NRSG367 : Position Statement Critique – Nursing Assignment

Position Statement Critique – Nursing Assignment Topic

Continuous Professional Development (CPD) is a mandatory requirement to maintain a nurse’s registration, to ensure they are able to maintain and enhance their knowledge, skills and performance to deliver safe  patient care. Yet the minimum number of hours required is difficult for many nurses to attain, and can take away from the time needed for patient care.

According to Australian Health Practitioner Regulation Agency (AHPRA), it is stated that “Under the National Law, which governs the operations of the National Boards and AHPRA, all registered health practitioners must undertake Continuous Professional Development (CPD)” (Australian Health Practitioner Regulation Agency, 2017). For healthcare professionals wanting to deliver quality care and meet 
the public’s changing health care needs, nurses must be up to date with professional knowledge, to ensure that the best care can be given to the patient (Australian Health Practitioner Regulation Agency, 2017).CPD is a progress offered to healthcare  professionals, intending to advance and broaden their knowledge, skill and competence to grow as a professional (Australian Health Practitioner Regulation 
Agency, 2017). The Nursing and Midwifery Board of Australia (NMBA) further outlines a set of nursing values and standards, that supports the requirements of CPD for Registered Nurses (RN) (Registered nurse standards for practice, 2016). This essay will outline why it is important to accomplish the requirements of CPD and will also address the NMBA standards that support this position. Furthermore, it will consider an opposing view, whether if the full 20 hours is needed and if CPD  components are necessary for RN’s to complete yearly.

Questions :

1. Thinks critically and analyses nursing practice. 
2. Engages in therapeutic and professional relationships. 
3. Maintains the capability for practice. 
4. Comprehensively conducts assessments. 
5. Develops a plan for nursing practice.

6. Provides safe, appropriate and responsive quality nursing practice. 
7. Evaluates outcomes to inform nursing practice.

HSA 500Demographic Distribution, Mortality Trends, and Access to Health Care Services.Analyze the growing consumer demographics in a diverse U.S. society in terms of consumer satisfaction with health care services, and provide a rationale for the use of present health services in todays diverse demographical social framework. (This is an interesting topic and I look forward to the discussion. The United States is a diverse country and one size does not fit all. For example, in Florida the demographics are older folks, whereas Alaska, the demographics are diverse and very rural).Analyze the demands and growing trends in new diseases (e.g., heart disease and cancer) affecting the present U.S. population. Summarize the impact of these demands on available health services. (There are too many examples to list for this discussion. I look forward to hearing your thoughts. The one demand on health care that is in the media is Ebola and the respiratory virus that has killed several children. There is also the swine flu, sexually transmitted disease, chronic disease).Analyze the mortality trends in the U.S. and compare the demographic distribution associated with these trends. Evaluate the importance of societys role in promoting a healthy lifestyle, as well as adopting lifestyle choices.(This will be an interesting discussion. For example, in the 1950s before the polio vaccine was discovered, most children either died or had a physical impediment. I look forward to the discussion.)

1. Identify a nursing or health care issue which relates to health policy or health care economics. State the issue in neutral terms. For example: the need for legislation related to child safety seats/restraints or the need for school nursing. The paper will have a minimum of 4 pages and maximum of 5 pages, excluding the cover page, reference pages, and appendices.
2. The first page of the paper should introduce the issue and provide details of the issue and pertinent literature.
3. The second page of the paper should contain all major “pro” arguments supporting the issue.
4. The third page should contain “con” arguments disagreeing with the issue.
5. The final page should include a paragraph supporting your views after consideration of the “pro” and “con” arguments. It should be brief analyses of your best argument.
6. There should be a reference page which includes, at least 5 current, scholarly and evidence-based references cited in APA 6th Edition format.

Q

UNIT 3: INDIVIDUAL PROJECT
Unit: Geriatric Case Management Practices Part 2
Deliverable Length: 3-5 pages (excluding cover, abstract, and reference pages)
For this assignment review THE ATTACHED SUPPORTING MATERIAL and complete the following:
Using the Caremore model in the supporting material, write a paper based on geriatric case management assessments and the general assessment in the traditional hospital setting. In your paper, you will compare and contrast the similarities and differences of the chosen assessment in traditional settings versus geriatric or long-term care settings (e.g., nursing home, home health, or adult day services).
You must include at least 4 academic or professional peer-reviewed sources in your paper that were drafted within the last 5 years.

BACKGROUND

In psychopharmacology you met Katie, an 8-year-old Caucasian female, who was brought to your office by her mother (age 47) and father (age 49). You worked through the case by recommending possible ADHD medications. As you progress in your PMHNP program, the cases will involve more information for you to sort through.

For this case, you see Katie and her parents again. The parents have reported that the medication given to Katie does not seem to be helping. This has prompted you to reconsider the diagnosis of ADHD. You will consider other differential diagnoses and determine what information you need to accurately assess the DSM-5 criteria to make the diagnosis of ADHD or another disorder with similar diagnostic features.

When parents bring their child to your office, they may have read symptoms on the internet or they may have been told by the school “your child has ADHD”. Your diagnosis will either confirm or refute that diagnosis.

Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine a differential diagnosis and to begin medication, if indicated. The PMHNP makes this diagnostic decision based on interviews and observations of the child, her parents, and the assessment of the parents and teacher.

To start, consider what assessment tools you might need to evaluate Katie.

• Child Behavior Check List
• Conners’ Teacher Rating Scale

The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised” (Available at: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000099.1 ). This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, makes careless mistakes in her schoolwork, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. She has difficulty interacting with peers in the classroom and likes to play by herself at recess.

When interviewing Katie’s parents, you ask about pre- and post-natal history and you note that Katie is the first born with parents who were close to 40 years old when she was born. She had a low 5 minute Apgar score. The parents say that she met normal developmental milestones and possibly had some difficulty with sleep during the pre-school years. They notice that Katie has difficulty socializing with peers, she is quiet at home and spends a lot of time watching TV.

SUBJECTIVE

You observe Katie in the office and she is not able to sit still during the interview. She is constantly interrupting both you and her parents. Katie reports that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds some subjects boring or too difficult, and sometimes hard because she feels “lost”. She admits that her mind does wander during class. “Sometimes” Katie reports “I will just be thinking about something else and not looking at the teacher or other students in the class.”

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

Katie’s parents appear somewhat anxious about their daughter’s problems. You notice the mother is fidgeting with her rings and watch while you are talking. The father is tapping his foot. Other than that, they seem attentive and straight forward in the interview process.

MENTAL STATUS EXAM

The client is an 8-year-old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is neutral. Katie says that she doesn’t hear any ‘voices’ in her head but does admit to having an imaginary friend, ‘Audrey’. No reports of delusional or paranoid thought processes. Attention and concentration are somewhat limited based on Katie’s short answers to your questions.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHAT IS YOUR DIAGNOSIS FOR KATIE?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

The Assignment:

Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

• Decision #1: Differential Diagnosis
  • Which Decision did you select?
  • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
• Decision #2: Treatment Plan for Psychotherapy
  • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
• Decision #3: Treatment Plan for Psychopharmacology
  • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
• Also include how ethical considerations might impact your treatment plan and communication with clients and their families.

 Decision Point One
A-i selected Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation

B- Decision Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.Explain why i did not select Autism Spectrum Disorder (ASD), mild and co-occurring;  and why i did not select Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• You selected Attention deficit hyperactivity disorder, predominantly inattentive presentation. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer

 Decision Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

A-I SELECTED  

Begin Adderall XR 10 mg orally daily

B- EXPLAIN WHY YOU DID NOT SELECT  Wellbutrin 75 mg orally daily

 AND DID NOT SELECT Strattera 25 mg orally daily

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Katie’s parents seem absolutely delighted upon their return stating that Katie is paying more attention in school, but note that there is still room for improvement, particularly in the afternoon
• They report that Katie’s teacher has reported that Katie is able to maintain her attention throughout the morning classes but come afternoon, she “daydreams.”
• Katie’s parents are also concerned about her decrease in appetite since starting the medication

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

A- I SELECTED  to Add a small dose of immediate release Adderall in the early afternoon

B- EXPLAIN WHY I DID NOT SELECT Assure Katie’s parents that weight loss is common with stimulant medications used to treat ADHD Augment medication with family therapy

 Guidance to Student

Whereas weight loss is common with stimulant medication, this option does not address Katie’s parents’ concerns about the return of symptoms in the afternoon.

Augmentation with family therapy is also a good idea as it can help Katie with her symptoms and further help her parents to understand the unique challenges that Katie experiences, as well as ways that they can help her with symptoms, however, this option does not address the return of inattentive symptoms in the afternoon.

Adding a small dose of immediate relate Adderall in the afternoon can help Katie to maintain attention throughout the afternoon and into the early evening when she must do homework. This would be the best option.

Nursing Informatictis

Assignment: Application: Using the Data/Information/Knowledge/Wisdom Continuum

Have you ever gone online to search for a journal article on a specific topic? It is amazing to see the large number of journals that are available in the health care field. When you view the library in its entirety, you are viewing untapped data. Until you actually research for your particular topic, there is little structure. Once you have narrowed it down, you have information and once you apply the information, you have knowledge. Eventually, after thoughtful research and diligent practice, you reach the level of wisdom—knowledge applied in meaningful ways.

Are there areas in your practice that you believe should be more fully explored? The central aims of nursing informatics are to manage and communicate data, information, knowledge, and wisdom. This continuum represents the overarching structure of nursing informatics. In this Assignment, you develop a research question relevant to your practice area and relate how you would work through the progression from data to information, knowledge, and wisdom.

To prepare:

• Review the information in Figure 6–2 in Nursing Informatics and the Foundation of Knowledge.
• Develop a clinical question related to your area of practice that you would like to explore.
• Consider what you currently know about this topic. What additional information would you need to answer the question?
• Using the continuum of data, information, knowledge, and wisdom, determine how you would go about researching your question.
  • Explore the available databases in the Walden Library. Identify which of these databases you would use to find the information or data you need.
  • Once you have identified useful databases, how would you go about finding the most relevant articles and information?
  • Consider how you would extract the relevant information from the articles.
  • How would you take the information and organize it in a way that was useful? How could you take the step from simply having useful knowledge to gaining wisdom?

Write a 3- to 4-page paper that addresses the following: APA style with refernces

• Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.
  • Identify the databases and search words you would use.
  • Relate how you would take the information gleaned and turn it into useable knowledge.
• Can informatics be used to gain wisdom? Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search.

Your paper must also include a title page, an introduction, a summary, and a reference page.