Our Previous Samples

Positive or Negative Consequences of Legalizing Marijuana

Positive or Negative Consequences of Legalizing Marijuana

Legalizing marijuana is a controversial topic in human services, criminal justice, political arenas, and health arenas. From a human service policy perspective, analyze what you believe would be the positive and/or negative consequences of legalizing marijuana.

Discuss the implications for human services providers. If you agree or disagree with the stance of your peers, then explain specifically why and provide substantial evidence in your peer responses.

ORDER THROUGH BOUTESSAY

Positive or Negative Consequences of Legalizing Marijuana Instructions

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

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

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

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

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

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

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

Weekly Participation

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

APA Format and Writing Quality

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

Use of Direct Quotes

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

LopesWrite Policy

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

Late Policy

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

Communication

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

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

POST HSV 400 Discussions

POST HSV 400 Discussions

Discuss the benefits and limitations of ethical codes for social workers.

Unit 2.1

• In reading the case study for unit 1, what are your thoughts concerning Dr. Martinson’s course of action? What might you have done if you were Dr. Martinson. POST HSV 400 discussions

Unit 2.1

• In reading the case study for unit 2, what ethical responsibility does Peter have in this case? How would you deal with Eloise?

Unit 2.2

• How do you think your work as a counselor might have an impact on your personal life?

Unit 3.1

• What are some of the main challenges you expect to face in reaching diverse client populations?

Unit 3.2

• In reading the case study for unit 3, do you think the judge was too lenient in the case? How is this a good example of cross-cultural conflict? Would you have reported this case to Child Protective Services? Why or why not?

Also Read:

IDS 400 The Four General Education Lenses

BIO 111 – Genetics of Corn Experiment 1 A Monohybrid Cross

Applying Duck’s Change Curve Model NUR699

Borderline Personality Disorder (BPD)

Unit 4.1

• In reading the case study for unit 3, do you think Joy took care of her professional responsibility or do you think this was a case of client abandonment? Be sure to explain your answer. POST HSV 400 discussions

Unit 4.2

• What are your thoughts about counseling via the Internet? What specific ethical issues do you think need to be raised? How comfortable would you be in using this form of technology in your counseling practice?

Unit 5.1

• When clients have a history of criminal activity, in many circumstances counselors and therapists are bound to keep that history confidential. A client who reveals to a licensed psychologist that she robbed a liquor store last week, for example, probably has a right to have that information kept confidential unless she injured a child or an elder or otherwise acted in ways that come under the mandated reporting laws. How do you feel about keeping such information confidential?

Unit 5.2

• In reading the case study for unit 5, do you believe the therapist has a duty to notify the authorities? Why or why not? If she discloses the information, could this be considered a breach of confidentiality?

Unit 6.1

• In reading the case study for unit 5, how do you assess Dr. Kim’s behavior? Do you see any potential ethical issue?

Unit 6.2

• Some counselors take the position that counseling and friendship should not be mixed. The argument is that blending social relationships with professional ones simultaneously can negatively affect the therapy process, the friendship, or both. What are your ideas about this viewpoint?

Unit 7.1

• Discuss the difference between professional impairment and incompetence? In what ways do these concepts overlap?

Unit 7.2

• What are your thoughts about the assumption that training programs need to be designed so that students can learn a good deal more about themselves as well as acquire theoretical knowledge?

Unit 8.1

• What if you worked in an agency that required you to formulate a diagnosis and treatment plan based upon your impressions at the time of the initial session POST HSV 400 discussions, how would this influence your practice?

Unit 8.2

• Regarding the case study above, what diagnosis should Samual give Charlie and Amanda? Why? Do you think it is unethical or illegal for samuel to give Charlie or Amanda one diagnosis or another? How unethical is it that an insurance company POST HSV 400 discussions, who has not yet met the client can determine whether they will have services paid for, or how many sessions they can have?

Read Also:

CIS 502 SU Theories of Security Incident Detection Precursors & Indicators Discussion

Subsystem: Safety & Transportation Paper

DQ: Determine how violating health regulations and laws

NU621 Unit 8 Reflection Paper

PPT on Operational Budget for a 20-bed nursing unit

PPT on Operational Budget for a 20-bed nursing unit

The purpose of this assignment is to create an operational budget presentation identifying key components of budgeting and possible capital purchases that may be required.
Scenario: You have been asked to create an operational budget for a 20-bed nursing unit and present it to the senior leaders of your organization PPT on Operational Budget for a 20-bed nursing unit.

Create a presentation of 10-12 slides, including comprehensive speaker notes that detail the budget.
Provide the key components of budgeting, including the cost of staff, activities, services, and supplies.
Identify and describe a relevant capital purchase this unit may require, including the need, the return on investment, benefits, etc.

Use at least three references, including your textbook.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. PPT on Operational Budget for a 20-bed nursing unit

Practicing Dignity: An introduction to Christian Values PHI 413 Topic 2

The Christian concept of imago Dei is that “God created human beings to have a likeness to his character, not a likeness to his literal physical appearance” which helps “provide the basis for human dignity and worth” (White, 2020). Imago Dei also implies that “human being are more than simply bodies” (White, 2020). This concept emphasizes the importance of individuals being both physical and spiritual individuals.

This concept is important to health care because it focuses on the need to treat patient’s holistically. They need to be treated physically (of course), spiritually, emotionally and mentally throughout their health care experience. This concept is a constant reminder to treat individually holistically because they are much more than just their physical illness.

Imago Dei is relevant in healthcare because there are times that nurses and other health care staff can forget to treat patients holistically. It is easy to get busy with doing what we have to do to keep our patient alive, well and on the road to recovery that we forget that they need more that physical help.

I have seen nurses in my experience completely forget about all aspects besides physical care and yes of course they were still well taken care “medically” not all their needs were met during their hospitalization because of failure to provide holistic care. There is many factors that go into caring for individuals completely and giving them the best care and support during their health care experience.

PHI 413 Topic 2 Practicing Dignity: An introduction to Christian Values Reference

White, N. (2020). Practicing dignity: An introduction to Christian values and decision making in health care. Retrieved from https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/home

https://nursingbay.com/wp-content/uploads/2022/01/Spirituality-in-Healthcare.mp4

ORDER THROUGH BOUTESSAY

PHI 413 Topic 2 Practicing dignity: An introduction to Christian Values Instructions

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

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

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

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

PHI 413 Foundational Issues in Christian Spirituality and Ethics Example Solutions

Foundational issues in Christian spirituality and ethics are essential to understanding one’s worldview. The purpose of this assignment is to explore my worldview as a Christian by elaborating my understanding of ultimate reality, nature of the universe, human being, knowledge, basis of ethics, and purpose of existence.

What is ultimate reality?

According to Bogue and Hogan (2020), ultimate reality refers to the highest authority. In my Christian view, the ultimate reality is God. He is Supreme, Almighty, and creator of heaven and earth and all things visible and invisible. God is the unique source of all reality. He is supernatural. God is described as omnipresent, omniscient, eternal, omnipotent, and omnibenevolent (Bogue & Hogan, 2020).

Consequently, we Christians believe that God, who exists as the trinity, created the world and was pleased with His creation. Additionally, God is the source of morality. For instance, He commanded man, “You may surely eat of every tree of the garden, but of the tree of the knowledge of good and evil you shall not eat, for in the day that you eat of it you shall surely die” (Genesis 2:16-17). God also demonstrates His supremacy through various miracles and powerful signs that are well documented in both the old and the new testaments of the Bible.

What is the nature of the universe?

As a Christian, the universe was created by God, who rules over it. It is composed of both physical and spiritual worlds. Human beings have been given power over the physical world to be fruitful and multiply and explore the resources within the physical world. However, the spiritual world involves an interaction of the spirit of God and the spirits of human souls. As a result, human beings can communicate to God spiritually through prayer. The existence of the spiritual world is demonstrated by Christ himself when he teaches his disciples to pray, and He is also seen interceding on behalf of us.

What is a human being?

As Christian, human beings are part of God’s creation and were made on the last day of creation. They are superior to other creatures, for they were made in the image and likeness of God (Genesis 1:27). Similarly, as human beings, we are blessed by the Almighty. But unlike God, human beings have sinned and fallen short of the glory of God (Roman 3:23). The sinful nature of human beings is also depicted during the call of Moses when God orders him to remove his shoes, for he was standing on holy ground. However, God forgives us whenever we repent. Given the valuable nature of human beings as the image of God, human life must be respected and protected at all costs (Baumeister & Bushman, 2020). Likewise, human beings must be treated with dignity and love. Finally, God values his creation. For instance, God became a human being in the person of Jesus Christ.

What is knowledge?

Knowledge is the sum of what is known. As Christians, knowledge is a gift from God. God (1 Corinthians 12:8). Additionally, Christians regard scientific knowledge as a consequence of the utilization of power that was given to them by God. Therefore, human beings must utilize knowledge as a service to humanity (Cuellar De la Cruz & Robinson, 2017). The Bible remains the main source of Christian knowledge. Christians also acknowledge the limited nature of human knowledge and its hindrance by sin. Finally, Christians can pray to God to obtain knowledge through faith since knowledge is directly connected to God’s revelatory acts.

What is your basis of ethics?

Ethics refers to moral principles that govern an individual’s behavior. It encompasses systematizing, defending, and recommending the concepts of right and wrong behavior (Stanley et al., 2018). From a Christian point of view, God is the basis of morality. This is evidenced by the mentioning of the tree of knowledge of good and evil in the creation stories. Following the fall of mankind, human beings became aware of good and evil with an obligation to do good as evil doings are punishable. Subsequently, Christian ethics involves living a life pleasing to God that is guided by Christian scriptures and traditions. For instance, God issues commandments to the Israelites through Moses, which were to be followed, and these are later summarized into the two greatest commandments by Jesus Christ in the New Testament. Consequently, Christians rely on the Bible, a book penned down by human beings supernaturally inspired by God, as the most authoritative source of Christian morals and ethics.

What is the purpose of your existence?

The sole purpose of existence for Christians is to worship God and enjoy a relationship with Him forever. Christians exist to Love God and their fellow human beings, after which they will be rewarded with eternal life. Similarly, Christ encourages Christians to follow him and serve God through doing good deeds to the needy. Christ also redefines the purpose of life. For instance, He fights evil throughout His life, He is sentenced to death, resurrects and finally ascends into heaven, and finally promises to come back to judge the living and the dead. Consequently, Christians spend their life preparing for the second coming of Jesus Christ through service to God.

Conclusion

Foundational issues in Christian spirituality and ethics are core to understanding one’s worldview. For Christians, God is the ultimate reality, and they live to serve Him. Human beings are special and have dominion over other creatures.

References

Baumeister, R. F., & Bushman, B. J. (2020). Social Psychology and Human Nature. Cengage Learning.

Bogue, D. W., & Hogan, M. (2020). Practicing dignity: An introduction to Christian values and decision-making in health care. In Grand Canyon University. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/1

Cuellar De la Cruz, Y., & Robinson, S. (2017). Answering the call to accessible quality health care for all using a new model of local community not-for-profit charity clinics: A return to Christ-centered care of the past. The Linacre Quarterly, 84(1), 44–56. https://doi.org/10.1080/00243639.2016.1274631

Stanley, S., Purser, R. E., & Singh, N. N. (2018). Ethical foundations of mindfulness. In Mindfulness in Behavioral Health (pp. 1–29). Springer International Publishing. https://doi.org/10.1007/978-3-319-76538-9_1

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

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

Weekly Participation

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

APA Format and Writing Quality

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

Use of Direct Quotes

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

LopesWrite Policy

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

Late Policy

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

Communication

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

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

PHI 413 End of Life Decisions case Study Assignment

Case Study: End of Life Decisions

George is a successful attorney in his mid-fifties. He is also a legal scholar, holding a teaching post at the local university law school in Oregon. George is also actively involved in his teenage son’s basketball league, coaching regularly for their team. Recently, George has experienced muscle weakness and unresponsive muscle coordination. He was forced to seek medical attention after he fell and injured his hip. After an examination at the local hospital following his fall, the attending physician suspected that George may be showing early symptoms for amyotrophic lateral sclerosis (ALS), a degenerative disease affecting the nerve cells in the brain and spinal cord. The week following the initial examination, further testing revealed a positive diagnosis of ALS.

ALS is progressive and gradually causes motor neuron deterioration and muscle atrophy to the point of complete muscle control loss. There is currently no cure for ALS, and the median life expectancy is between 3 and 4 years, though it is not uncommon for some to live 10 or more years. The progressive muscle atrophy and deterioration of motor neurons leads to the loss of the ability to speak, move, eat, and breathe. However, sight, touch, hearing, taste, and smell are not affected. Patients will be wheelchair bound and eventually need permanent ventilator support to assist with breathing.

George and his family are devastated by the diagnosis. George knows that treatment options only attempt to slow down the degeneration, but the symptoms will eventually come. He will eventually be wheelchair bound and be unable to move, eat, speak, or even breathe on his own.

In contemplating his future life with ALS, George begins to dread the prospect of losing his mobility and even speech. He imagines his life in complete dependence upon others for basic everyday functions and perceives the possibility of eventually degenerating to the point at which he is a prisoner in his own body. Would he be willing to undergo such torture, such loss of his own dignity and power? George thus begins inquiring about the possibility of voluntary euthanasia.

Based on the attached ”Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic Resources you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview. Provide a 1,500-2,000-word ethical analysis while answering the following questions: How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world? How would George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?

As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person? What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia? Given the above, what options would be morally justified in the Christian worldview for George and why? Based on your worldview, what decision would you make if you were in George’s situation? Please use the attached document titled ”Death, Dying and Grief” as one of the references.

PHI 413 Topic 2 Case Study Healing and Autonomy Assignment

PLEASE SEE THE ATTCHED DOCUMENTS. CHART FOR TOPIC 3 IS ATTACHED. PLEASE USE THE REFERENCES ATTACHED.

In addition to the topic Resources, use the chart you completed and questions you answered in the Topic 3 about ”Case Study: Healing and Autonomy” as the basis for your responses in this assignment. Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.

In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?

In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Applying the Four Principles: Case Study Part 1: Chart (60 points)

Based on the “Healing and Autonomy” case study, fill out all the relevant boxes below. Provide the information by means of bullet points or a well-structured paragraph in the box. Gather as much data as possible.

Medical Indications

Beneficence and Nonmaleficence Patient Preferences

Autonomy The parents took the patient to the hospital for presenting symptoms related to A Streptococcus infection that led to Post-Streptococcal Glomerulonephritis (PSGN).

The patient had an acute kidney injury and hypertension as a consequence of the PSGN.

Part of the care plan was blood pressure control and dialysis.

Because the initial condition was not treated early, the patient suffered complications such as chronic kidney disease.

The patient required dialysis as a permanent treatment and a kidney transplant. The patient’s relatives were the legal guardians who had the legal authority to make decisions related to treatment. According to the case study, the doctor discussed with the family the treatment required to treat the acute renal failure and the hypertension. However, it did not appear that the physician presented an informed choice to the relatives and did not emphasize the seriousness of the complications and the urgency of treating an acute condition that could be reversed with treatment. This lack of information from the doctor did not give the relatives the alternatives to choose the therapeutic options and they decided to appeal to their religious beliefs.

The patient now requires a kidney transplant since the damage to the kidneys is irreversible. It seems that the autonomy of the relatives was violated again by not discussing the treatments to be chosen, such as hemodialysis and peritoneal dialysis, which allow the patient to lead a normal life until a good candidate for the transplant donation is found. This lack of information put the family in a dilemma to decide whether his brother would donate the kidney or not since he was the only match available at that time.

Quality of Life

Beneficence, Nonmaleficence, Autonomy

Contextual Features

Justice and Fairness The patient could recover the kidney conditions by providing an early dialysis treatment and controlling the blood pressure. As a result of the lack of intervention, the patient acquired a chronic condition that required dialysis or kidney transplant. The new condition and the alternative of treatment could impact negatively the patient’s normal live.

The parents opted for religious healing instead of dialysis with the consent of the doctor. This decision caused a delay to the necessary treatment leading to an irreversible damage to the patient, requiring a kidney transplant. Despite their religious faith, the parents doubted their decision, believing that the complications were derived from a sin.

The physician had the legal responsibility to act in the best interests of the patient in order to provide value to the patient and to prevent the complications, but the parents were the legal guardians who had the legal authority to make decisions related to treatment. There were not financial factors or conflicts of interest that affected the decision-making process for the clinical treatment of the patient. Only the parents were legally able to make decisions guided by the information presented by the clinicians, and by their religious faith.

Since the parents chose the faith healing service instead medical interventions, the patient was denied justice and fairness, and as a result, their medical conditions worsen, leading to an increased risk of developing a chronic condition that impairs his quality of life. The family had a dilemma to decide whether his brother would donate the kidney or not since he was the only match available at that time.

Part 2: Evaluation

Answer each of the following questions about how the four principles and four boxes approach would be applied:

1. In 200-250 words answer the following: According to the Christian worldview, how would each of the principles be specified and weighted in this case? Explain why. (45 points)     In the United States, the four fundamental concepts of bioethics are autonomy, beneficence, non-maleficence, and justice, all of which are intertwined and interdependent. In many cultures, autonomy is seen as the most important characteristic, followed by kindness, non-maleficence, and justice (White,2020).
   
   In this case, the concept of autonomy should be prioritized since it underlines the need of always respecting the patient and parents’ autonomy and never interfering with it. Respect for the autonomy is more than a state of mind; it is a way of doing that recognizes and even promotes the patient’s capacity to care for himself or herself (White,2020). According to the case study, the doctor met with the patient’s family to discuss the treatment options for acute renal failure and hypertension. But it did not seem that the physician provided the parents with an informed choice, nor did he underline the seriousness of the consequences or the need of treating an acute disease that was potentially reversible with therapy. Because of the lack of information, the relatives were unable to make informed decisions about the treatment choices available to them, and they were forced to turn to their religious beliefs for guidance.
   
   The principle of beneficence that promotes the benefit of the patient while also taking proactive steps to prevent and remove harm from the patient was taken in consideration (McCormick, 2018). The patient’s parents placed their confidence in the health-care system when they decided to admit him to the hospital, believing that it was in the patient’s best interests at the moment. The physician was legally required to work in the best interests of the patient in order to give value to them while also preventing and alleviating any complication or issues that may arise. Blood pressure management and dialysis were included in the treatment plan, which may have been implemented after the patient had signs and symptoms of acute renal failure that may have been reversed with hospital treatment.

2. In 200-250 words answer the following: According to the Christian worldview, how might a Christian balance each of the four principles in this case? Explain why. (45 points)

References:     Bioethics is an ethical field whose goal is to try to provide a solution to the ethical difficulties that arise as a consequence of scientific breakthroughs while taking a long-term perspective on life. In order to achieve its objectives, it is based on four bioethical principles, which have elevated this subject to one of the most important topics in contemporary research. Bioethics is based on four principles: autonomy, beneficence, non-maleficence, and justice, all of which are intertwined and interdependent. In many cultures, independence is seen as the most important characteristic, followed by kindness, non-maleficence, and justice (White,2020).

In the case study, it is clear that the patient’s family had a strong religious faith that helped them in making decisions. A clear and better communication on the part of the clinicians related to the seriousness of the complications, the benefits of the treatment and the therapeutic options, would have contributed to respecting the autonomy of the patient and their relatives and in making a better decision that would benefit to the patient. The combination of the therapeutic efforts required to improve the patient’s health condition with religious faith without undermining any option, exalting the principle of beneficence. This approach would also have reflected fairness in making the best decision. The optimal solution for the patient after his condition was identified would have been temporary dialysis to assist alleviate the fluid build-up and decrease his high blood pressure, in accordance with the beneficence and non-maleficence criteria, as previously stated.
Hoehner, P. J. (2020). Biomedical ethics in the Christian narrative. In Grand Canyon University
(Ed.). Practicing Dignity: An Introduction to Christian Values and Decision Making in Health Care. https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/3

McCormick, T.R. (2018). Principles of bioethics. Washington University Medicine, Department
of Bioethics and Humanities. https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/articles/principles-bioethics

Practicum Experience Plan PEP PRAC 6675

Practicum Experience Plan PEP PRAC 6675

The Assignment

Record the required information in each area of the Practicum Experience Plan template, including 3-4 measurable practicum learning objectives you will use to facilitate your learning during the practicum experience.

To Prepare

Review your Clinical Skills Self-Assessment Form you submitted last week and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the practicum help you achieve these aims?

Review the information related to developing objectives provided in this week’s Learning Resources. Your practicum learning objectives that you want to achieve during your practicum experience must be:
Specific
Measurable
Attainable
Results-focused
Time-bound

Also Read:

Journal Entry Assignment PRAC 6675

Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)

Discuss your professional aims and your proposed practicum objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.

Select one nursing theory and one counseling/psychotherapy theory to best guide your clinical practice. Explain why you selected these theories. Support your approach with evidence-based literature.

Create a timeline of practicum activities that demonstrates how you plan to meet these goals and objectives based on your practicum requirements.

Practicum Experience Plan

Overview:

Your Practicum experience includes working in a clinical setting that will help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and guide your practicum experience.

As part of your Practicum Experience Plan, you will not only plan for your learning in your practicum experience but also work through various patient visits with focused notes as well as one (1) journal entry.

Complete each section below.

Part 1: Quarter/Term/Year and Contact Information

Section A

Quarter/Term/Year: 2021-Winter-QTR-Term-wks-1-thru-11-(11/29/2021-02/13/2022)

Student Contact Information

Name:

Street Address:

City, State, Zip:

Home Phone:

Work Phone:

Cell Phone:

Fax:

E-mail:

Preceptor Contact Information

Name:

Organization:

Street Address:

City, State, Zip:

Work Phone:

Cell Phone:

Fax:

Professional/Work E-mail:

Part 2: Individualized Practicum Learning Objectives

Objective 1: I will apply knowledge in the development of an age-appropriate individualized plan of care, especially for minors, by the end of the week 11 quarter

Planned Activities:
–    Benchmark from my preceptor as he conducts psychiatric evaluations on children and adolescent patients each day

• Review patient charts and other evaluation materials and apply knowledge learned to determine the diagnosis and treatment course
• Collaborate with treatment team on determining whether my individualized care plan is appropriate for the patient

Mode of Assessment: Preceptor evaluation and documentation in Meditrek

PRAC Course Outcome(s) Addressed:

• Assess my excellent communication skills to collaborate with the preceptor and other treatment team professionals on developing an individualized care plan.
• Apply my advanced learning skills to patient evaluations and treatment courses.

Objective 2: To develop a list of ethical and legal implications of the patients and families through effective communication

Planned Activities:

• Research on effective methods of resolving legal and ethical issues that arise during the treatment and care of the patients
• Increase the patient education on the treatment possibilities for minors who have mental issues and effectively resolve the legal and ethical issues

Mode of Assessment: Documentation on Meditrek and preceptor evaluation

PRAC Course Outcome(s) Addressed:

• Increase the communication strategies to help resolve the legal and ethical issues effectively

Objective 3: To be more proficient in selecting medication plans through assessing the risks and benefits, patient preference, and financial status

 

Planned Activities:

• To review the available evidence-based and patient-centered information on patient care and provision
• Present individualized care plans for at least two patients each day and discuss with the preceptor

Mode of Assessment: Preceptor evaluation and Meditrek documentation

 

PRAC Course Outcome(s) Addressed:

 

• To create an individualized care plan for minor patients at the practicum placement clinic.

Part 3: Projected Timeline/Schedule

Estimate how many hours you expect to work on your Practicum each week. *Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.

This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.

I intend to complete 160 Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.

 Number of Clinical Hours Projected for Week (hours you are in Practicum Setting at your Field Site)Number of Weekly Hours for Professional Development (these are not practicum hour)Number of Weekly Hours for Practicum Coursework (these are not practicum hours)Week 11663Week 2000Week 31663Week 41663Week 51663Week 61663Week 71663Week 81663Week 91653Week 101653Week 111663Total Hours (must meet the following requirements)160 Hours58 Hours30 Hours

 

 

 

 

 

Part 4 – Signatures

 

Student Signature (electronic):                                       Date:12/11/2021

 

 

Practicum Faculty Signature (electronic)**:                               Date:

 

 

** Faculty signature signifies approval of Practicum Experience Plan (PEP)

 

Submit your Practicum Experience Plan on or before Day 7 of Week 2 for faculty review and approval.

 

Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.

 

 

 

Practicum Experience Plan Example

Overview:

Your Practicum experience includes working in a clinical setting to help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and guide your practicum experience.

As part of your Practicum Experience Plan, you will not only plan for your learning in your practicum experience but also work through various patient visits with focused notes as well as one(1) journal entry.

Complete each section below.

Part 1: Quarter/Term/Year and Contact Information

 

Section A

 

Quarter/Term/Year:

 

Student Contact Information

Name:

Street Address:

City, State, Zip:

Home Phone:

Work Phone:

Cell Phone:

Fax:

E-mail:

 

Preceptor Contact Information

Name:

Organization:

Street Address:

City, State, Zip:

Work Phone:

Cell Phone:

Fax:

Professional/Work E-mail:

 

 

 

 

 

Part 2: Individualized Practicum Learning Objectives

Refer to the instructions in Week 2 to create individualized practicum learning objectives that meet the requirements for this course. These objectives should be aligned specifically to your Practicum experience. Your objectives should address your self-assessment of the skills found in the “PMHNPClinicalSkills Self-Assessment Form”you completed in Week 1.

As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found in Week 2 to guide your development. Once you review your resources, continue and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.

** YOU MUST HAVE 3 NEW OBJECTIVES EACH QUARTER.  You may include previous practicum objectives; however, you still must have 3 new objectives for your current course.

Objective 1: To efficiently and effectively differentiate between client’s pathophysiological and psychopathological conditions through comprehensive research in nursing databases including PubMed, CINAHL, EBSOhost and Cochrane database of systematic review with the help of my preceptor with 120 hours of clinical practice.

Planned Activities:
– Conduct comprehensive research in the nursing databases found in Walden University Library

• Get any clarifications from my preceptor on criteria for distinguishing psychopathological and pathophysiological disorders
• Review case studies of patients presenting with various psychopathological and pathophysiological disorders and examine their differences

Mode of Assessment: Preceptor evaluation and Meditrek documentation

PRAC Course Outcome(s) Addressed:

• Demonstrate knowledge of psychopathology of mental disorders through discussions for various mental disorders and age groups
• Identify the signs and symptoms of various disorders

Objective 2: To become more proficient in selecting appropriate evidence-based clinical practice guidelines for symptom management through comprehensive research throughout the next 12 weeks of practicum rotation

Planned Activities:

• Working alongside the preceptor while assessing and diagnosing the patients
• An extensive review of the existing patient case scenarios and the listed differential diagnosis
• Consulting with my preceptor whenever faced with challenges formulating the primary and differential diagnosis

Mode of Assessment: Meditrek documentation, preceptor evaluation, and performance in the course assessments

PRAC Course Outcome(s) Addressed:

• Research various evidence-based interventions for various mental health disorders including CINAHL, PubMed, and Cochrane in the Walden University Library

Objective 3: To implement age-appropriate counseling techniques with individuals and any caregivers at every psychotherapeutic session throughout this practicum experience

Planned Activities:

• Research on the Walden University library about evidence-based age-appropriate counseling techniques
• Consult with primary caregivers on the best techniques for each age group

Mode of Assessment: Course assessment and Meditrek Documentation

PRAC Course Outcome(s) Addressed

• Assess my excellent communication skills to collaborate with the preceptor and physicians on developing an individualized care plan

Part 3: Projected Timeline/Schedule

Estimate how many hours you expect to work on your Practicum each week. *Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.

This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.

I intend to complete the 144 or 160Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.

 Number of Clinical Hours Projected for Week (hours you are in Practicum Setting at your Field Site)Number of Weekly Hours for professional development(these are not practicum hour)Number of Weekly Hours for Practicum Coursework (these are not practicum hours)Week 1822Week 2823Week 3823Week 41023Week 51022Week 61022Week 71023Week 81023Week 91023Week 101223Week 111223Total Hours (must meet the following requirements)1082230

 

 

 

 

 

Part 4 – Signatures

 

Student Signature (electronic):                               Date:

 

 

Practicum Faculty Signature (electronic)**:         Date:

 

 

** Faculty signature signifies approval of Practicum Experience Plan (PEP)

 

Submit your Practicum Experience Plan on or before Day 7 of Week 2 for faculty review and approval.

 

Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.

Practicum Experience Plan Example 2

Part 1: Quarter/Term/Year and Contact Information

Student Contact Information

Name:                    

Street Address:

City, State, Zip:                 

Home Phone:

Work Phone:          

Cell Phone:

Fax:

E-mail:       

Preceptor Contact Information

Name:                    

Organization:

Street Address:

City, State, Zip:                 

Work Phone:          

Cell Phone:

Fax:

Professional/Work E-mail:

Part 2:  Individualized Practicum Learning Objectives

Learning Objective 1: Distinguish between psychopathological and pathophysiological problems in at least 12 patients suspected of having mental health disorders before completing my practicum.

Planned Activities:

1. Review relevant literature and case studies to enhance my knowledge and understanding of the distinguishing factors between psychopathology and pathophysiology.
2. Engage in clinical discussions and case conferences with preceptors and interdisciplinary teams to analyze and differentiate between psychopathological and pathophysiological presentations.
3. Conduct regular self-reflection and self-assessment to evaluate progress in distinguishing between psychopathological and pathophysiological problems.

Mode of Assessment: Preceptor evaluation, self-assessment, and feedback from interdisciplinary team members.

PRAC Course Outcomes: Diagnostic reasoning skills, collaboration with multi-disciplinary teams.

Learning Objective 2: Improve my diagnostic reasoning skills by developing a comprehensive differential diagnoses list of mental health disorders from the DSM-5-TR diagnoses during my practicum.

Planned Activities

1. Actively engage in case analysis and discussions with preceptors and interdisciplinary teams to understand the process of developing differential diagnoses.
2. Utilize clinical resources, textbooks, and online databases to expand knowledge of psychiatric disorders and their differential diagnoses.
3. Practice creating comprehensive differential diagnoses lists for patient cases encountered during the practicum.

Mode of Assessment: Preceptor evaluation of differential diagnoses lists, self-assessment, and feedback from interdisciplinary team members.

 PRAC Course Outcomes: Diagnostic reasoning skills, collaboration with multi-disciplinary teams.

Learning Objective 3: Improve my knowledge of psychopathology for different age groups and mental illnesses before completing my practicum.

Planned Activities:

1. Attend seminars, workshops, and conferences focusing on specific age groups and mental illnesses to gain specialized knowledge.
2. Engage in case discussions and literature reviews to understand the unique psychopathological presentations in different age groups and mental illnesses.
3. Collaborate with preceptors and mental health professionals to learn from their expertise and experiences in managing various psychopathologies.

Mode of Assessment:

Preceptor evaluation, participation in seminars/workshops/conferences, self-assessment.

PRAC Course Outcomes: Diagnostic reasoning skills, collaboration with multi-disciplinary teams, psychotherapeutic treatment planning.

Nursing Theory: The Roy Adaptation Model

The Roy adaptation model is a nursing theory developed by Sister Callista Roy that focuses on holistic patient care and individuals’ ability to adapt to environmental changes (Callis, 2020). The Roy adaptation model provides a framework for understanding the complex process of human adaptation to stressors and guides nurses in promoting optimal health and well-being through supportive interventions. It emphasizes the importance of holistic care and individualized approaches to address each person’s unique needs. Incorporating this model into my practicum will enhance my diagnostic reasoning skills, collaboration with interdisciplinary teams, and ability to provide individualized care.

Counseling/Psychotherapy Theory: Cognitive-Behavioral Therapy (CBT)

CBT is a widely used counseling/psychotherapy theory that identifies and modifies maladaptive thoughts, beliefs, and behaviors. According to Chand et al. (2022), CBT effectively treats various mental health disorders and can be applied to the assessment and treatment planning processes. CBT techniques enable nurses to help individuals challenge negative thinking patterns, develop coping strategies, and improve their overall mental well-being (Nakao et al., 2021). CBT can be integrated into the psychosocial assessment and family psychiatric history process to identify cognitive distortions and develop targeted interventions.

Part 3: Projected Timeline

I plan to fulfill 160 practicum hours within the specified timeline/schedule. Additionally, I am aware that it is mandatory for me to engage with a minimum of 80 patients throughout my practicum experience. I acknowledge that I am not permitted to complete my practicum hours in less than eight weeks. Furthermore, I understand that with prior approval from my faculty, I can be at most 8 hours per day in the practicum setting.

 

Number of Clinical Hours Projected for Week

Number of Weekly Hours for Professional Development

Number of Weekly Hours for Practicum Coursework

Week 1

8

7

0

Week 2

7

6

1

Week 3

20

9

11

Week 4

20

9

11

Week 5

16

7

9

Week 6

17

10

7

Week 7

15

9

6

Week 8

15

10

5

Week 9

15

8

7

Week 10

14

10

4

Week 11

14

10

4

Total Hours (must meet the following requirements)

160 Hours

95

65

 

Part 4 – Signatures

Student Signature (electronic):                             Date: 

Practicum Faculty Signature (electronic):                 Date:

Practicum Experience Plan PEP PRAC 6675 References

Callis, A. M. (2020). Application of the Roy adaptation theory to a care program for nurses. Applied Nursing Research, 56, 151340. https://doi.org/10.1016/j.apnr.2020.151340

Chand, S. P., Kuckel, D. P., & Huecker, M. R. (2022, September 9). Cognitive behavior therapy (CBT). National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470241/

Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive–behavioral therapy for managing mental health and stress-related disorders: Recent advances in techniques and technologies. Biopsychosocial Medicine, 15(1). https://doi.org/10.1186/s13030-021-00219-w

Also Read: Nurse Practitioner Professional Career Planner NRNP 6675

PREOPERATIVE EDUCATION USING ONE-ON-ONE COUNSELING

Chapter One:  Overview of the Problem of Interest

Surgery is an important event in an individual’s life, impairing physical functioning thereby fear, anxiety and depression may be experienced by the patient (Ramesh et al., 2017), In 2008, more than 22 million surgeries were performed over 5,000 Ambulatory Surgery Centers in the United States.  Surgery can be a significant and potential danger to the patient’s health and may cause psychological reactions such as anxiety (Gezer & Arslan, 2019). With thousands of patients having elective surgery on a daily basis, it is essential that these patients are adequately prepared prior to their surgery (Kruzik, 2009).  Preoperative education is widely used by health-care professionals all over the world to help patients prepare for their impending surgery and postoperative needs (Spalding, 2004).  Preoperative education is a key element of the Enhanced Recovery After Surgery (ERAS) protocols and guidelines (Foss, 2011).  Preoperative education leads to significant improvements in patient satisfaction, surgical outcomes, and reduction in patient’s anxiety.

Background Information

Each year, an estimated 234 million major surgical procedures are conducted worldwide (Fink et al., 2013).  Evidence suggests that postsurgical complications occur in at least seven million cases annually, resulting in up to one million deaths. These figures illustrate the tremendous socio-economic burden associated with postoperative morbidity and mortality (Fink et al., 2013).  Patients suffer needlessly due to inadequate preoperative preparation and lack of information regarding their postoperative course as indicated by reports of unexpected pain, fatigue, and the inability to care for themselves (Fink et al., 2013). The prevention of these postoperative complications is of the highest medical interest and importance. The impact of well drafted standardized preoperative patient education will result in positive postoperative outcomes (Fink et al., 2013). This suggests that there is a need for improved efforts from all healthcare providers to step up and design preoperative educational interventions for better patient preparedness, reduce their anxiety and post-operative complications.

In late 2016, the American College of Surgeons (ACS) became the national home for Strong for Surgery which is a pre-surgical health optimization program (American College of Surgeons, 2016). The ACS has begun administering and promoting STRONG as a quality initiative aimed at identifying and evaluating evidence-based practices to prepare and optimize the health of patients before their operations. Strong for Surgery was developed by surgeons and empowers hospitals and clinics to integrate checklists into the preoperative phase of clinical practice for elective operations. These checklists are used to screen patients for potential risk factors that can lead to surgical complications, and to provide appropriate interventions to ensure better surgical outcomes (American College of Surgeons, 2016).

The project implementer’s clinical practice site is an inpatient facility which conducts approximately 40 surgeries a day, including same-day surgery and inpatients. In the project implementer’s clinical practice site only about 50 % of the patients are told by their surgeons to come to the pre-surgical testing area prior to their elective surgery. The preoperative surgical patients either come 1 to 2 days before their surgery, but the majority of them arrive on the day of their surgery. As a result, these patients are not be given the adequate preoperative counseling. Even if they receive preoperative counseling, there is less time for them to be prepared; for example, proper preoperative diet, exercise, medication management, smoking cessation, and co-morbidities such as diabetes and hypertension to be under control.

The key principles of the ERAS protocol include preoperative counseling, preoperative nutrition, avoidance of perioperative fasting and clear liquids up to 2 hours preop. But according to traditional surgical doctrine patients are instructed to take nothing by mouth (NPO) from mid night by the surgeons to avoid pulmonary aspiration after elective surgery; however, there is no evidence to support this. Melnyk, Casey, Black and Koupparis (2011) stated that, preoperative fasting actually increases the metabolic stress, hyperglycemia and insulin resistance, which the body is already prone to during the surgical process. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, the ERAS protocols challenge traditional surgical doctrine, and as a result, their implementation has been slow (Melnyk, Casey, Black and Koupparis, 2011).

Significance of Clinical Problem

Patients must be appropriately educated before any surgical procedure to ensure they understand the complete process and to improve surgical outcomes (Wunderle, Bena & McClelland, 2017). When patients are not adequately prepared for surgery, there is a high chance that their surgery can be canceled on the day of surgery. Surgery cancelations on the operative day cause a huge impact on the organizational effectiveness and the patient satisfaction.

Further, preoperative education plays a major role in prevention of post operative complications. Complications such as Surgical Site Infection (SSI) increase the length of the patient’s stay. The Center for Disease Control (CDC) health care – associated infection (HAI) prevalence survey found that there were an estimated 157,500 surgical site infections (1.9%) in 2008 among the inpatient surgical patients (CDC, 2018). Surgical site infections remain a substantial cause of morbidity, prolonged hospitalization and mortality of the patients. The implementer’s clinical practice site’s SSI task force data showed that the SSI rates among surgical patients was 2.2% in 2017. The preoperative education provides information to patients regarding the measures that can be used to prevent post-operative complications. A well-designed preoperative education with emphasis on SSI prevention measures such as usage of Hibiclens showering prior to surgery, hand hygiene and wound care may result in decrease rate of SSIs.

Other postoperative complications such as venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) affects an estimated 300,000-600,000 individuals in the U.S each year causing significant mortality and morbidity (Beckman et al., 2010). VTE is a leading cause of preventable hospital death in the Unites Stated (CDC, 2015). VTE is the fifth most frequent reason for unplanned hospital readmissions after surgery (CDC, 2015). A recent study of almost 500,000 surgeries performed at Department of Affairs (VA) hospitals found that about 4 in 10 patients developed VTE after surgery while they were still in hospital and approximately 6 in 10 surgical patients developed VTE up to 90 days after discharge from hospital (CDC, 2015). The implementer’s clinical practice site performance improvement (PI) data reported a significant increase in VTE rates in 2017.  Preoperative education plays a major role in educating patients in prevention of such complications. Preoperative education regarding the early ambulation after surgery helps the patient to be more compliant, thereby reducing the risk of VTE.

In addition, Oshodi (2007) suggested that preoperative information about surgical procedures and outcomes alleviates patient anxieties, lessens the need for postoperative analgesia, and allows the patient to be discharged earlier. The patients when educated before surgery know what to expect after their procedure, such as pain. Through preoperative education, the capability of patients to take care of themselves improves through meeting their postoperative self-care needs at home (Oshodi, 2007).  For example, information about appropriate behavior after discharge (mobility, exercise, relaxation, appropriate diet or adequate pain control) will facilitate full recovery and prevents postoperative complications.

Question guiding inquiry (PICO). A clinical question needs to be relevant to the patient or problem in the current practice, it should facilitate the search for the solution. PICO makes the search process easier. The formulation of a question used to challenge a current practice and provide evidence for new practice change is called a “PICO” question. The “P” stands for patient or problem, “I” for intervention, “C” for control/comparison and “O” for outcome. (Melnyk & Fineout-Overholt, 2015).  The PICO question that guided a literature inquiry for the problem of surgical patients is: In pre-surgical patients, does individualized one-on-one pre-operative counseling decrease the post-operative complications?

Variables of the PICO question

Population.  The population of interest was individuals eighteen years of age and older located in New Jersey.  Patients who participated were scheduled for ortho-spine procedures and was not limited by gender, education, nationality, religion, ethnicity, or race. The targeted population of interest that participated in the EBP change project were 18 years of age and older.

Intervention.  The intervention for this project was the implementation of individualized one-on-one pre-operative counseling.  Educational materials and a question and answer session were offered during the educational session.

Comparison.  There was no comparison group, but a comparison was made to assess the fear and anxiety of pre-surgical patients. There was a pre-test given before the start of the educational session. Immediately after the educational session, the participant was given a surgical fear post- test to determine if there were a decrease in fear and anxiety.

Outcomes.  Knowledge is the first step of prevention; therefore, the intended outcome of the EBP change project is to reveal if an increase in knowledge and decrease in fear occurred by comparing the pre-test and post-test scores after the educational sessions.

Summary

Preoperative education provides the surgical patients with the pertinent information concerning the surgical process and the intended surgical procedures, as well as anticipated patient behaviors (e.g., anxiety, fear); expected sensations; and probable surgical outcomes (Kruzik, 2009). Preoperative teaching plays a vital role in preoperative, intraoperative and postoperative management of patient. The preoperative education can help patients to be prepared for surgery, to decrease post-operative pain, reduce length of stay, decrease anxiety and increase patient satisfaction (Garretson, 2004). Lack of preoperative education can lead to postoperative complications such as DVT, SSI

Chapter Two: Review of the Literature

Preoperative education includes instruction about the preoperative period, the surgery itself, and the postoperative period. Patients who undergo surgical procedures experience a high level of stress and anxiety, which could have negative consequences on post-operative outcomes. Patient education appears to be effective in improving knowledge and reducing days of stay at the hospital (Chevillon, Hellyar, Madani, Kerr and Chae, 2015). The goal of preoperative education is to not only prepare the patient for their surgery, but also to prepare them for what to expect following the surgery. Patient preparedness for surgery has important implications for patient satisfaction and the perception of improvement after surgery (Greene et al., 2017).

Anxiety has been noted among patients who have been waiting for scheduled procedures ( Harkness, Morrow, Smith, Kiczula, and Arthur, 2003). Nurse-initiated preoperational education and counseling was associated with a reduced rate of perioperative complications and a reduced level of anxiety following surgery (Ji et al., 2012). Therefore, it is crucial that the patients are adequately educated and prepared for their surgery. To this end, various types of preoperative education have been evaluated to help reduce patient’s anxiety and complications after surgery. The purpose of this paper is to provide an overview of the literature regarding preoperative education. This chapter will review the literature regarding specific interventions utilized in preoperative education.

Methodology

In order to study the concept of preoperative education and its importance in patient preparedness, a comprehensive literature review was performed. After considering the concept and perusing several articles through the online library and databases, the decision was made on the possible search terms that will be covered to find scholarly articles on preoperative education and its importance in preparing the patients. The selection of the literature was based on the level of evidence and the relevancy to the EBP change project.

Sampling strategies. The databases searched for the literature review were as follows: ProMED , CINAHL Complete, the allied and complementary medicine database (AMED),  EBSCO Host, PyscINFO, the Cochrane Database of Systematic Reviews on preoperative education. The key terms included preoperative teaching, preoperative education, preoperative preparation, surgery preparedness, preoperative teaching and anxiety, preoperative education and surgery, preoperative teaching and surgical site infection, preoperative education and postoperative complications using the Boolean operator AND. Google scholar search was also performed to include possible additional literature. Please see Appendix A for the Literature Search Strategy Log.

Inclusion /Exclusion Criteria. After performing a literature review, titles were reviewed for relevance. If the title was unclear, the abstract was reviewed. Articles were included for further review if they related to preoperative education and preoperative teaching. Exclusion criteria included articles not in English and published prior to 2012.

A hierarchical rating system for evaluation of strength of the evidence was used in evaluating articles for inclusion or exclusion. As part of the EBP process, assessing individual articles for strength of the evidence is appropriate to ensure that findings are “best evidence” (Melnyk & Fineout-Overholt, 2015, p. 11). Articles were ranked according to the following Rating System for the Hierarchy of Evidence for Intervention/Treatment Questions:

Level I: Evidence from a systematic review or meta-analysis of all relevant RCTs

Level II: Evidence from well-designed RCTs

Level III: Evidence obtained from well-designed controlled trials without randomization

Level IV: Evidence from well-designed case-control and cohort studies

Level V: Evidence from systematic reviews of descriptive and qualitative studies

Level VI: Evidence from single descriptive or qualitative studies

Level VII: Evidence from the opinion of authorities and/or reports of expert committees

(Melnyk & Fineout-Overholt, 2015, p. 11).

Chapter Three:  Theory and Model for Evidence-based Practice

Concept- Theoretical- Empirical system (C-T-E) structure provides an outline and framework for the study project. Using C-T-E structure offers the advantages of improved readability and ease in understanding of complex problems. A concept is a mental formulation experience (perception) (Chinn & Kramer, 2015). The concept can be divided into separate, simple, logical building blocks and theory development is the product of research, which is a systematic process of inquiry (Fawcett, 2013).  A theory is a framework that guides nursing practice (Chinn & Kramer, 2015).  The empirical indicator is a measurement tool used to evaluate a proposed theory (Chinn & Kramer, 2015).  C-T-E structure for theory testing proceeds from the conceptual model to the theory to the empirical indicators (Gigliotti & Manister, 2012). As a doctoral prepared nurse, it is important to implement evidence-based practice for the identified clinical problem at the chosen site which is based on theoretical and empirical research background. Preoperative Education is the concept of the EBP project (C), Orem’s Self Care Theory (T) provides the theoretical outline and the empirical indicator used in this project is Surgical Fear Questionnaire (E).

Concept

The identified concept for this evidence-based practice (EBP) change project is preoperative education. The concept of preoperative education can be described as a nursing intervention used to assist the patient to understand and mentally prepare for surgery and the postoperative period (Chevillion et al., 2015).  Preoperative education includes instruction about the preoperative period, the surgery itself, and the postoperative period. Education plays an integral part in promoting health by increasing the knowledge and empowering skills needed for a healthier lifestyle.  The population selected is all adults scheduled for elective ortho spine surgery, the concept of the EBP and the desired change is to increase the impact of preoperative education to the patients in patient preparedness, post-operative care, reduction in surgical anxiety.  Patient education appears to be effective in improving knowledge and reducing days of stay at the hospital (Chevillion et al., 2015). The goal of preoperative education is to not only to prepare the patient for their surgery, but also to prepare them for what to expect following the surgery. Preoperative education and patient preparedness for surgery has important implications for patient satisfaction and the perception of improvement after surgery (Greene et al., 2017).

Theory

The use of theory furthers nursing knowledge in practice by educating and providing direction. Dorethea Orem’s theory of self-care has been chosen to guide and support the concept of preoperative education. Dorethea Orem’s theory is comprised of three related parts: theory of self-care; theory of self-care deficit; and theory of nursing system (Nursing Theory, 2016). The theory of self-care includes self-care, which is the practice of activities that an individual initiates and performs on his or her own behalf to maintain life, health, and well-being (Nursing Theory, 2016). The second part of the theory, self-care deficit, specifies when nursing is needed. According to Orem, nursing is required when an adult is incapable or limited in the provision of continuous, effective self-care (Nursing Theory, 2016). The theory of nursing systems describes how the patient’s self-care needs will be met by the nurse, the patient, or by both (Nursing Theory, 2016).  Orem’s approach to the nursing process is a method to determine the self-care deficits and then to define the roles of patient or nurse to meet the self-care demands. The steps in the approach can be used in educating patients preoperatively, so they can be prepared adequately and recover more quickly from surgery. According to Sürücü, & Kizilci (2012), nursing planning has been guided by the self-care agency of the patient who is supposed to take care of requisites and how the responsible person can help by means of nursing systems. The implementation of education has demonstrated improved self-care behaviors and brought positive changes to the health status of the patients

Chapter Four: Pre-implementation Planning

Pre-implementation is the process that includes project design and development. Evidence-based practice (EBP) is a critical element of an effective change management process to ensure the highest quality care, and successful outcomes are met.  Lack of preoperative education often results in fear and anxiety prior to surgery. Therefore, preoperative educational programs are the key in achieving better health outcomes by increasing knowledge.  Research suggests that ongoing preoperative education facilitates knowledge necessary for surgical patients and results in positive postoperative outcomes (Fink et al., 2013). The purpose of this chapter is to discuss organization readiness for change, planning, implementation, and evaluation of an educational program.

Project Purpose

The purpose of the EBP change project is to improve the preoperative education program using one-on-one counseling for patients scheduled for ortho-spine surgery.  Preoperative education is important to reduce the risk of postoperative complications from occurring as it also allows the individual to take an active role in their recovery process. The goal of preoperative education is not only to prepare the patient for their surgery, but also to prepare them for what to expect following the surgery. Patient preparedness for surgery has important implications for patient satisfaction and the perception of improvement after surgery (Greene, et al., 2017). Anxiety has been noted among patients who have been waiting for scheduled procedures (Harkness, Morrow, Smith, Kiczula, & Arthur, 2003). Ji, et al., (2012) study demonstrated that nurse-initiated preoperational education and one on one counseling were associated with a reduced rate of perioperative complications, such as surgical site infections and a reduced level of anxiety following surgery.  An educational intervention using individualized one-on-one counseling will be offered to the patient to help promote change and wellbeing of the patients prior to their scheduled surgery. The intervention will focus on type of surgery, diet, exercise, medication management, preoperative care, postoperative care and optimization of co-morbidities. Knowledge and understanding of procedures and rationale, promotes feeling of a sense of control to allay anxiety.

Project Management

According to Harris et al. (2016) management of any project entails the consistent integration of skills, tools, application of knowledge and techniques to project activities. The project investigator oversees the project and must be clear about the aim of the project and the stakeholder’s needs and wants to establish the appropriate baseline for comparison of outcome data (Harris et., 2016). The program investigator ultimately is responsible for the success or failure of a project.  The steps that were explored prior to implementing the project will be discussed below.

Organizational readiness for change.  An assessment of readiness for change analyzes the level of preparedness of the conditions, attitudes and resources, at all levels in an organization (Harris et al. 2016).  One crucial factor in an organization readiness for change is to recognize that there is a need for change (Harris et., 2016).  Readiness for change in an organization influences the successful outcome of a clinical change project.  The project implementer’s clinical practice site is a large urban multi-specialty inpatient facility which conducts approximately 40 same day and inpatient surgeries a day. There had been increasing concern regarding the surgery cancelations and rate of Surgical Site Infection rate among the ortho spine surgical patients. To address this concern, the preoperative team agreed on the implementation of an EBP change project focused on increase patient preparedness, reduction in anxiety, increase patient understanding of post-operative care, and thereby prevent postoperative complications such as surgical site infection

 

Discussion: Prescribing for Older Adults and Pregnant Women NRNP6675

Prescribing for Older Adults and Pregnant Women NRNP6675

Prescribing for Older Adults and Pregnant Women Example

ZOLOFT is an FDA-approved medication for major depressive disorder. It is used to treat panic attacks, obsessive-compulsive disorder, post-traumatic stress disorder, and premenstrual syndrome. It can help improve sleep, appetite, and energy levels that can restore interest in daily living. For off-label medications, doxepin is often prescribed for depression and anxiety (Hardy & Reichenbacker, 2019). It is in the class of medications known as tricyclic antidepressants.

It works by boosting the levels of certain natural chemicals in the brain that are necessary for mental equilibrium. Doxepin can also be taken as a pill to help with insomnia. Cognitive-behavioral therapy (CBT) is a safe and effective treatment for a generalized anxiety disorder during pregnancy.

Risk and Benefit Assessment

The main risk for Zoloft is that it can cause congenital disabilities in children. These defects include atrial septal defects, cleft palate, and omphalocele. The benefit is that the medication raises the amount of serotonin in the brain Cuomo et al. 2918). As the level of serotonin increases, so does the patient’s mood. Patients, therefore, experience improvements in appetite, sleep, mood, and energy levels.

Doxepin works on the central nervous system to increase the levels of various chemicals in the brain. The medication can improve energy levels and sleep for patients (Akmasi & Meza, 2019). The risk is that it may cause a condition that affects the heart rhythm and fainting symptoms that require medical attention immediately.

Clinical Practice Guidelines

The treatment of depression necessitates a thorough examination and accurate diagnosis. The evaluation must be based on a complete medical history, a thorough physical examination, and a thorough mental state examination (Gautam et al., 2017). All sources, especially the family, must be used to gather information about the past. The diagnosis must be documented using the most up-to-date diagnostic criteria.

Prescribing for Older Adults and Pregnant Women NRNP6675 References

Almasi, A., & Meza, C. E. (2019). Doxepin. https://europepmc.org/article/NBK/nbk542306

Cuomo, A., Maina, G., Neal, S. M., De Montis, G., Rosso, G., Scheggi, S. & Fagiolini, A. (2018). Using sertraline in postpartum and breastfeeding: balancing risks and benefits. Expert Opinion On Drug Safety, 17(7), 719-725. https://doi.org/10.1080/14740338.2018.1491546

Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical practice guidelines for the management of depression. Indian Journal Of Psychiatry, 59(Suppl 1), S34.

Hardy, L. T., & Reichenbacker, O. L. (2019). A practical guide to the use of psychotropic medications during pregnancy and lactation. Archives of Psychiatric Nursing, 33(3), 254–266. https://doi.org/10.1016/j.apnu.2019.04.001

Discussion: Prescribing for Older Adults and Pregnant Women Instructions

After assessing and diagnosing a patient, PMHNPs must take into consideration special characteristics of the patient before determining an appropriate course of treatment. For pharmacological treatments that are not FDA-approved for a particular use or population, off-label use may be considered when the potential benefits could outweigh the risks.

In this Discussion, you will investigate a specific disorder and determine potential appropriate treatments for when it occurs in an older adult or pregnant woman.

To Prepare:

Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5 to use.

Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved off-label drug, and one nonpharmacological intervention for treating the disorder in that population.

By Day 3 of Week 9

Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.

Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?

Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.

Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.

Learning Resources

Required Readings (click to expand/reduce)

American Psychiatric Association. (2016). The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia. https://doi.org/10.1176/appi.books.9780890426807

Agency for Healthcare Research and Quality. (2019). Maternal and fetal effects of mental health treatments in pregnant and breastfeeding women: A systematic review of pharmacological interventions.

https://effectivehealthcare.ahrq.gov/sites/default/files/pdf/protocol-pharm-pregnant-women_0.pdf

Hardy, L. T., & Reichenbacker, O. L. (2019). A practical guide to the use of psychotropic medications during pregnancy and lactation. Archives of Psychiatric Nursing, 33(3), 254–266. https://doi.org/10.1016/j.apnu.2019.04.001

National Library of Medicine. (2006 – 2020). Drugs and lactation database (LactMed). https://www.ncbi.nlm.nih.gov/books/NBK501922/

The LactMed® database is a peer-reviewed, evidence-based resource on drugs that may be used by breastfeeding mothers. It includes possible effects on nursing infants and offers drug alternatives where possible.

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

Chapter 27, Psychiatry and Reproductive Medicine
Chapter 33, Geriatric Psychiatry
Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.

Chapter 3, Vulnerable Populations
Chapter 4, Mental Health and Primary Care: A Critical Intersection
Chapter 5, Cultural Sensitivity and Global Health
Required Media (click to expand/reduce)

American Psychiatric Association. (2020). Geriatric telepsychiatry [Video]. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry/toolkit/geriatric-telepsychiatry

Prescribing for Older Adults and Pregnant Women NRNP6675 – Disruptive Mood Dysregulation Disorder in Pregnant Women Example

Extreme and persistent anger and temper outbursts characterize Disruptive Mood Dysregulation Disorder (DMDD). DMDD can greatly influence everyday functioning and social relationships and, therefore, requires prompt management.

Pharmacological and Non-pharmacological Interventions

FDA-approved drug: Sertraline – For pregnant women with DMDD, this selective serotonin reuptake inhibitor (SSRI) is generally safe and licensed to treat major depressive disorder. It helps to lessen irritability and stabilize mood (Gilliam et al., 2019).

Off-label drug: Lamotrigine – Lamotrigine is occasionally used off-label to treat mood problems, even though it is not FDA-approved for DMDD specifically. A study on pregnant, epileptic women who took this drug showed a comparatively reduced risk of birth abnormalities (Naguy & Al-Enezi, 2019). It also has mood-stabilizing effects.

Non-pharmacological intervention: Cognitive-Behavioral Therapy (CBT) is a recognized psychotherapeutic strategy for treating mood problems. It can be modified to help pregnant people with DMDD recognize and alter negative thought patterns and create coping mechanisms for emotional control without needing medication.

Risk Assessment

A thorough risk assessment is essential when choosing a course of treatment for pregnant women with DMDD to protect the health and safety of both the mother and the growing fetus. Improved mood stability and less irritability may result from using FDA-approved medications like Sertraline, improving the woman’s overall quality of life during pregnancy. However, certain risks should be considered, such as possible side effects, including nausea or shifts in sleeping patterns. SSRI use may also be connected with a modest incidence of birth abnormalities, necessitating cautious monitoring.

The benefits of the off-label medication Lamotrigine may include mood stability, but due to DMDD’s lack of FDA approval, caution is advised. Although findings suggest a low risk of birth abnormalities, the lack of data on its safety during pregnancy must be carefully considered. It is crucial to balance the potential advantages of using off-label drugs against the unidentified hazards and risks that could arise.

The risk evaluation must consider non-pharmacological therapies like Cognitive-Behavioral Therapy (CBT), which may offer benefits without imposing drug-related risks. To balance optimizing treatment benefits and limiting possible risks for the mother and the growing baby, collaborative decision-making, including healthcare providers, the pregnant woman, and her support network, is crucial (Zemestani & Fazeli Nikoo, 2019).

Practice Guidelines

There are clinical practice guidelines for DMDD, which can be useful for guiding treatment choices. Usually, the best available data from studies and consensus among experts serve as the foundation for these recommendations. Due to their well-established efficacy and safety profile, they may advise FDA-approved drugs like Sertraline as a first-line treatment for DMDD in pregnant women.

Guidelines may also advise against using off-label medications like Lamotrigine during pregnancy due to the limited knowledge available on their safety. However, since there are no particular recommendations for treating DMDD in pregnant women, it would be necessary to look at more information from studies on the use of drugs during pregnancy, potential dangers and benefits, and non-pharmacological therapies like CBT. Making informed treatment choices for this population requires consulting with psychiatric and maternal-fetal medicine experts.

References

Gilliam, F. G., Black, K. J., Carter, J., Freedland, K. E., Sheline, Y. I., Tsai, W., & Lustman, P. J. (2019). A trial of sertraline or cognitive behavior therapy for depression in epilepsy. Annals of Neurology, 86(4), 552–560. https://doi.org/10.1002/ana.25561

Naguy, A., & Al-Enezi, N. (2019). Lamotrigine Uses in Psychiatric Practice. American Journal of Therapeutics, 26(1), e96–e102. https://doi.org/10.1097/mjt.0000000000000535

Zemestani, M., & Fazeli Nikoo, Z. (2019). Effectiveness of mindfulness-based cognitive therapy for comorbid depression and anxiety in pregnancy: A randomized controlled trial. Archives of Women’s Mental Health, 23. https://doi.org/10.1007/s00737-019-00962-8

Also Read: Personality and Paraphilic Disorders Week 7 NRNP 6675

Prescription filling process for HMO’s pharmacy

Prescription filling process for HMO’s pharmacy

Ben Davis had just completed an intensive course in Statistical Thinking for Business Improvement offered to all large health maintenance organization employees. However, there was no time to celebrate because he was already under a lot of pressure. Ben works as a pharmacist’s assistant in the HMO’s pharmacy, and his manager, Juan de Pacotilla, is about to be fired.

Juan’s dismissal appeared imminent due to numerous complaints and even a few lawsuits over inaccurate prescriptions. Juan now was asking Ben for his assistance in trying to resolve the problem, preferably yesterday!

• “Ben, I really need your help! If I can’t show some major improvement or at least a solid plan by next month, I’m history.”
• “I’ll be glad to help, Juan, but what can I do? I’m just a pharmacist’s assistant.”
• “I don’t care what your job title is; you’re just the person who can get this done. I realize I’ve been too far removed from day-to-day operations in the pharmacy, but you work there every day.

You’re in a much better position to find out how to fix the problem. Just tell me what to do, and I’ll do it.”
“But what about the statistical consultant you hired to analyze the data on inaccurate prescriptions?”

ORDER THROUGH BOUTESSAY

“Ben, honestly, I’m disappointed with that guy. He has spent two weeks developing a new modeling approach to predict weekly inaccurate prescriptions. I tried to explain to him that I didn’t want to predict the mistakes; I wanted to eliminate them!

However, I don’t think I got through because he said we need a month of additional data to verify the model. Then he can apply a new method he just read about in a journal to identify ‘change points in the time series,’ whatever that means. But get this; he will only identify the change points and send me a list; he says it’s my job to figure out what they mean and how to respond.

I don’t know much about statistics — the only thing I remember from my college course is that it was the worst course I ever took– but I’m becoming convinced that it doesn’t have much to offer in solving real problems.

You’ve just gone through this statistical thinking course, so maybe you can see something I can’t. To me, statistical thinking sounds like an oxymoron. I realize it’s a long shot, but I was hoping you could use this as the project you need to complete the course officially.”

“I see your point, Juan. I felt the same way, too. This course was interesting, though, because it didn’t focus on crunching numbers. I have some ideas about improving prescription accuracy, and I think this would be a great project. We may not be able to solve it ourselves, however.

As you know, there is a lot of finger-pointing going on; the pharmacists blame sloppy handwriting and incomplete instructions from doctors for the problem; doctors blame pharmacy assistants like me who do most of the computer entry of the prescriptions, claiming that we are incompetent; and the assistants tend to blame the pharmacists for assuming too much about our knowledge of medical terminology, brand names, known drug interactions, and so on.”

“It sounds like there’s no hope, Ben!”

“I wouldn’t say that at all, Juan. It’s just that there may be no quick fix we can do by ourselves in the pharmacy. Let me explain how I’m thinking about this and how I would propose attacking the problem using what I just learned in the statistical thinking course.”

Source: G. C. Britz, D. W. Emerling, L. B. Hare, R. W. Hoerl, & J. E. Shade. “How to Teach Others to Apply Statistical Thinking.” Quality Progress (June 1997): 67–80.

Assuming the role of Ben Davis, write three to four (3-4) page papers in which you apply the approach discussed in the textbook to this problem. You’ll have to make some assumptions about the processes used by the HMO pharmacy. Also, please use the Internet and Strayer LRC to research articles on common problems or errors that pharmacies face. Your paper should address the following points:

• Develop a process map about the prescription filling process for HMO’s pharmacy, in which you specify the key problems that the HMO’s pharmacy might be experiencing. Next, use the supplier, input, process steps, output, and customer (SIPOC) model to analyze the HMO pharmacy’s business process.
• Analyze the process map and SIPOC model to identify possible main root causes of the problems. Next, categorize whether the problem’s main root causes are special or common causes. Provide a rationale for your response.
• Suggest the main tools you would use and the data you would collect to analyze the business process and correct the problem. Justify your response.
• Propose one (1) solution to the HMO pharmacy’s ongoing problem(s) and propose one (1) strategy to measure the solution above. Provide a rationale for your response.
• Use at least two (2) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.

Principles of disaster exercises and drills Essay

Principles of disaster exercises and drills Essay

Discussion Board Question. (Principles of Disaster Exercises and Drills)

Discussion Board Question:

The County Basic Emergency Plan is recorded in ESSD Section 8. Task Assignments for any EOP might be listed as follows:

• Comprehensive emergency management planning
• Staff and responder training
• Radiologic defense program management and training
• Resource management
• Communications and warning
• Hazardous materials training
• SARA Title III activities
• LEPC support
• Management of exercises and drills
• Evaluation of community preparedness

Briefly describe your task assignment and its role in the development or management of the County’s EOP.

My task assignment is only number 2- Staff and responder training.

Reading:

1. Integrated Emergency Management Course Exercise Simulation System Document (ESSD) – Sections 1-4
2. 139a Lesson 4 – Scenario and Master Scenario Events List Development
3. IEMC ESSD files: https://training.fema.gov/iemc/exercisesimulationd…

https://mail.google.com/mail/u/4?ui=2&ik=fdd7216d4c&attid=0.2&permmsgid=msg-f:1636744782107202410&th=16b6e2b51d79536a&view=att&disp=inline&realattid=f_jx2sb4dm0

ORDER THROUGH BOUTESSAY

Principles of disaster exercises and drills Essay Instructions

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

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

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

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

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

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

Weekly Participation

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

APA Format and Writing Quality

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

Use of Direct Quotes

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

LopesWrite Policy

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

Late Policy

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

Communication

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

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

Professional Capstone And Practicum Reflective Journal 6 HW

Professional Capstone And Practicum Reflective Journal 6 HW

Students must submit weekly reflective narratives throughout the course, culminating in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Students should also explain how they met a course competency or course objective(s) each week.

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below. In the Topic 10 graded submission, each area below should be addressed as part of the summary submission.

• New practice approaches
• Interprofessional collaboration
• Health care delivery and clinical systems
• Ethical Considerations in health care
• Practices of culturally sensitive care
• Ensuring the integrity of human dignity in the care of all patients
• Population health concerns
• The Role of Technology in Improving health care Outcomes
• Health policy
• Leadership and economic models
• Health disparities

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide located in the Student Success Center.

This assignment uses a rubric. Please review the rubric before beginning the assignment to become familiar with the expectations for successful completion.

ORDER THROUGH BOUTESSAY

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort, and you can expect your grade to suffer accordingly.

Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your article – in silence and then aloud – before handing it in, and make corrections as necessary.

Often, having a friend proofread your paper for apparent errors is advantageous. Handwritten corrections are preferable to uncorrected mistakes.

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

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

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

Also Read:

Professional Capstone And Practicum Reflective Journal 6 HW

HCS316 Culture Diversity and Health & Illness HW 5

NURS 6241: STRATEGIC PLANNING IN HEALTH CARE HW 6