Newborn Skincare and Hygiene

Newborn Skincare and Hygiene


The birth of a newborn is a delightful event, and parents prioritize safeguarding the health of their sensitive skin. This guide will thoroughly examine the intricacies of newborn skin, cover necessary skincare routines, tackle frequent issues, and offer useful advice to maintain the health and happiness of your baby’s skin.

Analyzing the Characteristics of Infant Skin:

The skin of a newborn is a remarkable example of nature’s ingenuity, characterized by its fragility and exceptional sensitivity. Parents must prioritize comprehending the unique characteristics of their child and acquiring knowledge on how to adequately provide for their needs. Now, let’s explore the complexities of infant skin:

1. Newborn Skin Characteristics 

Newborn skin is considerably thinner than adult skin, rendering it more susceptible to environmental influences. The epidermis, which is the outer layer, is currently undergoing development, resulting in increased skin permeability.

Restricted Oil Production: In contrast to the skin of adults, neonates have a reduced capacity to produce oil. The sebaceous glands, which are accountable for the production of oil, are still in the process of maturing, resulting in dryness and heightened sensitivity.

Vernix Caseosa: Vernix caseosa is a waxy and cheese-like material that is present before birth and serves to protect the skin while in the womb. Although it is often removed shortly after birth, traces of it may persist, offering a certain degree of inherent defense.

Newborn skin exhibits exceptional flexibility as a result of its elevated collagen levels. This increases its susceptibility to developing temporary skin disorders such as milia and mottling.

2. Prevalent Dermatological Conditions in Neonates 

Milia are little, pale or yellowish pimples that can develop on a newborn’s face as a result of keratin becoming stuck. Milia are benign and usually self-resolve.

Erythema Toxicum, commonly known as “newborn rash,” is a prevalent rash distinguished by red patches with a central whitish, pimple-like elevation. The condition is often benign and tends to resolve spontaneously within a few days.

Mottling refers to the presence of a lacy pattern of reddish-blue or purple dots on the skin, which is frequently observed in neonates. It frequently occurs as a consequence of the maturing circulatory system effectively managing the circulation of blood.

3. Determinants of Neonatal Skin Health 

Weather Conditions: Infants are susceptible to severe temperatures. Safeguard your infant from intense sunshine and guarantee suitable attire to avoid overheating or excessive cooling.

Attire Selection: Choose textiles that are gentle and allow air to pass through, such as cotton. Refrain from wearing garments that have bothersome seams or tags that could create friction on the sensitive skin.

Environmental factors, including as humidity levels, might affect the condition of a newborn’s skin. Employing a humidifier in arid regions aids in preserving the ideal humidity levels.

Skin-to-skin contact is direct physical contact between the baby’s skin and another person’s skin. This contact is beneficial as it helps to regulate the baby’s body temperature, promotes a strong emotional connection, and contributes to the proper development of the baby’s skin.

Gaining knowledge of these attributes and variables empowers parents to deliver the most effective care for their infant’s skin. When you are experiencing the initial stages of parenthood, remember that simplicity is frequently crucial. Ensuring the general health and well-being of your baby’s fragile skin involves employing a gentle cleansing routine, refraining from using harsh chemicals, and creating a pleasant environment. It is advisable to get guidance from your pediatrician if you have any concerns or inquiries regarding your newborn’s skin.

Foundational Skincare Regimen for Newborns

Bathing Protocol :

Offering a comprehensive, detailed procedure for bathing a baby, with precise instructions on water temperature, frequency, and suggested bathing materials.

Selecting Appropriate Skincare Products (H2): Identifying crucial components to steer clear of in baby goods and providing suggestions for reputable skincare companies that are appropriate for infants.

Diapering Best Practices :

Recommendations for correct diapering techniques, mitigating diaper rash, and selecting suitable diapers to ensure your baby’s comfort.

Clothing Tips for Newborns :

Advice on choosing breathable fabrics, dressing appropriately for the weather, and avoiding clothing options that may cause irritation.

Responding to Frequently Raised Issues:

Diaper Rash and Prevention: Explaining the typical reasons behind diaper rash and providing prevention strategies and treatments.

Understanding and Caring for Baby Acne: Elucidating the etiology of infantile acne and offering recommendations for delicate management.

Cradle Cap Remedies: Providing strategies for effectively controlling and treating cradle cap, a prevalent scalp ailment in infants.

Practices for Maintaining Hygiene in Newborns:

  • Umbilical Cord Care: Offering guidance on how to care for the umbilical cord stump until it detaches spontaneously.
  • Guidelines for Cleaning the Ears and Nose : Ensuring proper hygiene by safely cleansing a newborn’s ears and nose without causing any discomfort.
  • Nail Care for Newborns: Guidelines for carefully clipping your baby’s nails to avoid scratching and irritation.

Selecting Optimal Skincare Products:

Choosing the suitable skincare products for your infant is vital to maintain the health and prevent any irritation of their fragile skin.

1. Harmful Ingredients in Baby Products:

Fragrances: Fragrances may cause irritation to the delicate skin of a baby. Choose fragrance-free or hypoallergenic products to reduce the likelihood of irritation.

Parabens: These are preservatives that have the potential to interfere with the endocrine system. To avoid these chemicals, seek out items that are labeled as “paraben-free”.

Sulfates, such as sodium lauryl sulfate, have the potential to be abrasive and remove the skin’s natural oils. Opt for cleansers that are free of sulfates in order to preserve the skin’s inherent hydration.

Phthalates are chemical compounds that are utilized to augment the scent of certain products. Given that perfumes are best to be avoided, opting for goods that do not contain phthalates is a more secure option.

Dyes: Colored items may contain dyes that have the potential to induce skin irritation. Choose goods that are free from synthetic dyes to reduce the likelihood of experiencing allergic reactions.

2. Top Skincare Brands for Newborns:

1. Cetaphil Baby products are renowned for their mild cleansers and moisturizers, making them a popular choice among pediatricians. Their product selection encompasses shampoo, lotion, and diaper cream.

2. Aveeno Baby: Aveeno is renowned for its utilization of organic components. Their infant merchandise is developed using colloidal oatmeal, offering alleviating comfort for delicate skin.

3. Mustela: Mustela provides a selection of hypoallergenic and fragrance-free products specifically developed for newborns. Their products are frequently appropriate for infants with skin that is prone to eczema.

4. Earth Mama: Earth Mama products are composed of organic ingredients and are devoid of any detrimental chemicals. Their product range encompasses a diverse selection of baby care items, such as balms and oils.

The Honest Company, established by Jessica Alba, manufactures a range of baby care items that are devoid of harmful chemicals. Their product selection encompasses diapers, wipes, and skincare products.

3. Recommendations for Selecting Skincare Products:

Examine Labels: It is imperative to carefully review the list of ingredients. Seek out items containing a limited number of natural ingredients, while avoiding possibly hazardous compounds.

Select Hypoallergenic: Opt for products that are specifically labeled as hypoallergenic, as these are less prone to triggering allergic responses or skin irritation.

Prior to applying a novel product, perform a patch test on a small section of your infant’s skin to verify the absence of any unfavorable reactions.

Seek advice from a pediatrician: If your infant has certain skin issues or conditions, it is advisable to consult a pediatrician before using new products. They are capable of offering customized suggestions based on the specific requirements of your infant.

Frequently Asked Questions Regarding Newborn Skincare and Hygiene

Q1.What is the recommended frequency for bathing a newborn?

Initially, a frequency of 2-3 baths per week is adequate. since your infant develops, you can progressively augment the frequency of bathing, but exercise caution to avoid excessive bathing, since it might deplete the skin’s natural oils.

Q2: What should I do if my baby has a diaper rash?

If your kid is experiencing a diaper rash, you should take certain steps to address the issue.

Diaper rash is a prevalent condition that can be both prevented and managed. Ensure timely diaper changes, apply a diaper cream containing zinc oxide, and provide brief intervals of diaper-free time to facilitate skin ventilation.

Q3.Are all infant items deemed safe for newborns?

No, not all products possess equal quality or characteristics. Refrain from using products that contain abrasive chemicals, strong scents, and alcohol. Choose hypoallergenic and fragrance-free products that are specifically formulated for newborns with sensitive skin.

Q4.What is the most effective method for cleaning my baby’s nasal passages while minimizing discomfort?

Administer saline drops to facilitate the loosening of mucus, followed by the careful extraction of nasal secretions using a bulb syringe. Ensure that the environment is adequately humidified to prevent the occurrence of nose dryness. If the feeling of unease continues, get advice from your pediatrician.

Q5.Is it permissible to utilize conventional soap for bathing my infant?

It is optimal to utilize a gentle, unscented baby soap or cleaner. Adult soaps has strong properties that can potentially cause irritation to the sensitive skin of a baby.

Q6.What is the most suitable attire for my newborn?

Opt for textiles that are soft and allow for proper air circulation, such as cotton. To maintain optimal temperature, clothe your infant in multiple layers and refrain from using tight garments that may cause skin irritation or discomfort.

Q7.At what age is it appropriate to commence clipping my infant’s nails?

It is advisable to clip your baby’s nails during the initial weeks of their life. Utilize nail scissors or clippers that are specifically designed for infants, ensuring their safety. Trim your baby’s nails when they are in a peaceful state or when they are sleeping to minimize the risk of unintentional cuts.

Q8.What is the proper method for cleaning my infant’s ears?

Employ a moistened washcloth to delicately cleanse the external part of the ear, refraining from introducing any objects into the ear canal. If you observe an abundance of earwax or have any concerns, seek advice from your physician.

Q9.Is it typical for neonates to experience infantile acne?

Indeed, infantile acne is a prevalent occurrence that often manifests itself throughout the initial weeks of an infant’s life. Refrain from utilizing abrasive substances and instead cleanse the facial area alone with water. Typically, it resolves spontaneously.

Q10.What is the most effective method for tending to the umbilical cord stump?

Ensure that the stump remains free from dirt and moisture. Position the diaper beneath the stump to facilitate proper airflow. If you observe any signs of redness, discharge, or an unpleasant odor, it is advisable to get in touch with your pediatrician.


Ultimately, tending to the skin of your infant necessitates a careful equilibrium of understanding and fostering. To ensure optimal care for your infant, it is important to comprehend the distinctive attributes of newborn skin, develop a fundamental skincare regimen, and effectively tackle common issues. It is important to keep in mind that every baby is distinct, hence it is crucial to customize these rules to meet the specific requirements of your child. By dedicating time to sensitive care and making well-informed decisions, you are establishing the basis for a lifetime of optimal skin health for your child.

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Ethical and Legal Implications of Prescribing Drugs

Ethical and Legal Implications of Prescribing Drugs

You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs.  As advanced practice nurses, almost every clinical decision you make will have ethical or legal implications. Your ethical and legal knowledge is fundamental to your ability to resolve the multitude of challenging issues encountered in practice.  For the Week 1 Assignment, you will explore the ethical and legal implications of the following scenario, and consider how to appropriately respond:


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.

Write a 2- to 3-page paper that addresses the following: all papers submitted include a title page, introduction, summary, and references.

1.      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.

2.      Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.

3.      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.

4.      Explain the process of writing prescriptions, including strategies to minimize medication errors.

To Prepare

Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.

Review the scenario assigned by your Instructor for this Assignment.

Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region and reflect on these as you review the scenario assigned by your Instructor.

Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.

Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.


Ethical and Legal Implications of Prescriptions


In healthcare, practitioners often find out that their friends, co-workers, or relatives may request informal medical advice. In addition, people close to the practitioners may ask for medical prescriptions without following medical procedures.  Practitioners realize that engagement in informal prescriptions increase their chances of having malpractice liability. In serious cases, they face legal investigations and risk going to jail or losing their job (Arcangelo et al., 2017). This paper tries to determine the ethical and legal implications that are associated with casual prescriptions. It involves a scenario where a female friend calls for medical prescription while the practitioner does not have her medical history. With that autonomy, the prescription is still written.

Ethical and Legal Implications

The scenario creates an ethical challenge to the practitioner. Due to their close association, the practitioner’s professional objectivity may be affected. The fact that the practitioner prescribes medicine for the client without her medical history shows that the doctor’s judgment is based on their relationship. Legally, if the state law requires the patient to be present during prescription, the process would be against the authority. In addition, the process would be inefficient due to lack of physical examinations (Kling, 2015).

From another perspective, if the state requires an association between the physician and nurse, an investigation may be enforced on the practitioner for engaging in the process alone. Moreover, if the prescription is done away from the facility setting, it will be illegal. It can also be viewed that if the patient’s condition deteriorates after prescription, there will be no documentation to reveal the drugs she had taken. This act would jeopardize further assistance. Also, there will be no evidence of the patient’s informed consent (Arcangelo et al., 2017).

Strategies for Disclosure and Nondisclosure

Disclosure of patient safety is an important aspect in any healthcare situation. From the scenario, the practitioner may choose to orally disclose the error to a colleague and the patient. This act would increase trust between the practitioner and co-workers. In addition, it would create a suitable patient-nurse relationship. Also, the practitioner may create a formal report to the facility, revealing the details of the error in a way to reduce such errors in future (Kling, 2015).

Strategies for Decision Making

When it comes to decision making, the practitioner may choose to reject the patient’s request. This act would be done in a polite way, with the practitioner giving an explanation of associated ethical concerns. This may be followed by the practitioner assigning the patient to a different qualified nurse to engage in the prescription. Contrarily, the practitioner may choose to engage in the prescription process. However, the process needs the nurse to have a professional relationship with the patient. The procedure should be done in a facility setting, with the practitioner making suitable medical assessments of the patient. It would need official documentation which would enhance a suitable follow-up (Bao et al., 2016).

Prescription Writing Process

Having a systematic approach in prescribing drugs is required to enhance prescription quality. The process should start with proper evaluation and definition of the patient’s problem. This step is followed by development of a therapeutic objective. A proper drug therapy is initiated. Thereafter, details, warnings, and instructions should be provided. To avoid errors, the practitioner may apply the five rights of drug prescription. They involve the needs for the right drug, right patient, right dosage, right process, and right time. Another strategy is to employ computer technology in designing the prescription (Ladd & Hoyt, 2016).


The paper shows that prescription of drugs to people close to a practitioner is associated with ethical and legal implications. These issues may make a nurse lose his or her job, especially if it is associated with errors. Nurses need to be careful when administering drugs to patients who are associated with them. The paper tries to reveal that with proper strategies, the process can be done properly, thereby limiting ethical and legal consequences. In addition, it is observed that drug prescription needs to follow a systematic approach to avoid errors.


Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotheraeutics for advanced practice: A practical approach (4thed.). Ambler, PA: Lippincott Williams & Wilkins.

Bao, Y., Pan, Y., Taylor,A., Radakrishnan, S., Luo, F., Pincus, H. A., &Schackman, B. (2016). Prescription drug monitoring programs are associated with sustained reductions in opioid prescribing by physicians. Health Affairs, 35(6), 1045 -1051.

Kling, S. (2015). Is it ethical to treat one’s family and friends?: ethics article. Current Allergy & Clinical Immunology, 28(2), 118-120.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166-173.

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Simulation Technology

Simulation technology has been transformative in nursing education. Through the use of simulation, nurses can repeatedly practice skills and gain clinical confidence in a risk-free environment. Simulation, however, is not just for health care professionals. How can nurses leverage simulation technology for patient and family education? Share your experiences and ideas for leveraging simulation technology for patient education.


Simulation Technology

Simulation technology has been critical in the nursing profession. The technology helped me throughout the time I was doing my associate nursing degree. The university I attended helped me to gain practical skills that gave me confidence when working with patients. The institution had a lab with all simulation technologies to help students present real-life situations and prepare them from the beautiful and stressful life in nursing profession. For example, my classmates and I were presented with a patient with the condition that we were to determine based on the signs and symptoms presented. Using the simulation technology, we were able to run a code that helped us to establish that the patient had a heart attack and the technology was so effective in reducing the risk of losing the patient. According to Foronda et al., (2017) simulation technology can increase student’s confidence and knowledge when caring for critical patients. Besides, it is estimated that simulation technology could eliminate about 50% of clinical time, without having any adverse effects on both patient care and learning outcomes (Hayden Padilha, Machado, Ribeiro, & Ramos, 2018).

Patient education is also a critical element of simulation technology. Patients can benefit from simulation technology through education by helping them to understand clinical situations including, personal care, adherence to medication, and their outcome and wellbeing. Based on my experience when working with simulation technology, we were able to teach parents how to carry out CPR on their children during emergency.  We used a video about how CPR should be conducted on infants and asked them to explain and relay what they learned about performing CPR. Therefore, simulation technology is an excellent instructional strategy that can help nursing students to practice psychomotor skills, critical thinking, and clinical decision making without risking the life f a potential patient.


Foronda, C. L., Alfes, C. M., Dev, P., Kleinheksel, A. J., Nelson Jr, D. A., O’Donnell, J.M., & Samosky, J. T. (2017). Virtually nursing: Emerging technologies in nursing education. Nurse Educator42(1), 14-17. doi: 10.1097/NNE.0000000000000295

Padilha, J. M., Machado, P. P., Ribeiro, A. L., & Ramos, J. L. (2018). Clinical virtual simulation in nursing education. Clinical Simulation in Nursing15, 13-18.

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The use of SBIRT in Adolescent Population

The use of SBIRT in Adolescent Population
Quality Improvement Proposal

The use of SBIRT in Adolescent Population

Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal.

The use of SBIRT in Adolescent Population

Include the following:

  1. Provide an overview of the problem and the setting in which the problem or issue occurs.
  2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
  3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
  4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
  5. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
  6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

The use of SBIRT in Adolescent Population


The use of SBIRT in Adolescent Population

Problem Overview

            Abusing drugs among adolescents is primarily prevalent in the United States. This makes adolescent years a critical window for the development of substance use disorders. Abusing drugs among the youth influence both their social and psychological development primarily cognitive development (Aldridge, Linford, & Bray, 2017). Nurses and physicians need to intervene early before substance abuse leads to cognitive health issues.  According to Johnston, O’Malley, Bachman & Schulenberg, 2013), physicians need to provide both holistic and quality care to their patients. Through the Road to Evidence-based practice, health care practitioners can find the evidence, appraise the evidence, implement the evidence and evaluate the evidence. Through the use of SBIRT as an evidence-based practice, healthcare practitioners can recognize, decrease and prevent harmful and unhealthy ways of substance use and abuse (Aldridge, Linford, & Bray, 2017). This paper develops a proposal for quality improvement through the introduction of screening, Referral to Treatment (SBIRT) screening tools, intervention, and intervention procedures to adolescent population affected by substance abuse in a health care institution.

Why a Quality Improvement Initiative is Required

The quality improvement initiatives are required because the use and abuse of drugs have become common among adolescents, which make it a critical public concern. The Healthy People 2020 developed critical objectives aimed to reduce substance use and abuse among teenagers (Healthy People 2020, 2018). In addition, most government agencies, medical institutions and medical professional associations have developed free counseling programs and screenings for youth such as initiatives that involve SBIRT integration within the medical health care system in collaboration with the White House Office of National Drug Control Policy, Agency for Health care Research and Quality, Health Resources and Services Administration, National Institutes of Health (NIH), and SAMHSA (Johnston, O’Malley, Bachman & Schulenberg, 2013). Besides, the medical professional associations and international and national public health agencies developed recommendations aimed to guide health care professionals to carry out screening and interventions for individuals especially teenagers believed to abuse and use drugs. Therefore, SBIRT is a critical part that can be placed as part of the Affordable Care Act legislation and Patient Protection Act to help deal with the issue of substance abuse among teenagers in the US (Johnston, O’Malley, Bachman & Schulenberg, 2013). Besides, based on the Periodic Screening, Diagnosis, and Treatment statue, each federal government in the US is expected to provide Medicaid screening assessments for both physical and mental development among teenagers.

Results from Previous Research

According to National Institute on Drug Abuse (2014), drugs such as alcohol, tobacco and other illegally prescribed drugs during adolescent are often abused during the adolescent stage. It is estimated that about 70% of students in high school have abused either alcohol or other drugs while 30% might have abused prescribed medications for non-medical reasons (NIDA, 2014). The desire to fit in and faces new experiences, and deal with peer pressure or problems in school are the primary reasons for abusing drugs.

According to Singh et al., (2017) the factors that influence the use of drugs among adolescent youths include peer pressure and the availability of narcotics in the school, community or neighborhood. The family environment is also a critical factor that may influence teenagers to use and abuse drugs. For example, a violent environment, mental illness, physical and emotional abuse, and the use of drugs in the household may influence the child to use and abuse drugs (Singh et al., (2017). Other factors for abuse of drugs includes the beliefs that drugs are cold, mental health conditions such as ADHD, anxiety, and depression, personality traits such as the need for excitement or poor impulse control, and adolescent’s inherited genetic vulnerability.

The U.S. Preventive Services Task Force (USPSTF) recommends providing routine screening for substance abuse among teenagers between 16 years and 17 years. The USPSTF also found that the use of SBIRT among teenagers is a critical area within the nursing practice that needs to be looked into. According to Aldridge, Linford, & Bray, (2017), SBIRT is a public health approach that is integrated and comprehensive to the delivery of treatment and intervention for individuals at risk of developing substance abuse disorder or for individuals who have a substance abuse disorder. The practice of SBIRT as an evidence-based practice involves screening individual’s suspected of substance abuse and encouraging them to change their behavior through motivational interviews and putting them under a treatment plan. Thus, SBIRT is a simple medical practice that is both effective and brief. Evidence from researches shows that cost-effectiveness and efficacy of SBIRT among adults and its help in managing drug use although is useful, it has mixed reaction. A study by Aldridge, Linford, & Bray, (2017), further states that SBIRT is the evidence-based practice that can help the use of drugs among the youths and prevent cannabis use among teenagers.

The use of SBIRT in Adolescent Population

SBIRT, as an intervention, also leads to changes in substance use behaviors among patients who were addicted to drugs and went through the SBIRT tool intervention plan. The large-cohort SAMHSA study in 2017, showed the effectiveness of the SBIRT intervention. The study was quasi-experimental and sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA, 2017). The study sample was about one million individuals, and the study participants were screened for substance abuse disorders, and the SBIRT was used as an intervention plan for five years. The use of SBIRT intervention process was linked with a decrease in substance use among the individuals who were under the SBIRT intervention process (SAMHSA, 2017). SBIRT is a critical intervention tool that is validated to help assess the risk of substance abuse and developing intervention to encourage the reduction of substance use and ensure treatment who have improve both physical and psychological issues resulting from substance use and misuse (Schmidt, 2010). Therefore, SBIRT is a standardized and evaluated screening tool that is effective, patient-centered, evidence-based and an ongoing transition to treatment and care of patients addicted to substance use.

Steps to Implement the Quality Improvement Initiative

            The first step of implementation of SBIRT intervention plan for patients engaged in substance abuse is to train the health care providers and physicians who will participate in the program. The health care providers who will be involved in the study will be reimbursed for every screening (SAMHSA, 2017). The SBIRT will include four steps during the screening process.

  1. The first step: The first step will involve the screening process where the health care practitioners will develop an evidence questionnaire to identify patient admitted for substance abuse ranging from addiction, problematic and riskiness of substance abuse. The screening process is critical in raising awareness to help people reduce substance use and misuse. The risk of substance use can be divided into four patterns: low risk or abstinence involves those who no consumption of alcohol, tobacco or any other drug. Driving risk includes those adolescents who use drug and alcohol and drive or ride with adolescents high on drugs or alcohol. Moderate risk includes individuals who have started using drugs and alcohol. Finally, high risk involves individuals who use drugs and alcohol often.
  2. The second step: This step involves a brief intervention process where teenagers showing mild symptoms get about 15 to 45-minute intervention including motivational interviewing. This helps to develop a behavioral change among teenagers to help reduce substance use and abuse.
  • The third step: The step involves a brief treatment process where adolescents with a score of moderate to severe in substance use and abuse are provided with a treatment plan that requires counseling sessions.
  1. The fourth step: The step involves the referral to treatment where the patients are connected to a physician for behavioral health treatment, comparative health assessment, or a specialty treatment program for substance abuse disorder.

The use of SBIRT in Adolescent Population

These steps are critical during the implementation of the SBIRT as an intervention plan based on the following essential components: identifying adolescent at risk of substance abuse and disorders, educate adolescents and create awareness on substance abuse by showing the dangers of drinking and using drugs to help adopt a more healthy behavior (Schmidt, 2010). The potential for preventing substance abuse in the United States should not be underestimated. SBIRT is a critical intervention tool that helps in the reduction of substance abuse and its implementation as evidenced-based practices is an economic strategy that can help reduce abuse among teenagers in the US.

The use of SBIRT in Adolescent Population


Aldridge, A., Linford, R., & Bray, J. (2017). Substance use outcomes of patients served by a broad US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT). Addiction, 112, 43–53.

Healthy People 2020. (2018). Increase the proportion of adolescents aged 12 to 17 years perceiving great risk associated with substance abuse. Retrieved from

Johnston, L., O’Malley, P., Bachman, J., & Schulenberg, J. (2013). Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings. Bethesda, MD: National Institute on Drug Abuse, 2013. Retrieved from

National Institute on Drug Abuse [NIDA]. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide. Retrieved from

Schmidt, C. S., Schulte, B., Seo, H.-N., Kuhn, S., O’Donnell, A., Kriston, L., … Reimer, J. (2010.). A meta-analysis on the effectiveness of alcohol screening with brief interventions for patients in emergency care settings. ADDICTION, 111(5), 783–794.

Singh, M., Gmyrek, A., Hernandez, A., Damon, D., & Hayashi, S. (2017). Sustaining Screening, Brief Intervention, and Referral to Treatment (SBIRT) services in health-care settings. Addiction, 112, 92–100.

Substance Abuse and Mental Health Services Administration [SAMHSA]. (2017). About screening, brief intervention, and referral to treatment (SBIRT). Retrieved from



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VARK Learning Styles and Strategies

VARK Learning Styles and Strategies


Learning is a constant process in the life of an individual. However, people have different learning styles that help them to grasp knowledge in an efficient way. This feature has made educator to try to adapt their teaching styles to the way the students understand best. In healthcare, different learning strategies are considered important in helping practitioners to attain suitable skills and knowledge in their profession. With the application of technology, the different learning styles need to be incorporated in the provision of knowledge (Asiry, 2016). The paper tries to establish an individual’s learning style and strategies. It also focuses on determining the impact of learning styles on education and elucidates the importance of understanding learning styles in an educational setting.

Summary of My Learning Style

The Fleming’s model, which is known as VARK Learning Styles and Strategies, individual learners are identified by whether they have a preference for visual, auditory, reading and writing, and kinesthetic. From my VARK test my scores were as follows; – 3 for visual, 5 for auditory, 4 for reading and writing, and 4 for kinesthetic. From the score, my learning style is more aligned to auditory. As an aural learner, it can be observed that I attain more knowledge by hearing information. Therefore, lectures are more important for my learning. My learning style also shows that I am better at remembering what I am told than what I see. However, reading and writing and kinesthetic are also suitable learning styles for my education. This is because the difference in score between auditory and these styles is 1 which is very minimal (Asiry, 2016).

Description of My Learning Strategies

One of the most essential strategies for my learning is engagement with my classmates. This strategy allows me to explain to my classmates and getting efficient explanations from them. In addition, I also begin my learning early to ensure that I am not disturbed by noises from my surrounding. Moreover, I also ensure that I attend s many lectures as possible so that I can get a great understanding of my studies. Another suitable strategy for my studies is the use of recording devices to ensure that can listen to the information more times. This strategy is also used in summarizing my notes (Asiry, 2016).

While looking at the identified learning strategies for my preferred style, I have realized that my strategies align with what I’m required to apply. For instance, it is recommended for auditory learned to hold discussions with their fellow students and with teachers. Attending many classes is also a preferred strategy for the learning style. However, I am also required to read my notes loud for better understand (Asiry, 2016).

Impact of Learning Styles on Education

An individual’s learning style is depicted to affect the learning decisions one makes. As a result, it affects the level of adjustment a learner can make during changes in teaching strategies. In addition, learning styles also affect a student’s motivation during certain teaching activities. For instance, if the teaching does not align with a student’s learning style, he or she may have little motivation in the lesson. Therefore, student’s concentration level is affected by his or her learning style. Moreover, a learning style affects a student’s way of conceptualizing information. From this perspective, it is viewed that some styles need an individual to base on his or her experience to understand some information (McCutcheon et al., 2015).

Also, learning styles are essential in determining the way a student constructs ideas during the learning process.  It is very important for an educator to understand the learning style of an individual because it helps in developing a suitable teaching strategy that meets the individual’s requirements. It also helps the educator to guide the learner in a way that he or she becomes satisfied with the learning environment. Moreover, it also helps the educator to guide the student to move from an unsuccessful strategy to one that suits the student’s style (Mahmoud, Ahmed, & Ibrahim, 2019).

Importance of Understanding Learning Styles

A health promotion environment is full of different stimuli. The educators need to maximize the stimuli for them to get better outcomes. When the educator understands the learning styles of the individual in the promotion, it becomes easier for them to develop a suitable educational environment for the learners. In addition, it helps the educators to improve the quality of health promotion, thereby ensuring that the promotion entails effective learning (McCutcheon et al., 2015).

Learning styles affect the types of interactions between the learner and the educator. These interactions may affect the relationships between learner and the educator, hence affecting the level of understanding for the need of change. For instance, if the learning style requires a personal interaction with the learner, there are higher chances that he or she may consider to change behavior. It is observed that different learning styles may be accommodated by applying different teaching strategies to meet the requirements of every learning style. This act can be enhanced by understanding the different requirements of students and developing strategies that encompass all their needs (McCutcheon et al., 2015).


The paper has covered different issues regarding learning styles of individuals. Using a VARK Learning Styles and Strategies assessment, the individual style identified is auditory. It is shown that learning strategies for an auditory learner needs to focus on his or her learning. Therefore, one is recommended to engage in activities such as discussions and attendance of lectures. The paper also shows that learning styles have great impact in education s it affects features such s the way a learner conceptualizes information and how they develop ideas. Moreover, learning styles are considered to be important in healthcare promotion. Therefore, it is important for educators to align their teaching strategies with the learning requirements of different learners to ensure that there are better health outcomes.


Asiry, M. A. (2016). Learning styles of dental students. The Saudi Journal for Dental

            Research7(1), 13-17.

Mahmoud, H. G., Ahmed, K. E., & Ibrahim, E. A. (2019). Learning styles and learning

approaches of bachelor nursing students and its relation to their achievement. International Journal of Nursing Didactics9(03), 11-20.

McCutcheon, K., Lohan, M., Traynor, M., & Martin, D. (2015). A systematic review evaluating

the impact of online or blended learning vs. face‐to‐face learning of clinical skills in undergraduate nurse education. Journal of Advanced Nursing71(2), 255-270.


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Guidelines for effectively challenging a client

Guidelines for effectively challenging a client

Challenging a Client (Obj. 3.1, 3.2, 3.3, 3.4, and 3.5)

Write a 750-1,000-word essay outlining at least four guidelines for effectively challenging a client. For each guideline, provide a case example illustrating the principle. Address the following in your paper:

1.      How can counselors challenge a client without getting into a power struggle with a client, or provoking client defensiveness?

2.      How can counselors help a client to identify unused resources and strengths?

3.      How can counselors help a client to identify blind spots while continuing to provide empathy and support for the client?

4.      How would counselors work with a client within an interdisciplinary treatment team?

5.      How can a counselor act as a consultant when a practicing counselor asks for help to strengthen their challenging skills with clients?

6.      For this part of the assignment, you may write in the first person. Reflect on your level of assertiveness. Do you feel you are assertive enough to challenge clients comfortably or do you feel you are too passive or aggressive? What might keep you from challenging a client?

Guidelines for effectively challenging a client

Provide at least three scholarly references in your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Sample Answer 

Guidelines to Challenging a Client

Many therapists believe in the idea that only an individual can bring change in their lives and this is also a fundamental principle in some of the psychological theories that are used in psychotherapy. The concept highlights the fact that as a therapist it may not be possible to change your clients and therefore, the main role is to change the interaction with them, in the hope that they can apply some of the skills and change certain aspects of their life. However, despite this knowledge, there are instances when psychotherapists encounter resistance form their clients (Yotsidi et al., 2019). This resistance is described as stemming from the client and there are valid reasons why they would be resistant.

One thing that explains resistance is when there is an inability by the therapist to understand the world of the client and consequently their response to therapy. Secondly, resistance may be visualized as happening when there are inadequate techniques to manage the interaction n between the client and the therapist. Generally, there may be several situations where the resistant clients may need gentle challenging and the therapist may choose from a wide range of skills. The principle behind challenging the client is that it should be done empathetically and geared towards meeting the needs of the client. The therapist should also ensure that they remain calm and reframe the resistance so that there is no chance of having two people resisting each other.

Guidelines for effectively challenging a client

One guideline for challenging a client is the use of skills such as immediacy, a psychological approach that is associated with interpersonal process therapy (Hetrick et al., 2016). The approach enables the therapist to exploit the immediate situation and raise awareness to the client so that they can establish what is going on in the relationship. The main goal is to strengthen the therapeutic relationship and in the process challenging the client without making the client feel as though they need to be defensive. The therapist strives to increase awareness in the client and the process identifies the strengths and resources that have been unused. The therapist also seeks out the maladaptive relationship patterns that may be existent between the client and therapist and in the process helps the client to focus on the interpersonal process in the session as compared to the content for the session (Hill, Knox & Pinto-Coelho, 2018). This may be achieved by pointing out something as it happened, for instance, noticing a change in facial expression and pointing it out to allow for self-exposure. A case example will be to tell the client “I noticed that when I shared my interpretation of this issue, there was a change in your facial expression, what are your thoughts on it?

A second guideline is to express empathy and emotional validation towards the client. This may be achieved by coming up with statements that maybe not only empathetic but also emotionally validating.  Expressing empathy requires that the therapist does not argue with the client or make excuses for the actions or feelings that they have (Yotsidi et al., 2019). This will ensure that they do not get into a power struggle. The therapist will be careful enough to identify the blind spots and use them to continue providing support and empathy. The therapist can consult with other people in an interdisciplinary team on how to make use of the available skills to show empathy and validation. An example of empathy and validation is when a client says that they are angry with them. The therapist may validate this by apologizing for anything that they may have done to upset the client.

Another guideline for dealing with clients showing resistance is to seek support from others in the field.  In some cases, it may be embarrassing and shameful to experience challenges with a client despite training and experience. One way that will be ideal to help the therapist out of this situation is to share the issue with other mental health professionals. However, when this is done, care should be taken to maintain confidentiality. These discussions may be instrumental as there may be suggestions on how to handle the case. Another way to go about it is to seek a second opinion from a consultant either physically and in some cases through a phone call. The consultation enables the therapist to speak out on the concerns as well as insecurities that they have. As a consultant, the goal will be to reassure the therapist and provide alternative solutions to the issue at hand.


A guideline to dealing with challenging clients is to ensure that one cultivates patience. It is necessary for the therapist to not only cultivate patience in challenging clients but also with themselves. To achieve this, therapists may need to explore reappraisal, whereby they establish new ways to examine the existing challenges. For instance, a therapist may be frustrated by a client and may feel exhausted and drained. However, they may also choose to see the situation as being important since they are helping another person bear their burdens. Such thoughts may be refreshing and may provide the therapist with the strength to push through with the support despite the challenges. Another approach is mediation and this will allow the therapist to lovingly direct good thoughts and well wishes to themselves. However, when things become too tough, it is okay for a therapist to terminate the relationship and possibly refer the client especially if the therapist feels that the stress may prevent them from meeting the needs of the clients.

In conclusion, psychotherapy requires patience as it involves helping others bear their burdens and pains. However, there may be instances when one deals with challenging patients and therefore there are guidelines to help the therapists cope. A therapist may adopt skills such as immediacy to manage the client in addition to other strategies such as empathy and emotional validation. Also, the therapist should be calm about the situation, cultivate patience and whenever possible consult with the other mental heaths staff. However, whenever it is not possible to help, a therapist should consider referring the patient.


Hetrick, S. E., Cox, G. R., Witt, K. G., Bir, J. J., & Merry, S. N. (2016). Cognitive behavioral Therapy (CBT), third‐wave CBT and interpersonal therapy (IPT) based interventions for preventing depression in children and adolescents. Cochrane Database of Systematic Reviews, (8).

Hill, C. E., Knox, S., & Pinto-Coelho, K. G. (2018). Therapist self-disclosure and immediacy: A Qualitative meta-analysis. Psychotherapy, 55(4), 445.

Yotsidi, V., Stalikas, A., Pezirkianidis, C., & Pouloudi, M. (2019). The Relationships Between Client Resistance and Attachment to Therapist in Psychotherapy. Journal of Contemporary Psychotherapy, 49(2), 99-109.

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