discussion reply 3

provide further suggestions on how their database search might be improved. use 2 sources 

The PICO(T) question is, “Among hospitalized patients, does using two identifiers compared to one reduce medical errors?” My clinical issue of interest is the reduction of medical errors. Medical errors are gaps in care that bear potential or actual capacity to harm the patient, such as inaccurate diagnosis and incomplete diagnosis (Aljabari & Kadhim, 2021). These have the ripple effect of inappropriate investigations and treatment, then adverse care outcomes (Aljabari & Kadhim, 2021). Some solutions to medical errors include proper identification of patients, thorough history taking, and comprehensive physical examination. One evidence-based method for patient identification is using two identifiers rather than one (Mroz et al., 2019). Therefore, I am prompted to investigate whether using two identifiers compared to one among hospitalized patients reduces medical errors.

Search results discussion 

Regarding my search results, 19,600 articles appeared on the initial original search. As I added search terms such as two identifiers, one identifier, medical errors, and hospitalized patients using Boolean operators such as AND, NOT, and AND NOT, the number of articles appearing kept reducing. At first, they declined to 18,500, then to 17,200, and so on, in a declining trend.

Strategies to optimize database search on my PICO(T) question 

There are several strategies I can apply to optimize how effective a database search is while searching my PICO(T) question. These include having a specific search question, using Boolean operators, using more specific keywords, and using fewer synonyms (Degbelo & Teka, 2019). An example of a particular question is a PICO(T) question, which narrows down to a particular population, intervention, control, outcome, and timing. A more specific example is my PICO(T) question that reads, “Among hospitalized patients, does the use of two identifiers compared to one identifier reduce medical errors?” Besides, examples of Boolean operators are OR, AND, NOT, and AND NOT (Degbelo & Teka, 2019). Specific keywords, like particular search questions, direct the search further, optimizing it to give the best results. An example of keywords in my case includes “hospitalized patients,” “two identifiers,” “one identifier,” and “reduce medical errors.” Lastly, using fewer synonyms helps fetch more search results, broadening your search outcome and choosing relevant resources (Degbelo & Teka, 2019). Applying such strategies helps to make the search process more effective and thorough.

References

Aljabari, S., & Kadhim, Z. (2021). Common barriers to reporting medical errors. The Scientific World Journal, 2021, 1–8. https://doi.org/10.1155/2021/6494889Links to an external site.

Degbelo, A., & Teka, B. B. (2019). Spatial search strategies for Open Government Data. Proceedings of the 13th Workshop on Geographic Information Retrieval. https://doi.org/10.1145/3371140.3371142Links to an external site.

Mroz, J. E., Borkowski, N., Keiser, N., Kennel, V., Payne, S., & Shuffler, M. (2019). Learning from medical error: Current directions in research and practice on medical error prevention. Academy of Management Proceedings, 2019(1), 18084. https://doi.org/10.5465/ambpp.2019.18084symposiumLinks to an external site.  

Nursing 8-3

 Make a quality initiative proposal (7-10 PowerPoint slides) through a presentation, interpreting and communicating dashboard data to support the proposal. 

HERE2

Introduction

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 shared vision and team goals (Mulvale et al., 2016). Participation in interdisciplinary teams can also offer nurses opportunities to share their expertise and leadership skills, fostering a sense of ownership and collegiality.

You are encouraged to complete the Budgeting for Nurses activity before you develop the plan proposal. The activity consists of seven questions that will allow you the opportunity to check your knowledge of budgeting basics and as well as the value of financial resource management. The information gained from completing this formative will promote success with the Interdisciplinary Plan Proposal. Completing this activity also demonstrates your engagement in the course, requires just a few minutes of your time, and is not graded.

Demonstration of Proficiency

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

· 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.

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

· 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.

· 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.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

· Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Reference

Mulvale, G., Embrett, M., & Shaghayegh, D. R. (2016). 'Gearing up' to improve interprofessional collaboration in primary care: A systematic review and conceptual framework. 
BMC Family Practice
17.

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 [DOCX]
 Download Interdisciplinary Plan Proposal Template [DOCX]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 2–4 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.

Note: Faculty may use the Writing Feedback Tool when grading this assessment. The 
Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

Discussions board

APA format minimum of 1 page per discussion. Total of 3 pages for this assignment 

Decision Tree- Assessing and treating patients with anxiety disorder

Case Study:

https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6630/DT/week_05/index.html

Examine
 Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

References:

· Stahl, S. M. (2021). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.

· Chapter 8,  “Anxiety, Trauma, and Treatment” (pp. 359-378)

· American Psychiatric Association. (2010a). 

Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder
Links to an external site.
. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd.pdf

· American Psychiatric Association. (2010c). 

Practice guideline for the treatment of patients with panic disorder
Links to an external site.
 (2nd ed.). https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/panicdisorder.pdf

DEVELOPING A CULTURE OF EVIDENCE-BASED PRACTICE

To Prepare:

  • Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
    • This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
  • Reflect on which type of dissemination strategy you might use to communicate EBP.

Then Post a discussion post of at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified. please provide at least 3 references

The resources:

  • Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
    • Chapter 10, “The Role of Quality Improvement and Evidence-Based Quality Improvement in Practice Change” (pp. 365–393)
    • Chapter 12, “Leadership Strategies for Creating and Sustaining Evidence-based Practice Organizations” (pp. 410–427)
    • Chapter 14, “Models to Guide Implementation and Sustainability of Evidence-based Practice” (pp. 466–518)

w2PEP

this is in correspondence with the goals and objective of the previous work. the one you did,

Summary of strengths:

Psychiatric examination and therapy have been my clinical basis. I am confident in detecting clinical signs, differentiating pathophysiological and psychopathological problems, and performing thorough examinations. My mental state tests, psychosocial data interpretation, and functional evaluations demonstrate my comprehensive patient evaluation skills. I also excel in diagnostic reasoning, accurate diagnosis, and patient-responsive pharmacotherapy. Professional integrity, interdisciplinary teamwork, and empathy and non-judgment demonstrate my patient-centered care. Self-assessment and goal-setting help me grow via reflective practice. With my skills in these areas, I'm ready to improve and seize development possibilities.

Opportunities for growth:

I see places where I can improve my clinical skills as I reflect. While confident in many areas, I want to improve my capacity to distinguish normal and atypical age-related physiological and psychological symptoms to better comprehend patient presentations. I also see an opportunity to improve my selection of evidence-based clinical practice guidelines for psychotherapy planning and precision intervention. Another focus is creating age-appropriate customized care plans based on screening instrument results to improve my ability to give focused and effective treatments. I can recognize complex needs and build therapies that connect with patients' particular situations by strengthening these abilities. I want to improve my mental consultation suggestion and referral documentation. This will help multidisciplinary teams communicate and provide comprehensive patient care. My desire to enhance these areas drives my dedication to progress, helping me to confidently confront complicated mental health practice difficulties. Taking advantage of these changes will improve my skills and help me give excellent care to people and their families.

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1.

Goal: Enhance Diagnostic Reasoning Skills

a.
Objective: Refresh your DSM-5 criteria for common psychiatric diseases.

b.
Objective: Discuss differential diagnosis with preceptor regularly to emphasize various patient situations.

c.
Objective: Assess data and make accurate diagnoses based on age-related physiological and psychological changes.

2.
Goal: Strengthen Psychotherapeutic Treatment Planning

a.
Objective: Learn about evidence-based psychotherapy methods for various ages.

b.
Objective: Work with preceptor to choose psychotherapy methods for different patient circumstances, following professional criteria.

c.
Objective: Confidently use age-appropriate psychotherapy counseling methods and adjust them to patient reactions.

3.
Goal: Optimize Screening Instruments and Referrals

a.
Objective: Research and comprehend mental health screening tools throughout the lifetime.

b.
Objective: Effectively and supportively screen patients using screening equipment.

c.
Objective: Independently analyze screening instrument findings to suggest areas for additional examination and intervention.

I need plagiarism minimized, good references and medical words. the paper follows correct APA format, valid references (more than 4)

·

· Review your Clinical Skills Self-Assessment Form you submitted and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the practicum help you achieve these aims?  

· Review the information related to developing objectives provided in this week’s Learning Resources. Your practicum learning objectives that you want to achieve during your practicum experience must be: 

· Specific  

· Measurable  

· Attainable  

· Results-focused  

· Time-bound

· Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)  

Note: Please make sure your objectives are individualized and outlined in your Practicum Experience Plan (PEP). While you may add previous objectives to continue to work toward. You must have 3 new objectives for each class, each quarter. 

· Discuss your professional aims and your proposed practicum objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.  

· Select one nursing theory and one counseling/psychotherapy theory to best guide your clinical practice. Explain why you selected these theories. Support your approach with evidence-based literature.

· Create a timeline of practicum activities that demonstrates how you plan to meet these goals and objectives based on your practicum requirements.

THE ASSIGNMENT

Record the required information in each area of the Practicum Experience Plan template, including 3–4 
measurable practicum learning objectives you will use to facilitate your learning during the practicum experience.  

questions

Original Work, No Plagiarism, Cite and Reference

Kara is a pre-doctoral student who works for a very demanding principal investigator (PI) in psychology. Dr. Srichaphan considers himself her mentor even though he seems to offer no constructive guidance.

She considers herself an expert problem solver. The trouble is, she can’t figure out how to solve her problems with her mentor. Not only is he exacting and demanding, but he also is exploitative and intolerant—finding fault with her for not being able to keep up with the rigors of academic and clinical studies even though he’s the one who’s overloading her with too much work.

The last straw is an invitation to be a “guest lecturer” in a section of her mentor’s undergraduate cognitive processes class. She can’t very well say no. It would only make her look inept. Still, it couldn’t come at a worse time. The research study that Kara is primary coordinator of has just been halted—it turns out one of the protocols needs many changes, and some of the changes will have to go through the IRB again. They are complex and require careful thought. All the protocol forms will need to be filled out again, the consent forms revised, and the study procedures redone. These changes will have to be made quickly since the study cannot resume until the IRB approves of the new modifications. 

Meanwhile, the undergraduate section of the class Kara’s been given to lead is so large that it’s fast becoming like a full teaching load. The course is not going well because the syllabus that her mentor developed was not well thought out, and many students are coming to Kara’s office to complain. One of the complaints is that there is a cheating ring among some of the students. When she tells her mentor, Dr. Srichaphan blames it on her teaching. She is so taken aback that all she can do is splutter that it’s not her fault—the cheating ring extends to other study sections as well and may even have begun there. Ignoring her protests, he informs her that she needs to provide assistance at a clinical rotation site.

Kara can’t believe her ears. She feels like she will crack under the strain if one more thing is added to her load of duties. Just the thought of arguing with her mentor makes her queasy, but she does her best to remind him that she has her own coursework as a doctoral student and has two term papers due in the next three weeks. She begs him to assign someone else to the clinical rotation. He frowns. “It’s gotten to the point where you cannot handle your research and teaching responsibilities, evidently,” he goads her.  Kara, who prides herself on her “can do” style, finds she simply cannot do all that is required of her. She’s on the verge of retching from nerves. Her mentor is not impressed. He shakes his head and tells her that science is not for the faint of heart.

Questions

1. What’s the worst thing that could happen if she does nothing?

2. What’s the worst that could happen if she seeks a new approach to getting through this?

3. How might Kara ask for help? From whom? With what likely result?

4. What types of expectations should have been discussed among Kara, the mentor, the program director, and/or the graduate school to avoid these types of problems?

5. Can you offer an example of stressful or disastrous situation based on your own learning experiences? How did you deal with it, and what lessons did you learn?

customer service ip 3

 This soft drink brand is recognized worldwide. The drink has one of the most recognized corporate logos and is sold in over 200 countries through 250 bottlers throughout the world.

This company’s story began in Atlanta, Georgia, in 1886, when pharmacist John Pemberton was experimenting with a recipe that he later mixed with carbonated water and began to sell at his drugstore. Two years after its invention, Pemberton sold his secret formula to a businessman by the name of Asa Candler, who formed a corporation to bottle and distribute the trendy drink. He later sold the rights to two other businessmen who wanted to bottle the drink to enhance distribution. Candler sold syrup that his company produced to these distributors, but not his secret formula. They simply mixed the syrup with carbonated water and bottled it. From there, the product became a household name as more people began to take the drink home to enjoy.

Competitors soon emerged. To ensure that people could tell the original from the competition, the distributors created the trademarked contour bottle in 1916 so that customers would recognize the original product. Candler ultimately sold his company in 1919 to a group of investors, with Robert Woodruff as the president. The new group wanted to make the drink available anytime and anyplace. To accomplish this, the new company started adding bottling plants all over the world.

The six Ps of the company vision statement highlight its purpose and desired future objectives—people, portfolio, partners, planet, profit, and productivity.

To assist in accomplishing its vision, the company established a foundation in 1984. This entity focuses on helping and giving back to communities worldwide. Some of the issues supported in various countries include water stewardship (providing safe, clean drinking water), lifestyle and behavioral change programs (e.g., nutrition, exercise, and behavior modification), recycling, and education.

Assignment Details

Answer the following questions 

  1. What is your opinion of this company? Explain.
  2. Based on what you know or what you read on the Internet or in other sources, do you believe that the company is customer-focused? Why or why not?
  3. How does the company’s community involvement potentially affect its image in the eyes of customers or potential customers?

DB

Answer with at least 6 sentences, one scholarly reference ( discussion doesn’t have to be long just enough to get the question answered ) 

  

Scenario 1: Myocardial Infarction

CC: “I woke up this morning at 6 a.m. with numbness in my left arm and pain in my chest. It feels tight right here (mid-sternal).” “My dad had a heart attack when he was 56-years-old and I am scared because I am 56-years-old.” 

HPI: Patient is a 56-year-old Caucasian male who presents to Express Hospital  Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states this started this morning and has been getting worse, pointing to the mid-sternal area, “it feels like an elephant is sitting on my chest and having a hard time breathing”. He rates the pain as 9/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, or lightheadedness. Nitroglycerin 0.4 mg tablet sublingual x 1 which decreased pain to 7/10.

Lipid panel reveals Total Cholesterol 424 mg/dl, high density lipoprotein (HDL) 26 mg/dl, Low Density Lipoprotein (LDL) 166 mg/dl, Triglycerides 702 mg/dl, Very Low-Density Lipoprotein (VLDL) 64 mg/dl

His diagnosis is an acute inferior wall myocardial infarction.

Question:

Which cholesterol is considered the “good” cholesterol and what does it do?