1. Create a 5- to 7-minute powerpoint explaining the key components of your research proposal. By Wednesday, submit the following points:

·  A brief introduction, including your research questions and hypothesis

· The significance to nursing/nursing education

· An overview of your literature review

· A summary of your design and methodology

· Your sample data collection procedures

· An overview of your data analysis plan

· Ethical considerations

· A summary and conclusion of your research proposal

2. Include a brief self reflection about the project. If you were to implement your research, would you do anything differently? Why or why not? 

3. Add your powerpoint to this discussion board by creating a new thread with your name and Research topic. Ex: Smith_EHealth

Your powerpoint should be succinct and include visuals if necessary. Make sure to post your presentation by Wednesday of this week.

*This discussion board is worth 50 points this week. 

 Create a concept map for this case study using this template. 

Review your Clinical Skills Self-Assessment Form you submitted last week 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 main Assignment

POST : 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.  

 LEARNING Resources

Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.For review as needed:

“Section I. General Principles of Effective Interviewing” (Chapters 1–13)

“Section III. Interviewing for Diagnosis: The Psychiatric Review of Symptoms” (Chapters 19–22) Appendixes A–C

MeditrekLinks to an external site.

https://edu.meditrek.com/Default.html

Note: Use this website to log into Meditrek to report your clinical hours and patient encounters.

Links to an external site.

Walden University Academic Skills Center. (2017). Developing SMART goalsLinks to an external site..

https://academicguides.waldenu.edu/ld.php?content_id=51901492

Complete this schedule.

Part 2: Individualized Practicum Learning Objectives

Refer to the instructions in Week 2 to create individualized practicum learning objectives

that meet the requirements for this course. These objectives should be aligned specifically

to your Practicum experience. Your objectives should address your self-assessment of the

skills found in the “PMHNP Clinical Skills Self-Assessment Form” you completed in Week 1.

As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found to guide your development.

Once you review your resources, continue, and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.

 YOU MUST HAVE 3 NEW OBJECTIVES EACH QUARTER. You may include previous practicum objectives; however, you still must have 3 new objectives for your current course.

Objective 1: (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented )

PRAC Course Outcome(s) Addressed:

(for example) Develop professional plans in advanced nursing practice for the practicum experience

(for example) Assess advanced practice nursing skills for strengths and

opportunities

Objective 2: (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented)

PRAC Course Outcome(s) Addressed:

Objective 3: (Note: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented )

PRAC Course Outcome(s) Addressed:

Assignment Directions: 

1. Review your participant’s holistic assessment form from week 3 as well as feedback from your instructor. Make sure your participant and medical condition are approved before creating the presentation.
2. Using the Grand Rounds Slide Outline provided, create a 10-slide presentation. You should have one slide for each content area. Do not include more content slides. You may include an additional reference slide if needed. Slide design should be professional and engaging for the target audience.  Review the grading rubric for details and expectations. 

Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .

Lili Ketema

Clinical Decision Support Systems

Pros	Cons
Patient Safety. Clinical Decision Support Systems empower Advanced Practice Nurses to make decisions in a timely and informed manner by detecting diseases early and managing them effectively (Ayed Aloufi, 2020). CDSS has reminder systems for medical events different from the ones related to medicine. For example, CDSS for measuring blood glucose in the ICU can decrease the frequency of hypoglycemia events (Sutton et al., 2020). This CDSS automatically prompts nurses to take glucose measurements with respect to the local glucose monitoring protocol that specifies particular patient demographics and previous glucose trends.	Overreliance. CDSS may increase patient safety but increase reliance on the system, resulting in a decrease in critical thinking capabilities since the APN does not feel impelled to utilize their clinical judgment capabilities. This development is undesirable because the APN becomes less equipped for a task that they can execute in the absence of a CDSS. Sutton et al. (2020) compare overreliance on CDSS to using a calculator in math; the authors indicate that the user’s mental math skills decline with extended use. Therefore, APNs may end up less equipped to execute the services they should execute with ease.
Improved Accuracy and Efficiency. CDSS can process significant quantities of patient data swiftly and precisely, empowering providers of care to effectively diagnose and plan for treatment (Ayed Aloufi, 2020). This decreases the possibility of errors by providing computerized consultation. The Diagnostic Decision Support Service provides data/user selections and then outputs a list of possible diagnoses (Sutton et al., 2020). These developments enhance EHR-integration as well as standardized vocabulary such as Snomed Clinical Terms.	System and Content Maintenance. Maintenance is an often neglected aspect of the lifecycle of the CDSS. Maintenance encompasses technical and content of the systems that power the CDSS. The applications and knowledge-base of the CDSS should always be apace with the shifting nature of clinical guidelines and medical practice. Failure to stay updated may limit the CDSS’ capacity to maintain the desired levels of accuracy and efficiency. Sutton et al. (2020) assert that even the healthcare institutions that are highly advanced experience challenges keep9ing abreast with keeping their systems updated due to the inevitability of changes in medical knowledge bases.
Cost Containment. The capacity of CDSS to decrease the length of stay for in-patients, provide clinical interventions, decrease test duplication, and suggest cheaper alternatives of medicine makes the systems more efficient (Sutton et al., 2020). For example, a CPOE-integrated has the capacity to limit the scheduling of blood count to a 24-hr interval when implemented in a paediatric cardiovascular intensive care unit. This laboratory resource utilization cost-reduction has a predictable cost discount of $717,538 every year, minus increasing mortality or length of stay. These advantages reveal the highly capabe nature of the CDSS to contain costs associated with hospital procedures and the overall ROI associated with CDSSs.	The system is predicated on computer literacy. Decreased proficiency in technology can be limiting when a person is engaging with CDSS. The high design details associated with CDSS may be exceedingly complicated, decreasing the capacity of some APNs to use them to reach the advantages associated with the implementation of the system within a hospital setting (Sutton et al., 2020). Although some systems stay as close to close functionality as possible, every new system has a learning period, meaning the baseline of the technological competence of users is appropriate. Further training for APNs increase on the costs that the institution was aiming at cutting in the first place.

Future role as an APN and clinical patient and scenario 

A 68 year old man who has a history of diabetes, hypertension, and chronic renal disease shows up at the clinic complaining of fatigue, increased thirst, and frequent urination. Since I feel the patient's symptoms might be brought on by uncontrolled diabetes, I have made the decision as a prospective APN healthcare professional to ask for a blood test to confirm the diagnosis.

Impact of CDSS: Before prescribing any new medications, the system alerts me about the patient's current medications, which include metformin and lisinopril. The CDSS also prompts  to consider the patient's renal status.

After noting the CDSS alert, I decide to review the patient's most recent lab results, particularly the estimated glomerular filtration rate (eGFR). The patient has substantial renal impairment, as seen by their eGFR, which is less than 30 mL/min/1.73m2, as I learned after examining the lab results.

In light of the CDSS alert and the patient's test results, I decide to alter the patient's prescription regimen. As opposed to providing a conventional oral anti-diabetic prescription like sulfonylureas, which may be contraindicated in patients with severe renal impairment, as APN i would consider alternate choices such insulin treatment or a newer family of anti-diabetic pharmaceuticals that are safe for patients with renal impairment.

Based on the patient's renal function and the medications they were taking at the time, the CDSS made recommendations. This let the medical practitioner make a more informed decision and avoid any side effects or drug interactions.

This scenario demonstrates how a CDSS might influence a provider's decision by providing timely reminders and cautions based on the patient's specific clinical data. It guarantees that the healthcare provider considers all relevant information and selects the best course of action for the patient's unique needs.

References

Ayed Aloufi, M. (2020). Effect of clinical decision support systems on quality of care by nurses. 
International Journal for Quality Research, 
14(3), 665–678. https://doi.org/10.24874/ijqr14.03-01

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: Benefits, risks, and strategies for Success. 
Npj Digital Medicine, 
3(1). https://doi.org/10.1038/s41746-020-0221-y