Please answer the following question in your initial post:

Describe how you apply the first step (assessment) of the nursing process in your current practice setting. If you are not currently practicing as an RN, you may use an example from a prior clinical or work experience. Include the following information:

• Briefly describe your practice setting and the typical patient population.
• Provide examples of key subjective and objective data points you collect.
• Describe how you document your findings. Is there technology involved?
• Describe your process of data analysis. What is the end result of this process? (i.e., Do you formulate nursing diagnoses and care plans, collaborate with others and/or make referrals?)

Remember to use and credit the textbook or lesson, as well as an outside scholarly source, for full credit.

Assignment Details

Translating Evidence into Clinical Practice

Choose one evidence-based practice that you see yourself using as a provider in your clinical practice and discuss how it meets the listed benefits.

Why should we, as healthcare providers, use evidence-based practice?

Evidence-based practice benefits:

• Leads to highest quality care and patient outcomes
• Reduces health care costs
• Reduces geographic variations in the delivery of care
• Increases healthcareprovider empowerment and role satisfaction
• Reduces healthcare provider turnover rate
• Increases reimbursement from 3rd party payers
• Reduces complications and payment denials
• Meets the expectation of an informed public

Include 3 evidence-based articles to support your work that are less than 3 years old.

Before finalizing your work, you should:

• be sure to read the Assignment description carefully (as displayed above);
• consult the Grading Rubric (under the Course Home) to make sure you have included everything necessary; and
• utilize spelling and grammar check to minimize errors.

Your writingAssignment should:

• follow the conventions of Standard English (correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style; and
• use APA 6th Edition format as outlined in the APA Progression Ladder.

  

ASSIGNMENT.

1. To complete the strategic plan on Mayo Clinic, select the methods you will use to evaluate how your strategic goal is being met. Include specific metrics that will be used to evaluate the success of the implementation of the plan. What types of controls will you use? Provide your response in 400 words.

2. Effective oral communication is essential in the business setting, especially when it comes to achieving buy-in for significant, complex, or costly change. Create a 400 words presentation of the strategic plan for your manager or director or other essential stakeholders whose approval you would require. Be sure to address the “why” and “how” for your strategic plan in the presentation, providing all the necessary details your audience needs to make an informed decision.

Minimum of 300 words with two or more peer review reference

 

Identify the process of rational drug prescribing. Pick a condition and determine what steps you would complete specific to this condition to properly prescribe, manage, regulate, and educate the pharmaceutical need for your patient. What process would you institute in your future practice to ensure rational prescribing with new evidence-based practice guidelines?

 Write a brief Conclusion why you made these decisions and what will be the objective of obtaining an improvement in the condition of this patient .

  

Decision 1

The PMHNP will administer 10 mg of zyprexa orally at bed time and initiate 230mg of invega sustenna through intramuscular, in addition to 156 mg via the same route on day four. A similar dose will be administered within one months’ time. In addition the PMHNP will administer 10mg of Abfility orally at bed time. Expected outcome for this decision is a 25% decrease in the PANSS score (Stahl, 2013). This decision is also expected to alleviate the patient’s psychotic symptoms and achieve normalcy within one month. A slight weight gain is also expected as the drugs are known to increase weight in patients. Because I don’t select the other decisions, the patient is expected to have faster and noticeable changes in psychotic behavior within two weeks of treatment commencement. 

Decision 2

At this point the PMHNP will decide to continue with use of medications selected in decision 1 (Stahl, 2013). However the PMHNP will instruct the administering nurse to begin intramuscular injections of 300mg of Abfility and continue with 10 mg of the same drug in the morning. At this point, PANSS is expected to decrease by 50 % although the patient will also have noticeable weight gain due to use of invega sustenna (Stahl 2014). Because I don’t select other decisions, the patient is expected to have less cardiovascular drug toxicities and experience reduced risks for adverse drug reactions between Invega sustenna and Haldol Deaconoate. 

Decision 3

The decision at this point is to have the patient continue with Invega Sustenna and provide psychological counseling on the effects of the drugs associated with weight gain. It will be essential to explain to the patient that the weight gain from this drug is minimal in comparison with other drugs (Stahl, 2013). The PMHNP will set an appointment follow up date with the patient after one month duration and refer to the nutritionist and physical activity instructor. The difference between expected outcome in decision 3 and results of the decision is Abfility may not be efficacious for more than a period of 6 months given that it does not bind to D 2 receptors in a similar manner as Invega Sustenna. This will necessitate the PMHNP to change to Abfility Maintena because it is easily tolerated by patients on Abfility. 

Because I don’t select the other decisions, the patent will be able to utilize the same drug for the longest possible duration and optimize on their efficacy prior to switching to other types of medication (Stahl, 2013). Since the patient may not have the mental capacity to participate in the decision making process or make autonomous mental health decisions, it is essential to discuss treatment options with the spouse and explain the importance of adherence to treatment (Stein & Giordano, 2015). In addition, the mental health nurse is required to make those decisions which will benefit the patient and also outweigh the risk for adverse health outcomes. 

References

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Stahl, S. M. (2014). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Stein, D. J., & Giordano, J. (2015). Global mental health and neuroethics. BMC Medicine, 13(1), 44.  

Schizophrenia Treatment

Decision 1

The PMHNP will administer 10 mg of zyprexa orally at bed time and initiate 230mg of invega sustenna through intramuscular, in addition to 156 mg via the same route on day four. A similar dose will be administered within one months’ time. In addition the PMHNP will administer 10mg of Abfility orally at bed time. Expected outcome for this decision is a 25% decrease in the PANSS score (Stahl, 2013). This decision is also expected to alleviate the patient’s psychotic symptoms and achieve normalcy within one month. A slight weight gain is also expected as the drugs are known to increase weight in patients. Because I don’t select the other decisions, the patient is expected to have faster and noticeable changes in psychotic behavior within two weeks of treatment commencement. 

Decision 2

At this point the PMHNP will decide to continue with use of medications selected in decision 1 (Stahl, 2013). However the PMHNP will instruct the administering nurse to begin intramuscular injections of 300mg of Abfility and continue with 10 mg of the same drug in the morning. At this point, PANSS is expected to decrease by 50 % although the patient will also have noticeable weight gain due to use of invega sustenna (Stahl 2014). Because I don’t select other decisions, the patient is expected to have less cardiovascular drug toxicities and experience reduced risks for adverse drug reactions between Invega sustenna and Haldol Deaconoate. 

Decision 3

The decision at this point is to have the patient continue with Invega Sustenna and provide psychological counseling on the effects of the drugs associated with weight gain. It will be essential to explain to the patient that the weight gain from this drug is minimal in comparison with other drugs (Stahl, 2013). The PMHNP will set an appointment follow up date with the patient after one month duration and refer to the nutritionist and physical activity instructor. The difference between expected outcome in decision 3 and results of the decision is Abfility may not be efficacious for more than a period of 6 months given that it does not bind to D 2 receptors in a similar manner as Invega Sustenna. This will necessitate the PMHNP to change to Abfility Maintena because it is easily tolerated by patients on Abfility. 

Because I don’t select the other decisions, the patent will be able to utilize the same drug for the longest possible duration and optimize on their efficacy prior to switching to other types of medication (Stahl, 2013). Since the patient may not have the mental capacity to participate in the decision making process or make autonomous mental health decisions, it is essential to discuss treatment options with the spouse and explain the importance of adherence to treatment (Stein & Giordano, 2015). In addition, the mental health nurse is required to make those decisions which will benefit the patient and also outweigh the risk for adverse health outcomes. 

References

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Stahl, S. M. (2014). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Stein, D. J., & Giordano, J. (2015). Global mental health and neuroethics. BMC Medicine, 13(1), 44.