2025 These are two discussion questions DQ 1 and DQ 2 posts must be at least 150 words and have

Topic 8 DQ 1 and DQ 2 2025

These are two discussion questions DQ 1 and DQ 2 posts must be at least 150 words and have at least one reference cited for each question. In-text citation, please Tutor MUST have a good command of the English language Sources need to be journal/scholarly articles. Use only articles that are published between 2015-2019 (except for your theory articles which will be older as you must cite primary sources). No textbook or direct quotes Please separate the two DQ with their reference page My project is CLABSI prevention DQ 1 How is ethical behavior an integral part of the doctorally prepared advanced practice nurse’s role? Why is the doctorally prepared advanced practice nurse considered a role model? How does one display the characteristics of a role model? Does a doctorally prepared advanced practice nurse have a legitimate right and/or ethical foundation to interject their ideas into business practice? DQ 2 Locate the “Comprehensive Assessment Part One: Competency Matrix” assignment in this topic and identify any competency “blank spaces” that were left unmet by either programmatic or course-based assignment completion thus far. Also locate the instructor feedback notes you made while completing the matrix regarding both programmatic and course-based assignments to date. What program competencies were left unmet in your matrix? What content areas do you need to address and strengthen based on instructor feedback? Develop and post an action plan to address these two areas as you move forward into the practicum stage of the program.

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2025 Case Study Chapter 11 Health Care of the Older Adult 1 The nurse

case study 11 2025

Case Study, Chapter 11, Health Care of the Older Adult 1. The nurse working at the senior center notices Mrs. Jones, a 78-year-old, crying. The nurse approaches Mrs. Jones and asks if she needs help. Mrs. Jones states “I am so embarrassed. I had another accident and my pants are all wet. It’s like I’m a baby. I never should have come to the senior center.” What factors may be contributing to the urinary incontinence? How should the nurse respond to Mrs. Jones? 2. The nurse is completing the admission assessment for a patient scheduled for cataract surgery in the outpatient center. Because the patient is over the age of 70 and has several chronic conditions, including hypertension and congestive heart failure, the nurse focuses on completing a thorough medication history. What questions should the nurse include in the medication history? The patient states that she stopped taking one of her medications due to cost, since her health insurance would not reimburse for the medication. What are other reasons that older adults may be noncompliant with ordered medications? How does aging affect drug absorption, metabolism, distribution, and excretion?

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2025 For your Assignment your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources

Assignment: Decision Tree for Neurological and Musculoskeletal Disorders 2025

For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders To Prepare Review the interactive media piece assigned by your Instructor. Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece. Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned. You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment. Interactive media piece: Alzheimer’s Disease Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal. According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation. SUBJECTIVE During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so you perform a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia. MENTAL STATUS EXAM Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive) RESOURCES § Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources. Assignment: Write a 1- to 2-page summary paper that addresses the following: Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources. What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources. Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

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2025 To Prepare Review the Resources and consider the importance of critically appraising research evidence Reflect on the four peer reviewed

Evidence-Based Project, Part 4: Critical Appraisal of Research 2025

To Prepare: Review the Resources and consider the importance of critically appraising research evidence. Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3. Review and download the Critical Appraisal Tools document provided in the Resources. The Assignment (Evidence-Based Project) Part 4A: Critical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tools document. Be sure to include: An evaluation table A levels of evidence table An outcomes synthesis table Part 4B: Critical Appraisal of Research Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

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2025 Submit your Synthesis Paper using this assignment portal Please note in the instructions this paper should have no

Synthesis Paper 2025

Submit your Synthesis Paper using this assignment portal. Please note in the instructions, this paper should have no more than 4 pages of content. Coaches will stop grading after the fourth page of content, so please be sure to be concise in your writing. See the Synthesis Paper Assignment Instructions for details. Due by 2359 on Saturday of Module 7.

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2025 Benchmark Part B Literature Review In Part A you described the population and quality initiative related to your

Benchmark – Part B: Literature Review 2025

Benchmark – Part B: Literature Review In Part A, you described the population and quality initiative related to your PICOT ( P opulation/ P roblem, I ntervention, C omparison, O utcome, and T ime to achieve the outcome) statement. In this assignment, you will formalize your PICOT and research process. Use the GCU Library to perform a search for peer-reviewed research articles. Find five peer-reviewed primary source translational research articles. In a paper of 1,250-1,500 words, synthesize the research into a literature review. The literature review should provide an overview for the reader that illustrates the research related to your particular PICOT. Include the following: Introduction: Describe the clinical issue or problem you are addressing. Methods: Describe the criteria you used in choosing your articles Synthesize the Literature: Part A: Discuss the main components of each article (subjects, methods, key findings) and provide rationale for how this supports your PICOT; Part B: Compare and contrast the articles: Discuss limitations, controversies, and similarities/differences of the studies. Areas of Further Study: Analyze the evidence presented in your articles to identify what is known, unknown, and requires further study. You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. 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. Please refer to the directions in the Student Success Center.

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2025 A uncooperative client is placed in restraints after lesser restrictive measures were attempted

mental health 2025

A uncooperative client is placed in restraints after lesser restrictive measures were attempted. To address basic needs of the client, what should the nurse offer the client regularly? What is nursing care for the client with acute mania related to bipolar disorder?Suggested Mental Health Learning Activity: Personality Disorders ​A client has an alcohol use disorder. Name a referral that would be appropriate.

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2025 Benchmark Capstone Change Project Objectives In 250 words review your problem or issue and the cultural

PICOT QUESTION PAPER AND Benchmark – Capstone Change Project Objectives 2025

Benchmark – Capstone  Change Project Objectives In 250 words review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale. After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. PICOT Question Paper Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process. Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem. The PICOT question will provide a framework for your capstone project change proposal. In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome. Describe the problem in the PICOT question as it relates to the following: 1. Evidence-based solution 2. Nursing intervention 3. Patient care 4. Health care agency 5. 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.

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2025 If you were to ask 10 people what they believe to be

Review of Current Healthcare Issues 2025

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption? These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed. In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue. To Prepare: Review the Resources and select one current national healthcare issue/stressor to focus on. Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting. By Day 3 of Week 1 Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples. By Day 6 of Week 1 Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor. Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message. Will be adding two discussions that will need at least three references all in APA 7 format each. will be included in this payment. The mail discussion will need at least 3 references and also in APA 7 format Adams Discussion Current Healthcare Issue National Healthcare Stressor The last decade in healthcare has been volatile at best with the adoption of the Affordable Care Act (ACA) and performance-based payment systems, the ever-increasing polar divide between our political party’s healthcare theories and the never ending back and forth political discord that threatens to blow it all up and start over with something better, but never explained in detail. One of the constants that I continue to see is the increase in psychiatric patients coming into the hospital that I work. A number of these patients are undiagnosed with a psychiatric diagnosis or cannot find a provider that is seeing new patients. Many providers that are seeing new patients currently have wait times four weeks out. Someone that is experiencing psychiatric symptoms this wait could have a derailing effect on the efficacy of the treatment. The number of patients needing psychiatric treatment in the United States is increasing and roughly one-third of the 10 million Americans are diagnosed with a psychiatric disorder but not getting treatment. (Olfson, 2016) One of the reasons for this is the lack of providers in the psychiatric specialty. With reimbursement rates falling lower than many other specialty services many institutions are struggling to cover salaries. With more than 60% of current providers aged 55 years or greater, this is also adding to the decreasing numbers. Another factor, is the increase in acceptability in discussing mental health issues and seeking out treatment. According to Weiner, (2018), with more patients seeking treatment, current providers are unable to increase their treatment numbers. Impact on work setting The institution that I work at is a safety net hospital that provides medical and social care to a population where 70% live at or below the poverty line. Many of these patients have undiagnosed or unmanaged psychiatric disorders that provide harm and are a detriment to their medical issues such as diabetes, cardiac issues and COPD. Working nights, I am accustomed to doing more with less. One of the challenges that I face constantly is the lack of psychiatric evaluations once a patient leaves the emergency department. Medical teams are forced to make psychiatric pharmaceutical decisions off the cuff until 7 AM when the psychiatric team rounds on a particular patient. This is particularly difficult on patients and staff alike. Respondence to the issue To create a discussion on this our staff used our unit council to speak to the Director of Critical Care, Nursing and Medicine, inviting the Psychiatric department to our monthly unit council meeting in hopes to better understand why this was not a priority as well as speaking to the Vice President of Nursing and the Medical Director about the importance of psychiatric services outside the emergency room on a 24 hour basis. After years of voicing concerns to upper Medicine and Nursing Management our institution increased inpatient psychiatric coverage to 24 hours per day. Patients in need of psychiatric evaluations who have made in past the emergency room have an opportunity to be treated when they arrive on our unit. Our ICU team now has a partner when questioning what type of medication to give an irate patient who is a danger to himself or others. This intervention exemplifies the use of the quadruple aim approach with its increase in global health, improving patient experience, lowering costs and improving work-life for our staff. (Jacobs et al., 2018) References: Jacobs, B., Heinmiller, J., McGovern, J., & Drenkard, K. (2018). Engaging Employees in Well-Being: Moving From the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly , 42 (3). https://doi.org/10.1097/NAQ.0000000000000303 Olfson, M. (2016). Building The Mental Health Workforce Capacity Needed To Treat Adults With Serious Mental Illnesses. Health Affairs , 35 (6), 983–990. https://doi.org/10.1377/hlthaff.2015.1619 Weiner, S. (2018, February 12). Addressing the escalating psychiatrist shortage . AAMC. https://www.aamc.org/news-insights/addressing-escalating-psychiatrist-shortage. Rebeccas Discussion Review of Current Healthcare Issues National Healthcare Issue/Stressor Healthy People is a set of strategic goals released by the U. S. Department of Health and Human Services designed to measure progress toward specific health objectives aimed at enabling people to live long and healthy lives. Healthy People 2020 is the fourth Healthy People initiative released. It includes the goal of improving mental health through prevention and by ensuring access to appropriate, quality mental health services (Healthy People, 2020). Mental health disorders such as anxiety, depression, and substance abuse are increasing in prevalence and most cases of mental illness occur earlier in life. The disease burden and costs associated with untreated or under-treated mental health disorders are rapidly increasing. Mental health disorders are a common cause of disability and suicide is the 10th leading cause of death in the U.S. In addition, our country will see a heavier mental health burden due to the COVID-19 pandemic (Stephenson, 2020). Therefore, it is crucial to include mental health objectives in the Healthy People goals, to measure our progress, and to recognize the importance of meeting these goals. Impact on Work Setting Currently, I work for a large health insurance company where I conduct medical necessity reviews of behavioral health treatment modalities to include both inpatient and outpatient care. Our company has seen sharp increases in the need for behavioral health treatment to include inpatient mental health stays, inpatient detox stays, partial hospital stays, and intensive outpatient therapy. More behavioral health clinicians had to be brought on and trained to meet this current demand. Another impact to my work setting involves the fact that poor mental health has negative impacts on physical health. Untreated mental illness can lead to chronic diseases which drive up the cost of health care. Active treatment of mental health issues, as opposed to prevention and early intervention, is more costly. Responding to the issue Our company firmly believes in quality, cost-effective care and awards facilities that meet these milestones. We continuously assess and update our guidelines and coverage policies to reflect this. The company recognizes that mental health treatment is not a one-size-fits-all approach. Recently we changed guidelines for reviewing substance abuse treatment to the American Society of Addiction Medicine (ASAM) guidelines. This approach looks at the whole patient by assessing 6 dimensions that consider a person’s needs and severity of illness to help develop a treatment plan. The premise is that patients can be assigned to treatments that “yield the best outcomes in the least restrictive and costly settings” (Stallvik et al., para 8). By reviewing against these guidelines, we are ensuring that patients get the appropriate treatment at the appropriate time. The company has been educating staff on current behavioral health trends, new treatments, and the impact of the COVID pandemic. We have an active behavioral health case management team that reaches out to patients before, during, and after treatment to ensure they are set up with the necessary follow up. We encourage and assist patients with finding primary care providers. Park et al. (2018) state that primary care produces a higher quality of care, improves access and outcomes, and lowers cost. Additionally, one of our nurse leaders recently posted an informative series about the social determinants of health and the importance of helping our patients overcome barriers so they can achieve their best physical and mental health. An organization needs effective leaders like this who can bring these issues to the forefront and encourage others to become active participants in the change process (Broome & Marshall, 2021). The company’s website includes links to many resources such as food pantries, ride- sharing, and mental health services. By making this information readily available, we are making efforts to increase prevention and early intervention. As a whole, I believe the company has responded well to the national healthcare issue of mental illness and I feel confident that we will continue to look for ways to improve patient access and patient outcomes. References Broome, M., & Marshall, E.S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer. Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2020: Mental health and mental disorders. Retrieved November 28, 2020 from https://www.healthypeople.gov/2020/topics-objectives/topic/mental-health-and-mental-disorders Park, B., Gold, S.B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. Journal of the American Board of Family Medicine, 31 (4), 588-604. Stallvik, M., Gastfriend, D.R., & Nordahl, H. M. (2015). Matching patients with substance use disorder to optimal level of care with the ASAM Criteria software. Journal of Substance Use , 20 (6), 389-398. https://doi.org.ezp.waldenulibrary.org/10.3109/14659891.2014.934305 Stephenson, J. (2020). CDC report reveals “considerably elevated” mental health toll from COVID-19 stresses. Retrieved November 29, 2020 from https://jamanetwork.com/channels/health-forum/fullarticle/2770050

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2025 The collection of evidence is an activity that occurs with an endgame in mind For example law enforcement

Assignment: Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change 2025

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes. In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach. To Prepare: Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT. Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection. Consider the best method of disseminating the results of your presentation to an audience. The Assignment: (Evidence-Based Project) Part 4: Recommending an Evidence-Based Practice Change Create an 9-slide narrated PowerPoint presentation in which you do the following: Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.) Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered. Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy. Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking. Add a lessons learned section that includes the following: A summary of the critical appraisal of the peer-reviewed articles you previously submitted An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides) By Day 7 of Week 10 Submit Part 4 of your Evidence-Based Project.

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