As an advanced practice nurse, you will likely encounter patients who will present with symptoms affecting the gastrointestinal (GI) tract. Of special note, is the consideration that most symptoms concerning the GI tract are non-specific and therefore, diagnosing diagnoses of the GI tract require thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.

How might you tease out the specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?

This week, you examine GI and hepatobiliary disorders. You will review a patient case study and consider those factors in recommending and prescribing a drug therapy plan fo your patient.

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

• Chapter 64, “Drugs for      Peptic Ulcer Disease” (pp. 589–597)
• Chapter 65, “Laxatives” (pp.      598–604)
• Chapter 66, “Other      Gastrointestinal Drugs” (pp. 605–616)
• Chapter 80, “Antiviral Agents I: Drugs for      Non-HIV Viral Infections” (pp. 723–743)

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance fro

ASSIGNMENT: 

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.  

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

To Prepare

· Review the case study assigned by your Instructor for this Assignment

· Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

· Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.

· Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Write a 1-page paper that addresses the following:

· Explain your diagnosis for the patient, including your rationale for the diagnosis.

· Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

· Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

This week we will be discussing the gastrointestinal and hepatobiliary systems and drugs used to treat those disorders. We will specifically focus on nausea/vomiting,  gastroesophageal reflux disease, peptic ulcer disease,  constipation, diarrhea, irritable bowel syndrome,  inflammatory bowel disease, and  cirrhosis. 

CASE STUDY: Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

· Synthroid 100 mcg daily

· Nifedipine 30 mg daily

· Prednisone 10 mg daily

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course.

By Day 3 of Week 4

Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Then, post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.

  

There are two parts to this:

1. Self-evaluation paper that addresses your growth as a nurse in relation to clinical experiences, education, maturity, and professionalism and how the PRICE (Professionalism, Respect, Integrity, Caring, Engagement) model has impacted you. This should be one to two pages long. 

2.  Professional Goals, how will you achieve them? One short term, One long term. This should be a page long.

No references needed.

 

Write a 4–7-page analysis of your care setting that supports development of a strategic plan and includes both the discovery and dream phases of an appreciative inquiry (AI) project and a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the care setting.

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

Identifying analysis techniques for assessing competitive advantage is important for building health care strategy. Sustaining health care competitive advantage requires that leaders understand environmental demands to assist with minimizing weakness and threats from the external environment. This assessment provides you with an opportunity to examine your health care environment to determine whether what is being accomplished in your organization, department, team, community project, or other care setting is making a positive difference.

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

• Competency 1: Evaluate qualities and skills that promote effective leadership within health care organizations.
  • Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an appreciative inquiry (AI) and a strengths, weaknesses, opportunities, and threats (SWOT) approach.
• Competency 2: Apply strategies to lead high-performing health care teams to meet organizational quality and safety goals.
  • Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.
  • Conduct a SWOT analysis of a care setting, with respect to quality and safety goals.
  • Describe an area of concern identified in a SWOT analysis—relevant to a care setting’s mission, vision, and values—that should be improved.
  • Compare the AI and SWOT approaches to analysis with regard to data gathering and interactions with others.
• Competency 3: Apply cultural, ethical, and regulatory considerations to leadership decision making.
  • Propose positive, attainable quality and safety improvement goals for a care setting.
• Competency 5: Communicate with stakeholders and constituencies to build collaborative partnerships and create inclusive work environments.
  • Communicate analyses clearly and in a way that demonstrates professionalism and respect for stakeholders and colleagues.
  • Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

 QUESTIONS TO CONSIDER

 

• As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
  One key aspect to being an effective leader, manager, or administrator is an awareness of your leadership strengths, weaknesses, and style.
  • How would you assess your general leadership, communication, and relationship-building skills?
  • How would describe your leadership style?
  • Imagine the future for a care setting that is your place of practice or one in which you would like to work.
  • What aspirational goals can you envision that would lead to improvements in health care quality and safety?
  • How well do these goals align with the mission, vision, and values of your care setting?

 

Assessment Instructions

Note: You will use the results of this analysis to develop a strategic plan in Assessment 2.

Preparation

You have been asked to conduct an analysis of your care setting that will result in two potential pathways toward a strategic plan to improve health care quality and safety in your organization, department, team, community project, or other care setting. To accomplish this, you will take two approaches to the analysis:

1. Complete the discovery and dream phases of an appreciative inquiry (AI) project.
2. Conduct a strengths, weaknesses, opportunities and threats (SWOT) analysis.

To help ensure that your analysis is well-received, the requester has suggested that you:

• Present your analysis results in four parts:
  • Part 1: Appreciative Inquiry Discovery and Dream.
  • Part 2: SWOT Analysis.
  • Part 3: Comparison of Approaches.
  • Part 4: Analysis of Relevant Leadership Characteristics and Skills.
• Your analysis should be 4–7 pages in length.

Note: Remember, you can submit all, or a portion, of your draft plan to Smarthinking for feedback before you submit the final version for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

Analysis Requirements

Note: The requirements outlined below correspond to the grading criteria in the scoring guide, so at a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

Writing, Supporting Evidence, and APA Style

• Communicate professionally when conducting interviews and collecting data.
• Write clearly, with professionalism and respect for stakeholders and colleagues.
• Integrate relevant sources of evidence to support your assertions.
  • Cite at least 3–5 sources of scholarly or professional evidence.
  • Include relevant interview information.
• Format your document using APA style. The APA Style Paper Template and associated tutorial, linked in the Resources, are provided for your use. Be sure to include:
  • A title page and reference page. An abstract is not required.
  • A running head on all pages.
  • Appropriate section headings.
  • Properly formatted citations and references.
• Proofread your writing to minimize errors that could distract readers and make it more difficult to focus on the substance of your analysis.

Part 1: Appreciative Inquiry Discovery and Dream

• Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.
  • Collect stories from your care setting. You may collect stories through interviews or conversations with colleagues or provide your own.
  • Explain how your stories are related to quality and safety goals.
  • Describe the evidence you have that substantiates your stories.
  • Identify the positive themes reflected in your stories.
  • Describe other evidence (for example: data, awards, accreditations) that validates your care setting’s positive core.
• Propose positive, yet attainable, quality and safety improvement goals for your care setting.
  • Explain how accomplishing these goals will lead to ethical and culturally-sensitive improvements in quality and safety.
  • Explain how your proposed goals align with your care setting’s mission, vision, and values.

Part 2: SWOT Analysis

• Conduct a SWOT analysis of your care setting, with respect to quality and safety goals.
  • Provide a narrative description of your analysis.
  • Identify the assessment tool you used as the basis of your analysis.
  • Describe your key findings and their relationships to quality and safety goals.
• Describe one area of concern that you identified in your SWOT analysis—relevant to your care setting’s mission, vision, and values—for which you would propose pursuing improvements.
  • Explain how this area of concern relates to your care setting’s mission, vision, and values.
  • Explain why you believe it will be necessary and valuable to pursue improvements related to this area of concern.

Part 3: Comparison of Approaches

Compare the AI and SWOT approaches to analysis and reflect on the results.

• Describe your mindset when examining your care setting from an AI perspective and from a SWOT perspective.
• Describe the types of data and evidence you searched for when taking an AI approach and a SWOT approach.
• Describe the similarities and differences between the two approaches when communicating and interacting with colleagues.

Part 4: Analysis of Relevant Leadership Characteristics and Skills

Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an AI and SWOT approach.

• Explain how these characteristics and skills would help a leader facilitate a successful AI-based project and a successful SWOT-based project.
• Comment on any shared characteristics or skills you identified as helpful for both AI and SWOT approaches.

 GRADING RUBRIC

1-  Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals. 

Passing Grade:  Synthesizes stories and evidence about times when a care setting performed at its best with regard to quality and safety goals. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the synthesis). 

2-  Propose positive, attainable quality and safety improvement goals for a care setting. 

Passing Grade:  Proposes positive, attainable quality and safety improvement goals for a care setting, and identifies assumptions on which proposed goals are based. 

3-  Conduct a SWOT analysis of a care setting, with respect to quality and safety goals. 

Passing Grade:  Conducts a SWOT analysis of a care setting, with respect to quality and safety goals, and impartially considers conflicting data and other perspectives. 

4-  Describe an area of concern identified in a SWOT analysis—relevant to a care setting’s mission, vision, and values—that should be improved.
 

Passing Grade:  Describes an area of concern identified in a SWOT analysis—relevant to a care setting’s mission, vision, and values—that should be improved. Identifies criteria that could be used to evaluate such an improvement.

5-  Compare the AI and SWOT approaches to analysis with regard to data gathering and interactions with others. 

Passing Grade:  Compares the AI and SWOT approaches to analysis with regard to data gathering and interactions with others, and acknowledges one’s own assumptions and biases 

6-  Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an AI and SWOT approach. 

Passing Grade:  Analyzes the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an AI and SWOT approach. Identifies areas of uncertainty or knowledge gaps.
 

7-  Communicate analyses clearly and in a way that demonstrates professionalism and respect for stakeholders and colleagues. 

Passing Grade:  Communicates analyses clearly, logically, and persuasively, demonstrating professionalism and respect for stakeholders and colleagues. Grammar and mechanics are virtually error-free. 

8-  Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. 

Passing Grade:  Integrates relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. Citations are error-free.