M3: Lesson 9 – Discussion

1. Create an original posting with a minimum of 250-300 words.
2. Back up your arguments with reliable evidence.

Hypothesis and Variables

Scenarios:

A researcher wonders how well the sense of smell functions during sleep. In general, we know that our sensory systems operate at a higher threshold during sleep. That is, a more intense stimulus is required to elicit a response during sleep than during wakefulness. Furthermore, we are less responsive during some stages of sleep than during others. Experiments using sounds suggest that we are less responsive during stages 3 and 4 sleep (deep sleep) than during stages 1, 2, or REM sleep (lighter sleep). Thus, the 4 – 16 researcher predicts that research participants will be less responsive to odors during stages 3 and 4 sleep than during the other stages of sleep. The researcher devises a system for delivering odors while college students sleep in the laboratory. Peppermint fragrance is delivered at specific times through a modified oxygen mask that the students wear while they sleep. Electrodes are attached to each student’s scalp, face, and chin to determine sleep staging. Electrodes are also attached to each student’s chest to record heart rate. A change in heart rate following presentation of the odor is used to indicate that the participant detected the odor.

Instructions:

1. Read the scenario above and answer the following questions:
   1. What is the research hypothesis?
   2. What is the independent variable?
   3. Is the independent variable a qualitative variable or a quantitative variable?  Explain. 
   4. Why might the researchers want to use multiple dependent variables?
   5. Describe one limitation of this study. 

 Use the Walden library database to search for a qualitative research article from a peer-reviewed journal on a topic of your interest. Before you read the full article and begin your annotation, locate the methodology section in the article to be sure that the article describes a qualitative study. Confirm that one of the types of qualitative research designs or approaches, such as narrative, ethnographic, grounded theory, case study, or phenomenology, was used in the study. Annotate one qualitative research article from a peer-reviewed journal on a topic of your interest. Provide the reference list entry for this article in APA Style followed by a three-paragraph annotation that includes: A summary An analysis An application as illustrated in this example Format your annotation in Times New Roman, 12-point font, double-spaced. A separate References list page is not needed for this assignment. 

  

Treatment of Psychiatric Emergencies in Children Versus Adults

The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations.

In this Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.

Learning Objectives

Students will:

· Compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients

· Analyze legal and ethical issues concerning treatment of child or adolescent psychiatric emergency clients

To Prepare:

· Review the Learning Resources concerning emergency psychiatric medicine.

· Consider a case where an adult client had a psychiatric emergency. If you have not had a personal experience with an adult client who had a psychiatric emergency, you can conduct an internet or library search to identify.

Post:

· Briefly describe the case you selected.

· Explain how you would treat the client differently if he or she were a child or adolescent.

· Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.

 Required Readings ( Need 3 references)

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

• “Bipolar and Related      Disorders”

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 23, “Emergency Psychiatric Medicine”      (pp. 785–790)
• Chapter 31, “Child Psychiatry” (pp. 1226–1253)

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell. 

• Chapter 50, “Provision of Intensive Treatment:      Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)
• Chapter 64, “Suicidal Behavior and Self-Harm”      (pp. 893–912)

First

Comparison of Virginia, Maryland and District of Columbia APRN Regulations

     The region of Virginia in which I live is locally known as “the DMV” (the abbreviation for District/Maryland/Virginia). It is common for many practitioners to live in one jurisdiction and practice in another. For this reason, I chose to compare the three jurisdictions.

     According to the American Association of Nurse Practitioners, an APRN’s practice is restricted in Virginia. However, in the District and Maryland, APRNs may practice to their full scope of education and experience. Two differences I noted were in regulating agencies and in prescriptive authority. In Virginia, APRNs are regulated jointly by the Board of Nursing and the Board of Medicine. In contrast, in the District and Maryland, the respective Boards of Nursing are the only regulatory agencies.

     Regarding prescriptive authority, in Virginia, in order for a nurse practitioner (other than a nurse anesthetist or midwife) to have autonomy in practice, one must have practiced in a restricted capacity for at least five years (9000 hours). Also, nurse practitioners may only prescribe Schedule II – V medications in partnership with a physician. In the District, APRNs have full prescriptive authority (DC Health), and in Maryland, full prescriptive authority includes prescribing medical marijuana (Maryland Board of Nursing).

     Loversidge (2019), in addressing the regulation of Advanced Practice Registered Nurses (APRNs), proffered that it “has been inconsistent because…states [have] the right to establish laws governing professions and occupations” (p. 65). As a note of interest regarding practicing

RNs, the District does not participate in the Nursing Licensure Compact either, and an RN that wants to practice in DC must obtain a separate DC-specific license. In a region as geographically close as the DMV, especially during health-related crises, collaboration among the three regions Boards of Nursing could allow for scope expansion of a Virginia-licensed APRN. In the meantime, it is essential for APRNs crossing borders into other jurisdictions to familiarize themselves with the regulations of each in order to adhere to both prescriptive authority and other regulations.

References

American Association of Nurse Practitioners. Retrieved September 28, 2020, from https://www.aanp.org/advocacy/state/state-practice-environment

DC Health, Nursing Regulations, Nurse Practitioners. Retrieved September 28, 2020, from

https://dchealth.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/Chapter%2059%20Nurse-Practitioners.pdf

Loversidge, J.M. (2019). Government response: regulation. In J. A.Milstead, & N. M. Short (Eds.), Health policy and politics: A nurse’s guide (6th ed., pp 57-86). Burlington, MA: Jones & Bartlett Learning

Maryland Board of Nursing Scope and Standards of Practice. Retrieved September 28, 2020, from http://www.dsd.state.md.us/comar/comarhtml/10/10.27.07.03.htm

Virginia Department of Health Professions Board of Nursing. Retrieved September 28, 2020, from https://www.dhp.virginia.gov/media/dhpweb/docs/nursing/leg/NursePractitioners.pdf

Second 

 APRN Board of Nursing Regulations in Texas and Florida.

Most states in the U.S of America have similar and different regulations to govern APRN in their practice acts because of the complexity of the health care system. According to Milstead & Short (2019), “Regulation means to control over something by rule or restriction, and health professions regulation is needed as a mechanism to protect the interest of the public safety (p. 60). Each states Board of Nursing in the U.S put in place regulations to protect the public of interest because of the potential risk for harm so that APRN can be held accountable and responsible of any rules that are outline in the practice acts. In Texas, to renew APRN license, applicant must completed an APRN educational program, attest to having a minimum of 400 hours of current practice within the preceding biennium, and attest to being in compliance of continuing competency and APRN with prescriptive authority (Office of the Secretary of States, n.d). In Texas, APRN with full valid prescription authorization number can obtain authority to order or prescribe control substance in Schedule II, III through V. Prescription for controlled substance in Scheduled III through V including refill of the prescription shall not exceed 90 days’ supply, beyond the initial 90 days the refill prescription cannot be authorized, and prescription of the controlled substance in Schedule III through V for child less than two years of age can not be authorize prior to consultation with delegating physician and notation of consultation in the patient’s chart (Office of the Secretary of States, n.d). This regulation enables the APRN to follow the guidelines when prescribing certain categories of control substance.

In Florida, to renew APRN license, the applicant must prescribe up to 30 hours of continuing education biennially as a condition for renewal of a license or certificate, must complete at least 3 hours of continuing education on the safe and effective prescription of controlled substances, and complete a 2-hour continuing education course on human trafficking. In Florida, APRN has been granted legal authority to prescribed drugs listed as controlled substance subject to approval by their supervising Practioner, will need mid-level Practioner DEA registration, APRN cannot prescribe more than 7-day supply of Schedule II control substance except the APRN is a psychiatric nurse who only can prescribe 7-day supply of Schedule II controlled substance that is mental health drugs, and ARNPs who are not psychiatric nurses cannot prescribe psychiatric mental health controlled substances for children younger than 18 years of age (Akerman LLP – Health Law Rx, 2016).

Regulations for Advance Practice Registered Nurse (APRNs): Legal Authority to      Practice

American Health care delivery system is face with so many complex issues which requires adequate access to health care for positive health outcome. There is a barrier to health delivery because of shortage of health care providers in the U.S and these are affecting millions of Americans to seek health care at their convenient time. Every year, foreign immigrants, people living in rural areas, lower-middle class citizen find it difficult to access health care due to race, color, ethnicity, nationality, sexual orientation or socioeconomic status. Granting APRN full legal authority to practice without limitation can help resolve the issue of the barriers facing health care delivery system in the U.S. Some states allow APRNs to practice independent without physician supervision to lessen the high demands of their health care delivery system while other states are still deliberately on the issue. In 2017, 15 states report that NPs are regulated solely by a BON and have independent scope of practice and prescriptive authority without physician supervision, delegation, consultation, or collaboration… (Milstead & Short, 2019 p.63). If an APRN with full legal right to practice moved to another states with limitation, the APRN must abide to the regulations of the new states when it comes to renewal of license and prescription of some categories of control substance. For example, Texas regulation requires APRN to obtain authority to prescribe control substance in Schedule II, III through V, the APRN with legal right to practice independently must abide to the rules of Texas with no exception to the law because the APRN is within the jurisdiction of the new states.

                                                References

Akerman LLP – Health Law Rx. (2016). Deciphering Florida’s New Laws on ARNP and PA Controlled Substance Prescribing. Retrieve from: https://www.jdsupra.com/legalnews/deciphering-florida-s-new-laws-on-arnp-25553.

Milstead, J & Short, N. (2019). Health Policy and Politics: A Nurse’s Guide. Government Response: Regulation. p. 60, 63, 6th edition. Burlington. MA. Jones & Bartlett Learning.

Office of Secretary of States. (n.d). Texas Administrative Code. Retrieve from: https://texreg.sos.state.tx.us/public/readta1c$ext.ViewTAC?tac_view=3&ti=22&pt=11

 I will need someone to do this with a female voice, APA style power point template. ALL material needed for this assignment is attached.

In this Performance Task Assessment, you will assume the role of a journal club member in your practice. As a member of this journal club, you will analyze quantitative and qualitative articles and develop a voice-over PowerPoint presentation that discusses the components and quality of each study.

Professional Skills: Written Communication And Interpreting Data and Quantitative Fluency  are assessed in this Competency.

Your response to this Assessment should:

• Reflect the criteria provided in the Rubric.
• Adhere to the required assignment length.
• Use the APA Presentation Template
• Download the Writing Checklist to review prior to submitting your Assessment.

This Assessment requires submission of one (1) document that includes your analysis of Case Study #1 and #2 along with your recommendations. Save this file as NR3002_firstinitial_lastname (for example, NR3002_J_Smith).

When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.

Instructions

Access the following to complete this Assessment:

• Quantitative Article: Sand-Jecklin, K., & Sherman, J. (2014, October). A quantitative assessment of patient and nursing outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 23(19/20), 2854–2863. doi:10.1111/jocn.12575
• Qualitative Article: Walsh, A., Meagher-Stewart, D. & Macdonald, M. (2015, April 25). Persistent optimizing: How mothers make food choices for their preschool children. Qualitative Health Research, 25(4), 527–539. doi:10.1177/1049732314552456Note: You will access this article from the Walden Library Databases

Before submitting your Assessment, carefully review the rubric. This is the same rubric the assessor will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.

For this Performance Task, you will imagine you are asked to present two research articles to a journal club. You will create two voice-over PowerPoint Presentations to explain the parts of each article to the journal club. You are encouraged to use the journal club templates provided in the learning activities to help you organize your presentation.

You will also practice the Professional Skills of Written & Oral Communication and Interpreting Data & Quantitative Fluency. To make certain you are addressing all aspects of the Professional Skills, please review the Rubric to determine what is necessary for meeting the requirements. Visit the Professional Skills resources, as needed.

Rubric

The Director of Clinical Education at Fallsview Hospital has asked you to present two research articles to a journal club at the hospital. One article is a quantitative research study and the other is a qualitative research study. In addition, he has asked you to provide a refresher to your peers on the parts of a research article to help them better understand research in the nursing field.

The PowerPoint you submit will include two sets of 5-8 PowerPoint slides with audio narration for each slide.

Note: Audio narration should be an extension of the information on the slides, and not a verbatim recitation. In your narration, you should

 

Quantitative Journal Club Presentation (5-8 slides)

Your first PowerPoint presentation should include the following information:

• A title slide for your journal club presentation
• A brief overview of the parts of a research article as a refresher to your peers in the journal club

Using the Quantitative Article by Sand-Jecklin, K., & Sherman, J. (2014), identify the following information:

• Article citation
• In your own words, describe the purpose of the study
• Explain the type of research design that is used
• Describe the data collection methods that were used
• Explain the data collection measures and tools
• Analyze any plans for data analysis
• Describe the strengths and weaknesses of the overall research design

 

Qualitative Journal Club Presentation (5-8 slides)

Using the Qualitative Article by Walsh, A., Meagher-Stewart, D. & Macdonald, M. (2015), identify the following information:

• A title slide for your journal club presentation
• Article citation
• In your own words, describe the purpose of the study
• Explain the type of research design that is used
• Describe the sample selection
• Describe the data collection methods that were used
• Analyze any plans for data analysis
• Analyze the strengths and weaknesses of the overall research design

Provide voice-over narration for each slide in your presentations, including the strengths and weaknesses of the types of study design.