Questions

Please write formally and Harvard references 

Topic- sexual health and well-being 

Using the Driscoll’s model of reflection.

Step 1: What?  Task: Describe Your learning experience (approx. 400words)

Step 2: So What?  Task: Describe why this experience was significant to you as a student nurse (approx. 850words

Step 3: Now What? Task: Describe next steps – what do you want to do with this new knowledge, where might it take you? (approx. 400words)

Action plan  Task: How will you implement the next steps? – what do you practically need to do now to accomplish step 3?  (approx. 400words)

 1: Define your end goal  Be clear about what you want to achieve, then write down your goal, make sure that it is 

• Specific – well-defined and clear
• Measurable – include measurable indicators to track      progress  
• Attainable – realistic and achievable within the resources,      time, money, experience, etc. you have
• Relevant – align with your other goals 
• Timely – has a finishing date 

 2: Prioritise tasks and add deadlines: Decide what steps you need to take, what order they need to be in and what resources you will need. 

 3: Monitor, evaluate and update: How will you check your progress? 

You can use some of these articles belolw. Only use uk sources.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30418-0/fulltext

https://www.rcn.org.uk/-/media/royal-college-of-nursing/documents/publications/2016/june/005575.pdf?la=en

https://www.stonewall.org.uk/system/files/unhealthy_attitudes.pdf 

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 14, “The Electronic Health Record and Clinical Informatics” (pp. 267–287)
Chapter 15, “Informatics Tools to Promote Patient Safety and Quality Outcomes” (pp. 293–317)
Chapter 16, “Patient Engagement and Connected Health” (pp. 323–338)
Chapter 17, “Using Informatics to Promote Community/Population Health” (pp. 341–355)
Chapter 18, “Telenursing and Remote Access Telehealth” (pp. 359–388)

 Dykes, P. C., Rozenblum, R., Dalal, A., Massaro, A., Chang, F., Clements, M., Collins, S. …Bates, D. W. (2017). Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: The Promoting Respect and Ongoing Safety Through Patient Engagement Communication and Technology Study. Critical Care Medicine, 45(8), e806–e813. doi:10.1097/CCM.0000000000002449

HealthIT.gov. (2018c). What is an electronic health record (EHR)? Retrieved from 
https://www.healthit.gov/faq/what-electronic-health-record-ehr

Rao-Gupta, S., Kruger, D. Leak, L. D., Tieman, L. A., & Manworren, R. C. B. (2018). Leveraging interactive patient care technology to Improve pain management engagement. Pain Management Nursing, 19(3), 212–221. doi:10.1016/j.pmn.2017.11.002
Note: You will access this article from the Walden Library databases.

Skiba, D. (2017). Evaluation tools to appraise social media and mobile applications. Informatics, 4(3), 32–40. doi:10.3390/informatics4030032
Note: You will access this article from the Walden Library databases.

Discussion: Healthcare Information Technology Trends

Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.

In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.

To Prepare:

• Reflect on the Resources related to digital information tools and technologies.
• Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
• Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.

By Day 3 of Week 6

Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.

write an answer based on this assignment. use at least 2 references. do not use the same that appears here. 

People and the Process of Change

Changing from a route I am used to would imply leaving earlier for class. This is one of the changes I would make. Leaving early would assist in dealing with any unexpected distance of the new route. I believe changing the route I am used to would bring about resistance to stick to the route, especially if it is a longer route. Personal needs would arise when sticking to the new route. Personal needs would relate to gaining trust based on safety and security (Weiss & Tappen, 2015). I would resist following the new route, where I do not believe in assured safety and security. Unlike the normal route used I was used to; the new route would take time as I adapt. The process follows freezing, changing, and unfreezing. The freezing would happen when I decide to change to a new route. The change would happen during the use of the route as I familiarize myself with the path. Gaining familiarity assists in building trust in using the route. One of the large changes would involve adjusting the time I leave for the class to ensure I am not late. The second large change is trusting in the route. The change aligns with the personal need that humans look for during stability. I would seek to adapt to having faith in the route I would be comfortable taking.

Stability would also imply emotional stability. Emotional stability means having the full trust of security and safety (Weiss & Tappen, 2015). Small changes include seeing different environments and different people using the route. I would meet different people using the new route. Other people would be using the route, which would imply meeting different people. Hence, continuous use of the route would prompt meeting failure faces. Meeting familiar faces becomes the unfreezing part as the route becomes my norm. The more familiar the route becomes, the more I will use the path. Also, the more different people become familiar to me, the more I will trust the route. This falls under attaining stability and having the assurance that the route will not have me lost. Unless I am familiar with the route to get to my destination fast, I may not change during the final exam day. During exams, individuals are required to arrive early. Hence, not being familiar with the route would mean I may get late.

The only way to avoid lateness is by using a route that gets me to the exam room on time. Therefore, trusting the route and attaining emotional stability is vital on the final exam day. This will only happen if I am assured that I will not get lost as I use the route. The change to another route during the final day of the exam is a micro or small change. Using the new route is a small change because the effect of the change is on me. No one else is affected by the change. One of the positive impacts of changes is learning (Otken & Beser, 2017). I would learn about a new environment. My mind would become familiar with solving the way I will get to class on time. Hence, the small change would allow me to change from my comfort zone to attain new ideas regarding a different environment. Concerning nursing staff adhering to an administrator making a minor change, learning is the linking factor and an advantage. Change of route and adapting to minor change for nursing promotes learning to come in terms with new ideas.

One negative effect of the change is restructuring from the norm. The restructuring would require leaving earlier to get to the exam room on time. For the nursing staff, losing power and experiencing a downgrade in a position are negative impacts. Weiss & Tappen (2015) implies that restructuring causes altering certain norms for employees such as salary cuts, downgrade in a position, loss of benefits, job loss, or relocation to another department. Having a negative impact of change creates resistance to change (Imran et al., 2016). The resistance makes nurses seek a way of protecting interests as a team. Resisting to using the path and resistance by nurses to adherence to the change creates a negative impact because one must unlearn the old methods and adopt new methods. The new methods create a delay in how one will do what is expected. Arriving in class on time is resisted when I am forced to leave early than usual. Altering my time of going to class implies I change or drop a certain activity I am used to doing before going to class. For instance, instead of waking early to read, circumstances may force me to wake up early to prepare and leave early. For nurses, a minor change may cause a slower rate in meeting the patients’ needs. Slowness comes about during the learning process from freezing, change, and unfreezing.

A change that has occurred in my life is losing my grandmother. My grandmother died due to cancer. The loss took place when I was a child. My initial reaction to the loss was anger since I did not understand that my grandmother would leave without saying goodbye. The explanation I received is my grandmother had traveled to the sky to become a star that shines over us. Coming into terms with the betrayal of being left by my traveling grandmother was not easy. I would miss her, and I did not know how to tell her. If I knew that my grandmother died because of a brain tumor, I would have reacted differently. I would have forgiven my grandmother for leaving without any goodbyes. Knowing what death is as a child meant understanding that not everyone would be in my life for long. Having more information about death would empower me to understand that death happens in uncertain and unexpected ways. Applying Lewin’s change model means using basic elements of freeze, change, and unfreeze (Weiss & Tappen, 2015). Freezing is when I became aware of what happened to my grandmother. Learning about death made me realize that people leave and go to be with God. The change was when I learned that death is a process of life and must occur. Lastly, I went through the unfreezing process of becoming aware death is a common occurrence. The next time I lost a relative, I did not feel betrayed by the relative going without saying goodbye. I learned that a person might die when I am not close to them. Hence, no goodbyes will occur.

References

Imran, M. K., Rehman, C. A., Aslam, U., & Bilal, A. R. (2016). What’s organization knowledge management strategy for successful change implementation?. Journal of Organizational Change Management.

Otken, A. B., & Beser, H. S. G. (2017). The effect of authentic leadership on organizational learning providing organization the ability to adapt quickly and conveniently to changing circumstances. PressAcademia Procedia, 3(1), 457-471.

Weiss, S. A., & Tappen, R. M.(2015).Essentials of Nursing Leadership and Management (6th Ed.). F. A. Davis Company

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

8 Replies 

APA Style 

References 

Please organize the replies by class names.

Define human-made and natural disasters.  Describe the nurse leader’s role in emergency disaster planning and disaster response.

What is involved in the activation of the emergency response system? 

How will you prioritize nursing actions?

Write 200 words, and reference a professional nursing journal article within the last 5 years.  Upload your article with your post.

Bipolar Therapy
Client of Korean Descent/Ancestry

BACKGROUND INFORMATION

The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. 

Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?”

She weights 110 lbs. and is 5’ 5” 

SUBJECTIVE

Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.” 

You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work. 

Genetic testing reveals that she is positive for CYP2D6*10 allele. 

Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago. 

MENTAL STATUS EXAM

The patient is alert, oriented to person, place, time, and event. She is dressed quite oddly- wearing what appears to be an evening gown to her appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation.

The Young Mania Rating Scale (YMRS) score is 22

RESOURCES

§ Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6

Decision Point One

Select what the PMHNP should do:

Begin Lithium 300 mg orally BID

Begin Risperdal 1 mg orally BID

Begin Seroquel XR 100 mg orally at HS

Examine Case Study: An Asian American Woman With Bipolar Disorder. 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.

Choice one: I choose to start Seroquel

Decision Point One

Begin Seroquel XR 100 mg orally at HS

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• Client is reporting that she sleeps a bit more at bedtime
• Client states that she has gained about 2 or 3 pounds, which she does not like
• Client also reports that she has been constipated since starting this medication
• Client is also complaining of dry mouth which she does not like.
• Client’s score on the Young Mania Rating Scale has decreased from a 22 to an 18
• Client is reporting really good mood, but is asking for a different medication because of the weight gain

Decision Point Two

Select what the PMHNP should do next:

Increase Seroquel XR to 300 mg orally daily 

Discontinue Seroquel and start Geodon 40 mg orally BID. Administer with 500 calorie meal 

Continue same dose of Seroquel and counsel client regarding ways to prevent constipation

I choose to discontinue Seroquel and start Geodon 40 mg orally BID. ADminister with 500 calorie meal

Discontinue Seroquel and start Geodon 40 mg orally BID. Administer with 500 calorie meal 

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Client demonstrates a 50% decrease in score on the Young Mania Rating Scale (from 22 to 11)
• Client denies any additional weight gain and denies any additional side effects

Decision Point Three

Select what the PMHNP should do next:

Continue same dose and reassess in 4 weeks 

Increase Geodon to 60 mg orally BID with a 500 calorie meal 

Augment with Lithium sustained release 300 mg orally BID

I now choose to continue same dose and reassess in 4 weeks

Decision Point Three

Continue same dose and reassess in 4 weeks 

Guidance to Student
The PMHNP should provide counseling to the client about this side effect and encourage increased fluids and fiber in the diet to combat constipation. Hard candies or gum can be used to prevent dry mouth. This is another issue as the drug can cause dental problems as a result of dry mouth.

Changing to Geodon clearly helped with symptoms and arrested weight gain in this client. The PMHNP could wait 4 weeks and see if any changes in Young Mania Rating Scale are noted, or increasing to 60 mg orally BID in an attempt to hasten symptom improvement. Increasing dose may be associated with side effects.

Augmentation with Lithium may be appropriate if the goal of therapy is to discontinue antipsychotic therapy and treat with Lithium monotherapy. Lithium was problematic for this client but changing formulation to the extended release may overcome the difficulties she was experiencing with side effects. The PMHNP would need to educate client regarding side effects of medication and need to maintain compliance. 

Barbara was recently hired as a regional manager for the Urgent Care Clinic Organization (UCCO). One of her first tasks is to compile a strategic plan for the executive committee to review. The overall goal of the strategic plan is to identify specific actionable items that can better position the clinic organization.

For this assignment on UCCO, complete a minimum 2-page summary to explain why the organization should devote time to planning and why a strategic plan is needed.

Visit the Rasmussen online Library and search for a minimum of 4 articles covering the topics of strategic planning and healthcare management. Conduct academic research using the library’s databases, like:

• Discovery
• Business Source Complete via EBSCO
• Business via ProQuest
• What can a healthcare organization accomplish with the strategic planning process?
• What would you recommend as areas of focus for Barbara’s strategic plan?
• Discuss how Barbara can achieve a balance between historical and current topics in healthcare?
  • How should she apply them for her strategic plan?
• What type(s) of primary and secondary research would you recommend Barbara conduct? What are the benefits? Explain.

Remember to integrate citations accurately and appropriately for all resource types; use attribution (credit) as a method to avoid plagiarism. Use NoodleTools to document your sources and to complete your APA formatted reference page and in-text citations

4 discussion 

1 Analysis paper 

 Week 4: Writing Assignment Instructions

You are working in the community as a part of the county health department.  You are writing from a health perspective as an educator for the community. Select two out of the following four discussion questions for your writing assignment:

• Why are lifestyle and health behaviors significant for the adult age group compared to other age groups?
• How can community health efforts affect the leading causes of death for the adolescent and the young adult age group?
• What can happen to increase the likelihood of older adults utilizing community facilities and services?
• How will the changing demographics of older adults affect healthcare services?

Support your responses from the literature, using at least 3 scholarly resources, of no more than 5 years of age. Scholarly references  Your textbook is a good source of information and can be cited and referenced.  A scholarly resource is defined as an evidence-based practice; peer-reviewed journals; textbook; and national standard guidelines. Your paper should be in APA format 7th edition, 3-5 pages in length, not counting the title page and reference page. 

Use Checkpoint to check your draft for plagiarism.