Please complete this assignment on the worksheet attached.
1.Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..
2.Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.
3.Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE form) to document the practice issue presented and approved by your instructor in the Week 2 Discussions.
4.You are required to complete the form using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page.
5.Your practice issue will be the same for all three Milestone assignments in this course.
6.Please type your answers directly into the worksheet.
Evidence Summary Worksheet Directions
1.Develop an evidence summary by following the grading criteria below.
2.Document this on the evidence summary portion of the worksheet.
3.You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
4.Please type your answers directly into the worksheet.
THE CHOSEN REVIEW SYSTEM
Obstetrics/Delivery
McFadden, A., Gavine, A., Renfrew, M. J., Wade, A., Buchanan, P., Taylor, J. L., … MacGillivray, S. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD001141. doi:10.1002/14651858.CD001141.pub5
Abstract
Background
There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended that infants be breastfed exclusively until six months of age, with breastfeeding continuing as an important part of the infant’s diet until at least two years of age. However, current breastfeeding rates in many countries do not reflect this recommendation.
Objectives
To describe forms of breastfeeding support which have been evaluated in controlled studies, the timing of the interventions and the settings in which they have been used.
To examine the effectiveness of different modes of offering similar supportive interventions (for example, whether the support offered was proactive or reactive, face-to-face or over the telephone), and whether interventions containing both antenatal and postnatal elements were more effective than those taking place in the postnatal period alone.
To examine the effectiveness of different care providers and (where information was available) training.
To explore the interaction between background breastfeeding rates and effectiveness of support.
Search methods
We searched Cochrane Pregnancy and Childbirth’s Trials Register (29 February 2016) and reference lists of retrieved studies.
Selection criteria
Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care.
Data collection and analysis
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach.
Main results
This updated review includes 100 trials involving more than 83,246 mother-infant pairs of which 73 studies contribute data (58 individually-randomised trials and 15 cluster-randomised trials). We considered that the overall risk of bias of trials included in the review was mixed. Of the 31 new studies included in this update, 21 provided data for one or more of the primary outcomes. The total number of mother-infant pairs in the 73 studies that contributed data to this review is 74,656 (this total was 56,451 in the previous version of this review). The 73 studies were conducted in 29 countries. Results of the analyses continue to confirm that all forms of extra support analyzed together showed a decrease in cessation of ‘any breastfeeding’, which includes partial and exclusive breastfeeding (average risk ratio (RR) for stopping any breastfeeding before six months 0.91, 95% confidence interval (CI) 0.88 to 0.95; moderate-quality evidence, 51 studies) and for stopping breastfeeding before four to six weeks (average RR 0.87, 95% CI 0.80 to 0.95; moderate-quality evidence, 33 studies). All forms of extra support together also showed a decrease in cessation of exclusive breastfeeding at six months (average RR 0.88, 95% CI 0.85 to 0.92; moderate-quality evidence, 46 studies) and at four to six weeks (average RR 0.79, 95% CI 0.71 to 0.89; moderate quality, 32 studies). We downgraded evidence to moderate-quality due to very high heterogeneity.
We investigated substantial heterogeneity for all four outcomes with subgroup analyses for the following covariates: who delivered care, type of support, timing of support, background breastfeeding rate and number of postnatal contacts. Covariates were not able to explain heterogeneity in general. Though the interaction tests were significant for some analyses, we advise caution in the interpretation of results for subgroups due to the heterogeneity. Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Several factors may have also improved results for women practising exclusive breastfeeding, such as interventions delivered with a face-to-face component, high background initiation rates of breastfeeding, lay support, and a specific schedule of four to eight contacts. However, because within-group heterogeneity remained high for all of these analyses, we advise caution when making specific conclusions based on subgroup results. We noted no evidence for subgroup differences for the any breastfeeding outcomes.
Authors’ conclusions
When breastfeeding support is offered to women, the duration and exclusivity of breastfeeding is increased. Characteristics of effective support include: that it is offered as standard by trained personnel during antenatal or postnatal care, that it includes ongoing scheduled visits so that women can predict when support will be available, and that it is tailored to the setting and the needs of the population group. Support is likely to be more effective in settings with high initiation rates. Support may be offered either by professional or lay/peer supporters, or a combination of both. Strategies that rely mainly on face-to-face support are more likely to succeed with women practising exclusive breastfeeding.
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Practice Experinece
/in Uncategorized /by developerPractice Experience: Quality Improvement Storyboard
Storyboard Instructions
The Practice Experience Project Storyboard is a brief, visual summary of a completed quality improvement initiative. The storyboard highlights key aspects of a quality improvement effort by documenting the Practice Experience Project from beginning to end.
The course template uses a PowerPoint format to complete this assignment. You only need to provide two slides, no more. The first slide is the summary of your project; the second slide is the reference page. You will need to choose the most pertinent information from your practice experience and Capstone Paper to complete the Storyboard. No voice over is required.
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Practice Issue And Evidence Summary Guidelines
/in Uncategorized /by developerPlease complete this assignment on the worksheet attached.
1.Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..
2.Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.
3.Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE form) to document the practice issue presented and approved by your instructor in the Week 2 Discussions.
4.You are required to complete the form using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page.
5.Your practice issue will be the same for all three Milestone assignments in this course.
6.Please type your answers directly into the worksheet.
Evidence Summary Worksheet Directions
1.Develop an evidence summary by following the grading criteria below.
2.Document this on the evidence summary portion of the worksheet.
3.You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
4.Please type your answers directly into the worksheet.
THE CHOSEN REVIEW SYSTEM
Obstetrics/Delivery
McFadden, A., Gavine, A., Renfrew, M. J., Wade, A., Buchanan, P., Taylor, J. L., … MacGillivray, S. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD001141. doi:10.1002/14651858.CD001141.pub5
Abstract
Background
There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended that infants be breastfed exclusively until six months of age, with breastfeeding continuing as an important part of the infant’s diet until at least two years of age. However, current breastfeeding rates in many countries do not reflect this recommendation.
Objectives
To describe forms of breastfeeding support which have been evaluated in controlled studies, the timing of the interventions and the settings in which they have been used.
To examine the effectiveness of different modes of offering similar supportive interventions (for example, whether the support offered was proactive or reactive, face-to-face or over the telephone), and whether interventions containing both antenatal and postnatal elements were more effective than those taking place in the postnatal period alone.
To examine the effectiveness of different care providers and (where information was available) training.
To explore the interaction between background breastfeeding rates and effectiveness of support.
Search methods
We searched Cochrane Pregnancy and Childbirth’s Trials Register (29 February 2016) and reference lists of retrieved studies.
Selection criteria
Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care.
Data collection and analysis
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach.
Main results
This updated review includes 100 trials involving more than 83,246 mother-infant pairs of which 73 studies contribute data (58 individually-randomised trials and 15 cluster-randomised trials). We considered that the overall risk of bias of trials included in the review was mixed. Of the 31 new studies included in this update, 21 provided data for one or more of the primary outcomes. The total number of mother-infant pairs in the 73 studies that contributed data to this review is 74,656 (this total was 56,451 in the previous version of this review). The 73 studies were conducted in 29 countries. Results of the analyses continue to confirm that all forms of extra support analyzed together showed a decrease in cessation of ‘any breastfeeding’, which includes partial and exclusive breastfeeding (average risk ratio (RR) for stopping any breastfeeding before six months 0.91, 95% confidence interval (CI) 0.88 to 0.95; moderate-quality evidence, 51 studies) and for stopping breastfeeding before four to six weeks (average RR 0.87, 95% CI 0.80 to 0.95; moderate-quality evidence, 33 studies). All forms of extra support together also showed a decrease in cessation of exclusive breastfeeding at six months (average RR 0.88, 95% CI 0.85 to 0.92; moderate-quality evidence, 46 studies) and at four to six weeks (average RR 0.79, 95% CI 0.71 to 0.89; moderate quality, 32 studies). We downgraded evidence to moderate-quality due to very high heterogeneity.
We investigated substantial heterogeneity for all four outcomes with subgroup analyses for the following covariates: who delivered care, type of support, timing of support, background breastfeeding rate and number of postnatal contacts. Covariates were not able to explain heterogeneity in general. Though the interaction tests were significant for some analyses, we advise caution in the interpretation of results for subgroups due to the heterogeneity. Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Several factors may have also improved results for women practising exclusive breastfeeding, such as interventions delivered with a face-to-face component, high background initiation rates of breastfeeding, lay support, and a specific schedule of four to eight contacts. However, because within-group heterogeneity remained high for all of these analyses, we advise caution when making specific conclusions based on subgroup results. We noted no evidence for subgroup differences for the any breastfeeding outcomes.
Authors’ conclusions
When breastfeeding support is offered to women, the duration and exclusivity of breastfeeding is increased. Characteristics of effective support include: that it is offered as standard by trained personnel during antenatal or postnatal care, that it includes ongoing scheduled visits so that women can predict when support will be available, and that it is tailored to the setting and the needs of the population group. Support is likely to be more effective in settings with high initiation rates. Support may be offered either by professional or lay/peer supporters, or a combination of both. Strategies that rely mainly on face-to-face support are more likely to succeed with women practising exclusive breastfeeding.
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Practicum Assessing Client Progress
/in Uncategorized /by developerAssignment 2: Practicum – Assessing Client Progress
Learning Objectives
Students will:
· Assess progress for clients receiving psychotherapy
· Differentiate progress notes from privileged notes
· Analyze preceptor’s use of privileged notes
To prepare:
· Reflect on the client you selected for the Week 3 Practicum Assignment.
· Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.
The Assignment
Part 1: Progress Note
Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):
· Treatment modality used and efficacy of approach
· Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)
· Modification(s) of the treatment plan that were made based on progress/lack of progress
· Clinical impressions regarding diagnosis and/or symptoms
· Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)
· Safety issues
· Clinical emergencies/actions taken
· Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)
· Treatment compliance/lack of compliance
· Clinical consultations
· Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)
· Therapist’s recommendations, including whether the client agreed to the recommendations
· Referrals made/reasons for making referrals
· Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
· Issues related to consent and/or informed consent for treatment
· Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
· Information reflecting the therapist’s exercise of clinical judgment
Note: Be sure to exclude any information that should not be found in a discoverable progress note.
Part 2: Privileged Note
Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment.
· The privileged note should include items that you would not typically include in a note as part of the clinical record.
· Explain why the items you included in the privileged note would not be included in the client’s progress note.
· Explain whether your preceptor uses privileged notes, and if so, describe the type of information he or she might include. If not, explain why.
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Practicum Assessing Clients 18583081
/in Uncategorized /by developerLearning Objectives Students will: •Assess clients presenting for psychotherapy •Develop genograms for clients presenting for psychotherapy
To prepare: •Select a client whom you have observed or counseled at your practicum site. •Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.
The Assignment
Part 1: Comprehensive Client Family Assessment With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations): •Demographic information •Presenting problem •History or present illness •Past psychiatric history •Medical history •Substance use history •Developmental history •Family psychiatric history •Psychosocial history •History of abuse/trauma •Review of systems •Physical assessment •Mental status exam •Differential diagnosis •Case formulation •Treatment plan
Part 2: Family Genogram Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).
Required Readings:
(1) Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
ATTACHED WITH THIS HOMEWORK IS A SAMPLE OF THIS ASSIGNMENT AND REMEMBER IT HAS TWO PARTS.
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Practicum Assessing Clients 18583085
/in Uncategorized /by developerLearning Objectives Students will: •Assess clients presenting for psychotherapy • Develop genograms for clients presenting for psychotherapy
To prepare: • Select a client whom you have observed or counseled at your practicum site. • Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.
The Assignment
Part 1: Comprehensive Client Family Assessment With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations): •Demographic information •Presenting problem •History or present illness •Past psychiatric history •Medical history • Substance use history •Developmental history •Family psychiatric history •Psychosocial history •History of abuse/trauma •Review of systems •Physical assessment •Mental status exam •Differential diagnosis •Case formulation •Treatment plan
Part 2: Family Genogram Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).
Required Readings:
(1) Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
ATTACHED WITH THIS HOMEWORK IS A SAMPLE OF THIS ASSIGNMENT AND REMEMBER IT HAS TWO PARTS.
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Practicum Assessing Clients 18583091
/in Uncategorized /by developerLearning Objectives Students will: •Assess clients presenting for psychotherapy • Develop genograms for clients presenting for psychotherapy
To prepare: • Select a client whom you have observed or counseled at your practicum site. • Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.
The Assignment
Part 1: Comprehensive Client Family Assessment With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations): •Demographic information •Presenting problem •History or present illness •Past psychiatric history •Medical history • Substance use history •Developmental history •Family psychiatric history •Psychosocial history •History of abuse/trauma •Review of systems •Physical assessment •Mental status exam •Differential diagnosis •Case formulation •Treatment plan
Part 2: Family Genogram Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).
Required Readings:
(1) Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
ATTACHED WITH THIS HOMEWORK IS A SAMPLE OF THIS ASSIGNMENT AND REMEMBER IT HAS TWO PARTS.
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Practicum Assessing Clients 18583097
/in Uncategorized /by developerLearning Objectives Students will: •Assess clients presenting for psychotherapy • Develop genograms for clients presenting for psychotherapy
To prepare: • Select a client whom you have observed or counseled at your practicum site. • Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.
The Assignment
Part 1: Comprehensive Client Family Assessment With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations): •Demographic information •Presenting problem •History or present illness •Past psychiatric history •Medical history • Substance use history •Developmental history •Family psychiatric history •Psychosocial history •History of abuse/trauma •Review of systems •Physical assessment •Mental status exam •Differential diagnosis •Case formulation •Treatment plan
Part 2: Family Genogram Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).
Required Readings:
(1) Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
ATTACHED WITH THIS HOMEWORK IS A SAMPLE OF THIS ASSIGNMENT AND REMEMBER IT HAS TWO PARTS.
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Practicum Assessing Clients 18583101
/in Uncategorized /by developerLearning Objectives Students will: •Assess clients presenting for psychotherapy • Develop genograms for clients presenting for psychotherapy
To prepare: • Select a client whom you have observed or counseled at your practicum site. • Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.
The Assignment
Part 1: Comprehensive Client Family Assessment With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations): •Demographic information •Presenting problem •History or present illness •Past psychiatric history •Medical history • Substance use history •Developmental history •Family psychiatric history •Psychosocial history •History of abuse/trauma •Review of systems •Physical assessment •Mental status exam •Differential diagnosis •Case formulation •Treatment plan
Part 2: Family Genogram Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).
Required Readings:
(1) Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
ATTACHED WITH THIS HOMEWORK IS A SAMPLE OF THIS ASSIGNMENT AND REMEMBER IT HAS TWO PARTS.
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Practicum Assessing Clients
/in Uncategorized /by developerLearning Objectives Students will: •Assess clients presenting for psychotherapy •Develop genograms for clients presenting for psychotherapy
To prepare: •Select a client whom you have observed or counseled at your practicum site. •Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.
The Assignment
Part 1: Comprehensive Client Family Assessment With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations): •Demographic information •Presenting problem •History or present illness •Past psychiatric history •Medical history •Substance use history •Developmental history •Family psychiatric history •Psychosocial history •History of abuse/trauma •Review of systems •Physical assessment •Mental status exam •Differential diagnosis •Case formulation •Treatment plan
Part 2: Family Genogram Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).
Required Readings:
(1) Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
ATTACHED WITH THIS HOMEWORK IS A SAMPLE OF THIS ASSIGNMENT AND REMEMBER IT HAS TWO PARTS.
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Practicum Assignment 19202329
/in Uncategorized /by developerAssignment: Practicum – Week 1 Journal Entry
As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your practicum experience. By applying the concepts you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.
In preparation for this course’s practicum experience, address the following in your Practicum Journal:
· Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.
Explain why you selected these theories. Support your approach with evidence-based literature.
· Develop at least three goals and at least three objectives for the practicum experience in this course.
· Create a timeline of practicum activities based on your practicum requirements.
Resources:
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