Assigned Reading

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 3, “Examination Techniques and Equipment”This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.

Chapter 8, “Growth and Nutrition”In this chapter, the authors explain examinations for growth, gestational age, and pubertal development. The authors also differentiate growth among the organ systems.

Chapter 5, “Recording Information”  (Previously read in Week 1)This chapter provides rationale and methods for maintaining clear and accurate records. The text also explores the legal aspects of patient records.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Student checklist: Health history guide. In Seidel’s guide to physical examination (9th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line:  Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.

Centers for Disease Control and Prevention. (2018). Childhood overweight and obesity. Retrieved from http://www.cdc.gov/obesity/childhood

This website provides information about overweight and obese children. Additionally, the website provides basic facts about obesity and strategies to counteracting obesity.

Chaudhry, M. A. I., & Nisar, A. (2017). Escalating health care cost due to unnecessary diagnostic testing. Mehran University Research Journal of Engineering and Technology, (3), 569.

This study explores the escalating healthcare cost due the unnecessary use of diagnostic testing. Consider the impact of health insurance coverage in each state and how nursing professionals must be cognizant when ordering diagnostics for different individuals.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 1, “Clinical Reasoning, Evidence-Based Practice, and Symptom Analysis”
This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.

Gibbs , H., & Chapman-Novakofski, K. (2012). Exploring nutrition literacy: Attention to assessment and the skills clients need. Health, 4(3), 120–124.

This study explores nutrition literacy. The authors examine the level of attention paid to health literacy among nutrition professionals and the skills and knowledge needed to understand nutrition education.

Martin, B. C., Dalton, W. T., Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-Wommack, R. (2014). Weight status misperception as related to selected health risk behaviors among middle school students. Journal of School Health, 84(2), 116–123. doi:10.1111/josh.12128
Credit Line: Weight status misperception as related to selected health risk behaviors among middle school students by Martin, B. C., Dalton, W. T., Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-Wommack, R., in Journal of School Health, Vol. 84/Issue 2. Copyright 2014 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

Noble, H., & Smith, J. (2015) Issues of validity and reliability in qualitative research . Evidence Based Nursing, 18(2), pp. 34–35.

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). History subjective data checklist. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the Copyright Clearance Center.

This History Subjective Data Checklist was published as a companion to Seidel’s Guide to Physical Examination (8th ed.) by Ball, J. W., Dains, J. E., & Flynn, J.A. Copyright Elsevier (2015). From https://evolve.elsevier.com

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Week 1)
Chapter 5, “Pediatric Preventative Care Visits” (pp. 91 101)

 

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

 

Include the following:

• An explanation of the health issues and risks that are relevant to the child you were assigned.
• Describe additional information you would need in order to further assess his or her weight-related health.
• Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
• Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
• Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.
• Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
• Consider how you could encourage parents or caregivers to be proactive toward the child’s health

The Assignment

Case #2:  75-year-old non-English speaking female recently diagnosed with breast cancer

Assignment (4 pages, not including title and reference pages):

  

Which translation model provides a framework for practice change?

The transitional model I would use for implementation would be the Havelock’s model. Havelock’s translation model provides a framework for practice change. From personal experience, the idea of change is often greeted with resistance due to the challenges that accompany it. It is easier to remain glued to our conservative norm than embrace innovative approaches.

Havelock improved on Lewin’s change model and created a systematic process for the implementation of innovation in the work culture stating that change encompasses a series of cyclical actions that are repeated as progress is being realized, and added that the agent of change must be alert and attentive towards the steps of the process (White & Dudley-Brown, 2012). Havelock’s theory lends us a simple six step sequential strategy that guides the team into embracing an innovation. The steps are as follows:

1. The establishment of a relationship with the interprofessional team and stakeholders

2. The establishment of a diagnosis related to the need for change

3. Acquisition of the vital resources

4. Selecting of the applicable and suitable strategy

5. Acceptance and adaptation of the selected solution

6. Providing guidance towards self-renewal or the power to change

In reiterating the points mentioned above, the initial approach is the establishment of a relationship because when relationships are positive, it is easier to effect change to an environment. Havelock’s strategy permits the inclusion of all representatives as members of the change project. The representatives are involved in the planning of the innovation.

In the 2nd stage which is establishing a diagnosis regarding the need for change, the agent for change which is the DNP scholar would have to grant opportunity to the rest of the team to brainstorm according to their expertise with the practice problem. The issue of managing the effects of the opioid overdose dilemma will be discussed weekly, then biweekly and then monthly.

In the 3rd stage which has to do with the acquisition of the vital resources, members of the interdisciplinary collaborative team are delegated to come up with appropriate solutions based on the evidence presented from research and translation science. Results from health resources and search engines such as Medline, PubMed, CINAHL will be examined for best evidence-based practice guidelines. These will be used for the gleaning and acquiring of related information.

The 4th stage is the selection of the relevant and suitable strategy. It is after the resource information have been presented that the team would conduct a review of the presentation, detect likely options, meanwhile also stating the consequences for the chosen actions. A series of possible solutions should be designed, such as educational approaches that emphasize patient centered focus, and evidence-based practice guideline conclusions that would lead to the desired innovation.  When this meeting comes to an end, there should exist a selection of possible strategies that would be reviewed and critiqued by all members of the team.

The 5th stage in Havelove’s Change Theory which is acceptance and adaptation of the selected solution is marked with addressing of the practicability or feasibility for the selected solution. The DNP scholar takes charge as facilitator in reviewing the possible potential advantages or remunerations, applicability, and adoptability of each possible strategy.

The 6th stage which is the provision of guidance towards self-renewal or the power to change is critical since it leads to the enablement and incorporation of the desired innovation.

What is the value of an interprofessional team to address this practice problem?

The fundamental features of interprofessional collaboration involves a shared common objective or goal, efficient communication, interpersonal and professional expertise, and liability (Hamric, Hanson, Tracy & O’Grady, 2014).

But there are challenging aspects that threaten to inhibit collaboration effectiveness and these may include the absence of role clarification, lack of availability of team members, limited time, miscalculations in terms of scope of practice, communication errors, hierarchy disparities, mistrust, and clashing viewpoints (Lancaster, Kolakowsky-Hayner, Kovacich, & Greer-Williams, 2015). 

Irrespective of the barriers and obstacles, the concept of interprofessional collaboration is invaluable for preventing misinterpretations that can result in decreased patient satisfaction, oversights, lapses in treatment plans, and adverse clinical outcomes (Howard, Jacobson, & Kripalani, 2013).

Interprofessional collaboration offers an overabundance of effective teamwork benefits and one of such is the enhancement of consumer safety and efficiency regarding care (Weller, Boyd, & Cumin, 2014). When the collaborative team approaches innovation from an evidenced-based teamwork method, this is capable of assisting the members to express a plethora of varying perspectives resulting in the optimization of collaboration and communication.  

What strategies can you implement to inspire others to embrace change?

When change is necessary, we need colleagues to adopt the change; we need for them to do things differently. But inspiring others to embrace change is difficult and people often pose a resistance because it is easier to remain with the familiar and just follow the status quo. But some simple steps that can help in the implementation to inspire others to embrace change include being in the habit to always keep colleagues in the loop and informed on the need for innovation, inspiring them about the benefits and potential that the change offers, educating them about the improved conditions outlook, as well as making it a priority to involve them in creating the desired change.

References

White, K., & Dudley-Brown, S. (2012). Translation of Evidence Into Nursing and Health Care Practice. Retrieved from: https://eds-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/ebookviewer/ebook/bmxlYmtfXzM5MjU3NF9fQU41?sid=5880161b-d91d-4abf-b505-61c0350bb1ed@sessionmgr4006&vid=3&format=EK&rid=17 (Links to an external site.)

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E.T. (2014). Advanced practice nursing: An integrative approach (5th edition). St. Louis, MO: Saunders Elsevier

Lancaster, G., Kolakowsky-Hayner, S., Kovacich, J., Greer-Williams, N. (2015). Interdisciplinary communication and collaboration among physicians, nurses, and unlicensed assistive personnel. Journal of Nursing Scholarship, 47(3), 275-284. doi:10.1111/jnu.12130

Howard, T., Jacobson, K., & Kriplani, S. (2013). Doctor talk: Physicians’ use of clear verbal communication. Journal of Health Communication, 18(8), 991-1011. doi:10.1080/10810730.2012.757398

Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: Overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 90(1061), 149-154. doi:10.1136/postgradmedj-2012-131168

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