Medication error reporting is an essential component of patient safety. Please review the following article:Alsulami, S. L., Sardidi, H., Almuzaini, R. S., Alsaif, M. A., Almuzaini, H. S, & Moukaddem A. K. (2019). Knowledge, attitude and practice on medication error reporting among health practitioners in a tertiary care setting in Saudi Arabia. Saudi Medical Journal, 40(3), 246-251.Write a 5-6-page paper, not including the cover and reference pages, using the readings, research, and your knowledge of medication error reporting to analyze the following:

• The prevalence and common causes of medication errors
• Consequences on patients including types of harm
• The barriers to medication error reporting
• Provide a recommendation for policies and procedures addressing the reporting of medical errors
• Recommend how to evaluate whether the policy is effective

Your report should meet the following structural requirements:

• Be 5-6 pages in length, not including the cover or reference pages.
• Be formatted according to Saudi Electronic University and APA writing guidelines.
• Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
• Utilize headings to organize the content of your work.

Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

Photo Credit: Getty Images/Caiaimage

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

• Review the Resources for this module and consider the      legal and ethical implications of prescribing prescription drugs,      disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for      this Assignment.
• Search specific laws and standards for prescribing      prescription drugs and for addressing medication errors for your state or      region, and reflect on these as you review the scenario assigned by your      Instructor.
• Consider the ethical and legal implications of the      scenario for all stakeholders involved, such as the prescriber,      pharmacist, patient, and patient’s family.
• Think about two strategies that you, as an advanced      practice nurse, would use to guide your ethically and legally responsible      decision-making in this scenario, including whether you would disclose any      medication errors.

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

• Explain the ethical and legal implications of the      scenario you selected on all stakeholders involved, such as the      prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and      nondisclosure as identified in the scenario you selected. Be sure to      reference laws specific to your state.
• Explain two strategies that you, as an advanced      practice nurse, would use to guide your decision making in this scenario,      including whether you would disclose your error. Be sure to justify your      explanation. 
• Explain the process of writing prescriptions, including strategies to minimize medication errors.

Scenario

As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

REPLY 1

The best way to handle s situation and to aide Mrs. Faulkenberg’s compliance would be another health care professional apologizing to start. As a rule of thumb, I was taught when working with patients especially elderly Mr. and Mrs. Should be used when addressing them unless told otherwise (Mayne, 2019). If no-one responded when the name was called, then I feel the women should have been asked what her name is or if she is waiting to be seen. The approach just seems uncaring or professional. When calling names out into the waiting room I make sure to ask the patient if I pronounced their name right or if that is what they want to be called out of respect and the fact not everyone goes by their legal name. Making eye contact, a smile while introducing yourself is also important. If someone treated your grandmother like this how would you feel?

There are multiple things to consider as to why Alma Faulkenberger did not respond the way this situation played out. A full assessment should be completed before assuming, the patient also deserves specifics about herself to be asked in a private area. In this specific case I believe asking the patient what she would like to be called would be a great way to show respect and start forming a good patient-health care provider relationship. A bond must be established of trust before there will be a good working relationship. There is no way to even begin to know what this patient is dealing with or experiences she has had with healthcare providers simply approaching with empathy and attempting to listen to the patient can get you far. This patient could be hard of hearing, in pain, dealing with chronic conditions, or just flat out had bad experiences with providers. The other huge consideration could be the patient’s independence. The patient may feel hopeless or may have others making decisions for her and feels all she has left is her name and how dare someone take that. Elderly in general do not like to be told what to do or disrespected who would? I’ve personally had some patients that were resistant to everything just plan angry with life until they are allowed to make decisions and be apart of their care. These people are aging but they should be respected, and the best should still be provided no matter how difficult they are. Once these people see you care you can have a wonderful relationship it is rewarding for all parties.

After an assessment should be a discussion of how the patient is feeling, and what questions she has about the procedure. Everything should be explained slowly. Medications should always be approached by educating the patient but allowing the patient to understand and actively decide whether those medications are a choice the patient wants. This will require a further understanding of the patient’s beliefs as well as goals. The entire patient must be considered. I would get to know the patient and discuss alternative options as well as medications. Then if the patient agrees I would provide education in person as well as with hand outs since it can be a lot of information to remember, small amounts of info at a time is less overwhelming.

Reference:

Farris, C. (2015). The teach back method. Retrieved from https://www.nursingcenter.com/journalarticle?Article_ID=3126832

REPLY2

Alma Faulkenberger, an 85-year-old female outpatient who is seated in a waiting room awaiting an invasive pelvic procedure, has clearly become upset when the health care professional mis-pronounces her name several times. The health care professional further offends her be assuming that, due to her age and the fact that she did not answer to the mis-pronounced name, she must suffer from a hearing impairment. It is important in this instance to take extra care and consideration in ensuring that Alma is compliant with the procedure and post-treatment medications and receives effective patient education. This is necessary as frustrated patients can often become non-compliant, and Alma is clearly upset by the current situation. Furthermore, negative experiences within health care can impact a patient’s health outcomes as they may not seek medical assistance with necessary.

     According to the article How to Facilitate Better Patient Compliance, “several key factors are linked to non-compliance, including social and family relationships, experiences with the health care system and patient perceptions about illness and medication.” For this reason, considerations are necessary such as attempting to understand the patient’s perception of the situation. This includes acknowledging Alma’s feelings and addressing what has made her upset. This will address the issue at hand, thus, clarify any misunderstanding as well as change the negative tone of the encounter. A more positive tone will encourage compliance of the procedure.

     A patient-centered approach should be implemented in order to develop an effective plan of care. This must include patient education in order to ensure compliance with post-treatment medications. Patient-centered approaches in health care highlight the partnership which exists between the patient and the health care professional (Falvo, 2011). Furthermore, this approach ensures that the patient is fully involved in the decision-making process and obtains any information related to their health and wellness. By being fully involved in this process, patients better understand plans of care, as well as medications and treatments. Patient-centered approaches in health care result in compliance and positive patient outcomes. Ultimately, “adherence is a reflection of good communication and a relationship that is built on respect, active participation, and partnership between patient and health professional” (Falvo, 2011). Thus, by addressing what has upset Alma, and implementing a patient-centered approach giving Alma a sense of understanding and control of her health, this will ensure an overall positive outcome is achieved.

References:

Falvo, D. R. (2011). Effective Patient Education: A Guide to Increased Adherence. Retrieved from https://viewer.gcu.edu/RQBKXW

Rothenberg, G. (2003, June 03). How To Facilitate Better Patient Compliance. Retrieved fromhttps://www.podiatrytoday.com/article/1612

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

1. Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.

2. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.

3. Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.

4. Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.

5)  Describe one innovative health care delivery model that incorporates an interdisciplinary care delivery team. Explain how this model is advantageous to patient outcomes.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be from GCU library and 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.

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.

Main Post

Pharmacokinetics and Pharmacodynamics

As advanced practice nurses it is important that we understand pharmacokinetics and pharmacodynamics when caring for our patients. There are many factors to consider when prescribing medications because not one person is the same. Pharmacokinetics is the study of drug movement throughout the body, and has four basic processes: absorption, distribution, metabolism, and excretion (Rosenthal, 2021, p 13). Pharmacodynamics is the study of the biochemical and physiologic effects of drugs on the body and the molecular mechanisms by which those effects are produced (Rosenthal, 2021, p 22). In my experience I can not pinpoint one specific scenario in which pharmacokinetic and pharmacodynamic factors altered an anticipated response to a drug but multiple scenarios.

I can think of things to consider when prescribing medications like their medical history, medications they take, whether prescribed or over the counter, compliance, genetics, age, race, and family history. Other things to consider is the patients liver function and renal function, which affect the drugs absorption and excretion rate. One class of drugs that comes to mind are chemotherapy medications. Not everyone has the same outcome with chemotherapeutic agents when treating cancers. Another class of medications are psychotropic medications, some psych medications work better for others and do not work at all for some. And one of the most common ailments hypertension, antihypertensive drugs that work for some and not others. Immunosuppressed, CHF, renal failure, liver failure patients and patients with multiple ailments on multiple medications, all have to be prescribed medications carefully because of possible polypharmacy and drug interactions. A-fib patients prescribed coumadin needing their PT/INR checked to make sure their coumadin is therapeutic, educating them not to eat green leafy vegetables or drink grapefruit juice.

A patient’s genetics may play a role in whether the medication prescribed is going to work or not. It became evident in the 60’s that therapeutic doses of psychotropic medications vary markedly from person to person, with some patients failing to respond despite treatment with high dosages (Lerer, 2004, p158). Among many factors that may influence the drug response, hepatic function, and drug metabolism ae of great importance for nearly all medications used in psychiatry and even more importantly patient compliance with medication use (Lerer, 2004, p158). The CYP2D6 genetic polymorphism was discovered in late 1970’s and represents one of the most intensively studied monogenic variations in drug metabolism, approx. 7% of Caucasians are poor metabolizers of CYP2D6 substrates while the rest are considered as extensive metabolizers (Lerer, 2004, p160). CYP2D6 enzyme has particular significance for clinical psychiatry as it is involved in clearance of many psychotropic drugs such as tricyclic, antidepressants, selective serotonin reuptake inhibitors, classical antipsychotics, some atypical antipsychotics, drugs of abuse and codeine (Lerer, 2004, p160). In patients who rapid metabolize and have multiple copies of CYP2D6, conventional dose titration may cause delays in therapeutic response and lead to prolonged inpatient hospitalization. It is important to know our patient’s, do lab work according to the drugs being prescribed and refer our patients to specialty physicians if necessary.

                Another consideration is gender when prescribing medications. Research shows that women have different absorption due to lower gastric pH and longer gastrointestinal transit, lower P-glycoprotein expression, different body fat percentage than men, and that estrogen in women can affect drug metabolizing enzymes (Pierzchlinska, 2018, p 117). All of the topics discussed are why it is so important to develop an individualized care plan for each patient to provide the best care possible. The care plan should include goals of therapy, interventions, and follow up evaluation of treatment outcomes. Well rounded individualized treatment plans specific for each patient allow patients to establish trusting relationships with their providers.

Reference

Lerer, B. (2004). Pharmacogenetics of psychotropic drugs. (electronic source). Cambridge University Press.

Pierzchlinska, A., & Bialecka, M. (2018). An introduction to gender differences in neurological treatment. Aktualnosci Neurologiczne, 18(3), 117-122. https://doi-org.ezp.waldenulibrary.org/10.15557/AN.2018.0016

Rosenthal, L.D., & Burchum, J.R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier

Professional Leadership Communication and the Practice Scholar Guidelines

Instructions: Doctorate level paper. 5-7 pages. Double spacing, APA format. At least 6 references (must be within 5 years so between 2015/2020) 

Purpose

The purpose of this paper is to provide the student with the opportunity to explore and explain verbal, non-verbal, and written communication at the highest professional level. This assignment allows for the assimilation of professional leadership competencies as a doctorally prepared practice scholar. Assignment content supports professional formation, communication, and dissemination of skills relevant to the DNP practice scholar.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

-Differentiate attributes of effective leaders and followers in influencing healthcare. 

-Assimilate attributes for intra-/inter-professional collaboration across healthcare settings (

-Formulate selected strategies for leadership and influence across healthcare systems. 

Preparing the Assignment

Follow these guidelines when completing each component of this assignment. The assignment will include the following components within 5-7 pages (not including title page or reference page):

a. Title Page (Title matches the first-page title)

b. Use the following required Level 1 headings:

i. Verbal Communication Competencies and the Practice Scholar

ii. Non-verbal Communication Competencies and the Practice Scholar

iii. Written Communication Competencies and the Practice Scholar

iv. Conclusion

c. Introduction (Note: Do not use “Introduction” as a heading). Place the paper’s title on the first line.

i. In a brief paragraph, introduce your paper’s topic and establish its importance.

ii. Present a clear purpose statement and a mini-outline, in sentence format, of the paper. The best introductions outline the paper according to the major sections in the assignment guidelines (which are the required level 1 headings for the body of the paper).

d. Verbal Communication Competencies and the Practice Scholar

i. This section describes the leadership competency of verbal communication for the Doctor of Nursing Practice (DNP) practice scholar.

ii. Present your understanding of the components, comportment, and collaborative nature of effective and ineffective verbal communication as a leader.

e. Non-Verbal Communication Competencies and the Practice Scholar

i. This section describes the leadership competency of non-verbal communication for the DNP practice scholar.

ii. Present your understanding of the positive and negative behaviors of non-verbal communication as a leader and examples of each.

f. Written Communication Competencies and the Practice Scholar

i. This section describes the leadership competency of written communication for the DNP practice scholar.

ii. Include your understanding of (a) professional tone & style, (b) use of standard English, and (c) strategies for effective writing as a DNP leader in documents such as emails, memos, curricula vitarum, grant proposals, white papers, poster presentations, project dissemination manuscripts, and other formal written forms of professional leadership communication.

g. Conclusion

i. Recap the paper’s purpose statement and mini-outline criteria.

ii. Draw major conclusions from the body of your paper.

iii. Summarize the importance of effective communication competencies for the DNP leader.

h. Clarity of writing

ix. Use consistent standard English grammar and sentence structure is evident throughout the paper. The sentences and wording should be clear and concise, without slang, colloquialisms, street language, or conversational style.

x. Paper should be generally free of grammar, punctuation, spelling, and typographical errors.

xi. The paper should be organized and use the required Level I Headings headers and others as needed to organize the content.

a. APA Style and Organization

. Format as required in APA o (e.g., font, margins, title page, matching title on the 1st page, running head, level headings, reference pages, etc.).

i. Citations in the text must match the APA format 

ii. (Minimum 6 scholarly sources that match the reference)

iii. References must match APA examples Professional Papers.” (Minimum 6 scholarly sources, must be within 5 years)

Please review the substantive posting requirements posted in the forum and announcements: When you post responses to your peers the response needs to be “substantive” to receive credit. Substantive posting criteria includes: Acknowledge what your peer stated (agree or disagree). Include additional information. End the post with an open-ended follow up question. This is important to encourage further discussion.

Cite and reference the article in APA format for this assignment.

**Please include one question along with post for peer to answer****

Please answer the attached assignment and make sure you go through the rubric.

Need help please Follow the Rubric

Assessment 1

**** this assignment leads to assessment 2 and 3. Read directions carefully.
Rubric is attached. You must get distinguished score in all categories or revise it***

• Planning and Presenting a Care Coordination Project
• Develop a care coordination project plan for a population that is in need of care from multiple organizations. Then, develop 10–12 slides for use in presenting your plan to administrative decision makers.
  Note: Complete the assessments in the order in which they are presented. The assessments that follow will build upon the work you have completed in this first assessment.
  The role of professional nursing continues to expand and incorporate increasingly higher levels of expertise, specialization, autonomy, and accountability. This is particularly true in regard to the scope and challenges of providing coordinated care to members of various populations within a community. In addition, care coordination leaders must be confident in their abilities to navigate and lead change in their work environments.
  • Competency 1: Propose a project for change, for a community or population, within a care coordination setting. 
    • Articulate a vision of interagency coordinated care for a population.
  • Competency 2: Align care coordination resources with community health care needs. 
    • Determine the resource needs of a population.
  • Competency 3: Apply project management best practices to affect ethical practice and support positive health outcomes in the delivery of safe, culturally competent care in compliance with applicable regulatory requirements. 
    • Identify project milestones and outcome measures.
  • Competency 4: Identify ways in which the care coordinator leader supports collaboration between key stakeholders in the care coordination process. 
    • Identify the organizations and groups who must participate in caring for a population.
  • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards. 
    • Present a project plan to administrative decision makers.
    • Support main points, arguments, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.
  • us/article/Record-a-slide-show-with-narration-and-slide-timings-0b9502c6-5f6c-40ae-b1e7-e47d8741161c?ui=en-US&rs=en-001&ad=US 
    • A tutorial on recording slide narration and setting slide timing.
  • Writing Resources
    You are encouraged to explore the following writing resources. You can use them to improve your writing skills and as source materials for seeking answers to specific questions.
  • APA Module.
  • Academic Honesty & APA Style and Formatting.
  • APA Style Paper Tutorial [DOCX].
  • Capella Resources
  • Using Kaltura.
  • Disability Services.
  • Smarthinking.
  • ePortfolio. 
    • This resource provides information about ePortfolio, including how to use the different features of the product.
  • Additional Resources
    The following resources are books you may have used in your previous Care Coordination courses. You may find them helpful in providing background information for this course as well.
  • American Academy of Ambulatory Care Nursing. (2016). Scope and standards of practice for registered nurses in care coordination and transition management. Pitman, NJ: Author.
  • American Nurses Association. (2018). Care coordination: A blueprint for action for RNs. Silver Spring, MD: Author.
• Assessment Instructions
• ****Note:Your work in subsequent assessments will be based on the project plan you develop in this assessment. Therefore, complete the assessments in the order in which they are presented.
  Preparation
  For this assessment, you will assume the role of Care Coordinator Project Manager in your present organization or in an organization or setting you aspire to work in, are familiar with, or interested in. Within this context, you will develop a care coordination project plan for a population of your choice that is in need of care from multiple organizations.
  In this role, you must consider a comprehensive strategy to organize and coordinate care for the selected population on a local, state, national, or international level, depending upon the population. Your project plan will serve as a model for addressing the care coordination needs of another population, or of an entire community, in Assessments 2 and 3.
  After completing your project plan, you will then develop a presentation of your plan to gain the support of administrative decision makers in the organization.

  *******Use the speaker’s notes section of each slide to develop your talking points and cite your sources, as appropriate. If you need help designing your presentation, you are encouraged to review the presentation resources provided for this assessment. These resources will help you to design an effective presentation, whether you choose to use PowerPoint or other presentation software.

  • For this assessment:
    1. Develop a care coordination project plan for a population of your choice. For example:
  • Children or the elderly.
  • Chronic care patients.
  • Patients with disabilities.
  • End-of-life care patients.
  • Special needs patients.
  • Inner city or rural area residents.
• • 2. Develop a presentation of your plan for administrative decision makers in the organization to obtain their support.
    Note:Choose any population you are familiar with and interested in addressing. However, you will have an option to address the care coordination needs of an undocumented immigrant or refugee population in the next assessment, so donotchoose this population for this assessment.
    In addition to the requirements outlined below for developing and presenting your project plan, you are encouraged to include whatever additional information is appropriate for the specific population for whom you have chosen to provide a care plan.
    Project Plan and Presentation Format and Length
    You may use either Microsoft Word or Excel to format your project plan.
  • For Word documents, use theAPA Style Paper Template [DOCX]. An APA Style Paper Tutorial is also provided (linked in the Resources) to help you write and format your project plan. There is no required page length but be sure to include: 
    • A title page and references page. An abstract is not required.
    • A running head on all pages.
    • Appropriate section headings.
  • For Excel spreadsheets, be sure to include properly formatted citations and references.
  • At a minimum, your presentation must include the following slides:
  • Title.
  • Purpose (the reasons for your presentation).
  • References (at the end of your presentation).
  • Your slide deck should consist of 10–12 slides, not including the title, purpose, and references slides.
    Supporting Evidence
    Cite 5–7 sources of scholarly or professional evidence to support your project plan.
    Developing and Presenting Your Project Plan
  • speaker notes
    Note:The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that, at a minimum, you address each criterion. You may also want to read the Planning and Presenting a Care Coordination Project scoring guide to better understand how each criterion will be assessed.
  • Articulate your vision of interagency coordinated care for this population.
    • Consider how you would organize and consolidate care for this population.
    • What assumptions underlie your vision?
  • Identify the organizations and groups who must participate in caring for this population.
    • Consider coordinated care on a local, state, national, or international level, as applicable.
    • Identify the team members who will comprise your interprofessional care coordination team.
  • Determine the resource needs of this population.
    • Operational and capital budgeting needs, including:
      • General supplies.
      • Staffing.
      • Capital purchases.
    • Costs: Estimated funds.
    • Assumptions.
  • Identify project milestones and outcome measures. 
    • Determine the key steps in attaining your goals for this project.
    • Determine timeframes for each milestone.
    • Identify outcome measures for your project.
  • Present your project plan to administrative decision makers. 
    • Be clear and focused about the why this care coordination project plan is important to successfully support this population.
    • Address the anticipated needs and concerns of your audience.
    • What questions or alternative points of view might you expect? How will you respond?
    • Express your main points, arguments, and conclusions coherently.
    • Proofread your slides to minimize errors that could distract the audience and make it more difficult to focus on the substance of your presentation.
  • Support main points, arguments, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style. 
    • Is your supporting evidence clear and explicit?
    • How or why does particular evidence support a claim?
      • Will your audience see the connection?
  • Additional Requirements
    Be sure that you have used the APA Style Paper Template [DOCX]to format your project plan and that your document includes:
  • A title page and references page.
  • A running head on all pages.
  • Appropriate section headings.
  • In addition, be sure that:
  • Your slide deck consists of approximately 10–12 slides, not including the title, purpose, and references slide.
  • You have cited 5–7 sources of relevant and credible scholarly or professional evidence to support your project plan.
  • Portfolio Prompt:You may choose to save your project plan and presentation to your ePortfolio.