Complete Clinical Assignment Revision (BALIR)

/0 Comments/in /by

Question Description

I COMPLETED THIS ASSIGNMENT WRONG! I HAVE ATTACHED THE ANSWERS AND EXAMPLE OF HOW IT SHOULD LOOK!! PLEASE USE THE ANSWERS I-ATTACHED AND FORMAT

ANSWER:

The Subjective&Objective and Assessment&Plan Homework assignment was incorrect

Here is an example of what it should look like. The instructor is giving me an opportunity to redo them because they are worth 50 points
•PLEASE let me know if you need additional information.
•Using the same treatment sessions as before

ORIGINAL INSTRUCTIONS:

Assessment Plan Assignment

Below you will see a summary of two different 1 hour treatment sessions for the same patient as well as a section summarizing the patient’s information.Please write the Assessment portion of a SOAP note based on how the patient performs from treatment session 1 to treatment session 2. Please also write the Plan section of the SOAP note including at least 2 ideas for treatment. The ideas need to be appropriate for the level of this patient.

Patient Information:Dx: CVA c L hemi. Weakness noted t/o L UE and L LE. Pt does have active movement in her L arm, but having difficulty grasping and manipulating objects. Pt c 3- strength in her L quads and 2 in her L gluts. Her static supported standing balance is F/F+, however, her dynamic supported standing balance is P. She is using a LBQC for amb.

PMH: HTN, CAD, NIDDM, S/P THR in 2009

Home Information: One story home with 3 STE with no HRs

Social Information: Pt likes to play golf.

Treatment Session One: January 31, 2010 at 1:32 p.m.

Pt arrived to Rx session in a w/c. She was not feeling very well. She said she was feeling very tired; hadn’t slept well the night a. Pt noted to be very quiet t/o Rx session, and appeared sad. The Rx session began with PTA t/f pt → mat with pt using her LBQC. PTA had to give mod.PA. PTA noticed that pt puts all of her weight through her R LE and pushes post.during sit ↔ stand. Once pt is on mat, PTA works c pt doing repeated sit ↔ stands focusing on proper technique. PTA then has pt step ↑ on 4” step c R LE and reach ↓ and ↑ for bean bags c L UE, and toss into container. Pt needed to rest after about 10 bean bags for each of attempts totaling 4 attempts because of fatigue and SOB. O2 sat was89% after 1st attempt and noted to be 92% within 1 minute of sitting. PTA completed gt. training having pt use her LBQC. PTA had to give mod. –max. PA. Ptamb 25’, was unable to advance her L LE I, consistently looked down and hyperextension of her L knee was noted 75% of the time. 1 significant LOB noted when pt’s family arrived and pt turned her head to the L. After gt.training, PTA took pt back to her room.

Second Treatment Session: February 1, 2010 at 2:40 p.m. Pt arrived to Rx session in a w/c feeling better this date. Stated she slept much better last pm. The Rx session began c PTA t/f pt → mat using LBQC. PTA had to give mod PA. PTA noted pt to have some post. pushing and pt putting more weight thru L LE during

sit→stand. PTA continued to have pt. practice sit ↔ stands at varying heights. PTA also had pt put R LE on 4” step and throw ball against a wall at various targets. Pt noted to be SOB with activity, taking frequent rest breaks. O2 sat 93%. PTA ended Rx c gt. training using LBQC. Pt having difficulty remembering what foot to move first. Pt looking down less with VC and TC from PTA. Pt starting to advance L LE on her own, however, PTA still needing to clear her L foot. Pt amb 30’ c mod PA – max PA from PTA, and pt able to control knee better. Pt not sad during any of the Rx session. P Rx was done, PTA took pt back to room.

Discussion reply

/0 Comments/in /by

Question Description

September 23, 2019 8:43:43 PM EDT3 days ago

Access the profile card for user: Amanda KellsAmanda Kells

Main Discussion – Week 5

Collapse

Main Post

Personal Leadership Strengths

Nurse leaders are responsible for leading and managing individuals in their work area, requiring a strong relationship building skill in order to coach employees to their full potential. Positive outcomes are achievable when the relationship consists of trust, mutual respect, support, and open communication (Manion, 2011). Relationship building may or may not be a strength for all nurse leaders, but understanding one’s strengths and gaps are essential when faced with a disengaged employee.

Self-assessment tools are available online, through an organization’s development program, or books for nurse leaders to identify which leadership skills fall into the categories of strengths and opportunities. Relationship building, role modeling, and active listening with open communication are foundations of this nurse manager’s leadership style. Utilizing these skills allow the nurse manager to demonstrate an authentic leadership style and connect with employees who feel disengaged from their work.

Situation-Lack of a Nurse Manager

The clinical head nurse (CHN) role is a nurse leader position at the academic medical center. The CHNs spend 80% of worked hours in the charge nurse role and 20% of worked hours performing administrative duties. From 2016-2017, there was an interim nurse manager (NM) supervising the unit that was also managing two other clinical areas. With such a broad span of control, the director chose to change the worked hours of the two CHNs to that of 50/50 to support the interim NM. The clinical staff felt unsupported during this year and felt disconnected from the CHNs, believing the CHNs could not understand their daily struggles. The CHNs perceived they were supporting the staff beyond expectations, and because of this disconnect, all parties felt resentment; leading the CHNs to disengage from their clinical requirements and display avoidance behavior with the clinical staff because they felt unappreciated.

With the hiring of the permanent NM, this challenge was one of the first problems that the NM needed to address. Utilizing the strengths of relationship building, role modeling, and active listening with open communication, the nurse manager interviewed all clinical staff and the CHNs during the first 60 days to understand all perspectives on the problem. Sharing the findings with the CHNs is the next step in finding an adequate solution. The NM determined that the CHNs and staff needed to reconnect as a team, so the CHNs now work one shift a month in the staff nurse role. The CHNs did not receive this decision well at first, but over time have come to understand, accept, and enjoy this time with their team. The NM role-modeled the importance of connecting with the team by spending time in the charge nurse role and shadowing staff nurses. These adjustments in responsibilities allowed the entire team to build a professional and personal relationship.

Clinical Head Nurse Strengths

The CHNs shared similar strengths in their leadership style, but also have their unique methods. A shared strength is relationship building; their ability and passion for working as part of a team is a motivator for both CHNs (MindTools, n.d.). Spending time with staff outside their administrator and charge nurse role, allows the CHNs to directly assist the staff in their daily work as well as building a personal relationship with their colleagues. The more time they interact together, the staff will see how much the CHNs desire to help them and their capability to perform the staff nurse role, anticipating this will allow for all parties to appreciate each other and their contributions to the team.

One CHN shows strength with execution; she is efficient with managing her time, consistently meets deadlines, and has a “get it done” attitude (MindTools, n.d.). Spending more time in the clinical staff role allowed her to identify quick fixes to improve efficiency for the staff, improving their work environment overall.

The other CHN shows strong strategic thinking with the ability to find new and creative ways to accomplish tasks and overcome obstacles (MindTools, n.d.). Demonstrating this skill to the staff increased her ability to motivate others to think outside of the box and find creative ways to execute job tasks and incorporating new initiatives into their workflow.

Summary

The NM and CHN in this scenario are leaders for this clinical unit team, each with their strengths and natural abilities. Together the leaders utilized their skills of execution, strategic thinking, and role modeling to make a successful change despite the gaps in their leadership styles (Kanefield, 2011). They executed a plan that helped to rebuild trust amongst all team members, reconnect with their employees and purpose, and demonstrate appreciation for the contributions of all team members.

References

Kanefield, A. (2011). Know your own strength. Smart Business St. Louis, 4(2), 6. Retrieved from the Walden Library databases.

Manion, J. (2011). From management to leadership: Strategies for transforming health care (3rd ed.). San Francisco, CA: Jossey-Bass.

MindTools. (n.d.). Strengths-Based Leadership: Understanding Strengths and Weaknesses. Retrieved from https://www.mindtools.com/pages/article/strengths-…

What is moral dilemmas?

/0 Comments/in /by

Question Description

Assessment 2

  • PRINT

  • Moral Dilemmas and Ethical Decisions

  • Toggle Drawer

    Overview

    Create a 15-minute oral presentation (3–4 pages) that examines the moral and ethical issues related to triaging patients in an emergency room.By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Toggle Drawer

    Context

    Working in an emergency room gives rise to ethical dilemmas. Due to time restraints and the patient’s cognitive impairment and lack of medical history, complications can and do occur. The nurse has very little time to get detailed patient information. He or she must make a quick assessment and take action based on hospital protocol. The organized chaos of the emergency room presents unique ethical challenge, which is why nurses are required to have knowledge of ethical concepts and principles.

  • Toggle Drawer

    Questions to Consider

    To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

    • How does a triage nurse decide which patient gets seen first?
    • How does health disparity affect the triage nurse’s decision making?
    • What ethical and moral issues does the triage nurse take into account when making a decision?
    • What are triage-level designations?
  • Toggle Drawer

    Resources

    Suggested Resources

    The following optional resources are provided to support you in completing the assessment or to provide a helpful context. For additional resources, refer to the Research Resources and Supplemental Resources in the left navigation menu of your courseroom.

    Capella Resources

  • Assessment Instructions

    Your supervisor has asked you to do a 15-minute oral presentation at a staff meeting about a recent issue that occurred at another hospital in town. Following an industrial accident, two patients arrived at the emergency room of that hospital at the same time, presenting with very similar inhalation injuries. The hospital received a great deal of negative press due to how the patients were triaged in the ER. Your supervisor would like you to use the specifics of this case to review triage procedures and best practices at your facility. Here are the details:

    • One is a 32-year-old firefighter, Frank Jeffers, who is presenting with respiratory difficulties that he obtained while evacuating victims of an industrial accident. He is a married homeowner and father of two young boys. He has lived in the community all his life. He has full and comprehensive health insurance through his employer.
    • The other is Brent Damascus, a 58-year-old man. Brent is presenting with respiratory difficulties with the same intensity as Mr. Jeffers above. He is well known at the hospital emergency room, as he is a frequent visitor with various complaints, including asthma, headaches, and tremors. He is homeless, unemployed, and uninsured. He stays many nights at the YMCA and eats lunch at the soup kitchen. He has lived in the community for over 10 years and has been arrested several times for petty theft.

    Preparation

    Search the Capella library and the Internet for scholarly and professional peer-reviewed articles on best practices in triage nursing. You will need at least three articles to use as support for your work on this assessment.

    Directions

    Create a 15-minute presentation (3–4 pages) that examines the moral and ethical issues that occurred when triaging these two patients and the best practices for managing this in the future.Divide your draft into a number of talking points that you can summarize neatly. Keep in mind that an oral presentation requires slightly different language than an essay. The aim is to communicate your message so keep sentences simple and focus on the key points you want to deliver. Address the following in your presentation:

    • Explain the health care policies and protocols that are in place that direct triage care in an emergency situation.
    • Explain how health care disparities impact treatment decisions.
    • Identify the health care policies that are in place that direct care for uninsured individuals. Is there a difference in how these individuals are triaged?
    • Describe the moral and ethical challenges nurses can face when following hospital policies and protocols. Is there a conflict when a severely injured person is also uninsured?
    • Recommend evidence-based strategies that should be applied for managing the care of uninsured and indigent population.

    Additional Requirements

    Your presentation should meet the following requirements:

    • Written communication: Written communication should be free of errors that detract from the overall message.
    • References: Include a reference section with a minimum of three references; a majority of these should be peer-reviewed sources. All resources should have been published within the last 5 years.
    • APA format: Resources and citations should be formatted according to current APA style and formatting.
    • Length: 3–4 typed, double-spaced pages, excluding title page and reference page. Use Microsoft Word to complete the assessment.
    • Font and font size: Times New Roman, 12-point.

Community health nursing, demographic and epidemiological data

/0 Comments/in /by

Question Description

Overview

The primary focus of a community health nurse is to improve the health of the community. To do this involves using demographic and epidemiological findings to assess the community’s health and diagnose its needs. This assessment is aligned with the module objective “Discuss the elements of practice in community/public health nursing.”

This assignment is not a paper, so there is no cover page. All of the work is completed by completing the attached template. As part of the assignment, you will complete the following tasks: typing data, an analysis of the findings with four (4) references, and community health nursing diagnoses directly on the template.

  • Compile a range of relevant demographic and epidemiological data found on the community assessment rubric for this assignment. Use the websites listed below, as well as other websites (you can also do a Google search to find the health data you are looking for), gather information about your county and compare it with your state and national numbers.

Example Websites:

Click for more options

  • How your community is doing in comparison with other communities?

Points: 40

Due Date: Sun, Oct 6 by 11:59 p.m. Eastern Standard Time (EST) of the US.

References

Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style

Unless otherwise specified, all the written assignment must follow APA 6th edition formatting, citations and references. Click here to download the Microsoft Word APA 6th edition template. Make sure you cross-reference the APA 6th edition book as well before submitting the assignment.

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

Instructions

To be successful, complete the following steps in order:

STEP 1. Review the instructional materials and finish learning activities in this module.

STEP 2. Click here to download the rubric. Click here to download the template.

To download template, click on File > Save as > Download a copy to your computer

STEP 3. Create a new Word document, write your paper based on the above overview.

STEP 4. Refer to APA book and rubric for correctly formatting the paper.

STEP 5. Save the document with the filename: ” Lastname_Firstname_Module_1_Assessment_2″ (Example: Smith_Jill_Module_1_Assessment_2.docx)

STEP 6. Submit the document by clicking the link on the left titled ” M1 A2 WA: SUBMISSION AREA – COMMUNITY HEALTH DIAGNOSES “

Note: You will have three (3) attempts to submit a written assignment, only the final attempt will be graded. For each attempt you will receive a SafeAssign originality report. This will give you a chance to correct the assignment based on the SafeAssign score. Click hereto view instructions on how to interpret your SafeAssign originality report. Your safeAssign score may high in this assignment due to the required template.

Got questions? Please post them to the ‘QUESTION & ANSWER FORUM’ in Blackboard.

Show Learning Module Table of Contents

Table of Contents

Expand Table of ContentsMaximize Table of ContentsMove to the Left

answer this question 2 paragraphs needed

/0 Comments/in /by

Question Description

Need 2 paragraphs with sources on this prompt.

What clinical trial endpoints have been shown to improve when ACE inhibitors and/or ARBS are used in preventing the progression of kidney disease in patients with diabetes? Which patients with diabetes benefit the most? At what point is it recommended that an ACE inhibitor or ARB be initiated in a patient with diabetes?

Formulate a response to this discussion. Need 2 paragraphs

In the study Role of ACE inhibitors in Patients with Diabetes Mellitus the results showed that that not only do ACE inhibitors help to slow the progression of kidney disease but that they also help with the protection of other organs. “ACE inhibitors have been reported to improve kidney, heart, and to a lesser extent, eye and peripheral nerve function of patients with diabetes mellitus.” This study was more directed at providing evidence of adding the ACE inhibitor earlier in therapy because it could help prevent other complications in the future such as kidney disease. ACE inhibitors are already indicated in patients with hypertension. I can understand their thought process in doing this but only in high risk diabetes patients for high blood pressure, mainly type 2 diabetes. The patients that benefit the most from taking an ACE or an ARB for preventing the progression of kidney disease is someone who has hypertension or proteinuria. I would also argue that someone who could benefit the most is someone who is high risk for hypertension. Overall there is a lot of evidence from lots of studies pointing towards ACE inhibitors and ARBs being given in patients with both diabetes and hypertension, and this is why it’s initiated after patients have both.



Formaulate response to this discussion. Need 2 paragraphs.

There is a renoprotective effect that ARBs and ACE inhibitors possess that makes them a good candidate to help prevent kidney issues within patients with diabetes. There is evidence for ACE inhibitors in type 1 and ARBs for type 2 diabetes to reduce progression in both diseases. For ACE inhibitors this is seen because of moderately increased albuminuria, there was a study where a diabetic patient had decreased albumin excretion and after two years of disease progression the patients on ACE inhibitors had less albuminuria than those with placebo. There was another study that had overt nephropathy and randomly assigned therapies with either captopril or a placebo. After 4 years patients with captopril had slower rate of creatine increases with less likelihood of progressing to end stage renal disease. This however only worked for patients with creatine of greater than 1.5 mg/dL and it was reduced by 50% per year compared to placebo group. There was no improvement for those with lower baseline plasma creatinine concentration because the rate of progression is slow. Some patients had antiproteinuric effects with remission or regression of nephropathy, 40 were randomly assigned to active therapy with captopril and after 7.7 years 6 patients were still in remission with lower proteinuria after using an ACE inhibitor of captopril. Aggressive blood pressure therapy has been connected with remission and regression. After treatment with ACE inhibitors the rate of decline in GFR was faster after a nine year follow up.

A good reason this method is effective has to do with good blood pressure control and management is a key factor in preventing progression of diabetic nephropathy. United Kingdom Prospective Diabetes Study determined that 10 mmHG reduction in systolic pressure gives a 12% decrease in risk for diabetic complications. This would indicate that by utilizing these avenues of ACE inhibitor or ARBs to control blood pressure would indirectly reduce a patient’s risk of developing kidney disease complications.

Both diabetic types receive effects from this type of treatment, however it was found that ARBs have better efficacies and that could be a better form for treatment in both type 1 and type 2. With that said, ACE inhibitors have been frequently tested in type 1 diabetics whereas ARBs were tested in type 2. Both had seemingly congruent results that lead to believe either treatment would be recommended but distinguished in which type of diabetes a patient is suffering from.

Patients with urinary albumin excretion rates of 30 to 300 mg in 24 hours are those who should be prescribed these medications in order to utilize this special property for stalling of diabetic nephropathy disease in both type 1 and type 2 diabetic patients which was recommended by the The Kidney Disease: Improving Global Outcomes guidelines . After doing a lot of research on this topic my results found that the best method for this prevention of diabetic kidney disease is by using both an ACE inhibitor and ARB together to have a greater reduction in protein excretion, but it was concluded to not use these medications at the same time as it increases likelihood of adverse events.. There however is more data for ARB efficacy rather than ACE inhibitors with this indication.

economics of nursing

/0 Comments/in /by

Question Description

Each student will complete a 500 – 750 word (not including title and references pages) individual paper discussing the economic costs of staff turnover in hospitals and healthcare facilities in the United States. Refer to the websites provided in the Welcome Module for helpful information.

Focus on four major themes: 1) impact on quality of patient care, 2) impact on healthcare system costs, 3) impact on retention of nurses in the profession, and 4) strategies to positively influence these costs. Students are expected to apply concepts and analytical understanding gained in course readings and videos to address these topics.

No more than 15% of your paper should be found from online/other sources according to Turnitin’s plagiarism report.

A minimum of three references should be used. Two of these sources should be from a peer-reviewed article. Avoid the use of undated references. This document must be submitted using APA format. After the paper is graded, edit the paper and place it in your portfolio.

See the Economics of Nursing Grading Rubric for complete details of grading.

These websites will have information to use in your discussion posts and class written assignments:

https://www.ncsbn.org/workforce.htm (Links to an external site.)

http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NurseRetention.html (Links to an external site.)

https://www.afscme.org/news/publications/health-care/solving-the-nursing-shortage (Links to an external site.)

https://www.nursingeconomics.net/necfiles/2017/MJ17/110.pdf (Links to an external site.)

https://www.osha.gov/dsg/hospitals/documents/1.2_Factbook_508.pdf (Links to an external site.)

https://www.osha.gov/dsg/hospitals/ (Links to an external site.)

https://www.osha.gov/dsg/hospitals/documents/1.1_Data_highlights_508.pdf

Rubric for Economics of Nursing Paper

Criteria

Poor

(0 – 79%s)

Adequate

(80% – 89%)

Good

(90% – 100%)

Points earned/possible

Introduction:

Relevant introduction that synthesizes the focus of the paper (Nursing economic themes))

Omits or fails to provide an introduction to nursing economics issues

Introduction is present, but does not fully synthesize an adequate introduction to focus of the paper

Introduces the paper, synthesizing the focus of the nursing economics topic in an above satisfactory manner

___/20

Discusses the economic impact of staff turnover on quality of patient care

Omits or fails to address the relevance/impact on quality of patient care

Provides some relevance/impact on quality of patient care

Provides an above satisfactory relevance/impact on quality of patient care

___20

Discusses the economic impact of staff turnover on universal healthcare costs

Omits or fails to address the relevance/impact on universal healthcare costs

Provides some relevance/impact on universal healthcare costs

Provides an above satisfactory relevance/impact on universal healthcare costs

___/20

Discusses the economic impact of retention of nurses in the profession

Omits or fails to address the relevance/impact on retention of nurses in the profession

Provides some relevance/impact on retention of nurses in the profession

Provides an above satisfactory relevance/impact on retention of nurses in the profession

___/20

Discusses strategies to positively influence the economic impacts of staff turnover

Omits or fails to address the strategies to positively influence the economic impacts of staff turnover

Provides some strategies to positively influence the economic impacts of staff turnover

Provides above satisfactory strategies to positively influence the economic impacts of staff turnover

___/20

Conclusion

Omits and/or fails to provide conclusion to paper

Omits and/or fails to summarize key points

Provides conclusion, but has difficulty summarizing key points

Provides above satisfactory conclusion to the paper, addressing key points fully.

___/20

Grammar and syntax

Grammar and syntax with significant errors

Some errors in grammar and syntax are noted

Grammar and syntax without errors

___/15

References

Provides no or inadequate references.

Provides 1-2 references, of which 1 are peer reviewed.

Provides 3 or more references, of which two or more are peer-reviewed.

___/25

APA format (title page, headings, citations, reference(s) page, etc.)

Omits significant portions and/or fails to follow APA format

Uses elements of APA format, but many errors noted; less than 3 references included

Uses appropriate APA format consistently and accurately throughout paper; 3 or more references included

___/15

COMMENTS:

Total

____/150


600 words about Depression and Immune Function

/0 Comments/in /by

Question Description

Depression and Immune Function

The body manifests what the mind harbors.
—Jerry Augustine, Former American baseball player

If the body be feeble, the mind will not be strong.
—Thomas Jefferson, American co-author of the Declaration of Independence

These quotes illustrate what researchers know about how the condition of the mind and the body influence one another. In fact, research suggests that severe depression may decrease the number of immune factors in the body affecting immune responses such as inflammation. The impact of less immune factors could lead to chronic diseases. For those battling chronic diseases, research supports that these individuals might be more susceptible to depression. When it comes to health, the mind and the body are engaged in an interrelated and bi-directional relationship.

To prepare for this Assignment, search the Walden Library and select two research studies that examine the relationship between depression and inflammation.

The Assignment:

In a Word document, respond to the following questions in a short-answer bulleted format:

  • What are two symptoms of depression? Provide a description for both.
  • What are two symptoms of inflammation? Provide a description for both.
  • What are two similarities between depression and inflammation at the cellular level?
  • What were the results of the two research studies that you selected that examined depression and inflammation?
  • Describe two influences that these research results might have on the treatment of depression.

Support your Assignment with specific references to all resources used in its preparation.

READINGS

  • Contrada, R. J. (2011). The handbook of stress science: Biology, psychology, and health. New York, NY: Springer Publishing Company, LLC.
    • Chapter 5, “Behavioral, Emotional, and Cognitive Sequelae of Immune System Activation” (pp. 65–76)
    • Chapter 25, “Stress and Depression” (pp. 345–358)
    • Chapter 26, “Stressors and Mental Health Problems in Childhood and Adolescence,” (pp. 359–372)
    • Chapter 27, “Physical Health Outcomes of Trauma,” (pp. 373–384)
  • Kendall-Tackett, K. (Ed.). (2010). The psychoneuroimmunology of chronic disease: Exploring the links between inflammation, stress, and illness. Washington, DC: American Psychological Association.
    • Chapter 5, “Depression, Hostility, Posttraumatic Stress Disorder, and Inflammation: The Corrosive Health Effects of Negative Mental States” (pp. 113–131)
    • Chapter 6, “Cognitive and Behavioral Reactions to Stress Among Adults with PTSD: Implications for Immunity and Health” (pp. 133–158)
    • Chapter 9, “Treatments for Depression That Lower Inflammation: Additional Support for an Inflammatory Etiology of Depression” (pp. 219–242)
  • Altemus, M., Dhabhar, F., & Ruirong, Y. (2006). Immune Function in PTSD. Annals of the New York Academy of Sciences, 1071(1), 167–183.
    Retrieved from the Walden Library databases.
  • Dantzer, R. (2012). Depression and inflammation: An intricate relationship. Biological Psychiatry, 71(1), 4–5.
    Retrieved from the Walden Library databases.
  • Dantzer, R., O’Connor, J. C., Freund, G. G., Johnson, R. W., & Kelley, K. W. (2008). From inflammation to sickness and depression: when the immune system subjugates the brain. Nature Reviews Neuroscience, 9(1), 46–56.
    Retrieved from the Walden Library databases.
  • Gill, J. M., Saligan, L., Woods, S., & Page, G. (2009). PTSD is associated with an excess of inflammatory immune activities. Perspectives in Psychiatric Care, 45(4), 262–277.
    Retrieved from the Walden Library databases.
  • Gill, J., Vythilingam, M., & Page, G. G. (2008). Low cortisol, high DHEA, and high levels of stimulated TNF-α, and IL-6 in women with PTSD. Journal of Traumatic Stress, 21(6), 530–539.
    Retrieved from the Walden Library databases.
  • Howk, C., & Bennett, M. (2010). Immune function and health outcomes in women with depression. BioPsychoSocial Medicine, 4, 3–11.
    Retrieved from the Walden Library databases.
  • Leonard, B. E. (2010). The concept of depression as a dysfunction of the immune system. Current Immunology Reviews, 6(3), 205–212.
    Copyright 2010 by Bentham Science Publishers, Ltd. Reprinted by permission of Bentham Science Publishers, Ltd., via the Copyright Clearance Center.
  • Sarapas, C., Cai, G., Bierer, L. M., Golier, J. A., Galea, S., Ising, M.,…Yehuda, R. (2011). Genetic markers for PTSD risk and resilience among survivors of the World Trade Center attacks. Disease Markers, 30(2–3), 101–110.
    Retrieved from Walden Library databases.
  • Scott-Tilley, D., Tilton, A., & Sandel, M. (2010). Biologic correlates to the development of post-traumatic stress disorder in female victims of intimate partner violence: Implications for practice. Perspectives in Psychiatric Care, 46(1), 26–36.
    Retrieved from Walden Library databases.
  • Wilson, D. R. (2010). Health consequences of childhood sexual abuse. Perspectives in Psychiatric Care, 46(1), 56–64.
    Retrieved from Walden Library databases.
  • National Institute of Mental Health. (2009). Key molecule in inflammation-related depression confirmed. Retrieved from http://www.nimh.nih.gov/news/science-news/2009/key-molecule-in-inflammation-related-depression-confirmed.shtml

Optional Resources

Sex Research Ethics Tuskegee Study

/0 Comments/in /by

Question Description

Resources:

After watching the film (link below) on the Tuskegee study, reflect on what you feel were the main violations of ethics. What do you feel are the main ethical concerns facing sexuality research today?

1. Watch the video
2. Answer question (250-400 words)
3. Reply the 2 Topics (A & B) below

A. After watching the Tuskegee study film, there are many violations of ethics that occurred within the study. This study would have violated many rules and conducts of today’s society, but during the 1920s-1930s when the study was issued, the film mentions that no one or very little people would care about the inhumane treatment of the all-black study group that was chosen for the study. This means the study was designed under racial motivations. The health officials who designed the study knew this and, therefore chose this study group in order to avoid any backfire from the inhumane conditions they operated under. The study group was not acknowledged of the treatment and diagnosis, but only told that they had “bad blood” and the study would cure them. A testimony from one of the study group members states that he received a spinal tap and had no idea what the purpose or reason for it. The film also mentions that those in the study group were given placebos and Advils in order to make them believe that it was medication to help cure the disease. The scientists and researchers who operated the study were only concerned with recording valuable information to create a treatment while neglecting the health status and needs of the study group which displays their wrong motives and malpractices. The researchers also understood that the black community of Tuskegee, Alabama were uneducated. They targeted this black community because they knew no one would speak up or ask questions about what or why something was done. The study was racially motivated, violated many ethics, and displayed dishonesty, distrust, and malpractices. I believe some of the ethical concerns facing sexuality research today can very much be related to the Tuskegee study. Issues with consent, dishonesty, and wrong motivations can create a study with malpractices. If researchers are conducting a study with the wrong motivations, patients and those in the study group may face inhumane conditions much like the Tuskegee study. Dishonesty from researchers can violate the patients’ rights to understand the reason for the study and its aspects.

B. The Tuskegee Study violated many ethical standards over its forty year period. A couple of main ethics I believe this study violated was honesty and integrity. The study was originally supposed to last six months, but instead lasted forty years, from 1932-1972. The impoverished African-Americans participating were promised free medical care from the United States government. However, researchers still continued the study after it lost its funding, but without informing that those infected would not get treated. The whole purpose of the study was to observe the history of syphilis in hopes of finding treatment, however when penicillin was proven to be a successful antibiotic to treat the infection, subjects did not receive the treatment. The participants were misled with the purpose, with what they were promised, and fully taken advantage of over the course of this study. I say this because researchers intentionally preyed on the indigent minority and researchers abused the situation those African-American men were in. The Tuskegee Study simply lacked concern and respect for their participants and I think overall negatively affected the subjects trust in healthcare professionals and healthcare as a whole. I feel the main ethical concerns facing sexuality research today is fidelity and trust and if the research is of beneficence. I think that researchers probably struggle with whether or not their study would benefit people and do good, especially if the study involves humans. This brings up an ethical concern regarding using people as subjects to test on; a life (or lives) could potentially be in the hands of the testers. In general, effective communication goes a long way; if sexuality research is conducted to gain a participants trust they need to be informed of the “purpose and the potential risks and [the] benefits” (Yarber, 2019, p. 31). In other words, full disclosure and effective communication would need to be understood by both of the parties involved to establish and maintain trust for an ethical study.

Quantitative and Qualitative

/0 Comments/in /by

Question Description

This week we learned how research designs are different and help us to objectively study nursing problems; the key is to decide which type of research and design will serve the purpose or intent to find a solution. After completing Week 4 readings and lesson, answer the following:

  • Reflect on your learning about Quantitative and Qualitative research; share two ways that helped you understand how they are different.
  • Choose one category of study design that you found interesting and describe; include what you learned about the design and how you believe it can help study nursing problems.
  • Refer back to your clinical nursing priority problem and evidence you located for your week 3 assignment:
    • The nursing-evidenced practice (NEBP) committee has requested for you to make a recommendation to the team: Describe the type of research and the design that you believe would be the best way to study your problem. Discuss your rationale.
  • Discussion Board Rubric 9_19
  • Discussion Board Rubric 9_19
    Criteria Ratings Pts
    This criterion is linked to a Learning OutcomeAnswers the initial graded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week.

    16.0 pts

    Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.

    14.0 pts

    Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.

    12.0 pts

    Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.

    0.0 pts

    Minimally addresses the initial discussion question(s) or does not address the initial question(s).
    16.0 pts
    This criterion is linked to a Learning OutcomeIntegrates evidence to support discussion. Sources are credited. ( APA format not required)

    12.0 pts

    Integrates evidence to support your discussion from: assigned readings OR online lessons, AND at least one outside scholarly source. Sources are credited.

    10.0 pts

    Integrates evidence to support discussion from: assigned readings OR online lesson. Sources are credited.

    9.0 pts

    Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson. Sources are credited.

    0.0 pts

    Does not integrate any evidence.
    12.0 pts
    This criterion is linked to a Learning OutcomeEngages in meaningful dialogue with classmates or instructor before the end of the week.

    14.0 pts

    Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.

    12.0 pts

    Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.

    10.0 pts

    Responds to a classmate and/or instructor but does not further the discussion.

    0.0 pts

    No response post to another student or instructor.
    14.0 pts
    This criterion is linked to a Learning OutcomeCommunicates in a professional manner.

    8.0 pts

    Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).

    7.0 pts

    Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).

    6.0 pts

    Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).

    0.0 pts

    Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).
    8.0 pts
    This criterion is linked to a Learning OutcomePARTICIPATION: Response to initial question:

    Responds to initial discussion question(s) by
    Wednesday, 11:59 p.m. M.T.

    0.0 pts

    0 points deducted
    Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.

    0.0 pts

    5 points deducted
    Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.
    0.0 pts
    This criterion is linked to a Learning OutcomePARTICIPATION Total posts:

    Participates in the discussion at least three times on at least two different days.

    0.0 pts

    0 points deducted
    Posts in the discussion at least three times AND on two different days.

    0.0 pts

    5 points deducted
    Posts fewer than three times OR does not participate on at least two different days.
    0.0 pts
    Total Points: 50.0

edit my work

/0 Comments/in /by

Question Description

Patient-centered care

Introduction

Quality and safety nursing competencies (QSEN) faculty have designed a set of competencies to be imparted into newer nursing graduates. Patience centered care is one of the six main components that need be taught to new nursing students in the knowledge, skills, and attitudes (KSAs) program.The nurses are hence adequately prepared to work under an approved orthodox and ethics codes as they are to be instrumental towards t improving quality and safety in the health care system (Ironside & Sitterding, 2009). Patients Care can be enhanced through effective management of care. Care coordination also acts as a supportive pillar in ensuring that effective care is established as a clinical routine. This paper, therefore, takes a look at what both management of care and care coordination entails.

Effective management of care

The main aim of care management is to enhance improvement in care for patients. It, in addition, eases the delivery of quality health services. On this note, therefore, it becomes easier to avail the necessary medical supplements to patients. The caregivers are also supplied with optimal skills to take enough care for patients under their attention. Chronic illnesses vitally need constant attention. As a result, therefore, a timely provision of health attention to patients under such conditions serves to enhance care management. Nurses and caregivers can hence, not evade accountability. Effective care management hence comes in to serve the purpose

Care coordination

Care coordination is auxiliary support to care management. It ensures that optimal care is provided to patients within the required scope. As a result, therefore, service delivery stems from the highest pinnacles of the health sector. Proper management of resources is followed up till they reach the patients in question. Accountability is an essential aspect in that case. It hence diminishes chances of spillages that can lead to violation of QSEN program principles. Care coordination has various components.

One of the main factors that hinder quality services delivery in the health sector is the payment process. It is such circumstances that make the bureaucratic process leading to untimely services. As a result, the QSEN program has emphasized the application of electronic means of payment (Mansfield & Burke, 2018). The payment transactions are instantly recorded in the health facilities system. In a different case, the insurance services are automatically prompted to the health facility systems. The process is hence simplified since the number of parties involved is reduced. Health specialist is also offered adequate time to deliver medical services in preference to following up on payment records.

It is moreover the aim of QSEN to cultivate and maintain a culture of care management. The health department shall, therefore, bear it in their every day to day operation. In such a case, therefore, every stakeholder shall make every effort to adhere to the underlying principles. The patients shall also develop confidence in the health sector. Nurses shall also be adequately trained in providing constant care thereof. It is encouraged that the health personnel’s should create rapport with their patients. The openness enhances patients expounding on their problems. Health service delivery, therefore, becomes simplified.Organizations are mostly faced with internal conflicts. QSEN, however, emphasizes on creation of good relations from top to bottom. Attention shall hence be driven to service delivery other than solving conflicts.

Conclusion

QSEN program is established to improve care to patients in the health sector. As a result, a six principles program is set to be instilled in newer nursing graduates. One of the main principles is care management. It has two main components: care coordination and care management. Care management functions to ensure that both constant and timely attention is given to patients. Care coordination, on the other hand, monitors the process of care management. It creates a simplified process of service delivery while reducing conflicts between health professionals and patients.

References

Ironside, P. M., & Sitterding, M. (2009). Embedding Quality and Safety Competencies in Nursing Education. Journal of Nursing Education, 48(12), 659-660.

Mansfield, J. A., Scheurer, D., & Burke, K. (2018). The Future Role of the Registered Nurse in Patient Safety and Quality. Introduction to Qual