When completing practicum requirements in clinical settings, you and your Preceptor might complete several patient assessments in the course of a day or even just a few hours. This schedule does not always allow for a thorough discussion or reflection on every patient you have seen. As a future advanced practice nurse, it is important that you take the time to reflect on a comprehensive patient assessment that includes everything from patient medical history to evaluations and follow-up care. For this Assignment, you begin to plan and write a comprehensive assessment that focuses on one female patient from your current practicum setting.

To prepare

• Reflect on your Practicum Experience and select a female patient whom you have examined with the support and guidance of your Preceptor.
• Think about the details of the patient’s background, medical history, physical exam, labs and diagnostics, diagnosis, treatment and management plan, as well as education strategies and follow-up care.

To complete

Write an 8- to 10-page comprehensive assessment that addresses the following:

• Age, race and ethnicity, and partner status of the patient
• Current health status, including chief concern or complaint of the patient
• Contraception method (if any)
• Patient history, including medical history, family medical history, gynecologic history, obstetric history, and personal social history (as appropriate to current problem)
• Review of systems
• Physical exam
• Labs, tests, and other diagnostics
• Differential diagnoses
• Management plan, including diagnosis, treatment, patient education, and follow-up care

References

 

Learning Resources

Schuiling, K. D., & Likis, F. E. (2017). Women’s  gynecologic health (3rd ed.). Burlington, MA: Jones and Bartlett  Publishers.

Chapter 5, “Gynecologic Anatomy and Physiology” (pp. 77-93)
This chapter explores female anatomy and physiology with a focus on the female reproductive anatomy. It also describes the physiology of the menstrual cycle, including the hormonal feedback system and the ovarian and endometrial cycles.

Chapter 6, “Gynecologic History and Physical Examination” (pp. 95-133)
This chapter identifies the core knowledge and skill base required for obtaining a gynecologic health history and performing physical examinations such as pelvic and breast exams.

Chapter 7, “Periodic Screening and Health Maintenance” (pp. 135-149)
This chapter explores preventive health services for women such as screening tests, counseling, immunization, and chemoprevention. It also compares screening recommendations from organizations such as the U.S. Preventive Services Task Force, American College of Obstetricians and Gynecologists, and American Cancer Society.

Chapter 13, “Intimate Partner Violence” (pp. 303-322)
This chapter defines intimate partner violence (IPV) and describes the epidemiology and health effects of IPV. It also examines screening tools for assessing IPV and strategies for managing patients experiencing IPV, particularly pregnant women, adolescents, and older women.

Chapter 14, “Sexual Assault” (pp. 327-349)
This chapter examines strategies for identifying sexual violence and providing care to women who are victims of sexual violence. It explores potential health consequences of sexual violence on women, including physical injury, spread of sexually transmitted diseases, and unintended pregnancy.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th  ed.). Burlington, MA: Jones & Bartlett Publishers.
Chapter 6, “Care of the Well Woman Across the Life Span”
“Primary Preventive” Health Care for Well Women” (pp. 301-303)
This section examines social, mental, and physical issues that affect women during different stages of their lives. It also examines the provider’s role in prevention and care.
“Care of the Well Woman: Health Assessment and Screening for Women of Childbearing Age” (pp. 303-310)
This section provides a list of health information for the health care provider to address during well-woman examinations, as well as an immunization schedule for women across the life span.
“Care of the Well Woman: Health Assessment and Screening During Menopause” (pp. 338-349)
This section explains the physiologic changes that occur during menopause, including health issues that are likely to present. It also examines treatment and management options related to diet, exercise, sleep, and sexual comfort.                   Chapter 8, “Primary Care in Midwifery and Women’s Health”
“Care of the Woman: Prevention of Osteoporosis” (pp. 576-584)
This section explores factors that increase risks of osteoporosis in women, particularly postmenopausal women. It also provides strategies for identifying risk factors of osteoporosis and diagnosing and treating the condition.
“Care of the Woman in Need of Smoking Cessation” (pp. 471-475)
This section outlines factors that impact successful smoking cessation. It also describes treatment options and patient education strategies for women in need of smoking cessation.

U.S. Department of Health and Human Services. (2012b). Screening tests and vaccines. Retrieved from http://www.womenshealth.gov/screening-tests-and-vaccines/screening-tests-for-women/

This article provides guidelines for recommended screening tests for women. The guidelines are categorized by age and type of test.

 

Instructions

Phase 3: Analyzing the Aggregate Strengths and Weaknesses

For Phase 3 of the Capstone project, analyze and describe the strengths and weaknesses of the aggregate
and the community where the aggregate resides.
Be sure to apply Mobilize, Assess, Plan, Implement, Track (MAP-IT) in your assessment process.

• By the due date assigned, submit your response in a 1-page Microsoft Word document.
• Support your responses with examples.
• Cite all sources in APA format.

Phase 4: Risk Assessment

For Phase 4 of your project, you will select a family in your aggregate and complete a risk assessment in
the field using the information from chapter 18 “Community as Client: Assessment and Analysis” and
“Appendix D Friedman Family Assessment Model (Short Form)” as a guide. Describe how the family,
environment, home, and risk assessments were conducted, using your course textbook as a reference.
Describe the results of the assessments, drawing conclusions about the health risks to the aggregate as you
see them.

• By the due date assigned, submit your response in a 2- to 3-page Microsoft Word document.
• Support your responses with examples.
• Cite all sources in APA format.

Submission Details:

Combine Phase 3 and Phase 4 documents into one paper. Use bold sub-headings in the paper to distinguish
Phase 3 from Phase 4.
Phase 3: Analyzing the Aggregate Strengths and Weaknesses and Phase 4: Risk Assessment

• Name your combined document SU_NSG4075_W4_Project_LastName_FirstInitial_Phase3andPhase4.doc.
• Submit your combined document to the Submissions Area by the due date assigned.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
• Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

  

For this assignment you will create a 2-4 page plan proposal for an interprofessional team to collaborate and work toward driving improvements in the organizational issue you identified in the second assessment.

The health care industry is always striving to improve patient outcomes and attain organizational goals. Nurses can play a critical role in achieving these goals; one way to encourage nurse participation in larger organizational efforts is to create a culture of ownership and shared responsibility (Berkow et al., 2012). Participation in interdisciplinary teams can also offer nurses opportunities to share their expertise and leadership skills, fostering a sense of ownership and collegiality.

Demonstration of Proficiency

· Competency 1: Explain strategies for managing human and financial resources to promote organizational health. 

o Explain organizational resources, including a financial budget, needed for the plan to be a success and the impacts on those resources if nothing is done, related to the improvements sought by the plan.

· Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes. 

o Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific objective related to improving patient or organizational outcomes.

o Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.

· Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals. 

o Explain a change theory and a leadership strategy, supported by relevant evidence, that are most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.

· Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes. 

o Communicate the interdisciplinary plan with writing that is clear, logically organized, and professional, with correct grammar and spelling, using current APA style.

Reference

Berkow, S., Workman, J., Aronson, S., Stewart, J., Virkstis, K., & Kahn, M. (2012). Strengthening frontline nurse investment in organizational goals. JONA: The Journal of Nursing Administration, 42(3), 165–169.

Professional Context

This assessment will allow you to describe a plan proposal that includes an analysis of best practices of interprofessional collaboration, change theory, leadership strategies, and organizational resources with a financial budget that can be used to solve the problem identified through the interview you conducted in the prior assessment.

Scenario

Having reviewed the information gleaned from your professional interview and identified the issue, you will determine and present an objective for an interdisciplinary intervention to address the issue.

Note: You will not be expected to implement the plan during this course. However, the plan should be evidence-based and realistic within the context of the issue and your interviewee’s organization.

Instructions

For this assessment, use the context of the organization where you conducted your interview to develop a viable plan for an interdisciplinary team to address the issue you identified. Define a specific patient or organizational outcome or objective based on the information gathered in your interview.

The goal of this assessment is to clearly lay out the improvement objective for your planned interdisciplinary intervention of the issue you identified. Additionally, be sure to further build on the leadership, change, and collaboration research you completed in the previous assessment. Look for specific, real-world ways in which those strategies and best practices could be applied to encourage buy-in for the plan or facilitate the implementation of the plan for the best possible outcome.

Using the Interdisciplinary Plan Proposal Template (attached) will help you stay organized and concise. As you complete each section of the template, make sure you apply APA format to in-text citations for the evidence and best practices that inform your plan, as well as the reference list at the end.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

· Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes.

· Explain a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.

· Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.

· Explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if the improvements described in the plan are not made.

· Communicate the interdisciplinary plan, with writing that is clear, logically organized, and professional, with correct grammar and spelling, using current APA style.

Additional Requirements

· Length of submission: Use the provided template. Remember that part of this assessment is to make the plan easy to understand and use, so it is critical that you are clear and concise. Most submissions will be 2 to 4 pages in length. Be sure to include a reference page at the end of the plan.

· Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.  

· APA formatting: Make sure that in-text citations and reference list follow current APA style.

   A

 

Health Care Delivery Models and Nursing Practice

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

1. Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
2. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
3. Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
4. Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.  

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.