Nursing Theory

Now that you understand middle range theory, look through the list of middle range theories in your text. Find 2-3 that are related to concepts that you are interested in and read about them. Can you determine what type of theory it is? What are the concepts? How could this theory be used for research or practice?

FYI

Theory is made up of concepts and propositions about a phenomenon.

Concept = word or phrase that captures the essence of something such as functional status or mood.

For example: a single dimension might be physical energy. On the other hand, a multidimensional might be functional status which would include several factors.

A proposition is a statement about one or more concepts. For example, Functional status is defined as performance of usual activities of daily living. A proposition about two or more concepts states an association between the concepts, including the relation between the concepts or the effect of one or the other. So, nursing theory focuses on experiences of health conditions and health related events.

Types of middle range theory

Descriptive: describe a phenomenon. Typically comprise one concept and one proposition that is a definition or description of the concept.
Examples include “Theory of Functional Status”. The concept is functional status. The proposition is that it is a multidimensional concept that is defined as performance of usual family care activities, household activities, social activities, community activities, person care activities and of occupational activities.

Explanatory: Specify how concepts are related to one another, they provide explanations about a phenomenon. They consist of two or more concepts, the propositions that are definitions or descriptions of each concept, and the propositions that specify the relations between the concepts.
Example: The theory proposition that specifies the relation between concepts is as follows: chronic pain, physical disability, social support, age, and gender are related to perceived daily stress, which is related to depression.

Predictive: Specifies how a concept affects one or more other concepts. They are made up of two or more concepts the propositions that are definitions or descriptions of each concept, and the propositions that specify the effect(s) of one concept on one more other concept.
Example: A theory about the effects of cancer support groups with coaching on symptom distress, emotional distress, functional status and quality of the relationship with a significant other. Women with breast cancer who participate in a cancer support group with coaching would have less symptom distress, less emotional distress, greater functional status, and higher quality of relationship with a significant other than women who participated in a cancer support group without coaching and women who did not participate in any support group

evidence-based practice (EBP)

On April 16, 2019, Washington state senator, Maureen Walsh made a remark on the senate floor suggesting that nurses “probably play cards for a considerable amount of the day” while denouncing a bill that would allow nurses to get mandatory, uninterrupted meal and rest breaks (Garcia, 2019). This statement received lots of air time in the news and on many media platforms. The bill did go on to pass but considering the possibility of the bill not being passed because of such a statement should be the drive for nurses wanting to see a change in policy concerning this profession. The only way to ensure that there are individuals in politics speaking on our behalf is to become the individual or hire someone to do it. Now is time that nurses recognize how we can impact change.

Change will never happen overnight and will take hard work and dedication but the days of just complaining must be put behind. The strategies nurses can use to impact health policy decisions start with educating ourselves about the ins and outs of politics, understanding it is not a solo but a group effort pulling together resources, and remaining united using the difference of opinions to map out a goal that will be beneficial for all nurses. While it sounds so simple, I’m aware its not. Many nurses were upset about the statements of one republican senator but besides venting to one another on social media platforms not many joined any efforts to rebuttal. The senator later apologized but not enough nurses were motivated to stand up for the profession.

In order to gain the confidence needed to stand up for the profession, an individual staff nurse would have to learn about the policies and the process to turn ideas into action. It is the influence of networks and coalitions, or like-minded groups that wield power most effectively. An individual nurse may not have sufficient power to champion an issue through the legislative or regulatory process, but a network, coalition, or alliance of nurses or nursing organizations can wield significant power to move an issue to the public agenda and to successfully solve it (Mason, Gardner, Outlaw & O’Grady, p. 84-85). After determining what policy needs to be implemented or changed, the nurse would need to gather those who feel the same way to tackle the issue. This makes the research and work easier as everyone is working towards a common goal. As a group you can research individual politicians and see where they stand on the side of your goals and look at ways to sway them towards siding with what nursing needs. Find out how money is involve and how working with particular politicians can get both agendas met if beneficial.

As a nurse, we come into contact with many individuals from different walks of life. It takes compassion and devotion to do nursing daily and its just assumed that all nurses must feel that way about the profession, so we do it without ever asking for anything in return. While this is true, nurses can use the rapport built with the many different people to educate about how nursing is affected by policies and why the should vote with nursing when the policy that we want is important. Developing networks involves keeping track of what you have done for others and not being afraid to ask for a favor in return (Mason, Gardner, Outlaw & O’Grady, p.88). Helping provides a rewarding feeling but these relationships can help you earn decide rewards of policy change.

It is critical for nurses to frame their policy work in terms of improving the health of patients and the broader health delivery system, rather than a singular focus on the profession (Mason, Gardner, Outlaw & O’Grady, p. 86). By staying focused on the goal and remembering how each group or coalition that is working on behalf of the goal intends to benefit than this united front can help impact policy change.

Reply 2

It is important to have evidence-based practice (EBP) in healthcare, because this helps to improve patient care and healthcare by data and interventions that are proven to have positive outcomes. There are different strategies that can be used to improve collecting and sharing evidence that can make an impact in health policy decisions, and these include providing data with strong explanation, cultivating the spirit of inquiry in the evidence-based practice environment and culture, and lastly is the critical appraisal of the evidence.

The first strategy is providing a strong explanation. During the collections of evidences which are aimed at informing policy decisions, the nurses should nature a spirit that is bound by evidence-based practice environment and culture. For example, the nurse ought to ask the patient the clinical question that is set in an organized format, collect and search the most relevant evidence, then carefully appraise the evidence; for example, synthesis, evaluate and recommend the evidence, including the best evidence which has patients preferences and that with clinical expertise by making a practice change or decision. Evaluate the practice decision outcome and change depending on the evidence and deliver the outcome of the decision from EBP.

The second strategy is cultivating the spirit of inquiry in the EBP environment and culture. This can be done by developing a continuous inquiry of clinical practices when providing health care to your clients or patients and consistently inquire about the current practices. For example, the use of bronchodilators that contains metered-dose inhalers with children who have asthma lead to improved levels of oxygen in the body. Also, double-checking medications can lead to fewer medication errors. This strategy can lead to advanced organization goals, mission and vision, orientation period for clinicians who communicate an anticipation of aiming evidence-based practice qualifications for training registered nurses. It also leads to advanced evidence-based practice procedures and policies, because it causes integration of EBP qualifications in clinical and evaluation performance.

The last strategy that can be used is the critical appraisal of the evidence. After the best evidence have been collected, The appraisal process starts when a rapid critical appraisal is conducted questions like: the kind of results they are, are they valid, did the researcher used the right study methods, if the results are going to be of help during patient care, and if the treatment good with patients. The answers and explanations should be well-formatted to be able to emphasize and highlight the impact of the evidence provided. The rapid appraisal checklist helps in evaluating the reliability, applicability and validity.

Evidence-based practice is a crucial tool for delivering high-quality care in numerous nursing specialties. EBP enables nurses to make data-backed solutions that incorporate clinical expertise and current research into the decision-making process (Master of Science in Nursing). There are a lot of benefits in healthcare when EBP is used, that is why it is very important for healthcare professionals to provide strategies that will help improve how to share evidence to impact healthcare positively.

All replies must be constructive and use literature where possible. 200 words.

Evidence-Based Population Health Improvement Plan

Write a 4-5 page population health improvement plan, based on your evaluation of the best available evidence from a minimum of 3-5 current scholarly or professional sources of demographic, environmental, and epidemiological data that focuses on your diagnosis of a widespread population health issue.

Part of effectively engaging in evidence-based practice is the ability to synthesize raw health data with research studies and other relevant information in the literature. This will enable you to develop sound interventions, initiatives, and outcomes to address health concerns that you find in data during the course of your practice.

In this assessment, you have an opportunity to evaluate community demographic, environmental, and epidemiological data to diagnose a widespread population health issue, which will be the focus of a health improvement plan that you develop.

Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 2: Apply evidence-based practice to design interventions to improve population health.
Evaluate community demographic, epidemiological, and environmental data to diagnose widespread population health issues.
Develop an ethical health improvement plan to address a population health issue within a community.
Competency 3: Evaluate outcomes of evidence-based interventions.
Propose criteria for evaluating population health improvement plan outcomes.
Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.
Justify the value and relevance of evidence used as the basis of a population health improvement plan.
Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.
Develop a strategy for communicating with colleagues and members of the community in an ethical, culturally sensitive, and inclusive way.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.
Scenario
Your organization is undertaking a population health improvement initiative focused on one of the pervasive and chronic health concerns in the local community. Examples of health improvement initiatives include nationwide concerns, such as type 2 diabetes, HIV, obesity, insect bites, and Zika. However, your organization has asked you to determine which widespread health concern should be addressed in a population health improvement plan for your community and has entrusted you with gathering and evaluating the relevant data.

Your Role
You are a nurse in a community clinic or hospital and you have a good idea about the most common chronic health issues among its patients. You have been asked to prepare a presentation for the next staff meeting about the issue and the plan that you are proposing to help improve the community’s health.

Instructions
The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may want to review the performance-level descriptions for each criterion to see how your work will be assessed.

Part 1: Data Evaluation
Evaluate the outcomes of a population health improvement initiative from community demographic, epidemiological, and environmental data.

Identify the relevant data.
Identify the level of evidence, validity, and reliability for each source.
Describe the major community health concerns suggested by the data.
Explain how environmental factors affect the health of community residents.
Part 2: Health Improvement Plan
Develop a health improvement plan that ethically and effectively addresses the population health concern that you identified in your evaluation of the relevant data.

Base your plan on the best available evidence from a minimum of 3–5 current scholarly or professional sources.
Apply correct APA formatting to all in-text citations and references.
Attach a reference list to your plan.
Ensure that your plan meets the cultural and environmental needs of your community and will likely lead to some improvement in the community’s health related to this concern.
Consider the environmental realities and challenges existing in the community.
Address potential barriers or misunderstandings related to the various cultures prevalent in the community.
Justify the value and relevance of the evidence you used as the basis of your plan.
Explain why the evidence is valuable and relevant to the community health concern you are addressing.
Explain why each piece of evidence is appropriate and informs the goal of improving the health of the community.
Propose relevant and measurable criteria for evaluating the outcomes of your plan.
Explain why your proposed criteria are appropriate and useful measures of success.
Explain how you will communicate with colleagues and members of the community, in an ethical, culturally sensitive, and inclusive way, with regard to the development and implementation of your plan.
Develop a clear communications strategy mindful of the cultural and ethical expectations of colleagues and community members regarding data privacy.
Ensure that your strategy enables you to make complex medical terms and concepts understandable to members of the community, regardless of language, disabilities, or level of education.
The headings for your Evidence-Based Population Health Improvement Plan should be the following:
Data Evaluation.
Meeting Community Needs.
Evidence.
Measuring Outcomes.
Communication Plan.
Additional Requirements
Length: Your recommendation will be 4–5 double-spaced pages, not including title and reference pages.
Font: Times New Roman, 12 points.
APA Format: Your title and reference pages need to conform to APA format and style guidelines. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.
Scoring Guide: Please review this assessment’s scoring guide to ensure you understand how your faculty member will evaluate your work.
Grading Rubric:

1. Evaluate community demographic, epidemiological, and environmental data to diagnose widespread population health issues.

Passing Grade: Evaluates community demographic, epidemiological, and environmental data to diagnose widespread population health issues. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the evaluation).

2. Develop an ethical health improvement plan to address a population health issue within a community.

Passing Grade: Develops an ethical health improvement plan to address a population health issue within a community, identifying multiple complementary elements that will sensitively meet a wide variety of community members’ needs.

3. Justify the value and relevance of evidence used as the basis of a population health improvement plan.

Passing Grade: Justifies the value and relevance of evidence used as the basis of a population health improvement plan, and impartially considers conflicting data and other perspectives.

4. Propose criteria for evaluating population health improvement plan outcomes.

Passing Grade: Proposes criteria for evaluating population health improvement plan outcomes, and explains why other possible criteria were considered and rejected.

5. Develop a strategy for communicating with colleagues and community members in an ethical, culturally sensitive, and inclusive way.

Passing Grade: Develops a strategy for communicating with colleagues and community members in an ethical, culturally sensitive, and inclusive way; acknowledges potential difficulties and how those challenges will be met.

6. Write clearly and logically, with correct grammar and mechanics.

Passing Grade: Writes clearly, logically, and persuasively; grammar and mechanics are error-free.

7. Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

Passing Grade: Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Citations are error-free.

Assessing The Abdomen

Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.

With regard to the Episodic note case study provided:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
The Assignment
Analyze the subjective portion of the note. List additional information that should be included in the documentation.
Analyze the objective portion of the note. List additional information that should be included in the documentation.
Is the assessment supported by the subjective and objective information? Why or why not?
What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

Week 6: Assessment of the Abdomen and Gastrointestinal SystemABDOMINAL ASSESSMENTSubjective:•CC: “My stomach hurts, I have diarrhea and nothing seems to help.”•HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.•PMH: HTN, Diabetes, hx of GI bleed 4 years ago •Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs•Allergies: NKDA•FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD •Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)Objective:•VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs•Heart: RRR, no murmurs•Lungs: CTA, chest wall symmetrical•Skin: Intact without lesions, no urticaria •Abd: soft, hyperactive bowel sounds, pos pain in the LLQ•Diagnostics: NoneAssessment:•Left lower quadrant pain •GastroenteritisPLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

PERSONAL LEADERSHIP PHILOSOPIES

Assignment: Personal Leadership Philosophies

Many of us can think of leaders we have come to admire, be they historical figures, pillars of the industry we work in, or leaders we know personally. The leadership of individuals such as Abraham Lincoln and Margaret Thatcher has been studied and discussed repeatedly. However, you may have interacted with leaders you feel demonstrated equally competent leadership without ever having a book written about their approaches.

What makes great leaders great? Every leader is different, of course, but one area of commonality is the leadership philosophy that great leaders develop and practice. A leadership philosophy is basically an attitude held by leaders that acts as a guiding principle for their behavior. While formal theories on leadership continue to evolve over time, great leaders seem to adhere to an overarching philosophy that steers their actions.

What is your leadership philosophy? In this Assignment, you will explore what guides your own leadership.

To Prepare:

· Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

· Reflect on the leadership behaviors presented in the three resources that you selected for review.

· Reflect on your results of the CliftonStrengths Assessment and consider how the results relate to your leadership traits.

The Assignment no more than (2-3 pages):

Personal Leadership Philosophies

Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:

· A description of your core values

· A personal mission/vision statement

· An analysis of your CliftonStrengths Assessment summarizing the results of your profile

· A description of two key behaviors that you wish to strengthen

· A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.

· Be sure to incorporate your colleagues’ feedback on your CliftonStrengths Assessment from this Module’s Discussion 2.

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Complex Regional Pain Disorder

BACKGROUND

This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”

SUBJECTIVE

The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!”

The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”

He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it.”

During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation, and is future oriented.

Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)

The Assignment
Examine Case Study: A Caucasian Man With Hip Pain. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

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Workplace Environment Assessment

Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.

In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.

To Prepare:

Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
Review the Work Environment Assessment Template.
Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
Select and review one or more of the following articles found in the Resources:
Clark, Olender, Cardoni, and Kenski (2011)
Clark (2018)
Clark (2015)
Griffin and Clark (2014)
The Assignment (3-6 pages total):

Part 1: Work Environment Assessment (1-2 pages)

Review the Work Environment Assessment Template you completed for this Module’s Discussion.
Describe the results of the Work Environment Assessment you completed on your workplace.
Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
Explain what the results of the Assessment suggest about the health and civility of your workplace.
Part 2: Reviewing the Literature (1-2 pages)

Briefly describe the theory or concept presented in the article(s) you selected.
Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.
Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)

Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.
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Assessing Client Family Progress

Assignment
Part 1: Progress Note

Using the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following:

Treatment modality used and efficacy of approach
Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the treatment plan for progress toward goals)
Modification(s) of the treatment plan that were made based on progress/lack of progress
Clinical impressions regarding diagnosis and or symptoms
Relevant psychosocial information or changes from original assessment (e.g., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job)
Safety issues
Clinical emergencies/actions taken
Medications used by the patient, even if the nurse psychotherapist was not the one prescribing them
Treatment compliance/lack of compliance
Clinical consultations
Collaboration with other professionals (e.g., phone consultations with physicians, psychiatrists, marriage/family therapists)
The therapist’s recommendations, including whether the client agreed to the recommendations
Referrals made/reasons for making referrals
Termination/issues that are relevant to the termination process (e.g., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
Issues related to consent and/or informed consent for treatment
Information concerning child abuse and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
Information reflecting the therapist’s exercise of clinical judgment
Note: Be sure to exclude any information that should not be found in a discoverable progress note.
Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment.

In your progress note, address the following:

Include items that you would not typically include in a note as part of the clinical record.
Explain why the items you included in the privileged note would not be included in the client family’s progress note.
Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why.
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PICOT Question And Literature Search

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this assignment.

1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.

2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).

3. The PICOT question will provide a framework for your capstone project.

4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem from the school library.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.

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.

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.

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Approach to Care

Benchmark – Nursing Process: Approach to Care
The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

Describe the diagnosis and staging of cancer.
Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.
You are required to cite to a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN-BSN

2.1: Incorporate liberal arts and science studies into nursing knowledge.

3.1 Utilize the nursing process to provide safe and effective care for patients across the life span.