Nursing ASSIGNMENT

To Prepare:

· Review the steps of the Systems Development Life Cycle (SDLC) and reflect on the scenario presented.

· Consider the benefits and challenges associated with involving a nurse leader on an implementation team for health information technology.

The Assignment: (2-3 pages not including the title and reference page)

In preparation of filling this role, develop a 2- to 3-page role description for a graduate-level nurse to guide his/her participation on the implementation team. The role description should be based on the SDLC stages and tasks and should clearly define how this individual will participate in and impact each of the following steps:

· Planning and requirements definition

· Analysis

· Design of the new system

· Implementation

· Post-implementation support

· Use APA format and include a title page and reference page.

· Use the Safe Assign Drafts to check your match percentage before submitting your work.

BY DAY 7 OF WEEK 10

DB

  

Respond using APA, at least 4 scholarly references

*Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

*One key insight from the scholarly resources I selected is the importance of effective communication skills in leadership

* The second scholarly resource I selected is the impact that teamwork and support from leadership have on the team’s success in nursing. 

week 2 reply

Professor and class,

I have been lucky enough to work with three different EHR systems between clinical and my current job in the ED. I have been able to compare and contrast the pros and the cons between the EHRs’ and their health information systems. Upon starting in my ED a year and a half ago I was originally oriented to the EHR called Cerner. I really enjoyed this EHR as I felt that the HIS worked well at providing safe and efficient patient care. The allergies and current patient medications came up as a “to-do” flag within each patient upon admission. This ensured that the nurse was able to check off what the patient may have already taken that day, or what they may be allergic to before giving a patient a medication. After entering the patients history it was then documented in a place that was easy for the doctors and pharmacy to locate in order to enter and verify medications. This allowed for three different healthcare professionals to verify that this patient would be getting a medication that was safe for them. I now work with the EHR “Epic.” Although I like EPIC a lot, I feel that there are some flaws with it’s HIS system. I did some research, and found a study on the effectiveness of healthcare information systems throughout the city of Neyshabur in 2019. “Despite great effort to develop and utilize HISs and improve their effectiveness in improving patient care, the present study indicated an index of 64.42 out of 100 and reflected that there was still a gap to complete effectiveness” (Mohammadpour et al., 2021). They found many gaps in the staffs’ understanding on how to gather and implement data in order to form safe and efficient interventions for each patient. I find that, with EPIC, it is easier to be quickly inputting data within the ED and forget to acknowledge the patients prior history and allergies as the system does not prompt you to do so (at least with the version of EPIC that we have). With that being said, it is easier for medication errors to happen. I also feel that EPIC does not communicate with the PYXIS (medication administration station) as well as it could. With Cerner it would not let you scan a medication in to give it to a patient if it was not physically ordered within the chart. In Epic it will let the nurse scan any medication into the chart, and will open the medication up under a “non-ordered” medication admin panel. If not paying attention, this could make for a huge medication error in the ED as we mainly pull potentially dangerous medications on override when in emergent situations. Lastly, with Epic patients now have 24/7 access to their health chart. They can view and screenshot their labs, meds, appointments etc. This is exciting for the patient as they are able to easily access appointment changes, and medication requests through all of their HCP. “Astute nurses need to be familiar with these advantages and disadvantages so that they can advise patients correctly” (Chamberlain College of Nursing, 2020). The nurse should be able to properly advise the patient on how to interpret their laboratory values. It is important for the patients to be educated on the need to speak with the HCP after getting new laboratory results before coming to their own conclusions. A struggle that I have seen through my ED is that we will be very busy and start what we call protocols in the waiting room. This is where the nurse draws the patients blood without them being sent to a room yet in order to speed up their care. This ensures we see the sickest patients as soon as possible. The patients will then get these results back while in the waiting room, and google them. This allows some patients extreme health anxiety while in the waiting room, and on the other hand will result in patients leaving without treatment as they feel whatever results they got back were “good enough to go home.” These three things have made the transition from Cerner to Epic negative for me, but I feel as though my nursing supervisor actively works on any complaints that we have regarding the transition we are having as a hospital. Epic has a lot of different versions and updates and through our feedback we are working out all of the “kinks”.  This makes the transition into a new EHR less scary, and more positive, as I always think back to how much technology has the potential to upgrade as we identify areas in need of change. I feel that technology is very important in healthcare as it allows for quick and “easy” access to patient records, but there will always be room for improvements which means that nurses need to be that more cognizant of the potential of errors.

Resources 

Mohammadpour, A., Ghaemi, M. M., Darrudi, R., & Sadagheyani, H. E. (2021). Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective. 
Galen medical journal. DOI: 

10.31661/gmj.v10i0.1830

Chamberlain College of Nursing (2020). 
NR361 Information Systems in Healthcare: Downers Grove, IL: Online Publication. 

Care Setting Environmental Analysis

Preparation

You have been asked to conduct an analysis of your care setting that will result in two potential pathways toward a strategic plan to improve health care quality and safety in your organization, department, team, community project, or other care setting. To accomplish this, you will take two approaches to the analysis:

  1. Complete the discovery and dream phases of an appreciative inquiry (AI) project.
  2. Conduct a strengths, weaknesses, opportunities and threats (SWOT) analysis.

To help ensure that your analysis is well-received, the requester has suggested that you:

  • Present your analysis results in four parts:
    • Part 1: Appreciative Inquiry Discovery and Dream.
    • Part 2: SWOT Analysis.
    • Part 3: Comparison of Approaches.
    • Part 4: Analysis of Relevant Leadership Characteristics and Skills.
  • Your analysis should be 5-8 pages in length.

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

One key aspect to being an effective leader, manager, or administrator is an awareness of your leadership strengths, weaknesses, and style.

  • How would you assess your general leadership, communication, and relationship-building skills?
  • How would describe your leadership style?

Imagine the future for a care setting that is your place of practice or one in which you would like to work.

  • What aspirational goals can you envision that would lead to improvements in health care quality and safety?
  • How well do these goals align with the mission, vision, and values of your care setting?
Part 1: Appreciative Inquiry Discovery and Dream
  • Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.
    • Collect stories from your care setting. You may collect stories through interviews or conversations with colleagues or provide your own.
    • Explain how your stories are related to quality and safety goals.
    • Describe the evidence you have that substantiates your stories.
    • Identify the positive themes reflected in your stories.
    • Describe other evidence (for example: data, awards, accreditations) that validates your care setting’s positive core.
  • Propose positive, yet attainable, quality and safety improvement goals for your care setting.
    • Explain how accomplishing these goals will lead to ethical and culturally-sensitive improvements in quality and safety.
    • Explain how your proposed goals align with your care setting’s mission, vision, and values.
Part 2: SWOT Analysis
  • Conduct a SWOT analysis of your care setting, with respect to quality and safety goals.
    • Provide a narrative description of your analysis.
    • Identify the assessment tool you used as the basis of your analysis.
    • Describe your key findings and their relationships to quality and safety goals.
  • Describe one area of concern that you identified in your SWOT analysis—relevant to your care setting’s mission, vision, and values—for which you would propose pursuing improvements.
    • Explain how this area of concern relates to your care setting’s mission, vision, and values.
    • Explain why you believe it will be necessary and valuable to pursue improvements related to this area of concern.
Part 3: Comparison of Approaches

Compare the AI and SWOT approaches to analysis and reflect on the results.

  • Describe your mindset when examining your care setting from an AI perspective and from a SWOT perspective.
  • Describe the types of data and evidence you searched for when taking an AI approach and a SWOT approach.
  • Describe the similarities and differences between the two approaches when communicating and interacting with colleagues.
Part 4: Analysis of Relevant Leadership Characteristics and Skills

Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an AI and SWOT approach.

  • Explain how these characteristics and skills would help a leader facilitate a successful AI-based project and a successful SWOT-based project.
  • Comment on any shared characteristics or skills you identified as helpful for both AI and SWOT approaches.

questions

Original Work, No Plagiarism, Cite and Reference

You (a research assistant) are administering an electronic survey about chemotherapy-induced peripheral neuropathy to Edith, a participant receiving chemotherapy, in the infusion suite. The survey is administered using software on a iPad. You hand Edith the iPad and while she is clicking around to answer the survey, she accidentally navigates to the main page of the survey administration software, revealing the first and last names of everyone on the study. This is not the first time that a data privacy incident has occurred during the conduct of this study.

Discussion Questions

1. What security steps could you take in the future to prevent participants from navigating to the home page of the survey administration software when they complete the survey on the iPad? 

2. If you were the PI of this study, how would you explain to your research assistant the importance of data privacy/security?

3. If you were the PI of this study, should you report this incident to the IRB? Why or why not? 

4. In an alternate scenario, when you approach Edith to administer the survey, Edith says that she does not remember being apart of a research study. How would you respond in this situation? Should you still administer the survey? 

Measures to Prevent Cancere

due 10- 6-23 @ 10 am

Community Teaching Plan & Evaluation

 

After reviewing Module 6: Lecture Materials & Resources, explain approaches to community intervention and evaluation. Implement a teaching and evaluation plan.

  1. Choose one topic from the prevention strategies and intervention recommendations identified in Module 4 Assignment.
  2. Develop a teaching plan, including objective, content outline, teaching method, and time in a table format found in slide 3 of the Template Download Template.
  3. Develop an evaluation plan for your teaching intervention and create a tool for feedback from your learners. Be sure to include the questionnaire and any other teaching tools within the powerpoint presentation for faculty analysis.
  4. Implement the teaching plan and evaluation during Visit 5 of your clinical experience.
  5. Summarize the outcomes of your teaching plan and evaluation based on the results from the questionnaires.

Unit 7 Discussion Case Study 600W. APA. 4 references due 10-17-23.

Advanced Psychopharmacology and Health Promotion

Unit 7 Discussion Case Study 600W. APA. 4 references due 10-17-23.

Case Study:

· Your patient is a 36-year-old woman with bipolar disorder and anxiety. She has been stable on a combination of fluoxetine and olanzapine for two years.  She is morbidly obese at 340 pounds at 5’5” in height, has type II diabetes, hypertension, and hyperlipidemia.  She has concerns about her weight and has tried numerous ‘fad diets’ to no avail.  She explains she has lost, at most, 15 pounds and has been able to keep it off for three months. 

· She has three children, one of which is severely disabled, and a husband who has a terminal diagnosis. She expresses worry that her weight will impact her ability to care for her disabled child when her husband dies.  She reports she eats out frequently due to her children’s busy schedules.  She is a stay-at-home mother but gets little exercise and performs no regular physical activity. 

· She reports feelings of shame that she can no longer orgasm on the rare occasions her husband has the energy and desire to be intimate.

  
Questions: 

· What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence. 

· What would be our approach to the sexual side effects she is experiencing? 

· If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended? 

· Please include the subjective and objective information in this post.

All responses must by supported by correct APA 7th edition formatted citations and references.

1. What would be your approach to managing this patient's weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence. 

1. Non-pharmacological Approach

2. Pharmacological Approach

2. What would be our approach to the sexual side effects she is experiencing?

· Lifestyle changes, avoidance of stress or anxiety, drug therapy, physical activity, and psychological support. 

3. If you suggested additional medication, look up your state's prescribing laws. Are PMHNPs able to prescribe the medication you recommended?

· Additional medication is Flibanserin, the PMHNP can prescribe this without the supervision of a psychiatrist since PMHNP is Psychiatric-Mental Health Nurse Practitioner which is Board Certified. And/or hormonal therapy which is usually prescribed by a gynecological physician.

Please see the explanation below. 

Step-by-step explanation

Approach to solving the question:

· Identification of clinical problems that a bipolar patient attained, classification of nonpharmacological and pharmacological treatment of a patient, planning for therapies essential in treating the patient, and evaluation of the process for positive outcomes.

1. What would be your approach to managing this patient's weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence. 

1.
Non-pharmacological Approach

·
Detailed explanation: this is an approach that is essential in managing a patient's weight concern without the involvement of drugs to treat the weight problem. This aim is to provide alternative prevention in treating weight gain without any chemical side effects on the body. 
(Focus (American Psychiatric Publishing). 2021)

·
Examples: (1) Physical activity such as aerobic exercises, can help the patient maintain her within the normal range which will enhance her conditions of type II diabetes, hypertension, and hyperlipidemia and help in improving her sexual desire, (2) Healthy food intake such as fruits, vegetables, whole grains, nonsalty and fatty foods, can reduce the risk of weight gain, and increase blood pressure and cholesterol which can improve her well being, and (3) Peer support which is very helpful in getting motivation from those people who are experiencing the same situation with the patient which increase the chance of preventing to expose her self to stress and anxiety. 

2.
Pharmacological Approach  

·
Detailed explanation: this is an approach that is essential in managing a patient's weight concern with the involvement of drugs to treat the weight problem. This aim is to provide drug prevention to avoid the progression of the presenting clinical manifestation and development of complications. 
(Focus (American Psychiatric Publishing). 2021)

·
Examples: (1) Phentermine-topiramate which is helpful in cutting the cravings, and lessens the appetite during stress and anxiety. This is helpful to increase the chance of weight gain especially when the patient attempted to expose herself to overeating.

2. What would be our approach to the sexual side effects she is experiencing?

· The approach
 to the sexual side effects the patient is experiencing are lifestyle changes, avoidance of stress or anxiety, drug therapy, physical activity, and psychological support. Sexual side effects based on the scenario are linked to the stress, anxiety, and weight gain of the patient. It is important that as a healthcare provider, you must assess the related factors to the presenting problem. For a patient with bipolar disorder, it is important to have a care plan to follow so that the patient will be encouraged to do. Lifestyle changes such as physical activity and eating healthy food are the most important since the patient tends to eat out frequently due to her children's busy schedules, gets little exercise, and performs no regular physical activity. If the patient is healthy, their sexual desire will improve and help her to have orgasms since her hormones are healthy. Avoidance of stress and anxiety is helpful in sexual desire because a patient who is stressed can affect the sympathetic nervous system limiting the blood flow to the genitals to achieve genital arousal. Also, therapies are helpful in correcting abnormal hormones in the body system. 
(Lancet Public Health. 2021)

3. If you suggested additional medication, look up your state's prescribing laws. Are PMHNPs able to prescribe the medication you recommended?

· Since the patient is already taking combinations of olanzapine which is useful in treating schizophrenic episodes and fluoxetine which is an antidepressant used in bipolar disorder and linked to weight loss, the additional medication that I may recommend is Flibanserin which is an antidepressant helpful in correcting the imbalance of the neurotransmitters in the brain increasing the chance to sexual desire. The PMHNP can prescribe this medication in all states because Flibanserin should be prescribed by a psychiatrist physician and certified nurse practitioners. Another additional medication that I would like to conclude is hormonal therapy like estrogen therapy because the abnormal level of hormones in the body affects the body in sexual desires and can lead to stress and anxiety. 
(Psychiatr Serv. 2018)

REFERENCES:

· Vancampfort D, Firth J, Correll CU, et al.. The impact of pharmacological and non-pharmacological interventions to improve physical health outcomes in people with schizophrenia: a meta-review of meta-analyses of randomized controlled trials. 
Focus (American Psychiatric Publishing).2021;19:116-28. 

· Mitchell K.R., Lewis R., O'Sullivan L.F., Fortenberry J.D. What Is Sexual Wellbeing and Why Does It Matter for Public Health? 
Lancet Public Health. 2021;6:e608-e613. doi: 10.1016/S2468-2667(21)00099-2.  

· Blackmore M.A., Carleton K.E., Ricketts S.M. Comparison of collaborative care and colocation treatment for patients with clinically significant depression symptoms in primary care. 
Psychiatr Serv. 2018;69(11):1184-1187. doi: 10.1176/appi.ps.201700569.

improved team communications

improved team communications, patient and family centered care, and disparities and inequities in care, into your practice

Question on Discussion Post

 

An individual is referred to your office by his parole officer.  This 19-year-old male, named Sam, was recently arrested for a “psychotic break” that caused him to throw a chair through the neighborhood drug store window.   Sam’s parents arrive and Sam agrees to have his parents present during the interview.

His parents state Sam recently withdrew from college after experiencing a “resounding moment” in which he changed his major from engineering to philosophy and increasingly had reduced his sleep, spending long hours engaging individuals in the commons in conversations about the nature of reality and how he is gaining an appreciation “for all life”. He had been convinced about the importance of his ideas, stating frequently that he was more learned and advanced than all his professors. He told many that “I should be the one teaching these courses, after all, I understand it much better than my professors”. Sam has also increased the number of high-risk behaviors – drinking and engaging in sexual relations in a way that was unlike his previous history.  He also has spent a considerable sum of money on “projects to help the world” – unfortunately, he has never completed a project.

Sam’s parents also state that Sam was diagnosed previously by his PCP with MDD and GAD.  “These new behaviors are just that – new – since he went to college”.

Further discussions with Sam and his parents reveal that he has never experienced hallucinations and you believe that he currently is not experiencing any delusions.  Sam states “I am what I am”.

  1. What diagnosis do you believe may apply to this individual?
  2. What classifications of medications can be used to treat this disorder?  Which medication do you recommend and why?