The purpose of this assignment is to examine the practice authority and scope of practice differences among APRNs in the United States. You are asked to review the Nurse Practice Act from state of California and compare that to another state that has restrictive or different practice authority. Review the websites below (AANP, NCSBN) to identify the scope of practice of APRNs in the United States. Also, you may review state California board of nursing website to identify specific practice authority guidelines for APRNs. The expected length of the paper is approximately 2-3 pages, which does not include the cover page and reference pages. 

American Association of Nurse Practitioners (AANP)

National Council of State Boards of Nursing (NCSBN)

Submission Parameters:

1. Introduction (including purpose      statement)
2. Compare and contrast between your      two selected states (one of them needs to be your state of residence) and      address the following items: 
   • Nurse Practitioner definition
   • Practice authority (collaborative       agreement, independent, restrictive)
   • Scope of practice (functions       APRNs may perform)
   • Licensure requirements
   • Prescriptive authority and       requirements to attain DEA number
   • Education requirements
   • Certification requirements
3. Future of APRN practice 
   • Please discuss current bills or       legislation that support full practice authority in the state that has       restrictive practice
4. Full Practice Authority 
   • Identify at least one research       study (primary source) that supports the following statement: “APRNs with       full practice authority benefit society and health care system”
5. Conclusion

Using Giger and Davidhizar’s Transcultural Assessment Model, found on pp. 8-10 in your Giger textbook as your assessment framework, perform and document a cultural assessment performed with an individual with a different ethnicity than your own (please avoid using family members). Please provide the client with confidentiality in preparing this assessment.

In your narrative style paper, address each phenomena of the cultural assessment framework. Provide a brief description of the assessment component, your client’s data, and then a comparison of your client to the identified cultural norms.

The submitted document should be 8-10 pages, in APA format excluding the title page and reference page with use of appropriate headings, and be written as a narrative that includes five (5) resources specifically relating to the individual’s ethnicity. Two or more of these resources should be scholarly research.

Rubric

Transcultural Assessment Paper Grading Rubric 2018-2020Transcultural Assessment Paper Grading Rubric 2018-2020CriteriaRatingsPtsThis criterion is linked to a Learning OutcomeComprehensive collection of dataAssessment Categories to be included are Culturally Unique Individual, Communication, Space, Social Organization, Time, Environmental Control, Biological Variations, and Nursing Assessment.140.0 ptsAll categories are included with comprehensive data or references to sources of data.125.0 ptsFewer categories are addressed. Data present but not very comprehensive. Categories left unaddressed.100.0 ptsPaper is vague with little support or strays from the assessment. Superficial attempt at assessment. Many categories with incomplete data.140.0 pts
This criterion is linked to a Learning OutcomeQuality of sources40.0 ptsEvidence of a variety of sources of data collection including direct observation, interviews, written sources e.g scholarly articles, textbook, news pieces. 5 references related to the ethnicity cited. 2 scholarly research references35.0 ptsSome variety of methods, but limited to primarily written reports and some direct observation. 3-5 references related to the ethnicity cited. 1 scholarly research reference30.0 ptsLittle evidence of a variety of sources. Mostly written reports and/or little observation. Less than 3 references related to the ethnicity cited. No scholarly research used as reference.40.0 pts
This criterion is linked to a Learning OutcomeAPA Writing Style and Organizationview longer descriptionthreshold: 3.0 pts5.0 ptsExceeds Expectations: Excellent control of language, clear consideration of an academic or professional audience. Sentence and paragraph variety appropriate for audience. The entire paper is cohesive Editing and proofreading are clearly evident.3.0 ptsMeets Expectations: Usage is sometimes less precise or with awkward or unclear passages and some consideration of audience. Paragraphing structure is present with some poorly constructed sentences or word choices. Most of the paper is cohesive with one or two areas that are less concise. Proofreading and editing are evident.1.0 ptsNeeds Improvement: Inaccurate word choice, fragmented and monotonous sentences and little or no concern for the reader. Paper lacks organization and structure in more than two areas No editing or proofreading evident0.0 ptsDoes not meet: No paper submitted or Paper lacks organization and cohesion at all levels. Impossible for the reader to follow.5.0 pts
This criterion is linked to a Learning OutcomeAPA Formattingview longer descriptionthreshold: 3.0 pts5.0 ptsExceeds Expectations: Grammar and punctuation issues are addressed correctly. No errors in APA style. Paper is in full APA format. Complete; correct documentation, integration of citation and paraphrases.3.0 ptsMeets Expectations: Rare errors in APA style that do not detract from the paper and has a scholarly style. Acceptable work but clumsy inclusion of sources.1.0 ptsNeeds Improvement: Problems include repeated grammar and usage errors which are distracting to the reader.0.0 ptsDoes not Meet Expectations: No Paper submitted or APA clearly not used5.0 pts
This criterion is linked to a Learning OutcomeAssignment Specific8-10 pages Uses Headings Provides a brief description of the assessment component, your client’s data, and then a comparison of your client to the identified cultural norms.10.0 ptsExceeds ExpectationsUses APA headings accurately to guide the reader. 8-10 pages Provides a brief description of the assessment component, your client’s data, and then a comparison of your client to the identified cultural norms.8.0 ptsMeets ExpectationsUses APA headings with some accuracy to guide the reader. 7 or less pages or 11 or more pages Provides two of the three: a brief description of assessment components, your client’s data, and then a comparison of your client to the identified cultural norms.5.0 ptsNeeds improvmentNo use of APA headings to guide the reader 7 or less pages or 11 or more pages. Provides one of the three: a brief description of assessment components, your client’s data, and then a comparison of your client to the identified cultural norms.0.0 ptsDoes not meet expectations.No Paper Submitted.10.0 pts
Total Points: 200.0

 

BACKGROUND

In psychopharmacology you met Katie, an 8-year-old Caucasian female, who was brought to your office by her mother (age 47) and father (age 49). You worked through the case by recommending possible ADHD medications. As you progress in your PMHNP program, the cases will involve more information for you to sort through.

For this case, you see Katie and her parents again. The parents have reported that the medication given to Katie does not seem to be helping. This has prompted you to reconsider the diagnosis of ADHD. You will consider other differential diagnoses and determine what information you need to accurately assess the DSM-5 criteria to make the diagnosis of ADHD or another disorder with similar diagnostic features.

When parents bring their child to your office, they may have read symptoms on the internet or they may have been told by the school “your child has ADHD”. Your diagnosis will either confirm or refute that diagnosis.

Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine a differential diagnosis and to begin medication, if indicated. The PMHNP makes this diagnostic decision based on interviews and observations of the child, her parents, and the assessment of the parents and teacher.

To start, consider what assessment tools you might need to evaluate Katie.

• Child Behavior Check List
• Conners’ Teacher Rating Scale

The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised” (Available at: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000099.1 ). This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, makes careless mistakes in her schoolwork, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. She has difficulty interacting with peers in the classroom and likes to play by herself at recess.

When interviewing Katie’s parents, you ask about pre- and post-natal history and you note that Katie is the first born with parents who were close to 40 years old when she was born. She had a low 5 minute Apgar score. The parents say that she met normal developmental milestones and possibly had some difficulty with sleep during the pre-school years. They notice that Katie has difficulty socializing with peers, she is quiet at home and spends a lot of time watching TV.

SUBJECTIVE

You observe Katie in the office and she is not able to sit still during the interview. She is constantly interrupting both you and her parents. Katie reports that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds some subjects boring or too difficult, and sometimes hard because she feels “lost”. She admits that her mind does wander during class. “Sometimes” Katie reports “I will just be thinking about something else and not looking at the teacher or other students in the class.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. She offers no other concerns at this time.

Katie’s parents appear somewhat anxious about their daughter’s problems. You notice the mother is fidgeting with her rings and watch while you are talking. The father is tapping his foot. Other than that, they seem attentive and straight forward in the interview process.

MENTAL STATUS EXAM

The client is an 8-year-old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is neutral. Katie says that she doesn’t hear any ‘voices’ in her head but does admit to having an imaginary friend, ‘Audrey’. No reports of delusional or paranoid thought processes. Attention and concentration are somewhat limited based on Katie’s short answers to your questions.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHAT IS YOUR DIAGNOSIS FOR KATIE?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

 

The Assignment:

Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

• Decision #1: Differential Diagnosis
  • Which Decision did you select?
  • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
• Decision #2: Treatment Plan for Psychotherapy
  • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
• Decision #3: Treatment Plan for Psychopharmacology
  • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
• Also include how ethical considerations might impact your treatment plan and communication with clients and their families.

 Decision Point One
A-i selected Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation

B- Decision Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.Explain why i did not select Autism Spectrum Disorder (ASD), mild and co-occurring;  and why i did not select Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• You selected Attention deficit hyperactivity disorder, predominantly inattentive presentation. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer

 Decision Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

A-I SELECTED  

Begin Adderall XR 10 mg orally daily

B- EXPLAIN WHY YOU DID NOT SELECT  Wellbutrin 75 mg orally daily

 AND DID NOT SELECT Strattera 25 mg orally daily

 

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Katie’s parents seem absolutely delighted upon their return stating that Katie is paying more attention in school, but note that there is still room for improvement, particularly in the afternoon
• They report that Katie’s teacher has reported that Katie is able to maintain her attention throughout the morning classes but come afternoon, she “daydreams.”
• Katie’s parents are also concerned about her decrease in appetite since starting the medication

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

A- I SELECTED  to Add a small dose of immediate release Adderall in the early afternoon

B- EXPLAIN WHY I DID NOT SELECT Assure Katie’s parents that weight loss is common with stimulant medications used to treat ADHD Augment medication with family therapy

 Guidance to Student

Whereas weight loss is common with stimulant medication, this option does not address Katie’s parents’ concerns about the return of symptoms in the afternoon.

Augmentation with family therapy is also a good idea as it can help Katie with her symptoms and further help her parents to understand the unique challenges that Katie experiences, as well as ways that they can help her with symptoms, however, this option does not address the return of inattentive symptoms in the afternoon.

Adding a small dose of immediate relate Adderall in the afternoon can help Katie to maintain attention throughout the afternoon and into the early evening when she must do homework. This would be the best option.

  

Defining Scholarship

A hallmark of your education at Walden University is your development as a scholar-practitioner. As a doctoral student, you have been actively engaged in scholarly activities that support your growth as a scholar-practitioner. As you continue to develop, implement, and evaluate your EBP project, you will be applying scholarship as you translate research into practice. A key element of scholarship is dissemination.

As you prepare for this Discussion, consider the role of evaluation and dissemination in scholarship. If research is not disseminated, can it be considered scholarship?

To prepare:

• Reflect      on the definitions and criteria for scholarship presented in the Learning      Resources.
• Consider      AACN’s definition of scholarship and their vision of the role of the      DNP-prepared nurse in furthering nursing scholarship.

By tomorrow Wednesday 11/5/18, write a minimum of 550 words essays in APA format with at least 3 references from the list of REQUIRED READINGS below. Include the level one header as underlined below:

Post a cohesive scholarly response that addresses the following:

• What      is the role of the DNP-prepared nurse in scholarship? Provide at least two      specific examples.

Required Readings

White, K. M., Dudley-Brown, S. & Terhan, M.F. (2016). Translation of evidence into nursing and health care practice (2nd ed.) New York, NY: Springer.

Chapter 18, Dissemination of Evidence (SEE ATTACHED FILE)

American Association of Colleges of Nursing. (1999). Defining scholarship for the discipline of nursing. Retrieved from http://www.aacn.nche.edu/publications/position/defining-scholarship

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf

Boyer, E. L. (1992). Scholarship reconsidered: Priorities of the professoriate. Issues in Accounting Education, 7(1), 87-91.

Carina, K., Chan, Y., Oldenburg, B., & Kasisomayajula, V. (2015). Advancing the science of dissemination and implementation in behavioral medicine: Evidence and progress. International Journal of Behavioral Medicine, 22, 277-282 doi 10.1007/s12529-015-9490-2 

Glassick, C. E. (2000). Boyer’s expanded definitions of scholarship, the standards for assessing scholarship, and the elusiveness of the scholarship of teaching. Academic Medicine, 75(9), 877-880. Retrieved from http://www.academicpeds.org/events/assets/Glassick article.pdf

Lane, J.P. & Stone, V.J. (2015). Comparing three knowledge communication strategies – diffusion, dissemination and translation – through randomized controlled studies. Assistive Technology doi:10.3233/978-1-61499-566-1-92

Leeman, J., Myers, A.E.,Ribisl, K.M.,& Ammerman, A.S. (2015). Disseminating policy and environmental change interventions: Insights from obesity prevention and tobacco control. International Journal of Behavioral Medicine, 22:301–311 doi 10.1007/s12529-014-9427-1

Rieger, K. & Schultz, A.S. (2014). Exploring arts-based knowledge translation: Sharing research findings through performing the patterns, rehearsing the results, staging the synthesis. Worldviews on Evidence-Based Nursing, 11(2), 133–139.

Tricco, a.C., Ashoor, H.M., Cardoso, R., MacDonald, H., Cogo, E., Kastner, M., Perrier, L., McKibbon, A., Grimshaw, J.M. & Straus, S.E. (2016). Sustainability of knowledge translation interventions in healthcare decision making: a scoping review. Implementation Science, 11(55) doi 10.1186/s13012-016-0421-7