Case 3: Volume 1, Case #29: The depressed man who thought he was out of options

·  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.

• 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 antidepressant 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.
• For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?
• 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

Discussion: The Application of Data to Problem-Solving

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.

Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

To Prepare:

· Reflect on the concepts of informatics and knowledge work as presented in the Resources.

· Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

By Day 3 of Week 1

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

Rubrics

Ø Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Ø Supported by at least three current, credible sources.

Ø Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

 Required Texts and Materials:  Smith, M. & Parker, M. (2014). Nursing Theories and Nursing Practice. (4th ed.). Philadelphia, PA: F. A. Davis Company. ISBN-13: 978-0-8036-3312-4 Publication Manual American Psychological Association (APA) (6th ed.).  2009 ISBN: 978-14338-0561-5 Recommended TextMasters, K. (2015). Nursing Theories: A Framework for Professional Practice. (2nd ed.). Burlington, Massachusetts. Jones & Bartlett Learning. ISBN-13: 9781284048353. 

1. Compose a focused paper that explains and describes your healthcare issue or topic from a cultural and ethical perspective of inquiry. (You will cover two perspectives in one paper.)
2. Form and answer two levels of research questions for each inquiry to address your chosen topic.

• Choose a “Level 1 Research Question/Writing Prompt” from both of the lists below to answer in the paper.
• Compose a “Level 2 Research Question/Writing Prompt” for each kind of inquiry that provides detail, specificity, and focus on your inquiry, research, and writing.
• State your research questions in your paper’s introduction.
• Form the body of your paper by answering each research question and support your assertions with evidence (research).
• In the conclusion of the paper, briefly review the issues, research questions, answers, and insights.

1. Level 1 Research Questions/Writing Prompts
   ETHICAL Perspective of Inquiry

• What laws govern or pertain to the issue?
• What ethical obstacles affect how the medical community addresses the issue?
• How do ethical theories apply to the issue?
• How do money, power, and control matters relate to the issue and its treatment?

1. Level 1 Research Questions/Writing Prompts
   CULTURAL Perspective of Inquiry

• Which cultural values and/or norms influence the issue?
• How is the issue addressed differently in varying cultural contexts and situations?
• Which cultures or societies are most affected by the issue? Why?
• Which cultural traditions affect the treatment(s)?

1. Your paper must be five pages in length and reference four to six scholarly, peer-reviewed resources. Be sure to follow current APA Style (e.g., spacing, font, headers, titles, abstracts, page numbering).

Use a provided template to develop a 2-4 page submission in which you research and define a patient, family, or population health problem relevant to personal practice.

Important: Complete this assessment first and complete all other assessments in the order they are presented.

In this assessment, you will lay the foundation for the work that will carry through your capstone experience and guide the practice hours to complete the work in this course. The purpose of this assessment is to allow you to define a patient, family, or population health problem that is relevant to your personal practice and to begin building a body of evidence that will inform your approach to your practice hours, the intervention you design, and the professional product you will deliver.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Lead people and processes to improve patient, systems, and population outcomes.     
  • Define a patient, family, or population health problem that is relevant to personal practice.
• Competency 2: Make clinical and operational decisions based upon the best available evidence.     
  • Analyze evidence from the literature and professional sources to define and guide nursing actions related to a health problem.
• Competency 7: Implement patient-centered care to improve quality of care and the patient experience.     
  • Propose strategies to improve patient or population outcomes related to a health problem.
• Competency 8: Integrate professional standards and values into practice.     
  • Reflect on state board nursing practice standards relevant to a selected health problem.
  • Communicate professionally in writing that is clear and logically organized, with correct grammar, spelling, and use of APA style.

Important: Complete this assessment first and complete all other assessments in the order they are presented.

Professional Context

Nurses are leaders in problem identification and solution, planning and implementing patient care strategies to address problems in the home, hospital, and community. This assessment will help you develop a problem statement for a patient, family, or population health concern. 

Instructions

Throughout this capstone course, you will be investigating a patient, family, or population health problem relevant to your practice. For this assessment, you will identify the problem that you will address throughout your clinical practicum in this course, as well as begin to establish your evidence and research base to plan, implement, and share findings related to your project. The Problem Identification Template [DOC] will guide you through development of a problem statement, evidence collection and analysis, and best practices to help you create your implementation plan for the second assessment in this course.

Your submission for this assessment will be the completed template. When working through the template, you may use the resources provided in this course; however, most of your research and search for evidence will be conducted by you. Use the Capella University Library, professional organization and government resources, and relevant organizational best practices as sources of evidence. This is the capstone course for your BSN degree; your goal is to demonstrate your achievement of the program outcomes through your work on this project.

The following are some health issues that would be appropriate for your project:

• Diabetes self-management.
• Hypertension management and prevention.
• Medication reconciliation within a family or group.
• Parkinson’s disease support group.
• Patient family education communication improvements.
• Postoperative home care.

This list is by no means exhaustive. You should choose a patient, family, or population health issue that is relevant to your practice and organization; you must be able to study the problem in your clinical practicum effectively.

Scoring Guide Criteria

Your submission will be assessed based on the following criteria:

• Define a patient, family, or population health problem that is relevant to personal practice.
• Analyze evidence from the literature and professional sources to define and guide nursing actions related to a health problem.
• Propose strategies to improve patient or population outcomes related to a health problem.
• Reflect on state board nursing practice standards relevant to a selected health problem.
• Communicate professionally in writing that is clear and logically organized, with correct grammar, spelling, and use of APA style.

Please identify your relationship to the patient (friend and family) and how you made contact with the individual. Remember to only use the individual’s initials in your assessment to protect privacy.

CORE ELMS

Completion of this course requires a remote rather than a face-to-face clinical practicum. You are required to log your time in the CORE ELMS system just as you have for past courses with clinical interaction. The CORE ELMS link is located in the left-hand navigation pane.

Additional Requirements

• Length of submission: Use the provided template. Most submissions will be 2 to 4 pages. You do not need to include a title page. Be sure to complete the reference page at the end of the template.
• Number of references: Cite a minimum of 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old.
• APA formatting: Make sure that in-text citations and reference list follow current APA style.

Portfolio Prompt: Remember to save the assessment to your ePortfolio. After you complete your program you may want to consider leveraging your Portfolio as part of a job search or other demonstration of your academic competencies.