Provide a brief statement introducing the selected practice problem. • Identify three social determinant risk factors for the selected practice probl 

TO PREPARE

• Refer to the “Population-Focused Nurse Practitioner Competencies” in the Learning Resources, and consider the quality measures or indicators advanced practice nurses must possess in your specialty.
• Refer to your “Clinical Skills Self-Assessment Form” you submitted in Week 1 and consider your strengths and opportunities for improvement.
• Refer to your Patient Log in Meditrek; consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.

In 450–500 words, address the following:

Learning From Experiences

• Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
• Reflect on the 3 most challenging patients you encountered during the practicum experience. What was most challenging about each? 
• What did you learn from this experience? 
• What resources were available?
• What evidence-based practice did you use for the patients?
• What would you do differently? 
• How are you managing patient flow and volume?  How can you apply your growing skillset to be a social change agent within your community?

Communicating and Feedback

• Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
• Answer these questions: How am I doing? What is missing? 
• Reflect on the formal and informal feedback you received from your Preceptor. 

 Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined.  

Answer the questions below based on the following case study.

A 26-year-old woman presented to the clinic after her cleaning rituals had so exhausted her that she had given up and could now enter only two of the five rooms in her home. For more than a year she has worried that if her house is not sufficiently clean, her 3-year-old son will become ill and could die. Having touched a surface she has to disinfect it repeatedly – a procedure performed in a particular way and taking several hours. In addition, she repetitively washes her hands and sterilizes all the crockery and cutlery before eating. She realizes that she is ‘going over the top’, but she cannot stop thinking that items may have germs on them. This leads to disabling anxiety and fear for her son’s health, which she can only resolve by cleaning. This helps temporarily, but soon the thoughts return again.

1. Summarize the clinical case.
2. What is the DSM 5-TR diagnosis based on the information provided in the case?
3. Which pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment.
4. Which non-pharmacological treatment would you prescribe according to the clinical guidelines? Include the rationale for this treatment excluding a psychotherapeutic modality.
5. Include an assessment of the treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence to the chosen medication. Use a local pharmacy to research the cost of the medication and provide the most cost-effective choice for the patient. Use great detail when answering questions 3-5.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
• All replies must be constructive and use literature where possible.
• Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

Due 9/25   12pm EST

250 WORDS not including title and reference APA

As you complete the gathering and evaluation of the evidence, it’s important to review the significance and next steps related to EBP.

Consider the following questions in your discussion post:

• How does a nurse know what (if any) knowledge in a research study is usable for clinical practice?
• What would a critical thinker look for in the evidence before deciding to change?
• What influence do credibility and clinical significance have on your decisions to integrate research-based evidence into your practice?

Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with citations and references in APA format.

  All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.