Nursing

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of the property. In these and other cases, data not only help solve problems but adds to the practitioner’s and the discipline’s body of knowledge.
Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate data to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.
In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.
To Prepare:
Reflect on the concepts of informatics and knowledge work as presented in the Resources.
Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.
By Day 3 of Week 1
Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?
Place your order today!
Solution
Application of Data in Healthcare
In the modern era, healthcare facilities are still experiencing several management issues daily. One of the most immeasurable difficulties experienced by healthcare facilities management is figuring out enough time a physician is ought to spend with a patient (Ahmad et al., 2017). Healthcare providers find it challenging when they have to spend with their patients while attending to them is limited. As a result, lack of enough time with a patient, especially during a consultation, leads to an overload of other tasks, including the clinical and administrative tasks (Consoli et al., 2019). Therefore, the management requires the extensive collection and access of data of the physician’s time spent with a patient to minimize tasks overload.
According to McGonigle and Mastrian (2021), the management requires data to measure performance in healthcare facilities and improve the quality of care provided to the patients. The data used by the administration should include timed sessions and recordings of each patient with a physician. Data in healthcare helps reduce medical costs, improves quality care, and improves patient outcomes. Besides, data help in improving healthcare services by gathering enough knowledge (Pieterse et al., 2019). The awareness acquired from the collected information prompts better time management leading to consumer satisfaction. Also, data in healthcare helps in forecasting competencies. Therefore, a nursing leader can use reasoning and medical judgment when developing the standard time that one patient should spend with a physician during consultation.
Determining enough time the patients should spend with the physician during the consultation is an uphill task for healthcare facility management. The short time allocated to each patient challenges the healthcare providers since they cannot understand the patient’s health issue. Besides, taking a patient’s history and making a diagnosis is a challenge faced by the healthcare providers since the time provided is limited. However, data might be collected through timed sessions and patient interviews to maximize the time spent by the physician and the patent. The data collected through the timed sessions and patient interviews will help the healthcare providers to determine the adequate time required for consultation.
References
Ahmad, B. A., Khairatul, K., & Farnaza, A. (2017). An assessment of patient waiting and consultation time in a primary healthcare clinic. Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia, 12(1), 14.
Consoli, S., Recupero, D. R., & Petkovi?, M. (Eds.). (2019). Data science for healthcare: Methodologies and applications. Springer.
McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers.
Pieterse, A. H., Stiggelbout, A. M., & Montori, V. M. (2019). Shared decision-making and the importance of time. Jama, 322(1), 25-26.

Separation Anxiety Disorder (SAD) in a Child who Has Not Seen His Father in Two Years
Develop a Focused SOAP Note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
Reflection notes: What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you could follow up with this patient.?Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention, taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).
Learning Resources
Required /Optional Readings (click to expand/reduce)
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)
Chapter 9, “Anxiety Disorders”
Chapter 10, “Obsessive-Compulsive and Related Disorders”
Chapter 11, “Trauma- and Stressor-Related Disorders”
Chapter 12, “Dissociative Disorders”
Chapter 26, “Physical and Sexual Abuse of Adults”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
Chapter 26, “Psychosocial Adversity”
Chapter 27, “Resilience: Concepts, Findings, and Clinical Implications”
Chapter 29, “Child Maltreatment”
Chapter 30, Child Sexual Abuse”
Chapter 58, “Disorders of Attachment and Social engagement Related to Deprivation”
Chapter 59, “Post Traumatic Stress Disorder”
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
Chapter 6, “Physical Assessment, Diagnostic Tests, and Differential Diagnosis”
Chapter 12, “Anxiety Disorders”
Document: Career Planner Guide
Document: Focused SOAP Note Template
Document: Focused SOAP Note Exemplar
Required Media (click to expand/reduce)
Centers for Disease Control and Prevention. (2020, April 3). Adverse childhood experiences (ACEs) [Video].
https://www.cdc.gov/violenceprevention/aces/index.html
Dartmouth Films. (2018, September 25). Resilience [Video]. YouTube. https://www.youtube.com/watch?v=bAXZVYDNURY
NCTSN. (2007). The promise of trauma-focused therapy for childhood sexual abuse [Video]. https://www.nctsn.org/resources/promise-trauma-focused-therapy-childhood-sexual-abuse-video
Walden University. (2021). Case study: Dev Cordoba. Walden University Blackboard. https://class.waldenu.edu
Place your order today!
Solution
Separation Anxiety Disorder (SAD) in a Child who Has Not Seen His Father in Two Years
Subjective:
CC (chief complaint): The mother of the child claims that he has sleep problems, feels unloved, and is frequently restless and frightened. He is impatient and agitated, throwing objects around the house and at school. He sleeps with the lighting on and the door open at night, and he misses meals, resulting in weight loss. Finally, he claims to have headaches and stomach issues on a regular basis.
HPI: The patient in this case is accompanied by his mother to the clinic. He is seven years old and white. He has no prior history of the psychological issues he is experiencing. The symptoms first occurred a year ago, but have recently gotten severe. The symptoms are frequent and hard to ignore throughout the day and night. When at school and away from the mother, the symptoms worsen. He gets relief when not asleep and with company. The symptoms are there during the day, but they get more severe at night when he is alone in his room without his mother. The severity of his symptoms is given a 7/10 rating by the accompanying adult.
Substance Current Use: There is no history of substance abuse in the family. There was no drinking by the mother during his pregnancy. She is currently drug-free and does not drink. The mother is adamant about not disclosing any information regarding the deceased father’s status on substance or alcohol abuse.
Medical History: He has no previous admissions or chronic illnesses.
Current Medications: Over-the-counter (OTC) Melatonex for sleep.
Allergies: The boy has no known allergies to anything.
ROS (Only Positives):
GENERAL: Weight loss is reported.
HEENT: Mentions headaches but dismisses light sensitivity or vision problems.
CARDIOVASCULAR: He denies chest discomfort but states that he sometimes gets palpitations.
GASTROINTESTINAL: Has constant abdominal pains, especially at school, although they disappear when he goes home. He claims to have a sluggish appetite and only eats when he is hungry.
Objective:
Diagnostic results: The laboratory and imaging tests reveal no physical abnormalities.
Assessment:
Mental Status Examination
The client is a white boy of seven years old. He is alert and oriented in all spheres. He’s also dressed correctly for the weather and the time of day. There are no obvious motions or characteristics in the boy. His self-reported mood is “unhappy,” and his affect is dysphoric, which means the two are in sync. He admits to having suicidal ideas but denies having homicidal ones. There are no delusions or hallucinations. His insight and judgment are altered, which is to be anticipated because of his age.
Diagnostic Impression and Differential Diagnoses
Separation Anxiety Disorder (SAD) – 309.21 (F93.0)
This is the primary diagnosis for this boy as the diagnosis of separation anxiety disorder is age-dependent. Some of the main diagnostic criteria as found in the DSM-5 are:
Feeling anxious because the child fears that they may be separated from a parent or guardian,
Feeling overly distressed when the child thinks about the possible separation,
Experiencing a sense of threat that is overstated concerning the possibility of separation,
Suffering from the fear of remaining on one’s own in a dark room especially at night when sleeping,
Experiencing nightmares,
Not wanting to do to school out of fear that maybe the child may come back and find that the remaining parent has also disappeared, and
Persistent but unfounded complaints about physical symptoms such as stomachaches and headaches, which are in reality just psychosomatic in nature (APA, 2013; Sadock et al., 2015).
Based on the diagnostic criteria for separation anxiety disorder, it can be safely concluded that this boy meets the requirements to be diagnosed with the condition (APA, 2013).
Posttraumatic Stress Disorder (PTSD) – 309.81 (F43.10)
In this case, the symptoms of SAD and PTSD are so close that it’s possible that this youngster’s SAD was misdiagnosed as PTSD. However, the most crucial diagnostic requirement for PTSD is that it must have been brought on by a stressful event (APA, 2013; Sadock et al., 2015). The hypothesis of psychological trauma to this boy is feasible and probable. However, it does not seem possible judging by the fact that for the two year that his father has been missing no n really told him what had happened to the father. That hypothesis can therefore hardly stand and that is why this diagnosis is not the primary diagnosis but a possible differential. He is also still too young to comprehend the situation. The DSM-5 criteria for PTSD that must be met, even if only in part include history of a traumatic experience, and unsettling recollections of the traumatic experience that one cannot get rid of on his own.
Generalized Anxiety Disorder (GAD) – 02 (F41.1)
SAD and GAD belong to the same group of disorders in the DSM-5. The two anxiety disorders share a lot of similarities in terms of symptomatology and general presentation; so much so that it is very easy to misdiagnose one for the other. A key distinguishing characteristic however is that the anxiety and distress experienced in SAD is due to the disappearance of a parent or guardian to the child client (APA, 2013; Sadock et al., 2015). The presence of GAD manifestations is associated with clinically significant impairment in functioning.
Reflection
Since the evaluation and management of this child was done by following laid down procedures and practices, it would be honest to say that I would be quick to repeat the same procedures again next time (Carlat, 2017). Being a minor, all matters requiring consent were directed towards the adult accompanying the boy. I made particularly sure that the four bioethical principles advanced by Beauchamp and Childress of autonomy, beneficence, nonmaleficence, and justice were observed (Haswell, 2019). This included explaining to the mother all procedures so that she could offer informed consent. In the spirit of autonomy, I also asked her for her opinion before offering any intervention or suggestion. For any condition suffered by anyone, close observation and assessment would reveal that particular social determinants of health are responsible. In this case, the socioeconomic status of the family and their ability to get access to quality healthcare services were the main ones ((Powell, 2016). The former is determined by family income (that dropped when the breadwinner died in war), while the latter is determined by healthcare insurance coverage (that cannot be the same as when the breadwinner was alive and employed).
Case Formulation and Treatment Plan:
Because this is a minor, the selective serotonin reuptake inhibitor (SSRI) sertraline will be prescribed off-label at 25 mg orally daily (Stahl, 2017). Evidence-based practice (EBP) suggests that pharmacotherapy combined with psychotherapy produces better patient outcomes. For this reason, the child will also be started on cognitive behavioral psychotherapy or CBT on a weekly basis (Corey, 2017; Wheeler, 2020).
References
American Psychological Association [APA] (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th ed. Author.
Carlat, D.J. (2017). The psychiatric interview, 4th ed. Wolters Kluwer.
Corey, G. (2017). Theory and practice of counselling and psychotherapy, 10th ed. Cengage Learning.
Haswell, N. (2019). The four ethical principles and their application in aesthetic practice. Journal of Aesthetic Nursing, 8(4), 177-179. https://doi.org/10.12968/joan.2019.8.4.177
Powell, D.L. (2016). Social determinants of health: Cultural competence is not enough. Creative Nursing, 24(1), 5-10. http://dx.doi.org/10.1891/1078-4535.22.1.5
Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015). Synopsis of psychiatry: Behavioral sciences clinical psychiatry, 11th ed. Wolters Kluwer.
Stahl, S.M. (2017). Stahl’s essential psychopharmacology: Prescriber’s guide, 6th ed. Cambridge University Press.
Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice, 3rd ed. Springer Publishing Company, LLC.
Place your order today!

Analyzing Assessment Data
Assessment Description
Data from assessments can be used to determine if learners are meeting course or learning outcomes. Assessments can be utilized in many ways, such as learner practice, learner self-assessment, determining readiness, determining grades, etc. The purpose of this assignment is to analyze sample test statistics to determine if learning has taken place.
To address the questions below in this essay assignment, you will need to use the information from your textbook chapter readings and the data provided in the “Sample Item Analysis” resource.
In a 1,000-1,250 word essay respond to the following questions:
Explain what reliability is and whether this test is reliable based on the “Sample Item Analysis” resource. What evidence supports your answer?
What trends are seen in the raw scores? How would an instructor use this information?
What is the range for this sample? What information does the range provide and why is it important?
What information does the standard error of measurement provide? Does the test have a small or large standard error of measurement? How would an instructor use this information?
Explain the process of analyzing individual items once an instructor has analyzed basic concepts of measurement.
If one of the questions on the exam had a p-value of .100, would it be a best practice to eliminate the item? Justify your answer.
If one of the questions on the exam has a negative PBI for the correct option and one or more of the distractors have a positive PBI, what information does this give the instructor? How would you recommend that the instructor adjust this item?
Based on the “NUR-648E Sample Item Analysis” resource, what steps would you take to improve learning?
Place your order today!
Solution
Analyzing Assessment Data
Explain what reliability is and whether this test is reliable based on the “Sample Item Analysis” resource. What evidence supports your answer?
Reliability in research and statistics refers to how consistently a test or a measure produces the same result every time it is repeated under the same circumstances. If the same measurement can be extracted every time the test is used, then the instrument is reliable and can be applied across the board. Looking at the Sample Item Analysis, this test is not reliable at all. The evidence for this stems from the fact that the scores or performance history is wildly different each time. For instance, at one time the correct scores are 67 while the incorrect is only 1. But another time the correct scores are 27 and the incorrect ones are a whopping 41.
What trends are seen in the raw scores? How would an instructor use this information?
There are wild fluctuations in performance such that at one time the students are doing well but the next time they are scoring poorly. An instructor can use this information to either better the instruction methods or the assessment methods. Either way it is one of those two that presents the problem (McDonald, 2018; Oermann & Gaberson, 2014).
What is the range for this sample? What information does the range provide and why is it important?
The range of the sample can be given by subtracting the minimum from the maximum score. That gives 70-51 = 19. The range shows the spread of the data in the distribution that has been provided. It is important in that it measures variability among the test takers and also within the scores. Variability means how different the test takers are in terms of their ability to score points. The instructor can therefore use this descriptive statistical measure to improve instruction in particular areas and also concentrate on particular learners.
What information does the standard error of measurement provide? Does the test have a small or large standard error of measurement? How would an instructor use this information?
The standard error of measurement provides information about the spread of observed test scores around a true score. It essentially indicates the spread of measurement errors and would therefore be essential in testing for the reliability of a test (Frey, 2018). Standard error of measurement (SEm) is the standard deviation divided by the square root of the sample size. In this case, the standard deviation is 4.30. The sample size is 68 and so the square root of this is 8.25. Therefore, the SEm, in this case, is 4.30 divided by 8.25. The answer is 0.52. This test has a large or substantial standard error of measurement and this confirms the unreliability of the test as stated above. An instructor would use this information to fine-tune the test or assessment method and make it more reliable. This is because a reliable test gives a standard error of measurement of zero; while an unreliable one gives a value equal to or close to the standard deviation (Frey, 2018).
Explain the process of analyzing individual items once an instructor has analyzed basic concepts of measurement.
The process of individual item analysis involves an examination of the responses given by a student to specific questions. The aim is to find out the quality of those items as well as that of the whole test. The process starts by assessing those items that make up the examination or assessment. This is followed by the statistics of the test performance in general.
If one of the questions on the exam had a p-value of .100, would it be a best practice to eliminate the item? Justify your answer.
The p-value has to traditionally be small for the evidence to be strongest. The general guidelines are that a p-value of less than 0.001 shows very strong evidence against the null hypothesis. In the same vein, a p-value equal to or greater than 0.1 shows insufficient evidence for rejecting the null hypothesis (Yildirim, 2020). For that reason alone, the question on the examination with a p-value of 0.100 should be eliminated.
If one of the questions on the exam has a negative PBI for the correct option and one or more of the distractors have a positive PBI, what information does this give the instructor? How would you recommend that the instructor adjust this item?
A negative point biserial index or PBI indicates that those examinees that performed poorly in the test got it correctly. On the other hand, a positive PBI on the distractor only goes to show that the students who performed well selected it (Schoening, n.d.). The information that is given by the above (a negative PBI for the correct option and a positive PBI for the distractor) is that high performing students are getting the answer to the test item (question) wrong, whereas poorly performing students are getting the same test item correctly. The recommendation is that the instructor should adjust the item by writing it properly. This is because the reason for the above scenario is usually that the question is written poorly or cannot be understood well.
Based on the “NUR-648E Sample Item Analysis” resource, what steps would you take to improve learning?
Based on the resource that has been used in this exercise (the NUR-648E Sample Item Analysis), the steps that could be taken to improve learning include the following:
Giving regular formative assessments to help determine the suitability of test items way before the summative assessment.
To continuously refine test items depending on factors such as the point biserial index or PBI.
To use statistics such as the standard error of measurement to determine the difference or variability in test scores or spread of error. This way, it will be easy for the instructors to identify the weak students and then concentrate on them to bring them to par with the others.
To continuously check and test for the reliability of tests so that they are deemed consistent in the way that they assess the competencies of the students or examinees.
References
Frey, B.B. (2018). Standard error of measurement. The SAGE Encyclopedia of Educational Research, Measurement, and Evaluation. https://dx.doi.org/10.4135/9781506326139.n658Online Publication Date: June 5, 2018
McDonald, M.E. (2018). The nurse educator’s guide to assessing learning outcomes, 4th ed. Jones & Bartlett Learning.
Oermann, M.H. & Gaberson, K.B. (2014). Evaluation and testing in nursing education, 4th ed. Springer Publishing Company.
Schoening, A. (n.d.). Interpreting exam performance: What do those stats mean anyway? https://my.methodistcollege.edu/ICS/icsfs/PtT-Exam_Analysis_and_Recommendations.pdf?target=8cb58375-f4a7-4a07-9ee9-4439f46f2648
Yildirim, S. (2020). P value – Explained. https://towardsdatascience.com/p-value-explained-c7f5547c0562 Disciplines: Education
Print ISBN: 9781506326153 | Online ISBN: 9781506326139
Buy in print

Public health money should continue to fund Narcan and needle exchange programs PO
Once you receive your topic and position, prepare to create a video ( PLEASE DO A POWERPOINT PRESENTATION WITH NOTES SO I CAN READ AND ADD MY VOICE) ( POWERPOINT ON PUBLIC HEALTH MONEY SHOULD CONTINUE TO FUND NARCAN AND NEEDLE EXCHANGE PROGRAMS)
The video should be 4-5 minutes long and address the topic and viewpoint you were assigned.
You may not be personally in support or opposition of the topic, however it is your job to convince your peers of your position. Include evidence that supports the viewpoint
Include an introduction to the issue, your stance, the rationale for the stance, the ethical principles involved, theories and evidence supporting your position, and your proposed resolution. Review the rubric in this forum for complete grading criteria.
Your video should include both audio and visual components such a graphics or charts. You can choose to do a PowerPoint, yourself on video with a poster or visual aids, or anything that supports and convinces your peers of your stance.
Get creative! Be succinct but convincing. If you go over the time limit, you will only be graded on the first 5 minutes.
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution

Nursing Advanced Health Assestment of a case
Health Assessment questions for the patient assigned to me with the top 5 questions to ask. This is a Nurse practitioner doing the assessment.
My Patient:
14-year-old biracial male living with his grandmother in a high-density public housing complex
Instructions:
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
PLEASE USE CURRENT APA AND NO N/D ARTICLES.
Discussion: Building a Health History
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
Photo Credit: Sam Edwards / Caiaimage / Getty Images
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s social determinants of health?
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3 of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
RUBIC to Follow:
“Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution
Communication and Interview Techniques
Gathering accurate health history is essential for developing accurate treatment plans and patient education, and it is therefore important to have exemplary communication skills as a care provider. Since the patient is a fourteen-year-old, adolescents are not usually comfortable talking about their issues when other family members are present, and therefore, I would first meet the two when they are together and request permission to talk to the fourteen-year-old in private. AIDET will be appropriate when engaging the patient; it requires the care provider to acknowledge, introduce, duration, explain and finally thank the patient. Using this technique will be important to make the patient feel comfortable to speak about their health issues (Ho et al., 2020).
How might you target your questions for building a health history based on the patient’s social determinants of health?
To build a health history for this patient, the questions should focus on the daily activities that the patient participates in on a daily basis. Topics to focus on should include nutrition, for example, the number of meals a day, dental hygiene, engagement in exercises and other physical activities, friends and peer influence, education goals, and other interests such as sports, safe sex, and exposure to drugs (Tony-butler & Unison-pace, 2018).
Risk assessment instruments and potential health-related risks
Appropriate risk assessment instruments in this scenario would include HEEADSSS, which assesses the psychosocial status of a patient. It covers aspects such as home education, environment, eating, activities, drugs, sexuality, suicide, and safety. The psychosocial status of adolescents is important since it influences their behaviors which in turn affects their health. Based on the current environment and the adolescent stage of the patients, some health-related risks include engagement in drug abuse such as smoking and taking alcohol, mental health illnesses including anxiety and depression, sexually transmitted infections, unintentional injuries, eating disorders, and other recreational drugs (Register et al., 2020).
Develop at least five targeted questions
Some of the questions should include How is your school’s progress? This question provides important information about the experience of the patient at school and his social life, which is important in assessing health risk factors. What type of meal do you often have at home, and how many times? Have you ever tried any drug? How would you describe the relationship with your grandmother at home? How many friends do you have? Do you engage in sports or other physical activities? How frequently do you visit a hospital?
References
Ho, J., Fong, C. K., Iskander, A., Towns, S., & Steinbeck, K. (2020). Digital psychosocial assessment: an efficient and effective screening tool. Journal of Paediatrics and Child Health, 56(4), 521-531. https://onlinelibrary.wiley.com/doi/abs/10.1111/jpc.14675
Register, S. J., Blanchard, E., Belle, A., Viles, A., Moore, S. P., MacLennan, P., & White, M. L. (2020). Using AIDET® Education Simulations to Improve Patient Experience Scores. Clinical Simulation in Nursing, 38, 14-17. https://www.sciencedirect.com/science/article/abs/pii/S1876139919300052
Toney-Butler, T. J., & Unison-Pace, W. J. (2018). Nursing admission assessment and examination. https://europepmc.org/article/nbk/nbk493211

The Impact of Ethnicity on Antidepressant Therapy
Major depressive disorder is one of the most prevalent disorders you will see in clinical practice. Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture. As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions. For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture.
Case 3: Volume 1, Case #29: The depressed man who thought he was out of options
To prepare for this Discussion:
• Examine the case study and Take the pretest for the case study.
• Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
• Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
• Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
• Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
• Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
• Review the posttest for the case study.
ACTUAL ASSIGNMENT
PLEASE Addressed each of the following numbers with a subtopic, all the references used must have an in-text citation in each paragraph. All Articles used should come from USA and must be within last five years only that is from 2014 to 2018. Please do not begin a paragraph with author name(s) (PLEASE USE parenthetical/in-text citations)
Post a response to the following bullets
? Provide the case number in the subject line of the Discussion thread.
? List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.
? Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
? Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.
? List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.
? List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
? For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?
? If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.
? Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations
References/Resources
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
–Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
–Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
• Chapter 7, “Antidepressants”
–Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
–American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
–Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21–24. doi:10.3928/02793695-20080901-06
Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health Services, 46(19), 21–24. doi:10.3928/02793695-20081001-05
Yasuda, S.U., Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics, 84(3), 417–423. Retrieved from https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/ScienceResearch

Elected Official Interview Paper PO
ELECTED OFFICIAL INTERVIEW PAPER
Purpose: This assignment will enhance your communication skills and help you advance a personal health policy agenda on an issue of interest to you. .
Directions: Conduct an interview of an individual who influences/interprets health care policy (legislator, legislative aide, council person, commissioner, ****member of a health care organization board****, lobbyist, judge, etc.) (In person face to face interview is highly recommended)
****** The Policy I am supporting to be passed is the H. R. 1474: Alzheimer’s Caregiver’s Support Act
https://www.govtrack.us/congress/bills/117/hr1474
******I am a resident in the state of Texas*****
I would like the paper to be written with conducing and interview with a member of a health care organization on the topic of the H.R. 1474 Alzheimer’s Caregiver Support Act bill important of being passed.
** NOTE: Papers should be no longer than 10 double spaced pages in length (excluding Title Page and References and please note faculty will stop reading after 10 pages of content).
Headings are expected please use the grading criteria items for headings
Papers must be typed and in APA format
ELECTED OFFICIAL INTERVIEW PAPER
EVALUATION CRITERIA
Criteria Possible Points Points Earned Comments
Background: Provide biographical sketch on this official that includes: credentials, education and training, relevant publications and committee appointments; major accomplishments; years served in current capacity; expertise in influencing health policy at local, state, national or international level, and other relevant information including mode of interview. 10
Content Analysis: State the specific issue(s) discussed.
• Review and reference background material for each issue discussed. State the rationale for choosing the issues.
• Self-report of interview with elected official, Provide supporting information of the official’s involvement in health policy and the official’s current health policy objectives.
• What content was covered in the interview? Was it accurate and up to date? Discuss social, cultural, political and economic aspects of the issue. Discuss how this official decides to support or not support issues, and who influences their perspectives. Consider values, philosophical ideologies, research, and policy analysis frameworks. 40
Process Analysis:
• Describes lessons learned, effective tips and strategies you employed in communication with this elected official
• Describe attributes and competencies demonstrated by this elected official.
• Reflect on attributes and competencies possessed by official and how this will contribute to your professional development in the policy arena 20
Did you obtain the information you needed? If not, why not? Did you follow up with the individual? What are the nursing leadership and health policy implications for the issues discussed? 15
Clear grammar, spelling, writing style, references, double spaced paper within ten page limit (excluding references and title page) and APA style. Headings are expected. Please use the grading criterial items for headings. 15
TOTAL 100
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution
Elected Official Interview Paper
Every policy requires adequate support from the main stakeholders to be pushed forward for implementation and evaluation. Within the process of policymaking which includes policy formulation, presentation, passing, implementation, evaluation, and revision, different players are associated with the policy’s formulation, passing, and implementation. IN the healthcare system, the major players include the healthcare providers, the associations representing the healthcare providers, the patients represented by the public activists, the legislative wing, and the political wing. All these players contribute to the formulation of the policy and its implementation. A policy bill has been presented at the legislative level that calls for the provision of grants to the unpaid caregivers of patients with Alzheimer’s disease for education purposes and general support. This paper presents an interview with a member of the Texas Medical Board, a key player in the formulation and implementation of the policy.
Background
I interviewed Melinda, a physician assistant with a DMSc degree. She is also an MSL (Medical Science Liason) for Upsher-Smith Laboratories, a specialized role within healthcare, pharmaceutical, and biotechnology fields. She is specialized in neurology. Being a professional in the healthcare, she has worked in different capacities and organizations, including the role of adjunct faculty in the University of Mary Hardin-Baylor, telemedicine preceptor at Duquesne University, APP manager of Hospitalist, and specialty Medicine in Baylor Scott & White Health, and currently MSL at Upsher-Smith Laboratories. These roles have built enough competence in her capacity as a PA and thus made her way into the board. She is a progressive leader experienced in organizational leadership and playing essential roles in PA legislative initiatives, telemedicine practice, and formulation of health regulations. Melinda has served in several appointed and elected positions within the state and national professional organizations, including an appointment to work with FDA. She was appointed by Rick Perry, Texas governor, to be the founding PA member of the Texas Physician Health Program and later appointed to her current secretarial position for the Texas Physician Assistant Board by Governor Greg Abbott, now serving for the second term. She has influenced numerous policies supporting quality health and effective working environments for healthcare providers, including physician assistants. This background information about Melinda indicates that she is competent enough to discuss the bill’s issues, H. R. 1474: Alzheimer’s Caregiver’s Support Act. I conducted an in-person interview with the healthcare elected professional to discuss different aspects of the Act that supports the provision of grants to the unpaid caregivers for Alzheimer’s patients.
Content Analysis
Issues Discussed
In the interview with Melinda, we discussed four main issues concerning the policy with including the personal needs and risks for self-care amongst the patients with Alzheimer’s Disease, the need for unpaid caregivers in improving patients wellbeing, the role of education in improving the quality of care among the unpaid caregivers, and the impact of grants to the unpaid caregivers on the quality of caregiving.
Personal needs and risks of self-care amongst the patients with Alzheimer’s disease are essential to establish the effects of Alzheimer’s disease on the quality of life and wellbeing of patients to the extent of requiring assistance for their activities. Establishing whether dementia and Alzheimer’s disease is disabling condition places more weight on the need to support the motion to allow the provision of grants for the unpaid caregivers. The majority of the patients with Alzheimer’s disease are the elderly, affected by numerous health conditions, including hypertension, diabetes, osteoporosis, and cardiovascular diseases. These diseases require medications, and a higher adherence improves the quality of health and recovery time. Self-care amongst patients with dementia or Alzheimer’s disease increases the risk of poor adherence to medication which is a risk to their health and recovery process. A study by Cho et al. (2018) on the impact of dementia and Alzheimer’s disease on the association between cognitive impairment and poor adherence to antihypertensive medication adherence among the elderly population indicated that dementia conditions lead to poor adherence to medications. Hypertension is one of the killer diseases, and thus whenever elderly patients with dementia are unable to adhere to the medications for the chronic diseases, they increase the risk of chronicity or death if uncontrolled.
Dementia means forgetfulness, an inability to remember things. This is a risk condition for patients under self-care. In their living homes, they prepare food, use electric appliances, and do various operations requiring a high concentration level. There is a high risk of leaving the appliances on out of forgetfulness, a factor that can highly contribute to fires. Portacolone (2018), through a personal experience letter of a dementia patient living alone, indicates that fire risks are some of the concerns for patients with Alzheimer’s disease or dementia. There is also the risk of falls among patients with Alzheimer’s disease. They may not remember returning objects to safer places and thus may randomly place them along the way, thus increasing the risk of falls. Allali & Verghese (2020) note that dementia is a key contributor to falls among the elderly population and that isolation and lack of assistance increase the prevalence of hazards among the elderly, especially with Alzheimer’s condition. This shows numerous hazards and health risks associated with patients with Alzheimer’s disease living alone.
The second issue discussed is the need for unpaid caregivers. The bill to be discussed focuses on the plight of the unpaid caregivers for the AD patients, and thus it is until we realize their validity in the healthcare system when the discussion can be effective for decision making. According to Jenkins (2020), about 6.2 million elderly Americans have dementia and Alzheimer’s disease, an indication that the prevalence of the condition among Americans is very high. According to the source, about 11% of Americans across all ages have dementia, and thus more than 10 million Americans are estimated to be affected. This shows unevenness in the ratio of qualified paid caregivers to the patients. Other caregivers employ caregivers, leaving the low-income households with the option of volunteering to live with the affected patients for quality care. The unpaid caregivers thus help improve the quality of life for the low-income families unable to acquire services from the paid caregivers and cover the scarcity of paid caregivers within the healthcare system.
The other issue discussed is the importance of education to the caregivers. This is an important issue for discussion since the grants to be offered are meant to educate and train the unpaid caregivers to improve their efficacy and confidence in providing quality healthcare for AD patients. The largest number of the caregivers for AD patients in the US are unpaid, indicating that the largest portion of the AD patients in the country are under the care of unpaid caregivers who are majorly caregivers without professional expertise in caring for the affected patients. According to Jorge et al. (2021), 49.3% of the caregivers know AD and the disease risk factors with the care needed for the AD patients, while only 78.6% understand the symptoms of the disease. This indicates that most unpaid caregivers may not have enough knowledge on the health condition and thus may provide poor quality of services. A study by Tan et al. (2019) established that the quality of care among AD patients improves with increased training and education of the caregivers. Training and education thus enhance the knowledge on symptoms of the AD disease, the treatment medications needed, the quality of food to be given for improving the condition, the interventions in reducing depressive episodes, and the general practices in quality caregiving.
The other issue discussed in the interview is providing grants to unpaid caregivers. The issue was whether payment of the unpaid caregivers through the provision of grants might increase the performance of the caregivers in delivering more quality care to the patients. This is an important issue to discuss with the board member because the board is a key promoter of patient-related policies to alleviate health problems for quality improvement in care delivery. Apart from grants for education and training purposes, the bill proposes support for caregivers, which is highly debated. Payment and salaries are used as a model of motivation or compensation for services delivered. Even though caregivers can provide effective and quality care to patients even without payment, numerous studies have indicated that financial support or payment motivates caregivers to improve the quality of care to the patients. According to Reckrey et al. (2021), caregiving for patients with dementia requires much time and resources, and thus paying family caregivers enhances the quality of care.
Self-report of Interview
Melinda supports the bill by providing grants to the AD unpaid caregivers for education and personal support. The interview was effective, covering the highlighted issues on the role of unpaid caregivers in healthcare and the need for education and support grants for unpaid caregivers. The member provided various articles and positions that she has presented in various settings of the board and legislative processes in support for education and training of the family caregivers for quality care. She acknowledged not to have directly been involved in the specific bill but provided different advocacies and positions that handled the key parts of the bill. The interview was conducted for an hour, establishing the key challenges with the bill and her reason for support of the bill.
The Interview
Ms. Melinda identified various needs for the patients living with Alzheimer’s disease, supporting the idea that they should not be left alone in their houses because it is a risk for them and their families. She argued that AD patients are prone to forgetting and thus may increase the risk of hazards in their places of living. According to her, most people with AD living alone without a caregiver end up having numerous falls, fires, and accidents within their homes, which can be associated with dementia. She said, “I have received many AD patients with burns and bone fractures resulting from accidental fires and falls which can be minimized by close monitoring by a committed caregiver.” The PA reported that poor adherence to medications for the elderly population is highly associated with a dementia condition on prescribed medication. Thus lack of a caregiver increases the risks for developing complexities in care and the patients’ health. These statements indicated her concern for leaving the AD patients alone without a caregiver, citing the risks associated with self-caregiving for the AD patients.
On the value of the unpaid caregivers, Ms. Melinda acknowledged the gap in access of the qualified paid caregivers to be the main reason for the existence of the unpaid caregivers. According to her, unpaid caregivers come in to cover the deficit in caregiving services due to the inadequacy of the paid caregivers. She said, “There are limited professional caregivers worldwide, and it would be inappropriate to claim that it is only the healthcare professionals and the identified paid caregivers who can take care of the AD patients in the United States.” She said that most unpaid caregivers are mostly family members who rise to help their kin achieve quality health, a gap that cannot be covered by the inadequate number of professional and paid caregivers. The PA supported education as a key factor in improving the quality of care to patients. “Not only in AD caregiving, but every health care process also requires a higher level of competency which is highly gained through education, training, and personal experience,” she said. In addressing this question, Melinda thus supported the education of the unpaid caregivers for the AD patients to increase the quality of caregiving to the patients.
On grants, Melinda cited reasons for supporting the bill, citing the opposing teams’ fears associated with the bill. According to Melinda, education to the caregivers would reduce the prevalence of chronic diseases among the elderly population and those with AD disease, contributing to improved quality health. She argued that most family caregivers lack enough financial capacity to finance their education in AD care programs and thus should be facilitated to impact the same to their AD patients. Melinda also discussed the issue of personal support to the unpaid caregivers. “The unpaid caregivers spend much of their time with the AD patients, which limits their ability to develop economically despite the high demand for finances in sustaining both patient and the caregiver,” she said. She thus showed her support for the bill in improving the quality of care for AD patients and the quality of life for AD caregivers.
Influence of the Decision
Melinda stated her support for the bill through the board advocacy programs and positions that influence the political legislature for the passing of the bill. The information provided in support of the bill is up-to-date since she relied on her current experiences and researches on the quality of healthcare for AD patients. Her philosophical stand influences her position on the purpose of education on healthcare quality. She believes that knowledge on “how to” improves the quality of processes in healthcare, and thus education and training of any healthcare provider on a specified field would positively impact their level of competence and service delivery. Being a scientific researcher, she has enough evidence on the role of education in improving the quality of care and thus supports the policy to educate the AD caregivers.
Process Analysis
The interview was well coordinated and enjoyable in analyzing the contents of the Act. There are various lessons learned from the interview with Ms. Melinda. One of the lessons is that elective positions provide an important opportunity for advocating for quality improvement policies. To be elected in such positions, one has to be political enough to convince the policymakers of the need for the policy change for quality improvement. Another lesson learned is that, despite having a social and political influence on the elected leaders’ decision-making, leaders have the philosophies that guide them in advocating for what is right or wrong. Through this interview, I learned that identifying the key political elected leaders in the policy change process improves the policy’s chances of success. I employed two main communication strategies while interviewing Ms. Melinda. One of the strategies is maintaining eye contact to show value and concentration for the conversation. This is one of the positive non-verbal cues that enhance communication. Another strategy was more listening than talking. Listening allows the speaker to give their comments about the questions asked, showing value for their contribution.
Ms. Melinda showed high competencies in communication, maintaining a high level of confidence in addressing the issue with desirable clarity. She has the answers at her fingertips, showing her general preparedness in presenting and arguing about an issue in a political or social arena. She presents the content in a more organized and convincing way, indicating being competitive in communication. She is informed of nursing and healthcare issues, guided with enough evidence in arguing her positions. As an elected leader, she has enough content that is supported by scientific data and evidence to influence a policy change. Her reliance on scientific data increases her chances of influencing a policy change. Her style of communicating her ideas, backed with evidence, influences my professional development in the policy by encouraging me to practice being a public speaker with organized content and improving my competence in evidence-based practice to support the policy change process.
The Success of the Interview
In the interview, I sought to establish the stand of Ms. Melinda on the issue and whether it is a viable bill in the healthcare system. The interview was successful because I obtained the information I needed on the topic’s interviewees’ views. She answered all my questions to completeness, willing to offer enough time to allow the full interview without interruptions. The official provided supporting data for her positions and arguments supporting the bill, and thus the interview was successful. I never made a follow-up with the official due to her commitments but promised to get back to discuss further numerous issues affecting patients and specific vulnerable populations. There are various implications on nursing leadership for the issue discussed on the impact of grants to the unpaid AD caregivers. The introduction of education for the caregivers is important in reducing the chronicity and risks associated with uninformed caregiving for AD patients. The AD patients are exposed to numerous diseases and health risks, and thus the nurse leaders should provide health education to paid and unpaid caregivers for quality delivery of care. Implementing the policy for providing grants can highly impact the quality of life and living standards for both the caregiver and the AD patient since most of the caregivers are family members. The provision of the grants through the policy would largely impact the social and economic value for the AD caregivers that directly impact the quality of care of the AD patients.
References
Allali, G., & Verghese, J. (2020). Falls in Older Adults with MCI and Alzheimer’s Disease. In Falls and Cognition in Older Persons (pp. 211-228). Springer, Cham.
Cho, M. H., Shin, D. W., Chang, S. A., Lee, J. E., Jeong, S. M., Kim, S. H., … & Son, K. (2018). Association between cognitive impairment and poor antihypertensive medication adherence in elderly hypertensive patients without dementia. Scientific reports, 8(1), 1-7.
Jenkins, A. (2020). Facts and Figures. Alzheimer’s disease and dementia. Website
Jorge, C., Cetó, M., Arias, A., Blasco, E., Gil, M. P., López, R., … & Piñol-Ripoll, G. (2021). Level of understanding of Alzheimer disease among caregivers and the general population. Neurología (English Edition), 36(6), 426-432.
Portacolone, E. (2018). On living alone with Alzheimer’s disease. Care weekly, 2018, 1.
Reckrey, J. M., Boerner, K., Franzosa, E., Bollens-Lund, E., & Ornstein, K. A. (2021). Paid Caregivers in the Community-Based Dementia Care Team: Do Family Caregivers Benefit?. Clinical Therapeutics.
Tan, Z. S., Soh, M., Knott, A., Ramirez, K., Ercoli, L., Caceres, N., … & Jennings, L. A. (2019). Impact of an Intensive Dementia Caregiver Training Model on Knowledge and Self?Competence: The Improving Caregiving for Dementia Program. Journal of the American Geriatrics Society, 67(6), 1306-1309.

A personal statement of 1-2 pages that discusses how your clinical and professional background has prepared you to be successful at the graduate level; the statement must include your specific professional goals and objectives for obtaining an advanced degree in Psychiatric Mental Health Nurse Practitioner
I have been working as a Registered Nurse for twenty years plus and in psychiatric unit for the past fifteen years.
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution
How My Clinical and Professional Background Has Prepared You to Be Successful At the Graduate Level
Having been a registered nurse for the past 20 years and working in the psychiatric unit for the past 15 years, my clinical and professional background has prepared me significantly to be successful at the graduate level. My clinical background has therefore allowed me to interact with numerous psychiatric patients affected by different mental health conditions and to effectively support such patients in specific ways depending on their needs. By being able to work with a diverse group of patients, I have therefore gained the right skills to be able to be successful at a graduate level where the student is required to nurture and acquire adequate cultural competence skills to be able to complete the level effectively.
My clinical and professional background as a registered nurse working in the psychiatric unit has also prepared me to be successful at the graduate level through the nurturing of skills such as communication and collaboration. Working as a registered nurse in the psychiatric unit has therefore required me to provide psychological support services and other services to both patients and their families, which allowed me to be able to enhance my communication and collaboration skills. Clear communication and collaboration with patients are some of the main tools that I utilized to ensure that I provided adequate psychological support services to patients. Having sufficient communication and collaboration skills with therefore allow me to be more successful at the graduate level as I will be able to collaborate more effectively with fellow students and tutors in achieving my course objectives.
My clinical and professional background also allowed me to effectively document changes to the health and behaviour of patients and monitor patient progress. My clinical and professional background allowed me to improve my evaluation and documenting skills which will be central skills in pursuing the graduate level. Having adequate evaluation and documenting skills will therefore help me to comprehend different topics and concepts at the graduate level and to internalize knowledge effectively so as to be successful in the program. Finally, my clinical and professional background as a registered nurse in the psychiatric unit allowed me to nurture my teamwork and cooperation skills and to be able to work effectively with different interdisciplinary members. The ability to collaborate more effectively with members of the interdisciplinary team will therefore enhance my success at the graduate level.
Specific Professional Goals and Objectives for Obtaining an Advanced Degree in Psychiatric Mental Health Nurse Practitioner.
My specific professional goals and objectives for obtaining an advanced degree in psychiatric mental health nurse practitioner include being able to complete the national certification board examination, continuing to develop new skills, individualizing the care I deliver to my patients, and involving patients in the decision-making process of their care. Obtaining board certification is one of my main professional goals and objectives, as I can only be able to practice as a PMHNP after receiving board certification. Receiving board certification will therefore allow me to obtain a license to practice effectively. On the other hand, my main professional goal is to be able to individualize the care I deliver to patients. I intend to individualize the care I provide to patients according to their needs. Involving patients in the decision-making process of their care is also an important professional goal and objective for obtaining the advanced degree in psychiatric mental health nurse practitioner. Involving patients in the decision-making process of their care with therefore help to promote better healthcare provider-patient relationships and play a significant role in enhancing patient satisfaction and promoting greater compliance with the provided treatment plans.

ASSIGNMENT- PHN 652- TOPIC 4- Community Health Needs Assessment Report
PLEASE REFER TO ORDER 133833 TO COMPLETE THIS PAPER. I have uploaded a copy of order 133833 for reference.
Community Health Needs Assessment Report
The purpose of this assignment is to apply the public health nursing practice model in order to write a community needs assessment report. Utilizing the data collected from the Topic-3 chosen population (In ORDER NUMBER 133833) write a 1,100 word community needs assessment report with the following information:
1. A description of the community or population researched.
2. Explanation of current data available.
3. Summary of health needs identified through analysis of data.
4. Description of the data collection method planned for collecting secondary data.
5. Description of at least one key health issue/need from a nursing diagnosis, including the micro, meso, and macro level.
6. Summary of at least one social determinant of the health issue identified.
7. Brief outline of a plan for addressing the chosen health need.
Include three to five resources in your paper.
Prepare this assignment according to the APA 7 Style guidelines. An abstract is not required.
This assignment uses a rubric.
Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution
Description of Community or Population Researched
The population of focus is adolescents between 12 to 18 years old. Different studies that have been conducted by the National Institute of Drug Abuse (NIDA) have therefore indicated that the prevalence of alcohol and substance abuse is quite high among adolescents who are normally attending high school. The high prevalence of alcohol and substance abuse among high school students is also closely related to a rising prevalence of mental health issues among adolescents who are between 12 to 18 years (SAMHSA, 2019). The adolescence stage of a young person’s life is therefore characterized by peer pressure as an individual tries to create a personality and identity. The peer pressure that affects adolescents can therefore have significant negative impacts, especially if the peer group is involved in negative habits such as substance and alcohol abuse. Most people across the US are therefore introduced into drugs and substance abuse in the adolescent stage as they seek to blend into their peer group. Young people aged between 12 to 18 years are also more susceptible to mental health issues such as depression which can result from abusing substances or not fitting into a peer group (CDC, 2020).
Current Data Available
According to the CDC, marijuana, alcohol, and tobacco are some of the most abused substances by adolescents between 12 to 18 years of age in the US. According to the CDC, before reaching 12 grade, nearly two-thirds of all will have attempted taking alcohol (CDC, 2020). On the other hand, 50% of 9th to 12th-grade students reported having used marijuana while about four in every ten students between 9 to 12 grades reported smoking cigarettes. 2 in every ten 12th graders also reported using prescription medicine without having a prescription (CDC, 2020). According to the CDC, individuals between 12 to 20 years of age in the US consume about one-tenth of all the alcohol that is produced in the country. This is despite alcohol being illegal for people below 21 years of age (CDC, 2020).
The high prevalence of alcohol and substance abuse among adolescents between 12 to 18 years can therefore have numerous adverse health impacts on the populations, which includes affecting the development and growth of such teenagers, including their brain development (Oh et al., 2017). Alcohol substance abuse in adolescent years can also contribute to the development of problems such as high blood pressure, sleep disorders, and heart disease during adulthood. Substance and alcohol abuse among Adolescents also frequently occurs with other risky behaviors such as dangerous driving and having unprotected sex (Oh et al., 2017).
Summary of Health Needs
Considering the rising prevalence of substance and alcohol abuse among adolescents between 12 and 18 years in the US, several health needs can be deduced in the population. The health needs of adolescents, therefore, include sexual and reproductive health needs, mental health needs, and frequent examinations and assessments (Das et al., 2016). The provision of mental health services such as guidance counseling and other psychotherapeutic services such as cognitive behavioral therapy among adolescents can go a long way in helping to prevent alcohol and substance abuse in the population. On the other hand, regular examination and assessment of the general health of adolescents can help in the detection of alcohol and substance abuse behaviors early at the beginning of interventions to address such behaviors (Das et al., 2016). Adolescents between 12 to 18 years also require sexual and reproductive health services that can play a significant role in preventing them from being involved in risky sexual behaviors and contracting sexually transmitted diseases (Das et al., 2016).
Data Collection Method for Secondary Data
The data collection method that can be utilized to collect secondary data on the prevalence of substance and alcohol abuse among adolescents between 12 to 18 years and the various causes and explanations of such behavior is evaluating government publications and public records. Federal Government agencies such as the Centers for Disease Control and Prevention CDC and the National Institute on Drug Abuse (NIDA) normally conduct assessments of the prevalence of alcohol and substance abuse among adolescents and publish reports. The CDC also frequently publishes articles to explain the causes of alcohol substance abuse among adolescents between 12 to 18 years. The publications by government agencies such as the CDC and NIDA will therefore be utilized to obtain secondary data related to alcohol and substance abuse among adolescents between 12 to 18 years.
Key Health Issue from a Nursing Diagnosis
The main key health need from a nursing diagnosis related to the issue of alcohol and substance abuse among adolescents between 12 to 18 years is altered family processes. Altered family processes can therefore be related to adolescents coming from a family history of substance abuse. As a result of substance abuse and adolescence can therefore show shame, embarrassment, and anxiety or anger (Laski, 2015). An Adolescent might also be emotionally isolated, vulnerable, and have repressed emotions. An Adolescent might also have disturbed family dynamics and closed communication systems in the family and the disruption of family roles (Laski, 2015).
To address the nursing diagnosis of altered family processes, the ideal intervention on the micro-level would include reviewing the family history and trying to understand the circumstances that led an adolescent to abuse drugs, and eventually determining the areas of focus to enhance behavior change (Laski, 2015). On the other hand, on the Meso level, the nursing intervention would include introducing strategies to prevent substance abuse in a school that the particular adolescent attends. On the other hand, on the macro-level, the ideal nursing interventions would include advocacy efforts to ensure the adoption of strategies to prevent alcohol and substance abuse among adolescents across a given community or state (Laski, 2015).
Social Determinant of Health
The main social determinant of health on the issue of alcohol and substance abuse among adolescents between 12 to 18 years is age. Adolescents are more susceptible to peer pressure which increases their chances of abusing substances, especially if they interact with peers who are involved in alcohol and substance abuse (Das et al., 2016).
Plan for Addressing Chosen Health Need
To effectively address the challenge of alcohol and substance abuse among adolescents, the most effective interventions would include introducing substance and alcohol abuse prevention programs in high schools and formulating laws to limit the access of alcohol substances to adolescents. Substance and alcohol abuse prevention programs would therefore help to educate adolescents on the various dangers of substance and alcohol abuse and deter such groups from engaging in such behaviors.
References
CDC. (2020, February 10). Teen Substance Use & Risks. Centers for Disease Control and Prevention. Retrieved November 28, 2021, from https://www.cdc.gov/ncbddd/fasd/features/teen-substance-use.html#:%7E:text=Alcohol%2C%20marijuana%2C%20and%20tobacco%20are,most%20commonly%20used%20by%20adolescents.&text=By%2012th%20grade%2C%20about%20two,of%20students%20have%20tried%20alcohol.&text=About%20half%20of%209th%20through,reported%20ever%20having%20used%20marijuana.&text=About%204%20in%2010%209th,students%20reported%20having%20tried%20cigarettes.
Das, J. K., Salam, R. A., Arshad, A., Finkelstein, Y., & Bhutta, Z. A. (2016). Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews. Journal of Adolescent Health, 59(4), S61–S75. https://doi.org/10.1016/j.jadohealth.2016.06.021
Laski, L. (2015). Realising the health and wellbeing of adolescents. BMJ, h4119. https://doi.org/10.1136/bmj.h4119
Oh, S., Salas-Wright, C. P., & Vaughn, M. G. (2017). Trends in drug offers among adolescents in the United States, 2002–2014. Health & Justice, 5(1). https://doi.org/10.1186/s40352-017-0051-4
Substance Abuse and Mental Health Services Administration. (SAMHSA) (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/

Discuss two (2) professional career goals, identifying how your professional experiences to date have prepared you for graduate study at Pace University and how the graduate program will assist you in meeting these goals. Describe your plans to alter your professional and/or personal obligations to have the time needed for graduate study, including the required clinical experiences
A typewritten essay, not to exceed 750 words, that responds to the following:
* Discuss two (2) professional career goals, identifying how your professional experiences to date have prepared you for graduate study at Pace University and how the graduate program will assist you in meeting these goals.
* Describe your plans to alter your professional and/or personal obligations to have the time needed for graduate study, including the required clinical experiences.
I have been working for Bronxcare Health System Hospital for 9 years as Registered Nurse.
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution
Two Professional Career Goals
Professional goals have been a major source of motivation and have provided a framework for measuring progress towards success. One of the professional goals is becoming an expert through increased knowledge, skills, and experience. I have always viewed being an expert as an effective and efficient way of providing excellent patient care. My professional experience involves working in Bronxcare Health System as a registered nurse for the last nine years. Being part of the staff team in the organization has improved my experience in the clinical field and has led to the realization that advanced training is required to provide quality care to patients. The experience at the organization, especially experience related to working as a team, has improved my learning techniques, interpersonal skills, and quest for knowledge. The experience has also led to the development of important values and skills such as patience, critical thinking, and problem-solving. The values will promote educational training in the University. The graduate program will enable me to increase my knowledge and skills in my medical field; hence I will achieve the goal of becoming an expert.
The second professional goal is improving the quality of care to patients. I aspire to have more impact in the healthcare industry to improve health care services and care offered to patients. The educational level determines my level of impact, including the level of leadership influence in the clinical setting. With further training, I expect to have a higher level of influence in the clinical setting to improve the quality of care and experience of both patients and nurses. My experience in working with the non-profit making healthcare system has been a source of motivation to improve my skills and knowledge based on experience related to challenges facing the patients and healthcare settings. I am more passionate about improving various areas of the healthcare industry, including increasing access to patients and providing comprehensive care. Advanced nursing training will expand my scope of practice in the nursing field, providing an opportunity and platform to implement efficient and effective solutions to healthcare-related challenges.
Plans to Alter Professional or Personal Obligations to Create Time for Graduate Study
The graduate study will be demanding in terms of time spent attending classes, completing assignments, researching, engaging in group discussions, and studying for examinations. To create more time to engage fully in my studies, I intend to reduce the number of hours I spent working in the Bronxcare Health System. I intend to reduce the number of shifts in the health organization and work overtime. The move will create more time that can be used to engage in study-related activities while ensuring that I attain the required clinical experience. Alteration in personal obligations includes reducing time spent executing home related duties. I intend to hire help to ensure I have more time to spend in academic related activities. Another major alteration involves spending less time with the family and friends, including time spent in recreational activities. I have already discussed with family and friends about the impact of taking graduate study, and they have promised to offer full support. They are in support of all the changes that the graduate program will have on our relationships. I believe the plans of altering professional and personal time and the professional experience to date shows enough preparation for graduate study.