Nursing

Part 1
Choose two geriatric assessment tools that are appropriate for primary care (excluding depression, anxiety and pain screening tools) and discuss the following:
-explain the purpose of the tool
-explain the scoring guidelines
-how you apply the assessment in practice
Part 2
Anxiety and depression are the most common psychiatric problems you will encounter in your primary care practice.
Review this case study
HPI: KB, 55 year old Caucasian female who presents to office with complaints of fatigue. The fatigue has been present for 6 months and seems worse in the morning, improving slightly through the day. KB reports a lack of energy and ”loss of joy”. States” I really don’t feel like going anywhere or doing anything” Reports she often has difficulty staying on task and completing projects for work. She reports not feeling hungry and does not feel rested when she wakes up in the morning. KB is a widow for 2 years, social events that are couples only can make her symptoms worse. She tries to do at least one social activity a week but it can be really exhausting. Her husband died in their car while she was driving him to the hospital and sometimes driving in that car makes all the memories come back. She recently got a puppy, which she thought would help with the loneliness but the care of the puppy seems overwhelming at times. Rest and exercise, specifically yoga and meditation seem to make her feel better. At this time she does not want to do either. She has not tried any medications, prescribed or otherwise. She reports drinking a lot of coffee, but that does not seem to help.
Current medications: Excedrin PM about once a week when she can’t sleep, seems to help a bit. NKDA.
PMH: no major illnesses. Immunizations up to date.
SH: widowed, employed full time as a manager. Drinks wine, 1 glass every night. No tobacco, no illicit drugs. Previously married while living in France, reports an abusive relationship. The French government gave custody of her son to the ex-husband. She returned to US without her son 10 years ago. She sees her son two times a year, they skype and text ”all the time” but she misses him.
FH: Parents are alive and well. Has one son, age 21, he is healthy but lives in France with his father.
ROS
CONSTITUTIONAL: reports weight loss of 2-3 pounds, no fever, chills, or weakness reported
HEENT: Eyes: No visual loss, blurred vision, double vision or yellow sclera. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose or sore throat.
CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema.
RESPIRATORY: No shortness of breath, cough or sputum.
GASTROINTESTINAL: Reports decreased appetite for about 3 months. No nausea, vomiting or diarrhea. No abdominal pain or blood.
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.
GENITOURINARY: no burning on urination. Last menstrual period 4 years ago.
PSYCHIATRIC: No history of diagnosed depression or anxiety. Reports great anxiety due to verbal and concern for physical abuse, reports feeling very sad and anxious when divorcing and leaving her son in France. Did not seek treatment. She started to feel better after about 4 months.
ENDOCRINOLOGIC: No reports of sweating, cold or heat intolerance. No polyuria or polydipsia
ALLERGIES: No history of asthma, hives, eczema or rhinitis.
Discussion Questions:
1. Research screening tools for depression and anxiety.
Choose one screening tool for depression and one screening tool for anxiety that you feel are appropriate to screen KB.
Explain why you chose that particular tool for KB. If you can, attempt to score KB based on the information provided (not all data may be provided). Include what questions could be scored, and your chosen sore.
2. Identify your next step for evaluation and treatment for KB.
What medication, if any, would you recommend for treatment? Provide the rationale. This should include the medication class, mechanism of action of the medication and why this medication is appropriate for KB. Include initial prescribing information.
If the medication works as expected, when should KB expect to start feeling better?

Take one component in the Metaparadigm of Nursing, identify and discuss the concept or concepts of Watson’s Theory of Caring that support that Watson wrote a theory of nursing based on the criteria established in the Metaparadigm of Nursing.
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Solution
Personal Theory
Nursing theories usually explain the main pillars that guide nursing practice. Theoretically, all relevant evidence-based therapies used by nurses in the course of patient care should be sound. Conceptual frameworks, which are found exclusively in nursing theories, supply them. As a result, conceptual frameworks serve as the foundation for solid evidence-based practice, or EBP. Nursing theoretical concepts guide, direct, and steer practice in the same manner that a lighthouse at sea guides, directs, and steers a ship to avoid hazards and obstructions that may render interventions inefficient and useless. There are three types of nursing theories, each with its own level of abstraction in terms of concepts. All nursing theories, according to Wayne (2020), will be grand theories, mid-range theories, or practice-level theories. Grand theories are the most abstract of the three, while practice-level theories are the least abstract. Practice-level theories are simple and direct, but middle-range theories are narrower in scope and are the most common type of nursing theory (Risjord, 2018). Environmental Theory, Transcultural Nursing (TCN) Theory, Self-Care Deficit Theory (SCDT), and Watson’s Theory of Human Caring are some of the most well-known and frequently discussed nursing theories (Alharbi & Baker, 2020; Gonzalo, 2019a; Gonzalo, 2019b; Pajnkihar et al., 2017; Borji et al., 2017 ). This paper presents a theory about the formation of pressure ulcers (concept A) and the causality relationship that this has with the actions of nurses providing care (concept B), while giving the correlative proposition linking the two together at the same time.
In my area of practice, I have observed that rates of pressure ulcer development usually go down when particular measures are practiced consistently over time by the nurses. The theory I have come up with is that a positive relationship exists between performing these acts and obtaining favorable patient outcomes. This is a relationship of causality because these actions by nurses directly result in improved quality of care and reduced hospital stay. The actions include:
• Elevating the head of the bed at an inclination of less than 30° (Burk & Grap, 2012).
• Keeping everything clean and dry, proper diet and hydration to keep skin healthy, and frequent repositioning
• Using appropriate pressure-relieving support surfaces such as special mattresses, and
• Performing pressure area care (massaging and applying baby powder) every two hours for bed-ridden patients (Angmorterh et al., 2019; Gaspar et al., 2019; Nixon et al., 2019; Baron et al., 2016).
The main point of discussion is the theory that the omissions and commissions of nurses are responsible for the causation of pressure injuries. As the above evidence stated portray, that there are evidence-based interventions that will prevent the development of pressure ulcers if nurses implement them consistently. This deduction is made from the proposition that a correlation exists between the actions/ inaction of nurses and the formation of the pressure injuries in bed-ridden patients.
Concept A: Nurses perform pressure area care every two hours to bed-ridden patients., keeping skin dry and clean. Proper nutrition / hydration. They also turn the patients, make them lay on comfortable support surfaces, and elevate the head of the bed (Angmorterh et al., 2019; Gaspar et al., 2019).
Concept B: Pressure ulcer rates drop significantly as a consequence of the actions of the nurses as outlined in concept A (Nixon et al., 2019; Baron et al., 2016).
Proposition: The actions in concept A by the nurses have a clear bearing on the reality in concept B. The actions result in the reduction of the number of bed-ridden patients developing pressure sores (Kottner et al., 2019). In other words, there is a direct relationship between the actions of the nurses and the improvement in the quality of nursing care.
The concept explained above is drawn from clinical practice and informed by what has been observed. Pressure ulcers are one of the occurrences that put a dent in the quality of care. Finding a theory that explains their prevention is therefore important for evidence-based practice. Concept A is related to concept B and the proposition in-between has been clearly explained.
References
Alharbi, K.N., & Baker, O.G., (2020). Jean Watson’s middle range Theory of Human Caring: A critique. International Journal of Advanced Multidisciplinary Scientific Research, 3(1), 1-14. https://doi.org/10.31426/ijamsr.2020.3.1.3011
Angmorterh, S. K., England, A., Webb, J., Szczepura, K., Stephens, M., Anaman-Torgbor, J., … & Hogg, P. (2019). An investigation of pressure ulcer risk, comfort, and pain in medical imaging. Journal of Medical Imaging and Radiation Sciences, 50(1), 43-52. http://dx.doi.org/10.1016/j.jmir.2018.07.003
Baron, M. V., Reuter, C. P., Burgos, M. S., Cavalli, V., Brandenburg, C., & Krug, S. B. F. (2016). Experimental study with nursing staff related to the knowledge about pressure ulcers. Revista Latino-Americana de Enfermagem, 24. https://doi.org/10.1590/1518-8345.1134.2831
Borji, M., Otaghi, M. & Kazembeigi, S. (2017). The impact of Orem’s self-care model on the quality of life in patients with type II diabetes. Biomedical & Pharmacology Journal, 10(1), 213-220, http://dx.doi.org/10.13005/bpj/1100
Burk, R.S., & Grap, M.J. (2012). Backrest position in prevention of pressure ulcers and ventilator-associated pneumonia: Conflicting recommendations. Heart & Lung: The Journal of Acute and Critical Care, 41(6), 536–545. https://doi.org/10.1016/j.hrtlng.2012.05.008
Gaspar, S., Peralta, M., Marques, A., Budri, A., & Gaspar de Matos, M. (2019). Effectiveness on hospital-acquired pressure ulcers prevention: A systematic review. International Wound Journal, 16(5), 1087-1102. http://dx.doi.org/10.1111/iwj.13147
Gonzalo, A. (2019a). Madeleine Leininger: Transcultural nursing theory. https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/
Gonzalo, A. (2019b). Florence Nightingale: Environmental theory. Nurses Labs. https://nurseslabs.com/florence-nightingales-environmental-theory/#:~:text=The%20Environmental%20Theory%20by%20Florence,health%2C%20and%20that%20external%20factors
Kottner, J., Cuddigan, J., Carville, K., Balzer, K., Berlowitz, D., Law, S., … & Sigaudo-Roussel, D. (2019). Prevention and treatment of pressure ulcers/injuries: The protocol for the second update of the international Clinical Practice Guideline 2019. Journal of Tissue Viability, 28(2), 51-58. https://doi.org/10.1016/j.jtv.2019.01.001
Nixon, J., Smith, I. L., Brown, S., McGinnis, E., Vargas-Palacios, A., Nelson, E. A., … & Henderson, V. (2019). Pressure relieving support surfaces for pressure ulcer prevention (PRESSURE 2): Clinical and health economic results of a randomized controlled trial. EClinicalMedicine, 14, 42-52. http://dx.doi.org/10.1016/j.eclinm.2019.07.018
Pajnkihar, M., McKenna, H.P., Stiglic, G., & Vrbnjak, D. (2017). Fit for practice: Analysis and evaluation of Watson’s theory of human caring. Nursing Science Quarterly, 30(3). https://doi.org/10.1177/0894318417708409
Risjord, M. (2018). Middle-range theories as models: New criteria for analysis and evaluation. Nursing Philosophy, 1-10. https://doi.org/10.1111/nup.12225
Wayne, G. (2020). Nursing theories and theorists. Nurses Labs. https://nurseslabs.com/nursing-theories/#:~:text=There%20are%20three%20major%20categories,%2C%20and%20practice%2Dlevel%20theory

Protected Health Information (PHI): Privacy, Security, and Confidentiality Best Practices
Prepare a 2-page interprofessional staff update on HIPAA and appropriate social media use in health care.
Introduction
As you begin to consider the assessment, it would be an excellent choice to complete the Breach of Protected Health Information (PHI) activity. The activity will support your success with the assessment by creating the opportunity for you to test your knowledge of potential privacy, security, and confidentiality violations of protected health information. The activity is not graded and counts towards course engagement.
Health professionals today are increasingly accountable for the use of protected health information (PHI). Various government and regulatory agencies promote and support privacy and security through a variety of activities. Examples include:
Meaningful use of electronic health records (EHR).
Provision of EHR incentive programs through Medicare and Medicaid.
Enforcement of the Health Insurance Portability and Accountability Act (HIPAA) rules.
Release of educational resources and tools to help providers and hospitals address privacy, security, and confidentiality risks in their practices.
Technological advances, such as the use of social media platforms and applications for patient progress tracking and communication, have provided more access to health information and improved communication between care providers and patients.
At the same time, advances such as these have resulted in more risk for protecting PHI. Nurses typically receive annual training on protecting patient information in their everyday practice. This training usually emphasizes privacy, security, and confidentiality best practices such as:
Keeping passwords secure.
Logging out of public computers.
Sharing patient information only with those directly providing care or who have been granted permission to receive this information.
Today, one of the major risks associated with privacy and confidentiality of patient identity and data relates to social media. Many nurses and other health care providers place themselves at risk when they use social media or other electronic communication systems inappropriately. For example, a Texas nurse was recently terminated for posting patient vaccination information on Facebook. In another case, a New York nurse was terminated for posting an insensitive emergency department photo on her Instagram account.
Health care providers today must develop their skills in mitigating risks to their patients and themselves related to patient information. At the same time, they need to be able distinguish between effective and ineffective uses of social media in health care.
This assessment will require you to develop a staff update for the interprofessional team to encourage team members to protect the privacy, confidentiality, and security of patient information.
Preparation
To successfully prepare to complete this assessment, complete the following:
Review the infographics on protecting PHI provided in the resources for this assessment, or find other infographics to review. These infographics serve as examples of how to succinctly summarize evidence-based information.
Analyze these infographics and distill them into five or six principles of what makes them effective. As you design your interprofessional staff update, apply these principles. Note: In a staff update, you will not have all the images and graphics that an infographic might contain. Instead, focus your analysis on what makes the messaging effective.
Select from any of the following options, or a combination of options, the focus of your interprofessional staff update:
Social media best practices.
What not to do: social media.
Social media risks to patient information.
Steps to take if a breach occurs.
Conduct independent research on the topic you have selected in addition to reviewing the suggested resources for this assessment. This information will serve as the source(s) of the information contained in your interprofessional staff update. Consult the BSN Program Library Research Guide for help in identifying scholarly and/or authoritative sources.
Instructions
In this assessment, assume you are a nurse in an acute care, community, school, nursing home, or other health care setting. Before your shift begins, you scroll through Facebook and notice that a coworker has posted a photo of herself and a patient on Facebook. The post states, “I am so happy Jane is feeling better. She is just the best patient I’ve ever had, and I am excited that she is on the road to recovery.”
You have recently completed your annual continuing education requirements at work and realize this is a breach of your organization’s social media policy. Your organization requires employees to immediately report such breaches to the privacy officer to ensure the post is removed immediately and that the nurse responsible receives appropriate corrective action.
You follow appropriate organizational protocols and report the breach to the privacy officer. The privacy officer takes swift action to remove the post. Due to the severity of the breach, the organization terminates the nurse.
Based on this incident’s severity, your organization has established a task force with two main goals:
Educate staff on HIPAA and appropriate social media use in health care.
Prevent confidentiality, security, and privacy breaches.
The task force has been charged with creating a series of interprofessional staff updates on the following topics:
Social media best practices.
What not to do: Social media.
Social media risks to patient information.
Steps to take if a breach occurs.
You are asked to select one or more of the topics and create the content for a staff update containing a maximum of two content pages. This assessment is not a traditional essay. It is a staff educational update about PHI. Consider creating a flyer, pamphlet, or PowerPoint slide. Remember it should not be more than two pages (excluding a title and a reference page).
The task force has asked team members assigned to the topics to include the following content in their updates in addition to content on their selected topics:
What is protected health information (PHI)?
Be sure to include essential HIPAA information.
What are privacy, security, and confidentiality?
Define and provide examples of privacy, security, and confidentiality concerns related to the use of technology in health care.
Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
What evidence relating to social media usage and PHI do interprofessional team members need to be aware of? For example:
How many nurses have been terminated for inappropriate social media use in the United States?
What types of sanctions have health care organizations imposed on interdisciplinary team members who have violated social media policies?
What have been the financial penalties assessed against health care organizations for inappropriate social media use?
What evidence-based strategies have health care organizations employed to prevent or reduce confidentiality, privacy, and security breaches, particularly related to social media usage?
Notes
Your staff update is limited to two double-spaced content pages. Be selective about the content you choose to include in your update so you can meet the page length requirement. Include need-to-know information. Omit nice-to-know information.
Many times people do not read staff updates, do not read them carefully, or do not read them to the end. Ensure your staff update piques staff members’ interest, highlights key points, and is easy to read. Avoid overcrowding the update with too much content.
Also, supply a separate reference page that includes two or three peer-reviewed and one or two non-peer-reviewed resources (for a total of 3–5 resources) to support the staff update content.
Additional Requirements
Written communication: Ensure the staff update is free from errors that detract from the overall message.
Submission length: Maximum of two double-spaced content pages.
Font and font size: Use Times New Roman, 12-point.
Citations and references: Provide a separate reference page that includes 2–3 current, peer-reviewed and 1–2 current, non-peer-reviewed in-text citations and references (total of 3–5 resources) that support the staff update’s content. Current means no older than 5 years.
APA format: Be sure your citations and references adhere to APA format. Consult the Evidence and APA page for an APA refresher.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 1: Describe nurses’ and the interdisciplinary team’s role in informatics with a focus on electronic health information and patient care technology to support decision making.
Describe the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team.
Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
Competency 2: Implement evidence-based strategies to effectively manage protected health information.
Identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information.
Develop a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage.
Competency 5: Apply professional, scholarly communication to facilitate use of health information and patient care technologies.
Follow APA style and formatting guidelines for citations and references.
Create a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling.
Protected Health Information (PHI): Privacy, Security, and Confidentiality Best Practices Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Describe the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team. Does not describe the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team. Attempts to identify the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team. Describes the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team. Provides a comprehensive and insightful summary of confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team.
Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information. Does not explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information. Explains interdisciplinary collaboration to safeguard sensitive electronic health information, but the explanation lacks detail or is missing critical information. Explains the importance of interdisciplinary collaboration to safeguard sensitive electronic health information. Explains in detail, and with professional insight, the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
Identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information. Does not identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information. Attempts to identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information; however, omissions and errors exist. Identifies evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information. Identifies multiple appropriate and well-researched evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information.
Develop a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage. Does not develop a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage. Attempts to develop a staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage. Develops a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage. Develops a comprehensive, professional, and effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage.
Follow APA style and formatting guidelines for citations and references. Does not follow APA style and formatting guidelines for citations and references. Partially adheres to APA style and formatting guidelines for citations and references. Formatting inhibits effective communication or detracts from good scholarship. Follows APA style and formatting guidelines for citations and references. Academic citations and references are largely error-free. Follows flawless APA style and formatting guidelines for citations and references.
Create a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling. Does not create a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling. Creates a staff update that contains errors in grammar, punctuation, and spelling that distract from good scholarship. Staff update is more than two pages of content. Creates a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling. Creates a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling. Adheres to all applicable disciplinary and scholarly writing standards.
Protected Health Information (PHI): Privacy, Security, and Confidentiality Best Practices Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Describe the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team. Does not describe the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team. Attempts to identify the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team. Describes the security, privacy, and confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team. Provides a comprehensive and insightful summary of confidentially laws related to protecting sensitive electronic health information that govern the interdisciplinary team.
Explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information. Does not explain the importance of interdisciplinary collaboration to safeguard sensitive electronic health information. Explains interdisciplinary collaboration to safeguard sensitive electronic health information, but the explanation lacks detail or is missing critical information. Explains the importance of interdisciplinary collaboration to safeguard sensitive electronic health information. Explains in detail, and with professional insight, the importance of interdisciplinary collaboration to safeguard sensitive electronic health information.
Identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information. Does not identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information. Attempts to identify evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information; however, omissions and errors exist. Identifies evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information. Identifies multiple appropriate and well-researched evidence-based approaches to mitigate risks to patients and health care staff related to sensitive electronic health information.
Develop a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage. Does not develop a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage. Attempts to develop a staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage. Develops a professional, effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage. Develops a comprehensive, professional, and effective staff update that educates interprofessional team members about protecting the security, privacy, and confidentiality of patient data, particularly as it pertains to social media usage.
Follow APA style and formatting guidelines for citations and references. Does not follow APA style and formatting guidelines for citations and references. Partially adheres to APA style and formatting guidelines for citations and references. Formatting inhibits effective communication or detracts from good scholarship. Follows APA style and formatting guidelines for citations and references. Academic citations and references are largely error-free. Follows flawless APA style and formatting guidelines for citations and references.
Create a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling. Does not create a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling. Creates a staff update that contains errors in grammar, punctuation, and spelling that distract from good scholarship. Staff update is more than two pages of content. Creates a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling. Creates a clear, concise, well-organized, and professional staff update that is generally free from errors in grammar, punctuation, and spelling. Adheres to all applicable disciplinary and scholarly writing standards.
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Solution
Social Media Risks to Patient Information
Protected Health Information (PHI)
PHI is a HIPAA privacy provision that protects the personalized health information of patients kept by certain organizations. Patients have a variety of rights under PHI. In order to comply with PHI rules, all medical payment, treatment, and operation organizations, as well as any other organizations with access to PHI, are considered covered entities and business associates. Under the privacy regulation, PHI can only be disclosed when it is absolutely necessary, such as while delivering medical care (Cohen & Mello, 2018). Patient names, addresses, and other personal information are among the PHI that covered agencies and their business associates are prohibited from disclosing to third parties under the HIPAA privacy standards.
Privacy, Security, and Confidentiality
The necessity that all healthcare personnel who have access to patient data maintain such information in trust is all what confidentiality means in the healthcare sector. Electronic health records should not be shared with any third parties or passwords to health portals shared or left logged in by healthcare providers (Keshta & Odeh, 2021).
Privacy, on the other hand, refers to the right of each patient to decide how their confidential information is shared. As a result, PHI is safeguarded under the HIPAA privacy rule, which also lays forth limits for when such information about patients may be disclosed (Keshta & Odeh, 2021). For example, healthcare practitioners should never post patients on social media or identify patients in public forums while employing technology in healthcare settings.
Security is a term used to describe the methods employed to safeguard patient health information and give assistance to healthcare practitioners in maintaining the confidentiality of PHI. (Keshta & Odeh, 2021). As a result of the widespread use of technology, healthcare providers are obligated to take precautions to protect patient information such as logging out of public accounts and storing passwords securely and only exchanging patient information with authorized persons
Interdisciplinary Collaboration
In order to preserve sensitive electronic health information, a team effort by health care experts working in diverse companies is necessary, and interdisciplinary teamwork is the best way to do it. Interprofessional collaboration allows medical professionals to take unilateral actions to ensure the safety of sensitive electronic health data (Cohen & Mello, 2018). As a result of their improper use of social media, thousands of nurses in the United States have been dismissed. Professionals on the multidisciplinary team must exercise caution while using social media in the course of their job so as not to reveal any information about activities or practices that might be used to identify patients, whether they do so intentionally or not (Flew et al., 2019). Health care providers who breach social media standards are typically fired by their employers, while others are suspended indefinitely while their cases are being evaluated.
Evidence-based Strategies (EBP)
Hospitals and other healthcare institutions have used a variety of EBP measures to protect patient confidentiality and security while using social media. Private social networks like Doximity, Sermo, and Peer, which are only available to physicians are examples of such data security measures (Huo et al., 2029). Public social media networking sites like LinkedIn and Facebook, on the other hand, pose security risks (Chan & Leung, 2018). There are also formal social media rules in healthcare businesses that all staff members are expected to adhere to. Additionally, these regulations are complemented by formal staff training and technological solutions that boost security. HIPAA-compliant social media use is made possible by the proper use of policies, training, and technology.
References
Cohen IG, & Mello, MM. (2018). HIPAA and Protecting Health Information in the 21st Century. JAMA. 320(3):231–232. doi:10.1001/jama.2018.5630. https://jamanetwork.com/journals/jama/article-abstract/2682916
Flew, T., Martin, F., & Suzor, N. (2019). Internet regulation as media policy: Rethinking the question of digital communication platform governance. Journal of Digital Media & Policy, 10(1), 33-50. https://www.ingentaconnect.com/content/intellect/jdmp/2019/00000010/00000001/art00005
Chan, W. S., & Leung, A. Y. (2018). Use of social network sites for communication among health professionals: systematic review. Journal of medical Internet research, 20(3), e8382. https://www.jmir.org/2018/3/e117
Huo, J., Desai, R., Hong, Y. R., Turner, K., Mainous III, A. G., & Bian, J. (2019). Use of social media in health communication: findings from the health information national trends survey 2013, 2014, and 2017. Cancer Control, 26(1), 1073274819841442. https://journals.sagepub.com/doi/full/10.1177/1073274819841442
Keshta, I., & Odeh, A. (2021). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal, 22(2), 177-183. https://www.sciencedirect.com/science/article/pii/S1110866520301365

ID WRITER 1307 SHOULD BE ASSIGNED FOR THIS ASSIGNMENT PLEASE.
Compare at least two evidence-based treatment plans for adults diagnosed with schizophrenia with evidence-based treatment plans for children and adolescents diagnosed with schizophrenia.
Explain the legal and ethical issues involved with forcing children diagnosed with schizophrenia to take medication for the disorder and how a PMHNP may address those issues.
Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references
A TOTAL OF AT LEAST FIVE REFERENCES NOT OLDER THAN 5 YEARS.

Classmate Carlos-Response (1): Evidence-Based Practice In Public Health- (see upload for classmate original post) CO
QUESTION- Discuss the sources of evidence for public health nurses. How can this evidence be applied to support evidence-based practice? Cite at least two sources of evidence in your response.
Classmate Response- (Carlos) Response (1)
The source of evidence that one uses to gain knowledge regarding a specific area within nursing is as important as the data itself. There are many channels through which public health nurses can gather knowledge from, however, not all information is considered to have the same level of strength of evidence. Given that the nursing field had expanded, so too has the number of journals, articles and textbooks that provide a vast amount of information. According to Weum, Bragstad and Glavin, (2017), there are four major sources from which public health nurses go to for knowledge: national plans and guidelines, knowledge that they gained through personal experience, knowledge gained through training, and guidelines set in place by local authorities. In the United States, individuals within the health care field also use one of the country’s leading source of public health information that is also meant to guide the country towards a better healthy future, Healthy People 2030. Healthy people 2030 is the framework set in place for the betterment of the communities within the country by utilizing health literacy. (Office of Disease Prevention and Health Promotion, 2021). All examples listed are valuable for the public health nurse because they all provide some form of knowledge that is considered by other professionals within the field to be successful. Take the corona virus as an example, it was a new disease process that had to be learned and no one had much knowledge of it in terms of treatments plans. After caring for several individuals with Covid-19, they began to learn what sort of things were successful and what wasn’t. This same concept can be applied to public health nurses in the field. They come across situations from which they learn from and use the knowledge that they have gained through experience and pair it with knowledge from literary sources to provide interventions that benefit the individual being cared for. Therefore, while personal experience might not have the same evidence strength as studies might, it does provide some form of knowledge that individuals go for when performing interventions.
References
Office of Disease Prevention and Health Promotion. (2021). Healthy People 2030. Retrieved from https://health.gov/our-work/national-health-initiatives/healthy-people/healthy-people-2030
Weum, M., Bragstad, L., Glavin, K. (2017). How Public Health Nurses Use Sources of Knowledge. Retrieved from https://sykepleien.no/en/forskning/2018/02/how-public-health-nurses-use-sources-knowledge
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Solution
Response – Carlos
Public health nursing is an essential health care practice that builds a strong base for quality health within a community. In your response, you have cited four main sources of evidence for public health nurses: national plans and guidelines, personal knowledge through experiences, guidelines set in place by local authorities, and knowledge through training. National plans and guidelines are usually set depending on priorities and rely on experts and evidence-based researches, and thus can be relied on as a source of evidence (Terwindt et al., 2016). Personal experiences provide a trustworthy source of evidence since the public health nurse has a full structure of the events.
Above the four named sources of evidence, you may also include research journals and medical databases as essential sources of evidence for nursing practice. Peer-reviewed medical articles mainly conducted through scientific methods provide a vital source of evidence for nursing practices. Grove and Gray (2018) support research studies for evidence-based practice for nursing as an essential source of evidence in making nursing and healthcare decisions for public health. As you have stated, a public health nurse may acquire practice evidence from personal experiences and formal training. These are essential sources of evidence. You can also add nursing experts as a great source of evidence for public health nursing. There are professionals with vast experience and expertise in a specific field or in handling a particular health issue in the healthcare environment. Grove & Gray (2018) supports experts and experienced professionals as a great source of evidence since they have a long experience in handling similar issues and thus can broadly advise the public health nurses in choosing the best practices suitable for effective and quality healthcare. As listed, Healthy People 2030 is also a suitable source of evidence for public health nurses since it is a repository of various experiences by nursing professionals.
References
Grove, S. K., & Gray, J. R. (2018). Understanding Nursing Research E-Book: Building an Evidence-Based Practice. Elsevier Health Sciences. https://books.google.co.ke/books?hl=en&lr=&id=cxNkDwAAQBAJ&oi=fnd&pg=PP1&dq=Journals+for+nursing+evidence+based+practice&ots=nTBYVB8PcW&sig=85Orlu1iDX-2-Pki76lqvIAEkG8&redir_esc=y#v=onepage&q&f=false
Terwindt, F., Rajan, D., & Soucat, A. (2016). Priority-setting for national health policies, strategies, and plans. Word Health Organization, 14, 2–65. https://apps.who.int/iris/bitstream/handle/10665/250221/9789241549745-chapter4-eng.pdf

Need to fill out the SOAP Template
Requieremtns
1. Before initiating any activity in Shadow Health, complete the required course?weekly?readings?and?lessons?as well as?review the introduction and?pre-brief
2. Complete the?Shadow Health Concept Lab prior to beginning any physical assessment assignment
3.Gather?subjective?and?objective data?by completing an appropriately detailed health history and physical examination?for each physical assessment assignment
4. Critically?appraise?the findings as?normal?or?abnormal
5. Based on the history and physical assessment findings, develop one primary and two differential diagnoses for the focused assessment assignments
6. Create treatment plans that include each of the following components for a comprehensive treatment plan: diagnostics, medication, education, consultation/referral, and follow-up planning
7. Complete the post activity assessment questions (if applicable) for each assignment
Summarize,?organize,?and appropriately?document?findings using correct professional terminology in the SOAP Note Template and submit to this assignment

Pharmacology for Healthcare Professionals
Homework is to be presented as a short (50-100-word) paragraph response for each question. The assignment is to be submitted as a Microsoft Word document electronically to the instructor.
Explain the process and purpose of the Five Rights.
What are the various methods of drug administration? Explain why one method may be chosen over another.
Assess the conditions under which a chest tube is placed and the maintenance and precautions needed.
What purpose do arterial venous lines serve and which vessels are they placed in.
Why is a pulmonary arterial line not an arterial line in the strictest sense of the word?
Organize a plan for your participation in a code.
What are the general requirements for a code cart setup?
APA format is not required, but solid academic writing is expected.
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Solution
Pharmacology for Healthcare Professionals
Explain the process and purpose of the Five Rights
The five rights help health care practitioners to reduce incidences and risks of medication errors. The five rights principles help healthcare practitioners to administer the right drug dose, utilize the right route and provide medication to the right patient at the right time (Wondmieneh et al., 2020). The first step of the five rights is the right drug. All individuals, including healthcare practitioners who administer medication to patients, are therefore required to double-check the label in the bottle of medication to ensure that they do not accidentally administer the wrong medication. On the other hand, double-checking the label can also help healthcare practitioners to administer the right doses to a patient. Administering medication to a patient at the right time is also important, which includes utilizing a medication log schedule or remaining aware of the dosing frequency and setting the alarm. On the other hand, utilizing the right route of medication is also important, while administering medication to the right person is also an important strategy in the administration of medication (Wondmieneh et al., 2020).
What are the various methods of drug administration? Explain why one method may be chosen over another
The routes of administration of medication include sublingual, oral, topical, rectal, and parenteral, which includes intramuscular intravenous and subcutaneous administration (Smeulers et al., 2015). The oral method of drug administration is one of the most economical and convenient methods, which makes it the most frequently used route of drug administration. However, in some instances or administration may not be preferred because of the Unpredictable nature of gastrointestinal drug absorption. On the other hand, the sublingual method of drug administration is preferred because the sublingual mucosa will provide a rich supply of blood vessels through which drugs can be absorbed. On the other hand, the rectal route of drug administration has numerous disadvantages, including providing unpredictable drug absorption ways and having low acceptability among patients (Smeulers et al., 2015).
Assess the conditions under which a chest tube is placed and the maintenance and precautions needed
A chest tube is recommended among patients with different conditions, including lung infections, collapsed lungs, fluid buildup due to other medical conditions such as pneumonia and cancer, breathing difficulty due to buildup of air and fluid, and after surgery, including lung heart and esophagus surgery (Porcel, 2018). A chest tube, therefore, has to drain fluid, blood, and air from the pleural space. Various precautions have to be taken before the placing of a chest tube, including sterilization and shaving of the insertion area. An ultrasound may also be utilized to identify the best location to insert the chest tube. The administration of anesthesia is also important during the placement of a test tube, with local anesthesia being preferred (Porcel, 2018).
What purpose do arterial venous lines serve and which vessels are they placed in
Arterial venous lines are placed in arteries in the groin wrist or other locations. Arterial venous lines are therefore used to measure blood pressure more accurately than it would be possible with a blood pressure cuff or to draw blood samples for various tests (Gershengorn et al., 2016).
Why is a pulmonary arterial line not an arterial line in the strictest sense of the word?
The pulmonary arterial line is not an arterial line because it is inserted through large veins and subsequently moved up the heart chambers through the right ventricle and subsequently to the pulmonary artery (Gershengorn et al., 2016).
Organize a plan for your participation in a code
A plan for code participation involves highlighting the roles of different members of a code team. Each member of the code team will therefore have a specific role to play. The various members of a Code team, therefore, include code team leaders, event managers, first responders, recorder, bedside registered nurse, compressors, respiratory, medication RN and vascular access, code cart RN, security, and runner (Bizzel, 2019).
What are the general requirements for a code cart setup?
The general requirements for a code card setup include being a more experienced nurse who has more familiarity with the contents of a crash cart (Bizzel, 2019)
References
Bizzel, L. (2019). Code Roles. Code Management. Retrieved November 11, 2021, from https://lsc-mcodemanagement.weebly.com/code-roles.html
Gershengorn, H. B., Garland, A., Kramer, A., Scales, D. C., Rubenfeld, G., & Wunsch, H. (2016). Variation of Arterial and Central Venous Catheter Use in United States Intensive Care Units. Anesthesiology, 120(3), 650–664. https://doi.org/10.1097/aln.0000000000000008
Porcel J. M. (2018). Chest Tube Drainage of the Pleural Space: A Concise Review for
Pulmonologists. Tuberculosis and respiratory diseases, 81(2), 106–115. https://doi.org/10.4046/trd.2017.0107.
Smeulers, M., Verweij, L., Maaskant, J. M., de Boer, M., Krediet, C. T. P., Nieveen Van Dijkum, E. J. M., & Vermeulen, H. (2015). Quality Indicators for Safe Medication Preparation and Administration: A Systematic Review. PLOS ONE, 10(4), e0122695. https://doi.org/10.1371/journal.pone.0122695
Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: a cross sectional study. BMC Nursing, 19(1). https://doi.org/10.1186/s12912-020-0397-0

Classmate Response (Ajikwaga) PUB 655 Topic 1 DQ 1 : Defining Poverty And Global Health Classmate Response (1)
Respond to the classmate essay by:
1. providing at least one point of agreement and one point of disagreement.
2. sharing an insight
3. offering and supporting an opinion please elaborate on one or two points from the classmate’s post.
4. validating an idea
5. making a suggestion
6. or expanding on the classmate essay and asking a probing question
-Please use your own words and do not copy what she wrote
– Sources must be published within the last 5 years. It must be from 2017 and after and appropriate for the paper criteria and public health content.
– Please do not use blogs as references
-References should be in APA 7th ed.
-Add references to reference page
-Add the hyperlink/DOI for each reference in APA 7th edition format.
Thank you.
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Solution
Reply Ajikwaga
I agree with you that global health is public health that requires similar training and research methods. I join you in refuting the statement that global health is a separate discipline that requires specific training and research. Global health and public health services have the same purposes of protecting the well-being and health of communities, with a significant emphasis on preventing diseases and illnesses among large groups of people (Turcotte-Tremblay et al., 2020). Public health and global health also involve different activities and education, disease prevention, child wellness, disaster relief, addressing health care, and access to clean water, among other functions. A conclusion can therefore be made that global health is public health on a global scale. The same principles and main functions that public health utilizes are therefore the same principles and functions that global health seeks to achieve on a global scale. Global Health does not require specific training and research because scholars can rely on the research methods and data and the specific training from public health in specific countries (Chen et al., 2020). Utilizing the foundation of public health global-health involves always working tirelessly across the globe to ensure that there is clean water to drink for all communities’ higher quality of air to breathe more nutritious food to eat and various services to promote human health such as through enhancing access to vaccines and promoting physical activity. The functions of global health, therefore, originated from specific public health efforts in different countries (Kyobutungi et al., 2021). I also support your argument that public health events are those that affect specific countries, while a global health event is one that affects several countries at the same time. Some of the current challenges being experienced currently in the world related to covid-19 have therefore been from treating the pandemic as a public health event facing specific countries as opposed to a coordinated approach that views the pandemic as a global health event.
References
Chen, X., Li, H., Lucero-Prisno, D. E., Abdullah, A. S., Huang, J., Laurence, C., Liang, X., Ma, Z., Mao, Z., Ren, R., Wu, S., Wang, N., Wang, P., Wang, T., Yan, H., & Zou, Y. (2020). What is global health? Key concepts and clarification of misperceptions. Global Health Research and Policy, 5(1). https://doi.org/10.1186/s41256-020-00142-7
Kyobutungi, C., Robinson, J., & Pai, M. (2021). PLOS Global Public Health, charting a new path towards equity, diversity, and inclusion in global health. PLOS Global Public Health, 1(10), e0000038. https://doi.org/10.1371/journal.pgph.0000038
Turcotte-Tremblay, A. M., Fregonese, F., Kadio, K., Alam, N., & Merry, L. (2020). Global health is more than just ‘Public Health Somewhere Else.’ BMJ Global Health, 5(5), e002545. https://doi.org/10.1136/bmjgh-2020-002545

Roles of Healthcare Professionals
This assignment will be at least 1500 words or more. Reflect on the roles of nurses, and other healthcare professionals as the roles of physicians in the healthcare system move from one of working in silos to a more progressive value-based system. Write a paper that discusses in detail why a value-based system may improve health care in the U. S. and address the following questions:
1) How has current policy transformed the current practice of nurses, physicians, and other healthcare professionals?
2) What distinction can you make between physicians/healthcare providers working in a fee-for-service system and a value-based care system?
3) How do you view shared power between physicians and nurses in your healthcare system? How does it impact care?
Assignment Expectations
Length: 1500-2000 words in length
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word amount for this assignment. Your essay must include an introduction and a conclusion.
References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment
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Solution
Roles of Healthcare Professionals
Introduction
Patients’ outcome is significantly determined by what is done together rather than what are accomplished for them in silos as the future of healthcare communications and effectiveness in care delivery are connected teams (Salmond & Echevarria, 2017). Different factors have influenced the change from silo-based to value-based care models. These include rising costs, increasing aging population, innovative technologies, high staff burnout, and administrative complexity. As a priority, the global healthcare stakeholders are dedicated to inventing solutions and strategies to balance the sector. Increasingly, the healthcare community is establishing collaboration as a transition from a wasteful and siloed care delivery model to more value-based, patient-centered and productive healthcare.
Adopting value-based healthcare connects clinicians with their primary purpose of healing by supporting their professionalism, hence being a powerful mechanism to counter clinician burnout (Teisberg, Wallace & O’Hara, 2020). Linked with better outcomes, reduced spending by improving patients’ health experience, the value-based approach has redefined the roles of nurses and other care professionals by recognizing collaboration approach over individualism in their daily operations as caregivers. This paper discusses the impact of the change from siloed care model to a value-based system of healthcare professional roles and why the system may improve healthcare in the US.
How the Current Policy Has Transformed the Current Practice of Nurses, Physicians, and other Healthcare Professionals
The adoption of value-based policy in the healthcare industry has seen a much-needed revolution in care delivery and the impact on nurses and other professionals’ practice. According to Teisberg et al. (2020), there has been no doubt that nurses, among other professionals in the healthcare industry, have assumed roles to improve health, increase value, and advance health. The policy has seen an increased shift from a disease focus to care to promote health and the best patient experience across the continuum. The policy has fostered the need for a teamwork approach in healthcare delivery as nurses and other professionals have been required to partner with patients and their close friends and families in understanding their social environment and subsequently engage in devising care strategies that would address patient-defined patient outcomes.
Secondly, the policy has recognized teamwork as a significant face in delivering the best patient experience by gaining greater awareness of the diverse resources across the continuum and community needed so that patients can be aligned or accorded support needed for maximal wellness. Tracking outcomes has become a significant unit if the measure for effectiveness and leading the healthcare players to ensure excellence will demand outstanding teamwork for excellence to be registered across departments, roles, and responsibilities. The different professionals working in the healthcare industry can no longer choose to take a back seat. For example, it has become the time for nurses to take their role at the center of patient care, equally taking lean in implementing the policy to make healthcare more patient-based and quality fueled.
The policy has led to the recognition of teamwork and integrated care delivery. This is whereby different professionals work together to complement each other’s role and devise the best, affordable, and quality care practice for a patient (Salmond & Echevarria, 2017). Additionally, with patients recognized as a significant part of the value-based policy, healthcare professionals have focused their input on receiving the best patient experience. This has, in turn, put the professionals to train on how to deliver the best patient experience. These include learning skills such as effective communication, empathy, stress management, time management, flexibility, and teamwork.
The distinction between Physicians/Healthcare Providers Working in a Fee-For-Service System and a Value-Based Care System
The revolution in the healthcare industry is seeing increasing adoption of value-based care models over the traditional fee-for-service. Equally, the transition is redefining the role of caregivers regarding care delivery. The primary difference between the two care delivery strategies is that, while fee-for-service, the professionals’ remunerations are directly aligned with the number of patients served, the valued-based approach views the quality of care provided and patient outcome as central metric units, hence defining how the physicians should be rewarded.
Secondly, professionals in value-based approaches work as a team, collaborating to provide the best patient outcome and the lasting solution to the problem at hand. However, in the fee-for-service model, the physicians’ and clinicians’ contribution is individualized, meaning each care provider works on his/her line of expertise on the patients’ needs (University of Alabama at Birmingham, 2020). The collaborative approach to care delivery in value-based care has led to the recognition and adoption of different stakeholders, deemed less necessary in the fee-for-service care model. These include the nurse informatics and IT experts as part of the team. In value-based care, physicians have actively depended on informatics input in decision making and formulating the best care model for a patient.
Regarding the fee-for-service approach, the teamwork approach is minimized, which reduces the collaboration approach as physicians give their advice and treatment in accordance with their best-known practice and not the best suited for patient needs. In value-based care, quality comes first, directly tethered to reimbursements, incentivizing care providers to prioritize patients and their needs. Fee-for-service sees monetary gain as the primary motivating incentive for the care providers.
Patient position in the healthcare industry determines the role and relationship of nurses and the patient. In the value-based approach, the patient is an integral part of the team in deciding the best care practice. This, in turn, redefines the role of physicians as healers and informers. They instill the patients with understanding and knowledge, facilitating the best quality and available treatment. The fee-for-service approach sees minimal recognition of patients as part of their team, hence seeing minimized contribution by professional caregivers in comparing diverse care practices to settle for the best. Finally, as quality is recognized as a major defining factor in the value-based care model, nurses and physicians are motivated to gain more skills and knowledge, which would make them better in terms of decision making and deciding the best for their patients. Unlike the case in the value-based model, the fee-for-service approach sees individualism on a high level, as physicians, among other experts, view themselves as the best, hence less motivated to learn from others towards improving their skills in care delivery.
View On Shared Power between Physicians and Nurses in Healthcare System & How Does It Impact Care
Shared power between physicians and nurses means collaboration and working together, sharing responsibilities towards devising lasting solutions to problems and making decisions to formulate the best patient care experience. Despite the complexity and revolution witnessed in the healthcare industry, collaboration among healthcare professionals has provided a path towards improving healthcare services in hospitals and other facilities. The shift towards value-based care has seen recognition and the need for teamwork among professionals. Nurse physician collaboration and cooperation in the sector can positively impact patient outcomes while lowering the care cost, increasing the professionals’ job satisfaction, and improving patient safety (Elsous, Radwan & Mohsen, 2017). On the other, communication between different professionals is considered as an integral part of the value-based care and information flow in the care industry. Through the shared power, mutual respect and recognition of each other’s roles and differences are defined, hence fostering cohesion and motivation in every profession to deliver the best patient experience. For example, in Alberta, Canada the shared power has fostered a reliable care workforce with reference to addressing patient needs.
The paradigm of shared power and inter-professional experience has fostered safety and quality in the healthcare industry, hence building an environment best for patient care and outcome. Adopting a collaborative approach in care delivery has improved patient outcomes in reducing preventable negative drug reactions and decreased mortality and morbidity among patients. To the professionals, shared power has been aligned with a unique way to address the shortage of workers and reduce burnout and extra work while increasing job satisfaction (Aghamohammadi et al., 2019). Healthcare leaders and managers have found it easy to implement their role to teams over individual workers. In turn, shared power among healthcare professionals has provided a basic unit for integrated care delivery, making the process more effective and successful for a value-based care system linked with the desired patient outcome.
Why a Value-Based System May Improve Health Care in the U. S
The lack of a uniform healthcare system and the need to regulate the ever-rising cost of healthcare in the United States has led to government and stakeholders devising strategies to deliver affordable quality care. This quest for better and quality services has led to the adoption of a value-based system linked to a patient-based care model. In order to add value, the shift from fee-for-service to a value-based care model has revolutionized the health industry. In addition to providing an affordable path to healthcare services, the value-based approach has improved healthcare in the US by providing the best care practices and maximizing available resources. The system has promised quality care, increased research, and recognition of professionals’ input in the care delivery process (Teisberg et al., 2020). Other reasons include; reducing the cost of care services, increased patient satisfaction, reduced medical errors, improved care coordination, and promoting healthy habits.
Conclusion
In a recap, the change in healthcare and the widespread adoption of value-based care requires strong collaboration, openness, trust, and strong partnerships between all stakeholder groups. This change has redefined the roles of nurses and other professionals working in the health industry towards being more team players providing patient-based care, resulting in more influence on care quality and patient experience. The care delivery process has become a teamwork approach, demanding each of the professionals to perform their duties as part of the team. Adopting value-based care has shifted the industry to more effective control measures regarding cost and workers’ management. In the US, the value-based model has provided a care improvement model benefiting patients, care providers, more robust cost control, and overall positive and better patient outcome and experience. The policy may be a significant breakthrough regarding redefining the US healthcare system, which has been viewed as the most expensive and lacks a well-recognized healthcare system.
References
Aghamohammadi, D., Dadkhah, B., & Aghamohammadi, M. (2019). Nurse-Physician Collaboration and the Professional Autonomy of Intensive Care Units Nurses. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine, 23(4), 178–181. https://doi.org/10.5005/jp-journals-10071-23149
Elsous, A., Radwan, M., & Mohsen, S. (2017). Nurses and Physicians Attitudes toward Nurse-Physician Collaboration: A Survey from Gaza Strip, Palestine. Nursing research and practice, 2017, 7406278. https://doi.org/10.1155/2017/7406278
Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopedic nursing, 36(1), 12–25. https://doi.org/10.1097/NOR.0000000000000308
Teisberg, E., Wallace, S., & O’Hara, S. (2020). Defining and Implementing Value-Based Health Care: A Strategic Framework. Academic medicine: journal of the Association of American Medical Colleges, 95(5), 682–685. https://doi.org/10.1097/ACM.0000000000003122
University of Alabama at Birmingham. (2020, July 27). Fee-for-service vs. value-based healthcare. UAB Online Degrees. Retrieved November 27, 2021, from https://businessdegrees.uab.edu/blog/fee-for-service-vs-value-based-healthcare

The Assignment (Evidence-Based Project)
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Create a 6- to 7-slide PowerPoint presentation in which you do the following:
Identify and briefly describe your chosen clinical issue of interest.
Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analyses on your topic, then use the highest level of evidence peer-reviewed article.
Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
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Solution
1 ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS
2 PATRICIA OMOROGBE MASTER OF SCIENCE IN NURSING, WALDEN UNIVERSITY
NURS 6052: 2 ESSENT OF EVIDENCE-BASED PRACT
Dr. Constance Cooper
Jan 3rd, 2021
Introduction
3 SELECTED CLINICAL ISSUE OF INTEREST DEVELOPING A PICOT QUESTION
PICOT question
Research databases Level of evidence of each article
4 STRENGTHS OF SYSTEMATIC REVIEWS IN CLINICAL RESEARCH
5 THIS PRESENTATION WILL DISCUSS MY SELECTED CLINICAL ISSUE OF INTEREST AND DESCRIBE HOW I DEVELOPED A PICOT QUESTION FOCUSED ON THE CLINICAL ISSUE OF INTEREST. 6 I WILL INCLUDE THE FOUR RESEARCH DATABASES USED TO CONDUCT THE SEARCH FOR THE PEER-REVIEWED ARTICLES AND THE CITATIONS FOR THE ARTICLES. 7 BESIDES, I WILL DESCRIBE THE LEVEL OF EVIDENCE OF EACH PEER-REVIEWED ARTICLE. 4 LASTLY, I WILL DISCUSS THE STRENGTHS OF USING SYSTEMATIC REVIEWS FOR CLINICAL RESEARCH.
2
2 CLINICAL ISSUE OF INTEREST COGNITIVE DECLINE IN MILD-MODERATE AD
8 AD-PROGRESSIVE DECLINE IN COGNITIVE FUNCTION
Deficits in memory, language, judgment, & reasoning
Drugs slow/ reverse AD progression Proposed therapies have been unsuccessful
Need for non-pharmacological approaches to improve cognitive function
2 THE CLINICAL ISSUE OF INTEREST IS COGNITIVE DECLINE IN MILD-MODERATE ALZHEIMER’S DISEASE (AD). AD IS A NEUROCOGNITIVE DISORDER CHARACTERIZED BY PROGRESSIVE DETERIORATION OF COGNITIVE FUNCTION (BERG-WEGER & STEWART, 2017). THE DECLINE IN COGNITIVE FUNCTION RESULTS IN COGNITIVE DEFICITS, EVIDENCED BY SHORT-TERM MEMORY, LANGUAGE DYSFUNCTION, POOR JUDGMENT, IMPAIRED REASONING, DIFFICULTY MANAGING COMPLEX TASKS, AND VISUOSPATIAL DYSFUNCTION (BERG-WEGER & STEWART, 2017). Pharmacological therapies available for AD helps only to slow or reverse the progression of AD but do not reverse the effects of cognitive decline. Besides, therapies previously proposed for AD have produced mostly disappointing outcomes (Berg-Weger & Stewart, 2017). Therefore, there is a major need to identify non-pharmacological approaches to improve cognitive function in the early stages of the disease before the symptoms progress.
3
9 DEVELOPING A PICOT QUESTION
I developed a PICOT question centered on cognitive function in AD by first identifying a population of interest. In this case, the population of interest was patients with mild to moderate AD.
The second step was to identify an intervention that would help address the issue of cognitive decline in AD. The identified intervention was cognitive training combined with drug therapy. The intervention will be compared to drug therapy alone. The next step entailed identifying a measurable outcome that will be used to determine the effectiveness of the proposed intervention. The desired outcome after cognitive training is improved cognitive function. Lastly, I set up a time frame that will be used to evaluate the intervention. The time frame for this case is six months.
10 THE PICOT QUESTION FOR THE CLINICAL ISSUE IS:
In patients with mild to moderate AD (P), does cognitive training combined with drug therapy (I) compared to drug therapy alone (C) improve cognitive function (O) in six months (T)?
4
Population of interest- patients with mild to moderate AD
Intervention- cognitive training +drug therapy
Comparison- Drug therapy alone
Outcome- Improved cognitive function
Time- Six months
PICOT Question
In patients with mild to moderate AD (P), does cognitive training combined with drug therapy (I) compared to drug therapy alone (C) improve cognitive function (O) in six months (T)?
10 THE PICOT QUESTION FOR THE CLINICAL ISSUE IS:
In patients with mild to moderate AD (P), does cognitive training combined with drug therapy (I) compared to drug therapy alone (C) improve cognitive function (O) in six months (T)?
5
Research Databases
APA PsycInfo
BioMedCentral
CINAHL Plus
11 COCHRANE DATABASE OF SYSTEMATIC REVIEWS.
The research databases used to search peer-reviewed articles on non-pharmacological interventions that can improve cognitive functioning in patients with mild-moderate AD include APA PsycInfo, BioMedCentral, CINAHL Plus, and Cochrane Database of Systematic Reviews.
6
APA Citations
Butler, M., McCreedy, E., Nelson, V. A., Desai, P., Ratner, E., Fink, H. A.,. & Kane, R. L. (2018). 8 DOES COGNITIVE TRAINING PREVENT COGNITIVE DECLINE? 12 A SYSTEMATIC REVIEW. Annals of internal medicine, 168(1), 63-68. 8 HTTPS://DOI.ORG/10.7326/M17-1531
13 CRUZ GONZALEZ, P., FONG, K. N., CHUNG, R. C., TING, K. H., LAW, L. L., & BROWN, T. (2018). 14 CAN TRANSCRANIAL DIRECT-CURRENT STIMULATION ALONE OR COMBINED WITH COGNITIVE TRAINING BE USED AS A CLINICAL INTERVENTION TO IMPROVE COGNITIVE FUNCTIONING IN PERSONS WITH MILD COGNITIVE IMPAIRMENT AND DEMENTIA? 15 A SYSTEMATIC REVIEW AND META-ANALYSIS. FRONTIERS IN HUMAN NEUROSCIENCE, 12, 416. 14 HTTPS://DOI.ORG/10.3389/FNHUM.2018.00416
APA Citations
Hill, N. 16 T., MOWSZOWSKI, L., NAISMITH, S. L., CHADWICK, V. L., VALENZUELA, M., & LAMPIT, A. (2017). 17 COMPUTERIZED COGNITIVE TRAINING IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT OR DEMENTIA: 15 A SYSTEMATIC REVIEW AND META-ANALYSIS. 16 AMERICAN JOURNAL OF PSYCHIATRY, 174(4), 329-340. 18 HTTPS://DOI.ORG/10.1176/APPI.AJP.2016.16030360
Kallio, E. L., Öhman, H., Kautiainen, H., Hietanen, M., & Pitkälä, K. (2017). 12 COGNITIVE TRAINING INTERVENTIONS FOR PATIENTS WITH ALZHEIMER’S DISEASE: A SYSTEMATIC REVIEW. Journal of Alzheimer’s Disease, 56(4), 1349-1372. https://doi.org/10.3233/JAD-160810
Levels of Evidence Article Level of Evidence Butler et al. (2018) Level I Cruz Gonzalez et al. (2018) Level I
19 HILL ET AL. (2017) Level I
19 KALLIO ET AL. (2017) Level I
19 BUTLER ET AL. (2018): Level I. 12 THIS WAS A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS OF COGNITIVE TRAINING INTERVENTIONS.
Cruz Gonzalez et al. (2018): Level I. 20 THE STUDY CONDUCTED A SYSTEMATIC REVIEW OF RANDOMIZED CONTROL TRIALS (RCTS) WITH META-ANALYSIS.
19 HILL ET AL. (2017): Level I. 18 THE RESEARCHERS CONDUCTED A SYSTEMATIC REVIEW AND META-ANALYSES OF RCTS OF CCT IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT OR DEMENTIA.
19 KALLIO ET AL. (2017): Level I. Researchers systematically reviewed the current evidence from RCTs.
9
4 STRENGTHS OF USING SYSTEMATIC REVIEWS FOR CLINICAL RESEARCH
Addresses a question by analyzing clinical research Only the best & relevant evidence is provided
Minimal bias- dependable & accurate conclusions
Sums up findings from various studies
Precise estimates on the impact of interventions
Reveal gaps in knowledge
A systematic review refers to a type of publication that addresses a question by analyzing research that matches a particular explicitly-specified criterion.
21 THE STRENGTHS OF USING SYSTEMATIC REVIEWS FOR CLINICAL RESEARCH INCLUDE:
The researchers systematically search, appraise, and summarize all available literature for a particular topic. Consequently, only the best and relevant evidence is provided.
The approach used to search and select the research articles minimizes bias resulting in reliable and accurate conclusions.
A systematic review sums up findings from various studies, and thus the information is easier to read and understand.
Systematic reviews provide precise estimates of interventions that benefit clinical research. For instance, a systematic review can provide accurate results on the outcomes of cognitive training in AD patients.
When used in clinical research, they reveal gaps in knowledge, which informs future research studies.
10
References
2 BERG-WEGER, M., & STEWART, D. B. (2017). 2 NON-PHARMACOLOGIC INTERVENTIONS FOR PERSONS WITH DEMENTIA. MISSOURI MEDICINE, 114(2), 116–119.
Tawfik, G. 22 M., DILA, K. A. 22 S., MOHAMED, M. Y. 22 F., TAM, D. N. 23 H., KIEN, N. 22 D., AHMED, A. M., & HUY, N. T. (2019). 22 A STEP-BY-STEP GUIDE FOR CONDUCTING A SYSTEMATIC REVIEW AND META-ANALYSIS WITH SIMULATION DATA. 23 TROPICAL MEDICINE AND HEALTH, 47(1), 1-9. 24 HTTPS://DOI.ORG/10.1186/S41182-019-0165-6
Citations (24/24)
1Another student’s paper
2Another student’s paper
3Another student’s paper
4Another student’s paper
5Another student’s paper
6Another student’s paper
7Another student’s paper
8Another student’s paper
9Another student’s paper
10Another student’s paper
11https://en.wikipedia.org/wiki?curid=10013
12https://www.cmaj.ca/content/179/10/1019
13Another student’s paper
14Another student’s paper
15https://eurekamag.com/research/065/310/065310750.php
16Another student’s paper
17https://www.mcmasteroptimalaging.org/blog/detail/blog/2017/07/24/computer-brain-games-for-treating-cognitive-impairment
18Another student’s paper
19Another student’s paper
20https://en.wikipedia.org/wiki?curid=5750
21Another student’s paper
22Another student’s paper
23Another user’s paper
24Another student’s paper
Matched Text
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ADVANCED LEVELS OF CLINICAL INQUIRY AND SYSTEMATIC REVIEWS
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Advanced Levels of Clinical inquiry and systematic reviews
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PATRICIA OMOROGBE MASTER OF SCIENCE IN NURSING, WALDEN UNIVERSITY
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Patricia Omorogbe Master of Science in Nursing, Walden University
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ESSENT OF EVIDENCE-BASED PRACT
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Essent of Evidence-Based Pract
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CLINICAL ISSUE OF INTEREST COGNITIVE DECLINE IN MILD-MODERATE AD
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The clinical issue of interest is cognitive decline in mild-moderate Alzheimer’s disease (AD)
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THE CLINICAL ISSUE OF INTEREST IS COGNITIVE DECLINE IN MILD-MODERATE ALZHEIMER’S DISEASE (AD)
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The clinical issue of interest is cognitive decline in mild-moderate Alzheimer’s disease (AD)
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AD IS A NEUROCOGNITIVE DISORDER CHARACTERIZED BY PROGRESSIVE DETERIORATION OF COGNITIVE FUNCTION (BERG-WEGER & STEWART, 2017)
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AD is characterized by progressive deterioration of cognitive function
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THE DECLINE IN COGNITIVE FUNCTION RESULTS IN COGNITIVE DEFICITS, EVIDENCED BY SHORT-TERM MEMORY, LANGUAGE DYSFUNCTION, POOR JUDGMENT, IMPAIRED REASONING, DIFFICULTY MANAGING COMPLEX TASKS, AND VISUOSPATIAL DYSFUNCTION (BERG-WEGER & STEWART, 2017)
Source – Another student’s paper
The decline in cognitive function causes cognitive deficits, characterized by short-term memory, language dysfunction, poor judgment, impaired reasoning, difficulty managing complex tasks, and visuospatial dysfunction (Berg-Weger & Stewart, 2017)
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BERG-WEGER, M., & STEWART, D
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Berg-Weger, M., & Stewart, D
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NON-PHARMACOLOGIC INTERVENTIONS FOR PERSONS WITH DEMENTIA
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Non-pharmacologic Interventions for Persons with Dementia
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MISSOURI MEDICINE, 114(2), 116–119
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Missouri medicine, 114(2), 116–119
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SELECTED CLINICAL ISSUE OF INTEREST DEVELOPING A PICOT QUESTION
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Developing a PICOT question was able to help me think critically about different aspects of my selected clinical issue of interest
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STRENGTHS OF SYSTEMATIC REVIEWS IN CLINICAL RESEARCH
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Strengths of using systematic reviews for clinical research
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LASTLY, I WILL DISCUSS THE STRENGTHS OF USING SYSTEMATIC REVIEWS FOR CLINICAL RESEARCH
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Strengths of using systematic reviews for clinical research
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STRENGTHS OF USING SYSTEMATIC REVIEWS FOR CLINICAL RESEARCH
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Strengths of using systematic reviews for clinical research
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THIS PRESENTATION WILL DISCUSS MY SELECTED CLINICAL ISSUE OF INTEREST AND DESCRIBE HOW I DEVELOPED A PICOT QUESTION FOCUSED ON THE CLINICAL ISSUE OF INTEREST
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Description and development of PICOT question focused on clinical issue of interest(contd.) The developed PICOT question for this clinical issue of interest is
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I WILL INCLUDE THE FOUR RESEARCH DATABASES USED TO CONDUCT THE SEARCH FOR THE PEER-REVIEWED ARTICLES AND THE CITATIONS FOR THE ARTICLES
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The four research databases used to conduct search for the peer-reviewed articles
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BESIDES, I WILL DESCRIBE THE LEVEL OF EVIDENCE OF EACH PEER-REVIEWED ARTICLE
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Peer Reviewed Article Level of Evidence and
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AD-PROGRESSIVE DECLINE IN COGNITIVE FUNCTION
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Terminal decline in cognitive function
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DOES COGNITIVE TRAINING PREVENT COGNITIVE DECLINE
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Does Cognitive Training Prevent Cognitive Decline
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HTTPS://DOI.ORG/10.7326/M17-1531
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http://doi.org/10.7326/M17-1531
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DEVELOPING A PICOT QUESTION
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PICOT Question P
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THE PICOT QUESTION FOR THE CLINICAL ISSUE IS
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PICOT is an acronym for the elements of the clinical question
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THE PICOT QUESTION FOR THE CLINICAL ISSUE IS
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PICOT is an acronym for the elements of the clinical question
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COCHRANE DATABASE OF SYSTEMATIC REVIEWS
Source – https://en.wikipedia.org/wiki?curid=10013
The Cochrane Database of Systematic Reviews
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A SYSTEMATIC REVIEW
Source – https://www.cmaj.ca/content/179/10/1019
a systematic review
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COGNITIVE TRAINING INTERVENTIONS FOR PATIENTS WITH ALZHEIMER’S DISEASE
Source – https://www.cmaj.ca/content/179/10/1019
Cognitive training in Alzheimer’s disease
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A SYSTEMATIC REVIEW
Source – https://www.cmaj.ca/content/179/10/1019
a systematic review
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THIS WAS A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS OF COGNITIVE TRAINING INTERVENTIONS
Source – https://www.cmaj.ca/content/179/10/1019
a systematic review of randomized, controlled trials [Technology report no
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CRUZ GONZALEZ, P., FONG, K
Source – Another student’s paper
Cruz Gonzalez, P., Fong, K
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N., CHUNG, R
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N., Chung, R
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C., TING, K
Source – Another student’s paper
C., Ting, K
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H., LAW, L
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H., Law, L
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L., & BROWN, T
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L., & Brown, T
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CAN TRANSCRANIAL DIRECT-CURRENT STIMULATION ALONE OR COMBINED WITH COGNITIVE TRAINING BE USED AS A CLINICAL INTERVENTION TO IMPROVE COGNITIVE FUNCTIONING IN PERSONS WITH MILD COGNITIVE IMPAIRMENT AND DEMENTIA
Source – Another student’s paper
Can Transcranial Direct-Current Stimulation Alone or Combined With Cognitive Training Be Used as a Clinical Intervention to Improve Cognitive Functioning in Persons With Mild Cognitive Impairment and Dementia
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HTTPS://DOI.ORG/10.3389/FNHUM.2018.00416
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https://doi-org.ezp.waldenulibrary.org/10.3389/fnhum.2018.00416
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A SYSTEMATIC REVIEW AND META-ANALYSIS
Source – https://eurekamag.com/research/065/310/065310750.php
A Systematic Review and Meta-Analysis
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FRONTIERS IN HUMAN NEUROSCIENCE, 12, 416
Source – https://eurekamag.com/research/065/310/065310750.php
Frontiers in Human Neuroscience 12
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A SYSTEMATIC REVIEW AND META-ANALYSIS
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A Systematic Review and Meta-Analysis
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T., MOWSZOWSKI, L., NAISMITH, S
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T., Mowszowski, L., Naismith, S
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L., CHADWICK, V
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L., Chadwick, V
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L., VALENZUELA, M., & LAMPIT, A
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L., Valenzuela, M., & Lampit, A
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AMERICAN JOURNAL OF PSYCHIATRY, 174(4), 329-340
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American Journal of Psychiatry, 174(4), 329-340
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COMPUTERIZED COGNITIVE TRAINING IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT OR DEMENTIA
Source – https://www.mcmasteroptimalaging.org/blog/detail/blog/2017/07/24/computer-brain-games-for-treating-cognitive-impairment
Computerized cognitive training in older adults with mild cognitive impairment or dementia
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HTTPS://DOI.ORG/10.1176/APPI.AJP.2016.16030360
Source – Another student’s paper
https://doi.org/10.1176/appi.ajp.2016.16030360
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THE RESEARCHERS CONDUCTED A SYSTEMATIC REVIEW AND META-ANALYSES OF RCTS OF CCT IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT OR DEMENTIA
Source – Another student’s paper
A Systematic Review and Meta-Analysis” is an analysis of randomized controlled trials of CCT in elderly patients with mild cognitive impairment or dementia
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HILL ET AL
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HILL ET AL
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KALLIO ET AL
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Man et al
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BUTLER ET AL
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Man et al
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HILL ET AL
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HILL ET AL
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KALLIO ET AL
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Man et al
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THE STUDY CONDUCTED A SYSTEMATIC REVIEW OF RANDOMIZED CONTROL TRIALS (RCTS) WITH META-ANALYSIS
Source – https://en.wikipedia.org/wiki?curid=5750
A systematic review and meta-analysis of randomized controlled trials”
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THE STRENGTHS OF USING SYSTEMATIC REVIEWS FOR CLINICAL RESEARCH INCLUDE
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Strengths of Using Systematic Reviews for Clinical Research Include
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M., DILA, K
Source – Another student’s paper
M., Dila, K
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S., MOHAMED, M
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A., Mohamed, M
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F., TAM, D
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Y., Tam, D
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D., AHMED, A
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D., Ahmed, A
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M., & HUY, N
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M., & Huy, N
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A STEP-BY-STEP GUIDE FOR CONDUCTING A SYSTEMATIC REVIEW AND META-ANALYSIS WITH SIMULATION DATA
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A step by step guide for conducting a systematic review and meta-analysis with simulation data
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H., KIEN, N
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H., Kien, N
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TROPICAL MEDICINE AND HEALTH, 47(1), 1-9
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Tropical Medicine and Health, 47(46), 1-9
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HTTPS://DOI.ORG/10.1186/S41182-019-0165-6
Source – Another student’s paper
https://doi.org/10.1186/s41182-019-0165-6