Using resources such as the CDC, state and county health department websites, and various local resources, identify an opportunity for improved health behavior in an individual client. Your paper should be 1 – 2 pages in length in addition to the cover page and reference page. You should use a minimum of three references to support your work.

Be sure to cover the following:

• Identify an opportunity to for improved health behavior in an individualized client.
• Identify short and long term goals for the achievement of the overall health goal.
• Using Healthy People 2020, identify which problem you are working on improving.
• Recognize local resources to aid in the resolution of the identified problem.
• Assist in the evaluation in the response to interventions.

 

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Problem statement
3. Purpose of the change proposal
4. PICOT
5. Literature search strategy employed
6. Evaluation of the literature
7. Applicable change or nursing theory utilized
8. Proposed implementation plan with outcome measures
9. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
10. Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Use the feedback to make appropriate revisions to the portfolio components before submitting

 

For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.

Photo Credit: Getty Images/Science Photo Library RF

To Prepare

• Review the interactive media piece assigned by your Instructor. 
• Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
• Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
• You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

By Day 7 of Week 8

Write a 1- to 2-page summary paper that addresses the following:

• Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
• Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
• What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
• Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

 

Complex Regional Pain Disorder
White Male With Hip Pain

BACKGROUND

This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”

SUBJECTIVE

The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!”

The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”

He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it.”

During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation, and is future oriented.

Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)

Decision Point One

Select what you should do:

Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafterAmitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per dayNeurontin 300 mg po BEDTIME with weekly increases of 300 mg per day to a max of 2400 mg  

PLEASE PAY ATTENTION TO MY CASE STUDY

five references not more than 5 years

Zero plagiarism

I need 120 words for each assignment and each question with its individual references separate to each question

Unit 1

Topic 1: Health Care Systems, Organizational Relationships, and Interprofessional Health Care Environments

Q1

Discuss the shift to value-based health care and its impact on the roles and responsibilities of advanced registered nurses. What major evolving trends in the health care delivery system will affect your practice in the next 3-5 years, and how do you think advanced registered nurses will continue to influence the direction of health care?

Q2

From your experience, how can developing strong interprofessional relationships increase collaboration and benefit patient outcomes or organizational initiatives? What are some ways you can form an interprofessional team and collaborate with other advanced registered nurse roles? Make sure to incorporate the Interprofessional Education Collaborative (IPEC) competencies in your response.

STUDY MATERIALS

Read Chapters 5 and 6 in Advanced Practice Nursing: Essential Knowledge for the Profession. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php

Read Chapter 9 in Leadership in Nursing Practice: Changing the Landscape of Health Care. URL:https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/leadership-in-nursing-practice_changing-the-landscape-of-healthcare_3e.php

Read “Interprofessional Collaboration: Three Best Practice Models of Interprofessional Education,” by Bridges, Davidson, Odegard, Maki, and Tomkowiak, from Medical Education Online (2011). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081249/ 

Read “Core Competencies for Interprofessional Collaborative Practice: 2016 Update,” by Interprofessional Education Collaborative (2016). URL:https://nebula.wsimg.com/2f68a39520b03336b41038c370497473?AccessKeyId=DC06780E69ED19E2B3A5&disposition=0&alloworigin=1

Unit 2

Q1

From your experience in the health care industry, what is the difference between leadership and management? How can an advanced registered nurse both lead well and provide management? Think about interactions with patients, team members, daily tasks, and responsibilities as you formulate your response.

Q2

The underlying principle of servant leadership is that leaders address the needs of the team before their own and serve others before serving the self. After reviewing the topic materials and conducting your own research on servant leadership, describe how the vocation of the nurse is similar to the goals of a servant leader. Identify any examples you have seen in your practice, and the best way you can demonstrate servant leadership in nursing practice.

STUDY MATERIALS

Review Chapter 6 in Advanced Practice Nursing: Essential Knowledge for the Profession. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php  Read Chapters 2-4, 7, and 14 in Leadership in Nursing Practice: Changing the Landscape of Health Care. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/leadership-in-nursing-practice_changing-the-landscape-of-healthcare_3e.php Read “Great Leaders Inspire Great Followership,” by Cruz, from Leadership Excellence Essentials (2014). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=97399121&site=eds-live&scope=site   Read “Advancing the Nursing Profession Begins With Leadership,” by O’Neill, from Journal of Nursing Administration (2013). URL:https://lopes.idm.oclc.org/login?url=http://gateway.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=ovft&AN=00005110-201304000-00001&PDF=y      Read “From Trait to Transformation: The Evolution of Leadership Theories,” by Johns and Moser, from Education (1989). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=4717838&site=ehost-live&scope=site   

Read “Nursing Leadership From Bedside to Boardroom: Opinion Leaders’ Perceptions,” by Blizzard, Khoury, and McMurray (2015), located on the Campaign for Action website. URL: http://campaignforaction.org/resource/nursing-leadership-bedside-boardroom-opinion-leaders-perceptions/

Read “Leadership Styles: Choosing the Right Approach for the Situation,” located on the Mind Tools website. URL: http://www.mindtools.com/pages/article/newLDR_84.htm  Read “Transformational Leadership: Becoming an Inspirational Leader,” located on the Mind Tools website.URL: http://www.mindtools.com/pages/article/transformational-leadership.htm Read “Servant Leadership: Putting Your Team First, and Yourself Second,” located on the Mind Tools website. URL: https://www.mindtools.com/pages/article/servant-leadership.htm  Read “What Is the Difference Between Management and Leadership?” by Murray (2014), located on The Wall Street Journal website.    URL: http://guides.wsj.com/management/developing-a-leadership-style/what-is-the-difference-between-management-and-leadership/

Complete the “Nurse Manager Skills Inventory,” by the Nurse Manager Leadership Partnership (NMLP), located on the American Association of Critical-Care Nurses website. The resource is located under the “Authentic Leadership” heading. URL: https://www.aacn.org/nursing-excellence/healthy-work-environments/hwe-resources  

These resources will be used to complete the Leadership Style Reflective Essay assignment, due in this topic. Please refer to the assignment details for additional instructions.

1. Emotional Intelligence Assessment: “Emotional Intelligence Test”: http://testyourself.psychtests.com/testid/3038
2. Personality Assessment: “Personality Traits Test”: http://testyourself.psychtests.com/bin/transfer?req=MnwyMjk2fDE5NTM1MTV8MXwxfDE=&refempt
3. Learning Styles Assessment: “The VARK Questionnaire: How Do I Learn Best?”: http://vark-learn.com/the-vark-questionnaire/
4. Values Assessment: “Values Profile”: http://testyourself.psychtests.com/bin/transfer?req=MnwzMzE5fDE5NTM1MTV8MXwxfDE=&refempt
5. Values Assessment: “Rokeach Values Survey”: http://faculty.wwu.edu/tyrank/Rokeach%20Value%20Survey.pdf
6. Diversity Assessment: “Cultural Competence Self-Test”:  https://www.oregon.gov/DHS/SENIORS-DISABILITIES/DD/PROVIDERS-PARTNERS/SCPAconference/Cultural%20Competence%20Self-Test.pdf

Explore the “Nurse Manager Leadership Partnership” section on the American Organization of Nurse Executives website.

URL:http://www.aone.org/resources/nurse-manager-leadership-partnership

Explore the “What Is Servant Leadership?” page of the Greenleaf Center for Servant Leadership website. URL: https://www.greenleaf.org/what-is-servant-leadership/

Unit 3

Q1

How have you seen or experienced organizational change within an organization? Did it go well or not? Was there any correlation in how the organizations used stakeholders or change models?

Q2

You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee?

STUDY MATERIALS

Review Chapter 5 in Advanced Practice Nursing: Essential Knowledge for the Profession. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php    Read Chapter 1 in Leadership in Nursing Practice: Changing the Landscape of Health Care. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/leadership-in-nursing-practice_changing-the-landscape-of-healthcare_3e.php

Unit 4

Q1

Are there professional barriers to being involved with the legislative process, such as retaliation from institutions or individuals who do not share your same viewpoints? What steps would you take to ensure you can represent the advanced registered nurse as a leader and patient advocate under these types of circumstances?

Q2

Chapter 14 in the textbook, Leadership in Nursing Practice: Changing the Landscape of Health Care, discusses the nursing profession’s lack of representation in health care policymaking, even though nurses currently represent the largest profession within the health care industry. The text suggests that this may be related to gender inequality, with women making up a large percentage of the nursing profession. Do you see any correlation to this argument?

STUDY MATERIALS

Read Chapters 11 and 13-15 in Leadership in Nursing Practice: Changing the Landscape of Health Care. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/leadership-in-nursing-practice_changing-the-landscape-of-healthcare_3e.php Read “Preparing Nurses for Leadership in Public Policy” (2014), located on the Robert Wood Johnson Foundation website. URL: http://www.rwjf.org/en/library/articles-and-news/2014/02/preparing-nurses-for-leadership-in-public-policy.html  Explore your state legislature website and access legislation information. The link to the Arizona State Legislature website is provided, but students living in other states should access their state departments. This resource will be used for the Topic 5 assignment. URL: http://www.azleg.gov/

Unit 5

Q1

Research an organization that uses an innovative model of care. How does this innovative model affect interprofessional collaboration? How might this model contribute to the delivery of cost of effective health care? Make sure to identify the organization and model in your response.

Q2

Define ACOs and discuss their impact on the contemporary health care system. How do ACOs drive cost-effectiveness, innovation, and collaboration in the delivery of health care?

STUDY MATERIALS

Read Chapters 8 and 9 in Advanced Practice Nursing: Essential Knowledge for the Profession. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php  Read Chapter 5 in Leadership in Nursing Practice: Changing the Landscape of Health Care. Review Chapter 1. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/leadership-in-nursing-practice_changing-the-landscape-of-healthcare_3e.php Read “Accountable Care Organizations (ACOs): General Information,” located on the Centers for Medicare and Medicaid Services website (2015).    URL: https://innovation.cms.gov/initiatives/ACO   Read “Accountable Care Organizations (ACO),” located on the Centers for Medicare and Medicaid Services website (2015). URL: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/aco/  Read “Productivity and Quality of Hospitals that Joined the Medicare Shared Savings Accountable Care Organization Program,” by Highfill and Ozcan, from International Journal of Healthcare Management (2016). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=118862971&site=eds-live&scope=site    Read “Accountable Care Organizations (ACOs),” by Dewey, from Salem Press Encyclopedia of Health (2016). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ers&AN=113931243&site=eds-live&scope=site

Unit 6

Q1

In what ways can informatics help health care providers overcome current or emerging barriers to care and increase access to safe, quality health care? Include a discussion of the value and challenges of clinical provider order entry (CPOE) and clinical decision support systems (CDSS) in providing safe patient care in your response.

Q2

Differentiate between EMRs and EHRs. Discuss the importance of interoperability in relationship to both types of records and to how the EMR and EHR improve quality and access to care.

STUDY MATERIALS

Read Chapters 12 and 15 in Advanced Practice Nursing: Essential Knowledge for the Profession. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php Read Chapters 2, 9, 10, 11, and 13 in Nursing Informatics and the Foundation of Knowledge. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2017/nursing-informatics-and-the-foundation-of-knowledge_4e.php   Read “EMR vs EHR – What Is the Difference?” by Garrett and Seidman (2011), located on the Health IT Buzz website. URL: https://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference/   Read “What Is the Difference Between Health Informatics and Health Information Management?” by Kirshner, located on the Oregon Institute of Technology website. URL: http://www.oit.edu/docs/default-source/programs-information-technology-documents/health-informatics/what-is-the-difference-between-hi-him.pdf?sfvrsn=2   Read “Quality Measures,” located on the Centers for Medicare and Medicaid Services website (2016). URL: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/index.html   Explore the American Health Information Management Association (AHIMA) website. URL: http://www.ahima.org/   Explore the Agency for Healthcare Research and Quality (AHRQ) website. URL: http://www.ahrq.gov/   Read “Writing an Issue Brief,” located on the American Association of Colleges of Pharmacy website (2016). This resource will help you complete your Topic 6 assignment. URL: https://www.aacp.org/article/writing-issue-brief  Read “The Mechanics of Writing a Policy Brief,” by DeMarco and Tufts, from Nursing Outlook (2014). This resource will help you complete your Topic 6 assignment.   URL: http://www.nursingoutlook.org/article/S0029-6554%2814%2900057-8/abstract Explore the issue briefs available on the Expert Policy Analysis page of the American Nurses Association (ANA) website. This resource will help you complete your Topic 6 assignment. URL: http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs   Explore the issue briefs available on the ACNM Library page of the American College of Nurse-Midwives (ACNM) website. This resource will help you complete your Topic 6 assignment. URL: https://www.midwife.org/default.aspx?bid=59&cat=7&button=Search

Unit 7

Q1

What quality standards or performance measures guide your role or specialty as an advanced registered nurse? Using these standards, discuss how informatics can be used to improve quality of care. Make sure to discuss meaningful use and incorporate the topic materials, such as the American Health Information Management Association (AHIMA) and Information Governance websites in your response.

Q2

Review HIPAA, protected health information (PHI), and requirements for privacy and confidentiality in EHRs. Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice. Discuss possible consequences for compromising patient data and measures you can implement in your own practice to protect patient privacy and confidentiality.

STUDY MATERIALS

Read Chapters 16 and 17 in Advanced Practice Nursing: Essential Knowledge for the Profession. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php Read Chapters 8, 14, 16, and 18 in Nursing Informatics and the Foundation of Knowledge. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2017/nursing-informatics-and-the-foundation-of-knowledge_4e.php   Review “What Is the Difference Between Health Informatics and Health Information Management?” by Kirshner, located on the Oregon Institute of Technology website. URL: http://www.oit.edu/docs/default-source/programs-information-technology-documents/health-informatics/what-is-the-difference-between-hi-him.pdf?sfvrsn=2 Review “Quality Measures,” located on the Centers for Medicare and Medicaid Services website (2016). URL: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/index.html   Explore the Meaningful Use section of the Centers for Disease Control and Prevention (CDC) website. URL: http://www.cdc.gov/ehrmeaningfuluse/resources.html

Unit 8

Q1

Open and clear communication is critical for the effective functioning of the interprofessional team and the delivery of safe patient care. Discuss the way communication technologies can enhance coordination of care by interprofessional teams. Be sure to discuss a specific communication technology in your responseQ2

Virtual care and telehealth technologies have the capability to greatly expand access to quality health care. Discuss some benefits and drawbacks of virtual care/telehealth particularly related to the collaboration and coordination of care and the role of the advanced registered nurse.

STUDY MATERIALS

Read Chapters 15 and 23 in Nursing Informatics and the Foundation of Knowledge. URL: https://www.gcumedia.com/digital-resources/jones-and-bartlett/2017/nursing-informatics-and-the-foundation-of-knowledge_4e.php

Explore the HealthIT.gov website.URL: https://www.healthit.gov/