Think about the articles you have been reading each week.
Were there any recommendations for practice that you thought could be implemented in your clinical practice tomorrow? Next week? Next year? Provide rationale to support your response.
Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario:
Jax is a 66-year-old Caucasian female whose wife has encouraged her to seek treatment. She has never been in therapy before, and has no history of depression or anxiety. However, her alcohol use has recently been getting in the way of her marriage, and interfering with her newly-retired life. She describes drinking increasing amounts over the last year, currently consuming approximately a six-pack of beer per day. She notes that this amount “doesn’t give me the same buzz as it used to.” She denies ever experiencing “the shakes” or any other withdrawal symptoms if she skips a day of drinking.
Jax comments that her wife is her biggest motivation to decrease her alcohol use. She tells Jax that she gets argumentative and irritable when she drinks, though she does not always remember these incidents. She has also fallen while intoxicated twice, causing bruises both times and hitting her head on one of the occasions.
Questions:
Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers.
Submission Instructions:
Be sure to provide 2 APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking.
****1 paragraph for each peer response and 2 citations.********
Please be sure to follow EACH AND EVERY BULLET POINT.
(TOPIC is based on the peer that’s being reviewed)
Please do not plagiarize nor reword another person’s assignment that has been previously submitted.
Look at the attachment for responses that are needed!!!
Step 1: Reflect on your personal views related to nurses’ being appointed to boards, organizations or other policy forming entities.
Step 2: Post a response to the discussion board by addressing the following questions:
Cite any sources in 7th ed. APA format.
Select Reply to join the discussion. See rubric for grading details. You can find this by clicking the three dots to the top right of this thread.
Response Posts: In your responses to your classmates, contribute to the discussion with your own original opinions about why a nurse would seek an appointed position in government and offer other examples of how nurses can affect public policy.
review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. All answers to case studies must-have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites) per case Study
Attached you can find both case study
Week 5 Discussion: Gastrointestinal Alterations (USLOs 1, 2, 3, 4)
You are caring for 39-year-old Kali Kim-Collins who arrived for follow-up care at her primary physician's office after being discharged from the emergency department with peptic ulcer disease. Mrs. Collins went to the emergency department after experiencing severe gastric pain for three days. She reported the pain was relieved after eating.
Based on this information, your prior knowledge of this client (refer to medical card from the Collins-Kim family tree interactive), and your knowledge of the pathophysiology of peptic ulcer disease, respond to the following prompts:
1. Thoroughly explain the pathophysiology of peptic ulcer disease. Use a
scholarly or
authoritative source to support your answer.
2. Examine each of the following three factors related to this disease process.
Support all three with a scholarly source.
1. cultural
2. financial
3. environmental implications
3. Identify 3-5 priority nursing interventions for the client after discharge home.
4. Describe labs and diagnostic testing you would anticipate monitoring for the client upon follow-up with her PCP. What are critical indicators?
Support with a scholarly source.
5. What members of the interdisciplinary team need to be included for holistic patient-centered care?
Provide a rationale and support with a scholarly source.
Name:_____________
Date:_______________
N6145 _Week 3_Writing
Based on the readings for last week and this week, discuss the following (citing relevant sources from text):
|
1. Name and · 2. Name three types of “Knowing” in nursing and give an example of each. · 3.Are nursing practice and nursing care the same thing? Explain. Give an example. · 4.What is the relationship of the nursing theory to practice? |
NU117/NUR1172 Section 03 Nutritional Principles in Nursing
Module 02 Written Assignment – Macronutrients and Their Impact
Top of Form
Bottom of Form
Module 02 Content
1.
Top of Form
Each slide should include information about each macronutrient.
· Definition of the macronutrient inclusive of its function and structure
· Where they are digested and absorbed
· Types and their purpose
· Special characteristics and function
· Clinical applications as they relate to health and diets
Bottom of Form
Throughout this course you have focused on practice problems to address in applying nursing and interdisciplinary theories, and in the application of evidence-based practice for quality improvement. This week you begin exploring the components of evidence-based practice by framing a practice problem as a critical question. You will begin a search of the literature for evidence to answer the question and inform a practice change for quality improvement.
Respond to two of your colleagues by suggesting a different way of framing their critical question. Cite sources to support your posts and recommend to colleagues.
PEER #1
Week 7 Discussion Main Post
A Critical Question with Measurable Outcomes
Question: Will adding pharmacological interventions to nonpharmacological treatments improve post-traumatic stress disorders in adults?
Article Selection
A total of six articles were discovered and appraised using the “Adapted Rating System for the Hierarchy of Evidence” (Dang & Dearholt, 2017; Fineout-Overholt et al., 2010). The type of article and information that supported the purpose statement were used in the selection process.
Critical Question Explanation
Post-traumatic stress disorder (PTSD) has long been associated with military members
exposed to combat. Before PTSD was coined, Charles Myers used shell “shock” to describe injured soldiers during World War I (Horwitz, 2018). According to Friedman (2019), PTSD is defined as direct or indirect exposure to a traumatic event where a person is severely traumatized based on that event. According to the National Center for PTSD (2021), 60% of men and 50% of women will experience at least one traumatic event in their lives, 6% of the population will have PTSD at some point in their lives, and about 15 million adults have PTSD during a given year. For most individuals, psychotherapy is a sufficient treatment for PTSD, but not for others. Could pharmacological interventions assist individuals where psychotherapy alone does not work?
Article Synthesis
For some individuals, psychotherapy alone does not work. Similarly, pharmacological use alone can be ineffective (Raskind et al., 2018; Rasmusson et al., 2017). However, combining SSRIs or other medications with CBT or other therapies may reduce PTSD symptoms in some individuals (Mithoefer et al., 2019; Wagner et al., 2017). Mithoefer et al. (2019) found that MDMA- assisted psychotherapy effectively treated PTSD. According to Wagner et al. (2017), MDMA increases oxytocin, facilitates openness, and enhances the therapy's effectiveness. In the prolonged exposure and sertraline trial conducted by Rauch et al. (2020), PTSD subjects were given strict instructions on collecting their saliva for testing. They made a ground-breaking discovery about cortisol, finding that cortisol levels were lower in individuals with PTSD than those without PTSD (Rauch et al., 2020). Not only was this discovery made, but following the combination treatment of sertraline and prolonged exposure, significant improvements were noted for one year (Rauch et al., 2019). While combining psychotherapy with some drugs improved PTSD symptoms, others did not.
References
Dang, D., & Dearholt, S. (2017).
Johns Hopkins nursing evidence-based practice: Model and guidelines (3rd ed.). Sigma Theta Tau International.
Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B. & Williamson, K. M. (2010). Critical
appraisal of the evidence: Part I.
American Journal of Nursing, 110(7), 47-52.
https://doi.org/10.1097/01.NAJ.0000366056.06605.d2Links to an external site.
Friedman, M. J. (2019, October 14).
PTSD History and Overview. U.S. Department of Veterans Affairs.
https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.aspLinks to an external site.
Horwitz, A. (2018).
PTSD: A short history. Johns Hopkins University Press
Mithoefer, M. C., Feduccia, A. A., Jerome, L., Mithoefer, A., Wagner, M., Walsh, Z., Hamilton, S., Yaza-Klosinski, B., Emerson, A., & Doblin, R. (2019). MDMA-assisted psychotherapy for treatment of PTSD: Study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials.
Psychopharmacology, 236(9), 2735-2745.
https://doi.org/10.1007/s00213-019-05249-5Links to an external site.
PTSD: National Center for PTSD. (2021, September 10).
How common is PTSD in adults? U.S. Department of Veterans Affairs.
https://www.ptsd.va.gov/understand/common/common_adults.aspLinks to an external site.
Raskind, M. A., Peskind, E. R., Chow, BB., Harris, C., Davis-Karim, A., Holmes, H. A., Hart, K. L., McFall, M., Mellman, T. A., Reist, C., Romesser, J., Rosenheck, R., Shih, M. C., Stein, M. B., Swift, R., Gleason, T., Lu, Y., & Huang, G. D. (2018). Trial of prazosin for post-traumatic stress disorder in military veterans.
The New England Journal of Medicine, 378(6), 507-517.
https://doi.org/10.1056/NEJMoa1507598Links to an external site.
Rasmusson, A. M., Marx, C. E., Jain, S., Farfel, G. M., Tsai, J., Sun, X., Geracioti, T. D., Hamner, M. B., Lohr, J., Rosse, R., Summerall, L., Naylor, J. C., Cusin, C., Lang, A. J., Raman, R., & Stein, M. B. (2017). A randomized controlled trial of ganaxolone in post-traumatic stress disorder
. Psychopharmacology, 234(15), 2245-2257.
https://doi.org/10.1007/s00213-017-4649-yLinks to an external site.
Rauch, S. A. M., Kim, M., Powell, C., Tuerk, P. W., Simon, N. M., Acern, R., Allard, C. B., Norman, S. B., Venners, M. R., Rothbaum, B. O., Stein M. B., Porter, K., Martis, B., King, A. P., Liberzon, I., Luan Phan, K., & Hoge, C. W. (2019). Efficacy of prolonged exposure therapy, sertraline hydrochloride, and their combination among combat veterans with post-traumatic stress disorder.
JAMA Psychiatry, 76(2), 117-126.
https://doi.org/10.1001/jamapsychiatry.2018.3412Links to an external site.
Rauch, S. A. M., King, A., Kim, H. M., Powell, C., Rajaram, N., Venners, M., Simon, N. M., Hamner, M., & Liberzon, I. (2020). Cortisol awakening response in PTSD treatment: Predictor or mechanism of change.
Psychoneuroendocrinology, 118, 1-16.
https://doi.org/10.1016/j.psyneuen.2020.104714Links to an external site.
Wagner, M. T., Mithoefer, M. C., Mithoefer, A. T., MacAulay, R. K., Jerome, L., Yazar- Klosinski, B., & Doblin, R. (2017). Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy.
Journal of Psychopharmacology, 31(8), 967-974.
https://doi.org/10.1177%2F0269881117711712Links to an external site.
Critical Question: Nursing burnout and its impact on nurses and patient care.
Nursing burnout is a state of emotional, physical, and mental exhaustion resulting from prolonged and intense stress in the nursing profession. It significantly impacts nurses by causing increased job dissatisfaction, higher turnover rates, and adverse mental and physical health effects (Mudallal et al., 2017). Moreover, burnout has a direct and detrimental impact on patient care, leading to decreased quality, increased medical errors, and reduced patient satisfaction due to compromised nurse-patient interactions and reduced attention to detail (Garcia et al., 2019). Addressing nursing burnout is crucial for maintaining a resilient nursing workforce and ensuring high-quality patient care outcomes.
Synthesis of Scholarly Articles
1. Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis
This study comprehensively analyzed existing research and found compelling evidence that burnout among healthcare professionals significantly impairs patient safety. The meta-analysis synthesized data from multiple studies, revealing a strong association between burnout and increased risks of medical errors, compromised quality of care, and adverse patient outcomes, highlighting the critical importance of addressing burnout as a crucial factor in ensuring patient safety in healthcare settings (Garcia et al., 2019).
2. Relationship between nurse burnout, patient and organizational outcomes: Systematic review
This study examined a broad range of studies and revealed a clear and intricate relationship between nurse burnout, patient outcomes, and organizational effects. It found that higher levels of nurse burnout are consistently linked to adverse patient outcomes such as increased mortality rates, longer hospital stays, and decreased patient satisfaction. Additionally, burnout has detrimental organizational consequences, including higher nurse turnover and lower overall workplace performance. This study underscores the interconnectedness of nurse well-being, patient care quality, and organizational success, emphasizing the urgency of addressing burnout to improve healthcare outcomes and workplace environments (Jun et al., 2021).
3. Nurse Burnout and Quality of Care: Cross-National Investigation in Six Countries
This study conducted a comprehensive cross-national analysis and identified a consistent and alarming pattern: nurse burnout substantially negatively impacts the quality of patient care across different healthcare systems and countries. The study's findings highlighted that high levels of nurse burnout were associated with lower perceptions of care quality among both nurses themselves and patients. This suggests that addressing nurse burnout is imperative not only for the well-being of healthcare professionals but also for maintaining and improving the quality of care delivered in diverse healthcare settings globally (Poghosyan et al., 2021).
4. Association of resident fatigue and distress with perceived medical errors
This study demonstrates a significant correlation between resident physician fatigue and distress levels and the perception of medical errors. The research findings suggest that higher levels of resident fatigue and distress are associated with increased instances of perceived medical errors. This indicates that addressing the well-being and mental health of healthcare providers, including reducing fatigue and distress, can play a crucial role in improving patient safety and reducing the likelihood of medical errors in healthcare settings, emphasizing the need for interventions and policies aimed at mitigating these factors to enhance patient care quality. (West, 2019)
Value for Stakeholders
Addressing nursing burnout is a moral imperative and a strategic quality improvement initiative. The identified articles provide compelling evidence that nurse burnout directly impacts patient satisfaction, healthcare outcomes, and organizational effectiveness (Mudallal et al., 2017). By investing in interventions to reduce burnout, healthcare organizations can enhance patient care quality, increase staff retention, reduce medical errors, and ultimately improve their bottom line. Moreover, addressing nursing burnout aligns with the mission of healthcare organizations to deliver safe, effective, and patient-centered care, enhancing their reputation and competitiveness in the healthcare industry (Jun et al., 2021).
References
Garcia, C. de L., Abreu, L. C. de, Ramos, J. L. S., Castro, C. F. D. de, Smiderle, F. R. N., Santos, J. A. D., & Bezerra, I. M. P. (2019, August 30). Influence of burnout on Patient Safety: Systematic Review and meta-analysis. Medicina (Kaunas, Lithuania). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780563/
Jun, J., Ojemeni, M., Kalamani, R., Crecelius , M., & Tong , J. (2021, March 26). Relationship between Nurse Burnout, patient and organizational outcomes: Systematic review. International Journal of Nursing Studies. https://www.sciencedirect.com/science/article/abs/pii/S0020748921000742
Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017, January 1). Nurses’ burnout: The influence of leader empowering behaviors, work conditions, and demographic traits. Inquiry : a journal of medical care organization, provision and financing. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798741/
Poghosyan, L., Clarke, S. P., Finlayson, M., & Aiken, L. H. (2021, August). Nurse Burnout and quality of care: Cross-national investigation in six countries. Research in nursing & health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908908/#:~:text=Across%20countries%2C%20higher%20levels%20of,quality%20of%20care%20in%20hospitals.
West, C. (2019, September 23). Association of resident fatigue and distress with perceived medical errors. JAMA. https://jamanetwork.com/journals/jama/article-abstract/184625
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