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Please summarise the attached handout in one page  

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.

The assignment will be used to develop a written implementation plan.

For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.

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 prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Goal:

The purpose of this assignment is to identify a theory or model which can be used as a framework for a future evidence-based project

Content Requirements: 

1. Review literature regarding issues or concerns within your selected area of advanced practice nursing. Select a theory or model which is relevant to your selected area of advanced practice nursing. Offer a meaningful context for evidence-based practice surrounding the issue or concern which you identified.
2. Address Theoretical Framework to Support Evidence-based Practice Assignment
3. Identify and describe a theory or model, and explain its relevance to the selected area of advanced practice
4. Describe an issue or concern regarding the selected area of advanced practice and explain its impact on health care outcomes.
5. Explain how the theory or model can be used as a framework to guide evidence-based practice to address the issue or concern, and discuss the unique insight or perspective offered through the application of this theory or model.

Submission Instructions:

• The PowerPoint presentation is original work and logically organized. It should consist of 10-15 slides excluding the title and reference.
• The PowerPoint presentation should be clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
• The PowerPoint presentation should be formatted per APA and references should be current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions)
• Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).

 I have a class running up to March 2022, I do not have enough time to deal with it as my job is quite demanding. I’m looking for a reliable tutor to take care of everything. If you are interested you can check more details from the link below. My email is also attached because I may not always be online to engage tutors. Email me if you can do the work. Link with details Nursing homework help 

 FINAL PAPER DUE Week 10 (today). Topic: Select Health Policy Analysis Paper on a local, state, or federal policy that you have explored along with recommendations based upon the analysis. • Analyze and evaluate the Health Policy • Identify application of health policy into clinical practice. ➢ Your paper must have an Introduction and a Conclusion ➢ Maximum of 6 pages (not including Title and Reference page). ➢ APA format ➢ At least 5 references within 5 years. 

   Hello i need a Briefly, Good and Positive Comment for this Post.Thank you.  I need at least two references. 

RUFINA EWANE 

Initial post

COLLAPSE

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Psychiatric emergencies are severe behavioral changes that may result from worsening mental illness. Psychiatric emergency is any disturbance in thoughts, feelings, or actions that require immediate therapeutic intervention (Stahl, S. M., 2014). The providers approach, attitudes and work environment may escalate the situation and interfere with the quality of care. Certain therapeutic measures can reduce the intensity of the situation and provide a more dignified way for patients to recover from the crisis. It is thus important that the PMHNP understand how to assess patient’s emergency status and address their unique needs while maintaining safety.

 Case selected.

Patient is a 25-year-old AA male who presents to the emergency department with psychotic behavior in believing he should kill his mother which led to his attempt to stab his mother. Patient is admitted for inpatient psychiatric stabilization. Patient has a history of schizoaffective disorder and major depression that was managed with use of clozapine 150mg twice a day and Zoloft 100mg daily. Family reported that patient has a history of medication non-compliant and had been on different psychiatric medications in the past but were not working for him. Additional reports by his parents shows that patient had missed several doses of his medication, decompensated and they had notices some changes  recently including increase agitation, delusional believes that he is the savior in the family and God had directed him to cast the demon in his mother. Reports also that he had drawn a picture of himself with knives cutting a woman he portrayed as a demon with blood flowing with a man standing to the side, laughing. Patient currently stated that he participates in a meeting with angels from which he gets directives on how to attack his mother which led to his attempt to stab his mother. Because of this, patient was considered dangerous to his mother per admitting physician. Patients symptoms include psychosis, extreme agitation, paranoia, verbal outburst, combative and very difficult to redirect. Patient has no known drug allergies per parents.  Verbal restraint was used including letting patient know what will happen if he does not comply, respecting his autonomy, empathetic listening, decrease environmental stimulation, reassure patient that they will be safe, and maintain a safe environment. The patient was given emergency medications including haloperidol lactate 5mg, lorazepam 2mg, and diphenhydramine 50mg all IM for severe agitation and danger to others. To prevent re-hospitalization within 12-24 hours of discharge, the physician ordered outpatient therapy and continued use of clozapine and Zoloft along with necessary lab work.

How I would treat the client differently if he or she were a child or adolescent

Children and adolescent are usually brought for treatment when their behavior or thoughts come to the attention of parents, teachers, social workers, or school.  For pediatric patients in a mental health crisis, the typical chaotic nature of the situation may easily further exacerbate an already traumatized state of the patient. Just like in adults, as a PMHNP I would perform an evaluation to determine the type of emergency and contributing factors in child and adolescent emergency by assessing not just the child but also the entire family. Additionally, safety and protection are essential mandate in psychiatric emergency evaluation especially when the patient pose imminent threat to self or others. What I will do different when interviewing children especially younger children is to assess the underlying cause of the violent behavior and delusional symptoms within a developmental context. Specifically, I would clarify that “bizarre thinking ” or accounts of seeing or hearing things that others do not see or hear are different from developmentally appropriate fantasy or difficulty while distinguishing inner voices from distressing hallucinations. On like in adults where they can provide information during the interview, when it comes to younger children, I would need to obtain information from parents or guardian. For adolescents, I would obtain information from the patient first then talk to their parent or guardian if the adolescent is able to tell most of their own story. This may also help to give a sense of autonomy and control to the adolescent which promote cooperation with the interview process.  However, information from family is very crucial particularly for a child who is psychotic, frightened, unable, or unwilling to corporate with the provider to help understand how the situation occurred and the severity of the behavior.

Same interviewing strategies used in adult may be used including speaking in a soft voice respecting patients’ autonomy, assuring safety, validating feelings, offering distractions (like video games) especially with very young children, and clear limit-setting can be helpful. However, children should be evaluated in a carefully planned setting with doors closed for limiting access, and be sure appropriate backup is available (Margret, C. P., & Hilt, R., 2018). 

In violent situations children may require a different approach in deescalating the situation than adults. Safety is the essential mandate in an aggression evaluation, with the interviewer specifically looking for imminent threats, plans, targeted people, and access to means of harm (Margret, C. P., & Hilt, R., 2018). Because adults are much stronger, they may require physical restrain specially to administer medication to calm the patient. Verbal restrain such as providing verbal directions in a nonthreatening manner, setting limits, and assuring the child that treatment may help them calm may be used for children first. However, if the child is dangerously out of control and aggressive, they may need medication to keep them calm and safe.

Legal or ethical issues I would consider when working with a child or adolescent emergency case

The ethical issue I will consider when working with children and adolescent is respect for their autonomy, privacy, and confidentiality. For very young children parents must consent to treatment and the health care provider treating the child should make every reasonable effort to obtain and document informed consent. (American Academy of Pediatrics, 2015). Just like adults, maintaining a patient’s confidentiality is an important ethical consideration when providing care to children and adolescents. However, when a PMHNP is concerned that the patient may be at imminent risk for harm to self or others, confidentiality requirements no longer apply (Chun, T. H., Katz, E. R., & Duffy, S. J., 2013). This means that the PMHNP in this situation may disclose information collected  from patient to caregivers or others as needed and may obtain information from others such as friends, family members, school personnel, employers and other without obtaining consent from the patient or guardians (Chun, T. H., Katz, E. R., & Duffy, S. J., 2013. Patient autonomy is a major principle in making decisions about an individual’s health, and as a PMHNP we are obligated to respect this right and allow patients to practice their autonomy in the course of their treatment (Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F., 2014). However, a psychiatric emergency and age may limit a child’s ability to make such decisions. Regardless, it is always important to involve the child in informed decision making even if the consent is signed by the parents or guardian.

References

Chun, T. H., Katz, E. R., & Duffy, S. J. (2013). Pediatric mental health emergencies and special

health care needs. Pediatric clinics of North America, 60(5), 1185–1201. Retrieved from,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792398/

Da Silva, A. G., Baldaçara, L., Cavalcante, D. A., Fasanella, N. A., & Palha, A. P. (2020). The

Impact of Mental Illness Stigma on Psychiatric Emergencies. Frontiers in psychiatry, 11,

573. https://doi.org/10.3389/fpsyt.2020.00573

Margret, C. P., & Hilt, R. (2018). Evaluation and Management of Psychiatric Emergencies in

Children. Pediatric Annals, 47(8), e328–e333. https://doi-

org.ezp.waldenulibrary.org/10.3928/19382359-20180709-01

Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F. (2014). Autonomy of children and

adolescents in consent to treatment: ethical, jurisprudential and legal considerations.

Iranian journal of pediatrics, 24(3), 241–248. Retrieved from,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276576/

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New

York, NY: Cambridge University Press.

 What are your thoughts about the debate regarding whether health care is a right or a privilege? How has the changing health care environment impacted your practice?

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources

Minimum of 250 words with at least one peer review reference in 7th edition apa style

 Integrate ethical decision-making principles that promote a culture of care. 

 THIS IS A DOCTORATE DEGREE IN NURSING PROGRAM 

PLEASE FOLLOW YOUR INSTRUCTIONS

ZERO PLAGIARISM

5 REFERENCES

Understanding the strengths of each type of therapy and which type of therapy is most appropriate for each client is an essential skill of the Psychiatric Mental Health Nurse Practitioner. In this Discussion, you will compare Existential-Humanistic therapy to a therapy you select from the previous weeks of this course. You will identify the strengths and challenges of each and describe a fictional client that you think is best suited for each.

Learning Objectives

Students will:

• Compare types of psychotherapy

To prepare:

• Review this week’s Learning Resources
• Review this week’s media and consider the insights provided.
• Review the other types of psychotherapy presented in this course and select the one that resonates with you the most at this time

By Day 3

Post a summary of the psychotherapy that you selected and explain why it resonates with you the most at this time. Then compare the psychotherapy you selected with existential-humanistic therapy. What are the strengths and challenges of each type of psychotherapy? Describe a fictional client that you think would be best suited for the therapy you selected and one fictional client you think would be best suited for existential-humanistic therapy. Explain why.

“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some time with the patient. One of the things that the nurse did to coordinate care was to meet with the family to see what times worked best for them; then she posted family time on the patient’s activity schedule outside her cubicle to communicate the plan to others involved in Mrs. Walsh’s care.
When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done in this unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They turned down the lights, closed the doors, and put music on; the nurse, the patient’s daughter, and the patient’s son all cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter should be sharing this time alone with their mother. Then she realized that they really wanted her to be there with them. This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines”
Critical thinking activities
1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011).
2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care?
3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice.