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Discussion: clinically oriented problem or issue in future practiceORDER HERE FO ...

Discussion: clinically oriented problem or issue in future practice

ORDER HERE FOR ORIGINAL, ORDER THROUGH BOUTESSAY ON Discussion: clinically oriented problem or issue in future practice.

Discussion: clinically oriented problem or issue in future practice

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Background
Problem statement
Purpose of the change proposal
PICOT
Literature search strategy employed
Evaluation of the literature
Applicable change or nursing theory utilized
Proposed implementation plan with outcome measures
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Below are papers to REFERENCE only. No plagiarism please.

capstone_exp_3_lr.doccapstone_picont_2_exp.docxcapstone_picot_1_exp.docxcapstone_exp1_lr.docxcapstone_exp_2_lr.docx

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Running head: NURSE BURNOUT LITERATURE REVIEW

Nurse Burnout Literature Review

The review of literature will help to see how the PICOT question has been researched by other authors and the evidence that is available regarding the question. The PICOT question is:

In patients who are hospitalized/SNF’s(P), how does reducing the number of hours nurses work per week(I) compared to an increase in overtime(C) affect nurses satisfaction towards their job and patients satisfaction with the nursing staff(O) during their stay(T).

As such, the literature review aims to find out how the authors have researched the topic of nurses burnout and its effect on the job satisfaction as well as service rendered to patients. Research Questions Various articles tackling the issue of burnouts among nurses tackle different research questions. For instance, Dall’Oral et al. (2015) research the association between working long hours and burnouts and job dissatisfaction.Similarly, Stimpfell et al. (2012) compare long hours with burnouts, job dissatisfaction, and intention to leave jobs by the nurses. A different question researched in connection with the PICOT is the connection of nurse environments with the nursing outcomes due to burnout (Valley, et al., 2010). Stimpfel & Aiken (2014) research the connection between shift length, scheduling characteristics, and safety and quality.Of the four sets of authors two research identical questions regarding the connection of burnouts with job satisfaction while the other two research connected questions on scheduling and safety due to burnout. Further, Wisetborisut et al. (2014) simply research the relationship between shiftwork and burnout. The risks that long hours of work, poor sleep, and shift work cause to employees and patients are researched by Caruso (2013).This research is similar to Stimpfel and Aiken’s NURSE BURNOUT LITERATURE REVIEW 3 concerning the safety of workers as well as patients. Lockley et al. (2007) study the effects of long work hours for nurses on their safety and the errors that they make. The other research was by Canadas De la Fuente et al. (2014), and it assessed the prevalence of burnout. Most of the research questions seek to find the job satisfaction and safety related to burnouts. Also, the issue of prevalence of burnouts is viewed in the research articles.Sample Populations The authors use different sample populations, which make their studies varied and thus covering wide populations. Canadas De la Fuente et al. (2014), for instance, carry out their research in public health centers in Andalusia, Spain. Lockley et al. (2007) carry out their research across different hospitals in the U.S. Caruso (2013) carries out his study in the Midwest while Wisetborisut et al. (2014) undertake their research at Chiang Mai University Hospital, Thailand.Another area where the sample population is taken from is 577 acute care hospitals in four U.S states by Stimpfel & Aiken (2014). Valey et al. (2010) researched 20 urban hospitals across the U.S. The authors engage in different geological areas thus increasing the validity of their findings. Stimpfel et al. (2012) carried their quantitative research in four states, the same area that they further carried out a qualitative research. Finally, Dall’Oral et al. (2015) carried out their research in 12 general Med-Surg European hospitals.The sample populations taken by each of the researchers show diversity and the coverage of a wide area of study. For instance, among the eight sets of researchers, only one set carries out their research in a single location. The diverse set of the sample populations allows the researchers to explore the different populations. The most diverse population sample is the 577 acute care hospitals where Stimpfel and Aiken NURSE BURNOUT LITERATURE REVIEW 4 carry out their research.Therefore, the PICOT research spread out in the U.S and parts of Europe and Asia presents compelling results. Limitations The research carried out by the different researchers provides a good basis for the PICOT study. However, there are various limitations to the studies that they carry out in the different areas. The first limitation observed is with Wisetborisut et al. (2014) whereby the research was carried out in only one hospital.The researchers carried out an online questionnaire research with employees from only one hospital thus reducing the validity of the results. The other limitation observed in the literature review is the use of cross-sectional study in the research (Caruso, 2013; Lockley et al., 2007). Although the cross-sectional research may have produced results from the population, the research is limited to the feelings of the sample population at that moment. Therefore, it fails to validate the results over different atmospheres and time differences.

Conclusion and Recommendations

The analysis of the eight research articles allows the development of insight in the issue of nurse burnout and how it affects dissatisfaction as well as the risks that it presents. As such, it supports the PICOT study regarding the effects of long hours on the nursing burnout and the risks that they experience in the case of the burnout. Further research can be conducted on how to manage the shift work to ensure that nurses finish their work within a ‘safe’ period where they will not experience burnouts as they lead to increased risks and lower job satisfaction levels.NURSE BURNOUT LITERATURE REVIEW 5The articles recommend that nursing working hours should be shortened to at most 12 hours per 24 hour day and 60 hours per week. Also, they come up with the recommendation that nursing environment be improved to limit the effects of burnout and increase the nurses’ efficiency in the working place. The training of managers is also necessary to avoid the work shifts that cause burnouts. The government should also be involved in setting a shift-hour limit.These articles form a proper basis for examining the PICOT question in focus. Further study in the appropriate means of reducing the shift hours and increasing safety can be done to assist in eliminating the burnouts.NURSE BURNOUT LITERATURE REVIEW 6

References

Cañadas-De la Fuente, A. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. International Journal of Nursing Studies, 52(1), 240 – 249. DOI:http://dx.doi.org/10.1016/j.ijnurstu.2014.07.001
Caruso, C. (2013). Negative Impacts of Shiftwork and Long Work Hours. Rehabilitation Nursing; 39(1): 16–25. doi:10.1002/rnj.107
Dall’Ora, C., Grifitths, P., Ball, J., Simon, M. & Aiken, L. (2015). Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open 2015; 5: e008331. doi:10.1136/bmjopen2015-008331
Lockley, S., Barger, L. & Ayas, N. (2007). Effects of Health Care Provider Work Hours and Sleep Deprivation on Safety and Performance. The Joint Commission Journal on Quality and Patient Safety, 33(11), 7-18.
Stimpfel1, W., Sloane, W., and Aiken, L. (2012). The Longer the Shifts or Hospital Nurses, the Higher the Levels of Burnout and Patient Dissatisfaction. Health Affairs, 31(11), 25012509. doi:10.1377/hlthaff.2011.1377
Stimpfel, W. & Aiken, L. (2014). Hospital Staff Nurses’ Shift Length Associated with Safety and Quality of Care. Journal of Nursing Care Quality, 28(2): 122–129. doi:10.1097/NCQ.0b013e3182725f09
Vahey, D., Aiken, L., Sloane, D., Clarke, S., & Vargas, D. (2004). Nurse Burnout and Patient Satisfaction. Medical Care, 42(2), II57–II66. doi:10.1097/01.mlr.0000109126.50398
Wisetborisut, C., Angkurawaranon, W., Jiraporncharoen, R., & Wiwatanadate, A. (2014). Shift Work and Burnout Among Health Care Workers. Occupational Medicine, https://academic.oup.com/occmed/article/64/4/279/1464114/Shift-work- and-burnoutamong-health-care- workers 7

Running head: NURSING BURNOUT

Nursing Burnout Relates to Long Shift Hours. Nursing burnout has long been a problem in the healthcare industry. Nurses are the frontline of healthcare and have numerous numbers of tasks to be done and at the same time has increased liabilities. Many studies have been completed to try to determine what exactly causes nurses to become “burnt-out” and the problems that arise from it. Burnout, as defined by Maslach and Jackson is, “a syndrome characterized by emotional exhaustion, depersonalizations and a perceived lack of personal accomplishment” (Maslach and Jackson 2014).

As more and more nurses suffer from burnout, nurse and also patient satisfaction is going down. There are a lot of factors that contributed to nursing burnout, from inadequate staffing, working long hours, high demands from the job and verbal abuse that they get from the patients and maybe even other staff members. Nurses are humans too, they can only handle so much, however hospitals and other healthcare settings have been utilizing nurses as much as they can for their profit.Due to working too many hours in a given week, there has been increase in nurses calling in sick, patient satisfaction ratings and quality of care has been going downhill, and nurse’s job dissatisfaction has been increasing (Dall’Ora, 2015). There has been an increase in medical errors and also less and less patient interaction has become a problem (Baker, 2011). This capstone project is aimed to find some causes and to formulate a recommendation to decrease nursing burnout in the hospitals, skilled nursing facilities and other health care facilities. This project is also aimed to determine a way to increase patient and nurse satisfaction by decreasing nursing burnout.Nurses experiencing burnout may have impaired attention, memory and critical thinking skills that is important to give a safe and effective patient care. “The cognitive detachment associated with high levels of burnout may result in inadequate hand hygiene and lapses in other infection control procedures among registered nurses” (Cimmiotti et al, 2012). Diminished vigilance, cognitive function and increased safety lapses increases the risk for errors for nurses.They can develop negative attitudes towards patients and decrease interest in career improvement and personal development. It also brings poor decision making and poor interaction and communication with patients (Zimmerman, 2017). Studies show that nurses who work 12 hours shift is more likely to experience nursing burnout than those who work 8 hours shift (Stimple, 2013). There are some health care facilities that have been giving out bonus, incentives and spacing out nursing staff’s off days in order to give nurses the ample time to rest and recuperate after a long shift.There are other health care facilities that have been hiring more nursing staff and as needed nurses to help alleviate the burnout and lack of staffing that may be present. The recommendation of hours of work per week a nurse should work should not exceed more than 54 hours and the patient to nurse ratio should not exceed 10 patients to one nurse. The Accreditation Council for Graduate Medical Education (ACGME) implemented rules limiting the work hours for all (physician) residents, stating that residents cannot work more than 80 hours per week or 24 hours in a row.This rule was set in place after a patient died due to a medication errors made by a physician working a 36-hour long shift (U.S. Department of Health NURSING BURNOUT 4 and Human Services, 2016). This is something that should be implemented in health care field for all health care providers, including nursing staff. “Although some states have laws against mandatory overtime, voluntary overtime has no limits and nurses have reported feeling coerced into working late or taking extra shifts” (Stimpfel, Sloane, and Aiken 2012). This is a major contributor to the nursing burnout problem. To decrease this problem in health care, nursing staff should be allowed to work only a maximum 54 hours per week.

References

Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care–associated infection. American Journal of Infection Control,40(6), 486-490. doi:10.1016/j.ajic.2012.02.029
Barker, L.M. & Nussbaum M.A. (2011). Fatigue, performance, and the work environment of Registered nurses. Journal of Advanced Nursing, 76(6), 1370-1382. Doi:10.1111/j.13652648.2010.05597.x
Burnout Among Health Professionals and Its Effect on Patient Saftey. (2016, February). Retrieved from http://psnet.ahrq.gov/perspectives/perpective/190/burnout-amounghealth-professionals-and-its-effect-on-patient-saftey
Dall’Ora, Chiara, Peter Griffiths, Jane Ball, Michael Simon, and Linda H. Aikens. “Association of 12 h shifts and nurses job satisfaction, burnout and intention to leave: finding from cross-sectional study of 12 European countries.: BMJ Open. September 01, 2015. Received from http://bmjopen.bmj.con/content/5/9/e008331.info.
Maslach, C., & Jackson, S. (1981). The Measurement of Experienced Burnout. Journal of Occupational Behaviour, 2(2), 99-113. Retrieved from http://www.jstor.org.libproxy.nau.edu/stable/3000281
Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The Longer The Shifts For Hospital Nurses. The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs,31(11), 2501-2509. doi:10.1377/hlthaff.2011.1377
U.S. Department of Health and Human Services. (2016, July). Physician Work Hours and Patient Safety. Retrieved February 22, 2017, from https://psnet.ahrq.gov/primers/primer/19
Zimmerman, B. (2017, May 05). Survey:70% of nurses report burnout in current position. Retrieved from http://www.beckershospitalreview.com/human-capital-and-risk/survey70-of-nurses-report-burnout-in-current-position.html

Nursing Burnout Related to Long Shift Hours

Nursing burnout is a term that is difficult to explain or diagnosed due to the many, different changing factors involved in the word itself. There is no standard guideline or screening that can be used to determine whether an individual is experiencing burnout. The term was coined by a psychologist, Herbert Freudenberger, who stated that it was a condition that is most often experienced by public servants (Freudenberger, 2013). Nursing burnout does not only affect the nurse but also the patients they are sworn to care for.

This condition affects the whole health care system due to the fact that nurses are an integral part of care from time of admission to time of discharge. Public servants, like nurses, experience this condition because they are constantly under pressure to perform during high levels of stress and to exhibit high level of ideals expected from them by the community. In patients who are hospitalized/SNF’s(P), how does reducing the number of hours nurses work per week(I) compared to an increase in overtime(C) affect nurses satisfaction towards their job and patients satisfaction with the nursing staff(O) during their stay(T).

Nursing burnout occurs due to the amount of hours and workload that a nurse is put under without having the adequate time to recover. Nurses often have to work in these conditions because of the high nurse to patient ratio given to them by the facility they work for. Facilities often do not have adequate staffing that causes nurses to work longer than their shift entails or sign up for a shift they are suppose to be off. Mandatory overtime is also an issue that is a current practice in some states. In Arizona, 15% of nurses working in hospital settings are required to work mandatory overtime (Mandatory Overtime, 2012).

This can lead to nursing burnout and will have different products. Nursing burnout will lead to nurses calling off during Nursing Burnout shifts, high turnover rates, higher nurse to patient ratios for other nurses, and/or substance abuse. The patients are affected as well if they are under the care of a nurse experiencing exhaustion. The patients are more at risk for not receiving the adequate care they need and and an increased risk of medication/care error when the critical thinking of the nurse is impaired. This can affect the nurse physically and mentally.

A nurse working more hours than recommended can neglect nutrition due to the fact that by taking a break, it can put them behind during their shift, therefore, risking not finishing their assignment by the time they need to punch out of their shift. A nurse can also neglect exercise because by the the end of their shift they are exhausted and sleep is what their body needs. Mental exhaustion also occurs and this can alter their critical thinking and response during certain events.

A mentally exhausted nurse can make medication errors or poor judgment that can put the lives of their patients in jeopardy. Some mentally exhausted nurses can also turn to substance to help cope with the high levels of stress the are experiencing. Substances affect the critical thinking of nurses and therefore more susceptible in making an error while providing care. There are many proposed solutions to combat nursing burnout. The main suggestions include shortening shifts, decreasing nurse to patient ratio, increasing staff pool, and having a set amount of hours a nurse can work during the week.Shortening the shift can allow the nurse to be more efficient throughout the day, reducing near misses or errors during the care they provide to the patient. Decreasing nurse to patient ratio is also helpful as this can decrease the emotional stress the nurse experiences during the shift. Being part of the life of the patient can lead to mental exhaustion as the nurses are also undergoing the troubles the patient is going through. Facilities also need to provide debriefing for nurses to evaluate what happened during events. This allows the nurse to verbally relay how they are feeling and what they need after going through such an event.Increasing the size of the staff pool can also help as a nurse would not be required to taken on unnecessary overtime because there are designated nurses who can pick up the workload. There are agencies advocating for nurses to help prevent nursing burnout. One of the organizations is the American Nurses Association (ANA). ANA is advocating for adequate nurse staffing (Nurse Staffing, 2015). They want to ensure that a nurse receives the proper support they require for the facilities they work for. Another organization advocating for nurses is the National Nurses United.This organization is demanding facilities to give nurses guaranteed ratios. This will ensure that the nurse can provide the right amount of attention per patient. This will help ensure the nurse does not try to rush or take shortcuts as this can affect the level of care provided to patients (Issues, 2017). Nursing burnout is an unknown term to the public but it is very well known in the nursing community. It is difficult to determine what nursing burnout is as every nurse has different capacities and coping mechanisms. A nurse needs to be able to admit to themselves that they are experiencing physical and emotional distress.A nurse needs to also be able to tell employers that they require adequate time of rest and relaxation to fully work in a proficient way. Ample time for rest, exercise, and proper nutrition is something every nurse requires to be able to provide the highest level of care their patient deserves.

Nursing Burnout References

Freudenberger, H. (2013). What is “nurse burnout?”. Retrieved July 14, 2017, from http://www.ananursespace.org/blogs/oret

Discussion: Certification and Licensure Plan NRNP 6675Discussion: Certification ...

Discussion: Certification and Licensure Plan NRNP 6675

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

Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice.

Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.

Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure.

The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.

To Prepare:

Review practice agreements in your state.

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

Research the following:

How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
What is the application process for certification in your state?

What is your state’s board of nursing website?

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

What is included in your state practice agreement?

How do you get a DEA license?

Does your state have a prescription monitoring program (PMP)?

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

By Day 3 of Week 1

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

Week 1: Nurse Practitioner Professional Issues

Psychiatric-mental health nurse practitioners are committed to the assessment, diagnosis, and treatment of psychiatric disorders in individuals and groups through psychotherapy and medication. Since the role of the PMHNP carries such responsibility, it is no surprise that there is a rigorous path to obtain and maintain your PMHNP certification and licensure.

PMHNPs currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the psychiatric/mental-health nurse practitioner (across the lifespan) board certification (PMHNP-BC). In many states, board certification is a necessary prerequisite to receiving an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. Malpractice insurance providers may also require board certification prior to issuing coverage to NPs.

This week, you will review your state specific PMHNP certification and licensure requirements and scope of practice, as well as prescriptive authority issues.

Learning Objectives

Students will:

Summarize nurse practitioner certification and licensure processes
Explain state-specific scope of practice for psychiatric-mental health nurse practitioners
Explain state-specific restrictions or limitations for practice
Explain nurse practitioner prescriptive authority and DEA registration processes
Learning Resources
Required Readings (click to expand/reduce)

American Association of Nurse Practitioners. (2020). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

On the map on the webpage, click on your state and review. After you complete the PMHNP Program, pass the certification exam, and get a job, you will need to revisit this website to apply for the privilege to practice as an APRN with your state Board of Nursing.

American Psychiatric Association. (2020). Telepsychiatry. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry

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

Chapter 1, What Is a Nurse Practitioner?
Chapter 2, Nurse Practitioner Scope of Practice
Chapter 3, State Regulation of the Nurse Practitioner Practice
Chapter 4, Federal Regulation of the Nurse Practitioner Profession
Chapter 5, Prescribing
Centers for Disease Control and Prevention. (2020). Using telehealth to expand access to essential health services during the COVID-19 pandemic. https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html

Centers for Medicare & Medicaid Services. (2019). National provider identifier standard (NPI). https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.

Drug Enforcement Administration Diversion Control Division. (2020). Registration. https://www.deadiversion.usdoj.gov/drugreg/index.html

This site contains information about applying for your DEA registration number. This number is required for writing prescriptions.

After completing PMHNP Program and passing the PMHNP certification exam, complete the DEA application to request prescriptive privileges. Your DEA number will be renewable every five years.
National Panel for Psychiatric Mental Health NP Competencies. (2003). Psychiatric-mental health nurse practitioner competencies. National Organization of Nurse Practitioner Faculties (NONPF). https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/imported/PMHNPcomps03.pdf

Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.

Chapter 1, Historical Perspectives: The Art and Science of Nurse Practitionering

Nurse Practitioner Core Competencies

Nurse Practitioners’ Unique Role

Chapter 13, Quality, Safety, and Prescriptive Authority

Substance Abuse and Mental Health Services Administration. (2020). Become a buprenorphine waivered practitioner. https://www.samhsa.gov/medication-assisted-treatment/buprenorphine-waiver-management/apply-for-practitioner-waiver

This site contains information about applying for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000).

After you obtain a Drug Enforcement Agency (DEA) number and completed 24-hour medication-assisted treatment (MAT) waiver training, you may apply to Substance Abuse and Mental Health Services Administration (SAMSHA) for MAT waiver to be able to prescribe Schedule III, IV, or V opioid drugs for the maintenance and detoxification treatment of opioid use disorders relapse prevention.
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

Chapter 2, The Role of the Psychiatric-Mental Health Nurse Practitioner: Regulations and Scope of Practice

Chapter 3, Theoretical Foundations of Care and Nonpharmacological Therapies

Recommended Resources

Consult these professional organization websites as needed.

American Psychiatric Nurse Association (APNA) https://www.apna.org

International Society of Psychiatric-Mental Health Nurses (ISPN) www.ispn-psych.org

National Alliance on Mental Illness (NAMI) https://www.nami.org

National Council for Behavioral Health (NCBH) www.thenationalcouncil.org

National Institute of Mental Health (NIMH) https://www.nimh.nih.gov/index.shtml

Substance Abuse and Mental Health Services Administration (SAMHSA) www.samhsa.gov

Discussion: Certification and Licensure Plan NRNP 6675 Example

I intend to practice in California after completing my nursing and receiving the necessary licensure. The California Board of registered nursing licenses and certifies nurses for practice in the state. To qualify for the licensure and certification to practice in California, one must have completed the relevant level of nursing training and passed the relevant nursing council examination.

For certification as advanced practice registered nurses (APRNs), the applicants must submit copies of their transcripts electronically and only through the nursing school, college, university, or the organization providing the transcripts. Most importantly, the applicant must first be licensed as a registered nurse (RN) in the state of California.

Applying for certification and licensure as an APRN is entirely done online through the board’s website and the board’s email (California Board of Registered Nursing, n.d.). Various documents required are stated and submitted through email. The website defines the scope of practice for various APRNs and public health nurses (Huynh & Haddad, 2021). The state of California has multiple regulations that define the nursing practice.

The California Nursing Practice Act defines these regulations as well as the bruising scope for licensed nurses in the state (California Board of Registered Nursing, 2013). The Drug Enforcement Authority (DEA) certification application is made through the United States Department of Justice. What surprised me from my research was that California is one of the few states that grant nurses full practice authority.

Physical supervision and collaboration are not required for independent practice. However, this authority is only granted to these registered APRNs who have completed at least 4600 hours of practice under physician supervision before the transition to full authority. The timeline restriction is one of the barriers that I expect to meet during practice. However, I hope it is for the best. This law was passed and will be applied into practice from 2023 (Nurse.org, n.d.). California is a state that I cherish, and can wait to practice and enjoy the full authority of practice.

References

California Board of Registered Nursing. (n.d.). Advanced practice and certification. Rn.ca.Gov. Retrieved February 27, 2022, from https://www.rn.ca.gov/applicants/ad-pract.shtml

California Board of Registered Nursing. (2013). California nursing practice act. Board of Registered Nursing. https://www.rn.ca.gov/pdfs/regulations/npr-i-15.pdf

Huynh, A. P., & Haddad, L. M. (2021). Nursing Practice Act. In StatPearls [Internet]. StatPearls Publishing.

Nurse.org. (n.d.). California grants Nurse Practitioners full practice authority by 2023. Nurse.Org. Retrieved February 27, 2022, from https://nurse.org/articles/california-nurse-practitioners-full-practice/

Discussion Details of the CAC coding systemDiscussion Details of the CAC coding ...

Discussion Details of the CAC coding system

THREE: Instructions

Develop a PowerPoint presentation for the clinic’s employees, discussing the details of the CAC coding system. Include the following in the presentation:

Requirement needs for installing the CAC system
CAC system storage capacity
How the system helps ensure data integrity
How the use, storage, and revision of data is managed within the system
Managing coding alerts and reminders in the system.
How CAC Systems Incorporated will ensure interoperability between the CAC system and the existing EHR system.
The systems development life cycle and the tasks that would be included in each phase of the life cycle for the implementation of the CAC system.

The PowerPoint slides should only contain general information as a visual for the audience. Be sure to include details of each slide within the slide’s note pane.

FOUR: Presentation of Deliverables-After completing the above deliverables to the best of your ability, you will present them to your Remote HIM Professional Mentor.

1. Set up your deliverables in a presentable fashion for display over WebEx. The deliverables should be portrayed in a professional, neat fashion, and it should easily be used as a visual reference.

2. Prepare a verbal summary of the project you have completed. It should explain the project challenge, the project purpose, and the project steps. Include a story with your presentation such as a) Cover what was difficult for you and b) how your own experiences helped you complete this project, etc. Make this presentation as if you were a reporter and your mentor is a student learning about HIM.

3. Use professional language, professional tone, be well organized – you are the leader of this presentation. Be prepared to answer questions from your Remote Mentor. You should know this scenario and the work you completed on it.

Discussion Evaluating Online ResourcesDiscussion Evaluating Online ResourcesDire ...

Discussion Evaluating Online Resources

Directions: There is so much information and misinformation on the web about health, nutrition, and fitness. When looking at resources, it is important to evaluate the credibility of a resource in order to determine the reliability of the information presented.

Review the document Evaluating Online Resources. Then do an online search using the words “diet” and/or “nutrition”. You can use www.google.com to do the search, or any other search engine of your choice. From the results of your search, choose three websites that you would like to evaluate. For each of the websites, answer the questions below and write a final recommendation on the website’s credibility.

Website #1:

1. What is the URL (http:// address) of the website? (1 pt)

2. As far as you can tell, what company or organization does the website belong to (i.e. WebMD, MSNBC, Juice Diet, Inc., US Department of Agriculture, etc). (1 pt)

3. What is the extension on the web address (i.e. org, gov, com, etc)? (1 pt)

4. Is the site promoting a specific product or just supplying information? (1 pt)

5. Briefly review the information on the website. Does the information seem inline with the information you learned in Section 4.1 on nutrition? Explain. (1 pt)

6. As far as you can tell, is the information based on scientific facts and from credible resources? (1 pt)

7. In terms of credibility, would you rate this website as “very credible”, “moderately credible”, or “probably not very credible”? Explain your reasoning. (2 pts)

Website #2:

1. What is the URL (http:// address) of the website? (1 pt)

2. As far as you can tell, what company or organization does the website belong to (i.e. WebMD, MSNBC, Juice Diet, Inc., US Department of Agriculture, etc). (1 pt)

3. What is the extension on the web address (i.e. org, gov, com, etc)? (1 pt)

4. Is the site promoting a specific product or just supplying information? (1 pt)

5. Briefly review the information on the website. Does the information seem inline with the information you learned in Section 4.1 on nutrition? Explain. (1 pt)

6. As far as you can tell, is the information based on scientific facts and from credible resources? (1 pt)

7. In terms of credibility, would you rate this website as “very credible”, “moderately credible”, or “probably not very credible”? Explain your reasoning. (2 pts)

Website #3:

1. What is the URL (http:// address) of the website? (1 pt)

2. As far as you can tell, what company or organization does the website belong to (i.e. WebMD, MSNBC, Juice Diet, Inc., US Department of Agriculture, etc). (1 pt)

3. What is the extension on the web address (i.e. org, gov, com, etc)? (1 pt)

4. Is the site promoting a specific product or just supplying information? (1 pt)

5. Briefly review the information on the website. Does the information seem inline with the information you learned in Section 4.1 on nutrition? Explain. (1 pt)

6. As far as you can tell, is the information based on scientific facts and from credible resources? (1 pt)

7. In terms of credibility, would you rate this website as “very credible”, “moderately credible”, or “probably not very credible”? Explain your reasoning. (2 pts)

Final Recommendations: Of the websites you reviewed, which sites would you deem as credible and which did you think were less than credible? (1 pt)

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Discussion Elder abuseDiscussion Elder abuseElder abuse has become a growing con ...

Discussion Elder abuse

Elder abuse has become a growing concern as the American population ages, and the elderly comprise a larger percentage.

Discuss the various forms of elder abuse and the court decisions that have helped to define elder abuse and standards of care.
Read the case study in Exercise 20–4, “Witnessing Patient Abuse,” (Guido, p. 437) of Legal and Ethical Issues in Nursing text, and then respond to the following questions:
- Did the elder abuse in the case study constitute civil or criminal abuse? State the rationale for your position.
- Ethically, how should the elder resident in the case study have been treated? What ethical principles were violated in the case?

Your initial post is to be about 150 words, referenced with at least one APA formatted reference.

Please include in the reference section:

Guido, G. (2014). Legal and Ethical Issues in Nursing. Vancouver: Pearson.

EXERCISE 20-4

Ethical Scenario 20–4 Witnessing Patient Abuse

An 83-year-old resident of a nursing home was physically in good health but had been diagnosed with Alzheimer’s disease. At times, this resident would become confused and wander toward the nursing home doors, looking for her parents and a way to exit the facility.

To prevent her from leaving the nursing home, the resident was fitted with a special bracelet that automatically locked an outer door if she came within 30 feet of the door. For fire-safety purposes, the door automatically unlocked within a 15-second time frame. Thus, staff members had a 15-second time frame to notice an elopement attempt and redirect the resident.

Early one morning, the resident was trying to get through the door, and a staff member came up behind her, slapped her on the buttocks, grabbed her by the shoulders, turned her around, and shoved her back into an interior hallway. This episode was reported to the director of nurses.

The director interviewed the other nursing staff members who were present during this incident; the director also examined the resident, noting that a red mark was on the resident’s buttocks. The director then reported the nursing staff member to the proper state agency, and the staff member was charged with criminal abuse of a nursing home resident.

Without argument, the treatment of this patient was abusive. You are one of the nurses who witnessed and later testified to this incident. Ethically, what should you have done at the time of the incident? How might you have prevented the overt abuse that the resident encountered? What are your and your peer nurses’ ethical responsibilities to ensure such an incident would not occur again?

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Discussion: Examining Nursing Specialties NURS 6003 ExampleChoice of Nursing Spe ...

Discussion: Examining Nursing Specialties NURS 6003 Example

Choice of Nursing Specialty

After considering all of the nursing specialties available in the MSN program, I decided on population-focused nurse practitioner (NP). A population-focused NP works in a variety of settings in the healthcare field, including hospitals, academia as nurse educators, and leadership as policymakers and influencers. Clinical expertise, communication skills, and advanced education and training enable NPs to perform effectively in various settings.

An NP goes beyond registered nurses (RNs) in terms of education and clinical training by earning a Master of Science in Nursing (MSN)-Family Nurse Practitioner (FNP) with a specific focus such as pediatrics, family medicine, or gerontology (Population-Focused Competencies Task Force, 2013). While NPs work in various settings and have a wide range of competencies, their primary roles in patient care revolve around disease prevention and health management.

Difficulties in Making the Choice

Discussion: Examining Nursing Specialties NURS 6003

One of the most difficult decisions to make before beginning an MSN program is the specialty. There are several nursing specialty programs from which to pick, which is a difficult undertaking. Furthermore, although one may be interested in a certain specialization, it is pretty easy to succumb to the pressure and influence of friends, family, and peers who may have conflicting perspectives about a particular nursing specialty. My greatest dilemma, I confess, was the several nursing specializations from which I had to choose one.

Also, I had friends and family who expected me to choose a specific path, only to be disappointed by my decision to pursue a different nursing specialization. The fact that a population-focused nurse practitioner specialization focuses on the whole population and allows a nurse to practice in pediatrics, gerontology, or family medicine (Population-Focused Competencies Task Force, 2013) was the motivation for my choice of the area. As a result, despite the difficulties, I ducked all other influences from family and friends and picked this specialty.

Factors that drove my Decision

This nursing specialty has always piqued my curiosity. Since my first years of practice as an RN, I have encountered a wide range of patients and have been able to address their difficulties. Regardless of the patient’s age, whether pediatric or geriatric, I have always carried out my responsibilities with rigor and the necessary skill.

Aside from my enthusiasm for the subject, I have an FNP preceptor, and the knowledge and skills I have gained from her have contributed to my interest in population-focused nursing practice. During clinical rotations, I also got to know nursing students pursuing FNP MSN programs, which piqued my interest even further. As I look forward to pursuing a population-focused nurse practitioner-FNP course, my major inspirations are my interest and the impact of prominent persons in the specialty.

Professional Organization Affiliated with the Chosen Specialty and Details of Membership

The International Family Nursing Association (IFNA) is one of the professional organizations with which FNPs are affiliated. IFNA believes in a compassionate family on health, human dignity, social justice, and respect for everyone (IFNA, 2022). The organization’s mission is to improve family health by (1) serving as a global unifying force and voice for family nursing, (2) sharing knowledge, skills, and practice to foster family nursing practice, and (3) fostering nursing leadership through education, scholarship, and research (IFNA, 2022).

To become a member, a nurse goes to the IFNA website and clicks on the membership icon to select the membership level that best fits them. Level 1A, the Sustaining Active Member, for example, requires a $225.00 prescription that is valid for one year and has no automatically repeating payments (IFNA, 2022). However, one must have the requirements, including academic credentials before applying for membership.

Discussion: Examining Nursing Specialties NURS 6003 References

IFNA. (2022, September 25). Association information. International Family Nursing Association. https://internationalfamilynursing.org/association-information/mission/

Population-Focused Competencies Task Force. (2013). Population-focused nurse practitioner competencies. Ymaws.com. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/Competencies/CompilationPopFocusComps2013.pdf

Discussion: Examining Nursing Specialties NURS 6003 Instructions

You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.

Often decisions are not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choice.

To Prepare:

Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization.

By Day 3

Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

Support main post with 3 of more current, credible sources and cite source within content of posting and on a reference list in proper APA.

By Day 6

Be sure to offer support from at least 2 current, credible sources in each required response to classmates’ main post and cite per APA.

Respond to at least two of your colleagues on two different days, by sharing your thoughts on their specialty, supporting their choice or offering suggestions if they have yet to choose.

Assignment: Academic Success and Professional Development Plan Part 4: 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 thought a great deal about 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 specialties. 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 1–4.

Note: For students in Nursing Education, Executive Nursing, Nursing Informatics, or Public Health Nursing, this Assignment is the first Portfolio Assignment in your program. You will have one Portfolio Assignment in each of your courses. You will need to save these Assignments for inclusion in your portfolio that you will submit in your Capstone course.

To Prepare:

Review the scope and standards of practice or competencies related to your chosen specialty in the resources for this module.
Review the MSN specializations offered at Walden by viewing the module resource, Walden University. (n.d.). Master of Science in Nursing (MSN).
Examine professional organizations related to the specialization you have chosen and identify at least one to focus on for this Assignment.
Reflect on the thoughts you shared in the Discussion forum regarding your choice of a specialty, any challenges you have encountered in making this choice, and any feedback you have received from colleagues in the Discussion.

The Assignment:

Complete the following items and incorporate them into the final version of your Academic Success and Professional Development Plan.

With the resources specific to the MSN specialization and the, Walden University. (n.d.). Master of Science in Nursing (MSN), shared in this module, write a paragraph or make a Nursing Specialty Comparison table, comparing at least two nursing specialties that include your selected specialization and second-preferred specialization.
Write a 2- to 3-paragraph justification statement identifying your reasons for choosing your MSN specialization. Incorporate feedback you received from colleagues in this Module’s Discussion forum.
Identify the professional organization related to your chosen specialization for this Assignment, and explain how you can become an active member of this organization.

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.

By Day 5 of Week 11

Submit your final draft of Parts 1-4 of your Academic Success and Professional Development Plan.

NURS 6003 Module 6 | Part 4: Finalizing the Plan Sample

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.

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.

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.

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.

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.

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.

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.

References

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. DOI: 10.1097/JXX.0000000000000327

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. https://doi.org/10.1097/01.nep.0000000000000455

Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan

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:

Review the scope and standards of practice or competencies related to your chosen specialty.
Download the Nursing Specialty Comparison Matrix.
Examine professional organizations related to the specialization you have chosen and identify at least one to focus on for this assignment.
Reflect on the thoughts you shared in the Discussion forum regarding your choice of a specialty, any challenges you have encountered in making this choice, and any feedback you have received from colleagues in the Discussion.

The Assignment:

Complete the following items and incorporate them into the final version of your Academic Success and Professional Development Plan.

Write a paragraph that provides a detailed comparison at least two nursing specialties, including your selected specialization and second-preferred specialization.
Write a clear and accurate 2- to 3-paragraph justification statement identifying your reasons for choosing your MSN specialization. Provide sufficient evidence of incorporating feedback you received from colleagues in this week’s Discussion Forum.
Clearly identify and accurately describe in detail the professional organization related to the specialization you have chosen to focus on for this assignment and explain how you can become an active member of this organization.

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.

Also Read: NURS 6053 Discussion: Workplace Environment Assessment

Discussion Filtered information and unfiltered informationDiscussion Filtered in ...

Discussion Filtered information and unfiltered information

PICOT

The PICOT guidelines are questions that help clinicians discover the answers to their research (Walden Student Center for Success, 2012). With these guidelines in mind I formulated the question “Is the daily use of CHG for all pediatric inpatients who have no allergy to CHG associated with a lower incidence of bacterial infection in these same patients?”

The P in the acronym stands for population or patients, in the case the characteristics of the population would be all patients who are staying in the hospital, especially for an extended period or those who have risk factors such as central lines.

The I stands for the intervention, which would be the daily chlorahexadine baths. This intervention would help reduce the risk of hospital acquired infections such as MRSA or c diff. Comparison is the next step and is what the C stands for.

In this case the comparison of the effectiveness of daily CHG baths would be compared to not doing CHG baths. The O stands for outcomes that we would hope to see, which would be a decrease in hospital acquired infections.

The T is the last and final letter and stands for time. In my hospital, the study was conducted over a three-month period to see if we saw a decrease in our hospital acquired infections. Using evidence based research I will find the conclusion to this question.

Evidence Based Research

When conducting research, it is very important to have filtered information and unfiltered information. “Filtered information is information that has been appraised for quality and clinical relevance (Hierarchy of Evidence Pyramid).”

Filtered information includes systematic review, critically appraised topics and critically appraised individual articles (Hierarchy of Evidence Pyramid). “Unfiltered information is evidence that has not necessarily been appraised for quality.

This information tends to come from primary sources (Hierarchy of Evidence Pyramid).” Unfiltered information includes randomized controlled trials, cohort studies, case-controlled studies and expert opinion (Hierarchy of Evidence Pyramid).

When searching the Walden Database for articles on my PICOT question, I used the search terms “CHG Bath,” “CHG Bath in Pediatric Patients,” and “Reducing infection using CHG Bath.” The first article I found multiple studies done on multiple patients with bone marrow transplants.

The purpose of the study was to see if bathing them daily with CHG would decrease the acquired infections, which it did. This article would be considered a systemic review because it had multiple resources and multiple studies.

When searching for critically appraised topics it was very difficult to find one that had a cohort study that had to do with CHG baths, there were some articles about other ways to reduce infection, but none that involved CHG.

The next article I found falls under the topic of expert opinion, in the case the expert opinion came from the nurses. In this study done in 2017, they interviewed nurses, nurse’s aides and nurse managers. They found that all interviewed did find a decrease in infection when CHG baths were used, however many times the nurses did not have time to administer the baths.

Research Advice

I think that when conducting a search for evidence base practice it is important to stay open minded and patient. Staying open minded will help you think of different search terms that may yield different search results. It is also important to be patient while searching so that you can stay focused and weed out the unwanted results.

References

Laureate Education (Producer). 2012g). Hierarchy of evidence pyramid. Baltimore, MD:Author

Musuuza, J. S., Roberts, T. J., Carayon, P., & Safdar, N. (2017). Assessing the sustainability of daily chlorhexidine bathing in the intensive care unit of a Veteran’s Hospital by examining nurses’ perspectives and experiences. BMC Infectious Diseases, 17(1)

Polit, D.F., & Beck C.T. (2017). Nursing research: Generating and assessing evidence for

nursing practice (10Th ed.). Philadelphia, PA: Wolters Kluwer

Robeson, P., Dobbins, M., DeCorby,K., &Tirillis, D. (2010). Facilitating access to pre-processed research evidence in public health. BMC Public Health,10,95.

Rosselet, R., Termuhlen, A., Skeens, M., Garee, A., Laudick, M., & Ryan-Wenger, N. (2009). CH

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Assignment: Academic Success and Professional Development Plan Part 4: Finalizing the Plan

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