explain the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism within health care.

/in /by

Details:

Based on the required topic study materials, write a reflection about worldview and respond to following:

  1. In 250-300 words, explain the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism within health care.
  2. In 250-300 words, explain what scientism is and describe two of the main arguments against it.
  3. In 750-1,000 words, answer each of the worldview questions according to your own personal perspective and worldview: (a) What is ultimate reality? (b) What is the nature of the universe? (c) What is a human being? (d) What is knowledge? (e) What is your basis of ethics? (f) What is the purpose of your existence?

Remember to support your reflection with the topic study materials.

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

Worldview Analysis and Personal Inventory

1
Unsatisfactory
0.00%

2
Less than Satisfactory
65.00%

3
Satisfactory
75.00%

4
Good
85.00%

5
Excellent
100.00%

70.0 %Content

20.0 %Christian Perspective of Spirituality and Ethics in Contrast to Postmodern Relativism

Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is incomplete or insufficient.

Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is unclear. Explanation is not supported by topic study materials.

Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is clear. Explanation is not supported by topic study materials.

Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is clear and detailed. Explanation is supported by topic study materials.

Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is clear, detailed, and demonstrates a deep understanding of the subject. Explanation is supported by topic study materials.

20.0 %Scientism and Arguments

Explanation of scientism or the explanations of two main arguments against scientism are inaccurate. Details are not supported.

Description of scientism is accurate. Explanations of two main arguments against scientism are unclear. Details are not clearly supported by topic study materials.

Explanation of scientism is clear. Explanations of two main arguments against scientism are clear. Details are supported by topic study materials.

Explanation of scientism is clear and accurate. Explanations of two main arguments against scientism are clear. Details are clearly supported by topic study materials.

Explanation of scientism is clear and accurate. Explanations of two main arguments against scientism are clear and insightful. Details are clearly supported by topic study materials.

30.0 %Personal Perspective and Worldview

Worldview questions are not fully answered.

Each of the worldview questions is answered but is lacking a personal connection or clarity.

Each of the worldview questions is answered with personal connection.

Each of the worldview questions is answered clearly and with personal connection.

Each of the worldview questions is answered clearly and with deep personal insight.

30.0 %Organization, Effectiveness, and Format

7.0 %Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

30.0 %Organization, Effectiveness, and Format

8.0 %Argument Logic and Construction

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

30.0 %Organization, Effectiveness, and Format

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

Writer is clearly in command of standard, written, academic English.

30.0 %Organization, Effectiveness, and Format

5.0 %Paper Format (use of appropriate style for the major and assignment)

Template is not used appropriately, or documentation format is rarely followed correctly.

Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

Appropriate template is used. Formatting is correct, although some minor errors may be present.

Appropriate template is fully used. There are virtually no errors in formatting style.

All format elements are correct.

30.0 %Organization, Effectiveness, and Format

5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

Sources are not documented.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

100 %Total Weightage

Middle Range or Interdisciplinary Theory Evaluation

/in /by

Assignment 2: Middle Range or Interdisciplinary Theory Evaluation

 

As addressed this week, middle range theories are frequently used as a framework for exploring nursing practice problems. In addition, theories from other sciences, such as sociology and environmental science, have relevance for nursing practice. For the next few weeks you will explore the use of interdisciplinary theories in nursing.

This Assignment asks you to evaluate two middle range or interdisciplinary theories and apply those theories to a clinical practice problem. You will also create a hypothesis based upon each theory for an evidence-based practice project to resolve a clinical problem.

Note: This Assignment will serve as your Major Assessment for this course.

 

To prepare:

 

  • Review strategies for evaluating theory presented by Fawcett and Garity in this week’s Learning Resources (see under list of Required Readings and attached pdf file)
  • Select a clinical practice problem that can be addressed through an evidence-based practice project. Note: You may continue to use the same practice problem you have been addressing in earlier Discussions and in Week 7 Assignment 1.
  • Consider the middle range theories presented this week, and determine if one of those theories could provide a framework for exploring your clinical practice problem. If one or two middle range theories seem appropriate, begin evaluating the theory from the context of your practice problem.
  • Formulate a preliminary clinical/practice research question that addresses your practice problem. If appropriate, you may use the same research question you formulated for Assignment #4.

Write a 10- to 12-page paper (including references) in APA format and a minimum of 8 references or more, using material presented in the list of required readings to consider interdisciplinary theories that may be appropriate for exploring your practice problem and research question (refer to the sample paper attached as “Assignment example”). Include the level one headings as numbered below:

1)       Introduction with a purpose statement (e.g. The purpose of this paper is…)

2)       Briefly describe your selected clinical practice problem.

3)       Summarize the two selected theories. Both may be middle range theories or interdisciplinary theories, or you may select one from each category.

4)       Evaluate both theories using the evaluation criteria provided in the Learning Resources.

5)       Determine which theory is most appropriate for addressing your clinical practice problem. Summarize why you selected the theory. Using the propositions of that theory, refine your clinical / practice research question.

6)       conclusion

MY PRACTICE PROBLEM IS AS FOLLOWED:

 

P: Patients suffering from Type 2 Diabetes Mellitus

 

I:  Who are involved in diabetic self-care programs

 

C: Compared to those who do not participate in self-care programs

 

O: Are more likely to achieve improved glycemic control

 

THE THEORIES USED FOR THIS MODEL ARE:

Dorothea Orem Self-Care Theory and The Self-Efficacity in nursing Theory by Lenz & Shortridge-Baggett, or the Health Promotion Model by Pender, Murdaugh & Parson (Pick 2)

 

Required Readings

 

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

  • Chapter 10, “Introduction to Middle Range Nursing Theories”

Chapter 10 begins the exploration of middle range theories and discusses their development, refinement, and use in research.

  • Chapter 11, “Overview of Selected Middle Range Nursing Theories”

Chapter 11 continues the examination of middle range theories and provides an in-depth examination of a select set of theories

·         Chapter 15, “Theories from the Biomedical Sciences”

Chapter 15 highlights some of the most commonly used theories and principles from the biomedical sciences and illustrates how they are applied to studies conducted by nurses and in nursing practice.

·         Chapter 16, “Theories, Models, and Frameworks from Administration and Management”

Chapter 16 presents leadership and management theories utilized in advanced nursing practice.

·         Chapter 18, “Application of Theory in Nursing Practice”

Chapter 18 examines the relationship between theory and nursing practice. It discusses how evidence-based practice provides an opportunity to utilize research and theory to improve patient outcomes, health care, and nursing practice.

 

 

 

 

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

  • Chapter 6, “Objectives, Questions, Variables, and Hypotheses”

Chapter 6 guides nurses through the process of identifying research objectives, developing research questions, and creating research hypotheses.

·         Review Chapter 2, “Evolution of Research in Building Evidence-Based Nursing Practice”

·         Chapter 19, “Evidence Synthesis and Strategies for Evidence-Based Practice”

This section of Chapter 19 examines the implementation of the best research evidence to practice.

 

 

 

Fawcett, J., & Garity, J. (2009). Chapter 6: Evaluation of middle-range theories. Evaluating Research for Evidence-Based Nursing. Philadelphia, Pennsylvania: F. A. Davis.

Note: You will access this article from the Walden Library databases.

This book chapter evaluates the use and significance of middle-range theories in nursing research and clinical practice.

 

DeSanto-Madeya, S., & Fawcett, J. (2009). Toward Understanding and Measuring Adaptation Level in the Context of the Roy Adaptation Model. Nursing Science Quarterly, 22(4), 355–359.

Note: You will access this article from the Walden Library databases.

This article describes how the Roy Adaptation Model (RAM) is used to guide nursing practice, research, and education in many different countries.

Jacelon, C., Furman, E., Rea, A., Macdonald, B., & Donoghue, L. (2011). Creating a professional practice model for postacute care: Adapting the Chronic Care Model for long-term care. Journal of Gerontological Nursing, 37(3), 53–60.

Note: You will access this article from the Walden Library databases.

This article addresses the need to redesign health care delivery to better meet the needs of individuals with chronic illness and health problems.

 

Murrock, C. J., & Higgins, P. A. (2009). The theory of music, mood and movement to improve health outcomes. Journal of Advanced Nursing, 65 (10), 2249–2257. doi:10.1111/j.1365-2648.2009.05108.x

Note: You will access this article from the Walden Library databases.

This article discusses the development of a middle-range nursing theory on the effects of music on physical activity and improved health outcomes.

 

 

Amella, E. J., & Aselage, M. B. (2010). An evolutionary analysis of mealtime difficulties in older adults with dementia. Journal of Clinical Nursing, 19(1/2), 33–41. doi:10.1111/j.1365-2702.2009.02969.x

Note: You will access this article from the Walden Library databases.

This article presents findings from a meta-analysis of 48 research studies that examined mealtime difficulties in older adults with dementia.

 

Frazier, L., Wung, S., Sparks, E., & Eastwood, C. (2009). Cardiovascular nursing on human genomics: What do cardiovascular nurses need to know about congestive heart failure? Progress in Cardiovascular Nursing, 24(3), 80–85.

Note: You will access this article from the Walden Library databases.

This article discusses current genetics research on the main causes of heart failure.

 

Mahon, S. M. (2009). Cancer Genomics: Cancer genomics: Advocating for competent care for families. Clinical Journal of Oncology Nursing, 13(4), 373–3 76.

Note: You will access this article from the Walden Library databases.

This article advocates for nurses to stay abreast of the rapid changes in cancer prevention research and its application to clinical practice.

 

Mayer, K. H., Venkatesh, K. K. (2010). Antiretroviral therapy as HIV prevention: Status and prospects. American Journal of Public Health, 100(10), 1867–1 876. doi: 10.2105/AJPH.2009.184796

Note: You will access this article from the Walden Library databases.

This article provides an in-depth examination of potential HIV transmission prevention.

 

Pestka, E. L., Burbank, K. F., & Junglen, L. M. (2010). Improving nursing practice with genomics. Nursing Management, 41(3), 40–44. doi: 10.1097/01.NUMA.0000369499.99852.c3

Note: You will access this article from the Walden Library databases.

This article provides an overview of genomics and how nurses can apply it in practice.

 

Yao, L., & Algase, D. (2008). Emotional intervention strategies for dementia-related behavior: A theory synthesis. The Journal of Neuroscience Nursing, 40(2), 106–115.

Note: You will access this article from the Walden Library databases.

This article discusses a new model that was developed from empirical and theoretical evidence to examine intervention strategies for patients with dementia.

 

Fineout-Overholt, E., Williamson, K., Gallagher-Ford, L., Melnyk, B., & Stillwell, S. (2011). Following the evidence: Planning for sustainable change. The American Journal Of Nursing, 111(1), 54–60.

This article outlines the efforts made as a result of evidence-based practice to develop rapid response teams and reduce unplanned ICU admissions.

 

Kleinpell, R. (2010). Evidence-based review and discussion points. American Journal of Critical Care, 19(6), 530–531.

This report provides a review of an evidence-based study conducted on patients with aneurismal subarachnoid hemorrhage and analyzes the validity and quality of the research.

 

Koh, H. (2010). A 2020 vision for healthy people. The New England Journal Of Medicine, 362(18), 1653–1656.

This article identifies emerging public health priorities and helps to align health-promotion resources, strategies, and research.

 

Moore, Z. (2010). Bridging the theory-practice gap in pressure ulcer prevention. British Journal of Nursing, 19(15), S15–S18.

This article discusses the largely preventable problem of pressure ulcers and the importance of nurses being well-informed of current prevention strategies.

 

Musker, K. (2011). Nursing theory-based independent nursing practice: A personal experience of closing the theory-practice gap. Advances In Nursing Science, 34(1), 67–77.

This article discusses how personal and professional knowledge can be used in concert with health theories to positively influence nursing practice.

 

Roby, D., Kominski, G., & Pourat, N. (2008). Assessing the barriers to engaging challenging populations in disease management programs: The Medicaid experience. Disease Management & Health Outcomes, 16(6), 421–428.

This article explores the barriers associated with chronic illness care and other factors faced by disease management programs for Medicaid populations.

 

Sobczak, J. (2009). Managing high-acuity-depressed adults in primary care. Journal of the American Academy of Nurse Practitioners, 21(7), 362–370. doi: 10.1111/j.1745-7599.2009.00422.x

This article discusses a method found which positively impacts patient outcomes used with highly-acuity-depressed patients.

 

Thorne, S. (2009). The role of qualitative research within an evidence-based context: Can metasynthesis be the answer? International Journal of Nursing Studies, 46(4), 569–575. doi: 10.1016/j.ijnurstu.2008.05.001

The article explores the use of qualitative research methodology with the current evidence-based practice movement.

 

 

 

Optional Resources

 

McCurry, M., Revell, S., & Roy, S. (2010). Knowledge for the good of the individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11(1), 42–52.

 

Calzone, K. A., Cashion, A., Feetham, S., Jenkins, J., Prows, C. A., Williams, J. K., & Wung, S. (2010). Nurses transforming health care using genetics and genomics. Nursing Outlook, 58(1), 26–35. doi: 10.1016/j.outlook.2009.05.001

 

McCurry, M., Revell, S., & Roy, S. (2010). Knowledge for the good of the individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11(1), 42–52.

 

 

The Patient Protection And Affordable Care Act (PPACA)

/in /by

 The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.”

Discuss how these two provisions have impacted, or will impact, your current practice of nursing.

 Nursing and Health Reform

The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Obama on March 23, 2010. This law will enact sweeping changes to almost every facet of the health care system over the next ten years. The law makes changes that will impact providers, insurers, consumers, Medicare & Medicaid, and payment policies. For the purposes of this document we wanted to provide readers with an overview of those provisions in the new law that will impact the nursing community as well as their facilities. This article is intended to provide an overview of those sections of the law most relevant to WOCN members. The information focuses on three main aspects of the law: nursing workforce provisions, payment reform provisions, and facility specific provisions. Each provision is given a brief summary and policy goal of the language contained in the law. Readers can find the full legislative language for each section here: http://www.gpo.gov/fdsys/pkg/PLAW111publ148/html/PLAW-111publ148.htm Nursing Workforce Provisions Policy makers recognized the need for an increased workforce to care for the millions of consumers who would be added to the ranks of the insured under PPACA. This — in conjunction with an already existing workforce shortage within the nursing community — led to a number of provisions designed to increase the number of nurses in the coming years. Those provisions are as follows: Section 5202 Nursing student loan program—Updates the loan amounts for the Nursing Student Loan program and after 2012 the Secretary (of the Department of Health and Human Services) has discretion to adjust this amount based on cost of attendance increases.

Section 5203 Health care workforce loan repayment programs—Establishes a loan repayment program for individuals who are willing to practice in a pediatric medical or surgical subspecialty or in a child mental or behavioral health care for at least 2 years in an underserved area. Recipients, which include psychiatric nurses, social workers, and professional/school counselors, are eligible to receive $35,000/year in loan repayments for participation in an accredited pediatric specialty residency or fellowship. HHS is to give priority to applicants who are or will be working in a school setting, have familiarity with evidence-based healthcare, and can demonstrate financial need. Section 5204 Public health workforce recruitment and retention programs—Establishes Public Health Workforce Loan Repayment Program to assure an adequate supply of public health professionals to eliminate workforce shortages in public health agencies. HHS will repay up to 1/3 of loans incurred by a public health or health professions student in exchange for an agreement to accept employment with a public health agency for at least three years. Those serving in priority service areas may qualify for additional loan repayment incentives at department’s discretion. Section 5205 Allied health workforce recruitment and retention programs—Authorizes an Allied Health Loan Forgiveness Program to assure there is an adequate supply of allied health professionals to eliminate workforce shortages at public health agencies, acute care facilities, ambulatory care facilities, and other underserved health facilities. Section 5206 Grants for State and local programs—Authorizes HHS to make grants to accredited educational institutions that support scholarships for mid-career public health and allied health professionals who seek additional training in their respective fields. Section 5207 Funding for National Health Service Corps—Increasing funding for National Health Service Corps (NHSC) and extends authorization of appropriations for the Corps thru 2015. For FY2016 and beyond, a formula for funding is established to tie increased costs in healthcare to the number of individuals residing in health professions shortage areas. Section 5209 Elimination of cap on commissioned corps—Removes cap of 2800 commissioned officers in National Health Services Corps regular corps. Section 5210 Establishing a Ready Reserve Corps—Reconstitutes the Public Health Service Corps into the commissioned Regular Corps and a Ready Reserve Corps for service in time of national emergencies. Section 5301 Training in family medicine, general internal medicine, general pediatrics, and physician assistantship—Establishes a grant program for hospitals, medical schools, academically and affiliated PA training programs to develop and operate accredited training programs for the provision of primary care. Section 5302 Training opportunities for direct care workers—Establishes a 3 year grant program under which an institution of higher education can subsidize training of individuals at that institution who are willing to serve as direct care workers in a long-term or chronic care setting for at least two years after completion of their training. Section 5305 Geriatric education and training; career awards; comprehensive geriatric education—Authorizes HHS to award grants to advanced practice nurses who are pursuing a doctorate or other advanced degree in geriatrics and who, as a condition of accepting a grant, will agree to teach or practice in the field of geriatrics, long-term care, or chronic care management for a minimum of 5 years. Section 5309 Nurse education, practice, and retention grants—Adds 2 new grant programs specifically focused on nurse retention. One will authorize HHS to award grants to accredited nursing schools or health facilities to promote career advancement among nurses. The 2nd will permit HHS to make awards to nursing schools or health facilities that can demonstrate enhanced collaboration and communication among nurses and other health care professionals. Priority directed towards applicants that have not previously received an award. Section 5310 Loan repayment and scholarship program—Expands Nurse Loan Repayment and Scholarship Programs to provide loan repayment for students who serve for at least two years as a faculty member at an accredited nursing school. Section 5311 Nurse faculty loan program—Increases the Nurse Faculty Loan Program amounts from $30,000 to $35,000 in FY 2010 and FY 2011, declares that the amount of these loans will thereafter be adjusted to provide for cost-of-attendance increases for yearly loan rates and the aggregate loan. Creates new authority to permit HHS to enter into an agreement with individuals who hold unencumbered RNs and who have already completed, or are currently enrolled in, a master’s or doctorate training program for nursing. HHS will provide up to $10,000/year to master’s recipients and $20,000/year to those who earn a doctorate so long as these individuals spend at least 4 years out of a 6 year period as a full-time faculty member at an accredited nursing school. Section 5312 Authorization of appropriations for parts B through D of title VIII— Authorizes $338 million in appropriations to carry out nursing workforce development programs in FY 2010. FY 2011-2016 will be funded according to what HHS determines as “such sums as may be necessary” to carry out these programs. Section 5404 Workforce diversity grants—Expands the workforce diversity grant programs by permitting such grants to be used for diploma and associate degree nurses to enter bridge or degree completion programs or for student scholarships and stipend programs for accelerated nursing degree programs, This statute instructs HHS to consider recommendations from the National Advisory Council on Nurse Education and Practice and to consult with nursing associations. Section 5507 Demonstration projects to address health professions workforce needs; extension of family-to-family health information centers—Establishes a demonstration grant program to provide educational and training opportunities for low-income individuals for positions in the healthcare field that pay well and are expected to be in high demand. Program will primarily serve State TANF recipients, but HHS required to award at least 3 demonstration grants to eligible entities that are Indian Tribes, tribal organizations or Tribal colleges and Universities. Section 5509 Graduate nurse education demonstration—Appropriates $50 million/year FY 2012 thru FY 2015 to establish a graduate nurse education demonstration program in Medicare. Hospitals selected will be reimbursed for educational and clinical instruction costs attributed to training advanced practice nurses to provide primary/preventive care, translational care, chronic care management, as well as any other nursing services appropriate for the Medicare eligible population. Those hospitals selected will partner with community based care settings and accredited nursing schools to undertake the demonstration program and will reimburse partners for their share of costs. Section 10501—Permits faculty at public health schools that offer PA education programs to obtain faculty loan repayment under the workforce diversity program. Also makes other improvements to the NHSC program, such as a provision to increase the loan repayment amount,  allowing half-time service and permitting teaching to count for as much as 20% of the service commitment to the NHSC. Pilot and Incentive Payment Program Provisions: In addition to policies aimed at increasing the number of nurses, policy makers also sought to more closely integrate nursing into new payment pilot programs that would offer incentives to primary and chronic care managements as well as provide alternatives to the current fee-forservice programs. Payment revisions are as follows: Section 2703 State option to provide health homes for enrollees with chronic conditions— Creates a state option under Medicaid to provide coordinated care through a “health home” for individuals afflicted with chronic conditions. States could receive 90 percent of the funding needed to support Medicaid enrollees who designate a provider or team of medical professionals as their health home through Federal Medical Assistance Percentages (FMAP). Section 3022 Medicare shared savings program—Establishes a shared savings program under which a group of providers and suppliers may form a legally structured Accountable Care Organization (ACO) to manage and coordinate care for Medicare fee for service beneficiaries. Section 3024 Independence at home demonstration program—Creates the Independence at Home demonstration program for chronically ill Medicare beneficiaries in order to test a payment incentive and service delivery system that would utilize physician and nurse practitioner directed, home-based primary care teams with the aim of reducing expenditures and improving health outcomes. Section 3501 Health care delivery system research; Quality improvement technical assistance—Establishes a Center for Quality Improvement and Patient Safety within the Agency for Healthcare Research and Quality (AHRQ). This center will support the identification of best practices for quality improvement in the delivery of health care services by identifying healthcare providers that employ best practices and finding ways to translate these practices rapidly and effectively into practice elsewhere. The Center will establish a Quality Improvement Network Research Program to support research on healthcare delivery system improvement. The Director of AHRQ, under this section, will also be directed to award technical assistance grants to struggling healthcare providers to aid in the implementation and adoption of best practices identified by the Center. Section 3502 Establishing community health teams to support the patient- centered medical home—Authorizes HHS to establish a grant program for states/state designated entities to establish community-based interdisciplinary, interprofessional teams to support primary care practices within a certain area. Health teams must support patient-centered medical homes, defined as a mode of care that includes personal physicians, whole person orientation, coordinated and integrated care and evidence-informed medicine. Section 5208 Nurse-managed health clinics—Authorizes $50 million in grants for the cost of operation of Nurse-Managed Health Clinics (NHMC) that provide comprehensive primary care or wellness services without regard to income or insurance status of patients. NHMCs must  provide care to underserved or vulnerable populations and be associated with an academic department of nursing, qualified health center or independent nonprofit health or social services agency. Also establishes a new program to support nurse-managed health centers, authorizes to be appropriated $50 million for FY 2010 and such sums as may be necessary for FY 2011-2014. Section 6301 Patient-Centered Outcomes Research—Establishes non-profit Patient Centered Outcomes Research Institute. Purpose of Institute will be to assist patients, physicians, purchasers and policy-makers in making informed health decisions. Facility Specific Provisions Finally, PPACA makes facility specific changes including provisions directly impacting hospice and palliative care facilities, those provision follow: Sections 6101-6121—Require Medicare Skilled Nursing Facilities (SNFs) and Medicaid nursing facilities to disclose information on their ownership and organizational structure to government authorities. Mandates that such facilities implement compliance and ethics program within 3 years of enactment. Section 6103 directs the Nursing Home Compare Medicare Website to release staffing data for each facility, including resident census data, hours of care provided per resident per day, staffing turnover and tenure. Section 6105 directs the Secretary to create a standardized complaint form and requires states to establish a complaint resolution process, as well as providing whistleblower protection. Both provisions are effective within 1 year of enactment. Section 3004 Quality reporting for long-term care hospitals, inpatient rehabilitation hospitals, and hospice programs—Requires quality reporting programs for long‐term care hospitals, inpatient rehabilitation facilities, and hospice providers in 2014. HHS must issue regulations by October 1, 2012 that will list the specific quality reporting measures that must be reported. Providers who do not participate in the program would be subject to a reduction in their annual market basket update. Section 10325 Revision To Skilled Nursing Facility Prospective Payment System—Delays implementation of certain skilled nursing facility Version 4 of the Resource Utilization Groups (RUG-IV) published in the Federal Register on August 11, 2009 payment system changes by one year to October 1, 2011. Section 10326 Pilot Testing Pay-for-Performance Programs for Certain Medicare Providers—Directs HHS to conduct a separate pilot program under Medicare to test the implementation of a value-based purchasing program for payments under such title for the following provider groups: Psychiatric hospitals, Long-term care hospitals, Rehabilitation hospitals, PPS-exempt cancer hospitals and Hospice programs.

Practicum – Week 1 Journal Entry

/in /by

  Assignment: Practicum – Week 1 Journal Entry

 

As a future advanced practice nurse, it is important that you can connect your classroom experience to your practicum experience. By applying the concepts, you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.

Learning Objectives

Students will:

· Analyze nursing and counseling theories to guide practice in psychotherapy*

· Develop goals and objectives for personal practicum experiences*

· Create timelines for practicum activities*

In preparation for this course’s practicum experience, address the following in your Practicum Journal:

· Review the media Clinical Interview: Intake, Assessment, & Therapeutic Alliance in your Learning Resources.

· Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.

Note: For guidance on nursing and counseling theories, refer to the Wheeler textbook in this week’s Learning Resources.

· Explain why you selected these theories. Support your approach with evidence-based literature.

· Develop at least three goals and at least three objectives for the practicum experience in this course.

· Create a timeline of practicum activities based on your practicum requirements.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

Required Readings

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 1, “The Nurse Psychotherapist and a      Framework for Practice” (pp. 3–52)

Required Media

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Clinical interview: Intake, assessment, & therapeutic alliance [Video file]. Mill Valley, CA: Psychotherapy.net.

PLEASE SEE THE ATTACHED Practicum Journal Template AND JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATION

Lifestyle Changes for Weight Loss

/in /by

Case Study 9-2: Lifestyle Changes for Weight Loss

 

 

 

Sally is a 43-year-old mother of two who has gained 50 pounds over the past five years. She is 64 inches tall and weighs 180 pounds with a BMI of 30.8. Her waist circumference is 37 inches. She acknowledges that she is not as physically active as she would like to be. She also notes how recent stresses in her life have affected her sleep and seem to have triggered her appetite for sweets. Sally’s father recently died from complications of type 2 diabetes and her mother and sisters are overweight. Sally says she is very motivated to “not get diabetes” and is disturbed that her recent physical exam revealed mildly elevated blood pressure, glucose, and cholesterol levels.

 

1.   How does Sally’s family history influence her weight and risk for diabetes? What lifestyle choices may influence her genetic predisposition to be overweight?

 

2.   Using information in this chapter, what is a reasonable goal weight for Sally? How long would you estimate it would take her to safely lose this amount of weight?

 

3.   What weight-loss strategies may help curb Sally’s stress-related eating?

 

4.   Sally has determined that—to lose weight—she needs to limit her daily caloric intake to 1400 kcalories. Use Table 9-2 and show a one-day plan for meals and snacks that meet her nutritional needs within this calorie level.

 

5.   What are some advantages to Sally keeping a food and exercise record? What other factors besides food intake and physical activity may be useful for Sally to record?

 

6.   Why might strength training be an important addition to Sally’s exercise regimen?

 

 

 

 

 

Translational Research Graphic Organizer

/in /by

Use the “Translational Research Graphic Organizer Template” to compare three types of translational research with traditional (qualitative or quantitative) research. Make sure to include methodology, goals, and data collection in your organizer.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Translational Research Graphic Organizer Template

 

 <Type Translational Research Type Here><Type Traditional (Qualitative or Quantitative) Research Type Here>Observations (Similarities/Differences)
Methodology 

 

 

 

 

 

  
Goals 

 

 

 

 

 

  
Data Collection 

 

 

 

 

 

 

Discussion: Cognitive Behavioral Therapy: Family Settings Versus Individual Settings

/in /by

THE JOB IS TO REPLY WITH A COMMENT TO EACH POST, POST 1 AND POST 2. WITH 2 COMPLETED REFERENCE IN APA WITH CITATION ABOVE 2013 PER COMMENT.

POST 1

 

Individual vs. Family CBT

Cognitive behavioral therapy is short-term psychotherapy that emphasizes the need for attitude change in order to maintain and promote behavior modification (Nichols, 2014). Cognitive behavior therapy (CBT) has been found to be effective in a broad range of disorders. CBT can be done as an individual treatment or in a family setting. Individual CBT has a broadly defined framework with an emphasis on harm-reduction, especially with clients that have anxiety and substance abuse (Wheeler, 2014).

Cognitive-behavioral therapy for families is also brief and is solution-focused. Family CBT is focused on supporting members to act and think in a more adaptive manner, along with learning to make better decisions to create a friendlier, calmer family environment (Nichols, 2014). An example from practicum is a male (T.M) that participates in individual CBT once a week and family CBT once a week. T.M is struggling with alcoholism.

He originally presented for individual CBT because he had been “told by his wife” that he had a problem with alcohol. He reported that he drank “a few vodka drinks” three times a week but none for six weeks. Individual CBT therapy is a collaborative process between the therapist and client that takes schemas and physiology into consideration when deciding the plan of care (Wheeler, 2014). We worked with him using open-ended questions to assist with obtaining cognitive and situational information.  He would become angry easily and it was a felt that he was not being truthful about his alcohol use. Each time he was questioned about it, the story would change. He attended two individual sessions and it was then recommended he begin family CBT with his significant other (S.M) because “things were not going well at home.”

With family CBT, cognitions, emotions, and behaviors are seen as having a mutual influence on one another (Nichols, 2014). The first session was stressful, to say the least. T.M began talking about his alcohol use. S.M interrupted and said, “what about that one-time last month at the hotel. You were seeing things.” He became defensive, raised his voice, and said, “I was drugged. It had nothing to do with drinking.” She then looked down and was tearful. When he left the room to use the bathroom, S.M questioned if he could be tested for alcohol. This led the therapist to believe that T.M’s last use was not six weeks ago.

T.M’s automatic thoughts were that his alcoholism was not a problem in the marriage or in life. One of the core principles in using CBT for SUDs is that the substance of abuse serves as a reinforcement of behavior (McHugh et al., 2010). Over time, the positive and negative reinforcing agents become associated with daily activities. CBT tries to decrease these effects by improving the events associated with abstinence or by developing skills to assist with reduction (McHugh et al., 2010).

It was noticed that when T.M was alone, his stories would change. But when his wife was in the room, he would look at her while he spoke to ensure what he was saying was accurate. The therapist informed the client that it would be appropriate to continue individual therapy and family CBT once a week with the recommendation of joining the ready for change group. The CBT model for substance use states that, when a person is trying to maintain sobriety or reduce substance use, they are likely to have a relapse (Morin et al., 2017).

Ready for change meetings was recommended because like this week’s media showed, clients may relate to others that are going through similar situations. Getting T.M to realize that his alcohol use is a problem, is the primary goal currently. This example was shared because it shows the difficulties that may be encountered with psychotherapy and that both individual and family may be needed to ensure that goals are met. Some challenges that counselors face when using CBT in the family setting are wondering if the structure of the session and if the proper techniques were effective (Ringle et al., 2015). Evaluating and consulting with peers may also assist with meeting client and family goals.

References

McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America, 33(3), 511-25. doi:10.1016/j.psc.2010.04.012

Morin, J., Harris, M., & Conrod, P.  (2017, October 05). A Review of CBT Treatments for Substance Use Disorders. Oxford Handbooks Online. Ed.  Retrieved fromhttp://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199935291.001.0001/oxfordhb-9780199935291-e-57.

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

Patterson, T. (2014). A Cognitive-Behavioral Systems Approach to Family Therapy. Journal of Family Psychotherapy, 25(2), 132–144. https://doi-org.ezp.waldenulibrary.org/10.1080/08975353.2014.910023

Ringle, V. A., Read, K. L., Edmunds, J. M., Brodman, D. M., Kendall, P. C., Barg, F., & Beidas, R. S. (2015). Barriers to and Facilitators in the Implementation of Cognitive-Behavioral Therapy for Youth Anxiety in the Community. Psychiatric services (Washington, D.C.), 66(9), 938-45. doi:10.1176/appi.ps.201400134

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to

guide for evidence-based practice. New York, NY: Springer.

POST 2

 

Cognitive Behavioral Therapy is one of the most effective psychotherapy approaches, whether it be used in group, family, or individual treatment. It is important to understand the purpose of it what its process consists off. It can be used to treat different mental health conditions, ranging from addiction to more severe illnesses. Its approach is to work with the patient into strategizing ways to change unhealthy thoughts and behaviors. Throughout the process, the patient not only learns solving skills, but also to re-evaluate and learn how to understand other’s perspectives, skill that helps build their confidence.

Some believe group therapy is more effective than individual therapy, as established by Kellett, Clarke, and Matthews (2007, p. 211). It has been established that CBT in general can be effective, but based on the Johnson Family Session video, it leads me to believe that either group/family or individual would be effective depending on the condition that is being treated. It is clear from the video that the girl who had been sexually assaulted at the fraternity does not believe talking or sharing her experience, even if it is with other girls who went through the same experience, will help in any way. She still has some internal issues that need to be addressed individually in order to make progress and get her to a place where she can participate in group/family therapy with an awareness that it will help her and purpose to it. Another important aspect of having a client be committed to the treatment is that research has showed “Poor compliance can adversely affect the remaining group members who may become worried or insecure” (Söchting, Lau, Ogrodniczuk, 2018, p. 185).

An example during practicum that supports my belief is the case of a terminally ill patient who had been recommended comfort care through hospice. She was ready to do so, understood and accepted her prognosis, but her daughters and husband were in denial. Every time they participated in a family session the patient held back on her wishes and verbalized whatever their wishes were as if they were her own. When treated as an individual client, she would express her concerns of not being able to “disappoint and abandon my family”. She had suffered all her life from anxiety, insecurities, severe depression, and low self-esteem. Those were issues that should have been addressed individually before she could fully engage in a family session in a healthy and productive way, if she would’ve had the time. CBT would have still been the choice of treatment for individual therapy for this client, as evidenced by Driessen et al. who stated it “is the psychotherapy method with the best evidence-base in the treatment of depression” (2017, p. 654). Not being fully engaged in the program, or believing the treatment will not help, or having other issues that need to be addressed on an individual basis, are all challenges presented in a family setting when relying on CBT.

References

Kellett, S., Clarke, S., & Matthews, L. (2007). Delivering Group Psychoeducational CBT in

Primary Care: Comparing Outcomes with Individual CBT and Individual

Psychodynamic-Interpersonal Psychotherapy. British Journal of Clinical Psychology,

           46(2).

Söchting, I., Lau, M., & Ogrodniczuk, J. (2018). Predicting Compliance in Group CBT Using the

Group Therapy Questionnaire. International Journal of Group Psychotherapy, 68(2).

Driessen,E., Van, H. L., Peen, J., Don, F. J., Twisk, J. W. R., Cuijpers, P., & Dekker, J. J. M.

(2017). Cognitive-Behavioral Versus Psychodynamic Therapy for Major Depression:

Secondary Outcomes of a Randomized Clinical Trial. Journal of Consulting Clinical

Psychology, 85)7).

In 250-300      words, explain the Christian perspective of the nature of spirituality and      ethics in contrast to the perspective of postmodern relativism within      health care.

/in /by

Based on the required topic study materials, write a reflection about worldview and respond to following:

  1. In 250-300      words, explain the Christian perspective of the nature of spirituality and      ethics in contrast to the perspective of postmodern relativism within      health care.
  2. In 250-300      words, explain what scientism is and describe two of the main arguments      against it.
  3. In 750-1,000      words, answer each of the worldview questions according to your own      personal perspective and worldview: (a) What is ultimate reality? (b) What      is the nature of the universe? (c) What is a human being? (d) What is      knowledge? (e) What is your basis of ethics? (f) What is the purpose of      your existence?

Remember to support your reflection with the topic study materials. 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.

Rubric 

· Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is clear, detailed, and demonstrates a deep understanding of the subject. Explanation is supported by topic study materials.

· Explanation of scientism is clear and accurate. Explanations of two main arguments against scientism are clear and insightful. Details are clearly supported by topic study materials.

· Each of the worldview questions is answered clearly and with deep personal insight.

· Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

· Writer is clearly in command of standard, written, academic English.

· Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

· All format elements are correct.

· Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

PROFESSIONAL PORTFOLIO

/in /by

1.  Create a professional mission statement (suggested length of 1 paragraph) that includes the following:

●   a representation of your career goals, your aspirations, and how you want to move forward with your career

●   an overview of where you would like to focus your time and energies within the profession

a.  Reflect on how your professional mission statement will help guide you throughout your nursing career.

2.  Complete a professional summary (suggested length of 3–4 pages) that includes the following:

a.  Explain how the specific artifacts or completed work or both in your portfolio represent you as a learner and a healthcare professional.

b.  Discuss how the specific artifacts in your portfolio represent your professional strengths.

c.  Discuss challenges you encountered during the progression of your program.

i.  Explain how you overcame these challenges.

d.  Explain how your coursework helped you meet each of the nine nursing program outcomes.
Note: Refer to the attachment “Nursing Conceptual Model.”
e.  Analyze how you fulfilled the following roles during your program:

•   scientist

•   detective

•   manager of the healing environment

f.  Discuss how you have grown professionally since the beginning of your program.
B.  Complete the following within the section “Quality and Safety”:

1.  Reflect (suggested length of 1 page) on your professional definition of quality and safety developed in Professional Roles and Values, including any necessary changes to your definition.

a.  Discuss how the program assisted you in developing your professional definition.

b.  Identify the artifacts in your portfolio that support your definition.

i.  Explain how these artifacts support your definition from part B1.
Note: The artifacts should be attached within the portfolio.
2.  Discuss the importance of the Institute for Healthcare Improvement (IHI) certificate for your future role as a professional nurse.
C.  Complete the following within the section “Evidence-Based Practice”:

1.  Reflect (suggested length of 1 page) on your professional definition of evidence-based practice developed in Professional Roles and Values, including any necessary changes to your definition.

a.  Discuss how the program assisted you in developing your professional definition.

b.  Identify the artifacts in your portfolio that support your definition.

i.  Explain how these artifacts support your definition from part C1.
Note: The artifacts should be attached within the portfolio.
2.  Reflect (suggested length of 1 page) on your understanding of evidence-based practice and applied nursing research by doing the following:

a.  Discuss how you are able to evaluate current primary research and apply the concepts to your nursing practice, considering the following:

•   relevancy and believability of data

•   differences between quality improvement and research (places and uses of each)

•   differences between primary and secondary research and resources and the implications of each in clinical practice

b.  Explain how your experience in the program helped you achieve excellence in evidence-based practice.
D.  Complete the following within the section “Applied Leadership”:

1.  Reflect (suggested length of 1 page) on your professional definition of applied leadership you developed in Professional Roles and Values, including any necessary changes to your definition.

a.  Discuss how the program assisted you in developing your professional definition.

b.  Identify the artifacts in your portfolio that support your definition.

i.  Explain how these artifacts support the definition from part D1.
Note: The artifacts should be attached within the portfolio.
2.  Summarize (suggested length of 1 paragraph to 1 page) your Learning Leadership Experience task by doing the following:

a.  Discuss the importance of professional collaboration for effective nursing leadership.
E.  Complete the following within the section “Community and Population Health”:

1.  Reflect (suggested length of 1 page) on your professional definition of community and population health you developed in Professional Roles and Values, including any necessary changes to your definition.

a.  Discuss how the program assisted you in developing your professional definition.

b.  Identify the artifacts in your portfolio that support your definition.

i.  Explain how these artifacts support the definition from part E1.
Note: The artifacts should be attached within the portfolio.
2.  Summarize (suggested length of 1 page) your Community and Population Health task (STIs) by doing the following:

a.  Discuss what you learned during your Community Health Nursing task (STIs).

b.  Discuss what you learned led to your community diagnosis ( Nursing Diagnosis Statement: Sexually transmitted infections are common among adolescent individuals living in Florida).

c.  Discuss how your initial focus and diagnosis evolved after working with your population.

DO WHAT YOU CAN. THERE ARE SOME SECTIONS YOU WILL NOT BE ABLE TO QUITE ANSWER SUCH AS THE ARTIFACTS. DO THE BEST YOU CAN. THANK YOU.

HYPOTHYROIDISM SOAP NOTE

/in /by

Hypothyroidism SOAP NOTE

Patient Initials: Age:  Gender:

SUBJECTIVE DATA:

Chief Complaint (CC): “ ”.

History of Present Illness (HPI):

Medications:

Allergies:

Past Medical History (PMH):

Current medication:

Past Surgical History (PSH):

Family History:

Personal/Social History:

Immunization: up to date.

Lifestyle:

Review of Systems:

General:

HEENT:

Neck:

Breasts:

Respiratory:

Cardiovascular/Peripheral Vascular:

Gastrointestinal:

Genitourinary:

Musculoskeletal:

Psychiatric:

Neurological

Skin:

Hematologic:

Endocrine:

OBJECTIVE DATA:

Physical Exam:

Vital signs: Temperature: ; BP:  mmHg; HR: bpm; RR:  /min; Oxygen Saturation: %; Pain: (0-10 scale), Weight lb; Height; BMI

General:.

HEENT:

Neck:

Chest

Lungs:

Heart:

Peripheral Vascular:

Genital/Rectal:

Musculoskeletal:

Neurological:

Skin:

ASSESSMENT:

Differential Diagnosis

1. Hyperthyroidism.

2.

3.

From both the subjective and objective data, it is clear that the main diagnosis is

PLAN:

Treatment Plan: (please prescription with dose)

Non-pharmacological approaches

For the follow-up, the patient should get back to the hospital after

References: 2 or 3 with APA format

 

Soap Note 2 Chronic Conditions (15 Points)

Pick any Chronic Disease from Weeks 6-10

Follow the MRU Soap Note Rubric as a guide:

Use APA format and must include minimum of 2 Scholarly Citations.

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

Please use the sample templates for you soap note, keep these templates for when you start clinicals.

The use of templates is ok with regards of Turn it in, but the Patient History, CC, HPI, The Assessment and Plan should be of your own work and individualized to your made up patient.