discussion 11/1/2023 Nur 605

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EXAMINING NURSING SPECIALTIES

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.

Decisions are often 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.


Note

: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are required to participate in the Discussion on at least three different days (a different day for main post and each response). It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner.

 

RESOURCES

· Bickford, C. J., Marion, L., & Gazaway, S. (2015). 

Nursing: Scope and standards of practice, third edition – 2015Links to an external site.
. Retrieved from http://ebooks.iospress.nl/publication/12524

· Cherry, B., Caramanica, L, Everett, L. Q., Fennimore, L., & Elaine, S. (2019).

Leveraging the power of board leadership in professional nursing organizationsLinks to an external site.
. 
JONA: The Journal of Nursing Administration, 49(11), 517-519.

· Echevarria, I. M. (2018). 

Make connections by joining a professional nursing organizationLinks to an external site.
. 
Nursing, 48(12), 35–38.  

· Truant, R., & Chan, R. J. (2017). 

Future ready: Strengthening oncology nursing leadership in the context of professional oncology nursing organizationsLinks to an external site.
. 
Canadian Oncology Nursing Journal, 27(1), 2-4.

· Walden University. (n.d.).

Master of Science in Nursing (MSN)Links to an external site.
. Retrieved November 14, 2018, from https://www.waldenu.edu/masters/master-of-science-in-nursing

·
Document:

 Academic Success and Professional Development Plan Template


 Download Academic Success and Professional Development Plan Template
(Word document)

·
Choose among the following to review your specialization’s Scope and Standards of Practice or Competencies:

·
Nursing Informatics
Ebook: Nursing Informatics: Scope and Standards of Practice 

American Nurses Association. (2015). 


Nursing informatics: Scope and standards of practice (2nd ed.)

Links to an external site.
. Silver Spring, MD: Author.

· “The Scope of Nursing Informatics Practice: Functional Areas of Nursing Informatics” (pp. 18–39)

·
Nursing Education

Website: Core Competencies for Academic Nurse Eeducators

National League for Nursing. (2022).

Nurse educator core competencyLinks to an external site.
. Retrieved from https://www.nln.org/education/nursing-education-competencies/core-competencies-for-academic-nurse-educators

Note: The competencies for the Academic Nurse Educator do not encompass the competencies or scope and standards of practice for the Nursing Professional Developer. The set of competencies associated with that specific role within the Nurse Education specialization will be examined in future competencies throughout your specialization program of study.

·
Nurse Executive

Website: Nurse Executive Competencies

American Organization for Nursing Leadership. (2015). 

AONL Nurse Executive competenciesLinks to an external site.
. Retrieved from https://www.aonl.org/resources/nurse-leader-competencies

·
Public Health Nursing

Website: Public Health Nursing Competencies

Quad Council Coalition. (2018). 

Community/Public Health NursingLinks to an external site.
 [C/PHN] competencies. Retrieved from https://www.cphno.org/wp-content/uploads/2020/08/QCC-C-PHN-COMPETENCIES-Approved_2018.05.04_Final-002.pdf

· American Nurses Association. (2013). 

Public health nursing: Scope and standards of practiceLinks to an external site.
(2nd ed.). Silver Spring, MD: Author.

·
APRN

Website: APRN Consensus Model

APRN Consensus Work Group & the National Council of State Boards of Nursing APRN Advisory Committee. (2008). 


Consensus model for APRN regulation: Licensure, accreditation, certification & education

Links to an external site.
. Retrieved from https://www.nursingworld.org/~4aa7d9/globalassets/certification/aprn_consensus_model_report_7-7-08.pdf

·
Adult-Gerontology Acute Care and Primary Care NP Competencies

Website: AGAC and ACPC NP Competencies

Adult-Gerontology NP Competencies Work Group. (2016). 


Adult-gerontology acute care and primary care NP competencies

Links to an external site.
. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/NP_Adult_Geri_competencies_4.pdf

·
Nurse Practitioner Core Competencies

Website: Nurse Practitioner Core Competencies

The National Organization of Nurse Practitioner Faculties. (2012). 

Nurse Practitioner core competenciesLinks to an external site.
. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/npcorecompetenciesfinal2012.pdf

·
Nurse Practitioner Programs

Website: Nurse Practitioner Programs

National Task Force on Quality Nurse Practitioner Education. (2016).

Criteria for evaluation of Nurse Practitioner programsLinks to an external site.
(5th ed.). https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/Docs/EvalCriteria2016Final.pdf

·
Population-Focused NP Competencies

Website: Population-Focused Nurse Practitioner Competencies

Population-Focused Competencies Task Force. (2013). 

Population-focused Nurse Practitioner competenciesLinks to an external site.
. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/Competencies/CompilationPopFocusComps2013.pdf

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 



WEEKLY RESOURCES

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 OF WEEK 10

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.

BY DAY 6 OF WEEK 10

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

Reflection Scenario Template

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 1) Watch the entire scenario. In the scenario assignment, you are asked to reflect on responses to the presented scenario. 

2) Fill out the template attached below

3) Compose the last question on the template reflection in a Word document and be sure to address, at a minimum, the following questions:

*Why do you feel the way you do about the issue presented?

*Of the four responses offered in the scenario, which do you think is the most ethical and why?

*Which ethical theory would you use to support your stance? Why does this theory work?

4)  Support your conclusions with evidence and specific examples from the textbook, including a minimum of one theory of ethics to defend your stance.

DISSSSCUSION

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THE ROLE OF THE RN/APRN IN POLICY EVALUATION

In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

To Prepare:

  • In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
  • Review the Resources and reflect on the role of professional nurses in policy evaluation.

BY DAY 3 OF WEEK 9

Select an existing healthcare program or policy evaluation or choose one of interest to you.

Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

Post an evaluation topic and a brief description of the evaluation. Discuss how social determinants impact this issue.

BY DAY 6 OF WEEK 9

Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.

Care Setting Environmental Analysis

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Preparation

You have been asked to conduct an analysis of your care setting that will result in two potential pathways toward a strategic plan to improve health care quality and safety in your organization, department, team, community project, or other care setting. To accomplish this, you will take two approaches to the analysis:

  1. Complete the discovery and dream phases of an appreciative inquiry (AI) project.
  2. Conduct a strengths, weaknesses, opportunities and threats (SWOT) analysis.

To help ensure that your analysis is well-received, the requester has suggested that you:

  • Present your analysis results in four parts:
    • Part 1: Appreciative Inquiry Discovery and Dream.
    • Part 2: SWOT Analysis.
    • Part 3: Comparison of Approaches.
    • Part 4: Analysis of Relevant Leadership Characteristics and Skills.
  • Your analysis should be 5-8 pages in length.

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

One key aspect to being an effective leader, manager, or administrator is an awareness of your leadership strengths, weaknesses, and style.

  • How would you assess your general leadership, communication, and relationship-building skills?
  • How would describe your leadership style?

Imagine the future for a care setting that is your place of practice or one in which you would like to work.

  • What aspirational goals can you envision that would lead to improvements in health care quality and safety?
  • How well do these goals align with the mission, vision, and values of your care setting?
Part 1: Appreciative Inquiry Discovery and Dream
  • Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.
    • Collect stories from your care setting. You may collect stories through interviews or conversations with colleagues or provide your own.
    • Explain how your stories are related to quality and safety goals.
    • Describe the evidence you have that substantiates your stories.
    • Identify the positive themes reflected in your stories.
    • Describe other evidence (for example: data, awards, accreditations) that validates your care setting’s positive core.
  • Propose positive, yet attainable, quality and safety improvement goals for your care setting.
    • Explain how accomplishing these goals will lead to ethical and culturally-sensitive improvements in quality and safety.
    • Explain how your proposed goals align with your care setting’s mission, vision, and values.
Part 2: SWOT Analysis
  • Conduct a SWOT analysis of your care setting, with respect to quality and safety goals.
    • Provide a narrative description of your analysis.
    • Identify the assessment tool you used as the basis of your analysis.
    • Describe your key findings and their relationships to quality and safety goals.
  • Describe one area of concern that you identified in your SWOT analysis—relevant to your care setting’s mission, vision, and values—for which you would propose pursuing improvements.
    • Explain how this area of concern relates to your care setting’s mission, vision, and values.
    • Explain why you believe it will be necessary and valuable to pursue improvements related to this area of concern.
Part 3: Comparison of Approaches

Compare the AI and SWOT approaches to analysis and reflect on the results.

  • Describe your mindset when examining your care setting from an AI perspective and from a SWOT perspective.
  • Describe the types of data and evidence you searched for when taking an AI approach and a SWOT approach.
  • Describe the similarities and differences between the two approaches when communicating and interacting with colleagues.
Part 4: Analysis of Relevant Leadership Characteristics and Skills

Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an AI and SWOT approach.

  • Explain how these characteristics and skills would help a leader facilitate a successful AI-based project and a successful SWOT-based project.
  • Comment on any shared characteristics or skills you identified as helpful for both AI and SWOT approaches.

Assigment .Apa seven . All instructions attached.

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rt 2 Writing Assignment Week 7

Top of Form

Bottom of Form

Health Promotion Proposal, Part 2 Content

1.

Top of Form

Health Promotion Proposal, Part 2

This is a continuation of the health promotion program proposal, part one, which you submitted previously. 

Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.

 

Directions 

You have already completed the steps 1-4. 
Do not resubmit part 1. Make sure you revise this initial submission according to your instructor’s comments. 

To assist in maintaining harmony between Part I and 2 here you have a reminder of the previous paper outline:

· 1. Describe the health problem. Using data and statistics support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program? Be sure your proposed outcome is realistic and measurable. 

· 2. Describe the vulnerable population and setting. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified. 

· 3. Provide a review of literature from scholarly journals of evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, you will write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search. 

· 4. Select an appropriate health promotion/disease prevention theoretical framework or conceptual model that would best serve as the framework guiding the proposal. Provide rationale for your selection which includes discussion of the concepts of the selected model 

 

For this assignment develop criteria 5-8 as detailed below: 

You will submit just this section 5-8 as essay. Please do not resubmit Part 1. 

Use a presentation page. Start the body of content with topic 5.

· 5. Propose a health promotion program using an evidence-based intervention found in your literature search to address the problem in the selected population/setting. Include a thorough discussion of the specifics of this intervention which include resources necessary, those involved, and feasibility for a nurse in an advanced role. 

· Be certain to include a timeline. (2 to 4 paragraphs- you may use bullets if appropriate). 

· 6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach. 
The SMART goal statement should be no more than one sentence (1 paragraph). 

· 7. Provide a detailed plan for evaluation for each outcome. (1 paragraph). 

· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (1 paragraph). 

· Finish the paper with a conclusion paragraph (1 paragraph) without typing the word “conclusion” before the paragraph. 

Paper Requirements 

Your assignment should be up to 3-5 pages (excluding title page and references). 

Remember, your Proposal must be a scholarly paper demonstrating graduate school level writing and critical analysis of existing nursing knowledge about health promotion. 

Finish the essay with a your reference page.

Please review the Grading Rubric for this Assignment.

 

Bottom of Form

Nursing Assignment 2

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Please follow directions 

Community Health Needs Assessment

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Give an example of a program at “Adventist healthcare white oak medical center” that was planned to meet the needs of the population they serve. Share the organization’s evaluation of effectiveness (if data is available). Provide three scientific citation in APA

WK4A

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Be sure to provide 5 APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking.

Please be sure to follow EACH AND EVERY BULLET POINT.

Make sure to ANSWER EACH QUESTION ACCURATELY.

(TOPIC: In Attachment and link above/below ***

***Please be sure to include all information from the attachment in the assignment*****

********* https://youtu.be/-BwzQF9DTlY?si=4vb7gejKMJACSED7 ********

Please use template attached to complete assignment.

EVIDENCE BASED TABLE

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Use the PICO question to look for 2 articles and  complete the evidence based table i have attached.  

  

PICO question: In individuals diagnosed with Parkinson’s disease (P), does the implementation of complementary supportive therapies in conjunction with standard practice (I) improve quality of life (O) compared with standard practice alone (C)?

case study week 9

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Examine 
Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Case

BACKGROUND

Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.

The parents give the PMHNP a copy of a form titled 
“Conner’s Teacher Rating Scale-Revised”. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work.

Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father.

SUBJECTIVE

Katie reports that she doesn’t know what the “big deal” is. She states that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”. She admits that her mind does wander during class to things that she thinks of as more fun. “Sometimes” Katie reports “I will just be thinking about nothing and the teacher will call my name and I don’t know what they were talking about.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time.

MENTAL STATUS EXAM

The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation.

Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation

RESOURCES

§ Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners' Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.

Decision Point One

Begin Wellbutrin (bupropion) XL 150 mg orally daily

RESULTS OF DECISION POINT ONE

·  Client returns to clinic in four weeks

·  Katie’s parents inform you that they stopped giving Katie the medication because about 2 weeks into the prescription, Katie told her parents that she was thinking about hurting herself. This scared the parents, but they didn’t want to “bother you” by calling the office, so they felt that it would be best to just stop the medication as they would be seeing you in two weeks

Decision Point Two

Educate the parents that Bupropion sometimes causes suicidal ideation in children and that this is normal, and re-start the drug at the previous dose

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Katie's parents again report that after about a week of treatment with the Bupropion, Katie began telling her parents that she wanted to hurt herself and began having dreams about being dead. This scared her parents, and they stopped giving her the medication At this point, they are quite upset with the results of their daughter’s treatment and are convinced that medication is not the answer

Decision Point Three

Refer the parents to a pediatric psychologist who can use behavioral therapy to treat Katie’s ADHD.

Guidance to Student

Bupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant.

At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie.

In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues.

The PMHNP should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow the PMHNP to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

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