Discuss how a comprehensive clinical assessment presents a unique opportunity for intervention in the psychotherapeutic context.

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Discuss how a comprehensive clinical assessment presents a unique opportunity for intervention in the psychotherapeutic context.

The student must answer the graded discussion with a substantive reply to the graded discussion question(s)/topic(s) posted by the course instructor by Thursday, 11:59 p.m. Eastern Time. Two scholarly sources references are required unless stated otherwise by your professor. 

The student provides a substantive response to the discussion question or topic on Thursday day and posts a minimum of two additional responses to peers on another day(s). The answers to classmates must be posted by Sunday, 11:59 pm Eastern Time. We expect each student to participate in the discussion board in a respectful manner. 

Remember that a new discussion rubric was approved by the professors, committee members, and a majority of the students. Please review the rubric before posting to ensure a maximum of points. 

Here are the categories of the new discussion rubric:

Initial Post relevance to the topic of discussion, applicability, and insight. (20%)

Quality of Written Communication Appropriateness of audience and words choice is specific, purposeful, dynamic, and varied. Grammar, spelling, punctuation. (20%)

Inclusion of APNA standards essentials explored in the discussion as well as the role-specific competencies as applicable.(10%)

Rigor, currency,  and relevance of the scholarly references. (Use articles that are below 5 years). (20%)

Peer & Professor Responses. The number of responses, quality of response posts. (20%)

Timeliness of the initial post and the answers to the peers. (10%

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MSN5400 REPLIES 2

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 Reply these words with 200 words each one and reference

Title: Influencing Healthcare Through Advocacy: A Personal Journey and how to 

create effective interdisciplinary organizational and systems leadership in the care of clients in diverse care settings.

Introduction

Learning the ropes of policy, politics, and advocacy is a transformative endeavor with the ultimate goal of influencing healthcare and broader social agendas that profoundly impact human health. In this discussion, I become an advocate to effect change in healthcare, reflecting the purpose of mastering these skills.

Advocacy for Universal Healthcare Access

My journey into healthcare advocacy began when I witnessed the struggles of a close friend, Emily, who was burdened by exorbitant medical bills due to a chronic illness. Fueled by empathy and a desire for equitable healthcare, I embarked on a path to advocate for universal healthcare access.

            1.         Policy Analysis and Research: I started by immersing myself in healthcare policy analysis and research (Smith et al., 2018). This included studying existing healthcare systems worldwide to understand their strengths and weaknesses. Through this, I gained the knowledge needed to advocate for an inclusive healthcare system.

            2.         Community Engagement: Recognizing that community support is crucial for advocacy, I organized town hall meetings, awareness campaigns, and grassroots movements to engage citizens in discussions about healthcare access (Gitterman, 2017). By fostering a sense of shared responsibility, we encouraged individuals to join the cause.

            3.         Legislative Advocacy: I proactively engaged with lawmakers, presenting data and personal stories to advocate for policy changes aimed at expanding healthcare access. Collaborating with like-minded organizations and lobbying for healthcare reform became integral to my advocacy efforts (Berkowitz & Wolff, 2020).

            4.         Patient-Centered Advocacy: To amplify the voices of patients like Emily, I encouraged them to share their experiences and struggles. These personal stories resonated with policymakers and underscored the urgent need for healthcare reform (Travis, 2019).

            5.         Building Coalitions: Recognizing the power of partnerships, I formed coalitions with healthcare professionals, advocacy groups, and community leaders. These alliances strengthened our advocacy efforts and allowed us to pool resources and expertise (Berkowitz & Wolff, 2020).

Conclusion

My journey in healthcare advocacy reflects the purpose of mastering policy, politics, and advocacy skills – to influence healthcare and broader social agendas. Through policy analysis, community engagement, legislative advocacy, patient-centered efforts, and strategic partnerships, I worked towards the vision of universal healthcare access.  This it highlights the profound impact advocacy can have in shaping the future of healthcare and improving human health on a broader scale.

2. I have learned to value the crucial part that politics, lobbying, and policy play in determining the healthcare landscape throughout my work as a nurse. One specific instance stands out as proof of the effectiveness of advocacy in changing health care and more general societal goals.

I recently came across a critical problem involving patient safety and drug delivery while working as a clinical nurse in a big urban hospital. It became clear that our current system had a history of mistakes, especially when it came to high-risk drugs. This finding is confirmed by Pozzi’s (2023) study. Concerns over near-miss occurrences and sporadic medication mistakes had been raised among the nursing team, and it was obvious that something needed to be done to safeguard the safety of our patients.

Seeing the gravity of the situation, I started an advocacy journey to deal with it. The first step was acquiring information and proof to support my claims. I carefully recorded incidences and reviewed the available research on the best medication administration methods. I used this knowledge to report my findings to the hospital’s quality improvement committee.

Gaining support for the suggested improvements required active participation from stakeholders, as evidenced in the study by Beaudry et al. (2019). I formed a multidisciplinary task force with other nurses, pharmacists, and doctors to enhance pharmaceutical safety. We held regular meetings to discuss solutions, examine policies, and implement actual initiatives.

The adoption of a barcode scanning technology for medicine administration was one of the main campaign initiatives. I thought this technology had a lot of promise for our hospital because it had successfully reduced prescription errors in other healthcare settings. I did a ton of study on the advantages and affordability of this approach, and I made a strong argument to hospital executives.

The practice of advocacy went beyond hospital boundaries. I spoke with representatives from pharmaceutical companies, went to patient safety seminars, and connected with industry experts. I was able to present creative solutions by keeping up with developments in medicine administration technologies and best practices.

I worked with the hospital’s nursing leadership to write a policy proposal describing the implementation strategy for the barcode scanning technology as the advocacy efforts picked up steam. This comprised a thorough rollout schedule, workflow modifications, and employee training. I made sure that frontline nurses’ involvement was included in the policy because their viewpoints were crucial for forming its actual implementation.

The conclusion of these campaign efforts was the effective introduction of barcode scanning technology for drug administration. The new approach greatly decreased prescription errors and near-miss instances, improving patient safety and boosting nursing staff trust.

This example demonstrated the significant influence lobbying may have on medical outcomes. I was able to have an impact on an important component of patient care by identifying a problem, obtaining data, enlisting stakeholders, and promoting creative solutions. It strengthened my resolve to be a proactive advocate for the welfare of my patients and the larger community, and it confirmed my belief in the ability of advocacy to bring about constructive change in the healthcare industry.

Peer response week2

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Conc of Pathophys of NSg peers response

· respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines. 

1st peer post

Samantha WootenSep 11, 2023 at 9:31 AM

Marshall (2022) reports “In anorexia nervosa’s cycle of self-starvation, the body is denied the essential nutrients it needs to function normally.  Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences” (P. 1). Marshall also surmises that lab work up on a patient may look normal, but this does not rule out impending death, death could happen quickly by cardiac arrest caused by electrolyte imbalances (2022. P. 1). 

Cultural and environmental implications affect a large amount of people within all ethnicity, gender, and age however women are largely targeted, the University of East Anglia state “his quite obvious connection between eating disorders and cultural expectations surrounding femininity is woefully neglected in much treatment” (P. 1).  With the technology boom in recent years this is ever more present for this population, a social media environment instills these behaviors in today's society.  

Financial implications that cause anorexia include lack of income and homelessness. Underprivileged populations have no choice but to sacrifice food to prioritize other necessities. Chan (2023) reports 64.7 billion being spent on eating disorders per year, with 23,560 hospitalizations yearly (p. 1). 

In the ED with 16-year-old Jonathan Collins coming into the facility for anorexia nursing interventions would include evaluating the patients diet/exercise regimen and educate on proper diet and exercise with adequate fluid intake. Identify coping strategies and emotions related to weight, allowing the patient time to think and express how they're feeling. This will allow underlying causes to surface for treatment. Lastly, addressing body images issues. Targeting these fears will allow the patient to accept a healthy body weight to maintain health and stay out of the hospital (Belleza, August 9, 2023. P. 1). 

According to Miller, Grinspoon, and Ciampa (2020) vital signs with anorexia tend to include a slower than normal heart rate, hypotension, and hypothermia. Lab values tend to include anemia and in some cases thrombocytopenia. Sodium levels average around 122, with normal levels being 135-145. Average potassium in patients with anorexia being 1.9 with normal values being 3.4-4.8. All of these values contribute to cardiac arrest via electrolyte imbalance. In some anorexia patients there are dysrhythmias due to electrolyte imbalances and hypovolemia. Also of note with women populations are menstrual dysfunction and osteoporosis (P. 1). 

Treatment includes a combination of psychotherapy, family therapy, and medicine according to St. Lukes Hospital (2015), they also state “A combination of treatments can give the person the medical, psychological, and practical support they need. Cognitive behavioral therapy, along with antidepressants, can be an effective treatment for eating disorders. Complementary and alternative (CAM) therapies may help with nutritional deficiencies” (P. 1). 

 

references

Belleza, M. August 9, 2023. Eating disorders: Anorexia & Bulimia Nervosa. Nurse Labs.
Eating Disorders: Anorexia & Bulimia Nervosa – Nurseslabs

Chan, T. H. 2023. Report: Economic Costs of Eating Disorders. Harvard School of Public Health.
Report: Economic Costs of Eating Disorders | STRIPED | Harvard T.H. Chan School of Public Health

Marshall, D. 2022. Anorexia Nervosa. National eating disorders association.
Anorexia Nervosa | National Eating Disorders Association

Miller, K. Grinspoon, S. Ciampa, J. (Marh 14, 2020). Medicla Findings in Outpatients with Anorexia Nervosa. JAMA internal medicine. Doi:10.1001/archinte.165.5.561.

St. Lukes Hospital. April 23, 2015. Complementary and Alternative Medicine of Anorexia Nervosa. A Division of Ebix.
Anorexia nervosa | Complementary and Alternative Medicine | St. Luke's Hospital (stlukes-stl.com)

University of East Anglia. November 13, 2017. Eating disorder treatments need to consider social, cultural implications of the illness. Science Daily.
Eating disorder treatments need to consider social, cultural implications of the illness | ScienceDaily

2nd peer post

Kira DespinsSep 11, 2023 at 3:20 PM

1. Thoroughly explain the pathophysiology of anorexia. Use a scholarly or authoritative source to support your answer.

Anorexia is a medical condition summarized by an inadequate intake of nutrients to regulate an individual’s weight to reduce their BMI and be ‘thin’.  It causes physiological imbalances such as amenorrhea and psychological imbalances such as an obsessive-compulsive need to exercise or an all-encompassing fear of gaining weight. This population exhibits body dysmorphia.  Once begun, this disease is persistent in select populations (Klein, 2004).

1. Examine each of the following three factors related to this disease process. Support all three with a scholarly source.

Cultural:  Western culture perpetuates a standard of beauty based on being thin.  This standard is propagated through social media outlets. Klein (2004) summarizes that popular media not only emphasizes the need to be a thing but perpetuates it through advertisements such as marketing diet fads and fitness trends.

Financial: Relating to the treatment of anorexia, a study by Gatt et al. (2014) found significant household financial stress for those seeking treatment for their eating disorder.  They compared treatment costs to being the second highest after cardiac artery bypass surgery.  As the disease is notoriously difficult to manage by oneself, it would be prudent to establish funding for this patient population so all individuals can access treatment without causing significant burdens on themselves and their families.

Environmental implications: Nature vs. nature has been heavily debated in pursuing the best understanding of anorexia. Klinger (2012) highlights that from an environmental perspective, children who have been neglected and/or abused are more prone to develop anorexia.

1. Identify 3-5 priority nursing interventions for the client in the emergency department.

-Cardiac monitoring due to electrolyte imbalance

-Fall risk prevention related to weakness

-Blood glucose monitoring related to low nutrient intake

1. Describe labs and diagnostic testing you would want to include in client’s plan of care and why. What are critical indicators? Support with a scholarly source.

Metevir, a nutrition counselor, highlights the importance of the following lab and diagnostic tests in anorexic patients (2022):

1. Vital sign monitoring, such as bradycardia, can signify a weak heart-conserving energy.

2. EKG to detect abnormal heart rhythm due to weakened heart muscles.

3. Complete metabolic panel to look for electrolyte imbalances in kidney and liver health. Hypokalemia would be a critical indicator.

4. Blood glucose tests as low food intake results in less glucose, which our brains depend upon

5. Hematology detects if our blood carries enough oxygen to perfuse our organs adequately.

6. Bone density test as low food intact can result in reduced hormone output, leading to weak and brittle bones.

 

1. What members of the interdisciplinary team need to be included for holistic patient-centered care? Provide a rationale and support with a scholarly source.

I believe that family members and friends are included in any team to support and care for those treated with anorexia.  Knowing the care plan, these individuals can best provide care and support to the patient while out of the hospital, setting them up for success.  Joy et al. (2003) believe that a physician, mental health professional, and nutritionist are also integral components of the care team as it affect an individual physically and mentally, and each has an overlapping specialty to assist the patient best.  In an emergency department setting, involving a social worker or case management is integral to establishing resources for patients seeking help in an outpatient or in-patient setting. 

 

References

Gatt, L., Jan, S., Mondraty, N., Horsfield, S., Hart, S., Russell, J., Laba, T. L., & Essue, B. (2014). The household economic burden of eating disorders and adherence to treatment in Australia. BMC Psychiatry, 14. 
https://doi.org/10.1186/s12888-014-0338-0

Joy, E., & Wilson, C., & Varechok, S. (2004). The multidisciplinary team approach to the outpatient treatment of disordered eating. Curr Sports Med Rep, 331(6), 6. https://pubmed.ncbi.nlm.nih.gov/14583163/#:~:text=Team%20members%20include%20a%20physician,of%20individuals%20with%20disordered%20eating.

Klein, D. A., & Walsh, B. T. (2004). Eating disorders: clinical features and pathophysiology. Physiology & Behavior, 81(2), 359–374. 
https://doi.org/10.1016/j.physbeh.2004.02.009

Klinger, D. (2012). Genes or environment: What causes eating disorders? GoodTherapy. 
https://www.goodtherapy.org/blog/genes-environment-what-causes-eating-disorders

Metevier, J. (2022). The eating disorder medical test and nutrition lab guide. Integrated Care Clinic. https://integratedcareclinic.com/blog/the-eating-disorder-medical-test-and-nutrition-lab-guide/#:~:text=Metabolic%2FElectrolyte%20Labs,your%20sugar%20and%20protein%20levels

Assigment .Apa seven . All instructions attached.

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Health Promotion Proposal, Part 1 Content

1.

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Health Promotion Proposal, Part 1

 

For this assignment you will submit 
Part One of your proposal, detailing a health problem that is

prevalent within 
your selected group and demonstrating your 
research of health promotion strategies for

addressing this specific health problem. At this point you already developed in your discussions the core ideas of the topic contained on this assignment. You will use the same information, but it won’t be a copy and paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluation. 

 

Directions

1. Introduction. Describe the health problem. Don't type “Introduction”.  (1 paragraph).

Using data and statistics, support your claim that the issue you selected is a problem.

What specifically will you address in your proposed health promotion program?

Be sure your proposed outcome is realistic and measurable.

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2. Describe the vulnerable population.  (1-2 paragraph).

What are the risk factors that make this a vulnerable population?

Use evidence to support the risk factors you have identified.

3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraph, one for each article).

After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (1-2 paragraph).

4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (1-2 paragraph).

For this assignment a conclusion paragraph is not required.

 

Writing Assignment Requirements

Three to five pages in length (excluding title page, references, and appendices)

Follow APA format

Cite a minimum of five research articles

Please review rubric prior to submission.

Sample APA paper for your reference:

PN1

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discuss

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1.Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of healthLinks to an external site., and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences, social determinants of health, and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life. 

Use 3 sources 

2. Post an explanation of how you anticipate enacting personal and professional commitment for advocacy to positively impact your patients, communities, and the profession. Be specific. Then, explain how your role as a DNP-prepared nurse contributes to advocacy for positive social change. 

Use 3 sources 

Centers for Disease Control and Prevention. (2021). Social determinants of health: Know what affects health.Links to an external site.https://www.cdc.gov/socialdeterminants/index.htm

Patient Interview

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  • What are the goals of a patient interview?
  • Name and described each component of the Patient History (Chief Complaint, History of Present Illness, etc.).
  • Describe an incident where you had used improper technique on measuring blood pressure, what did you learn from that incident?
  • What are the goals of a patient interview?
  • Name and described each component of the Patient History (Chief Complaint, History of Present Illness, etc.).
  • Describe a barrier when you had assess a patient from a different culture. 

psychiatric soap note

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psychiatric  soap note

MENTAL HEALTH DISCUSION

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 Michelle, a 21-year-old female, has been admitted informally to an acute mental health unit this is her first admission.  

Assigment .Apa seven . All instructions attached.

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Discussion Topic

I live in Miami FloridaTop of Form

QUESTION 1

Step 1: The three “Principles of Action” outlined in the 

final report to the Commission on Social Determinants of Health
 


https://apps.who.int/iris/bitstream/handle/10665/43943/9789241563703_eng.pdf

are essential to achieving health equity. These actions contain a host of SDH such as access to decent employment, and gender equity. Read the “Executive Summary” (pages 1-23) (provided above) paying special attention to the different social determinants of health the Commission addresses. 

Step 2: Find one recent news article (published within the past month), in a newspaper or on a news website, that features a health issue in your particular country or community. Alternatively, you can find one new story of interest on CDC Global Health Newsroom 

https://www.cdc.gov/globalhealth/newsroom/
 (Choose one story from the list of news stories).

Step 3: Write an 300-350 word essay that includes the following information and answers to the following questions:

1. Briefly summarize the main features of the health issue you selected, and how it is affecting the country or community where it exists.

2. What are the main 

risk factors
 for this health issue?

3. Outline three social determinants of health that could influence those who are most at risk for this health issue. Describe how these social determinants are linked and relevant to this health issue. (Note: it may help to go through the determinants described by the Commission and try to visualize how each may be linked to the health issue you selected. For example, how might income, employment, gender, structural racism, global warming, physical environments, access to health services, etc. influence those who are at risk?)

4. Briefly describe 3 actions you recommend that could improve health equity related to this health issue. (These recommendations can be community actions, government actions, or international actions but they must address all three of the social determinants you described in question 3).

QUESTION 2

After reviewing the Case Study 'John's Journey' 

(provided in Week 1 Folder)
 Describe 2 things that the Case Study helped you to understand about the link between community and client health and the impact of the SDOH. Specifically link your observations to John and his family demonstrating understanding and review of the Case Study provided. 

Please be sure to adhere to the following when posting your weekly discussions:

1. Students are to write their name and the appropriate discussion number/discussion title in the title bar for each discussion. For example 
Discussion 1: Micheal Cabrera or Discussion 3: Sheila 

Smith. This is important in identifying that students are submitting original posts as well as response posts as required.

2. Students are to submit their discussions 
directly onto Blackboard Discussion Board.

Attachments submitted as discussion board posts will not be graded.

3.  As a reminder, 
all discussion posts must be minimum 350-550 words, references 
must be cited in 
APA format 7th Edition, and 
must include minimum of 3 scholarly resources published within the past

5-7 
years (not part of the classroom coursework).  

DISCUSSION POSTS WILL BE DUE NO LATER THAN SUNDAY, Since there was a delay to Week 1&2, this post has been extended to Week 3 and is due by Sunday, 9/17/23 by 11:59 pm EST

Since there is only two students who is registered for this section of the course there will not be any peer responses therefore discussions/Cases will only have the original response and my feedback and the rationale for the length as normally the original discussions are 250 words and 2 peer responses are 150 (300 words). I have therefore increased the length of this original post for this reason. 

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