I have considered various options for my nursing specialty, including a close look at my selected (Psychiatric-Mental Health Nurse Practitioner) specialty and second-preferred specialty. (Family Nurse Practitioner) I have also developed a justification of my selected (or preferred) specialty. Lastly, I have examined one professional organization related to my selected or preferred specialty and considered how I can become a member of this organization.
The results of my efforts are below.
Directions: Complete Step 1 by writing 2-3 paragraphs in the space below comparing the nursing specialty you have selected – or the one you prefer if your choice is still under consideration – to your second preference.
Identify each specialty and describe the focus and the role that graduates are prepared for. Identify any other differentiators you feel are significant, especially those that helped or may help you reach a decision.
Complete Step 2 by writing a paragraph identifying and justifying your reasons for choosing your MSN specialization. Be sure to incorporate any feedback you received from colleagues in this week’s Discussion Forum.
Complete Step 3 by examining and identifying one professional organization related to your selected or preferred specialty. Explain how you can become a member of this organization.
Step 1: Comparison of Nursing Specialties
Use the space below to write 2-3 paragraphs comparing the nursing specialty you have selected – or the one you prefer if your choice is still under consideration – to your second preference. Identify each specialty and describe the focus and the role that graduates are prepared for. Identify any other differentiators you feel are significant, especially those that helped or may help you reach a decision.
Step 2: Justification of Nursing Specialty
Use the space below to write a paragraph identifying and justifying your reasons for choosing your MSN specialization. Be sure to incorporate any feedback you received from colleagues in this week’s Discussion Forum.
Step 3: Professional Organizations
Use the space below to identify and examine one professional organization related to your selected or preferred specialty. Explain how you can become a member of this organization.
– END –
Week 6 | Part 6
:
Finalizing the Plan Academic Success Part 6 Discussion
I have
considered various options for my nursing specialty, including a close look at my
selected (
Psychiatric
–
Mental Health Nurse Practitioner
) specialty and second
–
preferred
specialty.
(
Family Nurse Practitioner
)
I have also
developed a justification of my
selected (or preferred) specialty. Lastly, I have exa
mined one professional organization
related to my selected or preferred
specialty and
considered how I can become a
member of this organization.
The results of my efforts are below.
Directions:
Complete Step 1 by
writing 2
–
3 paragraphs in the space belo
w comparing
the nursing specialty you have selected
–
or the one you prefer if your choice is still
under consideration
–
to your second preference. Identify each specialty
and
describe
the focus and the role that graduates are prepared for. Identify any
other differentiators
you feel are significant, especially those that helped or may help you reach a decision.
Complete Step 2 by
writing a
paragraph identifying
and justifying
your reasons for
choosing your MSN specialization.
Be sure to i
ncorporate
any
feedback you received
Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan
Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan
At some point in every construction project, efforts turn from design and the focus moves to actual construction. With the vision in place and the tools secured, the blueprint can be finalized and approved. Then it is time to put on hardhats and begin work.
Throughout the course you have developed aspects of your Academic and Professional Development Plan. You have put a great deal of thought into your vision and goals, your academic and professional network of support, research strategies and other tools you will need, the integrity of your work, and the value of consulting the work of others. With your portfolio in place, it is now time to finalize your blueprint for success.
Much as builders remain cognizant of the building standards as they plan and begin construction, nurses must remain mindful of the formal standards of practice that govern their specialty. A good understanding of these standards can help ensure that your success plan includes any steps necessary to excel within your chosen specialty.
In this Assignment you will continue developing your Academic Success and Professional Development Plan by developing the final component: a review of your specialty standards of practice. You will also submit your final version of the document, including Parts 1–5.
To Prepare:
Also Read:
Strategies For Academic Portfolios NURS 6003
The Assignment:
Complete the following items and incorporate them into the final version of your Academic Success and Professional Development Plan.
Note: Your final version of the Academic Success and Professional Development Plan should include all components as presented the Academic Success and Professional Development Plan template. Make all corrections to each part based on faculty feedback and submit a final and edited copy of the template (Part 1-Part 6) in correct APA format.
By Day 7
Submit Parts 1-6 of your Academic Success and Professional Development Plan.
Remember to include an introduction paragraph which contains a clear and comprehensive purpose statement which delineates all required criteria, and end the assignment Part with a conclusion paragraph.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Grading Criteria
To access your rubric:
Week 6 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 6 Assignment draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 6 Assignment
Congratulations! After you have finished all of the assignments for this week, you have completed the course. Please submit your Course Evaluation by Day 7.
Nurses must advance their knowledge and competencies to fit in the current healthcare systems because of the existing dynamics and complexities surrounding quality health care. Advancing education and practical skills allow nurses to play a significant role in transforming clinical contexts and promoting interventions to address institutional challenges (Jormfeldt et al., 2018).
For instance, one of the benefits of advancing education in nursing practices is that it enables professionals to incorporate evidence-based practices (EBPs) in solving problems and making informed decisions. As an aspiring psychiatric-mental health nurse, I know that a Bachelor of Science in Nursing (BSN) is inadequate. Therefore, my BSN was only a gateway to higher education level, including Masters of Science in Nursing (MSN). As a result, I have decided to advance my career by selecting two nursing specialties of interest.
I have the determination to enroll in the Masters of Science in Nursing (MSN), where I will pursue either a master’s degree in psychiatric-mental health nursing (PMHN) or family nurse practitioner (FNP). My first choice (PMHN) entails various priority areas because it allows nurses to work with families, individuals, groups, and communities to identify issues regarding mental health. Advanced practice registered nurses in psychiatric-mental health play a significant role in providing primary care for vulnerable populations, assessing causal factors, and promoting health.
On the other hand, a master’s degree in family nursing practice (FNP) will allow me to work with families and communities while providing patient care across the lifespan, especially for the underserved population sections. Further, the FNP field will enable me to perform physical exams for patients within my specialty, develop care plans, and collaborate with other professionals in delivering primary care to the underserved population. Although the two fields are fundamental in promoting quality health care services, I prefer enrolling for an MSN in psychiatric-mental health nursing practice because its activities my strengths, knowledge, and the dream of delivering care to psychiatry patients.
The psychiatric-mental health domain is a fundamental specialty because of the issues surrounding nurses’ roles in delivering quality care for patients with mental health concerns. Lake (2017) argues that the current treatments and the dominant mental health care model do not effectively address challenges in this specialty. The reason for failing to address clinical constraints related to cognitive health is that mental illnesses account for approximately one-third of all adult disabilities (Lake, 2017). Arguably, this consideration validates the claim that mental health patients overwhelm the current global health system.
Similarly, dealing with causal factors such as depression, stress, and suicidal ideations is a daunting endeavor for nurses. Consequently, many unaddressed gaps and untapped opportunities exist in this operational area. My desire to advance knowledge in psychiatric-mental health nursing practice relies massively on the determination to help people struggling with mental concerns. Also, this field is ever-transforming, meaning I will have opportunities to develop my career and access benefits such as job promotions or increased pay.
Although psychiatric-mental health nurses require prerequisite professional and interpersonal skills, colleagues always acknowledge my ability to relate with other people, applying evidence-based practice in projects, and effective collaboration during my clinical rotations in the psychiatry department. For instance, my BSN instructor indicated that I portrayed professional attributes and personal characteristics that will allow me to excel in the psychiatry specialty.
Complements from my preceptor and peers are icing on the cake because they enhance the determination to transform the psychiatry department. Although I possess the necessary skills that will help me execute my responsibilities well, I am aware of various challenges facing psychiatric nurses. In this sense, the primary challenge when delivering care to patients with different mental health concerns is establishing meaningful relationships with them, their families, and other professionals. Also, nurses face challenges in embracing patient-centeredness principles when dealing with psychiatry patients.
One of the most prominent strategies to address these challenges is joining a reputable organization in the specialty to facilitate information sharing, consultation among nurses, and access to vital resources in the field. Therefore, I am looking forward to joining the American Psychiatric Nurses Association (APNA). Since 1986, APNA has been in the frontline to help nursing students with various education programs and professional services to enable them excess in psychiatry departments (Delaney, Drew & Rushton, 2018). Today, the organization services nurses of different qualifications, including registered nurses (RNs), associate degree (ADN), advanced practice registered nurses (APRNs), and baccalaureate (BSN).
The most profound strengths of the American Psychiatric Nurses Association (APNA) are the ability to accommodate nurses from the different healthcare setting. In this sense, it is an ideal avenue where nurses, scholars, and communities can access education opportunities, scholarly resources, and other relevant information regarding the psychiatric domain. Therefore, joining APNA will advance my professional skills, enhancing knowledge, and transforming my capabilities to care for patients with different mental health concerns.
References
Delaney, K., Drew, B., & Rushton, A. (2018). Report on the APNA national psychiatric mental health advanced practice registered nurse survey. Journal Of the American Psychiatric Nurses Association, 25(2), 146-155. https://doi.org/10.1177/1078390318777873
Jormfeldt, H., Doyle, L., Ellilä, H., Lahti, M., Higgins, A., & Keogh, B. et al. (2018). Master’s level mental health nursing competencies, a prerequisite for equal health among service users in mental health care. International Journal of Qualitative Studies on Health and Well-Being, 13(sup1), 1502013. https://doi.org/10.1080/17482631.2018.1502013
Lake, J. (2017). Urgent need for improved mental health care and a more collaborative model of care. The Permanente Journal. https://doi.org/10.7812/tpp/17-024
The current healthcare system is dynamic with changes aimed at improving the quality of care provided. As nurses, we play a significant role in helping revolutionize the provision of care services. Attaining my BSN was only a beginning to pave way for further advancement in my career life. Currently, I have decided to enroll in the masters of science in nursing (MSN) program at Walden University to gain the required knowledge and skills in specialized nursing practice.
My main focus out of the available specialty option is to peruse a master’s degree in gerontology or psychiatry. Gerontology focuses on providing healthcare services to the elderly patients which have gained more market in the current healthcare system, whereas an MSN- PMHNP program mainly equips nurses with adequate knowledge and skills in delivering a full spectrum of care among patients suffering from psychiatric disorders including substance abuse issues and organic brain disorders (Endsley, 2017). Out of the two, I prefer enrolling in an MSN- PMHNP program, which aligns with my strength and prior knowledge in taking care of psychiatry patients.
The current healthcare system is overwhelmed with psychiatry patients as a result of increasing mental illness cases such as depression and anxiety. As such, there is an increased demand for psychiatry healthcare specialists across all disciplines including nurses.
Consequently, nurses working in this field enjoy several benefits such as increased pay, with numerous job opportunities. Additionally, most of my colleagues have observed my good communication skills and a good relationship with my patients, which is crucial when taking care of patients with psychiatry disorders (Vargas et al., 2017). In the course of my BSN program, my preceptor, during my clinical rotation in the psychiatry department also observed my keen insight and good relationship with patients suffering from different mental disorders.
Consequently, in my report, she pointed out a good clinical outcome, among most of the patients who were under my care. As such, I find it very convenient and life-changing to focus on specializing in psychiatry, to help patients suffering from mental illness. However, it is very important to note that, the main challenge facing psychiatric nurses is forming a strong therapeutic relationship with patients suffering from mental illness together with their families.
In my professional line, I am looking forward to becoming a member of the American Psychiatric Nurses Association (APNA). This organization was founded in 1986 to provide leadership aimed at promoting psychiatric-mental health nurses, and improving the quality of mental health care services for patients from different cultural backgrounds, and shape the healthcare policies associated with improved mental health services (Delaney, Drew, & Rushton, 2019).
APNA membership incorporates all PMH nurses (RN), including baccalaureate (BSN), associate degree (ADN), and advanced practice (APRN). Members of this organization come from different healthcare settings such as inpatient, academic, community, and research settings, in both private and public sectors, and healthcare institutions at both federal and state levels.
APNA has made it easier for nurses to advance their education hence improving the quality of services provided to patients with mental illness, as such, becoming a member of this organization will help in advancing my career, and advance my knowledge and skills in taking care of psychiatry patients.
Delaney, K. R., Drew, B. L., & Rushton, A. (March 01, 2019). Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey. Journal of the American Psychiatric Nurses Association, 25, 2, 146-155. https://doi.org/10.1177/1078390318777873
Divane de Vargas, Janaina Soares, Talita Dutra Ponce, & Bruna Batista de Oliveira. (January 01, 2017). PSYCHIATRIC URGENCY AND EMERGENCY CARE NURSES: AN ANALYSIS OF THEIR PROFESSIONAL AND EDUCATIONAL PROFILE. Cogitare Enfermagem, 22, 4.) https://pdfs.semanticscholar.org/b73d/25882372abdd7f69079cd553b590845f441f.pdf.
Endsley, P. (January 01, 2017). School Nurse Workload: A Scoping Review of Acute Care, Community Health, and Mental Health Nursing Workload Literature. Journal of School Nursing, 33, 1, 43-52. https://doi.org/10.1177/1059840516681423
I have considered various options for my nursing specialty, including a close look at my selected (or currently preferred) and second-preferred specialty. I have also developed a justification for my selected (or preferred) specialty. Lastly, I have examined one professional organization related to my selected or preferred specialty and considered how I could become a member of this organization.
The results of my efforts are below.
Directions: Complete Step 1 by writing 2-3 paragraphs in the space below comparing the nursing specialty you have selected – or the one you prefer if your choice is still under consideration – to your second preference. Identify each specialty and describe the focus and the role that graduates are prepared for. Identify any other differentiators you feel are significant, especially those that helped or may help you reach a decision.
Complete Step 2 by writing a paragraph identifying and justifying your reasons for choosing your MSN specialization. Be sure to incorporate any feedback you received from colleagues in this week’s Discussion Forum.
Complete Step 3 by examining and identifying one professional organization related to your selected or preferred specialty. Explain how you can become a member of this organization.
Use the space below to write 2-3 paragraphs comparing the nursing specialty you have selected – or the one you prefer if your choice is still under consideration – to your second preference. Identify each specialty and describe the focus and the role that graduates are prepared for. Identify any other differentiators you feel are significant, especially those that helped or may help you reach a decision.
My primary area of interest within the nursing profession is Psychiatric Mental Health Nurse Practitioner (PMHNP). The chosen specialty of comparison is the family nurse practitioner (FNP). PMHNP is a subspecialty of nursing concerned with the assessment, diagnosis, and management of mental health issues in patients of all ages. PMHNPs provide holistic mental health treatment by coordinating efforts between patients, families, and other medical professionals (Delaney & Vanderhoef, 2019). Psychological and mental health illnesses, such as anxiety, depression, and schizophrenia, are just some of the many that PMHNP graduates are equipped to diagnose and treat. They could do their jobs anywhere from private practices to mental health clinics to hospitals.
Family nurse practitioners, on the other hand, treat patients of all ages and focus on disease prevention, wellness promotion, and the management of both acute and chronic conditions. FNPs have the knowledge and experience to evaluate patients, prescribe medications, order and interpret diagnostic tests, and determine treatment regimens (Owens, 2019). They also teach people how to take better care of themselves and how to prevent illness. Graduates of FNP schools are qualified to find employment in a wide range of medical facilities, including those providing primary care, outpatient care, and urgent care as well.
The emphasis/focus of each field is a key distinction between them. The main role of an FNP in care contrasts with the specialty care role of a PMHNP. PMHNPs and FNPs deal with distinctively different types of patients. FNPs treat patients of all ages who have a wide range of acute and chronic medical disorders, while PMHNPs focus primarily on those with mental health issues (Hodges et al., 2019). The context in which they do their work is also distinctive, contributing to another difference. Both PMHNPs and FNPs can practice in a variety of settings, including inpatient and outpatient care facilities. I can state that one’s personal preferences and professional aspirations should guide their decision between the two fields of study.
Use the space below to write a paragraph identifying and justifying your reasons for choosing your MSN specialization. Be sure to incorporate any feedback you received For a variety of reasons, I decided to pursue a career as a Psychiatric Mental Health Nurse Practitioner (PMHNP). To begin, I feel strongly that mental health deserves the same attention as physical health. By becoming a PMHNP, I will be able to deal with people of all ages and give them the full range of services they need for their mental health (Kverno & Fenton, 2021).
Secondly, I hope to have a positive impact by assisting people and families who are dealing with mental health issues because there is a rising need for mental health providers in our community. Finally, my colleagues in this week’s Discussion Forum provided insightful criticism, drawing on their experiences and perspectives as PMHNPs to offer suggestions for improvement. Their advice strengthened my resolve, and I came away from our conversation with a deeper appreciation for the work of PMHNPs and the difference they can make in patients’ lives. I am confident that focusing on PMHNP is the best route for me, and I look forward to beginning this journey to promote better mental health for all.
Use the space below to identify and examine one professional organization related to your selected or preferred specialty. Explain how you can become a member of this organization.
The American Nurses Association (ANA) has a Psychiatric-Mental Health Nursing Professional Organization that serves as a network for PMHNPs and other mental health nurses. Registered nurses (RNs) in the United States are represented by the American Nurses Association, and the Psychiatric Mental Health Nurses’ Programme is a subset of the ANA dedicated to improving the field of psychiatric-mental health nursing via practice and education. To become a member of the organization, the person needs to be a current member of the ANA to join the Psychiatric Mental Health Nurses’ Programme (Foster et al., 2019).
Members of the ANA must be registered nurses who are currently licensed to practice in the United States or one of its territories. Anyone who has already joined the ANA and paid the membership cost can also join the PMHNP. The American Nurses Association offers its members the chance to stay abreast of the newest research and advancements in the field of psychiatric-mental health nursing through continuing education courses, professional networking events, and newsletters (Bradshaw et al., 2021). One of the benefits of membership is the opportunity to take part in lobbying initiatives to expand the field of psychiatric-mental health nursing and raise public awareness of mental health issues.
Bradshaw, M., Gericke, H., Coetzee, B. J., Stallard, P., Human, S., & Loades, M. (2021). Universal school-based mental health programs in low-and middle-income countries: a systematic review and narrative synthesis. Preventive Medicine, 143, 106317. https://doi.org/10.1016/j.ypmed.2020.106317
Delaney, K. R., & Vanderhoef, D. (2019). The psychiatric mental health advanced practice registered nurse workforce: Charting the future. Journal of the American Psychiatric Nurses Association, 25(1), 11-18. https://journals.sagepub.com/doi/pdf/10.1177/1078390318806571
Foster, K., Roche, M., Delgado, C., Cuzzillo, C., Giandinoto, J. A., & Furness, T. (2019). Resilience and mental health nursing: An integrative review of international literature. International Journal of mental health nursing, 28(1), 71-85. https://doi.org/10.1111/inm.12548
Hodges, A. L., Konicki, A. J., Talley, M. H., Bordelon, C. J., Holland, A. C., & Galin, F. S. (2019). Competency-based education in transitioning nurse practitioner students from education into practice. Journal of the American Association of Nurse Practitioners, 31(11), 675–682.
Kverno, K. S., & Fenton, A. (2021). Specialization within a specialty: Advanced practice psychiatric nursing pathways for the greatest good. Journal of psychosocial nursing and mental health services, 59(10), 13-18. https://doi.org/10.3928/02793695-20210513-02
Owens, R. A. (2019). Nurse practitioner role transition and identity development in rural health care settings: a scoping review. Nursing Education Perspectives, 40(3), 157–161.
– END –
Also Read: NRNP 6566F Week 4 Scenario: 84 Year Old Female
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).
In the space below, write a 2- 3-paragraph analysis that includes the following:
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.
Expand on your thoughts from Part 1 by:
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.
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
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:
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:
Expand on your thoughts from Section 1 by identifying and describing strategies you intend to pursue to maintain integrity and ethics of your:
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.
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.
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.
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.
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.
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.
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.
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.
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) .
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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
Addictions Case Study: Case Conceptualization Grading Rubric
CriteriaLevels of Achievement Content 70% AdvancedSatisfies criteria w/ excellence
ProficientSatisfies Criteria
DevelopingSatisfies most criteria
Below Expectations Does not satisfy criteriaNot PresentIntroduction10 pts.Synopsis paragraph is clear, concise, understandable; covers: presenting problem, substance history, all substances used, side effects, and most important issues.
8–9 pts.Synopsis paragraph is good and understandable; mostly covers: presenting problem, substance history, all substances used, side effects, and most important issues.
7 pts.Synopsis paragraph is adequate; mostly covers: presenting problem, substance history, most substances used, side effects, and some important issues.
1–6 pts.Synopsis paragraph is adequate; does not or barely covers: presenting problem, substance history, some substances used, side effects, and some or nonimportant issues.
0 pointsDangers and Risks5 pts.Potential dangers/risks for the client clearly shown. Risk management steps shown. Correct stage of change given.
4 pts.Potential dangers/risks for the client shown. Risk management steps mostly shown. Correct/close to correct stage of change given.
3 pts.Potential dangers/risks for the client mostly shown. Risk management steps adequately shown. Close to correct stage of change given.
1–2 pts.Potential dangers/risks for the client barely or not shown. Risk management steps adequately or not shown. Incorrect stage of change given.
0 pointsAUDIT Items14-15 pts.All pertinent AUDIT items shown. Correct total score shown. Explanation of how points distributed, and total score arrived at shown.
12-13 pts.All pertinent AUDIT items shown. Correct/close to correct total score shown. Good explanation of how points distributed, and total score arrived at shown.
11 pts.Most pertinent AUDIT items shown. Close to correct total score shown. Adequate explanation of how points distributed, and total score arrived at shown.
1–10 pts.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.
0 pointsReferrals14-15 pts.Possible referrals – minimum of three “bullet-points” (5 points apiece).
12-13 pts.Two possible referrals shown as “bullet-points.”
11 pts.One possible referral shown as “bullet-points.”
1-10 pts.No possible referrals shown as per instructions.
0 pointsQuestions5 pts.Minimum of two questions would have asked client shown. Questions are well-done and pertinent to the client’s life and narrative.
4 pts.Two questions would have asked client shown. Questions are adequate to the client’s life and narrative.
3 pts.One question would have asked client shown. Question is adequate to the client’s life and narrative.
1-2 pts.No questions shown as per instructions.
0 pointsAddictions Genogram18-20 pts.3 levels of a basic genogram completely shown. Genogram relationships completely shown. All substance usage by family members shown.
15-17 pts.
3 levels of a basic genogram mostly shown. Genogram relationships mostly shown. Substance usage by client only is shown.
12-14 pts.3 levels of a basic genogram shown. Genogram relationships mostly shown. No substance usage by family members shown.
1-11 pts.Genogram not attached as per instructions.
0 pointsStructure 30%Advanced
Satisfies criteria w/ excellence
ProficientSatisfies Criteria
DevelopingSatisfies most criteria
Below ExpectationsDoes not satisfy criteria
Not PresentOrganization10 pts.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.
8-9 pts.
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.
7 pts.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.
1–6 pts.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.
0 pointsStyle10 pts.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.
8-9 pts.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.
7 pts.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.
1-6 pts.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.
0 pointsSources10 pts.
The Reference page meets or exceeds the required number of sources. All sources are referenced throughout the paper.
8-9 pts.The Reference page meets the required number of sources. Most sources are referenced throughout the paper.
7 pts.The Reference page does not meet the required number of sources. Not all sources are referenced throughout the paper.
1–6 pts.The Reference page is not present or contains few sources. Not enough sources are referenced throughout the paper, or none are referenced.
0 points
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).
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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 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.
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.
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
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.
Also Read: Professional Nursing and State-Level Regulations DQ 4