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Discussion: Sleep/Wake Disorders order code 0070004002019BB

Subject Area

Coursework

task (TSE) A new Task-

No.of pages/Wordcount

2 page

Urgency 6 to 12 hours. 

Citation Style

APA Style

Assignment Details

Discussion: Sleep/Wake Disorders
It is not uncommon to experience a night or two of disrupted sleep when there is something major going on in your life. However, sleep/wake disorders are much more than an occasional night of disrupted sleep. A recent report from the Centers for Disease Control and Prevention estimated that between 50 and 70 million American have problems with sleep/wake disorders (CDC, 2015). Although the vast majority of Americans will visit their primary care provider for treatment of these disorders, many providers will refer patients for further evaluation. For this Discussion, you consider how you might assess and treat the individuals based on the provided client factors.

Learning Objectives
Students will:
Assess client factors and history to develop personalized therapy plans for clients with sleep/wake disorders
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for sleep/wake disorders
Evaluate efficacy of treatment plans for clients presenting for sleep/wake therapy
Apply knowledge of providing care to adult and geriatric clients presenting for sleep/wake disorders
Learning Resources
Note: To access this week’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
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

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

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 11, “Disorders of Sleep and Wakefulness and Their Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

For insomnia

alprazolam
amitriptyline
amoxapine
clomipramine
clonazepam
desipramine
diazepam
doxepin
flunitrazepam
flurazepam
hydroxyzine
imipramine
lorazepam
nortriptyline
ramelteon
temazepam
trazodone
triazolam
trimipramine
zaleplon
zolpidem

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: Retrieved from Walden Library databases.

Davidson, J. (2016). Pharmacotherapy of post-traumatic stress disorder: Going beyond the guidelines. British Journal of Psychiatry, 2(6), e16-e18. doi:10.1192/bjpo.bp.116.003707. Retrieved from http://bjpo.rcpsych.org/content/2/6/e16

To prepare for this Discussion:

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.

Case 1: Volume 2, Case #16: The woman who liked late-night TV

Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady

Case 3: Volume 1, Case #5: The sleepy woman with anxiety

Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

By Day 3
Post a response to the following:

Provide the case number in the subject line of the Discussion.
List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.
List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s sleep/wake therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.
Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.
Read a selection of your colleagues’ responses.

  

Assignment: Practicum Experience

As your practicum proceeds, consider the topics addressed this week. Conduct research to further your understanding of how issues related to health information systems and other resources, such as financials, staffing, and materials, could influence the implementation of your proposed change.

In addition, you reflect on the effectiveness of your practicum experiences for fostering your professional development. What challenges are you encountering, or would you anticipate at this point? If necessary, what can be done to improve the situation?

To prepare:

• Reflect on the learning objectives and      activities you developed for your practicum experience during Week 1 (See      attached file). Also, consider the leadership competencies introduced in      Weeks 2 and 3.
• What new skills or insights have you      gained thus far in your practicum experience? How do you think this is      impacting your leadership development and the planning of your proposed      change? What adjustments might need to be made to your leadership presence      within the practicum environment—or your plan for change? What additional      supports would you find most beneficial right now?

To complete: By tomorrow 4/10/19 6mpm, write a minimum of 550 words essay in APA format with at least 3 scholarly references. Include the level one headers as numbered below:

1) What new skills or insights have you gained through your practicum experiences? 

2) How is this impacting your leadership development and planning related to your proposed change? 

3) What additional supports would be beneficial?

Required Readings

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). Translation of evidence into nursing and health care practice (2nd ed.). New York, NY: Springer.

· Review Chapter 6, “Translation of Evidence for Leadership”

This chapter addresses the pivotal role of leadership in the translation of evidence into practice.

American Association of Colleges of Nursing (AACN). (2006). The essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf

Use the information in this report to guide the formulation of goals for your practicum experience.

Kotter, J. P. (2007). Leading change: Why transformation efforts fail. Harvard Business Review, 85(1), 96-103. Retrieved from https://cb.hbsp.harvard.edu/cbmp/pl/57319806/57319860/3d20a24aeeedc7a83d2a918c5013078c

In this foundational reading, Dr. John Kotter discusses errors commonly made as organizations undergo change, and he recommends steps leaders can take to help avoid them.

Murphy, M. P., Staffileno, B. A., & Carlson, E. (2015). Original Article: Collaboration Among DNP- and PhD-Prepared Nurses: Opportunity to Drive Positive Change. Journal of Professional Nursing,31388-394. doi:10.1016/j.profnurs.2015.03.001

Nelson-Brantley, H. V., & Ford, D. J. (2017). Leading change: a concept analysis. Journal Of Advanced Nursing, 73(4), 834-846. doi:10.1111/jan.13223

Salmela, S., Eriksson, K., & Fagerström, L. (2012). Leading change: a three-dimensional model of nurse leaders’ main tasks and roles during a change process. Journal of Advanced Nursing, 68(2), 423-433. doi:10.1111/j.1365-2648.2011.05802.x

Sherrod, B., & Goda, T. (2016). DNP-Prepared leaders guide healthcare system change. Nursing Management, (9). 13.

Optional Resources

Osters, S., & Tiu, F. S. (n.d.). Writing measurable learning outcomes. Retrieved from http://www.gavilan.edu/research/spd/Writing-Measurable-Learning-Outcomes.pdf

Kotter International. (2017). Kotter International. Retrieved from http://www.kotterinternational.com/ 

National Center for Healthcare Leadership. (2017). NCHL Health Leadership Competency ModelTM.Retrieved from http://www.nchl.org/static.asp?path=2852,3238

  

Designing and Measuring Outcomes

As noted in previous courses of the DNP program, it is essential to design measurable outcomes that can guide the development, implementation, and evaluation of an initiative. For this Discussion, you are asked to examine professional standards and other factors that require consideration as you develop outcomes for your proposed evidence-based change. Think about the various groups that are invested in—or that may be affected by—this change. What measures would stakeholders need in order to help determine if the change aligns with organizational priorities and is successful in achieving its intended outcomes? Why is it important to establish accountability around this initiative?

To prepare:

• Look at outcomes established for at least one      evidence-based change currently underway or previously accomplished within      your practicum setting. What lessons can be learned to support the      development of outcomes for your proposed change?
• What outcomes would you identify for your proposed      change? How are these tied to AACN Essentials? What other standards or      guidelines should be considered? What interdisciplinary factors need to be      considered as you craft these outcomes? Think about other clinical and      administrative groups, as well as patients.
• How will the outcomes be measured?
• Be prepared to support your Discussion postings with      evidence from the literature and specific examples related to your      practicum setting.

By Day 3 of Week 8

Post a cohesive response that addresses the following:

By tomorrow Wednesday 4/17/19  2pm (America/New York time), write a minimum of 550 words essay in APA format with at least 3 references (see list or required readings below). Include the level one headers as numbered below:

1) Describe three outcomes for your proposed change. For each outcome, describe the evaluation criterion/criteria that is/are measurable.

2) Explain how these outcomes relate to multiple sets of standards, as well as differing groups’ needs and priorities. Why is intra- and interdisciplinary collaboration important as you design these outcomes?

3) How do the measurable outcomes for your proposed change establish accountability for you as a leader?

Required Readings

White, K. M., & Dudley-Brown, S.(2016). Translation of evidence into nursing and health care practice. (2nd edition)  New York, NY: Springer Publishing Company.

• Review Chapter 14, “Creating a Culture that Promotes      Translation”

Kutney-Lee, A., Germack, H., Hatfield, L., Kelly, S., Maguire, P., Dierkes, A., & … Aiken, L. H. (2016). Nurse Engagement in Shared Governance and Patient and Nurse Outcomes. Journal Of Nursing Administration, 46(11), 605-612. doi:10.1097/NNA.0000000000000412

Sung-Heui, B. (2016). CNE SERIES. The Centers for Medicare & Medicaid Services Reimbursement Policy and Nursing-Sensitive Adverse Patient Outcomes. Nursing Economic$, 34(4), 161-181. 

Twigg, D. E., Gelder, L., & Myers, H. (2015). The impact of understaffed shifts on nurse-sensitive outcomes. Journal Of Advanced Nursing, 71(7), 1564-1572. doi:10.1111/jan.12616

Yankovsky, A., Gajewski, B. J., & Dunton, N. (2016). Trends in Nursing Care Efficiency From 2007 to 2011 on Acute Nursing Units. Nursing Economic$, 34(6), 266-276.

 

Organizations rely on financial statements to carry out important business decisions. The statements are typically compiled into a cohesive document, which allow managers to evaluate, based on various financial analysis methods. This process involves a comparison of ratio outcomes from the financial statements. Collectively, the ratios are used to execute financial analysis of business operations, to assess profitability and viability. This portion of the project requires you to apply financial analysis methods, choose the best method to evaluate financial outcomes for your case, and explain why this method should be used over other methods.

Submit a minimum 2-page report that:

• Defines and describes various financial analysis methods, such as vertical and horizontal analysis.
• Explains how and why each method would be used in an organization’s financial review process.
• Compares the similarities and differences among the methods.
• Using the financial statements for your case, examine how at least one of the methods can be used.
  • Support your position with the actual ratio outcome(s).
  • Explain WHY this method should be used over the others, based on case financial challenges.

 

Using the ‘Week 4 | Part 4’ section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:

• The topic of interest you have selected
• Correctly formatted APA citation of the article you selected, along with link or search details
• Identify a professional practice use of the theories/concepts presented in the article.
• Analysis of the article using the Research Analysis Matrix section of the template
• Write a 1-paragraph justification explaining whether or not you would recommend the use of this article to inform professional practice
• Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:
  • Describe your approach to identifying and analyzing peer-reviewed research
  • Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research
  • Identify at least one resource you intend to use in the future to find peer-reviewed research