In this assignment, you will have the opportunity to review a reliable and valid process for reviewing and evaluating professional practice standards, The framework is the Appraisal of Guidelines for Research and Evaluation (AGREE Tool II).

1. Access the links provided for the AGREE process for evaluating professional practice guidelines. Explore the websites provided: AGREE Information and Resources and UpToDate Database. Review this document to provide background information for you.

2. Review the assessment tool (link provided). AGREE Assessment Tool. 

Note: the tool you will use to evaluate the required guideline is the AGREE II Tool. Once you access the document in the link, the tool is all the way at the bottom of the document Entitled: AGREE Tool II. You may need to reproduce the tool in a MS Word document or you may develop each domain in a narrative format but be sure to score each domain per the tool. 

3. Access the assessment form via the link provided. Use the tool to evaluate the practice guideline selected. 2013 ACCF/AHA Guideline for the Management of Heart Failure

4. As the AGREE tool is used, it is evident that the guidelines are evidence-based and the evidence to support the guideline is leveled using letters to identify strength of evidence.  Level of evidence guide to accompany AGREE Tool. 

Just review this document for your information. It is important to know professional guidelines are to be based on current evidence. 

5. Complete each portion of the assessment thoroughly, providing a score on the Likert scale and providing details in the comments section.

6. Once the AGREE assessment has been completed, develop an introductory paragraph discussing the purpose of the guidelines and other information you deem relevant, develop a narrative summary as to the outcomes of the assessment. Integrate the assigned reading for this week into the narrative, paying special attention to the implications for the micro, and macro systems levels’ application. Be sure to include information as to your support of using the tool in the practice setting. 

7. Include a title page and a reference list per current APA format. 

 In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.

Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.

Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

       Advocacy is one of the best tools that nurses can use to advancing the nursing field. Improve the nursing field means better patient outcomes. therefore, nurses must advocate in their workplaces and particularly in actively participating in government actions that change the health platform. Those actions include healthcare reforms that look for a better quality of care, access the healthcare, and healthcare cost-effective. The American Nurse Association provide tools to nurses that allow them to integrate advocacy committee to be able to work with the legislative branch of federal level as well as the state level (ANA, n.d.). in taking advantage of the advocacy committees, nurses can take many actions to improve healthcare trough legislation at both states and federal level.
Through the political action committee provided by the American Nurse Association, nurses can present themselves as candidates to represent the healthcare professional in capitol hill and other legislative activities at the state level. In doing so, nurse leaders will have the opportunity to raise their voices in policymaking, particularly within the legislative and regulatory arenas. They will bring their concerns about the nursing workforce and health disparities, which are examples of policies established in law. Their interventions are very important because health care policy is constantly changing; and nurses must always be part of the change analyst team to advocate not only their scope of practice but also the patient right to have access to health care and to receive excellent quality of care (Schaeffer & Haebler, 2019).
Nurses may use their researches and communicate with their concerns to their local government. As an example, a bill was taken in the state of Florida that authorizes qualified providers to collect medicine that was available in hospitals and other healthcare facilities. Still, those who had the prescription could not use it. Those medicines were ordered to serve homeless and other uninsured patients who cannot afford their medicine cost. Even though the senate’s health committee introduced the bill, nurses had to analyze the proposition and look if the patient’s right was considered and the consequences on patient outcomes.
In summary, there are many ways a nurse can intervene to advocate for better quality and access to healthcare. The patient center care should be the primary concern of the health care professional. Nurses may use the Association of American Nurses’ possibilities to get to federal and state legislators to bring their voices to health committees. Their concern must be affordable health care, improve healthcare access, improve quality of care, and improve the regulation of their scope of practice. When nurses are working closer to the governments, they can advocate for patient care and establish better means for improving the health care system. Nurse leaders should always think of how to make s difference in the quality of care that all patients deserve. That is why I plan to advocate not only in searching for issues that are raised in workplaces but also those that are in the laws to make a difference in patient care outcomes.

References
American Nurses Association. (n.d.). Advocacy, retrieved from https://www.nursingworld.org/practice-policy/advocacy/
Schaeffer, R., Haebler, J. (2019) Nurse Leaders: extending your policy influence. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1541461219301491

  

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

To Prepare:

Select a specific bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

https://www.congress.gov/

https://www.house.gov/

https://www.senate.gov/

http://www.senate.gov/senators/leadership.htm

The Assignment: (1- to 2-page Comparison Grid; 1-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

-Determine the legislative intent of the bill you have reviewed.

-Identify the proponents/opponents of the bill.

-Identify the target populations addressed by the bill.

-Where in the process is the bill currently? Is it in hearings or committees?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

-Advocate a position for the bill you selected and write testimony in support of your position.

-Describe how you would address the opponent to your position. Be specific and provide examples.

Use in text citations. References last 5 years and scholarly. APA format

Assessing and Treating Clients with Bipolar Disorder

Introduction

Bipolar disorder is attributed to the instability in the emotions of a person and may occur as a result of the genes of the patient. Stahl et al. (2019) record that other than the genetic possibility, the occurrence of a bipolar disorder may be blamed on the neurons or biological operation of the organs of the patient. Typically, bipolar disorder arises in the changes in the moods of patients frequently. A patient with bipolar disorder could be difficult to get the best diagnosis since the patient may have varying depressive moods and the diagnosis may be made wrongly to be other health conditions such as depression. A patient with bipolar disorder may, therefore, be seen to have symptoms similar to other health issues. This paper seeks to discuss the treatment for a patient who is diagnosed with bipolar disorder.

Decision Point 1

The three options that are there for selection to help in treating the patient are Begin Lithium 300 mg orally Bid, Begin Risperdal 1 mg orally, or Begin Seroquel XR 10o mg orally at HS. The choice that is selected for the patient to use to treat the health concern is Begin Lithium 300 mg orally Bid.

Decision Rationale

Begin Lithium 300 mg orally Bid is selected for use by the patient for the management of the change in moods. The patient is reported to have swings in his moods and the use of this medication will help in the management of the frequent changes in his moods. This medication is therefore selected with the need for the treatment of the patient by handling the symptoms that are recorded due to bipolar disorder (Landersdorfer et al., 2017). The medication is expected to help in the management of the change in moods since it acts on the neurotransmitters and hence allowing for management of the moods that a patient may have.

Desired Treatment Goals

 The manic symptoms that are recorded are as well expected to be reduced by the use of this medication. As such, this medication is selected to ensure that the exaggerated moods of the patient are managed. Gozutok et al. (2019) add that the use of this medication is as well important for treating issues of anxiety and issues of having loud speaking.

Outcomes of the decision

After four weeks the patient is brought back to the healthcare facility for follow up and is found that the patient has not fully been compliant with the use of the medication since there are instances that he used the medication and in other instances did not use the medication. The patient is reported to have had no change in his condition.

Decision Point 2

The selected option for this case is the use of Begin Seroquel XR 100 mg orally at HS. The patient should have had an increase in the dose for the medication but there must be a change of medication. Other than the increase in the dosage, the patient must be educated on the importance of compliance with the use of the medication

Decision Rationale

The use of this medication is because it will help in the process of determination of the easy ways of management of mood changes in the health setting. Thus, there is an ease in the process of patient care to ensure that one can eliminate the process of change. These efforts that are taken into account are expected to help in ensuring that cases of mood changes are managed effectively as opined by Garriga et al. (2017). This medication is as well of importance in the process of management of the working of the neurotransmitters.

Desired Treatment Goals

Outcomes

The outcomes that are attained with the use of this medication are seen after four months when the patient makes a visit to the healthcare facility and it found that the patient has had an addition of weight. The patient as well points out that he has had an incidence of dry mouth and instance of constipation. The positive response found in this case is that there is an improvement in the mania condition since there is a reduction in the occurrences. The patient indicates that there has been a rise in instances where he has a good mood. The complaint presented by the patient is that the medication has had an extensive case of side effects. There is a need therefore for handling the side effect that is seen in the use of this medication to ensure that it does not affect the quality of well-being of the patient. There is a need as well for handling the issues of education of the patient on the healthcare measures that should be put into an account at all times for the best aspect of health that should be taken into account. The education as well should be in line with the need for having a better understanding of the challenges that are faced in the process of decision making and the need for compliance to the use of the medication.

Decision Point 3

The decision that is made in this case concerning the need for having a better direction of care that allows for the patients to be well informed of the best healthcare direction needed. There is a need as well for ensuring that the healthcare providers can reach out to the patients to ensure that the side effects of the medication are is handled. As such, the decision will be useful for the determination of the option that is attained concerning the side effects and the healing and making a comparison of the best option to be made. The choice, in this case, is to discontinue Seroquel and go back to Lithium.  

Decision Rationale

The reasons for discontinuing the use of Seroquel and go back to Lithium is because the use of Seroquel has resulted in side effects that may not be preferable and can be avoided. As alluded by Yatham and Kesavan (2017), the use of lithium 300 mg orally daily allows for the patients to have effective management of the issue of bipolar disorder and has fewer side effects as compared to the use of Seroquel.

Desired Treatment Goals

The use of this medication will be of importance in that it allows for the reduction of issues of noncompliance with the effective education of patients. The patient will have to receive education on the issues of compliance with the use of medication and the necessary options that should be handled concerning the process of care for patients. The patient as well should be informed of the expectation with the adherence to the use of the medication. This will be a motivation for the patient to adhere to the medication and get the best health standards.

Patient Outcome

The expectation for the use of this medication was to have a better health standard for the patient. When the patient comes to the healthcare facility for follow up after four weeks, it is found that the patient has a change in mood and that the condition of the patient has become better and that the quality of life of the patient has improved. The process ensured that there is an improvement in the quality of health and that the issue of manic moods is managed.

Ethical and Legal Consideration

In the process of provision of care and the treatment plan for patients, one must consider the ethical standards. First, the process of care mustn’t be affected by the condition that is in place and that the use of the medication should not affect the health of the patient. The healthcare providers as well should act in a way to ensure that the process of care for patients is genuine and that there is the avoidance of any issues of poor health. This includes the kind of medication that is to be used and the dosage that is to be given to the patient. It is the importance that they are in linewith the require protocols of management of issues of bipolar disorder.