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NURS 6053 Leadership Theories in Practice Discussion

Healthcare organizations, just like any other, rely on leadership for their day-to-day running and success. Nurses need to have effective leadership skills when working in any environment so that they can influence the flow of activities to attain certain goals. Leaders exist at all levels of an organization both in formal and informal terms. The importance of leadership led to the development of several leadership theories based on traits of leaders, behavior or styles approaches to leadership, and contingency theories. Despite there being elaborate literature that describes these theories, real-world observation and experiences indicate that most of them are not always so easily found in practice. 

The behavioral or style approaches to leadership include authoritarian, democratic, person-oriented, and task-orientated styles of leadership. All these styles have their unique advantages and disadvantages. However, nurses often apply them selectively depending on different circumstances (Broome & Marshall, 2021). Whilst there exists a big difference between authoritarian and democratic leadership styles, snippets of each can be applied by nursing leaders to achieve personal or organizational goals. Person-oriented leaders are more inclined towards building good rapport and interpersonal relationships as well as showing support for subordinates, while task-orientated leaders are inclined towards role assignment and planning to ensure task completion and goal attainment.

The trait approach in evaluating leadership is the most practical theoretical understanding not only in nursing but also in other disciplines. One of the most widely accepted descriptions of personality is the Big Five Personality Traits Model that rates an individual according to openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Research indicates that some of these traits determine leadership emergence. Thus, several traits that cut across personality characteristics and psychological attributes, can be used to distinguish leaders from non-leaders. Among the listed good attributes that tend to increase effective leadership amongst nurses include high emotional intelligence and transformational leadership behaviors, self-esteem, and integrity (Prezerakos, 2018). Since the workplace dynamic often presents with changing circumstances, it is important to identify the conditions under which different traits affect a leader’s performance, as well as whether a person emerges as a leader.

The sources I selected for review had clear explanations with regards to leadership goals, key of which is the attainment of desired goals and outcomes. Emotional intelligence is essential for effective leadership since it involves understanding and communicating with people from diverse backgrounds in many different circumstances, and not overbearing on work results (Prezerakos (2018). Further, according to Duggan et al., (2015), good leadership entails having those at the helm being able to apply participatory decision-making and non-hierarchical collaboration, effective communication missions and visions and being supportive of quality improvements. Duggan et al. (2015) also mention that effective leaders have sufficient skills and experience to enable them to prioritize workforce development and influence other workers. Asamani, Naab, and Ofei (2016) established that while most nurse leaders use different leadership styles depending on circumstances, the majority prefer the supportive leadership style. 

Based on the above discussion, effective leaders are those that not only help in the attainment of organizational goals but also relate well with colleagues. In practice, there is never a clear-cut distinction as to which styles of leadership most nurses apply. Nurses who understand when or where to apply each of these leadership styles tend to perform better in terms of maintaining a cohesive working environment, improving nursing staff retention, and increasing the delivery of safe and effective care to patients. In my experience, I find nurses who have internal motivation, good social skills, and high emotional intelligence to have an easy time as managers in most hospital settings.

References

• Asamani, J. A., Naab, F., & Ofei, A. M. A. (2016). Leadership styles in nursing management: implications for staff outcomes. Journal of Health Sciences, 6(1), 23-36.
• Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd Ed.). New York, NY: Springer.
• Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1), 1-9. DOI: 10.1186/s12913-015-0891-3.
• Prezerakos, P. E. (2018). Nurse managers’ emotional intelligence and effective leadership: A review of the current evidence. The Open Nursing Journal, 12, 86-92. https://dx.doi.org/10.2174%2F1874434601812010086

Leading Interprofessional Teams Discussion NR703

Leading Interprofessional Teams Discussion NR703

NR703 Week 3 Leading Interprofessional Teams Discussion

Purpose

The purpose of this discussion is to explore your interprofessional collaboration skills to sustain a practice change project, manage conflict, and apply a professional practice model effectively.

Instructions

DNP-prepared nurses typically lead and manage interprofessional teams, departments, divisions, and healthcare organizations. Refer to the interactive exercise from this week’s lesson and respond to the following:

1. Determine what strategy you can envision using as a DNP-prepared nurse to sustain project improvements through intra- and interprofessional collaboration.
2. Using the Thomas-Kilmann Conflict Mode model, describe your typical reactionary style of conflict management and what you need to develop to deal with conflict in a collaborating mode, as guided by one of the interprofessional collaboration models.
3. Propose how a professional practice model might overcome barriers to leading a practice change project in an interprofessional environment.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

• Link (webpage): DNP Discussion GuidelinesLinks to an external site.

Program Competencies

This discussion enables the student to meet the following program competences:

2. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
3. Appraises current information systems and technologies to improve health care. (POs 6, 7)
4. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Also Read:

NR703 Week 4 Leading Through Ethical Relationships Discussion

Course Outcomes

This discussion enables the student to meet the following course outcomes:

1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)

Due Dates

• Initial?Post: By 11:59 p.m. MT on Wednesday
• Follow-Up Posts: By 11:59 p.m. MT on Sunday

Sample Leading Interprofessional Teams Discussion NR703 Week 3 Discussion

Hello Dr. D and class, 

Determine what strategy you can envision using as a DNP-prepared nurse to sustain project improvements through intra- and interprofessional collaboration. 

Once a practice change project has been implemented, sustainability will be the focus of the project.  Intra- and interprofessional collaboration from the planning stages through implementation will help to sustain the project.  I am fortunate that as a palliative nurse practitioner I am part of an intra-disciplinary team and thus am used to working collaboratively with multiple disciplines.  

We are all on the same medical team, but we are in different disciplines – nurses, nurse practitioners, physicians, chaplains and social workers. I have learned a lot working in this style of team and I believe it will help me with my project implementation.

I know that my ability to understand and respect the roles of others and to recognize them as the experts in their role will be reflected in the success of the practice change project. Clear and consistent communication with the team will also be necessary and I plan to ask my team the best way for them to receive communications and to adapt to the responses. Continuing to build relationships through trust and collaboration.  

Using the Thomas-Kilmann Conflict Mode model, describe your typical reactionary style of conflict management and what you need to develop to deal with conflict in a collaborating mode, as guided by one of the interprofessional collaboration models. 

Relationships will be integral to implementing a practice change project, and so will be awareness of the conflict that is inevitable with relationships. My response to potential conflict can affect the successful outcome of the project. Steen & Shinkai (2020) discuss an example of conflict in the healthcare workplace and how understanding the Thomas-Kilmann Conflict Model is useful to conflict resolution.

The Thomas-Kilmann Conflict Model recognizes five unique responses to conflict that emphasize agenda or relationship or a combination of both (avoiding, competing, compromising, accommodating, collaborating).  People can have any of these responses in different situations but tend to gravitate towards one they are most comfortable with.  Steen & Shinkai (2020) allow that some of the responses are more effective with different types of conflict, so none are inherently “good” or “bad”. 

Since any of these five responses can be appropriate for different situations, Steen & Shinkai (2020) advocate that recognizing and mastering all these styles is important for effective leadership.  Most of the time my own reaction to conflict is collaboration — a method to protect my relationships as they are very important to me. Collaboration comes naturally to me as my palliative medicine team by its nature is highly collaborative both within the team and with the rest of the patient care teams.

If there is conflict that I fear will hurt relationships and there is no other way around it, I tend to sacrifice my own wishes (accommodation) to make others happy. As Steen & Shinkai (2020) discussed, I can remember specific instances when I have had each of these reactions including more assertive means for conflict resolution as the situation required swift and decisive action in order to protect a patient (competing). 

In general, my response to conflict should always ensure that I’m taking into account everyone else’s opinion and also valuing it. I like to address conflict quickly as it makes me uncomfortable, and likely if I’m more patient, the most appropriate conflict reaction would become apparent.  

Propose how a professional practice model might overcome barriers to leading a practice change project in an interprofessional environment. 

Potential barriers to implementation of a practice change project are considered in the planning stages of the project, although some barriers that weren’t anticipated are likely to arise during the process.  Using a practice professional model can help overcome barriers that are encountered.

I work for Northwestern Medicine at one of their Magnet hospitals and the nursing model that we use is called the “Northwestern Medicine Interprofessional Relationship Based Care Model”. This professional practice model is pictured below and intertwines interprofessional collaboration among interdisciplinary teams with safety, quality and innovation/research while also encompassing the healthcare systems values which are based on the motto “patient first”. 

(Northwestern Medicine, 2023).  

I will use this practice model in implementing my project as it can help overcome barriers as it stresses the importance of interprofessional collaboration in order to improve patient outcomes and safety. I work in a Magnet hospital (one of the first in Illinois) and was one of the writers of our first Magnet re-designation documents (when the entire submission was paper and had to measure “x” height), and therefore I am comfortable and confident in using the Northwestern Medicine practice professional model. Working in a research-based facility with a highly collaborative culture will also help me overcome barriers.  

References 

Northwestern Medicine (2023). Delnor Hospital professional practice model. https://www.nm.org/for-medical-professionals/for-nurses/nursing-at-delnor-hospital/delnor-professional-practice-modelLinks to an external site.  

Steen, A. & Shinkai, K. (2020). Understanding individual and gender differences in conflict resolution: A critical leadership skill. International Journal of Women’s Dermatology, 6(1), 50–53. https://doi.org/10.1016/j.ijwd.2019.06.002Links to an external site. 

NR703 Week 3: Leading Interprofessional Teams Student Lesson Plan

Overview

Program Competencies

2. Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
3. Appraises current information systems and technologies to improve health care. (POs 6, 7)
4. Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

1. Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO 6)
2. Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PCs 2, 4; PO 6)
4. Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)

Weekly Objectives

1. Characterize nursing professional practice models. (PCs 2, 4; PO 6; COs 1, 2)
2. Create an approach to lead sustainable improvements. (PCs 2, 4; PO 6; CO 2)
3. Appraise principles of interprofessional collaboration in advanced nursing practice. (PCs 2, 4, 6; POs 6, 8; COs 2, 3, 4)
4. Explore conflict management in an interprofessional environment. (PC 6; PO 8; CO 4)

Main Concepts

1. Interprofessional collaboration models (PC 6; PO 8; CO 4)
2. Professional practice models (PC 6; PO 8; CO 4)
3. Leading sustainable improvements (PCs 2, 4; PO 6; COs 2, 3)
4. Conflict management & leadership style (PCs 2, 4; PO 6; CO 1)

Schedule

Foundations for Learning

Start your learning this week by reviewing the following:

Interprofessional Education Collaborative. (2011). The core competencies for interprofessional collaborative practice.Links to an external site. https://ipec.memberclicks.net/assets/2011-Original.pdf

Interprofessional Education Collaborative. (2016). The core competencies for interprofessional collaborative practice: 2016 update.Links to an external site. https://ipec.memberclicks.net/assets/2016-Update.pdf (Original work published 2011)

World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice.Links to an external site. https://www.who.int/publications/i/item/framework-for-action-on-interprofessional-education-collaborative-practice

Student Learning Resources

Click on the following tabs to view the resources for this week.

Required Textbooks

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

• Read Chapter 4
  • Section: Understanding Professional Practice Models
  • Section: Basic Elements of a Professional Practice Model
  • Section: Building the Case for Innovative Practice Models
  • Section: Care Delivery Practice Model Influencers
  • Section: Cultural Competency of Healthcare Professionals: Leading Through Diversity
• Read Chapter 7
  • Section: Shared Leadership and Managing Team Conflict
  • Section: Leaders Strive for Consensus

Dang, D., & Dearholt, S. (2018). Johns Hopkins Nursing Evidence-Based Practice: Model and guidelines. Sigma Theta Tau International.

• Read Chapter 9
  • Section: Interprofessional Collaboration
  • Section: Sustaining the Change
  • Section: Setting Expectations for EBP

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.

• Read Chapter 15
  • Section: Interprofessional Collaboration and Teamwork for Translation

Zaccagnini, M., & Pechacek. (2021). The Doctor of Nursing Practice essentials: A new model for advanced practice (4th ed.). Jones & Bartlett Learning.

• Read Chapter 6
  • Section: Interprofessional Collaboration
  • Section: Barriers to and Drivers of Effective Collaboration in Interprofessional Healthcare Teams

Required Articles

Scan the following articles on Professional Practice Models:

Al-Ruzzieh, M. A., & Ayaad, O. (2020). Nursing professional practice model development, implementation, and evaluation at an international specialized cancer center.Links to an external site. JONA, 50(11), 562-564. https://doi.org/10.1097/NNA.0000000000000937

Miles, K. S., & Vallish, R. (2010). Creating a personalized professional practice framework for nursing.Links to an external site. Nursing Economic$, 28(3), 171-189.

• Please review the figure on page 172 of this seminal article.

Olender, L., Capitulo, K., & Nelson, J. (2020). The impact of interprofessional shared governance and a caring professional practice model on staff?s self-report of caring, workplace engagement, and workplace empowerment over time.Links to an external site. JONA: The Journal of Nursing Administration, 50(1), 52-58. https://doi.org/10.1097/NNA.0000000000000839

Review the following images/drawings of nursing professional practice models and consider how you would create a similar one:

Keleekai-Brapoh, N., & Toresco, D. (2020). Anchoring a professional practice model: Success through collaboration.Links to an external site. Nurse Leader, 18(6), 552-556. https://doi.org/10.1016/j.mnl.2020.08.007

Additional Resources

Review the following additional resources for further exploration of the weekly topics/concepts:

The Myers-Briggs Company. (2019, July 31). Four tips for managing conflict [Video]. YouTube. https://www.youtube.com/watch?v=hsBOVhj9hYc

Silverstein, W., Kowalski, M. O. (2017). Adapting a professional practice model: Follow these steps to ensure nurse engagement and interprofessional collaboration.Links to an external site. American Nurse Today, 12(9). https://www.americannursetoday.com/adapting-professional-practice-model/

Learning Success Strategies

• As you review many familiar concepts in this week’s lesson and readings, reflect on their applications for you in your current and prospective practice settings.
• Look ahead to the Week 5 assignment. Begin an outline using the assignment guidelines, and start collecting ideas and evidence now.
• Develop your ideas and thoughts through the interactive discussion (Review the discussion guidelines and rubric to optimize your performance).
• You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
• Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

• Link (video): Looking at FeedbackLinks to an external site.(2:26)

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

• Link (video): Word: Track Changes and Comments(4:19)

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Week 3 Lesson Leading Interprofessional Teams

Interprofessional Collaboration Models

The American Association of Colleges of Nursing’s (AACN, 2021) revision of The Essentials: Core Competencies for Professional Nursing Education emphasizes the importance of interprofessional partnerships and intentional collaboration across professions. At the advanced nursing education level, specific competencies are being reframed to guide nursing leaders and DNP-prepared nurses. These competencies address several areas to facilitate person-centered care by professional teams. In this draft (AACN, 2021), there are four primary competency categories:

• Communicatein a manner that facilitates a partnership approach to quality care delivery.
• Perform effectivelyin different team roles, using principles and values of team dynamics.
• Use knowledgeof nursing and other professions to address healthcare needs.
• Work with other professions to maintain a climate of mutual learning, respect, and shared values. (pp. 43-45)

Interestingly, the core competencies of Interprofessional Education Collaborative, itself a collaboration of leaders from many different healthcare education professions, developed a similar set of competencies (IPEC, 2011/2016, p. 10).

Click on the segments in the following interactive form more information on the competencies.

IPEC Domains Interactive Transcript

An exciting study of Swiss medical and nursing interprofessional collaboration found that role clarification in interprofessional teams is crucial since leadership can change depending upon the function of the team (Josi et al., 2020). It corroborated other interprofessional collaboration models in emphasizing six domains of interprofessional care:

1. Patient-centered care
2. Interprofessional communication
3. Role clarification
4. Team functioning
5. Collaborative leadership
6. Interprofessional conflict resolution

Escape From the Isolated Silo!

Now that you have been introduced to leading thought trends of interprofessional collaboration, navigate your way from the nursing silo in which you are trapped into the fresh air of interprofessional collaborative practice.

Silo Interactive Transcript

Nursing Professional Practice Model

The American Nurses Credentialing Center (ANCC, 2020) historically has led the way in the development of nursing professional practice models. Most are based on, or modeled after, the ANCC’s own five components of magnet (excellent) healthcare organizations within which are embedded the 14 forces of magnetism (excellence). Notice that, while not one of the five components, the global issues in nursing and healthcare represent the global challenges faced by both. This is known as the Global Burden of Disease.

Click on each of the ANCC components to compare to the Forces of Magnetism.

Five Components Interactive Transcript

The magnet model stimulates individual organizations to create their own professional practice model tailored to their cultures, values, philosophies, quality methods, research methodologies, nursing theories, management styles, and communities.

Nursing professional practice models are usually displayed graphically throughout the organization in all units to remind teams that they are all professionally performing within the same operational methods and framework. In some organizations, the model is adopted by the entire organization (not just the nursing service) to align the efforts of all.

Three explanations or examples of organizations that have implemented a professional practice model and can inform your professional understanding and leadership practice are Al-Ruzzieh and Ayaad (2020), Silverstein and Kowalski (2017), and Miles and Vallish (2010).

• Link (library article): Nursing Professional Practice Model: Development, Implementation, and Evaluation at an International Specialized Cancer CenterLinks to an external site.
• Link (webpage): Adapting a Professional Practice ModelLinks to an external site.
• Link (library article): Creating a Personalized Professional Practice Framework for NursingLinks to an external site.

Conflict Management and Leadership Style

Conflict is recognized as a part of life, so conflict management is an essential tool for leaders to acquire. Conflict resolution involves problem-solving and decision-making. Regrettably, many organizations fail to recognize the value of preparing their leaders in conflict resolution because the costs are significant. Whether it is our profession, a specific institution, an individual, or a group, adverse outcomes from unresolved conflicts are multiplicative.

Before conflict escalates to unresolved anger, depression, and organizational costs such as litigation, it is best to approach conflict from a preventive standpoint. Just as health promotion leads to high-quality and cost-effective outcomes for healthy individuals, conflict prevention can lead to high-quality and cost-effective outcomes for healthy organizations.

Although early conflict management focused on conflict avoidance, such a course is unhealthy at best. One of the most significant conflict examination models and research tools since the 1970’s is the Thomas-Kilmann Conflict Mode Instrument (Thomas & Kilmann, 2007). The model describes five styles of interacting with others and approaching conflict.

The most productive style for interprofessional collaboration is the collaborating mode. Study these five modes and identify your preferred mode of interaction. Next, identify what leadership strengths you may need to develop to reach the collaborative mode. If you reflect deeply enough, you will discover that your default mode aligns highly with your current leadership style. Any surprises?

Thomas-Kilmann Conflict Modes Interactive

Leading Sustainable Improvements

Sustaining change in the healthcare environment can be a challenge, even after the successful implementation of an evidence-based intervention. This is often the case with practice change projects. Even when an organization’s stakeholders are invested in a practice change project, and the DNP student completes the relatively short intervention, the team reverts to its previous behaviors and practices. Sometimes these old practices recur even during the project itself.

For example, a manager may implement walking rounds based on the most recent best evidence, find that they are being implemented by the team, but discover later that they only occur when the manager is in the building and nearby. Such unsustainable improvements are common.

However, there are steps that both the nurse leader and the DNP student can take to improve sustainability. One foundational measure, over which the DNP student may not have control, is creating a supportive organizational culture. Organizations with a robust professional practice model or widely accepted magnet model have a built-in framework to support evidence-based interventions. But what steps might you take as a DNP student to improve the chances of sustainability?

Transactional styles of management should be replaced by transformational leadership using tips like these to sustain change:

• Use a science translation framework or QI model such as one of these:
  • Rogers’s diffusion of innovation
  • Knowledge-to-action
  • Promoting action on research implementation in health services
• Create a project culture
• Create a vision and the need for change
• Enlist the leadership team in supporting the change
• Seek early buy-in
• Use emotional intelligence skills to build relationships
• Lead from an Ethic of Care
• Enlist champions
• Expect barriers and be flexible to modifications
• Communicate clearly, transparently, and frequently
• Monitor the improved process through measurement
• Model the change
• Hold team members accountable

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Week 3 References

Al-Ruzzieh, M. A., & Ayaad, O. (2020). Nursing professional practice model development, implementation, and evaluation at an international specialized cancer center. JONA, 50(11), 562-564. https://doi.org/10.1097/NNA.0000000000000937 

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf

American Nurses Credentialing Center. (2020). Magnet model—Creating a magnet culture. https://www.nursingworld.org/organizational-programs/magnet/magnet-model/

Interprofessional Education Collaborative. (2020). What is Interprofessional Education (IPE)? https://www.ipecollaborative.org/about-ipec.html

Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update.  https://nebula.wsimg.com/2f68a39520b03336b41038c370497473?AccessKeyId=DC06780E69ED19E2B3A5&disposition=0&alloworigin=1

Josi, R., Bianchi, M., & Brandt, S. K. (2020). Advanced practice nurses in primary care in Switzerland: An analysis of interprofessional collaboration. BMC Nursing, 19(1), 1-12. https://doi.org/10.1186/s12912-019-0393-4

Miles, K. S., & Vallish, R. (2010). Creating a personalized professional practice framework for nursing. Nursing Economic$, 28(3), 171-189.

Silverstein, W., & Kowalski, M. O. (2017). Adapting a professional practice model: Follow these steps to ensure nurse engagement and interprofessional collaboration. American Nurse Today, 12(9). https://www.americannursetoday.com/adapting-professional-practice-model/

Thomas, K. W., & Kilmann, R. H. (2007). Thomas-Kilmann conflict mode Instrument: Profile and interpretive report. Xicom, Inc. http://www.lig360.com/assessments/tki/smp248248.pdf

Legal and Ethical Issues Related to Psychiatric Emergencies NRNP 6675

Legal and Ethical Issues Related to Psychiatric Emergencies NRNP 6675

Legal and Ethical Issues Related To Psychiatric Emergencies Sample Paper

California State Laws For Involuntary Psychiatric Hold

In California, individuals can be helped in psychiatric facilities without consent if it is determined that one is a danger to others, themselves, or gravely disabled. Under California law, only designated professional personnel can place individuals on a 72-hour hold, known as a 5150 hold (Zakhari, 2021). The experienced personnel includes police officers, members of the mobile crisis team, and other mental health professionals authorized by the country.

There must be paperwork stating the circumstances under which the person’s condition was called to the officers’ attention and the probable cause for believing the individual is a danger to themselves or others (Sadock et al., 2015). After 72 hours, individuals may be released. They may sign in as voluntary patients and can be put under the 14 days 5250 involuntary hold.

Differences Among Emergency Hospitalization For Psychiatric Hold, Inpatient Commitment, And Outpatient Commitment

In inpatient commitment, people are committed to mental illness and being a danger to themselves and others. These need to be presented to the magistrate in the community in the form of a petition (U.S. Department of Veterans Affairs, 2019). It includes information from someone who has direct knowledge of the issue. Outpatient commitment is a civil commitment in which the court orders individuals to comply with specific outpatient treatment programs (Sadock et al., 2015). The legal authority for the outpatient commitment is the state parens patriae power, which protects disabled individuals, and police power, which involves protecting others (Buppert, 2021).

Differences between Capacity and Competency

Competence is the global assessment and legal determination of mental health status made by a judge in court (Zakhari, 2021). Capacity is determined by physicians familiar with the patient’s case based on the functional assessment and clinical determination.

Patient Autonomy in Psychiatric Emergencies

Informed consent is the process where clinicians honor the patient’s autonomy. Consequently, patients understand the benefits and risks of treatment and therefore accept or refuse the treatment (U.S. Department of Veterans Affairs, 2019). The patient’s decision-making capacity should be assessed for communication, understanding, appreciation, and reasoning unless compelling additional concerns, and the patient’s confidentiality should be maintained (Thapar et al., 2015). In psychiatric emergencies, the physicians have the power to act as state agents.

Evidence-Based Suicide Risk Assessment and Violence Risk Assessment

The patient health questionnaire (PHQ-9) is the most commonly used screening tool for depression. It also covers suicidal ideation. Therefore, it is used to assess suicidal risk among patients in the clinical setting (Blakey et al., 2019). Item nine of the assessment tool evaluates the passive thoughts of death and self-injury in the last two weeks. The Broset violence checklist (BVC) is a short-term violence prediction instrument that assesses irritability, confusion, verbal threats, boisterousness, attacks on objects, and physical threats which are either absent or present.

The BVC is an effective tool for predicting inpatient violence in the coming 24 hours. The instrument’s psychometric characteristics are excellent (Blakey et al., 2019). The results of ongoing research will provide critical information on cultural differences, the BVC’s validity in understaffed wards, clinical usage of the checklist, and its capacity to predict violence throughout the hospital stay.

References

Blakey, S. M., Wagner, H. R., Naylor, J., Brancu, M., Lane, I., Sallee, M., & Elbogen, E. B. (2019). Chronic pain, TBI, and PTSD in military veterans: a link to suicidal ideation and violent impulses? The Journal of Pain, 19(7), 797-806.

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

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

U.S. Department of Veterans Affairs. (2019). VA/DoD clinical practice guidelines: Assessment and management of patients at risk for suicide (2019). Accessed 4th April 2022 from https://www.healthquality.va.gov/guidelines/MH/srb/

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

The Assignment Instructions

In 2-3 pages, address the following:

Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.

Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state (California).

Explain the difference between capacity and competency in mental health contexts.

Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.

Identify one evidence-based suicide risk assessment that you could use to screen patients.

Identify one evidence-based violence risk assessment that you could use to screen patients.

The diagnosis of psychiatric emergencies can include a wide range of problems from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical mental health divide in healthcare.

In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.

To Prepare

Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.

Learning Resources

Required Readings (click to expand/reduce)

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

Chapter 7, Negligence and Malpractice
Chapter 8, Risk Management
Chapter 16, Resolving Ethical Dilemmas
National Institute for Health and Care Excellence (2019). Brøset violence checklist. http://riskassessment.no/

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)

Chapter 23, Emergency Psychiatric Medicine
Chapter 36.2, Ethics in Psychiatry
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

Chapter 19, Legal Issues in the Care and Treatment of Children With Mental Health Problems

Chapter 64, Suicidal Behavior and Self-Harm

U.S. Department of Veterans Affairs. (2019). VA/DoD clinical practice guidelines: Assessment and management of patients at risk for suicide (2019).  https://www.healthquality.va.gov/guidelines/MH/srb/

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

Chapter 15, Violence and Abuse

Legal Aspects of US Health Care System Admin

Legal Aspects of US Health Care System Admin

Prevailing wisdom reinforces that working in the U.S. healthcare administration in the 21st Century requires knowledge of the various aspects of health laws as they apply to deal with medical professionals. Further, because U.S. healthcare administrators have to potentially interact with many levels of professionals beyond the medical profession, it is prudent that they are aware of any federal, state, and local laws that may apply to their organizations.

Thus, their conduct is also subject to the letter of the law. They must evaluate the quality of their professional interactions and be mindful of the implications and ramifications of their decisions.

You are employed as a top health administrator at the hypothetical Well Care Hospital in Happy Town. When you were hired, your pre-employment screening involved background checks into any violation of hospital medical misconduct during the last five (5) years.

The results showed that you stood well with the hospital administration community. During the past year, you had to undergo training in personnel conduct and inter-employee conduct with medical staff, nurses, technologists, etc. During the past six (6) months, the hospital has been under scrutiny for breach of medical compliance.

Note: You may create and/or make all necessary assumptions to complete this assignment.

Write a 4-page paper in which you:

1. Articulate your position as the top administrator concerned about the importance of professional conduct within the health care setting. Justify your position.

2. Ascertain the major ramifications of having professional staff compromise the boundaries of ethics and medical conduct.

3. Analyze the four (4) elements required of a plaintiff to prove medical negligence.

4. Discuss the overarching duties of the health care governing board in mitigating the effects of medical non-compliance as they apply to the rules of practice set forth in the Well Care Hospital governing board’s manifesto.

5. Use at least five (5) quality academic resources in this assignment. Note: Wikipedia and other Websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

• Be typed, double-spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
• Include a cover page containing the assignment title, the student’s name, the professor’s name, the course title, and the date. The required assignment page length is not included in the cover page and the reference page.
• Follow the rubric for the grading scale.

The specific course learning outcomes associated with this assignment are:

• Describe the sources of law in America, the relative legal procedure, and the related court system.
• Examine the various applications of the law within the health care system.
• Use technology and information resources to research health care policy, law, and ethics issues.

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Level 2 Emergency Department Radiographs

Level 2 Emergency Department Radiographs

Sister Mary is a patient in Level 2 Emergency Department. She must have a neural examination, physical assessment, radiographs of her facial bones, and a computed tomography scan of the head. Taking into consideration that she is a Roman Catholic nun, what would be the ideal course of patient education as this woman progresses from department to department?

What possible reservations could a health care professional have in working with Sister Mary? (Discuss the psychosocial responses the professional might have.)

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort, and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized.

Read over your paper – in silence and then aloud – before handing it in, and make corrections as necessary. Often, having a friend proofread your paper for obvious errors is advantageous. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12-point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. Letting your essay run over the recommended number of pages is better than compressing it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted and double-spaced with a one-inch margin on each page’s top, bottom, and sides. When submitting a hard copy, use white paper and print it out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words.

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two-sentence responses, simple statements of agreement or “good post,” and off-topic responses will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ are graded separately and do not count toward participation.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days for three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything due during the week.

APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the resources tab in LoudCloud, for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage the overutilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly.

As Master’s level students, you must be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding or critical analysis of the content.

It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report, and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper more of someone else’s thoughts than yours?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud, for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

Per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask questions or send messages. This will be checked at least once every 24 hours.

Level 2 Emergency Department RadiographsLevel 2 Emergency Department Radiographs

Limited Healthcare Access-Annotated Bibliography Sample

Health outcomes in developing countries relies on adequate access to and utilization of the available services. That access and positive health-seeking behavior are amongst other reasons, dependent on the public being adequately informed. The knowledge of healthcare services, availability of professionals, insurance services and basic appreciation of specific disease processes requiring caregiver intervention are critical to ensuring patients end up at the hospital for proper management (Hamiduzzaman et al., 2017).

Additionally, it is essential for crafting equitable healthcare resource allocation. Ngugi et al. (2017) effectively explore that prospect and its implications in healthcare services in rural Kenya, through assessing the prevalence of and determining the factors affecting the utilization of healthcare services. That is especially important as the country’s healthcare reels from an underutilized universal healthcare coverage (UHC), despite the healthcare frontier being devolved to the counties for ease and closeness of service provision.

Ngugi et al. performed a cross-sectional survey in the coastal area of Kenya using the WHO cluster sample design and execute multiple analyses that fed to the parameters assessed. Their findings reveal that up to 23.3% of household members do not seek healthcare services when ill, for various reasons which include self-medication with OTC drugs in 42.8% of them, unaffordability of services to 20% of them and the health facility being too distant to 8.1% of them (Ngugi et al., 2017). Most of the facilities visited were public health facilities nearest to the people’s homes, and comprised of level 2 facilities (dispensaries).

That underscored the role of primary health care in ensuring healthcare access across board. Importantly, it is fronted that poverty impacted the access to healthcare, as people shunned hospital related costs of drugs, transport and overall care for OTC medication, especially where the illness was thought not to be severe (Ngugi et al., 2017). Thus the need for healthcare subsidization and education on public insurance schemes. Whilst family dynamics and power structure came out as an influence in healthcare access, sociocultural issues were not canvassed in this particular study.

In the USA, disparities in healthcare access are as rife, especially among the vulnerable populace and rural communities. That persists despite the rapid evolution of healthcare, and is attributable, largely, to socioeconomic reasons. Therefore, the growing calls to modify care provision to cater for every citizen are only getting louder.

Some of the positives from the advocacy have been the enactment of the Affordable Care Act 2010 and the continual refinement of the Medicare and Medicaid policies to cater for affordability of care (Hamiduzzaman et al., 2017). Bhatt et al. (2018) explain the improvement of healthcare access mechanisms such as advancing care, the creation of novel model for stakeholder collaboration as well as improving commitment in healthcare access, partners, value and coordination.

Bhatt et al. underscore the tenets of the American Hospital Association, which seeks to improve quality, access, and integrated care. Healthcare access is even more vital since 25% of American have multiple chronic comorbidities which occasion the need for continuous care and increased healthcare expenditure (George et al., 2018). Consequently, they advocate for economic strategization of vulnerable communities through healthcare reforms that avail essential and specialized services at affordable value for them.

These vulnerable group comprise of an unhealthy mix of poor, uninsured, illiterate and unemployed people, who also deserve to benefit from the healthcare reform package in a simple, yet robust manner. To enhance healthcare access, Bhatt et al. (2018) proposes the ‘collecting of race, ethnicity, language preference, and other sociodemographic data and using those data to stratify quality metrics, as well as increasing cultural competency training for all clinicians and employees and increasing diversity in health care leadership and governance.’

The model is centred on strategies which include tackling the social health determinants, adopting novel virtual care modalities, and employing inpatient/outpatient transformation strategy (George et al., 2018). Overall, improving access to healthcare is thus corrected from a sociocultural, hospital, facility and federal level hence better outcomes.

Latinos constitute one of the minority groups in the USA, mostly habiting rural states and indulging in large-scale farming. Akin to other minority groups, access to healthcare, although steadily improving, has been low. Tulimiero et al. (2021) describe the reasons for this as limited hospital numbers and transport in the rural areas, language barriers with the existing caregivers, lack of insurance, financial challenges, as well as entrenched sociocultural practices that often preclude health-seeking behavior. Some of them are undocumented immigrants as well, hence have a lingering fear of deportation.

They demonstrate the role and acceptability of mobile clinic units in bridging primary care provision among the rural Latino community. That is because the clinics were accessible, convenient, and had short waiting times (Tulimiero et al., 2021). Consequently, the Latinos demonstrate structural vulnerability, which is not being receptive to the traditional healthcare models that centered on brick and motor effigies with specific clinic hours and appointment schedules. Tulimiero et al. (2021), therefore, suggest the innovation of healthcare provision strategies especially for such communities, if positive health-seeking behavior is to be encouraged.

References

• Bhatt, J., & Bathija, P. (2018). Ensuring access to quality health care in vulnerable communities. Academic medicine, 93(9), 1271. doi: 10.1097/ACM.0000000000002254
• George, S., Daniels, K., & Fioratou, E. (2018). A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania. International journal for equity in health, 17(1), 1-13. https://link.springer.com/article/10.1186/s12939-018-0753-9
• Hamiduzzaman, M., De Bellis, A., Abigail, W., & Kalaitzidis, E. (2017). The social determinants of healthcare access for rural elderly women-a systematic review of quantitative studies. The Open Public Health Journal, 10(1). https://openpublichealthjournal.com/VOLUME/10/PAGE/244/FULLTEXT/
• Ngugi, A. K., Agoi, F., Mahoney, M. R., Lakhani, A., Mang’ong’o, D., Nderitu, E., … & Macfarlane, S. (2017). Utilization of health services in a resource-limited rural area in Kenya: prevalence and associated household-level factors. PloS one, 12(2), e0172728. https://doi.org/10.1371/journal.pone.0172728
• Tulimiero, M., Garcia, M., Rodriguez, M., & Cheney, A. M. (2021). Overcoming barriers to health care access in rural Latino communities: an innovative model in the eastern Coachella Valley. The Journal of Rural Health, 37(3), 635-644.        https://doi.org/10.1111/jrh.12483

Listening Music Positively Impact Their Stress Level

Listening Music Positively Impact Their Stress Level

In Health care providers, does the use of listening music positively impact their stress level and improve the quality of care to the patient?

Evidence based practice

Topic – The Effectiveness of music on the stress for health care providers.

Listening Music Positively Impact Their Stress Level Instruction

Find the articles based on the information provided above.

https://mail.google.com/mail/u/2?ui=2&ik=fdd7216d4c&attid=0.1&permmsgid=msg-a:r-1869712535681389272&th=17045a6bdeb501e3&view=att&disp=safe&realattid=17045a6935dcf78c411

ORDER THROUGH BOUTESSAY

Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

• Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the
• Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

• I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
• As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

LopesWrite Policy

• For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
• Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
• Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
• Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

• The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
• Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
• If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
• I do not accept assignments that are two or more weeks late unless we have worked out an extension.
• As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

• Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
• Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Low Back Pain Case Study

Low Back Pain Case Study

PATIENT Kay Salisbury

DOB 03/30/1983

AGE 34 yrs

SEX Female

PRN DP278077

FACILITY

Northstar Physicians Center T (999) 999-9999 1234 Sunshine Way 100 Minneapolis, MN 99999

ENCOUNTER

NOTE TYPE SOAP Note

SEEN BY Nazir Ashaad

DATE 04/05/2017

AGE AT DOS 34 yrs

Not signed

Patient identifying details and demographics

FIRST NAME Kay MIDDLE NAME – LAST NAME Salisbury SSN –

SEX Female DATE OF BIRTH 03/30/1983 DATE OF DEATH – PRN DP278077

ETHNICITY – PREF. LANGUAGE

–

RACE White STATUS Active patient

CONTACT INFORMATION

ADDRESS LINE 1 4994 Shady Range

ADDRESS LINE 2 – CITY Ossawinamakee

Beach STATE MS ZIP CODE 39469

CONTACT BY – EMAIL – HOME PHONE (555) 555-5555 MOBILE PHONE (555) 555-5555 OFFICE PHONE – OFFICE EXTENSION

–

FAMILY INFORMATION

NEXT OF KIN – RELATION TO PATIENT – PHONE – ADDRESS –

PATIENT’S MOTHER’S MAIDEN NAME

–

PATIENT NOTES

Prefers that major diagnoses be discussed with her cardiologist Dr. Seifert

Subjective

The patient is a 34-year-old woman who presents with complaints of back pain. She describes the pain as a “dull ache in my lower back and into my right hip.” She is unable to identify any reason for the onset of pain. The pain does not radiate down legs.

The patient states that the pain has been present for 2 weeks and is progressively getting worse. No urinary or fecal incontinence Low Back Pain Case Study. Patient has not had any imaging studies.

She states that sometimes the pain is worst in the morning and other times it bothers her more during the day. OTC anti-inflammatory medication and ice have provided temporary relief.

Objective

Encounter – Office Visit Date of service: 04/05/17 Patient: Kay S… https://static.practicefusion.com/apps/ehr/?c=1385407302#/PF/…

1 of 2 4/5/17, 4:31 PM

CLICK HERE TO ORDER Low Back Pain Case Study

Patient’s blood pressure is 116/78. Patient’s HR is 80 bpm and regular. Pain is rated 5/10 while resting and 7/10 while standing and walking Low Back Pain Case Study. Lumbar spine ROM is limited to 50 degrees of flexion. All other lumbar ROM tests are WNL. Physical exam indicates bilateral lumbar muscle spasm and hypertrophy.

Low Back Pain Case Study Assessment

DDX: Lumbar strain with radiculopathy into the right hip and posterior thigh. Possible unilateral vertebral disk herniation or DJD of lumbar spine.

Lumbar strain [847.2]. Lumbar pain [724.2].

Low Back Pain Case Study Plan

Patient is encouraged to continue OTC anti-inflammatory medication b.i.d. Patient will be referred for lumbar and sacroiliac radiography. Radiographic findings will determine the need for follow-up MRI or physical therapy referral. The patient was given a handout on gentle low back stretches and was encouraged to try several gentle yoga positions at home.The patient should return to the clinic in one week.

Free cloud based EHR

Encounter – Office Visit Date of service: 04/05/17 Patient: Kay S… https://static.practicefusion.com/apps/ehr/?c=1385407302#/PF/…

2 of 2 4/5/17, 4:31 PM

Module 02 Course Project: Clinical Notes

Patient B – Virginia Thompson

If Virginia’s physician had noted any dry or scaly skin during this visit, which medical term might he have used to describe it? (Hint: Think about the word roots you studied this week.)

• Click here to enter text.

In the objective section of this SOAP note, the macules are described as “erythematous.” What color is this word referring to?

• Click here to enter text.

The lesion of concern is located in the anterolateral shoulder. How would you describe the location of this lesion in your own words?

• Click here to enter text.

In which section of this SOAP note (Subjective, Objective, Assessment, Plan) do you find a term that means “pertaining to the acromion and clavicle”?

• Click here to enter text.

What is the definition of a “macule”?

• Click here to enter text.

In this SOAP note, the terms “benign” and “malignant” are used to describe both the skin lesions. Define these terms.

• Click here to enter text.

In the plan section of this SOAP note, the doctor plans to perform a biopsy. Briefly describe this procedure.

• Click here to enter text.

Which word found in this SOAP note means “black tumor”?

Click here to enter text.

Which word found in this SOAP notes refers to a solid, elevated lesion?

• Click here to enter text.

References for Low Back Pain Case Study

You will primarily use your textbook as a reference this week. Provide a citation for your textbook (in APA format) here:

• Click here to enter text.

If you are unfamiliar with APA citation, please see the Rasmussen College APA Guide: http://guides.rasmussen.edu/apa. Select “References” on the left-hand panel and choose “Books” to learn how to properly cite your textbook for this course.

Also Read:

DNP835 All Modules Discussions

Dependent Personality Disorder (DPD)

SOCW 6111 Discussions Assessment Tools

HCA 459 Week 4 Discussion Question 2

Case 1 Discussion: Allied health program

Locating Credible Databases and Research on Chronic Bronchitis Sample

This assignment aims to help the new nurse locate valid and credible databases for research on Chronic Bronchitis. As the preceptor, it is good to teach her some effective strategies that she can use to retrieve information relevant to the scenario. Teaching her the said strategies will ensure that she has information on different health conditions she may encounter during practice. It shall also enhance her practice using evidence-based resources.

Capella Library databases provide helpful information on different health conditions, including Chronic Bronchitis, to inform evidence-based intervention. These databases shall be analyzed and presented in their order of significance in the search for evidence-based practice research articles. Locating credible Databases determines the quality of evidence used to inform the treatment of management decisions (Cook et al., 2020).

Good communication and interpersonal skills are vital in this assessment. Good communication skills will ensure that the nurse understands the instructions clearly. Verbal communication is the choice method and involves both written and spoken communication (McCorry & Mason, 2020). Communication is not complete without feedback. The new nurse must follow the instructions given and provide feedback to ensure the communication process is complete.

Interpersonal skills are helpful in the interaction between the nurse and the preceptor to ensure that no misinformation or conflict ensues (McCorry & Mason, 2020). Directing the new nurse to the facility’s database shall expose her to relevant policies, internal databases, and facility guidelines.

The most effective method of ensuring she has learned is using the teach-back method proposed by Klingbei and Gibson (2018). This method is widely used in relaying health messages to patients and their families. In this method, a student is taught on areas of interest and asked to recall the information and teach the tutor (teach back the tutor). The learner (in this case, the new nurse) is asked questions and allowed to answer questions (Klingbei & Gibson, 2018).

It ensures that the new nurse understands and knows what she is expected to deliver. To ensure patient safety, healthcare providers should evaluate clinical practices to ensure they are informed by current research evidence. That said, the databases of interest include:

1. This database provides the most accurate definitions from a collection of credible medical resources. The database has a filter that allows users to narrow the information to the subject of choice, desirable date range, length, media type, and collection. The most peculiar aspect of credo is that it provides links to related topics. The database, however, offers information about the disease before proceeding to evidence-based research. As such, it will be helpful to the nurse as she will be able to understand more about the unfamiliar diagnosis.
2. Summon

The database is widely used to search library databases. With summon, one begins with general searches and later can apply filters depending on the information needed. The main page allows one to perform advanced searches and different other features. The filters allow an individual to locate evidence-based practice papers quickly. Often, these are peer-reviewed journal articles ranked by relevance and published within the last five years. Incorporating evidence-based practice enables individuals to update their knowledge and question current practices (Schliehe, 2021). From my point of view, this database provides information from various databases and the database and is hence the resource of choice when one needs to find the latest peer-reviewed publication.

3. Cinahl Complete/EBSCO host

Cinahl operates in a way similar to Summon but leads you to advanced searches from the initial search. The database offers options for reading full texts to filter language, year of publication, peer-reviewed articles, and publication type. When these filters are applied, one can quickly get the most relevant articles. This database is second in my databases’ credibility list for peer-reviewed journal publications related to chronic bronchitis.

4. Health and Medical Collection ProQuest

This database has filters just like Cinahl Complete and Summon. This database allows individuals to narrow searches to suit their desired outcomes from the beginning. An individual can use two different thesauruses during the research, allowing one to get more resources in the database. The database’s main strength is that it offers resources with diversified languages hence useful when different languages are required in research. Evidence-based practices information should be put in forms accessible and usable by other people (Schliehe, 2021). This database would be the preferred database to search and retrieve peer-reviewed publications on the identified problem.

5. Ovid Nursing Full Text PlUS

Ovid Nursing Full Text PLUS provides a wide range of databases and multi-field research. This database provides both premium and free research articles. Fewer research journals and evidence-based research articles are available in this database. The database is limited due to the filters available. However, it allows an individual to search resources in a specified time range and offers full-text journals. Despite being user-friendly, it emerges as the least helpful database when looking for research articles related to chronic bronchitis.

Conclusion

The databases evaluated in this paper are directly linked to the Capella library’s extensive database and are related to resources on evidence-based nursing practices, a medical diagnosis, or a specific medical field. The new nurse in the scenario requires concise information to be able to make appropriate decisions. The best way is to suggest databases that would be useful for the identified medical diagnosis and other medical diagnoses she might encounter going forward. Finding credible, evidence-based research can be complex. However, with credible databases, a nurse can find vast information that informs nursing practice and improves care quality.

Locating Credible Databases and Research on Chronic Bronchitis Sample References

• Cook, B. G., Collins, L. W., Cook, S. C., & Cook, L. (2020). Evidence?based reviews: How evidence?based practices are systematically identified. Learning Disabilities Research & Practice, 35(1), 6–13. https://doi.org/10.1111/ldrp.12213
• Klingbeil, C., & Gibson, C. (2018). The teach-back project: a system-wide evidence-based practice implementation. Journal of Pediatric Nursing, 42, 81-85. https://doi.org/10.1016/j.pedn.2018.06.002
• McCorry, L. K., & Mason, J. (2020). Communication skills for the healthcare professional. Jones & Bartlett Publishers Incorporated.
• Schliehe, A. (2021). Mapping Impact: Reflections on Bridging Research and Practice. In Young Women’s Carceral Geographies: Abandonment, Trouble, and Mobility. Emerald Publishing Limited. https://doi.org/10.1108/978-1-83909-049-320211008

Madeleine Lininger – Theory of Culture Care Diversity and Universality

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For this project, you will select and critique a nursing theory of your choice.

The following are some conceptual models and theories you may choose from; however, you may choose any nurse theorist:

• Betty Neuman –
• Dorothea Orem – Self-Care Deficit Theory
• Dorothy Johnson – Behaviorial System Model
• Faye G. Abdallah – Patient-Centered Approaches Theory
• Florence Nightingale Environmental Model
• Hildegard Peplau – Interpersonal Process Theory
• Ida Jean Orlando – Nursing Process
• Imogene King –
• Jean Watson – Nursing as Caring Theory

• Margaret Newman – Health Expanding Consciousness
• Martha Rogers – Science of Unitary of Human Being
• Nola Pender
• Patricia Benner
• Rosemarie Parse
• Sister Callista Roy – Adaptation Model
• Virginia Henderson

• Topic Meaning (30 pts.)
• Origins of the Theory (30 pts.)
• Usefulness (20 pts.)
• Testability (10 pts.)
• Overall Evaluation (10 pts.)

Madeleine Lininger: Theory of Culture Care Diversity and Universality Description

1. Describe the main ideas of the theory (should include the assumptions under which the theory operates).
2. What are the main concepts?
3. What are the main relationships between the concepts?
4. How do different concepts affect each other?

• What was going on in the profession of nursing or in American society that may have influenced the theory?
• What values, theories, evidence, and/or existing knowledge did the theorist cite as support for the theory?
• What motivated the theorist to write the theory?
• What approach to theory development did the theorist use?

1. How useful is this theory in practice? Is the theory practical and helpful to nursing? Does it contribute to understanding and predicting outcomes?
2. Cite an example/case study where this theory could be used.
3. How testable is this theory? Has this theory generated research? How many and what types of studies?
4. Give one example of a study done using the theory 4. What types of statements are the propositions?
5. Is the theory comprehensive and specific? How general is the theory?
6. Summarize the strengths and weaknesses of the theory. Why would you use or not use this theory in your own advanced practice? (Begin to think about your presentation “Synthesis of Nursing Theory”).

Madeleine Lininger – Theory of Culture Care Diversity and Universality Instructions

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized.

Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

• Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

• I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
• As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

LopesWrite Policy 

• For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
• Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
• Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
• Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

• The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
• Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
• If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
• I do not accept assignments that are two or more weeks late unless we have worked out an extension.
• As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

• Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
• Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.