For this question, conduct an Internet search and produce at least one research article ( study design must be discussed) addressing one or more of the concepts noted.
How does APN practice demonstrate cost-effectiveness, reduction in errors and misuse or overuse of services?
Theories of successful aging explain factors that support individuals as they grow old, contributing to their ability to function. Increasing your understanding of factors that support successful aging improves your ability to address the needs of elderly clients and their families.
To prepare for this Discussion, review this week’s media. In addition, select a theory of successful aging to apply to Sara’s case.
Clark, E. (2018). Loss and suffering: The role of social work. Retrieved from
http://www.socialworker.com/feature-articles/practice/loss-and-suffering-the-role-of-social-work/
Fisher, C. (2018). Counseling connoisseur: Children and grief. Retrieved from
Zoll, L. (n.d.). A grief trajectory. Retrieved from https://www.socialworktoday.com/news/pp_063017_5.shtml
Post a Discussion in which you:
Post a comparison of the selected board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.
This has to 350 words not counting the title page and references. Only use scholar authors. Please see the attachment for some reference that you can use.
Discussion: Professional Nursing and State-Level Regulations
Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.
It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.
To Prepare:
Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.
Board of nursing (bon) exist in all 50 states, the district of columbia, American Samoa, Guam, the northern mariana island, and the virgin islands. Similar entities may also exist for different region. The mission of BON is the protection of the public through the regulation of nursing practice. Bons put into practice state/region regulation for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.
It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.
To Prepare:
Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.
At list two to three References
“For tomorrow belongs to the people who prepare for it today.” –African proverb
As this course has emphasized, healthcare leaders and managers typically have oversight of a vast array of responsibilities and outcomes. Like a general of an army or a physician helping a patient through a long-term disease, they must demonstrate that they can make critical day-to-day decisions, but they must also have a vision for a better future for those they serve. In healthcare management, that vision can best be achieved through planning involving a strategic process and group of stakeholders.
Healthcare leaders need to know how to ensure that their organizations succeed for the long term, and to anticipate market forces and policy and funding changes, among other challenges. In strategic planning, the process is as important as the plan itself.
This week, you will explore various aspects of strategic planning. You will examine challenges related to strategic planning in healthcare settings, the roles of stakeholders and healthcare leaders in the process, and components and goals of successful strategic plans.
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Course Text: Buchbinder, S. B., & Shanks, N. H. (2017). Introduction to health care management (3rd ed.). Sudbury, MA: Jones & Bartlett.
Chapter 5, “Strategic Planning” (pp. 107–123)
In this chapter, you will be introduced to the strategic planning process within healthcare settings. The author provides insight into the process of identifying a desired future state for a healthcare organization and planning as a means to achieve it.
Last Chance Hospital—Case or Chapters 5 and 6 (pp. 536–537)
Article: Javanparast, S., Freeman, T., Baum, F., Ziersch, A., Mackean, T., Labonte, R., & Sanders, D. (n.d). How institutional forces, ideas and actors shaped population health planning in Australian regional primary health care organisations. BMC Public Health, 18. doi:10.1186/s12889-018-5273-4
Note: You will access this article from the Walden Library databases.
This article features a look at collaborative healthcare planning for population health programs in Australia.
Laureate Education (Producer) (2014c). Strategic planning [Video file]. Baltimore, MD: Author.
The approximate length of this media piece is 4 minutes.
This media features public health leaders discussing various roles, informal and formal, in strategic planning.
Note: You may view this Course Video in the streaming Media Player below or attached and/or linked above with each resource listed. As a reminder, additional Learning Resources for the week are listed below the Media Player. Be sure to scroll to the bottom of the page to view the complete list of Required and/or Optional Resources.
If you experience technical difficulties viewing the Course Media through the Media Player, please contact your Student Support Team at 1-800-WALDENU or [email protected]
The six Ps in the title of this Discussion, “Prior Proper Planning Prevents Poor Performance,” indicate the value of planning. When healthcare leaders and managers carefully plan their goals and strategies for the long-term as well as the short-term and involve the right stakeholders and fully understand their perspectives, this helps the organization be more strategic in attaining its current and future goals.
To prepare for this Discussion:
Post a comprehensive response to the following:
TO REPLY WITH A COMMENT TO EACH POST WITH TWO REFERENCE PER POST APA WITH CITATION ABOVE 2013. THE SECOND POST WILL BE GIVING TOMORROW.
Post 1
Questions
Feedback
The most important people in the client’s life that could provide valuable feedback are her mother, grandmother, and teacher because they have the most contact with the client. The grandmother is important to interview as she may have different experiences with the client while in her care. The grandmother can also be asked about the mother’s behaviors and temperament during her childhood and adolescent years, especially considering the mother is exhibiting obvious symptoms of ADHD in her adult life. Studies have shown a mean heritability rate of 75% in family studies of behavioral disorders (Wilens & Spencer, 2010). The client’s teacher can provide a overview on any specific triggers preceding her tantrums and outbursts in class, and relationships with peers. The mother should be asked about the severity of the client’s behavior and tantrums at home, relationship with sister, and level of disobedience as these assessments may indicate progression into more severe behavioral disorders suggesting prompt attention (Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders, 2015).
Physical Exams and Diagnostic Tests
When diagnosing ADHD and other DBDs, a thorough physical evaluations is needed to rule out medical causes. A structural MRI could document diffuse abnormalities in children with ADHD. A study found, individuals with ADHD may have smaller total cerebrum, cerebellum, and four cerebral lobes that do not change over time; in adults, imaging studies have shown smaller anterior cingulate cortex, thought to be the region that regulates ability to focus on tasks and choose between options, and smaller dorsolateral prefrontal cortex, which controls memory and ability to process new information (Wilens & Spencer, 2010). EEG should also be considered as one study found EEG’s show more Beta activity than Theta/Alpha activity in children medication responders compared to non-medication responders, strongly suggesting a biological correlation to the behaviors in ADHD (Hamed et al., 2015). Blood chemistry, thyroid levels, and ferritin levels have also been linked to the diagnosis of ADHD.
Differential Diagnoses
Pharmacological Agents
Dexedrine Spansule 5mg daily is sustained-release amphetamine used to treat adults and children age 6 years and older with ADHD. The drug has up to an 8-hour duration of clinical action, making its use preferable over IR formulations (Stahl, 2014b). Most stimulants are highly and equally efficacious hence the label as first-line treatment for ADHD. The side effect profile consists of cardiovascular, CNS, and hormonal effects requiring pre-assessment and monitoring throughout therapy. Also, the once a day dosing is beneficial to children because it eliminates the interruption of the school day to take noon dose, maintains confidentiality, and increases likelihood of compliance (Shier, Reichenbacher, Ghuman, H., & Ghuman, J., 2013). Compared to Atomoxetine, a selective norepinephrine reuptake inhibitor used to treat ADHD in adults and children over the age of 6, amphetamines have a more robust response (Shier et al., 2013). Atomoxetine carries the FDA warning for the potential to increase suicidal ideation children and adolescents and is metabolized through the CYP2D6 pathway in which a small percentage of the Caucasian population are poor metabolizers, therefore dose adjustments may be required (Brown et al., 2018).
Lessons Learned
Recommendations for treatment usually accompany the diagnosis of ADHD and have since been a source of controversy. Although stimulant use to treat ADHD shows effectiveness in 65-75% of children after their first trial of use, the potentially dangerous side effects contribute to the indecisiveness of parents and children which affects treatment and compliance (Hamed et al., 2015). Approaching the diagnosis and suggested treatment should be done tactfully, as many parents have negative information and perceptions of the ADHD diagnosis. As the practitioner, it is imperative that the challenges associated with assessing and treated ADHD are known. The concerted effort to successfully treat children with ADHD involves family, caregivers, educators, and healthcare professionals alike.
REFERENCES
Brown, K., Samuel, S., & Patel, D. (2018). Pharmacological management of attention deficit hyperactivity disorder in children and adolescents: A review for practitioners. Translational Pediatrics, 7(1): 36-47. doi: 10.21037/tp.2017.08.02.
Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders (2015). Mental disorders and disabilities among low-income children. Washington, DC: National Academies Press (US).
Hamed, A., Kauer, A., & Stevens, H. (2015). Why the diagnosis of attention deficit hyperactivity disorder matters. Frontiers in Psychiatry, 6: 168. doi: 10.3389/fpsyt.2015.00168.
Shier, A., Reichenbacher, T., Ghuman, H., & Ghuman, J. (2013). Pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: Clinical strategies. Journal of Central Nervous System Disease, 5: 1-17. doi: 10.4137/JCNSD.S6691.
Stahl, S. (2014b). The prescriber’s guide (5th ed.). St. Louis, MO: Cambridge University Press.
Wilens, T. & Spencer, T. (2010). Understanding attention deficit/hyperactivity disorder from childhood to adulthood. Postgraduate Medicine, 122(5): 97-109. doi: 10.3810/pgm.2010.09.2206.
Case #21: Hindsight is always 20/20, or attention deficit hyperactivity disorder
Patient evaluation on intake•
31-year-old man with a chief complaint of anxiety of “different types” •Patient states that he “has been successful in graduate school, has financial worries, but states that he worries and is tense most of the time”
Psychiatric history
•Has been anxious for many years, mostly since college and now graduate school •Working part-time and going to school part-time and feels “torn in many directions” •Generally is tense, restless, irritable, and worries about things even outside school and work–When legitimate stressors diminish, the anxiety lowers, but is still present and discouraging •This causes him to be argumentative and temperamental most of the time •He says he is active and likes to stay busy all of the time, but he wonders if “he is doing too much, as he has no time for all of the things” he wants to do
Social and personal history
•Graduated high school, college, and is enrolled in a graduate-level training program for family counseling •Gainfully employed now in a clinical setting •Married and without children •Does not use drugs or alcohol.
Write a response to the following:
Tutor MUST have a good command of the English language
These are two discussion questions
Your DQ1 and DQ2 posts must be at least 150 words and have at least one reference cited for each question. In-text citation, please
DQ 1
Discuss how genetic and genomics can play a role in a demand for new health services and how it may impact health care expenditures in the chronic disease population. Give one example.
DQ 2
Describe one method that includes using evidence-based data to support a new or innovative way to care for those with chronic disease now or in the future. How will it impact care and what are the anticipated outcomes?
Tutor MUST have a good command of the written English language
There needs to be in text citation and at least 150 words
DQ 2
Evidence-based practice and standardized clinical guidelines have improved organizations and the ability of providers to provide the care with the highest level of evidence to each patient. Describe one pharmacological agent with a protocol/clinical guideline that is used. Discuss how this protocol may not take into consideration genetic variations. What can be done to tailor care to each patient while providing standardized treatments?
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