerid, I., Adler-Milstein, J., & Angst, C. (2018). Reducing Medicare spending through electronic health information exchange: the role of incentives and exchange maturity. Information Systems Research, 29(2), 341-361. https://doi.org/10.1287/isre.2017.0745
• Falkson, S. R., & Srinivasan, V. N. (2020). Health Maintenance Organization (HMO). StatPearls [Internet]. Available from https://www.ncbi.nlm.nih.gov/books/NBK554454/
• Heider, A. K., & Mang, H. (2020). Effects of Monetary Incentives in Physician Groups: A Systematic Review of Reviews. Applied Health Economics And Health Policy, 1-13. https://doi.org/10.1007/s40258-020-00572-x
• Jha, A. K. (2017). Value-based purchasing: time for reboot or time to move on?. JAMA, 317(11), 1107-1108. doi:10.1001/jama.2017.1170
• Kaufman, B. G., Spivack, B. S., Stearns, S. C., Song, P. H., & O’Brien, E. C. (2019). Impact of accountable care organizations on utilization, care, and outcomes: a systematic review. Medical Care Research and Review, 76(3), 255-290. https://doi.org/10.1177%2F1077558717745916
• Wilcock, A. D., Barnett, M. L., McWilliams, J. M., Grabowski, D. C., & Mehrotra, A. (2020). Association Between Medicare’s Mandatory Joint Replacement Bundled Payment Program and Post–Acute Care Use in Medicare Advantage. JAMA Surgery, 155(1), 82-84. doi:10.1001/jamasurg.2019.3957

ADDICTIONS CASE STUDY CASE CONCEPTUALIZATION GRADING RUBRIC

Addictions Case Study: Case Conceptualization Grading Rubric

Satisfies criteria w/ excellence

Satisfies Criteria

Satisfies most criteria

Synopsis paragraph is clear, concise, understandable; covers: presenting problem, substance history, all substances used, side effects, and most important issues.

Synopsis paragraph is good and understandable; mostly covers: presenting problem, substance history, all substances used, side effects, and most important issues.

Synopsis paragraph is adequate; mostly covers: presenting problem, substance history, most substances used, side effects, and some important issues.

Synopsis paragraph is adequate; does not or barely covers: presenting problem, substance history, some substances used, side effects, and some or nonimportant issues.

Potential dangers/risks for the client clearly shown.  Risk management steps shown. Correct stage of change given.

Potential dangers/risks for the client shown.  Risk management steps mostly shown. Correct/close to correct stage of change given.

Potential dangers/risks for the client mostly shown.  Risk management steps adequately shown. Close to correct stage of change given.

Potential dangers/risks for the client barely or not shown.  Risk management steps adequately or not shown. Incorrect stage of change given.

All pertinent AUDIT items shown. Correct total score shown.  Explanation of how points distributed, and total score arrived at shown.

All pertinent AUDIT items shown. Correct/close to correct total score shown.  Good explanation of how points distributed, and total score arrived at shown.

Most pertinent AUDIT items shown. Close to correct total score shown.  Adequate explanation of how points distributed, and total score arrived at shown.

Some or no pertinent AUDIT items shown. Incorrect total score shown.  Barely adequate explanation of how points distributed, and total score arrived at shown, or not shown.

Possible referrals – minimum of three “bullet-points” (5 points apiece).

Two possible referrals shown as “bullet-points.”

One possible referral shown as “bullet-points.”

No possible referrals shown as per instructions.

Minimum of two questions would have asked client shown.  Questions are well-done and pertinent to the client’s life and narrative.

Two questions would have asked client shown.  Questions are adequate to the client’s life and narrative.

One question would have asked client shown.  Question is adequate to the client’s life and narrative.

No questions shown as per instructions.

3 levels of a basic genogram completely shown.  Genogram relationships completely shown. All substance usage by family members shown.

3 levels of a basic genogram mostly shown.  Genogram relationships mostly shown. Substance usage by client only is shown.

3 levels of a basic genogram shown.  Genogram relationships mostly shown. No substance usage by family members shown.

Genogram not attached as per instructions.

Satisfies criteria w/ excellence

Satisfies Criteria

Satisfies most criteria

Does not satisfy criteria

All required elements are included and presented with strong headings and organizational clarity. There are clear transitions between paragraphs and sections. The treatment of the topic is logically oriented. The paper meets the page length requirement.

All required elements are included and organized. There are transitions between paragraphs and sections. The treatment of the topic is logically oriented. The paper meets the page length requirement or comes very close.

Most required elements are included and are mostly organized. Most paragraphs and sections have transitions. The logical treatment of the topic needs improvement. The paper may not meet the page length requirement.

Few or no required elements are included. Few or no transitions exist between paragraphs and sections. There may not be a logical treatment of the topic. The paper does not meet the page length requirement.

The paper properly uses current APA style.  Proper headings, in-text citations, and references are formatted correctly. The paper reflects a graduate level voice and vocabulary. There are very few spelling and grammar errors.

The paper consistently uses current APA style with few or no exceptions. Proper headings, in-text citations, and references are formatted with few or no errors. The paper reflects a graduate level voice and vocabulary. There are few spelling and grammar errors.

The paper inconsistently uses current APA style. Headings, in-text citations, and references are inconsistently formatted. The paper does not consistently reflect a graduate level voice and vocabulary. There are spelling and grammar errors.

The paper erroneously uses or does not use current APA style. Headings, in-text citations, and references are erroneously formatted or not present. The paper does not reflect a graduate level voice and vocabulary. There are spelling and grammar errors.

The Reference page meets or exceeds the required number of sources. All sources are referenced throughout the paper.

The Reference page meets the required number of sources. Most sources are referenced throughout the paper.

The Reference page does not meet the required number of sources. Not all sources are referenced throughout the paper.

The Reference page is not present or contains few sources. Not enough sources are referenced throughout the paper, or none are referenced.

Addiction Treatment and Termination of the Therapeutic Relationship

Addiction is a neuropsychological disorder characterized by continued use of drugs or substances despite psychological, physical harm, or adverse consequences. Socioeconomic status, environmental influences, and preexisting mental disorders contribute to drug addiction. Legal addiction is the persistent use of drugs/substances permissible in the country, such as alcohol and prescription drugs. In contrast, illegal addiction is the persistent use of regulated or unlawful substances such as cocaine, heroin, and cannabis. Addiction treatment aims to assist addicts in overcoming their habitual substance seeking and use.

Addiction treatment is the same for legal and illegal addiction since the aim is to prevent the use of the drug, whether illegal or legal. The treatment options include detoxification, medication, behavioral therapy, or a combination of the two and long-term follow-up. Treatments medications manage to suppress withdrawal symptoms during detoxification (National Institute of Drug Abuse, 2019). They are also used to prevent relapse by re-establishing normal functioning of the brain and decreasing cravings for the substance one is addicted to. For example, opioid addiction is treated using both methadone and naltrexone. The addiction treatment drugs act on the same targets as the addictive substances in the brain after detoxification. Behavioral therapy help patients to change their attitudes and behaviors towards drug use, develop healthy life skills, and stick with other types of treatment, such as addiction treatment medication (National Institute of Drug Abuse, 2020).

The Individual, Group, and Family Therapy.

Individual therapy involves the treatment of an individual by either one or more therapists. It benefits the person with an addiction to develop affective self-exploration, cultivate self-awareness and establish healthy coping skills by identifying the negative behavioral patterns which led to addiction and replacing these negative patterns with positive, healthy alternatives. The advantages include; an individual experiencing an intense and focused therapeutic experience by receiving the therapist’s full attention. Also, the therapy sessions are flexible depending on the client’s preferences. However, the patient only gets a viewpoint from single therapists, and the sessions are costly (Generes, 2022).

Group therapy is beneficial in addiction treatment as it provides a support network and groundwork for change. Group therapy provides an interaction session with other people and boosts self-esteem and confidence. Its advantage is that it helps people develop a sense of identity and belongingness after understanding that there are people with similar issues. They also provide lifelong connections between the group members, and the session is cheap. However, in group therapy, individuals do not receive focused attention and treatment, and there is the risk of a breach of confidence by group members (Generes, 2022).

Family therapy is beneficial in addiction treatment as it offers appropriate support to move through addiction treatment smoothly. It also improves family communication skills. It is also advantageous as it helps improve the family’s emotional health and helps develop a motivation for change. However, family therapy can alter the perception of the family towards the patient and painful and negative feelings within the family members (Hogue et al., 2019).

Termination of a Therapeutic Relationship

A therapeutic relationship is terminated when the therapist’s services are no longer since the objectives and goals of the therapy sessions have been achieved. Amicable termination of the therapeutic relationship involves openly discussing the termination phase at the beginning of the therapy to enable the client to see the therapy as temporary. Involving the client in preparation for termination helps the client face their next life chapter bravely and solidify counseling gains. However, if done acrimoniously, the termination causes emotional harm to the client, which can cause a relapse of the negative behavioral pattern and make the therapy ineffective. The acrimonious ending involves the abrupt ending of a therapeutic relationship without appropriate engagement and making the client aware of it. The client faces grief because of the ending of the relationship. 

References

• Generes, W., (2022). Psychotherapy Guide: Group Therapy vs. Individual Therapy. Retrieved May 3rd, 2022 from https://americanaddictioncenters.org/therapy-treatment/group-individual
• Hogue, A., Bobek, M., Dauber, S., Henderson, C. E., McLeod, B. D., & Southam-Gerow, M. A. (2019). Core elements of family therapy for adolescent behavior problems: Empirical distillation of three manualized treatments. Journal of Clinical Child & Adolescent Psychology, 48(1), 29-41. https://doi.org/10.1080/15374416.2018.1555762
• National Institute of Drug Abuse. (2020). What is drug addiction treatment?. Retrieved May 3rd, 2022 from https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/what-drug-addiction-treatment
• National Institute of Drug Abuse. (2019). Treatment Approaches for Drug Addiction. DrugFacts. Retrieved May 3rd, 2022, from https://nida.nih.gov/publications/drugfacts/treatment-approaches-drug-addiction.

Addressing the Mental Health and Psychological Issues of Nursing Home Residents

Expound on Mental Health and Psychological issues

Mental health and psychological issues are a significant concern to public health (Abbasi, 2020). Over the decades, many organizations concerned with mental health have come up, among them, the American Psychiatric Association, whose goal is to cater to mental health issues. Most of the nursing home residents, as seen earlier, are geriatrics. These patients are at greater risk of developing a broad spectrum of mental health and psychological issues. Some disorders are related to aging, while others, such as anxiety, are related to admission into these nursing home facilities. According to Abbasi (2020), 4 out of twenty nursing home residents have a mental health issue. In addition, 2-3 percent have severe mental health conditions (Abbasi, 2020). These issues include depression, anxiety, schizophrenia, bipolar disorder, and other mental health issues (Abbasi, 2020). As seen from the statistics, mental health issues are of public significance, hence the need for effective mitigation strategies. Interventions to prevent, recognize early, and manage this public health concern should be promptly done.

Reasons why I chose the topic and its relevance to the nursing profession.

Mental health and psychological issues are easily neglected in nursing homes. Mental issues are often acute, and care in nursing homes is often long-term (Arango et al., 2019). They are thus easily negligible. Cancer Care, reproductive health, endocrine disorders, cardiovascular disorders, and respiratory illnesses make up the significant concerns in nursing homes. Funding and other resources such as professionals are directed towards the care of these patients. In comparison, mental health issues rarely get attention, and if they do, they are not adequately managed. Thus, cases of mental health and psychological issues has been on the rise over the last few decades. Coupled with the fact that mentally ill patients are poorly managed in health institutions, mental health and psychological issues are an area of significant concern.

Leadership and change management in mental health and psychological issues

Leaders bear the role of initiating and managing change in any institution. For change to be effective, leaders must be actively involved in it. Management and leadership are integral in initiating change interventions. Leaders find opportunities to change. They also educate the other hospital members on the importance of the change. They create a sense of urgency by showing the other healthcare providers the deficits in current healthcare practice and the importance of embracing the change (Barrow, Annamaraju & Toney-Butler, 2017). Leaders provide incentives and facilitate adjustments during the change process. When change has the potential to produce positive effects on the mental health issue, leaders must institute it and include root it in the organizational traditions. Barrow et al. (2017) states that once a change is incorporated into an institutional culture, it gains stability and becomes a new normal.

In nursing homes, Kurt Lewin’s theory of change, is promptly applicable. Unfreezing shall occur when the leaders influence the people to accept mental health triaging into nursing homes routine care (Barrow et al., 2017). In moving, the leaders should facilitate change and ensure that required sources are available. Lastly, the leaders should ensure that mental health triaging is incorporated into the hospital culture and hospital policies. When management fails to back up any change, its likelihood of failure is remarkably high.

Propose strategies for communicating and collaborating with the patient, family, or group to improve associated with the mental health issue.

In this assignment, I met Florence, a 95-year-old who was recently diagnosed with Major depression. During the session, her family was in attendance. They were all in shock to hear of her diagnosis. I explained to them the importance of care collaboration and the effects that it has on healthcare outcomes. Major depressive disorder develops over time and recognizing depression in early stages would have been integral in its management. The patient is an integral part of their care. Informing the patient and family is thus important. As Park et al. (2018) notes. nurses and other healthcare providers should ensure that they educate the patient on their care. Patients have a right to know what is ailing them and what management they are undergoing.

Patients who are informed collaborate in care. Informing the patients of every detail concerning their care is thus imperative. According to Park et al. (2018), the teach-back method is one of the most effective methods of ensuring patients understand and retain what they are taught. Individuals should be taught how to recognize when their mental health and that of their loved ones begin to derail. They are then requested to reproduce the information to check if they have understood. Planning and organizing care is another effective strategy in ensuring collaboration during care. Assigning a task to an individual and ensuring they are responsible for it ensures care coordination and accountability care (Reeves et al., 2017).

Patients easily collaborate in care provision when they feel respected. Patients have unmet needs, and under whatever circumstances, healthcare providers should respect them. Patients often experience anxiety due to their conditions and may behave inappropriately. Healthcare providers should respect the patients’ and their families’ decisions at all times to enhance care collaboration (Park et al., 2018). Healthcare policies should be such that they promote and upholding patient respect.

Explain how your proposed intervention shall improve the quality of care, enhance patient safety, and reduce the cost to the system and individual.

Mental health triaging is a vital intervention. As mentioned earlier, most mental health issues in nursing home residents go unrecognized until later, when the mental health issues cause complications. Mental health issues interfere with a patient’s recuperation process, leading to further complications. Studies, for example, that of Teixeira et al. (2017), contend that mentally ill patients pose significant challenges in care collaboration. Most often, the care providers in nursing homes lack the necessary expertise to handle severe mental issues.

With mental health triaging, caretakers will be able to recognize mental health problems early, and complications shall be avoided with immediate and effective interventions. This minimizes the cost incurred by the individual and the systems in managing complications of mental health conditions (Arango et al., 2018). Patients who have severe mental issues are given special psychiatric care or referred to mental hospitals where they receive specialized care, thus improving the quality of care.

Improved care quality leads to improved healthcare outcomes and patients’ healthcare experience. Arguably, mental health triaging shall increase mental health awareness in the hospitals (Arango et al., 2018). It also ensures patients are correctly diagnosed. Poorly diagnosed patients are often mismanaged hence poor patient health outcomes. Medication errors are common with misdiagnosis. With mental health triaging and the right staff, the proper mental diagnoses are made, ensuring patient safety and treatment effectiveness. Individuals and systems are saved from costs incurred in trying one therapy to another with failure and complications that arise in the process.

Among mental health triage tools is assessing the risk of harm to self and others as exhibited by patients suffering from mental illnesses. The clinicians and nurses assess the patients for signs such as paranoia, suicidal ideations, and suicidal attempts and ascertain their safety and other patients’ safety. When a patient has such symptoms, they are isolated and given special care hence promoting their safety and the safety of others.

Mental health triaging categorizes patients according to the severity of symptoms and urgency of their needs. This gives a clear overview of mental health issues in a hospital at any given time. Classification of the patients informs their management. It makes it easy for the healthcare providers to determine those patients requiring urgent interventions and act swiftly. Thus, quality and effective care interventions are relayed to the patient. At another step, mental health triage determines the patients at risk for developing mental health conditions and necessary steps.

Mental health statistics from triaging help give insight into the nursing home’s mental health burden. Such information, according to Lesser (2021), is integral in helping the government to plan care healthcare funding. Government can allocate more resources directed towards mental healthcare funding depending on available data. Adequate government funding enhances quality care delivery to the patient and helps minimize care costs to the system and individuals. Mental health triaging has myriad benefits that accrue to it, hence the need for healthcare leaders to embrace it in nursing homes.

State/board/nursing practice standards and organizational/governmental policies

The national mental health act of 1946, through developments over time, informs and prioritizes mental health care (Lesser, 2021). The act regulates psychiatric and mental health education, research, diagnosis, and treatment of psychiatric conditions. The government has been on the frontline in developing policies that favor mental health service delivery. Provisions of the NMHA protect the rights of a mentally ill patient. It also ensures the implementation of the stated laws in respective institutions. A significant government input lies in funding.

Government funding determines the success of mental health care initiatives (Lesser, 2021). The government is also the primary source of funding for the development of community mental health resources. Thus, the government plays an integral role in managing the mental health of patients in the country. The state and federal governments play a significant role in funding research to improve mental healthcare delivery (Lesser, 2021). As seen above, a lack of government policies would lead to marked negative effects on public mental health delivery. For the government to intervene, much information on the current state of public health mental state must be available. Information from mental health triaging can influence government funding which shall enhance care delivery in the nursing homes.

Explain how technology, care coordination, and utilization of community resources can be used in addressing mental health and psychological issues.

A study by Reeves et al. (2017) assert that effective interprofessional collaboration and interprofessional communication are integral in improving patient health outcomes and healthcare experiences. Healthcare providers coordinate in the provision of care to ensure the patients receive quality holistic care. Poor communication is the basis of all healthcare errors. Health information systems (HIS) are integral communication channels in ensuring the correct information is available to all healthcare providers (Harerimana, Forchuk, & O’Regan, 2019). HIS ensures communication is effective and reaches all healthcare providers. Common healthcare errors occurring due to misinformation and poor communication are thus easily mitigated.

The use of smartphone apps has been helpful in the management of patients with anxiety disorders and depression (Harerimana et al., 2019). Using smartphone apps has a positive effect on patients’ mental health status (Harerimana et al., 2019). They contain information and thus fill in gaps where patients have insufficient knowledge. The apps have also positively affected the recuperation of patients with mental health disorders such as depression and anxiety (Lustgarten & Elhai, 2018). Smartphones have also increased patient-healthcare provider linkages. This has allowed for mental health consultation over the phone. In this way, necessary information is available to the patients. As a result, they make informed decisions leading to improved quality of care and better health outcomes.

Care of the mentally ill is made less costly by utilizing community resources (Lustgarten & Elhai, 2018). Community institutions that deal with mental illness are instrumental in managing these patients. As a result, patients are given focused professional care that is holistic and at a lower cost than that provided in nursing homes leading to better care quality and better patient healthcare outcomes.

Conclusion

As seen above, several factors interact in the delivery of quality care that is safe and affordable to the individual and the system. Each factor has a significant role to play. For instance, we have noticed that interprofessional collaboration and care coordination are integral in managing any patient. In addition, patient input in their care process is essential. Healthcare technology and community resources are also instrumental in managing the mental health and psychological issues among nursing home residents. Implementing mental health triaging shall require a collaborative effort and dedication from all healthcare providers. Healthcare technology, care coordination, community resources, government policies, and leadership are all integral parts that determine the success of mental health triaging in mitigating the surge in mental in psychological issues among nursing home residents.

References

• Abbasi, J. (2020). “Abandoned” nursing homes continue to face critical supply and staff shortages as COVID-19 toll has mounted. JAMA, 324(2), 123-125. doi:10.1001/jama.2020.10419
• Arango, C., Díaz-Caneja, C. M., McGorry, P. D., Rapoport, J., Sommer, I. E., Vorstman, J. A., & Carpenter, W. (2018). Preventive strategies for mental health. The Lancet Psychiatry, 5(7), 591-604. https://doi.org/10.1016/S2215-0366(18)30057-9
• Barrow, J. M., Annamaraju P., & Toney-Butler, T. J. (2020). Change Management. In: StatPearls. StatPearls Publishing, Treasure Island (FL). https://europepmc.org/article/nbk/nbk459380
• Harerimana, B., Forchuk, C., & O’Regan, T. (2019). The use of technology for mental healthcare delivery among older adults with depressive symptoms: a systematic literature review. International Journal of Mental Health Nursing, 28(3), 657-670. https://doi.org/10.1111/inm.12571
• Lesser, B. (Mar 2021). U.S. Mental Health Legislation: Dual Diagnosis org. Retrieved from https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiKqfyFionxAhUjnVwKHesWBAUQFjAMegQIHBAE&url=https%3A%2F%2Fdualdiagnosis.org%2Fmental-health-and-addiction%2Fus- legislation%2F&usg=AOvVaw2okPCkV_vuAsISpoanhpZi
• Lustgarten, S. D., & Elhai, J. D. (2018). Technology use in mental health practice and research: Legal and ethical risks. Clinical Psychology: Science and Practice, 25(2), e12234. https://psycnet.apa.org/doi/10.1111/cpsp.12234
• Park, M., Lee, M., Jeong, H., Jeong, M., & Go, Y. (2018). Patient-and family-centered care interventions for improving the quality of health care: a review of systematic reviews. International Journal of Nursing Studies, 87, 69-83. https://doi.org/10.1016/j.ijnurstu.2018.07.006
• Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6). https://doi.org/10.1002/14651858.CD000072.pub3
• Teixeira, L., Azevedo, M. J., Alves, S., Pires, C. L., & Paúl, C. (2017). Perception of risk of adverse outcomes of older people: comparison between nursing homes, day centers and home care services. Quality in Ageing and Older Adults, 18(3), 212-220. https://doi.org/10.1108/QAOA-11-2016-0043

Addressing Mental Health and Psychological Issues of Nursing Home Residents

Introduction/Problem Description

Considering the high number of nursing home residents with mental illnesses, the quality of care in these homes is a critical clinical and policy matter. Common mental health problems among elderly people in nursing homes include psychosis, anxiety, depression, and dementia. Besides, elderly people also suffer from other psychological problems such as deterioration in cognitive functioning, behavioral and sleep disorders. These issues are a big problem for nursing homes because they are not well-equipped to cater to residents with mental health problems. Despite years of reforms in nursing homes intended to cater to the needs of nursing home residents with mental disorders, the issue of the quality of mental health care in these homes continues to persist.

The patient identified is a 56-year-old retiree suffering from dementia and is living in a nursing home. The patient suffers from severe memory loss and has a short attention span. The patient also has a problem coping with new situations, and difficulty in organizing his thoughts and words. Dementia is one of the many forms of mental disorders where an individual exhibits a very rigid and unusual pattern of reasoning or thinking and behavior. Patients with dementia usually have difficulty in perceiving things and people. This usually brings about problems to such individuals and hampers greatly their social activities and even work. An individual’s personality is shaped and influenced by their surroundings, experiences, surrounding environment, and inherited traits and characteristics. Dementia affects the brain and affects how they think and behave which usually goes against societal expectations.

Common symptoms in all mental disorders mentioned above include distortion in perception, a change in behavior which can be classified as being abnormal, becoming anti-social in most cases, and personal distress in individuals afflicted. The one common factor in all the types of mental disorders mentioned above is that an individual’s brain is affected to the extent that their reasoning or thinking abilities are in one way or another affected leading to unreasonable behaviors

Evidence from Peer-Reviewed literature

Nursing homes need to have awareness of the appropriate interventions for mental health problems. They must have specialists who know the management of mental issues. In terms of policy, regulations require nursing homes to be aware of the classification system of mental health problems. There are two ways of classification of mental health problems, the International Classification of Diseases also called ICD-10 by the World Health Organization, and the Diagnostic and Statistical Manual of Mental Disorders also called DSM-5 and is published by the American Psychiatric Association (Fung, Xu, & Bodenreider, 2020). Both classifications have synchronized the characteristics of mental health problems, however, some differences exist in each classification. For example, ICD-10 does not recognize narcissistic disorder as a category of mental health problem in nursing home residents. On the other hand, DSM-5 does not also count personality change occurring after a traumatic experience as a psychological problem (Tolentino, & Schmidt, 2018). Even then, the two classifications of mental disorders by the World Health Organization and American Psychiatric Association have put in place common diagnostic parameters that all cases of mental disorders must meet before further and specific inquiries can be done.

Among the criteria used by health facilities and nursing homes to classify mental disorders include; remarkable changes in behavior and attitudes, an abnormal pattern of behavior that runs for long periods and is not limited to short episodes of abnormal behavior, and the fact that such abnormal behavior appears when one is young and continues throughout his adult life. Nursing homes must be aware of the mental status of their residents and which clusters they belong to for appropriate management.

Mental disorders are clustered into three major groups based on the similarities of their descriptions. Cluster A Mental disorders are disorders that have a close association with Schizophrenia. All mental disorders put under this group have common and similar symptoms that include individuals have very strong discomfort with those they have close relationships. Other common symptoms for mental disorders under this group include; distortion of perceptions and exhibiting eccentric behavior. Cluster B personal disorders, also called erratic or emotional disorders are characterized by antisocial behavior which entails a disregard for other people and having a bloated self-image (Liu et al., 2017). Other common symptoms under this cluster include excessive emotions, attention-seeking tendencies, and having no empathy whatsoever to others. Cluster C which is also a fearful and anxious disorder is characterized by such symptoms as being dependent on other people, becoming excessively controlling, and seclusion of oneself from leisure activities and people.

There are many types of mental disorders among nursing home residents. Some of the mental health problems include paranoid mental disorder, Schizoid mental disorders, avoidant mental disorder, and dependent mental disorder among many others. Paranoid mental disorder is characterized by having strong suspicion and distrust of other people, having the belief that other people are out to harm them, having strong suspicion about other people’s loyalty towards oneself, reacting angrily to perceived insults, and distorted perceptions.  Schizoid mental disorder has the following symptoms; always preferring to be alone, lack of interest in social activities, having limited or no emotional expressions, being indifferent to other people. Dependent mental disorder on the other hand is characterized by being excessively reliant on other people, being too submissive to other people, lack of self-confidence with a high degree of low self-esteem, and fear of being left alone. With avoidant mental disorder, an individual may experience certain symptoms such as; being extremely harsh on criticism, feeling insecure, having an inferiority complex, fear of rejection, and fear of embarrassment.

Practice Standards for Nursing Homes in dealing with Mental and Psychological issues

In the United States, over 600,000 people with mental disorders reside in nursing homes on any given day. This figure significantly exceeds the number of all other patients/persons admitted in all other health care facilities combined. Based on this analogy, mental illness sometimes become the decisive factor for admission into nursing homes. However, the issue of the appropriateness of nursing homes as a residing place for people with mental disorders is a controversial matter. After the dramatic closure of state psychiatric facilities in the 80s and the 90s, nursing homes gradually became the de facto facilities for caring for persons suffering from mental disorders.

The standards of care for nursing homes aim to improve the quality of care given to the residents of these homes. The Federal Nursing Home Reform Act of 1987-also known as OBRA sets the minimum standards of care and the rights of people living in nursing homes (Popp, 2018). The minimum health requirements for a nursing home are achieved through a variety of protocols established both by regulatory authorities and the nursing home itself. Based on this analogy, all nursing homes must use OBRA as the foundation stone of creating an environment that provides care, safety, fulfillment, and joy to residents of nursing homes.

One of the critical practice standards for nursing homes is the pre-screening process. The Federal government introduced the Pre-Admission Screening and Resident Review Program-PASRR that requires all states in America to pre-screen all persons seeking admission into nursing homes (Carpenter, 2018). The objective of the PASRR program is to identify persons with mental disorders and other people with intellectual disabilities. Most nursing homes are ill-equipped to deal with patients with mental disorders, especially severe disorders such as bipolar or schizophrenia. The facilities that admit people with severe mental disorders without having the requisite staff, equipment, and appropriate facilities put themselves and their patients in danger.

Some state laws and policies make it difficult for nursing homes to effectively manage and care for patients with mental problems/disorders. For example, patients with bipolar or schizophrenic conditions may get into altercations with other patients in the nursing home. However, creating separate quarters or units for such patients to secure them may be viewed as an unnecessary restriction which in some states is an infringement on the rights of nursing home residents.

Leadership Strategies to Improve Patient Outcomes in Nursing Homes

Leadership is integral for any organization to function optimally. Leadership comes in several styles; toxic leadership is one of them. Many leaders spend most of their time trying to pump in positivity in the workplace while reducing negative aspects to the bare minimum to create better systems of management. To do this, leaders must exhibit characteristics such as inspiration, motivation, and the ability to influence people into achieving goals set by the organization.

Collaborative leadership is essential in the healthcare sector for effective decision-making. Collaboration is essential because it promotes teamwork. Where people work together harmoniously, they find solutions for complex problems (Crowne et al., 2017). Collaboration also creates an inclusive environment where employees release their creativity and creates a productive work culture. Communication is another critical component of effective leadership. Good communication is essential for relaying information. It curbs chances of frequent misunderstandings as well as errors.

The increased complexity of the operations of modern-day organizations and globalization leads to the greater need for cooperation within members of the staff and with it come increased possibilities for conflicts. As a result, the functions of organizations are more involved, and the requirement by organizations to create a healthy working environment for their employees has created a greater need for employees from different sectors of the organization to come together to accomplish the mission of their organization. This interaction and cooperation between people with different backgrounds, ideas, opinions, beliefs, and education standards are bound to create some discord or conflict in the organization.

Dealing with mental disorders in nursing homes requires skills, tact, and effective leadership. Leaders of such facilities must create effective strategies to manage and cope with mental disorders within their facilities. Behavior management/therapy is one of the best strategies to improve patient outcomes in nursing homes. The theory of behavior therapy operates on the premise that all positive behaviors are learned whereas negative behaviors can be unlearned/changed. Thus, the focus of treating patients with mental disorders is to change current problems and the change will be achieved. The objective here is to identify unhealthy and destructive behaviors and change them. Cognitive-behavioral therapy is one of the most popular forms of therapy for mental disorders. This therapy combines both cognitive and behavioral therapy intending to influence a person’s actions and moods by influencing their beliefs and thoughts. The long-term objective of cognitive behavioral therapy is to change a person’s thoughts and behavior.

References

• Carpenter, J. (2018). PASRR: A unique gateway to community services. Commonwealth Medicine Publications. https://doi.org/10.13028/at5q-ar52.
• Crowne, K. A., Young, T. M., Goldman, B., Patterson, B., Krouse, A. M., & Proenca, J. (2017). Leading nurses: Emotional intelligence and leadership development effectiveness. Leadership in Health Services, 30(3), 217-232. https://doi.org/10.1108/lhs-12-2015-0055
• Fung, K. W., Xu, J., & Bodenreider, O. (2020). The new International Classification of Diseases 11th edition: a comparative analysis with ICD-10 and ICD-10-CM. Journal of the American Medical Informatics Association, 27(5), 738-746. https://doi.org/10.1093/jamia/ocaa030
• Liu, N. H., Daumit, G. L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P., Druss, B., Dudek, K., Freeman, M., Fujii, C., Gaebel, W., Hegerl, U., Levav, I., Munk Laursen, T., Ma, H., Maj, M., Elena Medina-Mora, M., Nordentoft, M., Prabhakaran, D., Pratt, K., … Saxena, S. (2017). Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry: Official Journal Of The World Psychiatric Association (WPA), 16(1), 30–40. https://doi.org/10.1002/wps.20384
• Popp, L. (2018). The Nursing Home Reform Act of 1987: A Policy Analysis. California State University, Long Beach.
• Tolentino, J. C., & Schmidt, S. L. (2018). DSM-5 criteria and depression severity: implications for clinical practice. Frontiers in Psychiatry, 9, 450. https://doi.org/10.3389/fpsyt.2018.00450

Addressing An Unmet Need Through Strategic Planning DQ 4

Addressing An Unmet Need Through Strategic Planning DQ 4

Post an explanation of the unmet need that affects a specific group, unit, or organization that you would like to focus on for your Course Project. Share data from your historical analysis and forecasting, and identify stakeholders who should be included in the strategic planning process. Explain your vision for addressing this need at the organizational or systems level.

ORDER THROUGH BOUTESSAY

Michele V. Sare and LeAnn Ogilvie, Strategic Planning for Nurses: Change Management in Health Care

As a nurse leader-manager, you can dynamically impact health care through your involvement in strategic planning. Identifying an unmet need is a critical aspect of strategic planning; however, the real value of this process lies in moving a group, unit, or organization through the analysis and actions required to address the unmet need effectively.

This week, you consider how the foundational topics introduced in the first several weeks of this course relate to the creation of a strategic plan. As you move forward, you will be guided through the strategic planning process to develop your Course Project: Developing a Strategic Plan.

Learning Objectives

Students will:

· Analyze historical data and forecasting pertaining to an unmet need in health care or nursing

· Analyze potential stakeholders for a strategic planning effort

· Formulate a vision for addressing an unmet health care-related need at the organizational or systems level

·: Hero Images/Hero Images/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the Course Readings List link in the Course Materials section of your Syllabus.

Required Readings

Balicer, R. D., Shadmi, E., Lieberman, N., Greenberg-Dotan, S., Goldfracht, M., Jana, L., . . . Jacobson, O. (2011). Reducing health disparities: Strategy planning and implementation in Israel’s largest health care organization. Health Services Research, 46(4), 1281–1299.

Retrieved from the Walden Library databases.

The authors examine the planning, implementation, and evaluation of an organization-wide strategy to address the need to reduce healthcare inequalities and improve quality in Israel.

Schaffner, J. (2009). Roadmap for success: The 10-step nursing strategic plan. Journal of Nursing Administration, 39(4), 152–155.

Retrieved from the Walden Library databases.

The author outlines a 10-step strategic planning process for nursing.

Strubhar, A. J. (2011). Applying an environmental scanning and strategic planning framework in an academic physical therapy department. Journal of Physical Therapy Education, 25(3), 53–59.

Retrieved from the Walden Library databases.

The author examines strategic planning, including environmental scanning, within a physical therapy department in an academic institution.

Authenticity Consulting. (n.d.b). Basic description of strategic planning. Retrieved March 13, 2013, from http://managementhelp.org/strategicplanning/basics.htm

This online article provides an overview of the strategic planning.

Authenticity Consulting. (n.d.c). Basic overview of various strategic planning models. Retrieved March 13, 2013, from http://managementhelp.org/strategicplanning/models.htm

This online article describes different models of strategic planning, including issues-based planning.

PlanWare. (n.d.). Business planning papers: Developing a strategic plan. Retrieved March 13, 2013, from http://www.planware.org/strategicplan.htm

View the strategic planning information on this website.

Required Media

Laureate Education (Producer). (2013d). Elements of a strategic plan model [Video file]. Retrieved from https://class.waldenu.edu

Note: The approximate length of this media piece is 6 minutes.

Dr. Carol Huston describes elements common to strategic planning models and discusses ways to approach the development of a strategic plan.

Accessible player

Optional Resources

Authenticity Consulting. (n.d.a). All about strategic planning. Retrieved March 13, 2013, fromhttp://managementhelp.org/strategicplanning/index.htm

Discussion: Addressing an Unmet Need Through Strategic Planning

Challenges can seem ever present in the health care field. Problems related to the quality of patient care, financial matters, technology, and interdisciplinary collaboration, for example, are often evident in organizations and professional groups.

In your role as a nurse leader-manager, it is important to consider challenges and how these translate into unmet needs. You can then create valuable change by addressing these unmet needs through strategic planning.

Through this Discussion, you may distinguish the focus for your Course Project. Your instructor and colleagues will provide feedback to help you refine your idea as you progress.

To prepare:

• Consider the information presented by Dr. Carol Huston in this week’s media program. Think about the process of moving from the identification of an unmet need through the development, implementation, and evaluation of a strategic plan.
•  Reflect on the initial thinking about trends and unmet nursing and health care needs that you addressed in Week 5.
•  Consider how the information in this week’s Learning Resources deepens and expands your understanding of these trends and unmet needs in relation to the strategic planning process.
• Proceed with planning for your Course Project as follows:
•  Select an unmet need that affects a specific group, unit, or organization.
• If possible, Deepen your understanding of this group, unit, or organization by examining the stated mission, vision, and values.
•  Analyze historical data related to the unmet need, and review the evidence in the literature. Use this information to engage in forecasting.
• Consider which stakeholders should be included in the strategic planning process.
•  Begin to formulate a vision for addressing this need at the organizational or systems level. (Note: Although not required for this Discussion, you will need to develop a strategic goal for your Course Project.)

Also Read: Professional Nursing and State-Level Regulations DQ 4

Advanced Pharmacology Asthma Discussion Paper

Advanced Pharmacology: Asthma

Among the appropriate pharmacological therapies to be prescribed for Johnathan is STEP therapy as recommended by EPR3, which places him in step three, due to his known use of Albuterol that is in step 1. Further, with a viral asthmatic attack, an inhaled corticosteroid (ICS) is recommended, which could be administered via a nebulizer machine (Lizzo & Cortes, 2020). The above, in combination with a leukotrine receptor antagonist (LTRA) would increase the efficacy of ICS.

Asthma exacerbation presents as medical emergency, which necessitates prompt treatment. Jonathan and his mother will therefore need to understand the need for an ICS inhaler even while in school. She also needs to know the need to involve the teacher in the management of Johnathan’s condition, in case of an exacerbation in school. Spirometric indices such as forced exhalation volume are integral in the assessment of asthma especially among children. EPR3 recommends this test among children above 5 years to measure the lung functionality through breath volumes using a spirometer (Dinakar & Chipps, 2017).

Asthma is classified on frequency of exacerbations and severity (Oksel et al., 2018). Mild intermittent asthma presents mildly for less than 2 days a week, resolving spontaneously. This type does not hinder performance of daily activities and includes exercise-induced asthma. Mild persistent asthma presents symptomatically more than twice a week, with symptoms persisting more than a day. Moderately persistent asthma presents symptomatically in most days of the week and at least one night each week. Severe persistent asthma, the most chronic, presents almost every day and severally at night. This type does not respond well to medications.

Johnathan’s mother needs education on the need to change the inhaler to an ICS inhaler. She also should be made aware of benefits of including Johnathan’s teacher in care for Johnathan. This will ease the use and storage of the inhaler in school setup. She also should be educated on the need to prevent Johnathan from contracting URTI from family and friends due to his sensitivity and vulnerability. The plan of care for Jonathan will include pharmacological management and health education. Pharmacological therapy will address the attack as an emergency, as well as prevention of future occurrences.

References

• Dinakar, C. & Chipps, B. (2017). Clinical Tools to Assess Asthma Control in Children. Pediatrics. 139 (1) e20163438; DOI: https://doi.org/10.1542/peds.2016-3438
• Lizzo, J. M. & Cortes, S. (2020). Pediatric Asthma. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551631/
• Oksel, C., Haider, S., Fontanella, S., Frainay, C., & Custovic, A. (2018). Classification of Pediatric Asthma: From Phenotype Discovery to Clinical Practice. Frontiers in Pediatrics, 6(258), 258–. doi:10.3389/fped.2018.00258

Adoption Sample Paper

The biggest psychological issue of adoption on children is mental and emotional trauma. Younger children such as infants may not experience trauma from adoption because they may not recall the ordeal. However, older children often have vivid memories of the process and may experience the trauma associated with losing a parent or being separated from a biological parent. Another common psychological problem associated with adoption is the identity problem (Anthony et al., 2020). Adopted children have to forget their history and ‘rewrite’ new ones as they struggle to fit into their new environment.

Dealing with Mental/Emotional Trauma in Adoption

Being a traumatic experience for a child, adoption affects childhood brain development. If not dealt with early, the trauma may make a child resort to negative behavior such as truancy, risky sexual behavior, and drug use. The best method of dealing with adoption trauma is by providing a home environment that exudes stability, support and understanding, nurturance, and predictability. Such an environment, as Sargent (2019) opines, helps a child to heal and adapt to their new environment. The efficacy of this intervention method draws from the fact that it helps a child to erase their old memories gracefully while creating pleasant new ones. The only remedy for helping adopted children deal with adoption trauma is to ensure that they are happy in their new environment. Loving and happy environments help adopted children forget their past traumatic experiences.

Treatment Options available for Adopted Children and Adolescents

One of the best intervention/treatment options for adopted children is behavioral family therapy. This technique is superior to other therapies such as the standard psychodynamic therapy and client-centered therapy because it uses operant principles (Dowell et al., 2018). Operant conditioning is a technique where the consequence is used as a motivation for behavior. A foster parent can leverage this concept by demonstrating certain desired behaviors to an adopted child. The parent then motivates the child to follow the demonstrated behavior. At the same time, the parent makes it clear to the child that following the demonstrated behavior is rewarded positively while doing the opposite attracts punishment. This method depends heavily on positive reinforcement of behavior, punishment for wrong-doing, and rewards for doing right. Foster parents need to create a stable and loving environment for adopted children to nurture love and discipline.

Explain how Culture influence Adoption

Cultural beliefs influence adoption positively or negatively. In some societies, adopted children cannot hold the same statuses as biological children. For example, some cultures may not permit adopted children to inherit their parent’s wealth as would biological children. In some societies, adopted children are not permitted to take the name of their adopted parents due to a lack of blood relationship. These practices are not healthy for children because they lead to long-term emotional trauma (Ma, 2017). Another critical cultural factor in adoption is the cross-cultural response to adoption. Some cultures are not yet open to adopting children from different ethnic and racial backgrounds. Furthermore, cross-cultural adoption raises pertinent questions about culture, class, and race, an aspect that makes the issue of identity a critical factor for adopted children. Further, cross-cultural adoption exposes children to anxiety and stress as they try to fit in their new environment.

References

• Anthony, R., Paine, A., Westlake, M., Lowthian, E., & Shelton, K. (2020). Patterns of adversity and post-traumatic stress among children adopted from care. Child Abuse & Neglect, 104795. https://doi.org/10.1016/j.chiabu.2020.104795
• Dowell, T., Donovan, C., Farrell, L., & Waters, A. (2018). Treatment of Anxiety in Children and Adolescents. Current Treatment Options In Psychiatry, 5(1), 98-112. https://doi.org/10.1007/s40501-018-0136-2
• Ma, K. (2017). Korean Intercountry Adoption History: Culture, Practice, and Implications. Families In Society: The Journal Of Contemporary Social Services, 98(3), 243-251. https://doi.org/10.1606/1044-3894.2017.98.25
• Sargent, J. (2019). 8.4 ADOPTION: WORKING WITH FAMILIES TO PROMOTE CONNECTIONS AND COMPETENCE. Journal Of The American Academy Of Child & Adolescent Psychiatry, 58(10), S145-S146. https://doi.org/10.1016/j.jaac.2019.07.675