• Please include in text citations from CDC and American Academy of Family Physicians website and school book resources(will be provided). Each rubric section should answer ALL the questions with at least a paragraph.

• COMPETENCIES

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7002.1.1 : Pathophysiology

The graduate evaluates high volume, high impact disease processes, including associated pharmacological interventions and implications for advanced practice.

7002.1.2 : Evaluation of Pharmaceutical Impact

The graduate analyzes pharmaceutical impacts, including physiological, psychological, financial, and lifestyle factors on the selected disease processes.

7002.1.3 : Managing Care Transitions

The graduate evaluates salient pharmacological issues in managing patient care transitions.

7002.1.4 : Salience

The graduate distinguishes between general information and relevant assessment findings to manage and minimize pathologies and risk factors to promote optimal patient outcomes.

7002.1.5 : Care Management

The graduate integrates relevant patient and population data to develop pathopharmacological management strategies for populations.

INTRODUCTION

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As an advanced practice nurse, it is important to diagnose, treat, and evaluate patients who have chronic disease. A nurse must understand how pathology, treatment, regimens, and psycho-social issues affect patients and the care they receive. Disease management is more than just monitoring a medication or treatment; it is evaluating the disease process from the micro to macro level. As a nurse with an advanced degree, you will be expected to assess patients and individual and population responses to chronic illness.

For this assessment, you will investigate pathopharmacological issues related to a specific disease process. You may choose to investigate traumatic brain injury, depression, obesity, asthma, or heart failure. As part of this assessment, you will analyze the various impacts the disease process has on the patients, their families, and populations at a local, national, and international level.

REQUIREMENTS

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Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.

Professional Communications is a required aspect to pass this task. Completion of a spell check and grammar check prior to submitting your final work is strongly recommended.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

A. Investigate one of the following disease processes: traumatic brain injury, depression, obesity, asthma, or heart failure.

1. Analyze the pathophysiology of the disease process you selected in part A.

2. Discuss the standard of practice for the selected disease process.

a. Discuss the evidence-based pharmacological treatments in your state and how they affect management of the selected disease in your community.

b. Discuss clinical guidelines for assessment, diagnosis, and patient education for the selected disease process.

c. Compare the standard practice for managing the disease within your community with state or national practices.

3. Discuss characteristics of and resources for a patient who manages the selected disease well, including access to care, treatment options, life expectancy, and outcomes.

a. Analyze disparities between management of the selected disease on a national and international level.

4. Discuss three or four factors (e.g., financial resources, access to care, insured/uninsured, Medicare/Medicaid) that contribute to a patient being able to manage the selected disease.

a. Explain how a lack of the factors discussed in part A4 leads to an unmanaged disease process.

i. Describe characteristics of a patient with the selected disease that is unmanaged.

B. Analyze how the selected disease process affects patients, families, and populations in your community.

1. Discuss the financial costs associated with the selected disease process for patients, families, and populations from diagnosis to treatment.

C. Discuss how you will promote best practices for managing the selected disease in your current healthcare organization.

1. Discuss three strategies you could use to implement best practices for managing the selected disease in your current healthcare organization.

2. Discuss an appropriate method to evaluate the implementation of each of the strategies from part C1.

D. When you use sources, include all in-text citations and references in APA format.

Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.

RUBRIC

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ARTICULATION OF RESPONSE (CLARITY, ORGANIZATION, MECHANICS):

UNSATISFACTORY / NOT PRESENT The candidate provides unsatisfactory articulation of response.

DOES NOT MEET STANDARD The candidate provides weak articulation of response.

MINIMALLY COMPETENT The candidate provides limited articulation of response.

COMPETENT The candidate provides adequate articulation of response.

HIGHLY COMPETENT The candidate provides substantial articulation of response.

A. INVESTIGATED DISEASE PROCESS:

UNSATISFACTORY / NOT PRESENT The candidate does not investigate 1 of the given disease processes.

DOES NOT MEET STANDARD Not applicable.

MINIMALLY COMPETENT Not applicable.

COMPETENT Not applicable.

HIGHLY COMPETENT The candidate investigates 1 of the given disease processes.

A1. PATHOPHYSIOLOGY:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a plausible analysis of the pathophysiology of the disease process selected in part A.

DOES NOT MEET STANDARD The candidate provides a plausible analysis, with no detail, of the pathophysiology of the disease process selected in part A.

MINIMALLY COMPETENT The candidate provides a plausible analysis, with limited detail, of the pathophysiology of the disease process selected in part A.

COMPETENT The candidate provides a plausible analysis, with adequate detail, of the pathophysiology of the disease process selected in part A.

HIGHLY COMPETENT The candidate provides a plausible analysis, with substantial detail, of the pathophysiology of the disease process selected in part A.

A2. STANDARD OF PRACTICE:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical discussion of the standard of practice for the selected disease process.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with no detail, of the standard of practice for the selected disease process.

MINIMALLY COMPETENT The candidate provides a logical discussion, with limited detail, of the standard of practice for the selected disease process.

COMPETENT The candidate provides a logical discussion, with adequate detail, of the standard of practice for the selected disease process.

HIGHLY COMPETENT The candidate provides a logical discussion, with substantial detail, of the standard of practice for the selected disease process.

A2A. PHARMACOLOGICAL TREATMENTS:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical discussion of the evidence-based pharmacological treatments in the candidate’s state and how they affect management of the selected disease in the candidate’s community.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with no detail, of the evidence-based pharmacological treatments in the candidate’s state and how they affect management of the selected disease in the candidate’s community.

MINIMALLY COMPETENT The candidate provides a logical discussion, with limited detail, of the evidence-based pharmacological treatments in the candidate’s state and how they affect management of the selected disease in the candidate’s community.

COMPETENT The candidate provides a logical discussion, with adequate detail, of the evidence-based pharmacological treatments in the candidate’s state and how they affect management of the selected disease in the candidate’s community.

HIGHLY COMPETENT The candidate provides a logical discussion, with substantial detail, of the evidence-based pharmacological treatments in the candidate’s state and how they affect management of the selected disease in the candidate’s community.

A2B. CLINICAL GUIDELINES:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical discussion of clinical guidelines for assessment, diagnosis, and patient education for the selected disease process.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with no detail, of clinical guidelines for assessment, diagnosis, and patient education for the selected disease process.

MINIMALLY COMPETENT The candidate provides a logical discussion, with limited detail, of clinical guidelines for assessment, diagnosis, and patient education for the selected disease process.

COMPETENT The candidate provides a logical discussion, with adequate detail, of clinical guidelines for assessment, diagnosis, and patient education for the selected disease process.

HIGHLY COMPETENT The candidate provides a logical discussion, with substantial detail, of clinical guidelines for assessment, diagnosis, and patient education for the selected disease process.

A2C. STANDARD PRACTICE OF DISEASE MANAGEMENT:

UNSATISFACTORY / NOT PRESENT The candidate does not provide an appropriate comparison of standard practice for managing the disease within the candidate’s community with state or national practices.

DOES NOT MEET STANDARD The candidate provides an appropriate comparison, with no detail, of standard practice for managing the disease within the candidate’s community with state or national practices.

MINIMALLY COMPETENT The candidate provides an appropriate comparison, with limited detail, of standard practice for managing the disease within in the candidate’s community with state or national practices.

COMPETENT The candidate provides an appropriate comparison, with adequate detail, of standard practice for managing the disease within the candidate’s community with state or national practices.

HIGHLY COMPETENT The candidate provides an appropriate comparison, with substantial detail, of standard practice for managing the disease within the candidate’s community with state or national practices.

A3. MANAGED DISEASE PROCESS:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical discussion of characteristics of and resources for a patient who manages the selected disease well, including access to care, treatment options, life expectancy, and outcomes.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with no detail, of characteristics of and resources for a patient who manages the selected disease well, including access to care, treatment options, life expectancy, and outcomes.

MINIMALLY COMPETENT The candidate provides a logical discussion, with limited detail, of characteristics of and resources for a patient who manages the selected disease well, including access to care, treatment options, life expectancy, and outcomes.

COMPETENT The candidate provides a logical discussion, with adequate detail, of characteristics of and resources for a patient who manages the selected disease well, including access to care, treatment options, life expectancy, and outcomes.

HIGHLY COMPETENT The candidate provides a logical discussion, with substantial detail, of characteristics of and resources for a patient who manages the selected disease well, including access to care, treatment options, life expectancy, and outcomes.

A3A. DISPARITIES:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a plausible analysis of disparities between management of the selected disease on a national and international level.

DOES NOT MEET STANDARD The candidate provides a plausible analysis, with no support, of disparities between management of the selected disease on a national and international level.

MINIMALLY COMPETENT The candidate provides a plausible analysis, with limited support, of disparities between management of the selected disease on a national and international level.

COMPETENT The candidate provides a plausible analysis, with adequate support, of disparities between management of the selected disease on a national and international level.

HIGHLY COMPETENT The candidate provides a plausible analysis, with substantial support, of disparities between management of the selected disease on a national and international level.

A4. MANAGED DISEASE FACTORS:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical discussion, of any factors that contribute to a patient being able to manage the selected disease.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with sufficient detail, of 1 or 2 factors that contribute to a patient being able to manage the selected disease.

MINIMALLY COMPETENT Not applicable.

COMPETENT Not applicable.

HIGHLY COMPETENT The candidate provides a logical discussion, with sufficient detail, of 3 or 4 factors that contribute to a patient being able to manage the selected disease.

A4A. UNMANAGED DISEASE FACTORS:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical explanation of how a lack of the factors discussed in part A4 leads to an unmanaged disease process.

DOES NOT MEET STANDARD The candidate provides a logical explanation, with no detail, of how a lack of the factors discussed in part A4 leads to an unmanaged disease process.

MINIMALLY COMPETENT The candidate provides a logical explanation, with limited detail, of how a lack of the factors discussed in part A4 leads to an unmanaged disease process.

COMPETENT The candidate provides a logical explanation, with adequate detail, of how a lack of the factors discussed in part A4 leads to an unmanaged disease process.

HIGHLY COMPETENT The candidate provides a logical explanation, with substantial detail, of how a lack of the factors discussed in part A4 leads to an unmanaged disease process.

A4AI. UNMANAGED DISEASE CHARACTERISTICS:

UNSATISFACTORY / NOT PRESENT The candidate does not provide an appropriate description of the characteristics of a patient with the selected disease that is unmanaged.

DOES NOT MEET STANDARD Not applicable.

MINIMALLY COMPETENT The candidate provides an appropriate description, with insufficient detail, of the characteristics of a patient with the selected disease that is unmanaged.

COMPETENT Not applicable.

HIGHLY COMPETENT The candidate provides an appropriate description, with sufficient detail, of the characteristics of a patient with the selected disease that is unmanaged.

B. PATIENTS, FAMILIES, & POPULATIONS:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a plausible analysis of how the selected disease process affects patients, families, and populations in the candidate’s community.

DOES NOT MEET STANDARD The candidate provides a plausible analysis, with no detail, of how the selected disease process affects patients, families, and populations in the candidate’s community.

MINIMALLY COMPETENT The candidate provides a plausible analysis, with limited detail, of how the selected disease process affects patients, families, and populations in the candidate’s community.

COMPETENT The candidate provides a plausible analysis, with adequate detail, of how the selected disease process affects patients, families, and populations in the candidate’s community.

HIGHLY COMPETENT The candidate provides a plausible analysis, with substantial detail, of how the selected disease process affects patients, families, and populations in the candidate’s community.

B1. COSTS:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical discussion of the financial costs associated with the selected disease process for patients, families, and populations from diagnosis to treatment.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with no detail, of the financial costs associated with the selected disease process for patients, families, and populations from diagnosis to treatment.

MINIMALLY COMPETENT The candidate provides a logical discussion, with limited detail, of the financial costs associated with the selected disease process for patients, families, and populations from diagnosis to treatment.

COMPETENT The candidate provides a logical discussion, with adequate detail, of the financial costs associated with the selected disease process for patients, families, and populations from diagnosis to treatment.

HIGHLY COMPETENT The candidate provides a logical discussion, with substantial detail, of the financial costs associated with the selected disease process for patients, families, and populations from diagnosis to treatment.

C. BEST PRACTICES PROMOTION:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical discussion of how the candidate will promote best practices for managing the selected disease in the candidate’s current healthcare organization.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with no detail, of how the candidate will promote best practices for managing the selected disease in the candidate’s current healthcare organization.

MINIMALLY COMPETENT The candidate provides a logical discussion, with limited detail, of how the candidate will promote best practices for managing the selected disease in the candidate’s current healthcare organization.

COMPETENT The candidate provides a logical discussion, with adequate detail, of how the candidate will promote best practices for managing the selected disease in the candidate’s current healthcare organization.

HIGHLY COMPETENT The candidate provides a logical discussion, with substantial detail, of how the candidate will promote best practices for managing the selected disease in the candidate’s current healthcare organization.

C1. IMPLEMENTATION PLAN:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a discussion of 3 strategies the candidate could use to implement best practices for managing the selected disease in the candidate’s current healthcare organization.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with no detail, of 3 strategies the candidate could use to implement best practices for managing the selected disease in the candidate’s current healthcare organization.

MINIMALLY COMPETENT The candidate provides logical discussion, with limited detail, of 3 strategies the candidate could use to implement best practices for managing the selected disease in the candidate’s current healthcare organization.

COMPETENT The candidate provides a logical discussion, with adequate detail, of 3 strategies the candidate could use to implement best practices for managing the selected disease in the candidate’s current healthcare organization.

HIGHLY COMPETENT The candidate provides a logical discussion, with substantial detail, of 3 strategies the candidate could use to implement best practices for managing the selected disease in the candidate’s current healthcare organization.

C2. EVALUATION METHOD:

UNSATISFACTORY / NOT PRESENT The candidate does not provide a logical discussion of an appropriate method to evaluate the implementation of each of the strategies from part C1.

DOES NOT MEET STANDARD The candidate provides a logical discussion, with no detail, of an appropriate method to evaluate the implementation of each of the strategies from part C1.

MINIMALLY COMPETENT The candidate provides a logical discussion, with limited detail, of an appropriate method to evaluate the implementation of each of the strategies from part C1.

COMPETENT The candidate provides a logical discussion, with adequate detail, of an appropriate method to evaluate the implementation of each of the strategies from part C1.

HIGHLY COMPETENT The candidate provides a logical discussion, with substantial detail, of an appropriate method to evaluate the implementation of each of the strategies from part C1.

D. SOURCES:

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Group Discussion WITH REPLIES IN FIRST PERSON!!!!!!!!

April 5, 2024/0 Comments/in Health Medical /by bonniejecinta

Question Description

Discussion Question: McMinn discussed guidelines when confronting sin during a counseling experience and the lectures reviewed some factors as well. Your thread needs to be answered in two parts:

First, what would be the challenges (based on the lectures) of confronting clearly wrong behavior/ “sin” in the life of your client if you were working in a secular human services setting? Draw in concepts from the lecture to support your position. How might the approach from psychology make it difficult to confront clearly wrong behavior (worldview and perspective on attribution, for instance)?

Second, assume that you counseled in a human services setting in which you could integrate spirituality and a Christian worldview. Review the following brief “case” and answer the following questions:

1. Based on the lectures and McMinn, why can’t a sensitive Christian counselor just automatically and quickly confront obvious sin in the life of the counselee?
2. Of the cautions mentioned by the course materials, which ones do you think counselors most often overlook?
3. From what you learned from the lectures/McMinn, how would you best address the clearly sinful behavior of this client?

Case Study

Jim is a client in your counseling center, who you have seen for about 8 months. He has been cycled through several other counselors and one described him as a “basket case.” Jim has several children, each with a different mother. He casually mentions that he rarely sees them, and since he can’t hold down a job, he provides no financial support. Some of his children are now in foster care. He engages in unprotected sex on a weekly basis. Typical of many of your clients, Jim drinks heavily and abuses street drugs. He comes to counseling only because it is required for him to receive the tangible support services of your agency. You are at the point in your counseling with Jim that you’d like to “let him have it” but your counseling training did not include that as a valid counseling technique. There is obviously much more to Jim’s story but suffice it to say that he is repeating many of the behaviors he learned from his parents’ dysfunctional parenting.

While you are sharing opinion here, you must demonstrate informed opinion by supporting your points with references to the course materials.

Replies: In your responses to 2 classmates, follow the suggestions in the grading rubric for responses to classmates.

Group Discussion Board Forum Instructions

The purpose of these Group Discussion Board Forums is to expand your thinking about the course materials or apply course materials to counseling scenarios. Some of the discussion board questions have a strong analytical component, as fitting a graduate level course. As a basis for your reflection/evaluation/application, you will be asked to review the content covered during the discussion modules/weeks.

In response to the posted discussion question (Modules/Weeks 2, 4, 6, and 8), post your thread by the date specified using at least 400 words. The grading rubric does not grade for word count. However, realize that too many words may indicate wordiness, but too few words may indicate incomplete thought. In addition to supporting your initial comments from course materials (with proper, current APA citation), the integration of a Christian worldview is always appropriate.

To foster discussion, you will be required to reply to the threads of at least 2 classmates. Your reply must be of appropriate length (at least 200 words), but word count is not a grading criteria. In addition, your instructor may ask you to reply to the instructor’s follow-up ideas as part of the discussion board requirement (and included in the grade). When you reply to student or instructor posts, expand the discussion. Limit “I agree” statements, but rather explain the reasons why you agree or disagree. Expand ideas, challenge thinking, probe, and ask for clarification. In all discussion board work, keep these points in mind:

• Use appropriate netiquette,
• Write at graduate level, and
• Cite in-text per current APA format and list references at the bottom of your post.

When citing any of the presentations provided in the Reading & Study folders, your references must look like the following:

Brewer, G., & Peters, C., (n.d). [Insert audio lecture title or notes title]. Lynchburg, VA: Liberty University.

So, for example, a reference would look like this:

Brewer, G., & Peters, C. (n.d.). COUN 506 Week Three, Lecture One: Christian spirituality and the ministry of counseling. [PowerPoint]. Lynchburg, VA: Liberty University Online.

First reply:

Amy Elrod

Discussion_Forum_4_Elrod

COLLAPSE

The challenges for confronting sin during a counseling session would be: make sure that the counselor does no harm to the client by asking what is in the best interest of the client with the confrontation, not act out in anger or with an attitude if the client is not compliant or argumentative, utilization of the power dynamic with the client, and lead the client to a redemptive and restorative relationship with God (Brewer, n.d). Without the incorporation of spirituality in session, the client is not seeking a relationship or need to heal their brokenness through Christ. Instead, confession may lead them to simply want to be told that they will be okay, feel more shame and remorse, or rely too heavily on the counseling relationship instead of taking personal responsibility for improvement. If the client’s attribution style is that of psychology or external, it would steer the client away from owning their responsibility for their actions and want others to pity them for being the victim.

It is not recommended that a counselor use direct censure since it can pose a significant risk to the clinical relationship and the rapport that has been achieved. It is also possible for the counselor to perverse the power dynamic by thinking that he/she is superior to the obvious neglect and lack of improvement in Jim’s case. This is probably a man that does not respond well to being berated and may very well put up a wall or switch to another counselor if shamed. McMinn states that the “counseling relationship works well when it mimics the redemptive relationship experienced with God through Jesus” (McMinn, 2011). Jesus knew that Judas and Peter would betray Him, but He sat with them and ate his final meal beforehand. We are to show this same type of love to others.

A caution that I think counselors consistently overlook is the humility aspect of counseling. It is so easy for anyone to judge another based on their sin, but what we all tend to forget is a sin is a sin is a sin. Jesus wasn’t excepting of certain sins nor did He rate them from least to worst. We all sin every single day and sometimes without purpose and to God any sin is forgivable and every person worth love and forgiveness. It could be relatively simple for a counselor to draw their own assumptions about a lifestyle or perversion that was not their own, in addition to, being more educated and knowledgeable could lead to an air of arrogance and dismissal of the client’s underlying need.

Jim may see nothing wrong with his behaviors if he is modeling his parents actions or has an attribution style of being the victim and helpless; maybe his world view is he was born bad and cannot be any different. Or maybe he feels as if he is so far gone, what would be the point of trying to change now. Instead of being another condemning nag to Jim, I would get his consent to introduce spirituality into his sessions and show him, through Scripture, that an unconditionally loving and compassionate parent did exist and He wanted to be a huge part of Jim’s life. I would use the pondering and questioning aspects of confrontation as McMinn described. I would reiterate the fact that we are ALL sinners, but we all have the capacity to determine our paths in life with God as our pilot. I would also refer Jim to a mental health medication clinic to be evaluated for an underlying mental disorder that may be driving his substance abuse and impulsive, risky behaviors. In session, he and I would work through the fact that everyone chooses their actions and everyone reaps the consequences. He may have had problem parenting, but he could change that cycle with parenting support and faulty thinking changes. If Jim was suffering from alcoholism or an opioid addiction, I would refer him for detox before continuing counseling sessions.

Brewer, G., & Peters, C. (n.d.). COUN 506, Week 7, Lectures 1 & 2. Sin, Confession, and Redemption in Counseling & Counseling Methods Related to Confrontation and Confession. [PowerPoint]. Lynchburg, VA: Liberty University Online.

McMinn, M.R. (2011). Psychology, theology, and spirituality in Christian counseling (Rev. ed.) Carol Stream, IL: Tyndale House.

Second reply:

Kasson Weldon

Discussion Board: Forum 4

COLLAPSE

There are several challenges that I would face as a counselor in a secular human services environment. The first challenge is that the perception of sin is different in the world or arena of psychology. The terminology in psychology is sin is seen as sickness and because of this view it has an external attribution where the focus is to minimize sin (Brewers & Peters,2019).

Also, it causes the client to see themselves as a victim blaming others for their choices and removing personal responsibility. It allows the client to come up with their own personal perception & interpretation of what is right and wrong versus the perspective that come from theology where God law is standard for truth and right and wrong (Brewers & Peters,2019).

It is important that a sensitive Christian counselor first connects to the person before he tries to address or confront sin in the life of client. Brewers & Peters mention that every client that we meet is first a stranger due to sin and it ultimately God at work through the gifts of conviction, contrition and repentance in the life of our clients (Brewers & Peters,2019).

Two cautions that I believe are mostly overlooked by counselors. The first is the counselor’s self-awareness. I don’t believe many counselors ask what is my attitude and motivation towards the client? Making sure that you have an empathic and humble attitude towards the client and are doing what is in the best interest of the client not what more convenient, comfortable and self-serving for the counselor. Secondly, I believe that the power dynamic of the client relationship is very overlooked. According to McMinn he mentioned the importance of how we use our power in the counselor/client relationship. This takes humility an awareness our own weaknesses, strengths and limitations and putting them in a proper perspective (McMinn,2011). I believe that there is delicate balance between not creating a dependency of the client towards counselor or the other extreme is imposing your will onto the client. McMinn mentioned that it important for the counselor to discern when the client is look for the approval of counselor rather than making choices and changes based on their own personal sense of identity and freedom (McMinn,2011).

Case Study

Jim is a client in your counseling center, who you have seen for about 8 months. He has been cycled through several other counselors and one described him as a “basket case.” Jim has several children, each with a different mother. He casually mentions that he rarely sees them, and since he can’t hold down a job, he provides no financial support. Some of his children are now in foster care. He engages in unprotected sex on a weekly basis. Typical of many of your clients, Jim drinks heavily and abuses street drugs. He comes to counseling only because it is required for him to receive the tangible support services of your agency. You are at the point in your counseling with Jim that you’d like to “let him have it” but your counseling training did not include that as a valid counseling technique. There is obviously much more to Jim’s story but suffice it to say that he is repeating many of the behaviors he learned from his parents’ dysfunctional parenting.

Honestly the first thing I would need to address is myself and how I’m actually feeling anger towards Jim. My motivation towards Jim cannot be to let him have it but to do what’s in the best interest of Jim. Secondly, I would seek consultation from my supervisor or a more experienced counselor. It’s been eight months and it appears that Jim is not making progress.

In three crucial areas Jim has not moved forward he doesn’t’ have an accurate awareness of self. Jim seems to lack a healthy sense of right and wrong and demonstrates many out of control behaviors. Jim also doesn’t show any remorse, repentance and willingness to take responsibility for any of his actions. Jim has not benefited from the therapeutic relationship.

I would pray for Jim but at this stage I feel that it would be important to confront Jim’s behavior with the goal of redemption in mind. Eight months is a significant amount of time where I believe a level of trust and support has been established.

References

Brewer, G., & Peters, C. (2019) (n.d.). COUN 506, Week 7, Lectures 1 & 2. Sin, Confession, and Redemption in Counseling & Counseling Methods Related [PowerPoint]. Lynchburg, VA: Liberty University Online.

McMinn, M.R. (2011). Psychology, theology, and spirituality in Christian counseling (Rev. ed.) Carol Stream, IL: Tyndale House.

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Read the issue brief from the Robert Wood Johnson

April 5, 2024/0 Comments/in Health Medical /by bonniejecinta

Question Description

Foundation entitled “Education and Health” 2011, located in the Reading and Study folder for this module/week. Discuss the following points in your thread. Review the Discussion Board Instructions before posting your thread.

• There appears to be a dose-response relationship between educational attainment and health—the more you get, the better it is. Why this is true is not clearly understood, though several reasonable hypotheses have been proposed. Describe the 3 interrelated pathways presented as explanations for this relationship in this brief. Which do you feel is the strongest? Why?
• According to data presented in the brief, “the United States is the only industrialized nation where young people currently are less likely than members of their parents’ generation to be high-school graduates.” What evidence is given to support this statement? Why do you think this situation exists? What will it take to correct it?
• As would be expected, parents’ educational attainment is linked to their children’s health and even their educational attainment. These linkages, in turn, influence the health and educational attainment of their children’s children, as well, perpetuating an endless intergenerational cycle of high (or low) educational attainment and its associated better (or poorer) health. How does this fit with the biblical understanding of multigenerational influence (Exodus 34:6–7)? In what ways can the Church help interrupt the vicious cycle beginning with low educational attainment? Pray that God will use you to be a positive influence on your children in this area or on others whom God will bring across your path.
• You will participate in 8 Discussion Board Forums by 1) posting a thread in response to the stated prompt, and 2) posting replies in response to classmates’ threads. Each Discussion Board Forum topic presents a thought-provoking question or prompt based on recent article(s) in the scientific and professional literature of public health. Each prompt is designed to enhance your learning experience as you write about your ideas, perspectives and experiences, and receive feedback from your classmates. Both the frequency of your participation and the depth of the content you write will affect your grade. Use the Discussion Board Grading Rubric to improve the quality of your contributions and follow the specific requirements described below.
•
• Note: Threads and replies must be completed within the assigned module/week or no credit will be awarded.
•
• THREAD
• For each forum, post a thread in response to the topic prompts provided. Your post should contain 400–500 words and adhere to AMA writing style guidelines. This word limit promotes writing that is thorough yet concise enough to permit your peers to read all the posts. If the Discussion Board Forum prompts you to answer a series of questions, make sure you address all of them thoroughly within the word limit. Do not restate the questions in your post; simply begin a new paragraph for each new thought. The goal is to have a seamless written argument closed by a brief conclusion tying together your individual responses. Use your best critical reasoning skills, employing the Universal Intellectual Standards as a guide, but not a strict outline. Refer to specific statements of the author(s) whenever appropriate but limit direct quotations to a maximum of 25 words for your entire post. Since this is a personal discussion, you may use first person; however, you should maintain professional decorum at all times.
•
• Your thread should be posted to the appropriate Discussion Board Forum by 11:59 p.m. (ET) on Thursday of the assigned module/week.
•
• REPLIES
• After reading your classmates’ threads, post a reply to at least 2 classmates by clicking “Reply” within the thread to which you intend to respond. These replies are designed to stimulate thought-provoking discussion, building upon or expanding the knowledge presented. Your instructor is looking for substantive, reasoned comments, not mere agreement with the initial thread on which your reply is based. In your replies, state why you liked or disliked a comment, adding additional thoughts or ideas to your classmate’s, and/or providing alternative ideas or disagreeing thoughts. Your comments should be critical but kind, “speaking the truth in love” (Eph. 4:15). Help one another with good communication skills, both by example and instruction. Substantiate your position by referencing pertinent statements from the resource under discussion, but avoid lengthy quotes from it. You may also reference other professional or peer-reviewed sources, though this is not a requirement. Each reply should contain 200–250 words and adhere to AMA writing style guidelines.
•
• Replies to your classmates’ threads are due by 11:59 p.m. (ET) on Sunday of the assigned module/week, except for Module/Week 8 when replies will be due by 11:59 p.m. (ET) on Friday.
First reply:Hanna Burnett
DB 5-Education & Health
COLLAPSE
In the ‘Education and Health’ brief1, three pathways are presented as explanations on why increased amount of education is linked to better health. These three areas are 1) health knowledge and education, 2) employment and income, 3) social and psychological factors. While they are interconnected, they all have distinct qualities in how they effect health as whole.

Health knowledge and education: It is thought that with increased education level people are able to make better judgements about health related choices and reduce participation in health compromising activities. Having an understanding on how nutrition, toxins and physical activity affects ones body can be a persuasive argument to make the ‘right choice’ on a daily base. I was very surprised to read that in adults with less than high school diploma basic health literacy was lacking in almost 50% of Americans.

Employment and income: There is no question that with higher education, one is able to find safer, more meaningful, and better compensated jobs. All of these things have a great impact on ones health. Current unemployment rates for for adults with less than high school diploma is 4.7%, compared to collage graduates at 2.4%.2 With better pay and safer jobs, people are able to live in neighborhoods that encourage healthy life styles; fresh produce abundantly, safe recreational areas, healthier living conditions and less stress in worrying about survival.

Social and psychological factors: As ones education level increases, opportunities in the job market increase as well. This brings about belief and sense of control of ones destiny. This in turn has an effect on mental freedom that can be experienced in the work place as there is not such dependence on current job. Perceived social standing as well as social networks have been shown to increase ones health.3 It is no surprise that connections play a major role in ‘getting ahead in life’. That’s why wealth and power are so narrowly distributed in many countries around the world. Higher education level propels one closer to this small and elite population.4

I feel the strongest factor by far is education level and income. With higher income comes better neighborhoods, more recourses for healthy nutrition and recreational opportunities, less stress about worrying how to support family, and more opportunities in the work market. Education backs up one’s knowledge, earns respect from people around you and lifts the social status within community. All of these have an effect on health.1-4 On the other hand, if one has just inherited income but no education, there is often much less respect, less job opportunities (as most would have to come from connections), and less wisdom to use resources wisely.5

As can be seen in the figure 51 of the brief, educational level varies in America by race. Asians have the highest proportion of collage graduates (49.8) while whites have the lowest proportion of less than high-school graduation (10.6). Hispanics have almost 40% of youth 25 and younger who have not graduated from high school. Blacks and Native Americans are both just around 20%. Some reasons why this could be is feeling the need to help out at home to support family by finding a (low paying) job, having very little if any social support for attaining education, and not being taught from young age the value of having an education. Partly this is also related to drugs and gangs in the poorer neighborhoods. Increased costs for education is certainly no help either.

In order to shift the trend we need to do a better job educating at risk communities on the life benefits that education often brings and how education is related to health. We also need to educate policy writers to the economical effects that education can have, both in decreased health care spending and in increased productivity at work.6

In Exodus 34:6-77 God proclaims his patience, love, and faithfulness to us while He also tells us the consequences sin has for generations. This sounds a bit harsh but if you compare it to Exodus 20:5 God says the same thing but adds ‘..of those who hate me’8. So clearly God is not telling that children are doomed just because their father’s abandoned God, but it’s because of the consequences of their sin. Expanding this to the Christian view on education, just because parents were not able to acquire higher education doesn’t mean that the children should not either. On the contrary, this would be the place where church comes in and makes every effort to help break this cycle. As the brief1 stated, perceived social standing has been linked to improved health. So what better way to improve this that to have ones self worth and identity linked directly to being God’s child. With this comes hope and healing, which will increase ability to persevere and succeed. Throughout history church has been a driving force behind education.9 This was seen as pathway to evangelizing large populations as people learned to read the Bible for themselves. Some ways to do this still is to continue to shape the societal attitudes towards higher education, educate church goers about the importance of early education, challenge congregations to influence policy makers at local level to focus resources on closing the educational gap, and by filling the physical needs for school children in their neighborhoods (school supplies, clean clothing, meals during school breaks).

References:

1. Robert Wood Johnson Foundation. Exploring the social determinants of health. Education and Health. Issue Brief #5.

2. FRED Economic Research. Unemployment rate by education attainment and age, monthly, not seasonally adjusted: 25 years and over. August 2019. https://fred.stlouisfed.org/release/tables?rid=50&eid=48713&od=#. Accessed September 17, 2019.

3. Manstead ASR. The psychology of social class: how socioeconomic status impacts through, feelings, and behavior. Br J Soc Psychol. 2018 Apr; 57(2): 267-291. Doi: 10.111/bjso.12251

4. Domhoff WG. Power in America. Wealth, income, and power. Who Rules America? Sociology Dept., University of California at Santa Cruz. https://whorulesamerica.ucsc.edu/power/wealth.html. Accessed September 17, 2019.

5. Luthar SS. The culture of affluence: psychological costs of material wealth. Child Dev. 2003; 74(6): 1581-1593. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1950124/. Accessed September 17, 2019.

6. Hahn RA, Truman BI. Education improves public health and promotes health equity. Int J Health Serv. 2015; 45(4): 657-678. Doi: 10.1177/0020731415585986

7. Exodus 34:6-7. The Holy Bible.

8. Exodus 20:5. The Holy Bible. New International Version.

9. Pew Research Center. Religion & Public Life. How religion may affect educational attainment: scholarly theories and historical background. https://www.pewforum.org/2016/12/13/how-religion-may-affect-educational-attainment-scholarly-theories-and-historical-background/. Accessed September 17, 2019.

Second reply:Beulah Aggrey
DB 5
COLLAPSE
The 3 interrelated pathways presented as explanations for the relationship between educational attainment and health were: health knowledge and behaviors, employment and income, and social and psychological factors.1 Education increases people’s knowledge, problem-solving and coping skills which enables them to make better-informed choices for themselves and their family.1 Having more education is typically linked with higher paying jobs which provides the necessary income to live in neighborhoods that are less stressful, can afford healthy foods, and provides access to recreational facilities. Also, with more education, there is a higher likelihood of having a job with healthier working conditions that provides better employment-based benefits and higher wages.1 Education is typically associated with higher social standing and higher levels of social support which has been linked to better health status.1

Educational attainment and increased health knowledge and healthy behaviors is the strongest. Adults with higher levels of education are less likely to engage in health-risk behavior such as smoking, alcohol and other drug use and more likely to engage in healthier behaviors such as healthy diet and adequate physical activity.2 Also people who are more educated are more aware of health risks and may be more receptive to health education campaigns. They would also be able to understand their health needs, follow or read instructions, advocate for themselves and their families, and communicate effectively with health care providers.2

Decreased income, joining gangs, becoming pregnant, using drugs, physical or other medical problems, family issues, school environment increases the likelihood of dropping out of school. Also the availability of job opportunities that do not require high school degrees such as YouTube encourages young people not to complete high school. Anyone with a phone or camera can make a video and upload it on YouTube and with time they can start making money from there. Parents and the environment people grow up in have a major role in correcting this situation. Also, companies that do not require high school degrees to get a job with them need to encourage young people to get their high school degrees and for high school dropouts, companies can offer to pay for them to complete their degrees.

Exodus 34:7 says “ he punishes the children and their children for the sin of the parents to the third and fourth generation”.3 Sin is like a contagious disease, that can be passed on to children and their children. Any child that sins like the parent would share the same punishment. God does not punish sinless children for their father’s sin. In relation to educational attainment and health, a child may not suffer low educational attainment or poorer health if they break the cycle. The church can help break this vicious cycle by continuously preaching and teaching about the value of education, hold information’s sessions and invite school leaders to speak at, show support by sharing students success stories, offer tutoring, mentoring, after-school program, etc.

References

Robert Wood Johnson Foundation. EXPLORING THE SOCIAL DETERMINANTS OF HEALTH: Issue brief #5. https://www.rwjf.org/en/library/research/2011/05/education-matters-for-health.html Published April 1, 2011. Accessed September 17, 2019.
Zimmerman E, Woolf SH. Understanding the relationship between education and health. Discussion Paper, Institute of Medicine, Washington, DC. 2014. http://nam.edu/wp-content/uploads/2015/06//understandingtherelationship. Accessed September 17, 2019.
The Holy bible. New International Version. Available at https://www.biblegateway.com/. Accessed September 17, 2019.

https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png 0 0 bonniejecinta https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png bonniejecinta2024-04-05 20:02:172024-04-05 20:02:17Read the issue brief from the Robert Wood Johnson

Head, Eyes, Ears, Nose, and Throat

April 5, 2024/0 Comments/in Health Medical /by bonniejecinta

Question Description

Learning Resources

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 11, “Head and Neck”

  This chapter reviews the anatomy and physiology of the head and neck. The authors also describe the procedures for conducting a physical examination of the head and neck.

• Chapter 12, “Eyes”

  In this chapter, the authors describe the anatomy and function of the eyes. In addition, the authors explain the steps involved in conducting a physical examination of the eyes.

• Chapter 13, “Ears, Nose, and Throat”

  The authors of this chapter detail the proper procedures for conducting a physical exam of the ears, nose, and throat. The chapter also provides pictures and descriptions of common abnormalities in the ears, nose, and throat.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 15, “Earache”
This chapter covers the main questions that need to be asked about the patient’s condition prior to the physical examination as well as how these questions lead to a focused physical examination.

Chapter 21, “Hoarseness”
This chapter focuses on the most common causes of hoarseness. It provides strategies for evaluating the patient, both through questions and through physical exams.

Chapter 25, “Nasal Symptoms and Sinus Congestion”

In this chapter, the authors highlight the key questions to ask about the patients symptoms, the key parts of the physical examination, and potential laboratory work that might be needed to provide an accurate diagnosis of nasal and sinus conditions.

Chapter 30, “Red Eye”

The focus of this chapter is on how to determine the cause of red eyes in a patient, including key symptoms to consider and possible diagnoses.

Chapter 32, “Sore Throat”

A sore throat is one most common concerns patients describe. This chapter includes questions to ask when taking the patient’s history, things to look for while conducting the physical exam, and possible causes for the sore throat.

Chapter 38, “Vision Loss”
This chapter highlights the causes of vision loss and how the causes of the condition can be diagnosed.

Note: Download the six documents (Student Checklists and Key Points) below, and use them as you practice conducting assessments of the head, neck, eyes, ears, nose, and throat.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Head and neck: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., & Solomon, B. S., & Stewart, R. W. (2019). Head and neck: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Eyes: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Eyes: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Ears, nose, and throat: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Ears, nose, and throat: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis.

Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

• Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Weeks 1, 3, 4, and 5)

Bedell, H. E., & Stevenson, S. B. (2013). Eye movement testing in clinical examination. Vision Research 90, 32–37. doi:10.1016/j.visres.2013.02.001. Retrieved from https://www.sciencedirect.com/science/article/pii/S0042698913000217

Rubin, G. S. (2013). Measuring reading performance. Vision Research, 90, 43–51. doi:10.1016/j.visres.2013.02.015. Retrieved from http://www.sciencedirect.com/science/article/pii/S0042698913000436

Harmes, K. M., Blackwood, R. A., Burrows, H. L., Cooke, J. M., Harrison, R. V., & Passamani, P. P. (2013). Otitis media: Diagnosis and treatment. American Family Physicians, 88(7), 435–440. Retrieved from http://www.aafp.org/journals/afp.html

Note: You will access this article from the Walden Library databases.

Otolaryngology Houston. (2014). Imaging of maxillary sinusitis (X-ray, CT, and MRI). Retrieved from http://www.ghorayeb.com/ImagingMaxillarySinusitis.html

This website provides medical images of sinusitis, including X-rays, CT scans, and MRIs (magnetic resonance imaging).

Optional Resource

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.

• Chapter 7, “The Head and Neck” (pp. 178–301)

This chapter describes head and neck examinations that can be made with general clinical resources. Also, the authors detail syndromes of common head and neck conditions.

Assignment 1: Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment.

Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.

In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

To Prepare

• By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
• Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.

With regard to the case study you were assigned:

• Review this week’s Learning Resources and consider the insights they provide.
• Consider what history would be necessary to collect from the patient.
• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
• Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Assignment

Focused Thyroid Exam Chantal, a 32-year-old female, comes into your office with complaints of “feeling tired” and “hair falling out”. She has gained 30 pounds in the last year but notes markedly decreased appetite. On ROS, she reports not sleeping well and feels cold all the time. She is still able to enjoy her hobbies and does not believe that she is depressed.

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png 0 0 bonniejecinta https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png bonniejecinta2024-04-05 20:01:552024-04-05 20:01:55Head, Eyes, Ears, Nose, and Throat

Practice Scenario for Evidence Based practice

April 5, 2024/0 Comments/in Health Medical /by bonniejecinta

Question Description

1. Read over each of the following directions.
2. You must read the Assignment Practice Scenario below before completing the PPE Worksheet.
3. Download and use the required PPE Worksheet (Links to an external site.).
4. Complete each section of the Problem/PICOT/Evidence (PPE) Worksheet. For the Clinical PICOT Question, use the NR439_Guide for writing PICOT Questions and Examples.N439_Guide for writing PICOT Questions and Examples (Links to an external site.) Use one of the templates/guides to write your Clinical PICOT Question using all of the PICOT elements. Be sure to include the PICOT letters in your question.
5. Be sure to use the PPE grading rubric to make certain you are meeting all grading criteria of the PPE Worksheet.
6. Use correct grammar, spelling, punctuation, and in-text APA formatting.
7. Submit the completed PPE Worksheet on the Week 3 Assignment page.

Assignment Practice Scenario

Your Chief Nurse Executive (CNE) recognizes you are pursuing your BSN and has asked you to be a member of the nursing evidence-based practice (NEBP) committee. She has advised the members that the purpose is to conduct nursing research studies involving clinical practice problems. Increasing nurses’ awareness of quality and safety concerns will help develop an attitude of inquiry and asking questions (Sherwood & Barnsteiner, 2017). Baccalaureate nurses “collaborate in problem identification, participate in the process of search, retrieval, and documentation of evidence, and integrate evidence using credible databases and internet resources” (AACN, 2008, pp. 16-17).

The CNE has advised all members of the following areas of quality and safety clinical practice that each committee member needs to consider and choose only one as a priority area for conducting a research study. Sources of research problems come from nursing clinical practice (Houser, 2018):

UNSATISFACTORY / NOT PRESENT When the candidate uses sources, the candidate does not provide in-text citations and references.

DOES NOT MEET STANDARD When the candidate uses sources, the candidate provides only some in-text citations and references.

MINIMALLY COMPETENT When the candidate uses sources, the candidate provides appropriate in-text citations and references with major deviations from APA style.

COMPETENT When the candidate uses sources, the candidate provides appropriate in-text citations and references with minor deviations from APA style.

HIGHLY COMPETENT When the candidate uses sources, the candidate provides appropriate in-text citations and references with no readily detectable deviations from APA style, OR the candidate does not use sources.

Quality	Safety
Patient satisfaction Patient education	Falls
Non-pharmacological pain management	Errors. Examples include: Medication Patient identification Communication
Readmissions Length of stay Costs	Healthcare Associated Infections (HAIs). Examples include: Central Line Associated Blood Stream Infections (CLABSI) Catheter Associated Urinary Tract Infections (CAUTI) Ventilator Associated Pneumonia (VAP) Surgical Site Infections (SSI) Sepsis (Screening or Prevention)
Discharge Teaching/Coaching Transitions of Care/Level of Care	Pressure Ulcers Skin Integrity

Your CNE has requested that you select ONLY one topic area and complete the PPE Worksheet using only one topic area. The committee will collaborate and decide as a team which nursing clinical problem area will be the priority focus of their next research study. Thank you for your valuable contributions to this important NEBP committee.

References

American Association of Colleges of Nurses (AACN). (2008). Executive summary: The essentials of baccalaureate education for professional nursing practice (2008). Retrieved from http://www.aacnnursing.org/Education-Resources/AAC…

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones and Bartlett.

Sherwood, G., & Barnsteiner, J. (2017). Quality and safety in nursing: A competency approach to improving outcomes (2nd ed.). Hoboken, NJ: Wiley-Blackwell.

Quality and Safety Education for Nurses (QSEN). (2018). QSEN knowledge, skills, and attitude competencies. Retrieved from http://qsen.org/competencies/pre-licensure-ksas/

Rubric

NR439 PPE Worksheet Rubric

NR439 PPE Worksheet Rubric

Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeClinical Nursing Practice ProblemSelect and identify only one quality or safety clinical priority area from the assignment guidelines practice scenario. Summarize why you believe the nursing practice problem/issue is the most important. Summarize your rationale (why) for choosing the problem.	50.0 pts Selects and identifies one quality or safety clinical priority practice problem from the assignment guidelines practice scenario. Thoroughly summarizes why you believe the nursing practice problem/issueis the most important. Thoroughly summarizes the rationale (why) the problem was chosen. Provides details. 46.0 pts Criteria from the first column are mostly summarized or one criteria lacks details or is missing. 40.0 pts Criteria from the first column are minimally summarized or two criteria lack details or are not present. 19.0 pts Criteria from the first column are poorly summarized. 0.0 pts Criteria are not discussed.	50.0 pts
This criterion is linked to a Learning OutcomeClinical Nursing PICOT QuestionClinical Nursing PICOT Question Using the NR439 Guide for writing PICOT Questions and Examples located in the assignment guidelines, write out your PICOT question. Include each letter of the PICOT in your question.	15.0 pts PICOT question has 5 elements correct. Question is nursing related. 13.0 pts PICOT question has 4 elements correct or question is not nursing related. 12.0 pts PICOT question has 3 elements correct. 6.0 pts PICOT has 1-2 elements correct. 0.0 pts PICOT question with no elements correct or no PICOT question present.	15.0 pts
This criterion is linked to a Learning OutcomeDefine PICOT ElementsDefine each of the elements from your above clinical PICOT question.	15.0 pts 5 PICOT elements are correctly defined. 13.0 pts 4 PICOT elements are correctly defined. 12.0 pts 3 PICOT elements are correctly defined. 6.0 pts 1-2 PICOT elements are correctly defined. 0.0 pts PICOT elements are not correctly defined or elements are not present.	15.0 pts
This criterion is linked to a Learning OutcomeEvidence Retrieval Process and SummaryUsing only the Chamberlain College of Nursing library: (1) Locate evidence that is relevant to your chosen nursing practice problem. Explain how you believe the evidence is relevant to your chosen clinical nursing problem/issue. (2) Explain why you chose the evidence. (3) Provide a complete APA reference to the evidence (must include authors, year, title of the evidence, title of the resource). (4) Evidence must be published within the last 10 years. (5) Provide the permalink.	20.0 pts All of the 5 criteria are present. (1) Locates evidence relevant to chosen nursing practice problem. Explains how the evidence is relevant to your chosen clinical nursing problem/issue. (2) Explains why the evidence was chosen. (3) Provides a complete APA reference to the evidence (includes authors, year, title of the evidence, title of the resource). (4) Evidence must be published within the last 10 years. (5) Provides the permalink. 18.0 pts Missing 1 criteria or 1 criteria lacks details. 16.0 pts Missing 2 criteria or 2 of the criteria lacks details. 8.0 pts Missing 3-4 of the criteria. 0.0 pts Missing all five criteria from the A column or none of the criteria are present.	20.0 pts
This criterion is linked to a Learning OutcomeImplications of the EvidenceSummarize what you learned from the evidence. Summarize why you believe the nursing evidence-based practice committee should focus their next research study on this practice problem.	40.0 pts Thoroughly summarizes what was learned from the evidence. Thoroughly summarizes why you believe the nursing evidence-based practice committee should focus their next research study on this practice problem. Excellent details provided. 35.0 pts Mostly summarizes the criteria in the first column or one criteria lacks details. 32.0 pts Fairly summarizes the criteria in the first column or one criteria is missing. Fair details are provided. 15.0 pts Poorly summarizes the criteria in the first column. Poor details are provided. 0.0 pts Criteria are not summarized or is missing.	40.0 pts
This criterion is linked to a Learning OutcomeEvidence Search TermsIdentifies 4 (or more) relevant searchable terms you used for your search for evidence.	10.0 pts Identifies 4 (or more) relevant searchable terms used for the search for evidence. 9.0 pts Identifies 3 relevant searchable terms used for the search for evidence. 8.0 pts Identifies 2 relevant searchable terms used for the search for evidence. 5.0 pts Identifies 1 relevant searchable term used for the search for literature. 0.0 pts No terms identified or terms are not present.	10.0 pts
This criterion is linked to a Learning OutcomeEvidence Search StrategiesIdentifies 4 (or more) relevant search strategies you used to narrow/limit your search for evidence.	10.0 pts Identifies 4 (or more) relevant strategies used to narrow/limit the search for evidence. 9.0 pts Identifies 3 relevant strategies used to narrow/limit the search for evidence. 8.0 pts Identifies 2 relevant strategies used to narrow/limit the search for evidence. 4.0 pts Identifies 1 relevant searchable term used for the search for evidence. 0.0 pts No strategies identified or strategies are not present.	10.0 pts
This criterion is linked to a Learning OutcomeScholarly Writing, Mechanics, Organization, Spelling, Sentence Structure, Grammar	8.0 pts Excellent writing, mechanics, organization, spelling, sentence structure, grammar. 1-2 errors noted. 6.0 pts Good writing, mechanics, organization, spelling, sentence structure, grammar. A few errors noted. 3.0 pts Fair writing, mechanics, organization, spelling, sentence structure, grammar. Some errors noted. 2.0 pts Poor writing, mechanics, organization, spelling, sentence structure, grammar. Many errors noted. 0.0 pts Very poor writing, mechanics, organization, spelling, sentence structure, grammar. Errors throughout are noted. Writing is difficult to understand or follow.	8.0 pts
This criterion is linked to a Learning OutcomeAPA In-Text Formatting for Cited Sentences	7.0 pts Excellent APA formatting. Uses APA in-text citation formatting with no errors. 6.0 pts Good APA formatting. Uses APA in-text citation formatting with 1-2 errors noted. 4.0 pts Fair APA formatting. Uses APA in-text citation formatting with some errors noted or does not use in-text citation formatting. 3.0 pts Poor APA formatting with many errors noted. 0.0 pts Very poor APA with errors noted throughout.	7.0 pts
This criterion is linked to a Learning OutcomeAssigned PPE Worksheet Used	0.0 pts 0 points deducted Assigned PPE Worksheet used for this assignment. 0.0 pts 17.5 points deducted (10%) Assigned PPE Worksheet NOT used for this assignment results in deduction.	0.0 pts
This criterion is linked to a Learning OutcomeLate deduction	0.0 pts 0 points deducted Submitted on time 0.0 pts Not submitted on time – Points deducted 1 day late=8.75 deduction; 2 day late =17.5 deduction; 3 day late=26.25 deduction; 4 day=35 deduction; 5 day=43.75 deduction; 6 day =52.5 deduction; 7 day =61.25 deduction; Score of 0 if more than 7 days late	0.0 pts
Total Points: 175.0

Next

DISCUSSION BOARD FORUM 7

Read “Evidence-Based Public Health – A Fundamental Concept for Public Health Practice” by Brownson, et al., 2009, located in the Reading & Study folder for this module/week. Discuss the following points in your initial thread. Review the discussion board instructions before posting your initial thread.

• What is evidence-based public health (EBPH), and why does it matter?
• Compare and contrast the analytical tools of EBPH (systematic reviews, public health surveillance, economic evaluation, health impact assessment, and participatory approaches).
• In what ways do systematic reviews provide better evidence on which to base intervention decisions than personal experience? Why should qualitative data from community members be considered in the mix of evidence when planning a community-based intervention
• How does Christianity blend historical reviews and personal experience as credentials of its authenticity?

Discussion Board Instructions

You will participate in 8 Discussion Board Forums by 1) posting a thread in response to the stated prompt, and 2) posting replies in response to classmates’ threads. Each Discussion Board Forum topic presents a thought-provoking question or prompt based on recent article(s) in the scientific and professional literature of public health. Each prompt is designed to enhance your learning experience as you write about your ideas, perspectives and experiences, and receive feedback from your classmates. Both the frequency of your participation and the depth of the content you write will affect your grade. Use the Discussion Board Grading Rubric to improve the quality of your contributions and follow the specific requirements described below.

Note: Threads and replies must be completed within the assigned module/week or no credit will be awarded.

THREAD

For each forum, post a thread in response to the topic prompts provided. Your post should contain 400–500 words and adhere to AMA writing style guidelines. This word limit promotes writing that is thorough yet concise enough to permit your peers to read all the posts. If the Discussion Board Forum prompts you to answer a series of questions, make sure you address all of them thoroughly within the word limit. Do not restate the questions in your post; simply begin a new paragraph for each new thought. The goal is to have a seamless written argument closed by a brief conclusion tying together your individual responses. Use your best critical reasoning skills, employing the Universal Intellectual Standards as a guide, but not a strict outline. Refer to specific statements of the author(s) whenever appropriate but limit direct quotations to a maximum of 25 words for your entire post. Since this is a personal discussion, you may use first person; however, you should maintain professional decorum at all times.

Your thread should be posted to the appropriate Discussion Board Forum by 11:59 p.m. (ET) on Thursday of the assigned module/week.

REPLIES

After reading your classmates’ threads, post a reply to at least 2 classmates by clicking “Reply” within the thread to which you intend to respond. These replies are designed to stimulate thought-provoking discussion, building upon or expanding the knowledge presented. Your instructor is looking for substantive, reasoned comments, not mere agreement with the initial thread on which your reply is based. In your replies, state why you liked or disliked a comment, adding additional thoughts or ideas to your classmate’s, and/or providing alternative ideas or disagreeing thoughts. Your comments should be critical but kind, “speaking the truth in love” (Eph. 4:15). Help one another with good communication skills, both by example and instruction. Substantiate your position by referencing pertinent statements from the resource under discussion, but avoid lengthy quotes from it. You may also reference other professional or peer-reviewed sources, though this is not a requirement. Each reply should contain 200–250 words and adhere to AMA writing style guidelines.

Replies to your classmates’ threads are due by 11:59 p.m. (ET) on Sunday of the assigned module/week, except for Module/Week 8 when replies will be due by 11:59 p.m. (ET) on Friday.

Replies in first person:

Beulah Aggrey

DB 7

COLLAPSE

Evidence-based public health (EBPH) is defined as the “process of integrating science-based interventions with community preferences to improve the health of populations”.^1,2 With EBPH, there is “access to more and higher-quality information on what works, a higher likelihood of successful programs and policies being implemented, greater workforce productivity, and more efficient use of public and private resources”¹

The analytic tools of EBPH are used to enhance the adoption of evidence-based decision making. Public health surveillance collects and analyze data, disseminates data to public health programs, and evaluate the effectiveness of the use of the disseminated data.^1,3 Conducting systematic reviews allows for one to become familiar with research and practice on many specific topics in public health which can provide a wealth of valuable information for decision making in public health. Economic evaluation provides information that helps to assess the relative appropriateness of expenditures on public health programs and policies.³ “However, relevant data to support this type of analysis are not always available, especially for possible public policies designed to improve health”.¹ Health impact assessments (HIA) attempts to predict the positive and negative impacts of an intervention such as a policy, program, or project. The overall aim of the HIA is to influence decision making to minimize the harm and maximize the health benefits of an intervention.⁴ With the participatory approach, stakeholders, particularly those involved in program operations, those served or affected by the program, and primary users of the evaluation, such as practitioners, academicians, and community members collaborate to defines issues of concern, develop strategies for intervention, and evaluate the outcomes.¹

Systematic reviews limits bias and random errors thereby providing more reliable results upon which to make intervention decisions where as personal experiences gives room for subjective bias which could lead to poor decision making. Systematic reviews can also reduce waste of resources and time by identifying consensus in research and avoiding unnecessary interventions.⁵ Qualitative data from community members should be considered when planning a community-based intervention because the data provides information on the direct needs or health concerns of the community, how the issues can be addressed, and the possible barriers and facilitators to addressing the issues in that community. It could also be used to provide information to explain quantitative findings.¹

The Bible is a guide for our relationship with God and other humans. It also guides us on how to go about our daily life, things we should and should not do. However, each person interprets and follows the Bible in their own way usually based on personal experiences, or traditions. In relation to EBPH, despite the available evidence from research, people still make public health decisions based on personal experiences.

References

• Brownson RC, Fielding JE, Maylahn JM. Evidence-Based Public Health: A Fundamental Concept for Public Health Practice. Annu. Rev. Public Health. 2009;30:175–201. https://doi.org/10.1146/annurev.publhealth.031308.100134 Accessed September 30, 2019.
• Kohatsu ND, Robinson JG, Torner JC. Evidence-based public health: an evolving concept. Am J Prev Med. 2004;27(5):417–421. https://doi.org/10.1016/j.amepre.2004.07.019 Accessed September 30, 2019.
• Brownson RC, Gurney JG, Land GH. Evidence-Based Decision Making in Public Health. J Public Health Manag Pract. 1999;5(5):86–97. Accessed September 30, 2019.
• Joffe M, Mindell J. Health impact assessment. Occup Environ Med. 2005;62(12):907–835. doi:10.1136/oem.2004.014969. Accessed September 30, 2019.
• O’Hagan EC, Matalon S, Riesenberg LA. Systematic reviews of the literature: a better way of addressing basic science controversies. Am J Physiol Lung Cell Mol Physiol. 2018;314(3):L439–L442. doi:10.1152/ajplung.00544.2017. Accessed September 30, 2019.

Second reply:

Taylor Ellison

Discussion Board 7

COLLAPSE

Evidence-based public health (EBPH) combines the fields of public health and research. As the article states, “key factors of EBPH include making decisions on the basis of the best available scientific evidence, using data and information systems systematically, applying program-planning frameworks, engaging the community in decision making, conducting sound evaluation, and disseminating what is learned¹.” This may seem like a tall order, but it basically means applying more science and research methods in order to create sounder evidence and better methods to apply to behavior change.

Systematic reviews are a great way to get an overview of a topic and tend to limit biases¹. Public health surveillance simply researches a population in order to get an idea of what the population needs in the realm of behavior or policy changes. Economic evaluations are a large portion of the analytical tools of EBPH (we can be honest here – money rules the field!) Health impact assessments are slightly different in the sense that it investigates the outcomes of health changes on other fields such as agriculture, transportation, et cetera¹. Participatory approaches involve the community¹. Each of these approaches focus on different aspects of health and policy, however, they have the overarching goal of working in the interest of the population’s overall health.

Personal experience is just that – limited to one person. Systematic reviews have the added benefit limiting biases and providing more reliable results¹. Imagine that you are asking people on their opinions of a restaurant. One person may despise it. A systematic review may find that the restaurant is excellent in the aspects of food safety, waste management, and cleanliness. That being said – qualitative data from the community is important since they live in the area of study and can provide a more personal dataset.

Christianity is a very personal subject, but it also has the historical evidence to back it up. We all know the evidence written in the Bible of personal testimonies, and we all know that real evidence such as pieces of what was perhaps Noah’s Ark and the cross have been found. As far as the personal aspect, we all have something that has made us believe and/or solidified our faiths. Perhaps it was a verse in Sunday school, a picture of a statue crying blood, a rainbow when you needed it, or even a miracle you experienced firsthand. This is how EBPM ties into religion – it can be personal and evidence based.

Reference:

• Brownson RC, Fielding JE, and Maylahn CM. Evidence-based public health: a fundamental concept for public health practice. Annu. Rev. Public Health. 2009;30:175-201. URL. Published January 14, 2009. Accessed September 30, 2019.

1. Read over each of the following directions, the required Reading Research Literature worksheet, and grading rubric.
2. Download and complete the required Reading Research Literature (RRL) worksheet (Links to an external site.).
3. Download or access the required article. The required article must be used. O’Connor, M., Tanner, P. , Miller, L., Watts, K., & Musiello, T. (2017). Detecting distress: Introducing routine screening in a gynecological cancer setting. Clinical Journal of Oncology Nursing, 21(1), 79-85.
4. You must use the grading rubric to ensure you are meeting all grading criteria of the worksheet.
5. Use correct grammar, spelling, punctuation, and in-text APA formatting.
6. Submit the completed Reading Research Literature Worksheet to the Week 6 Assignment.

NR439 Reading Research Literature Worksheet Rubric