Monthly Archives: May 2023

Data-Based Changes

Write an word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each number item. There should be three sections, one for each item number below, as well the introduction (heading is the title of the essay) and conclusion paragraphs. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) scholarly citations using APA citations in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.

1. Identify one aspect of big data and data mining that is interesting to you. Explain the concept and how it might bring value to healthcare. 
2. Describe the concept of continuity planning. If you were the director or manager for your current workplace, describe the preparedness program you would recommend.
3. Locate an article discussing the use of informatics in healthcare education of the general public or of nursing students. Discuss the benefits and drawbacks to using technology in this situation and recommendations from the author. Do you feel this use of technology is a viable method of educating (the public or nursing students)? Why or why not?

Assignment Expectations

Length: 500 words per essay prompt/section (1500 total for this assignment)

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment. All APA Papers should include an introduction and conclusion. 

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document 

Follow the guideline

excel sheet

I NEED A RESPONSE TO ASSIGNMENT

2 REFERENCES

Personality disorders refer to a group of mental illnesses that involve enduring patterns of thoughts, feelings, and behaviors that are not healthy which significantly and adversely affect how an individual functions in work, relationships, and various aspects of life.  According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), personality disorders fall into 10 distinct types: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, and obsessive-compulsive. The DSM-5 further divides PDs into three categories of clusters.  Cluster A: schizoid, schizotypal, paranoid the client may have odd or eccentric behaviors.  Cluster B borderline, histrionic, antisocial, narcissistic with dramatic behaviors.  Cluster C avoidant, dependent, obsessive-compulsive which includes anxious and fearful behaviors (American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 2013). 

This paper will discuss Narcissistic personality disorder a cluster B disorder.  A narcissistic personality disorder is characterized by a persistent pattern of grandiosity, fantasies of unlimited power or importance, and the need for admiration or special treatment. The client with NPD may experience significant psychological distress related to interpersonal conflict and functional impairment. Research has shown that core features of the NPD are associated with a poor prognosis in therapy, slow progress to behavioral change, premature patient-initiated termination, and negative therapeutic alliance (Dixon-Gordon et al., 2015).  A narcissistic personality disorder is prevalent, highly comorbid with other disorders, and associated with significant functional impairment and psychosocial disability.  NPD is a challenging clinical syndrome, variable presentation, difficult to treat, and often exists with co-occurring disorders which further complicates treatment.  

Therapeutic Approach

 Due to the complexity of identifying and treating NPD and the absence of expertise or resources for longer-term treatment of personality disorders, some specific approaches and techniques can be implemented to improve general clinical management of patients with the disorder.  There are no FDA-approved treatments for NPD, or any other personality disorder and clinicians use psychotherapy but the personality disorder is a challenging condition to treat (Dixon-Gordon et al., 2015).  Treatments for narcissistic personality disorder current treatment recommendations are based on clinical experience and theoretical formulations. Psychodynamic formulations have led to an increase in various treatment approaches, and case reports suggest that these treatments can be effective for some clients.  The recommended psychotherapies included: mentalization-based therapy, transference focused psychotherapy, and schema-focused psychotherapy. Each of these treatments targets psychological capacities thought to underlie and organize descriptive features of narcissistic personality disorder(Caligor et al., 2015).  However, medication may be used when clients with NPD have severe symptoms that compromise their safety. Medications include mood stabilizers or antidepressants for significant affective instability; mood stabilizer or antipsychotic for impulsive anger and aggression; or an antipsychotic for cognitive-perceptual disturbances such as paranoid thoughts, hallucination-like symptoms, depersonalization (Caligor et al., 2015).   Also, medication may be prescribed to treat co-occurring conditions, such as mood and anxiety disorders.  Clients with NPD tend to report being extra sensitive to side effects, which can cause them to stop taking their medication.  A strong therapeutic alliance has been linked to treatment success in clients with PDs. 

As the PMHNP providing care to a client with NPD, the diagnosis must be shared with the client.  This is an important part of informed consent.  In providing care for an NPD client it is imperative to discuss the etiology, clinical manifestations, course of illness, and treatment options.  Withholding diagnostic information may cause problems by focusing on comorbid conditions like depression or anxiety which the client may respond poorly to treatment.  Hence, if the narcissistic problems are not also addressed then the psychotherapies and medications to address depression and anxiety may be ineffective, lead to clinical worsening, and contribute to high drop out rates for NPD clients (Dixon-Gordon et al., 2011).      

In conclusion client with NPD are difficult to treat based on symptoms are closely linked to other psychosocial disorders and comorbid disorders. Also, treatment for NPD can be difficult for the client and therapist due to the frustration of the therapeutic progress.  NPD is an often misunderstood mental condition where a person acts arrogantly, lacks empathy, needs constant attention and admiration, and has an inflated sense of self.  There is still considerable research that needs to be done regarding the treatment of personality disorders. However, research suggests there is hope for the future in making significant changes in the psychosocial treatment for clients with personality disorders (Dixon-Gordon et al., 2011).  The PMHNP must be knowledgeable of available evidence-based practice, and well-trained to treat clients suffering from personality disorders.   Evidence has shown that PDs are treatable disorders.   The therapeutic alliance is an essential ingredient in all successful doctor-patient interactions, it is especially important when treating a narcissist. Patients with narcissistic traits commonly terminate treatment with medical providers after incidents that providers perceive as harmless misunderstandings.  Increased awareness of the clinician’s feelings when treating these patients will allow the clinician to better recognize the presence of narcissistic traits. This awareness, coupled with an improved understanding of what drives narcissistic behavior, will allow practitioners to manage these patients more effectively in a variety of medical settings.

References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). (2013). American Psychiatric Association.

Caligor, E., Levy, K. N., & Yeomans, F. E. (2015). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5), 415–422. https://doi.org/10.1176/appi.ajp.2014.14060723

Dixon-Gordon, K. L., Turner, B. J., & Chapman, A. L. (2011). Psychotherapy for personality disorders. International Review of Psychiatry, 23(3), 282–302. https://doi.org/10.3109/09540261.2011.586992

Dixon-Gordon, K. L., Whalen, D. J., Layden, B. K., & Chapman, A. L. (2015). A systematic review of personality disorders and health outcomes. Canadian Psychology/Psychologie canadienne, 56(2), 168–190. https://doi.org/10.1037/cap0000024

Resources: Strategic Plan Presentation Grading Criteria

Now that you have completed your review of the Stevens District Hospital Strategic Planning Scenario, you have been asked to provide a presentation to the governing board of the hospital. This board is comprised of the president of the hospital, four business leaders from the community, and three leaders of the medical staff.

Create a 10- to 12-slide Microsoft® PowerPoint® presentation that summarizes your analysis and goals created. Your presentation should:

• Provide an overview of the market.
• State the mission and vision for Stevens District Hospital.
• Provide the SWOT analysis.
• Summarize the goals created for Stevens District Hospital.
• Explain the rationale for goals created.
• Describe itemized resources that may be needed.
• Explain how the strategic plan provides focus and direction for Stevens District Hospital.

Format your assignment according to APA guidelines. Include a title page, detailed speaker notes, and a references page.

If you use resources outside of the information provided in the assignment, be sure to cite your references using correct APA formatting.

Submit your assignment.

Compare and contrast the symptoms of anorexia nervosa and bulimia nervosa.

  Anorexia and bulimia are types of eating disorders. They may have similar symptoms for instance body image but normally have different food related characteristics. For instance, individuals having anorexia tend to minimize their food consumption to lose weight. On the other hand, individuals having bulimia tend to increase their food consumption to gain weight. Unlike bulimia, physical symptoms of Anorexia may be severe and life threatening to the victims.

  What role does media/or society plays in the development of these disorders?  

The media has been negatively impacting eating disorders with how the media platforms uses their adverts, shows, programs, etc. To put many people at a higher disordered eating risk making anyone to feel dissatisfied about their body appearances, hence lowering their self-esteem. Conducted research shows that many girls who see photographs in the fashion magazines have a higher probability of finding means to lose weight because of the influence of an article (Feldman, Runfola & Lock, 2018). Concerns about losing weight matters and dieting and the desires to look like other prominent people may be used to indicate the rise in eating disorders risks. Although it is hard to avoid the influence of media with the current technology, media education can offer the necessary tools of evaluating and questioning the information received and in mitigating the negative effects (Marshall, G. W., Moncrief, Rudd & Lee, 2012).

          What are some important nursing considerations regarding the treatment of a client with eating disorders during inpatient hospitalization? 

  Treating eating disorders patients’ needs proper medical evaluation and care. Treatment options should include inpatient hospitalization, day program and outpatient medical care. Nurses should consider educating the patients of eating disorders to avoid the stigma they may experience due to their appearances. They should educate the patients also on knowledge of the disorders, thinness idealization, body dissatisfaction, dieting, BMI, etc.

Organizational Policies and Practices to Support Healthcare Issues

     Being a leader in the healthcare industry is very taxing, as many difficult decisions must be made, and numerous competing needs must be met. Healthcare is a business, and the bottom line must be met so the business can continue to run. However, healthcare is so much more than just a business; it is where people turn when they need healing. More often than not, the bottom line and the healing of patients do not run the same course. This means that leaders are left with a choice to make, knowing that at least one need will not be met. These differing needs often affect policy, and when needs are unmet, it can lead to problems such as nurse burnout.

The Effect of Competing Needs on Policy

     The effect of competing needs on policy can be seen clearly in many standardized clinical pathways, where patient care is often jeopardized with a standardized approach to care (Kelly & Porr, 2018). These standardized clinical pathways are often inflexible and do not allow for personalized care that will best meet the patient’s needs (Kelly & Porr, 2018). Administrator’s priorities when constructing new policies are often different than those implementing the policies and coming into direct contact with patients. As there are so many needs in healthcare that must be met, it is next to impossible for leaders to make decisions and construct policies that will meet all needs. With that being said, leaders must clearly communicate and explain the reasoning behind decision-making to help those whose needs have not been met understand the choices made (Laureate Education, 2009). If these choices are not clearly communicated, then the repercussions of not meeting all needs can be much more consequential.

The Effect of Competing Needs on Nurse Burnout

     Unmet needs in the healthcare industry can have many negative consequences. One of these consequences is nurse burnout. Leaders in healthcare typically prioritize the needs of the organization’s budget and patient outcomes. These priorities often overshadow the needs of the workforce. When nurses’ needs are not being prioritized and addressed, it can contribute to nurse burnout. Inadequate staffing is often a result of financial restrictions that have been prioritized over maintaining adequate staffing ratios. This leads to nurses being overworked, which is a component of nurse burnout (Brown et al., 2018). There are currently fourteen states that have laws and regulations in place that address nurse staffing (American Nurses Association [ANA], 2019). Healthcare organizations should have specific nurse staffing policies in place and ensure that they are strictly followed. This is not just important to prevent nurse burnout, but adequate staffing helps improve patient outcomes. Safe staffing ratios should be prioritized as it will help meet more than one of the competing needs that are seen in the healthcare industry.  

References

American Nurses Association. (2019). Nurse staffing advocacy. https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-advocacy/

Brown, S., Whichello, R., & Price, S. (2018). The impact of resiliency on nurse burnout: An integrative literature review. Medsurg Nursing, 27(6). https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=11&sid=ef9c2b5f-a5cc-4dfe-8116-de60692fca86%40pdc-v-sessmgr01

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance rn practice. The Online Journal of Issues in Nursing, 23(1). https://doi.org/10.3912/OJIN.Vol23No01Man06

Laureate Education. (2009). Working with individuals [Video]. Baltimore, MD: Author.

What motivates you?  Explain in 250 words what motivates you, how does it motivate you, why does it motivate you?  Do you have multiple motivators? 

You have until 10/23/2020 at 11:59 pm to respond.

Search entries or author Filter replies by unreadUnread   Collapse replies Expand replies Subscribe
 

 1- Discussion question: A predominant theme in research today is obesity, which is increasing at an alarming rate worldwide, and is most prevalent in the pediatric population.

a. In your viewpoint as a nurse, why should this be of concern in the region where you live?

b. What concepts of obesity need to be taken into consideration?

2- 3 paragraphs of 3 sentences each

3- APA style

4- 2 references not older than 2015

DQ1

It is significantly erroneous to believe that project implementation is simply a matter of organization and theory—that is, working the right processes and tasks, writing a perfect change document, having good leadership mechanisms in place, as well as having a perfect understanding of all the relevant change theories, including Lewin’s three stage theory, Lippit’s seven-step theory, B. F. Skinner’s and Pavlov’s operant and classical conditioning. Successful project implementation goes beyond these activities, and must include stakeholder support and involvement.

It is therefore pertinent to consider internal stakeholders, such as the nursing staff, supervisors, nurse managers, and other entities within the health care setting and the external stakeholders, which include health care regulators, competitors, health care consumers, and other entities outside the setting. According to Panorama Consulting Group (2020), doing a stakeholder analysis is very key for change implementation efforts for four reasons: to understand stakeholder needs and perspectives; to detect change resistance and increase commitment; to determine the best approach for stakeholder engagement; and to determine the appropriate messaging tactics that generate positive influence.

In view of the above, ensuring stakeholder support is important for the success of my change proposal because it ensure commitment and support for the change project. In a situation where most stakeholders in the setting where the change project will be implemented are in support and are fully involved, the chances are high that implementation will be successful. One important way to secure the support of both my internal and external stakeholders will include the organization of interactive forums in which the change project and its benefits will be discussed.

                                                                                     Reference

Panorama Consulting Group (2020). The role of a stakeholder analysis in change management. Available from: https://www.panorama-consulting.com/stakeholder-analysis-in-change-management/

Joseph, M. (2019). Importance of stakeholder support in implementation of evidence-based practice project in nursing. The Nursing Ace. Available from: https://thenursingace.com/importance-of-stakeholder-support-in-implementation-of-evidence-based-practice-project-in-nursing/#:~:text=Their%20support%20is%20necessary%20because,project%20in%20in%20interactive%20forums.

DQ2

Stakeholders are important in performance of an organization way of operating, by investing interest in medical decisions, and evidence-based practice. This can in include nurse, doctors, patients, payers, and policy-makers. Policy-makers create population-level metrics that inform their economic policies. Important questions they ask are eligibility to receive care, services provided, how services will be paid for, accessibility, other health care concerns to plan for. They set context in how the health care system will operate. Policies created are made to maximize patient health within the country’s financial and resources available. Patients receive care, and are the beneficiary customers of payers, who want to access health information from their smart phone or computer. Providers deliver care within policy framework. They are independent businesses that manage their own operations and finances. Payers are the financial element, who enroll patients as beneficiaries. They report to policy-makers about financial sustainability of the care program they have. 

For my change project, it is important to have the support of my fellow nurses, director, and possibly doctors. Evidence-based practice on why medication intervention for dementia related behavior are not effective, but instead adversely affects the patient is important to provide. I personally have noticed doctors like to prescribe many anti psychotics to patients with behavioral symptoms, which tend to sedate them and leads to decreased quality of life. I remember talking to the doctor about holding the patients second dose of quetiapine for the evening because I noticed he gets more confused and gets out of bed without calling for help. That evening I was able to communicate with the patient more effectively, and he seemed more relaxed with less confusion. It is important to have my fellow nurses to be on board with trying non-pharmacological interventions, instead of quickly asking for medications or restraining individuals.

Pressbooks. (n.d.). 3. Introducing the key stakeholders: Patients, providers, payors, and plicymakers (the four p’s). Retrieved from https://jln1.pressbooks.com/chapter/3-introducing-the-key-stakeholders-patients-providers-payors-and-policymakers-the-four-ps/