Nursing

Module 4 Assignment: Strategic Plan Sections 7–9
For this Assignment, you will create an evaluation plan, an Executive Summary, and a Reference List of resources you used to create your Strategic Plan.
Section 7: Evaluation Plan
To prepare:
Reflect on the elements of your Strategic Plan that you have developed thus far. Review the information on evaluation presented in the Learning Resources, and reflect on any insights you have gained from the Discussions throughout the course.
How would you evaluate the implementation of your Strategic Plan?
To complete:
Write a 1- to a 2-page explanation of your evaluation plan. Include the following in your plan:
Explain what kinds of information you would use to evaluate your Strategic Plan.
Explain how often you would analyze the data.
Explain how you would monitor the goals, objective, and vision for your Strategic Plan.
Explain how you would keep stakeholders informed.
Explain how you would handle potential deviations or needed changes in goals or objectives related to your Strategic Plan.
Section 8: Executive Summary
An Executive Summary provides an overview of your proposed change and allows your target audience to become acquainted with the essential elements of the strategic plan. Your Executive Summary should be informative and persuasive, delineating the business case for your proposed change.
To prepare:
Review the information in the Learning Resources related to developing an Executive Summary.
To complete:
Provide a 1-page Executive Summary for your Strategic Plan issue that appeals to your target audience and presents key information related to your Strategic Plan.
Describe the unmet need you are addressing with your Strategic Plan and convey the urgency or significance of this problem.
Clearly state your proposed change and substantiate your recommendation.
Section 9: References
The inclusion of a Reference List not only allows you to credit others’ work appropriately but also provides the information readers would need to read resources of interest to them and learn more about the underpinnings of your Strategic Plan.
To prepare:
As noted in Module 2 and 3 Assignment, you should have been documenting all resources used to develop your Strategic Plan.
Refine your Reference List as necessary, and add the resources you used to create Sections 7 and 8 of your Strategic Plan.
To complete:
Provide a Reference List for the resources cited when creating your Strategic Plan. (Your list should contain references used in all sections of your Strategic Plan, not just Sections 7 and 8.) Use correct APA formatting for the citations in your Reference List.
Place your order today!
Solution
Healthcare Organization Strategic Plan
Module 4 focuses on Section 7: Evaluation Plan, Section 8: Executive Summary, and Section 9: References on the strategic plan.
Section 7: Evaluation Plan
An evaluation plan is a documentation regarding the meaningful way to evaluate and monitor a project, including how the evaluation results will affect the decision-making process. Section 7 will then focus on information necessary for the strategic plan evaluation, data analysis frequency, ways to monitor strategic plan goals, objectives, and vision, ways to keep the stakeholders informed, and how to handle potential deviators.
Information Necessary for the Strategic Plan Evaluation
The main information necessary for the strategic plan evaluation includes assessing its mission and vision compatibility. Vaughn et al. (2019) accentuate that mission and vision statement helps develop a focal point that helps all stakeholders, especially the project team, align with the project. Such alignment helps each project member achieve the project goals, thus increasing productivity and efficiency. Hence, the strategic plan evaluation for our healthcare organization will need to keep on assessing the projects regularly to ensure that the goals of the project align with the mission where; if there will be a need to adjust the mission and the vision of the project, there must be enough reasons for the project to be a success. The other factors will include the SMART goal approach to ensure that the initial plan is realistic, balanced, and integrated. Clavel et al. (2019) posit that in most cases, project managers always find themselves stuck between beating project deadlines and integrating and balancing project elements. Hence, our healthcare strategic plan evaluation will always ensure that all project elements rhyme and there is a balance between learning and employees goals, internal business, customer, and financial processes.
Data Analysis Frequency
Frequency analysis of any factor connected with the project is crucial since it helps measure the quality and risks, thus controlling the organization’s future (Vasileiou et al., 2018). The strategic plan for our healthcare will take six months which then calls for every two months. The approach will be effective to ensure that before the proposed change is presented to the board by the healthcare’s project management, the strategies involved will have prioritized the overall goal of the healthcare facility of providing quality services and improving their patients’ well-being.
Ways to Monitor Strategic Plan Goals Objectives, And Vision
The best way to monitor the healthcare facility’s strategic plan is by using the balanced scorecard. Vaughn et al. (2019) accentuate that project goals and objectives change while the strategic plan vision and mission remain intact. Such factors then require an effective approach to ensure the changing nature of the objectives and goals. Hence, the healthcare facility’s strategic plan goals, vision, and objectives will be monitored using monthly reviews. These reviews will also involve biweekly meetings with the project team to brainstorm how to overcome risks and identify opportunities that will help complete the strategic plan successfully and on time.
Ways to Keep the Stakeholders Informed
Stakeholders are very integral in healthcare organization projects success. Gutberg and Berta (2017) assert that the most current way to inform the stakeholders on the project’s progress is by using platforms that encourage collaboration. Hence, considering the healthcare facility budget, the stakeholders will receive biweekly reports on their emails be notified using a customized text message twice per week to ensure that they go through the report.
How to Handle Potential Deviators
A strategic plan involves manageable and well-defined objectives and goals. However, these projects sometimes come across project deviators that derail the project’s success. Hence, if the strategic plan faces such potential deviators, there will be a need to revise the structure, strategies, objectives, and strategic standards to manage the project’s effectiveness.
Section 8: Executive Summary
Section 8 of the strategic plan will evaluate the following aspects;
Executive Summary for your Strategic Plan issue
The strategic plan was to find the most appropriate means to improve our healthcare organization’s funding and management issues to ensure that healthcare branches deliver efficient and quality services while providing a people-centric environment. Generally, the strategic plan involves various information, including creating the project mission and vision. The main reason why the project created a new mission and vision was to ensure that these statements would abide by the set organizational goals and objectives. Hence, the strategic plan’s success has undergone various processes that include healthcare organizations’ change strategy. Bokhour et al. (2018) postulate that organizational change strategies helping organizations achieve their long-term goals that increase their sustainability and competitive advantage. Hence, by our healthcare organization trying to implement changes in its other branches on funding and management, the patients and other stakeholders will be assured of quality services and an inclusive environment. As a result, some factors considered to ensure that the strategic plan was viable include the mission and vision revision to achieve a people-centric environment.
Furthermore, the healthcare organization was determined to recognize its strengths and weaknesses while pointing out potential threats, which prompted a SWOT analysis. The results from the analysis have been essential considering that they helped identify the right tools to involve in the strategic plan, which include the PERT chart, which helped create the project timeline and budgeting tool that helped analyze the project budget. Apart from these factors, the strategic plan has also analyzed the internal and external stakeholders. The healthcare leaders, managers, and providers are the internal stakeholders, while the external stakeholders include patients, suppliers, and partners. By ensuring that the healthcare organization’s funding and management issue is well-handled, the organization will attain its initial goal of serving a larger community with quality services to improve overall well-being. Consequently, the healthcare providers will receive a people-centric environment that will improve their productivity and efficiency, thus increasing job satisfaction.
Strategic Plan Unmet Needs and Problem Significance
Funding and management issues as part of our healthcare organization’s strategic plan are crucial to the operability of healthcare services. Bharsakade et al. (2021) assert that health financing is a crucial element that helps healthcare organizations to have enough economic incentives and resources to operate their healthcare systems. On the other hand, Gül et al. (2017) state that healthcare management issues affect how the funds are utilized and the well-being of the healthcare workers. Our healthcare organization has integrated several healthcare branches in other areas to ensure that patients from these areas can easily access the services. However, the funding and management issue has paralyzed the healthcare organization’s quality services as its long-term goal. As a result, our healthcare facility risks losing its patients and healthcare workers to its immediate competitors, who seem to have fewer, funding and management issues.
Consequently, due to poor funding and management, the healthcare main branch’s brand reputation is also deteriorating, thus calling for urgent measures to avoid the adverse effect of the issue. Mainly, the problems rising daily from the situation include insufficient medical products like medicines, thus making the patients spend much money seeking pharmaceutical services. The insufficient medical products are also a leading factor to patients’ unsatisfactory situation with the healthcare branches services, thus flocking the main healthcare facility. Furthermore, such an instance also affects healthcare workers from the central healthcare facility and other branches regarding job dissatisfaction (Manley et al., 2018). That is because the main healthcare facility workers work for long hours while the healthcare branches receive unmotivating patient numbers. Hence, to ensure that the healthcare facility retains its original reputation, there will be a need to develop a strategic plan to improve productivity.
Proposed Change and Recommendations
Funding and management are crucial factors in healthcare system performance which mainly determines health outcomes, efficiency, and equity. Hence, in addressing the funding and management issue, the healthcare facility should change its organizational culture by incorporating top-down and bottom-up approaches. Gutberg and Berta (2017) posit that in a strong healthcare organization culture, the employees will always understand what the top management requires them to perform differently. Such inclusive culture is also referred to as the clan culture that helps healthcare organization management develop an organizational environment that embraces its staff to give a sense of belonging. Hence, if the organization had created an enhanced people-centric environment, the healthcare providers would have already contacted the healthcare management earlier to prevent accelerating the current issues at the healthcare facility branches. In such a case, the leadership management will need to start applying transformational leadership. Olvera et al. (2017) state that transformational leadership helps healthcare leaders to motivate, inspire and encourage the healthcare staff to accept changes and be innovative at individual and social levels. The healthcare leaders and providers will need to integrate into informal and formal meetings for all healthcare facility’s branches to help them create a strong bond to improve the organization’s services.
Also, it will be necessary to ensure that the healthcare organization’s budgeting adopts the top-down approach to enable each healthcare branch to assess the amount of funding they require, which is later reviewed by the overall healthcare budgetary committee (Gutberg & Berta, 2017). In addition, the approach will reduce funding these healthcare branches using assumptions since each branch has its unique activities that require different financing procedures. That way, the healthcare branches will require to draft their budgets. Then, through consultation by the overall financing managers, they will receive funds that will help them attain the healthcare organization’s initial goal for long-term effects.
Hence, through such a strong organizational culture, the organization will manage to make more informed decisions in budget and management, choose the right funding stakeholders, and enhance the organization’s overall workflow.
References
Austin, T., Chreim, S., & Grudniewicz, A. (2020). Examining health care providers’ and middle-level managers’ readiness for change: a qualitative study. BMC health services research, 20(1), 1-14.
Bhaduri, S. D. (2020). United States of America: Health Care System Overview and SWOT Analysis. The Indian Practitioner, 73(9), 46-49.
Benzaghta, M. A., Elwalda, A., Mousa, M. M., Erkan, I., & Rahman, M. (2021). SWOT analysis applications: An integrative literature review. Journal of Global Business Insights, 6(1), 54-72.
Bokhour, B. G., Fix, G. M., Mueller, N. M., Barker, A. M., Lavela, S. L., Hill, J. N., … & Lukas, C. V. (2018). How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC health services research, 18(1), 1-11.
Clavel, N., Pomey, M. P., & Ghadiri, D. P. S. (2019). Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers?. BMC health services research, 19(1), 1-12.
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. Sigma Theta Tau.
Elrod, J. K., & Fortenberry, J. L. (2017). Centers of excellence in healthcare institutions: what they are and how to assemble them. BMC health services research, 17(1), 15-24.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations. John Wiley & Sons.
Gutberg, J., & Berta, W. (2017). Understanding middle managers’ influence in implementing patient safety culture. BMC health services research, 17(1), 1-10.
Hasan, R. U., & Chyi, T. M. (2017). Practical application of Balanced Scorecard-A literature review. Journal of Strategy and Performance Management, 5(3), 87.
Kamal Sobky, H., Ahmed Elsayed, K., & Farouk Kamel, F. (2021). Nursing Staff Perception about Quality Improvement and Organizational Development. Journal of Nursing Science Benha University, 2(2), 88-98.
Manley, K., Martin, A., Jackson, C., & Wright, T. (2018). A realist synthesis of effective continuing professional development (CPD): A case study of healthcare practitioners’ CPD. Nurse education today, 69, 134-141.
Moseley III, G. B. (2017). Managing health care business strategy. Jones & Bartlett Learning.
Manzini, F., Diehl, E. E., Farias, M. R., Dos Santos, R. I., Soares, L., Rech, N., … & Leite, S. N. (2020). Analysis of a Blended, In-Service, Continuing Education Course in a Public Health System: Lessons for Education Providers and Healthcare Managers. Frontiers in Public Health, 8, 827.
Mather, C. A., & Cummings, E. (2019). Developing and sustaining digital professionalism: a model for assessing readiness of healthcare environments and capability of nurses. BMJ health & care informatics, 26(1).
Obeidat, B. Y., Al-Hadidi, A., & Tarhini, A. (2017). Factors affecting strategy implementation: a case study of pharmaceutical companies in the Middle East. Review of International Business and Strategy.
Olvera, J., Llorens, S., Acosta, H., & Salanova, M. (2017). Transformational leadership and horizontal trust as antecedents of team performance in the healthcare context. anales de psicología, 33(2), 365-375.
Shahid, N., Rappon, T., & Berta, W. (2019). Applications of artificial neural networks in health care organizational decision-making: A scoping review. PloS one, 14(2), e0212356.
Tecker, G. (April 3 2017). What are associations spending to develop new strategies?Tecker International. https://www.tecker.com/cost-to-develop-new-strategic-plan/
Van Steenbergen, E. F., van der Ven, C., Peeters, M. C., & Taris, T. W. (2018). Transitioning towards new ways of working: do job demands, job resources, burnout, and engagement change?. Psychological reports, 121(4), 736-766.
Vasileiou, K., Barnett, J., Thorpe, S., & Young, T. (2018). Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC medical research methodology, 18(1), 1-18.
Vaughn, V. M., Saint, S., Krein, S. L., Forman, J. H., Meddings, J., Ameling, J., … & Chopra, V. (2019). Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies. BMJ quality & safety, 28(1), 74-84.
World Health Organization. (2018). Pharmaceutical system transparency and accountability assessment tool: good governance for medicines: progressing access in the SDG era (No. WHO/EMP/2018.04). World Health Organizatio

Self-Reflection of Leadership
In Weeks 1 and 3, you focused on a famous leader (BILL GATES) and his or her leadership style, ethics, moral intelligence, credibility, principles, power, and beliefs. You also assessed the effect the leader had on the culture and ethics of the organization. Now, it is time to take what you have learned in those areas and apply it in self-reflection.
•
• Analyze your own principles, values, beliefs, and behaviors, citing examples and research to support your assessment.
o
o What are your fundamental principles (e.g., four universal principles)?
o
o What are your core values?
o
o What are your beliefs about people in organizations, people outside organizations, power, processes/policies, and profit?
o
o In what ways do your behaviors align (or don’t align) to your principles, values, and beliefs?
• From research, choose two leadership theories that you most relate to in terms of your own leadership. Provide a substantive synthesis of each leadership theory, including primary authors or researchers, the major points of each theory, and the similarities and differences between the two theories.
•
• Analyze your leadership in relation to each of the two leadership theories, discussing how your principles, values, beliefs, and behaviors align (or don’t align) with each of the theories.
•
• Compare your own leadership qualities with that of the leader you used in Weeks 1 and 3. Where are you similar to that leader and where are you different from that leader?
• Use examples and research to support your assessment.
•
• Using examples and research, justify at least three key insights from your study that you can use to enhance the ethical aspects of your leadership influence.
USE AT LEAST 5 CURRENT REFERENCES
? USE HEADINGS

NUR 670 GC Week 11 Leadership Journal: Serving
Details:
Journaling provides a valuable tool for recording, reflecting on, and reviewing your learning. This approach provides an opportunity for you to “connect the dots” and observe the relationships between and among activities, interactions, and outcomes.
Unlike a personal journal of thoughts and feelings, this Leadership Journal is a record of your activities, assessments, and learning related to this academic experience.
Journal entries should include a record of the number of hours spent with your nurse leader each week.
Write a journal entry of 750-1,500 words on the subject of serving, including the following:
Provide observations and thoughts on the activities in Weeks 9-10.
Would your co-workers or those you “serve” consider you responsible for some aspect of their success? Describe a situation where you were able to assist another nurse with achieving a professional goal.
Reflect on at least two things you learned from the “Issue of Servant” video.
Order a NUR 670 GC Week 11 Leadership Journal: Serving Paper Today !
NUR 670 GC Week 11 Leadership Journal: Serving
APA format is not required, but solid academic writing is expected.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Practicum Journal: Authority
Journaling provides a valuable tool for recording, reflecting on, and reviewing your learning. This approach provides an opportunity for you to “connect the dots” and observe the relationships between and among activities, interactions, and outcomes.
Unlike a personal journal of thoughts and feelings, this leadership journal is a record of your activities, assessments, and learning related to this academic experience.
Journal entries should include a record of the number of hours spent with your nurse leader each week.
Write a journal entry of 750-1,500 words on the subject of authority, including the following:
Practicum Activities Reflection: Provide observations and thoughts on the activities in your practicum setting during Weeks 3-4.
Application of Leadership: Reflect on how change management is handled in your professional life. How is this related to strategic management principles? Explain your answer and provide an example.
Practicum Project Preparation: Explain how your project goals align with the mission and vision of your organization, as well as with the organizational needs. Is it important that these align? Provide your rationale.
Leadership Video Reflection: Reflect on at least two things you learned from the “Servant Leadership – Issue of Authority” video.
Use the “Leadership Journal Template” to complete this assignment.
Place your order now!
Solution
In my view, nurse leaders, directors, instructors, and bedside staff are examples of servant leaders in the healthcare context. They all have one thing in common: they consistently put other people’s needs ahead of their own. Being a team leader is challenging since each team member brings their own unique perspective to the table. According to Aij and Rapsaniotis (2017), a leader’s consistency in teaching/learning is an ideal technique for producing professional nurses who are eager and capable of reforming the healthcare environment to achieve higher levels of quality and safety. In order to generate a feeling of trust, a leader must establish a relationship with their workforce. Over the previous two weeks, the writer has spent eight hours at her practicum site, divided into two days with her preceptor. There are several opportunities to learn and perceive things in a new light when spending time with my preceptor as he goes about his day with his staff. During my week three and four observations, I saw hospital professionals work together as a team to negotiate a high-stress situation, plan, and fix the issue with little impact on patients and staff.
Application of Leadership
Nurse leaders are critical in ensuring the effectiveness of change implementation. Notably, some other employees are opposed to the transformation process since their opinions are divergent. Specific individuals may believe that the change would risk their job security and will do everything possible to resist it. The nurse leader should intervene at this moment and involve the other workers, ensuring that they understand why the adjustment is essential. This will help mitigate any opposition to the adjustment.
Additionally, a nurse leader makes all necessary resources accessible to assist in the change process. Typically, the change process requires several resources, including continual training and a significant amount of time to ensure that all stakeholders understand the method. As a leader, the nurse’s responsibility is to ensure that all necessary resources are readily available to implement change (Bianchi et al., 2018). Additionally, the nurse leader exhibits leadership characteristics and ensures that all stakeholders in the change work cooperatively to accomplish the change objective. To ensure the effectiveness of the change process, the leader must set an example and create clear goals and approaches. This also entails continuous assessments to determine if more training or development is necessary.
Change has an influence on healthcare organizations in a variety of ways. The following things are included in this list: Change increases the institution’s overall quality and safety. When it comes to patient care, the measurement of quality is by the services provided to them. If a positive change occurs, patients will get better treatment and feel more secure inside the business. The change also offers the additional advantage of decreasing a healthcare institution’s operating costs. This is especially true when the primary goal of the transformation process is to reduce expenses (Wanser, 2018).
Practicum Project Preparation
In my perspective, developing connections is critical to a leader’s success. The majority of life’s success comes from just showing up and being there. There’s a lot to be said about making eye contact with employees, colleagues, and employers during meetings or other interactions. As a leader, I must be able to speak out and utilize my voice effectively. Furthermore, I believe that cooperation is essential and that when done right, I can leverage those connections to achieve success. My tenacity has also benefited both my team and the patients we serve. Several times in my professional experience, I’ve had the opportunity to contribute to the achievement of others. One of my proudest achievements has been assisting others in developing their careers, whether via education, certification, or advancement within the organization’s leadership. True leadership is acting in the service of others, listening to and supporting them. When done correctly, this results in a mutually beneficial relationship in which people achieve excellent outcomes not just for themselves but also for the department.
Video Reflection
The authority movie taught me that the perception of authority is always negative. As the speaker outlines the relationship between authority and management, authority is typically seen in the traditional workplace as someone who leads others owing to their position or title. Managers are given tremendous authority in order to accomplish company goals. Organizations should utilize authority to earn the confidence of their subordinates in order to inspire them to perform productively for you. The objective of the operating room is to provide safe, superior, and effective care (Redaelli, 2018). Second, the film discussed trust in more depth, emphasizing the need for trust in accepting informal rather than formal authority. When you are a servant leader among nurses, your work environment may function more effectively when you and those who work for or with you have trust in one another (Hamouda and Al Nagshabandi, 2018).
Conclusion
“Authority is a fantastic gift for someone who is in a position of direct influence over others,” ends this week’s leadership diary. Nurses should be mindful of their influence over the people they work with and for. Nursing leaders should use their positions of authority to encourage new and beginning nurses to contribute positively to the profession and the profession itself. Nursing leaders that adopt a servant leader mindset may be better able to effectively motivate other nurses to put others first and provide an example for others to follow.
References
Aij, K. H., & Rapsaniotis, S. (2017). Leadership requirements for Lean versus servant leadership in health care: a systematic review of the literature. Journal of Healthcare Leadership, 9, 1.
Bianchi, M., Bagnasco, A., Bressan, V., Barisone, M., Timmins, F., Rossi, S., … & Sasso, L. (2018). A review of the role of nurse leadership in promoting and sustaining evidence-based practice. Journal of Nursing Management, 26(8), 918-932.
Hamouda, G. M. H., & Al Nagshabandi, E. A. H. (2018). The perception of emotional intelligence self-assessment among nursing students. Am J Nur, 7(5), 173-177.
Redaelli, I. (2018). Nontechnical skills of the operating theatre circulating nurse: An ethnographic study. Journal of advanced nursing, 74(12), 2851-2859.
Wanser, L. M. (2018). Change in Healthcare Facilities: A Qualitative Study (Doctoral dissertation, Northcentral University).

Kim is a 25-year-old woman who presented to an outpatient clinic for an evaluation. She complained of episodes of sadness, often unexplained, as well as difficulty controlling her temper and handling stressful situations. Her sadness would sometimes last an entire week, was very intense, and occurred all day every day, but she reported that she would eventually return to her normal self. Her sadness was sometimes accompanied by a restless energy and irritability that precipitated arguments with her husband. These arguments would sometimes lead to Kim hitting her husband or throwing things at him. The periods of restless, heightened energy, and irritability would often switch abruptly back to a state of intense, depressed mood. When depressed, Kim would sleep excessively and had a tendency to overeat. She would isolate herself from others, let the housework go, and found it hard to get anything done. During the initial interview, Kim is very animated and dramatic. Her response to the question- “What brings you here to see us today? – lasted 8 minutes without interruption. Kim switched topics a number of times, and her speech was moderately pressured. Her affect would alternate between laughing and crying.
Kim smokes 1-2 packs of cigarettes per day. She drinks 5 caffeinated soft drinks per day. She has been taking birth control pills since she had a baby 8 months ago. She has been somewhat healthy, but since delivering the baby, she continues to gain weight and complains of headaches that are increasing in frequency and duration. These brief, but intense, periods of depressed mood have only started since the delivery of the baby. Prior to the delivery, she was a very outgoing and happy person, and had never been treated for mood or anxiety problems. However, anxiety and depression runs in her family. Her maternal grandfather was diagnosed with “manic depression” and hospitalized in a state mental health facility on 3 occasions. Several other relatives abused alcohol and/or cocaine. Her father was an alcoholic. Kim admits to occasional alcohol use, “only 2-3 times a week.” Her mother had been treated for depression, and also had a history of hypertension and heart disease. Her maternal grandmother had a history of anxiety, diabetes and hypertension.
Kim was diagnosed with Bipolar disorder and placed on divalproex sodium (Depakote) and olanzapine (Zyprexa). The divalproex sodium dosage was titrated to 1500 mg/day in divided doses over 10 days. She was prescribed olanzapine 10mg 1 tablet at bedtime. Her sleep patterns returned to normal and she felt less irritable. This improvement continued over the next 4 weeks, and her brief, depressed moods disappeared. Her serum valproate level was 65µg/mL.
Two months into treatment, Kim calls the office and reports that she’s noticed a 16 lb. weight gain. She states her weight is now at 238 lbs. (height is 5’2). She reports worsening headaches, frequent urination, is always thirsty, and feels hungry all the time. She reports recent, intermittent periods of fatigue. Mood wise, she states she is doing very well.
1. Looking at Kim’s physical symptoms, her history, and her family’s medical/mental history, which psychiatric and medical disorders is she at risk for? Explain why.
2. Based on the information provided above, what labs would you have drawn? Explain why.
3. What education should have been provided to Kim regarding her medications at the initiation of treatment? Would you change her medications at this time? Explain why or why not. If so, what other psychotropic medications could be considered. Explain why.
4. Based on the information provided above, what lifestyle changes would you recommend to Kim? Explain why.
5. What referrals should be made? Explain why.

Discussion response
Janet
Scenario 2: A mother brings her 6-month-old daughter to the HCP for evaluation of possible colic. The mother says the baby has had many episodes of crying after eating and, despite having a good appetite, is not gaining weight. The mother says the baby’s belly “gets all swollen sometimes.” The mother says the baby tastes “salty” when the mother kisses the baby. Further work up reveals a diagnosis of cystic fibrosis. The mother relates that her 23-month-old son has had multiple episodes of “chest congestion” and was hospitalized once for pneumonia. The mother wants to know what cystic fibrosis is and she also wants to know if she should have any more children.
Cystic Fibrosis is a progressive genetic disease that can cause lung infection and limit breathing time. Genetics plays a role in developing the condition, given that CF is a result of a mutation in a single gene (Cutting, 2015). Furthermore, the condition is inherited when the two copies of cystic fibrosis transmembrane conductance regulator (CFTR) gene is passed down to their children (Cutting, 2015). The hallmark pathophysiologic triad of Cystic Fibrosis includes obstruction, infection, and inflammation (McCance & Huether, 2019).
The role genetics plays in the disease:
Cystic fibrosis is an autosomal recessive disorder that affects 70,000 individuals worldwide. The condition primarily affects those of European descent and males, although cystic fibrosis has been reported in all races and ethnicities (Cohen & Prince, 2012). One CF mutation gene from each parent is passed down to the child, which will leave the child with two mutated genes causing them to develop CF and have the signs and symptoms along with the associated complications of CF. In the scenario, the mother asked whether she should have more children; I would suggest genetic counseling as the healthcare provider. I would explain to mom that she and her husband are carriers and pass their copy of the CFTR gene mutation to their children. Each time two CF carriers have a child together, the chances are: “25 percent (1 in 4) the child will have CF, a 50 percent (1 in 2) the child will be a carrier but will not have CF and lastly that there is a 25 percent (1 in 4) the child will not be a carrier of the gene and will not have CF” (CF Genetics: the Basics, n.d.).
Why the patient is presenting with the specific symptoms described
The infant presents with the above specific symptoms because CF causes the exocrine glands to work incorrectly, leading to significant complications affecting several body systems. Abnormally thick sticky mucus in the lungs and in the ducts of the pancreas in individuals with cystic fibrosis causes obstructions or blockages that lead to inflammation, tissue damage, and destruction of both organ systems. Other organ systems containing epithelia, such as the sweat glands, the biliary duct of the liver, and the intestines, are also affected (Cutting, 2015).
The physiologic response to the stimulus presented in the scenario and why you
think this response occurred
In the above scenario, I identified several stimuli that led to the workup for CF- the taste of
salt when mom kisses the baby and the episodes of crying after eating along with the swollen belly and lack of weight gain despite a good appetite. When the mom kisses the baby, she is tasting the baby’s “salty sweat,” which is related to the defective CFTR of the sweat glands. The defective CFTR prevents Cl ions from entering the cells, and they combine with Na ions forming salt; therefore, the mom says the kiss is salty. The other stimuli (crying after eating and swollen belly, and poor weight gain) are related to the defective CFTR found in the digestive ducts of the
gallbladder and pancreas right where they meet the stomach and small intestines. The digestive
enzymes cannot flow into the duodenum to aid in the digestion of nutrients such as fat-soluble
vitamins (A, D, E, and K) and proteins, leading to malnutrition and poor weight gain. Mom also says the baby has a swollen belly sometimes. This distention/bloating and crying (baby’s way of
expressing abdominal pain) can be due to too much bacteria in the intestines. However, mom
does not report watery stool. It may be that the baby has distal intestinal obstruction syndrome
(DIOS). The baby will present with “colicky abdominal pain and distension due to a sticky mass
of intestinal contents and mucosa in the small intestine. It impacts approximately 16–21 % of
patients with CF”(Kelly & Buxbaum, 2015, p. 1906).
The cells that are involved in this process
According to Cutting (2015), a “variant (p.Phe508del; also known as F508del in legacy
nomenclature) in the cystic fibrosis transmembrane conductance regulator (CFTR) gene was
found to be the most common cause of cystic fibrosis” (p. 45), and it is responsible for the
defective transport of chloride ions across airway epithelial tissues.
How another characteristic (e.g., gender, genetics) would change your response
As the healthcare provider, characteristics or clues that would change or alter my response would most likely be the history of the older 23-month-old brother. If I were the provider for the older brother, his history would have led me to test him and screen the sister at birth. I would likely be attuned to this possible diagnosis, especially if the family is Caucasian, as CF is most commonly found in males of European descent (Cohen & Prince, 2012). The brother’s symptoms of “chest congestion” and having had “pneumonia” are in line with the diagnosis of CF. CF’s Cardinal features of CF involve the respiratory system include “persistent cough or wheeze, excessive sputum production, and recurrent or severe pneumonia”(Mccance & Huether, 2019, p. 1221).
References
CF genetics: The basics. (n.d.). CF Foundation. Retrieved, November 30th, 2021 from https://www.cff.org/What-is- CF/Genetics/CFGenetics-The-Basics/
Cohen, T., & Prince, A. (2012). Cystic fibrosis: A mucosal immunodeficiency syndrome. Nature
Medicine, 18(4), 509–519. https://doi.org/10.1038/nm.2715
Cutting, G. R. (2015). Cystic fibrosis genetics: From molecular understanding to clinical
application. Nature Reviews Genetics, 16(1), 45–56. https://doi.org/10.1038/nrg3849
Kelly, T., & Buxbaum, J. (2015). Gastrointestinal manifestations of cystic fibrosis. Digestive
Diseases and Sciences, 60(7), 1903–1913. https://doi.org/10.1007/s10620-015-3546-7
Mccance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in
adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Place your order today!
Solution
Discussion Response: Cellular Processes and the Genetic Environment
Hi Janet, your discussion post presents an informative analysis of your case scenario and how it relates to cellular processes and the genetic environment. I like that your case presents demographic information that offers medically relevant demographic information that does not violate information privacy regulations. In addition, I like that you focus on cystic fibrosis as the patient is diagnosed with the condition. The discussion on the genetics of cystic fibrosis shows that it is a genetic disease resulting from the mutation of a single gene, specifically mentioning the cystic fibrosis transmembrane conductance regulator (CFTR) gene inherited from both parents. Besides that, I like that you present a discussion on the population statistics of the disease, reporting on the population affected and probability of inheritance or acting as a carrier. Also, I like that you link the reported physiological response to cystic fibrosis (salty when kissed). Furthermore, I like that your discussion explores the cells involved in the psychological response. Moreover, I like that your discussion explores how other demographic characteristics of the patient can change the understanding of the case and diagnosis. Still, I feel that the discussion can be improved by including differential diagnoses. For instance, the patient has presented respiratory problems affecting the airway, which could be linked to other medical conditions like the common cold, asthma, acute bronchitis, chronic bronchitis, primary ciliary dyskinesia (Kartagener syndrome), bronchiectasis, emphysema, foreign body aspiration, bronchiolitis, pneumoconiosis, and interstitial lung disease (Kliegman et al., 2017). Also, the patient presents symptoms affecting the gastrointestinal tract with the differential diagnosis being gastroesophageal reflux. Also, there are some autoimmune effects with the differential diagnosis being sarcoidosis. These differential diagnoses could offer an alternative explanation for the reported symptoms (Broaddus et al., 2021). Overall, the discussion has been well presented but would be improved by including the mentioned suggestions.
References
Broaddus, C., Ernst, J., King Jr., T., Lazarus, S., Sarmiento, K., Schnapp, L., Stapleton, R., & Gotway, M. (Eds.) (2021). Murray & Nadel’s Textbook of Respiratory Medicine (7th ed.). Elsevier, Inc.
Kliegman, R., Toth, H., Bordini, B., & Basel, D. (2017). Nelson Pediatric Symptom-Based Diagnosis. Elsevier Health Sciences.
Place your order today!

NRNP 6665 Discussion WEEK 2: RESPONSE TO MY COLLEAGUE NO 2 (AMARACHI, E)
Ethical and Legal Foundations of PMHNP across Lifespan
Topic: Restraints
Restraints are the physical, environmental, or chemical interventions that healthcare professionals use to control undesirable behaviors among patients. In most cases, psychiatric mental health nurse practitioners (PMHNP) use restraints to limit unnecessary movements among patients in psychiatric care to minimize their threats to others or prevent them from experiencing injuries during their medication process. One of the primary types of restraints is physical equipment, such as straps that limit patients from moving. PMHNPs also use chemical restraints that involve injecting the patients with drugs to sedate them, thus preventing them from showing undesirable behavior. Finally, physicians use environmental restraints, which are structures in the patient’s surroundings, to limit their movements from one place to another. Environmental restraints are vital in determining the places where a patient can go.
Articles’ Summary
Ethical and Legal Issues Related to Restraints as they Concern Psychiatric-Mental Health Practice for Children/Adolescents.
Scheuermann et al. (2016) argue that some of the ethical issues that emanate from the use of restraints among children include lack of appropriate professional training and monitoring, leading to physicians’ failure to comply with safety standards when treating patients. Also, hazardous interventions result in injuries on adolescents, thereby negatively impacting their welfare (Scheuermann et al., 2016). Besides, when retraining patients, it is prudent to use the least invasive approaches before advancing to complex strategies to enhance their wellbeing (Scheuermann et al., 2016). The ethical issues above concern non-maleficence and beneficence principles, which require that nurses not intentionally harm the patients.
When treating children, it is prudent to consider the legal provisions, such as the Children’s Health Act (2000) which requires that individuals and professionals not engage in activities that negatively impact the health of mentally ill persons (Day et al., 2010). Besides, the physicians should consider the international position statements concerning physical restraints among children. For instance, the International Society of Psychiatric-Mental Health Nurses has issued a Position Statement on the Use of Restraints and Seclusion among children, which recommends that physicians restrain children as the last strategy (Day et al., 2010). Therefore, restraints among children should be applicable in instances where they are at risk of self-injury and where there are no alternatives to managing their undesirable conduct.
Ethical and Legal Issues Related to Restraints as they Concern Psychiatric-Mental Health Practice for Adults.
Duwadi et al. (2018) argue that the use of restraints among adult patients often leads to the contravention of ethical principles of autonomy, non-maleficence, and beneficence. As a result, practitioners should adequately balance the necessity of restraints and the patient’s welfare when making decisions on controlling behaviors among their patients (Duwadi et al., 2018). When treating critically ill adult patients, it is prudent to engage in activities that will enhance their benefits from the treatment programs. Therefore, a practitioner should avoid coercive approaches that can negatively impact the patients’ physical or psychological well-being.
According to Recupero et al. (2011), the federal policies have restricted the use of restraints and seclusion among adults in psychiatric care. When using restraints and seclusion, physicians must effectively manage the pain the patients can experience. According to Recupero et al. (2011), legal issues emanated from failure to comply with the Americans with Disabilities Act (ADA) and proper supervision and training of the staff to enhance patients’ safety. Therefore, patient-centered, and treatment-oriented strategies are vital in mitigating physicians’ legal liabilities when applying restraints and seclusion.
Application to My Practice
In the state of California, the information concerning legal issues relating to treating patients with disabilities will be vital in ensuring that I enhance the patients’ welfare. In particular, the ADA requires that professionals treat mentally ill patients with dignity. Therefore, when treating children or adults with mental disorders, it will be necessary not to use restraints in a manner that disparages their dignity. Further, legal considerations such as the Children’s Health Act will influence my practice by first considering their interests when treating them. On the other hand, the ethical issues in using restraints will influence my practice by adhering to the nursing principles of non-malfeasance, beneficence, and autonomy. Therefore, I will effectively engage the patients or their families to get informed consent before using restraints or seclusion.
References
Day, A., Daffern, M., & Simmons, P. (2010). Use of restraint in residential care settings for children and young people. Psychiatry, psychology, and law, 17(2), 230-244. Doi:10.1080/13218710903433964
Recupero, P. R., Price, M., Garvey, K. A., Daly, B., & Xavier, S. L. (2011). Restraint and seclusion in psychiatric treatment settings: regulation, case law, and risk management. Journal of the American Academy of Psychiatry and the Law Online, 39(4), 465-476.
Scheuermann, B., Peterson, R., Ryan, J. B., & Billingsley, G. (2016). Professional practice and ethical issues related to physical restraint and seclusion in schools. Journal of Disability Policy Studies, 27(2), 86-95. Doi: 10.1177/1044207315604366
Order a NRNP 6665 with us today!

Journaling provides a valuable tool for recording, reflecting on, and reviewing your learning. This approach provides an opportunity for you to “connect the dots” and observe the relationships between and among activities, interactions, and outcomes.
Unlike a personal journal of thoughts and feelings, this leadership journal is a record of your activities, assessments, and learning related to this academic experience.
Journal entries should include a record of the number of hours spent with your nurse leader each week.
Write a journal entry of 750 words on the subject of power, including the following:
Practicum Activities Reflection: Provide observations and thoughts on the activities in your practicum setting with nursing leadership and interprofessional collaboration.
Application of Leadership: Professional responsibility and power, authenticity, integrity, and emotional intelligence are key factors of multiple leadership styles. Discuss how you have observed your preceptor or your nurse leader in your professional setting integrate these elements into leadership styles.
Practicum Project Preparation: My practicum project will be on how nurse leaders can initiate and manage change. How does this project refine and build skills related to your career goals? My hopes are that this will meet the objective of performance improvement and staff development.
Leadership Video Reflection: Reflect on at least two things you learned from the “Servant Leadership – Issue of Power” video.
Use the “Leadership Journal Template” to complete this assignment.
APA style is not required, but solid academic writing is expected.
Place your order today!
Solution
Leadership Journal
Name:
Weeks Covering:
Preceptor/Mentor:
Clinical/Practicum Site:
Hours Worked (past 2 weeks):___
Total Hours: ____/150 total of all hours worked up to this point
Practicum Leadership Journal
Practicum is an essential program, especially for nursing students. It helps them gain more field experience and exposes them to a practical world where they can put the concepts and theories learned in class into practice. In addition, the practicum journal aims at reflecting on how nursing leaders manage change. Therefore, the journal will focus on practicum activities reflection, application of leadership, practicum project preparation, and leadership video reflection.
Practicum Activities Reflection:
Leadership essence revolves around the ability of a leader to use their power to influence and motivate other people. McCay et al. (2018) accentuate that a leader can use their power negatively or positively, which results in various consequences. During my nursing practicum, I realized that our nursing leader used a different method when engaging with the nurses in a different situation. For instance, whenever there would be an issue in any department, the leader would call out nurses for an emergency meeting that would help approach the situation in a more informed way. However, some leaders always believe that the best way to solve the upcoming issues is by punishing or using coercion so long as they are in power. The approach may at some help, but in general, it instills fear in the subordinate staff. After researching, I realized that our leader’s approach to governing the nursing staff was mainly the transformative perspective. Wheeler and Beaman (2018) accentuate that transformational leadership enables leaders to utilize their power in favor of their subordinates by encouraging them and providing better working conditions. Also, I noted that our nursing leader always encouraged team collaboration. For instance, when planning out the nursing roles, the nursing leader ensured that the nursing students carrying out their practicum would integrate with the registered nurses, thus developing strong bonds. Such collaboration is effective since it helps in increasing the nursing students’ skills and confidence in achieving patients’ overall outcomes.
Application of Leadership:
All leaders should ensure that as they exercise their power, integrity, authenticity, emotional intelligence, and professional responsibility are the key in their profession. According to McCay et al. (2018), leaders who excel in their profession always utilize their power to benefit the whole team. Hence, power becomes toxic when the leaders become self-centered at the expense of their team and good ethics. As a result, our nurse leader used a dynamic approach when executing his task to ensure that the healthcare professionals achieved the healthcare organization’s goals. For instance, whenever an issue came up, the nursing leader alerted the nurse fraternity that they had many nursing students to inspire. As a result, he always encouraged the nurses to conduct themselves in the right way to save their reputation from us. However, he would, later on, call out the nurses privately and summon them. Such actions proved that the nurse leader used his power effectively to achieve professional responsibility, integrity, and authenticity. Also, I realized that to be an effective leader, and they should employ emotional intelligence to support their positive power influence. For instance, during my first week of nursing practicum, I was always nervous. Even if I had any questions, I would ask another nursing student to ask on my behalf since I did not dare engage with people in a new environment. After noting the situation, the nurse leader called me privately, where we discussed my fears and promised to take me through. Such action motivated me more to gain confidence and trust myself and those around me. Hence, through the transformational leadership of the nurse leader, he would create a great rapport with all nursing staff and students, thus becoming their strong foundation.
Practicum Project Preparation:
Nurse leaders act as the foundation towards change where they have the responsibility to initiate and manage it in healthcare organizations. Wheeler and Beaman (2018) posit that nurse leaders should know the skills and leadership styles they should involve to make any change in a healthcare organization. Hence, from the practicum, I have gained various skills like encouraging interprofessional collaboration among nursing professionals to improve patient experience, safety, and overall outcome. Also, I have witnessed the need to use a transformational leadership style. It helps a leader create a strong rapport with the healthcare providers, thus improving their performance and job satisfaction. Therefore, in my future endeavors, I will ensure that my nurse leadership will always be firm in ethical practices and incline more on emotional intelligence for a successful interprofessional collaboration encounter.
Leadership Video Reflection:
The two factors learned from the video “Issues of Power” are managing people and influencing people through dynamic art. GCU Academics – Nursing (2016, 1.34-0.38) captures the speaker quoting that successful leaders do not equate their employees to money. The speaker believes that it is easy to control other aspects once a leader has managed the people from his perspective. That is due to the strong influence that employees in an organization have on the organization’s success. Therefore, when I become a leader, I will always create a strong rapport with my juniors to motivate them and increase their productivity. The use of dynamic art to influence people is a factor summed up by the video. As a nursing leader, I learned that there is a need to engage in ethical behaviors and activities since the juniors emulate the leaders. Hence, the practicum has created a great chance to develop my leadership skills for my future nursing career.
Conclusion
The practicum journal involves an analysis of my experience and thoughts about nurse leadership in initiating and managing change. Therefore, the journal evaluates more on how nurse leaders utilize their power in managing the healthcare providers.
References
GCU Academics – Nursing. (October 10, 2016). Servant Leadership – The Issue of Power. YouTube. https://www.youtube.com/watch?v=Z8yMNFMp0k8
McCay, R., Lyles, A. A., & Larkey, L. (2018). Nurse leadership style, nurse satisfaction, and patient satisfaction: a systematic review. Journal of nursing care quality, 33(4), 361-367.
Wheeler, K., & Beaman, M. (2018). The effects of a transformational nursing leadership program on perceived leader behavior. J Nurs Healthcare Managers [Internet], 1(1).

Chi-Square and Correlation- Classmate Response (2): Topic 4 DQ 1
QUESTION-Correlation is a common statistic to measure a general linear relationship between two variables. Explain why correlation does not equal causation.
Classmate (Samantha)-. Response to the question-
Correlation and causation are always heard like two peas in a pod. Sometimes I hear them used as correspondents and sometimes not. Correlations between variables show us that there is a pattern in the data: that the variables we have tend to move together. However, correlations alone don’t show us whether or not the data are moving together because one variable causes the other(JMP 2021). Even if there is a correlation between two variables, we cannot conclude that one variable causes a change in the other. This relationship could be coincidental, or a third factor may be causing both variables to change(Khan Academy 2021). an example of this would be when doing research on psychiatric medications. How do we know that the medications are what is affecting the imbalance of our thoughts and our feelings? There are also some other factors that could contribute to the side effects like not having enough nutritious vitamins as well as feeling stressed out. I always think about this when I used to work in a behavioral hospital. Then I would try to figure out ways to help the patients non-medicinally like doing yoga or going out on the patio or creating fun activities for the patients and their peers to release Seratonin. It helped alongside the medication which was a great outcome for their care.
Resources
Khan Academy. (n.d.). Correlation and causation | Lesson (article). Khan Academy. Retrieved October 3, 2021, from https://www.khanacademy.org/test-prep/praxis-math/praxis-math-lessons/gtp–praxis-math–lessons–statistics-and-probability/a/gtp–praxis-math–article–correlation-and-causation–lesson.
Correlation vs causation. JMP. (n.d.). Retrieved October 3, 2021, from https://www.jmp.com/en_us/statistics-knowledge-portal/what-is-correlation/correlation-vs-causation.html.
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution
Response
Hello, thank you for granting me this opportunity to respond to your post. I appreciate your interest in taking part in the discussion and contributing wholeheartedly. I will only add a few remarks to your post. Correlation tends to measure a relation between one variable over the other one. The variable can take either a positive or negative direction. Based on correlated data, the degree of one variable is related to change on another variable, which occurs in either positive or negative direction of correlation (Schober et al., 2018).
In addition to your points regarding the correlation does not equal causation, I would like to point out that it is crucial to note; an observed relationship between two variables does not determine any causal relationship. For instance, the coffee business tends to be on higher levels during cold and rainy seasons, thus increasing the sales, but buying umbrellas does not necessarily lead to high sales of coffee. Thus showing a relation between two variables takes different correlations (Schober et al., 2018). Therefore, causation exists, though it still does not mean that correlation determines causation.
Correlation and causation can be a little bit confusing to so many people and even to the researchers. The main aim is to focus on observational data and understand the relation between variables before making assumptions (Rohrer, 2018). Based on different research scenarios, a researcher should examine the various factors showing any association in the study, especially if it is a concept that involves observation and statistical testing. Categorizing the variables is also vital in proving the relationship of causation if the existing relation is on both variables or just one. Highlighting such concepts can help reduce the confusion between correlation and causation. Furthermore, a clear application of both terms can improve the quality of various research work that uses the terms interchangeably.
References
Rohrer, J. M. (2018). Thinking clearly about correlations and causation: Graphical causal models for observational data. Advances in Methods and Practices in Psychological Science, 1(1), 27-42. https://journals.sagepub.com/doi/pdf/10.1177/2515245917745629
Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763-1768. https://journals.lww.com/anesthesia-analgesia/Fulltext/2018/05000/Correlation_Coefficients___Appropriate_Use_and.50.aspx

Advanced Pharmocology
Write a 2- to 3-page paper, APA Format, that addresses the following:
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state ( Florida).
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.
You will also examine the ethical and legal implications of prescribing drugs, as well as advanced practice nurse strategies in guiding prescription drug decision-making.
Assignment Scenario:
A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway?
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution
Case Scenario Analysis
Ethical and Legal Implications
Healthcare providers are guided by a legal framework that controls the practices of the professionals even when they enjoy autonomy. In the case scenario, a friend calls for a medication prescription even when the autonomous prescriber has less or no medical history of the patient. In this scenario, various legal and ethical implications may concern the patient and the prescribing healthcare provider. The healthcare provider may highly prescribe a risky medication that may have adverse effects. The healthcare provider prescribing the medications to the patient without the patient’s history may contradict the ethical principle of non-maleficence since this may be an unsafe and ineffective prescription. The same principle applies to a pharmacist who provides OTC medications without assessing the patient and without official instructions and documentation from the physician. According to Markel (2016), it is unlawful to prescribe medications without proper documentation from the physician showing affirming the prescribed medications. It is thus unethical and illegal for a provider to prescribe medications without physical assessment of the patient and proper documentation of the patient’s health condition and official prescription form. The medications may lead to adverse health effects that may result in litigation against the prescriber and the pharmacists for prescribing harmful or wrong medications.
Strategies to address disclosure and nondisclosure
Disclosure is an important aspect of communicating to the patient on the possibility of any harm during the healthcare process. Prescription of medications attracts numerous health risks and harms to patients. For the case scenario, the physician may prescribe ineffective or harmful medications, and thus it is ethical to communicate to the patient. According to Russel (2018), disclosure to the patient and their families improves trust, indicating that the healthcare providers care much about the patient’s health. In the event of adversity resulting from an error in prescription, the patient can be allowed to report the progress and in case of adversity to the healthcare provider. The patient may maintain positive communication with the healthcare provider in monitoring the progress of the treatment. Additionally, on establishing adverse effects of the medication, the healthcare provider can communicate with the patient’s guardian or caregiver for error rectification through the phone. The federal law allows disclosure through phones, emails, fax, and others while maintaining confidentiality and privacy standards. According to the Florida law on medication disclosure, the patient and the healthcare provider should be in person, with proper medical record documentation. In case of adverse effects, the friend can only be disclosed through a formal physical encounter for assessment and proper documentation by the responsible or accountable healthcare provider. I would therefore adhere to the Florida law on disclosure.
Strategies Guiding Decision Making
Various strategies guide disclosure or nondisclosure of a patient’s medication error to the patient. One of the strategies is to consider whether harmful effects result from the prescribed medications or not. If there are adverse effects, it is important to inform the patient and assure them of quality care to rectify the error. This would avoid litigations and negative publicity by the patients or their families concerning the impactful error. Harmful errors attract legal suits and thus should be disclosed. “Nonharmful” errors are less recognized, and thus, healthcare providers are not inclined to disclose the errors (Chamberlain et al., 2016). The other strategy is considering the laws of the state. In some states, medication errors should be reported and disclosed once realized. This includes both harmful and “harmless” errors. As an advanced nurse practitioner, I would disclose to the patient when there are harmful results of the errors in avoiding confusing the patient. Changing the prescription would be the most effective strategy when the prescription is harmless. This would avoid unnecessary tension for the patient and their families.
Writing Prescriptions
Writing prescriptions involves the process of documenting the prescriptions for the patients. Writing prescriptions is procedural, including various steps. The prescriber should first evaluate the patient and define their problems through clinical assessment of the patient’s history. The prescriber should then select the appropriate drug therapy and initiate the appropriate details, considering the non-pharmacologic therapies. The next step is to give information about the therapy, instructions, and probably warnings on using the medications. After providing instructions and warnings, the prescriber should ensure close monitoring in considering the continuation or discontinuation of the drug. Different strategies can be used to reduce medication errors. Patient education plays a very important role in improving medication adherence and reducing errors resulting from poor following of the instructions (Lee et al., 2017). Other effective methods include using prescription checklists, improved coordinated care among health providers, and effective information technology systems.
References
Chamberlain, C. J., Koniaris, L. G., Wu, A. W., & Pawlik, T. M. (2016). Disclosure of “nonharmful” medical errors and other events: duty to disclose. Archives of Surgery, 147(3), 282-286. https://jamanetwork.com/journals/jamasurgery/fullarticle/1107400
Lee, Y. M., Yu, H. Y., You, M. A., & Son, Y. J. (2017). Impact of health literacy on medication adherence in older people with chronic diseases. Collegian, 24(1), 11-18.
Markel, E. (2016, December 3). Legal Considerations: Prescribing Medications for Friends and Family. thrive. https://thriveap.com/blog/legal-considerations-prescribing-medications-friends-and-family
Russell, D. (2018). Disclosure and apology: Nursing and risk management working together. Nursing Management, 49(6), 17-19.