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Family Therapies

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Family Therapies

Individuals are born into families, grow and develop in families, and live most of their lives in families. Therefore, it makes sense that clients are best understood within the context of the family system.

——Dr. Candice Knight, Psychotherapy for the Advanced Practice Psychiatric Nurse

 

The family system is a social unit that is based on unique relationships and roles. Structural and strategic therapies are important, because they offer unique insights to the theoretical underpinnings of this system. As a psychiatric mental health nurse practitioner, a strong theoretical foundation will help you better understand the family unit and family therapy; this understanding will, in turn, improve the effectiveness of your work with clients.

This week, as you continue exploring family therapy, you examine structural and strategic family therapies and their appropriateness for client families. You also consider your own practicum experiences involving family therapy sessions.

Learning Resources

 

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

  • Chapter 5, “Bowen Family Systems Therapy” (pp. 69–88)
  • Chapter 6, “Strategic Family Therapy” (pp. 89–109)
  • Chapter 7, “Structural Family Therapy” (pp. 110–128)

Gerlach, P. K. (2015). Use structural maps to manage your family well: Basic premises and examples. Retrieved from http://sfhelp.org/fam/map.htm

McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-income families with potential adolescent gang involvement: A structural community family therapy integration model. American Journal of Family Therapy, 41(2), 110–120. doi:10.1080/01926187.2011.649110

Note: Retrieved from Walden Library databases.

Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1. American Journal of Family Therapy, 42(2), 167–174. doi:10.1080/01926187.2013.794046

Note: Retrieved from Walden Library databases.

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025

Note: Retrieved from Walden Library databases.

Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403–414. doi:10.1080/01926187.2012.727673

Note: Retrieved from Walden Library databases.

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415–427. doi:10.1111/jmft.12113

Note: Retrieved from Walden Library databases.

Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research, 25(1), 121–133. doi:10.1080/10503307.2013.856044

Note: Retrieved from Walden Library databases.

Optional Resources

Coatsworth, J. D., Santisteban, D. A., McBride, C. K., & Szapocznik, J. (2001). Brief strategic family therapy versus community control: Engagement, retention, and an exploration of the moderating role of adolescent symptom severity. Family Process, 40(3), 313–332. Retrieved from http://www.familyprocess.org/family-process-journal/

Golden Triad Films (Producer). (1986). The essence of change. [Video file]. Mill Valley, CA: Psychotherapy.net.

National Institute on Drug Abuse. (2003). Brief strategic family therapy for adolescent drug abuse. Retrieved from https://archives.drugabuse.gov/TXManuals/BSFT/BSFTIndex.html

Navarre, S. (1998). Salvador Minuchin’s structural family therapy and its application to multicultural family systems. Issues in Mental Health Nursing, 19(6), 557–570. doi:10.1080/016128498248845

Psychotherapy.net (Producer). (2000b). Satir family therapy [Video file]. Mill Valley, CA: Author.

Psychotherapy.net (Producer). (2011b). Salvador Minuchin on family therapy [Video file]. Mill Valley, CA: Author.

Radohl, T. (2011). Incorporating family into the formula: Family-directed structural therapy for children with serious emotional disturbance. Child & Family Social Work, 16(2), 127–137. doi:10.1111/j.1365-2206.2010.00720.x

Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., … Szapocznik, J. (2011). Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents. Journal of Consulting and Clinical Psychology, 79(6), 713–727. doi:10.1037/a0025477

Santisteban, D. A., Suarez-Morales, L., Robbins, M. S., & Szapocznik, J. (2006). Brief strategic family therapy: Lessons learned in efficacy research and challenges to blending research and practice. Family Process, 45(2), 259–271. doi:10.1111/j.1545-5300.2006.00094.x

Szapocznik, J., Schwartz, S. J., Muir, J. A., & Brown, C. H. (2012). Brief strategic family therapy: An intervention to reduce adolescent risk behavior. Couple & Family Psychology, 1(2), 134–145. doi:10.1037/a0029002

Szapocznik, J., Zarate, M., Duff, J., & Muir, J. (2013). Brief strategic family therapy: Engaging drug using/problem behavior adolescents and their families in treatment. Social Work in Public Health, 28(3-4), 206–223. doi:10.1080/19371918.2013.774666

Vetere, A. (2001). Therapy matters: Structural family therapy. Child Psychology & Psychiatry Review, 6(3), 133–139. Retrieved from http://www.iupui.edu/~mswd/D642/multimedia/word_doc/StructuralFamilyTherapy_Vetare.pdf

Weaver, A., Greeno, C. G., Marcus, S. C., Fusco, R. A., Zimmerman, T., & Anderson, C. (2013). Effects of structural family therapy on child and maternal mental health symptomatology. Research on Social Work Practice, 23(3), 294–303. doi:10.1177/1049731512470492

Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.

Learning Objectives

Students will:

  • Compare structural family therapy to strategic family therapy
  • Create structural family maps
  • Justify recommendations for family therapy

To prepare:

  • Review this week’s Learning Resources and reflect on the insights they provide on structural and strategic family therapies.
  • Refer to Gerlach (2015) in this week’s Learning Resources for guidance on creating a structural family map.

The Assignment

In a 2- to 3-page paper, address the following:

  • Summarize the key points of both structural family therapy and strategic family therapy.
  • Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.
  • Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.
  • Recommend a specific therapy for the family, and justify your choice using the Learning Resources.

SAMPLE ANSWER

Structural versus Strategic Family Therapies

Family therapy is a critical aspect of psychotherapy that helps to investigate changes for the welfare of a family. Psychologists use either strategic or structural therapy when dealing with patients with different issues. Having a better understanding of the models helps psychologists to the best therapy to apply to their customers (Szapocznik et al., 2015). This paper analyzes both structural and strategic therapy as forms of family therapy by discussing their strengths and advantages. The paper also uses a structural family map to give and recommend the best recommendation that will be applicable to the family involved.

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The structural family therapy (SFT) is an intervention aimed to address interaction patterns that lead to challenges and issues among family members. The model diagnoses and treats the dysfunction by changing the structure of the family instead of looking to change individual members of the family (Nichols & Tafuri, 2013). It is assumed that problems in the family occur when there is a problem with the hierarchical family structure or when family boundaries are ignored and not met. SFT is critical in maintaining interactions and communications among family members to ensure a healthy healthier family structure (José et al. 2015). Engaging family members can help facilitate change. Changing the family structure can help family members to overcome challenges and interact positively.

The strategic family therapy is more of a problem-solving approach that helps to address dysfunctions within the family. The model aims to influence family members using directives for resolving problems and using carefully planned interventions (Szapocznik et al., 2015). Therefore, the strategic family therapy looks into the strategic way of developing a form of change for each individual in the family. In this way, the underlying problems are recognized and diagnosed to help eliminate negative vibes and unfavorable contacts (Szapocznik et al., 2015). Thus, strategic family therapy uncovers negative feelings within the family and provides ways of engaging destructive behaviors, which encourage positive interactions.

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Both the structural family therapy and strategic family therapy helps to ensure behavioral change, reduce dysfunctional communication, and improve communication among family members. Therefore, both models aim to reduce maladaptive practices that reduce family cohesion to guarantee appropriate family balance (Robbins et al., 2011).  However, both structural family therapy and strategic family therapy have disadvantages. The structural family therapy does not primarily look into the issues causing the issues of a dysfunctional family, and it only focuses on interaction and cohesion as the primary form of ensuring the excellent family balance (Nichols & Tafuri, 2013). The strategic family therapy also applies unbalanced techniques during the therapy process such as using a planned and practical form of solving individual family member problems (Robbins et al., 2011). Thus, the models do not use problem-focused form of intervention to address dysfunctional behaviors within the family.

A structural family map can be used as a form of intervention in a family I encountered during my practicum. The family involves Mr. John and Mrs. Mary, where parental communication was minimal, and the woman was dominated. The major conflict within the family was ways of raising their children leading to a mixed-up family hierarchy.

Figure 1: The structural family map.

Family Therapies

It is recommended that the family should undergo structural family therapy to help improve their communication skills. The therapist should use case-specific creativity by using structural treatment to develop a structural family map for the intervention. Thus, a structural therapy will help build interdependence and communication mechanism between Mr. John and Mrs. Mary because the treatment helps to analyze dysfunctional families and find solution to the underlying issues

References

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. DOI:10.1111/famp.12025

Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403–414. DOI:10.1080/01926187.2012.727673

Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., … Szapocznik, J. (2011). Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance-using adolescents. Journal of Consulting and Clinical Psychology, 79(6), 713–727. DOI:10.1037/a0025477

Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research, 25(1), 121–133. DOI:10.1080/10503307.2013.856044

 

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The ACHE leadership competencies

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The ACHE leadership competencies

Leadership competencies are essential to the success of health care leaders. Many of these competencies are developed through on-the-job training, administrative fellowship programs, professional conferences, and graduate education. As a graduate student, it is important that you are able to assess your own leadership competencies and develop a professional improvement plan to hone your skills and become an effective industry leader. For this Discussion, you examine the ACHE leadership competencies and consider how you might improve your own leadership skills.

To prepare:

  • Review the document, ACHE Healthcare Executive 2019 Competencies Assessment Tool, which is in this week’s Learning Resources. Focus on the leadership competencies.
  • Reflect on whether you meet these leadership competencies, and consider your strengths and weaknesses.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post a cohesive response to the following:

Assess whether you meet the ACHE leadership competencies. Then, recommend at least three strategies to better meet competencies by building on your strengths and improving your weaknesses. Defend your recommendations. Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.

Read a selection of your colleagues’ postings. Consider how your colleagues’ postings relate to the information presented in the Learning Resources and to your own posting.

By Day 5

Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7. Expand on this Discussion by providing additional insights or alternative perspectives.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.). Chicago, IL: Health Administration.

  • Chapter 10, “Development and Execution of a Strategic Plan” (pp. 243-270)

Note: This chapter was assigned in Week 1. Please review it for this week.

  • Chapter 14, “Strategic Leadership” (pp. 323-338)
  • Chapter 15, “Implementing, Monitoring, and Evaluating Strategy” (pp. 339-359)

American College of Healthcare Executives. (2019). ACHE healthcare executive 2019 competencies assessment tool. Retrieved from https://www.ache.org/-/media/ache/career-resource-center/competencies_booklet.pdf

Bouaine, W., Charfeddine, L., Arouri, M., & Teulon, F. (2015). The influence of CEO departure and board characteristics on firm performance. The Journal of Applied Business Research, 31(2), 345–356.

Note: Retrieved from Walden Library databases.

Budak, F., & Kar, A. (2014). The importance of strategic leadership in healthcare management. IIB International Refereed Academic Social Sciences Journal, 5(15), 155–171.

Note: Retrieved from Walden Library databases.

Capasso, A., & Dagnino, G. B. (2014). Beyond the “silo view” of strategic management and corporate governance: Evidence from Fiat, Telecom Italia and Unicredit. Journal of Management & Governance, 18(4), 929–957.

Note: Retrieved from Walden Library databases.

Cossin, D., & Metayer, E. (2014). How strategic is your board? MIT Sloan Management Review, 56(1), 37–43.

Note: Retrieved from Walden Library databases.

Effelsberg, D., & Solga, M. (2015). Transformational leaders’ in-group versus out-group orientation: Testing the link between leaders’ organizational identification, their willingness to engage in unethical pro-organizational behavior, and follower-perceived transformational leadership. Journal of Business Ethics, 126(4), 581–590.

Note: Retrieved from Walden Library databases.

Green, A. E., Albanese, B. J., Cafri, G., & Aarons, G. A. (2014). Leadership, organizational climate, and working alliance in a children’s mental health service system. Community Mental Health Journal, 50(7), 771–777.

Note: Retrieved from Walden Library databases.

Schweitzer, J. (2014). Leadership and innovation capability development in strategic alliances. Leadership & Organization Development Journal, 35(5), 442–469.

Note: Retrieved from Walden Library databases.

Self, T. B., Matuszek, T., Self, D. R., & Schraeder, M. (2014). The weaver’s loom: A conceptual framework for facilitating transformational human resource management through the strategic integration of knowledge management and continuous improvement. Journal of Business and Management, 20(1), 87–104.

Note: Retrieved from Walden Library databases.

Shen, W., & Gentry, R. J. (2014). A cyclical view of the relationship between corporate governance and strategic management. Journal of Management & Governance, 18(4), 959–973.

Note: Retrieved from Walden Library databases.

Stout, L. R. (2015). Board governance: Reform-driven transformation and reexamination of fundamentals. Frontiers of Health Services Management, 31(4), 43–49.

Note: Retrieved from Walden Library databases.

Zastocki, D. K. (2015). Board governance: Transformational approaches under healthcare reform. Frontiers of Health Services Management, 31(4), 3–17.

Note: Retrieved from Walden Library databases.

SAMPLE ANSWER

The ACHE leadership competencies

The ACHE leadership competencies are primarily categorized into five areas including Business, Health and Healthcare Environment, Professional and Social Responsibility, Communication and Relationship Management, and leadership (American College of Healthcare Executives, 2019).  I meet most of the ACHE leadership competencies because I have always ensured equity in access to and delivery of care, commitment to share leading practices, integrity, educational standards, service improvement, and accountability and transparency.  I also find it difficult to apply basic business practices including collecting and evaluating relevant data that can be used to make effective decisions. However, I find it difficult exercising cultural sensitivity in communication when dealing with patients. I also have problems showing problem solving skills.  Therefore, committing to a lifelong and active learning of leadership practices and using the leadership practices executing daily activities is critical (Green, Albanese, Cafri, & Aarons, 2014).  Besides, focusing on equitable, just, and ethical behavior has helped to improve patient’s health outcomes.

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To build all ACHE leadership competencies I will have to enroll in a short business course in business to understand business concepts and theories that will help to manage information resources in the clinical databases and reporting system such as operational decision-support. Secondly, attending leadership forums, conferences, and workshops will give me an opportunity to identify areas of improvement including an opportunity to develop communication skills that would be critical in promoting professional roles and values, which are compatible with patient’s health and improvement of their health outcomes (Green, Albanese, Cafri, & Aarons, 2014).  Finally, I will use a personal educational strategy by using internet sources to find relevant books and journals that can help develop leadership and communication skills. Having skills that facilitate collaboration, team work, commitment, involvement and empowerment will contribute to improvement in healthcare.

References

American College of Healthcare Executives. (2019). ACHE healthcare executive 2019

competencies assessment tool. Retrieved from https://www.ache.org/-/media/ache/career-resource-center/competencies_booklet.pdf

Green, A. E., Albanese, B. J., Cafri, G., & Aarons, G. A. (2014). Leadership, organizational

climate, and working alliance in a children’s mental health service system. Community Mental Health Journal, 50(7), 771–777.

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Professional Obligations of Advanced Nurses

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Professional Obligations of Advanced Nurses

Advanced registered nursing graduates are entering the profession at dynamic time when roles and scope of practice are shifting based on developments in legislation and policy in response to the evolving needs of the health care system. Professional nursing organizations play an important role in making sure the perspectives of advanced registered nurses are heard, and in supporting nurse specialties in their efforts to expand their scope of practice and their full participation throughout the health care system.

For this assignment, you will conduct research on the current scope of practice for your specialty and efforts that are being made to expand that scope and the role of the advanced nurse in positively influencing the health care system. Write a 1,250-1,500-word paper that includes the following:

  1. A discussion of the scope of your future role as an advanced registered nurse- NURSE EDUCATOR, including any regulatory, certification, or accreditation agencies that define that scope.
  2. A discussion of three professional nursing organizations that you think are most influential in advancing the scope and influence of advanced nursing. Of these organizations, evaluate the one that you would most like to join. How do its goals and mission fit in with your worldview and philosophy of care? How might membership in this organization improve your practice?
  3. A discussion of a controversial or evolving issue that is most likely to affect your scope of practice or role in the next few years. How do you think this issue could influence the profession and other stakeholders, and why does it matters to the advanced registered nurse?

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

 

SAMPLE ANSWER

Future Scope, Role, and Professional Obligations

Introduction

Advanced registered nursing graduates are going into a nursing field that is changing fast. They need to have a good understanding of specific issues happening in their field and how they can affect their practice as well as how they can take advantage of them. The following analysis discusses the scope of an advanced registered nurse-nurse educator, the regulators, and certification as well as accreditation bodies in place. It also discusses three key professional nursing organization and why American Nursing Association ANA stands out. Finally, it explores the evolving issue of nurse shortage and how it is going to affect the profession. With the increased responsibilities, an advanced nurse needs to have a good understanding of the scope of their role, the organizations to join and evolving issues and how they will affect their practice.

Scope of Advanced Registered Nurse – Nurse Educator

As a nurse educator, one is expected to use their experience and knowledge to bring knowledge as well enthusiasm in the process of training and preparing the students to be great nurses for generations to come (Hall & Mast, 2015). The role of nurse educator includes facilitating learning as well as using assessment and evaluation strategies to gauge how ready the students are for a future career in nursing and guide them accordingly on their areas of weakness. Nurse educators also participate in curriculum design and also help in evaluation of program outcomes. They are also engaged in scholarship, work as agents of change and as leaders as well as work on ways to make nurse educator role even better. They are involved in major activities that help to produce competent nurses that are going to meet the ever-changing needs of the health care sector.

Professional Obligations of advanced nurses

A lot of regulatory activities for nurse educators are conducted at the state level although the National Council of States Boards of Nursing also is involved. The regulators use the provision of the Nurse Practice act to come up with their regulatory guides (Rose & Regan-Kubinski, 2014). A case would be an educator working in Texas, the Texas state board of Nursing provides licensing, regulation, and monitoring or all the licensed nurse in the state including educators. For accreditation, the Accreditation Commission for Education in nursing which is a non-governmental organization accredits the educational programs and educators. The commission on Collegiate Nursing Education is also involved on matters of quality and integrity of programs offered and their mandate include regulation of the educators themselves.

Professional Obligations of advanced nurses

Nationally, the most famous accreditation body for nurse educators is the national league of nurses.it established the National League for Nursing Accrediting Commission with the primary role of accreditation (Rose & Regan-Kubinski, 2014). The commission has since changed its name to Commission for Nursing Education Accreditation CNEA. The commission describes its accreditation activities as guided by its parent body’s core value of diversity, integrity, and excellence. NLN is also involved in the certification programs through the Academic Nurse Educator Certification program. It offers two nurse educator certifications which are certified nurse educator and certified academic nurse educator. For the certified nurse educator, they facilitate learning by teaching, evaluating, and curriculum design. Certified academic nurse educators facilitating learning for students using clinical components of the learning program.

Nursing Organizations

There exist many professional nurses’ organizations for one to choose. One of those organizations is the American Nurses Association and it is one of the oldest and largest organizations in the in the country. Members receive many benefits from joining such as accessing an online library with various academic sources that relate to nursing (Mathews, 2015). It can be very helpful especially for those nurses that are involved in study or research activities. Members also get access to webinars on various topics that cover various areas of their profession. Members also get to save money on areas of certification and publications as they receive special offers. ANA is also credited with the development of the code of ethics for nurses with interpretive statement which is a huge source of guidelines on the steps that nurses need to make in ensuring that they operate ethically and helps to promote the scope of advanced nursing.

A second organization to consider is the hospice and palliative nurses association. The organization focuses mainly on hospice and palliative care as its name suggests. Nurses work in areas where dealing with death can be an often occurrence and they find being a member of this organization helpful as members support each other (Catallo, Spalding, & Haghiri-Vijeh, 2014). It provides a strong support system for nurses especially during the tough times when they lose patients or are exposed to a lot of human suffering. The organization allows members to have access to various professional journals that touch on areas of hospice and palliative care. Most of the members that join become either mentees or are mentors to others. Other benefits that members get include training on leadership skills and learn on approaches to better deal with patients and colleagues at work.

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Finally, nurses can also choose to be members of national league of nurses. It is an organization operating in the entire USA and its members are those in nursing education and faculty nurses. Among some of the benefits that members receive and which can help promote the work of advanced nursing is helping with faculty development (Catallo, Spalding, & Haghiri-Vijeh, 2014). It also allows members to network and provides testing services as well as providing grants for nurse involved in research. It is a good organization to consider for those in the teaching area mainly because it focuses on helping them become better educators. It is also one of the only few organizations that focus exclusively on the education sector and therefore gives that undivided attention on one specific area.

Professional Obligations of advanced nurses

The organization that is most interesting of the three is the ANA. There are several issues that makes it stand out key of them being ethics. As the developer of the code of ethics used in nursing work, stands for great issues that a lot of modern nurses would want to associate with (Mathews, 2015). As a nurse, it is natural for one to be attracted to ethics and human rights. The organization has it as one of its core areas and even has a center of ethics and human rights. Being a member of the organization therefore allows one to be a part of a group of people that are doing something to make the world better in matters of health but also ensure that human rights are protected and promoted.

Nursing Paper Help

Being a member of ANA would also promote a nurse’s practice through provision of free development resources and webinars. Field of nursing is dynamic with new evidence coming in all the time that helps make nurses more effective in their work (Mathews, 2015). Having an organization that allows nurses to have access to these resources will mean that such a nurse will always be in the know and have a chance to continuously improve him/herself.

Evolving Issue

An issue that is emerging and that is likely to impact the scope of practice for advanced registered nurse is nursing shortage. More and more people a living longer and needing care that only nurses can provide. The population is also growing and the demand for healthcare is also growing. Between years 2020 and 2030, the population of Americans older than 65 is expected to increase by close to 20 million people (“U.S. Nursing Workforce in 2018 and Beyond,” 2018). This is most likely to result in increased demand for nurses with research showing that by year 2026, nurses will represent one of the three paths of career that will see the biggest growth in new job openings.

Professional Obligations of advanced nurses

One of the impacts of the issue is that there will be shortages and the existing nurses will be required to work for longer hours and do a lot more work than they would have had to do. This should matter to advanced registered nurse because a lot of them will be having supervisory responsibilities. They will be required to come up with approaches that will help offset the problem and ensure that Americans continue to receive the nursing care that they deserve. Other stakeholder will also need to be involved such as government considering allowing foreign trained nurses to have easier chance of working in the USA

Conclusion

Advanced registered nurses-nurse educator has the responsibility of providing the USA with nurses with the right skills and abilities to perform their duties. However, the existing regulatory, certification and accreditation agencies are doing a great job of assisting with this goal. In America there exists numerous professional nursing organizations to choose from. However, ANA easily stands out from the rest mainly because if its stand on issues of ethics and human rights. In the field of nursing, it is expected that there will be huge shortage in nurses before 2030. Professionals and stakeholders need to come up with approaches to fix the situation while at the same time making do with the limited numbers of professionals’ nurses at their disposal. The future of nursing has its challenges but advanced registered nurses will hopefully be a part of the solution to these problems.

References

Catallo, C., Spalding, K., & Haghiri-Vijeh, R. (2014). Nursing Professional Organizations. SAGE Open, 4(4), 215824401456053. doi:10.1177/2158244014560534

Hall, N., & Mast, M. (2015). We Want You: Nurse educators. Nurse Education in Practice, 15(5), 339-340. doi: 10.1016/j.nepr.2015.05.003

Mathews, J. (2015). Role of Professional Organizations in Advocating for the Nursing Profession. OJIN: The Online Journal of Issues in Nursin, 17(1). Retrieved from DOI: 10.3912/OJIN.Vol17No01Man03

Rose, L., & Regan-Kubinski, M. J. (2014). Update on Advanced Practice Registered Nurse Regulation: Licensure, Accreditation, Certification and Education. Archives of Psychiatric Nursing, 24(6), 440-441. doi: 10.1016/j.apnu.2010.08.003

The U.S. Nursing Workforce in 2018 and Beyond. (2018). Journal of Nursing Regulation, 8(4), S3-S6. doi:10.1016/s2155-8256(18)30015-2

 

 

 

 

 

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Foundations of Evidence Based Practice

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Foundations of Evidence Based Practice

Write a 4 page APA paper addressing the following questions

1. Identify a project from a department at your place of employment that demonstrates a commitment to an improvement in patient care.  (Prefer pertaining to an inpatient PEDIATRIC UNIT)

2. Why is this project/study important?

3. What role would an APN play in this project?

4. Identify a PICOT question that you could use to guide the research of the identified problem.

5. Provide 5 databases that you might use for your research,and give a short description of each.

6. Provide 15 – 20 PEER reviewed references in APA format.

7. What barriers do you foresee in implementing this project?

Requirements for Paper:

  • APA Format, 6th
  • 4 pages in length, not including the title and reference page. (points will be deducted for papers over or under required length)

Note from teacher:   4 pages in length, not including the title and reference page. (points will be deducted for papers over or under required length)    PEER reviewed references do not go in the body of the paper but in the reference section.  That should give you enough space for the paper.  You do not have to incorporate all of the references into the paper. You just need to provide a list of appropriate references that you would use in researching the paper.

 

SAMPLE ANSWER

Foundations of Evidence Based Practice

Pediatric department of the health institution I currently work in has come up with a project to improve patient outcome through interventions in communication. The project management team will implement the plan through the use of a communication system that can put all the health caregivers on the same page (Berwick, 2016). The new communication system will include the use of whiteboards on the bedsides to indicate the daily objectives, the use of a dashboard for performance, and a note format for the daily progress of the residents (Lotz, Daxer,  Jox, Borasio, & Führer, 2017). The project will give families and patents who are excluded from rounds the courage to ask questions as well as express their concerns about the care plan.

Foundations of Evidence Based Practice

Why the Project is Important

Most of the breakdowns of teamwork and communication errors result in reduced patient outcome, increased costs, and prolonged losses in healthcare facilities. To solve these issues, the children’s department aims at improving communication to decrease medical errors during daily rounds (Katkin, et al. 2017). The project will begin by training healthcare workers on the rounds basics to help them conceptualize easily on its implementation (Gathara, et al. 2015). The project expectations are to increase the satisfaction of health care providers by more than 80 %. Besides, the project will be crucial in improving teamwork among health care providers, especially nurses, by reducing the number of nurses who multitask on bedsides during daily rounds (Hill, Knafl, &Santacroce, 2018). I will also reduce interruptions during presentations of the patients.

The role that an APN play in the project

Advanced Practice Nurses are those nurses with advanced certification and training with mostly a master’s degree and doctorates. Because of their advanced knowledge, APNs will play a crucial role in the implementation of the project. To begin with, the information on the bedside daily whiteboards will be verified by the APNs to ensure its high level of legitimacy in enhancing the highest quality of the patient outcome (Swan, Ferguson, Chang,  Larson&Smaldone, 2015).Besides, APNs will be involved in the project planning to ensure that the plan will be sound in meeting the goals and objectives of the project (Scotten, Manos,  Malicoat, & Paolo, 2015). APNs can work in the albescence of a doctor and other health practitioners because of their danced knowledge in nursing practice. Therefore, they will be useful in case of emergencies (Bryant‐Lukosius, et al. 2016). APNs will also have the role to educate and mentor other health practitioners on the best ways to implement the project primarily through teamwork and quality communication skills among healthcare professionals in the institution.

Foundations of Evidence Based Practice

PICOT question

Will the use of whiteboards on the bedsides to indicate the daily objectives, the use of a dashboard for performance and a note format for daily progress of the residents improve patient care within one year of project implementation?

Databases I might use for my research

  1. CINAHL Plus

CINAHL Plus is an advanced version of CINAHL index, and it provides a vast number of cited and full-text references and records. It includes nurse educators, nurses, researchers, students, and other health professionals with advanced literature in healthcare practice(Glanville, Dooley, Wisniewski, Foxlee, & Noel‐Storr, 2019). It provides easy access to high content that dates back to the late 1030s and a considerable number of healthcare journals. The database covers a wide variety of topics such as medicine, nursing, health sciences, biomedicine, complementary medicine, allied health disciplines, and consumer health, among others. The database would help conduct my search on how to improve communication to increase the quality of patient care.

Foundations of Evidence Based Practice

  1. Cochrane Library

Cochrane Library is an excellent source of quasi-randomized and randomized reports on controlled trails. It also provides other details such as the source, year of publication, and the author (English, Hillier & Lynch, 2017). However, they only give the summary of the report mostly through abstracts; that is, they do not provide the full text of the report. Cochrane Library will be a useful database for finding evidence-based information.

  • MEDLINE

MEDLINE is a library premier databases for medicine. The database provides the names of the authors and bibliographical citations and abstracts of the authors from about 4700 and above biomedical journals that are published in the United States and other countries (Duffy, de Kock, Misso, Noake, Ross, &Stirk, 2016). Some of the main topics covered in MEDLINE include nursing, medicine, veterinary, dentistry, pre-clinical sciences, and allied health. MEDLINE will be an accessible database when doing my research on the project to improve the quality of patient care.0

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  1. Nursing Reference Plus

Nursing Reference Plus is a database that is designed specifically for nurses. It educates nurses about nursing best practices and evidence-based practice(Oermann, et al. 2018). It mainly ensures that nurse educators, nurses, nursing students, and newly graduated nurses in the field have quick and easy access to the recent information in health practice to provide a maximum level of quality patient care.

  1. V) EMBASE

Embase is a pharmacological and biomedical database that contains more than 20 million articles and records that are published across the world (Bramer, Giustini,  Kleijnen, & Franco, 2018). It provides abstracts, citations, and indexing from peer-review journals and biomedical articles. Most of the quotes have summaries that are written by the authors. Some of the main topics covered by EMBASE include pediatrics, oncology, general clinical medicine, dermatology, and intensive care.

Barriers in implementing the project

Some of the barriers that may make the implementation of the project include; one, lack of full cooperation from the healthcare team members due to such factors as the conflict of interest or unwillingness to act according to the requirements of the project.

Foundations of Evidence Based Practice

Second, the costs involved incomplete implementation of the project may be higher, especially in redesigning the communication system in the institution. The administration of the institution may be reluctant in providing finances for designing bedside whiteboards and paying extra fees to the project management team (Friedman, Howard, Shaw, Cohen, Shahidi& Ferrante, 2016). This may hinder the successful implementation of the project.

Conclusion

Improving patient outcome through communication intervention is critical in the children’s department to improve communication among physicians and decrease medical errors during daily rounds. Developing and implementing a plan to facilitate communication between physicians and nurses will help reduce medical errors that result in reduced patient outcome, increased costs, and prolonged losses in healthcare facilities. APNs will play a crucial role in the implementation of the project, such as project planning and during education and mentoring program.  Databases such as CINAHL Plus, Cochrane Library, MEDLINE, Nursing Reference Plus, and EMBASE will provide more evidence on the interventional strategy including its application and importance. The major barriers during the implementation of the project will involve lack of full cooperation from the healthcare team members and the involved incomplete implementation of the project.

 

References

Berwick, D. M. (2016). Era 3 for medicine and health care. Jama, 315(13), 1329-1330.doi:

10.1001/jama.2016.1509.

Bramer, W. M., Giustini, D., Kleijnen, J., & Franco, O. H. (2018). Searching Embase and MEDLINE by using only major descriptors or title and abstract fields: a prospective exploratory study. Systematic reviews, 7(1), 200.doi: 10.1186/s13643-018-0864-9.

Bryant‐Lukosius, D., Spichiger, E., Martin, J., Stoll, H., Kellerhals, S. D., Fliedner, M., … & Schwendimann, R. (2016). Framework for evaluating the impact of advanced practice nursing roles. Journal of Nursing Scholarship, 48(2), 201-209.doi: 10.1111/jnu.12199.

Duffy, S., de Kock, S., Misso, K., Noake, C., Ross, J., & Stirk, L. (2016). Supplementary searches of PubMed to improve currency of MEDLINE and MEDLINE In-Process searches via Ovid. Journal of the Medical Library Association: JMLA, 016 Oct; 104(4): 309–312.doi: 10.3163/1536-5050.104.4.011

English, C., Hillier, S., & Lynch, E. (2017). Cochrane Corner. Stroke, 48, e275-e276. doi: 10.1002/14651858.CD007513.pub3.

Friedman, A., Howard, J., Shaw, E. K., Cohen, D. J., Shahidi, L., & Ferrante, J. M. (2016). Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators’ perspectives. The Journal of the American Board of Family Medicine, 29(1), 90-101.  doi: 10.3122/jabfm.2016.01.150175.

Gathara, D., Nyamai, R., Were, F., Mogoa, W., Karumbi, J., Kihuba, E., … & Todd, J. (2015). Moving towards routine evaluation of quality of inpatient pediatric care in Kenya. PloS one, 10(3), e0117048.doi: 10.1371/journal.pone.0117048.

Glanville, J., Dooley, G., Wisniewski, S., Foxlee, R., & Noel‐Storr, A. (2019). Development of a search filter to identify reports of controlled clinical trials within CINAHL Plus. Health Information & Libraries Journal, 36(1), 73-90.doi: 10.1111/hir.12251.

Lam, M. T., De Longhi, C., Turnbull, J., Lam, H. R., &Besa, R. (2018). Has Embase replaced MEDLINE since coverage expansion?. Journal of the Medical Library Association: JMLA, 106(2), 227. doi: 10.5195/jmla.2018.281.

Lotz, J. D., Daxer, M., Jox, R. J., Borasio, G. D., & Führer, M. (2017). “Hope for the best, prepare for the worst”: A qualitative interview study on parents’ needs and fears in pediatric advance care planning. Palliative medicine, 31(8), 764-771.doi: 10.1177/0269216316679913.

Katkin, J. P., Kressly, S. J., Edwards, A. R., Perrin, J. M., Kraft, C. A., Richerson, J. E., … & Wall, L. (2017). Guiding principles for team-based pediatric care. Pediatrics, 140(2), e20171489.doi: 10.1542/peds.2017-1489.

Oermann, M. H., Nicoll, L. H., Chinn, P. L., Ashton, K. S., Conklin, J. L., Edie, A. H., … & Williams, B. L. (2018). Quality of articles published in predatory nursing journals. Nursing Outlook, 66(1), 4-10. doi: 10.1016/j.outlook.2017.05.005.

Scotten, M., Manos, E. L., Malicoat, A., & Paolo, A. M. (2015). Minding the gap: Interprofessional communication during inpatient and post discharge chasm care. Patient Education and Counseling, 98(7), 895-900.doi: 10.1016/j.pec.2015.03.009.

Swan, M., Ferguson, S., Chang, A., Larson, E., &Smaldone, A. (2015). Quality of primary care by advanced practice nurses: a systematic review. International Journal for Quality in Health Care, 27(5), 396-404. doi: 10.1093/intqhc/mzv054.

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Health Legislation and Advocacy

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Health Legislation and Advocacy

  • Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

  • Determine the legislative intent of the bill you have reviewed.
  • Identify the proponents/opponents of the bill.
  • Identify the target populations addressed by the bill.
  • Where in the process is the bill currently? Is it in hearings or committees?
  • Is it receiving press coverage?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

  • Advocate a position for the bill you selected and write testimony in support of your position.
  • Describe how you would address the opponent to your position. Be specific and provide examples.
  • Recommend at least one amendment to the bill in support of your position.

 

SAMPLE ANSWER

Health Legislation and Advocacy

Part 1: Legislation Comparison Grid

Health-related Bill Name Strengthening the Healthcare Fraud Prevention Task Force Act of 2019 (H.R. 525).
Description  This bill is focused on amending the title XI of the Social Security Act with the aim of guiding the Secretary of Health and Human Services to create private-public collaboration with the purpose of identifying fraud, waste, and abuse in the healthcare system (Govtrack, n.d.).

 
Federal or State? Federal
Legislative Intent The bill entails statutory authority and requirements to establish an effective collaboration between government agencies, insurance plans, healthcare organizations, and law enforcement. This measure is to ensure that fraud, abuse, and waste in the healthcare system are detected. The collaboration is required to be developed under the Health Care Fraud and Abuse Control Program. This program is overseen by the Department of Justice and the Department of Health and Human Services (Govtrack, n.d.).

 

The bill intends to ensure that collaboration among healthcare parties involve promotion of data sharing to ensure that there is sufficient information to make a decision. Moreover, it focuses on ensuring that there is sufficient analysis of data to identify fraudulent activities. It also enforces the requirement to refer criminal activities to the Department of Justice. Another intention is to ensure that sufficient outreach and education is enhanced in the healthcare system (Govtrack, n.d.).

 

According to the sponsor, Greg Walden, the purpose of the new partnership is to ensure that voluntary sharing of data is done in all areas of the healthcare system. He also adds that the proposed bill transfers all functions, assets, and administrative activities of the existing partnership to the new collaboration (Govtrack, n.d.).

 
Target Population Secretary of Health and Human Services, Department of Justice, government agencies, insurance firms, healthcare organizations, and law enforcement.
Status of the bill (Is it in the hearings or committees? Is it receiving press coverage?) The bill is in the hearing. It has passed the House of Representatives and awaits hearing in the Senate for consideration. The bill is receiving press coverage with the media focusing in attaining opinion from the public. The press is also providing information on the legislators’ views of the bill.
General Notes/Comments In order for the healthcare system to establish a suitable coordination, proper partnership plans need to be put in place. This move requires the establishment of partnership education among different agencies in the healthcare system. Failure to engage in this change means that vices such as fraud will continue in the system. As a result, efficiency in one sector may not improve the healthcare services in the country. Therefore, passing the bill will ensure that drawbacks in healthcare are controlled fully.

 

Part 2: Legislation Testimony/Advocacy Statement

Healthcare services in the United States are viewed to be among the most costly in the world.  While this rise is partly due to the quality of services delivered, it is opined that it is majorly caused by abuse and fraud in the system. For instance, Medicare professionals are observed to be aware of fraud during the process of developing insurance plans. They hand over their information to new clients while hoping for illegitimate claims and deception. From this perspective, it can be postulated that fraud is a major flaw in the healthcare system and has made the industry to reduce the effectiveness of its services. In that regard, it is very important to control fraud through efficient partnership among various healthcare agencies (van Capelleveen et al., 2016).

Health Legislation and Advocacy

The introduction of the Healthcare Fraud Prevention Taskforce act is observed to have led to a significant reduction of fraud in various healthcare departments. The act has ensured that all the activities are accounted for through suitable provision of data. Since 2018, there has been a suitable link between the Secretary of Health and Human Services and third parties. Despite these achievements, it is viewed that there is inefficient partnership between the Department of Health Services and the Department of Justice. This depiction is seen in the low conviction rate of offenders in the healthcare system. Therefore, it can be argued that while the original act has been positively influential in reforming the healthcare system, there are still some gaps that it needs to reduce to attain suitable results. While there will be no direct effect on direct spending by clients, the act has been able to codify existing healthcare agency practice (Congregational Budget Office, n.d.).

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In order to bring better understanding the importance of fraud prevention act, it is essential to reveal the impact of its benefits. The bill amended the Social Security Act by providing a public-private partnership in the healthcare sector. Prior to the ct, there was little coordination between the agencies, thereby limiting their efficiency.  Moreover, the development of a contract between the Health Department and third parties is viewed to have limited the increase of fraud in the system. From the above depiction, it is easy to understand that the bill is more beneficial to healthcare system as it focuses in one of the major challenges in the industry (Govtrack, n.d.).

To ensure that there is a better control of fraud, in the healthcare system, there is a need to amend the time required for making reports. Currently, the bill proposes that the Secretary of Health should make a report every two years. This period is long given that the review of activities can be done within a year o operation. Therefore, reporting should be done on a yearly basis to increase efficiency in fraud control (Govtrack, n.d.).

 

References

Congregational Budget Office (n.d.). H.R. 6753: Strengthening the health care fraud prevention

            task force act of 2018. Retrieved from https://www.cbo.gov/publication/54552

Govtrack (n.d.). H.R. 525: Strengthening the health care fraud prevention task force act of 2019.

Retrieved from https://www.govtrack.us/congress/bills/116/hr525

Van Capelleveen, G., Poel, M., Mueller, R. M., Thornton, D., & van Hillegersberg, J. (2016).

Outlier detection in healthcare fraud: A case study in the Medicaid dental domain. International Journal of Accounting Information Systems, 21, 18-31.

 

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Informatics Proposal

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Informatics Proposal

  • Review the concepts of technology application as presented in the Resources.
  • Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

  • Describe the project you propose.
  • Identify the stakeholders impacted by this project.
  • Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.
  • Identify the technologies required to implement this project and explain why.
  • Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

 

SAMPLE ANSWER

Informatics Proposal

Electronic Health Records

Electronic Health Record refers to a tool of documentation that produces data which is useful in evaluating the quality of care, enhancing the safety of patients, measuring the needs of the staffs, and maximizing efficiency. The implementation of Electronic Health Records reduces the costs incurred by the patients and the health organization. This paper proposes the use of electron health records as a documentation tool to ensure accurate patient information which is necessary in making discharge, admissions and transfer decisions.

Informatics Proposal

Stakeholders that will be Impacted by the Project

The main stakeholders that will be affected by the project on the implementation of Electronic Health Records in the organization will be the nurses, physicians, pharmacists, and patients. Nurses will find it easy to signal and monitor when patients need to be discharged. Physicians will be able to prioritize rounding quickly (Ben-Assuli, 2015). The project will also impact on the pharmacists where the filling processes will be improved as well as the efficiency of discharge. The most significant impact will be on the patients since there will be no delays in discharge which results in higher costs. Thus, the implementation of the medical health records will contribute in provision of quality care leading to positive outcomes in patients.

Patient Outcome the Project is Aimed at Improving

The management of bed capacity in health care institutions has been a big challenge, which has resulted in inefficient discharge leading to slow care, high costs and also affects the flow of the patients.  Most hospitals focus on discharging a particular percentage of patients to free up hospital beds. However, the inefficiencies of bed capacity management system led to delayed discharges, transfers, and admissions (Ben-Assuli, 2015). As a result, there have been unnecessary lengths of stay in the hospital, which result in increased costs for every person involved, including the health organization. Therefore, the project team will develop a criterial for standard discharge for 15 inpatient diagnoses according to the expert consensus and available evidence. Then the information will be entrenched in the Electronic Health Record System to enhance a new process of discharge that will be specifically focused on the needs of the patients. The patients will be discharged when medically ready but not when beds are needed.  This will be a sign of the hospital’s commitment to the provision of quality patient care.

Informatics Proposal

Besides, by the implementation of the project, the inefficiencies related to discharges, the costs savings for patients and the organization will be enhanced. More beds will be available for the admission of more patients. Thus, the implementation of the medical health records will contribute in provision of quality care leading to positive outcomes in patients. Besides, the cost of care will be reduced by decreasing the length of stay at the hospital beds. The project will have estimated results of more than 40% percent of patients who are discharged after 3 hours. It also estimates approximately 6 million dollars cost savings.

The Technologies Needed to Implement the Project

Some of the techniques that will be necessary for successful implementation of the project will include:

  1. Configuration of software

The project team will work with the health IT to configure the Electronic Health Record to meet the necessary security measures. This will require the assessment of HIPAA risks (Lavin, Harper, & Barr, 2015). Customization of the software will also be required by developing a list of the elements built such as computerized order entry, demographics which are moved from practice management software, medication management systems, default patient history and discharge that is updated with new consents and codes.

  1. Server and Internet

Internet and server will be required for signaling the nurses on the patient needs. It will ensure that information is passed on effectively to minimize inefficiencies in hospital discharge, admissions as well as transfers.

  • Transfer data

Preparation of checklist of information needed to be transferred to the new Electronic Health Record system will be necessary. The list will upload all the past medical patient medical history, demographics, and discharge information in the new HER system (Lavin, Harper,& Barr, 2015).

Project Team Members and their Roles

The project team will be composed of the clinical members, lead physician, project manager, the super lead user and the nurse informatics. The clinical members will have two main roles, that is, bringing the clinical challenges to the project implementation team and teaching colleagues the skills of the new Electronic Health Record system (Daly, 2015). The lead physician will be in practice. He will also guide the health institution throughout the process of implementation by acting as a link between administrative staff, the technical team, and the frontline users.

The project manager will closely work with all the staff and the EHR vendor to ensure that the project stakeholders are acting according to their timeline, manage daily issues, and evaluate the progress of the project.

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The super lead user will act as an expert in the new Electronic Health Record system. His work will be to configure the new EHR system, order sets, create standard operating processes, and create templates for addressing the issues that frontline users raise.

Nursing informaticist will be critically required in the project team. They are specialists in defining, managing, identifying, and communicating data, knowledge, and the information in nursing practice. Nursing informaticist will play a vital role in designing, implementation, evaluation, development, and selection of the Electronic Health Record system (Daly, 2015). They will also play a significant role in the improvement of the new Health Electronic Health System on electronic devices for patient care (Rojas & Seckman, 2014). They will also be involved in the optimization and maintenance of the EHR system (Rojas & Seckman, 2014). The nurse informaticist will also play the role of educating other nurses and health professionals in the organization on the skills required for successful implementation of the new Electronic Health Record System to minimize inefficiencies related to discharges, admissions, and transfers.

Informatics Proposal

Conclusion

Electronic Health Record is useful in evaluating the quality of care, enhancing the safety of patients, measuring the needs of the staffs, and maximizing efficiency. The implementation of Electronic Health Records in the organization will result in more efficient patient discharge information to minimize delays which prolong the time of stay at the hospital beds. As a result, the costs incurred by the patients and organization will be reduced. Also, the implementation of the project will give space for new patient admissions. The overall aim of the project is to increase the quality of patient outcome. Thus, the implementation of the medical health records will contribute in provision of quality care leading to positive outcomes in patients.

 

References

Ben-Assuli, O. (2015). Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments. Health Policy, 119(3), 287-297.doi: 10.1016/j.healthpol.2014.11.014.

Daly, P. (2015). Clinical nurses lead the charge with EHR. Nursing 2019, 45(10), 25-26.doi: 10.1097/01.NURSE.0000471426. 47075.d2

Lavin, M. A., Harper, E., & Barr, N. (2015). Health information technology, patient safety, and professional nursing care documentation in acute care settings. Online J Issues Nurs, 20(2).DOI: 10.3912/OJIN.Vol20No02PPT04

Rojas, C. L., & Seckman, C. A. (2014). The informatics nurse specialist role in electronic health record usability evaluation. CIN: Computers, Informatics, Nursing, 32(5), 214-220. DOI:10.1097/CIN.0000000000000042

 

 

 

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The Creation of Hope

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The Creation of Hope

Chapter 11 in the textbook emphasizes the importance of hope and possibility in the counseling process. Clients come into counseling having tried many different solutions that have failed. In many cases, they are discouraged and hopeless about resolving their problems in a way that creates a better life.

The Creation of Hope

In some cases, clients face significant barriers of physical disability or illness, histories of trauma, occupational disadvantages, or addictions. Throughout the counseling process the counselor attempts to create hope.

Write a 750-1,000-word paper discussing the following:

1.      How can the counselor create a sense of hope and possibility for the client?

2.      How does establishing goals help clients to develop hope?

3.      What steps can the counselor take to help clients identify goals for change?

4.      What strategies can a counselor utilize to help clients commit to change?

Include 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 required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

SAMPLE ANSWER

Introduction

Illness, and especially the type that requires psychotherapy brings with it a need for hope.  The term hope refers to an emotion that involves positive feelings about the future whether in short-term or long term basis. It is characterized by high motivation and optimism. Patients undergoing therapy need messages that give them a reason to find hope and alleviate the hopelessness that they may be experiencing. This is because; by the time patients go for counseling, many of them have tried several options that may have been futile.  Therefore, during counseling, hope serves the purpose of envisioning a future that they would like to take part in and consequently, it forms a central feature in counseling practice (Larsen et al. 2018).

The Creation of Hope

How can the counselor create a sense of hope and possibility for the client?

According to Edey and Jevne, (2003), people seek various solutions including internet searches, confiding in religious people, and friends, reading books among others, a situation that makes hopelessness and pessimism to set in. Therefore, mental health practitioners come in to help them find solutions and achieve inner peace, and this requires them to hold a sense of hope (Bartholomew et al. 2019). There are several ways that mental health practitioners can infuse hope to their patients. One way would be to examine the circumstances under which the client was symptom-free and invite them to process some of the ways that they have been able to overcome the challenges that they have experienced in the past. The main aim of this action is to enhance resilience and identify sources both internally and externally that would be beneficial In encouraging them to get a fighting spirit by focusing on their strengths.

The Creation of Hope

It is also necessary for the clinician to recognize and consequently validate the efforts that are being put in by the client. This action is ideal as it serves to re-instate a feeling of hope. If the clients are made to write down the baby steps, they will be able to recognize that they are making progress and consequently gain hope. Also, clients can be encouraged to realize that they possess choices, power as well as wisdom and therefore they are capable of helping themselves. In doing so, they take out the past feelings and replace them with hope. Therefore hope forms the basis of the therapeutic relationship and is integral to the very aims and motivation of counseling

How does establishing goals help clients to develop hope?

Hope is an emotion-driven by a specific desired outcome, which is unlikely to occur. One thing that is very unique about hope is that it tends to direct people and encourage them to remain committed to their goals and take actions toward achieving them despite setbacks and obstacles. Setting goals can be used to help clients develop hope mainly because goal setting increases positivity and hope is involved with positive emotions regarding the future (Larsen et al.2018). When people have goals, they desire to achieve them and therefore they develop the strategies that are useful in helping them meet the goals. One effective thing about setting goals is that people tend to visualize their goals coming into fruition and this makes hope and positivity to set in. making realistic goals and sub-goal, therefore, goes a long way in helping the clients develop hope (O’Hara, 2013).

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What steps can the counselor take to help clients identify goals for change?

The process of psychotherapy has many goals and includes facilitating behavior change, promoting decision-making process, enhancing the ability of the client to cope with the issue as well as enhancing the ability to build and maintain relationships. These goals become a guideline for the therapist when helping the patient in making efforts towards a positive change. One step that the therapist needs to undertake is to analyze the goal and establish the impact of the therapy, the available barriers, the expectations and motivations for making the changes (Brewer, 2016). The first step is to identify the goal and choose the starting point while establishing the steps that are essential in achieving the goal. Once the starting point is established, then the process begins. It is necessary to ensure that the goals are specific and challenging but they should not be impossible to achieve. The goals may then be divided into sub-goals and alternatives to achieving the goals identified.

The Creation of Hope

What strategies can a counselor utilize to help clients commit to change?

One of the strategies that can be employed to help the clients maintain their commitment to change is to employ hope focused strategies.  Hope-focused counseling requires a conscious decision on the part of the therapist to incorporate hope into the counseling session. Interventions that foster hope include establishing a therapeutic relationship, reframing the situation or helping the client envision a new perspective, empowering the patients and helping the patients utilize the available resources (Brewer, 2016).  Also, the therapist should ensure that the main goal is broken down into manageable chunks that would be easier to achieve, for example, one may strive to re-join the gym and do regular exercise, or socialize more. In line with this, the therapist should ensure that they remain compassionate and also identify and recognize the efforts that are made by the clients hence motivating them to do more. Tracking the progress is also a significant strategy and this may be accompanied by encouraging the client to write down the reason why they should stick to the goal as this may positively boost the motivation.

The Creation of Hope

Conclusion

Psychotherapy is necessary and mainly the clients that undergo it have lost hope or suffer from conditions such as depression that are characterized by the feeling of hopelessness. Therefore, hope is necessary for the counseling process mainly because it is instrumental in ensuring positivity as people look forward to their goals coming to fruition. Hope is necessary for both the clients and the therapists hence efforts should be made to ensure that the therapists also remain hopeful. One way to instill hope is to set goals and come up with strategies that will ensure that the clients stick to their commitment to change.

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References

Bartholomew, T. T., Gundel, B. E., Li, H., Joy, E. E., Kang, E., & Scheel, M. J. (2019). The meaning of therapists’ hope for their clients: A phenomenological study. Journal of counseling psychology, 66(4), 496. http://dx.doi.org/10.1037/cou0000328

Brewer, A. B. (2016). A Qualitative Study on Clients’ and Therapists’ Perceptions of Therapeutic Interventions that Foster Hope.

Larsen, D. J., Stege, R., King, R., & Egeli, N. (2018). The hope collage activity: an arts-based group intervention for people with chronic pain. British Journal of Guidance & Counselling, 46(6), 722-737. doi.org/10.1080/03069885.2018.1453046

O’Hara, D. (2013). Hope in Counselling and Psychotherapy. Sage. Doi: 10.4135/9781446269992.

 

 

 

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Experiential Interventions

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Experiential Interventions

Read “Topic 6: Vargas Family Case Study.” Develop three experiential interventions that you would use with the Vargas family.

It’s time to get creative! You have noticed that the Vargas family struggles with emotional expression, particularly with congruent emotional expression (i.e., words, actions, and body language being congruent). Using the Experiential Interventions Template, create three unique experiential interventions that you would use with the family and describe how they would be helpful to the family. It may be helpful to refer to the library articles for ideas and inspiration, but do not copy existing interventions. Be sure to fully address each section in the template for each of the three interventions in your paper:

1. Title of your Intervention

2. General Goals

3. Materials Needed

4. Advance Preparation Needed

5. Description of the Intervention with the Vargas family

6. Discussion of the Benefits of the Intervention to the Vargas Family

7. References (if any)

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center.

 

SAMPLE ANSWER

PCN-521 Topic 6: Experiential Interventions

Intervention 1

Title of your Intervention:

Act and talk it out

General Goals:

-The main goal of this intervention is to allow the direct sharing of messages between family members.

-Additionally, the intervention aims to heighten emotional experiences between the Vargas family members

-enactments will redesign new interactions among the family members

-the intervention will create positive cycles of responsiveness

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Materials Needed:

-chairs

Advance Preparation Needed:

Critical knowledge of the family’s history will help the therapist know which family members have a problem with expressing their emotions. Additionally, an analysis of successful implementation of previous enactments in family therapy will help the therapist to customize activities for the Vargas family.

Description of the Intervention with the Vargas family:

The therapist will direct the family members to interact with each other to be able to observe presenting problems. Since every member of the family has narrated how they feel about each other, in this intervention, they will tell each other how they feel. For example, Elizabeth is disappointed in the way Bob counteracts her decisions about disciplining Frank. Instead of telling the therapist, Elizabeth should recreate the scenario during the picnic where she felt disrespected and tell Bob about it.

Discuss the benefits of the Intervention to the Vargas family:

-it will help them express their emotions better

-it will reduce stress

Citation for references (if any):

(Pagano, 2018)

Intervention 2

Title of your Intervention:

Soccer for the mind

General Goals:

-to reduce stress in the family

-to reduce symptoms of ADHD

-to reduce anxiety

Materials Needed:

-a ball

-playing field

Advance Preparation Needed:

-Bob will have to take time off work in the afternoon to play soccer with the family

Description of the Intervention with the Vargas family:

For three times a week, the family will meet up and play soccer for at least thirty minutes. Every family member will be expected to participate.

Discuss the benefits of the Intervention to the Vargas family:

-physical activity and more specifically soccer is a good way of reducing stress and depression

-soccer is fun and thus reduces anxiety

-Frank loves soccer, therefore, he will enjoy this activity

-the commitment to play soccer will increase family bonding and improve relationships among all family members

Citation for references (if any):

Sharma, Madaan & Petty, 2016

Intervention 3

Title of your Intervention:

Paint your feelings

General Goals:

-to examine emotional undertones in the paintings

-to help the family members better understand their feelings and behavior

Materials Needed:

-paint

-painting brush

-canvas

Advance Preparation Needed:

-there is no artistic talent needed for this exercise

Description of the Intervention with the Vargas family:

Color and texture play an important role in the therapeutic process. Painting and drawing will help the family reveal their thoughts and feelings. Every member of the family will be encouraged to participate in this intervention. During the next therapy session, canvas, paint and other materials will be provided and the family will engage in the activity for the duration of the therapy session. The therapist will not intervene during this activity.

Discuss the benefits of the Intervention to the Vargas family:

-relieves stress

-improves symptoms of anxiety

-it is fun for all family members especially Frank and Heidi

-helps every family member explore their emotions

Citation for references (if any):

Regev & Cohen-Yatziv, 2018

 

References

Pagano, C.J. (2018). Exploring the Therapist’s Use of Self: Enactments, Improvisation and Affect in Psychodynamic Psychotherapy. The American Journal of Psychotherapy, https://doi.org/10.1176/appi.psychotherapy.2012.66.3.205

Regev, D. & Cohen-Yatziv, L. (2018). Effectiveness of Art Therapy with Adult Clients in 2018-What Progress has Been Made? Frontiers in Psychology, 9, 1531. Doi: 10.3389/fpsyg.2018.01531

Sharma, A., Madaan, V. & Petty, F. D. (2016). Exercise for Mental Health. Priamry Care Companion to the Journal of Clinical Psychiatry, 8(3), 106.

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Strategic Controls and Monitoring Tools

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Strategic Controls and Monitoring Tools

Organizational leaders must be aware of external forces that may impact their organization. Strategic controls and monitoring tools allow leaders to evaluate these forces and develop tactical objectives to limit negative consequences. For this Team Discussion, you explore how strategic controls, monitoring tools, and tactical objectives might be used to address issues impacting health care organizations.

To prepare:

In Week 1, the Instructor assigned to your team a scenario that involves a health care organization with an issue requiring an evaluation of the organization’s strategic plan. Reflect on the issue and, as a team, begin identifying and discussing evaluation or monitoring tools that would be useful to address this issue. Be sure to consider the following:

  • What strategic controls (e.g., promise control, implementation control, strategic surveillance, and special alert control) might you use and why?
  • What monitoring tools (e.g., Gantt Chart, Balanced Scorecard, Dashboard, etc.) might you use and why?
  • What are two tactical objectives that the organization might leverage to effectively address operations requirements and limit negative consequences?

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  • Group C’s Scenario: Lake County Medical Practice is a large physician practice in Tallahassee, Florida providing one-stop medical and ancillary services to their patients. Of the approximately 80,000 patients Lake County serves annually, 38% are Medicare beneficiaries. Recently, the Centers for Medicare & Medicaid Services reduced reimbursement rates by approximately 11% for office visits, surgical procedures, and a range of diagnostic and therapeutic services. Based on a projection from the chief financial officer, the new reimbursement rates equate to a $5.8 million reduction in revenue for the medical practice. This comes at a time when Lake County Medical Practice has experienced an increase in new Medicare beneficiaries, as one of the area’s medical practices closed its door after the founder and chief executive officer retired four months ago. Other Medicare beneficiaries have been unsuccessful at finding new primary care physicians, as area physicians are not accepting new Medicare patients. Therefore, Medicare beneficiaries are traveling at least 40 miles to the nearest provider to get medical service.

 

SAMPLE ANSWER

Strategic Controls and Monitoring Tools

Strategic and implementation controls are designed to assess the overall organizational strategies and the impacts of internal and external factors. In this scenario, some of the external factors affecting Lake County Medical Practice include a reduction in Medicare and Medicaid reimbursement. The organization can employ various strategic controls such as strategic surveillance, implementations control, and premise control. With strategic surveillance, it would be possible to observe and continuously analyze the necessary factors that might impact the selected strategy (Ginter, Duncan & Swayne, 2018). Further, premise control will enable the management to track each strategy as it gets implemented to make necessary adjustments to achieve maximum results.

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Besides selecting and measuring the strategies, it is also essential for the organization to monitor the performance. Using monitoring tools such as balanced scorecard, the management would be able to address business performance comprehensively by combining both financial and non-financial indicators (Bisbe & Barrubés, 2012). With the organization currently projecting a $5.8 million reduction in revenue due to the new reimbursement, employing a balanced scorecard will facilitate proper monitoring and assessment of the implementation process. Besides, the Gantt charts can also be used for planning organizational strategies by determining the required resources and the order in which projects should be accomplished (Bisbe & Barrubés, 2012).

The organization can reduce the negative impacts by implementing tactical objectives that work synergistically with the selected strategies to complement one another in achieving positive results. As such, tactical objectives that should be considered, based on the strategies chosen may involve, increasing the number of primary care providers and reconsidering the hospital’s financial budget to accommodate the Medicare beneficiaries they are going to serve.

 

References

Bisbe, J., & Barrubés, J. (2012). The balanced scorecard as a management tool for assessing and

monitoring strategy implementation in health care organizations. Revista Española de Cardiología (English Edition), 65(10), 919-927.

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care

organizations. John Wiley & Sons.

 

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Article Review

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Article Review

Review the sample argument article for this week and answer the following: (Short answer assignments must meet a word count of 100-150 words per question.)

1- what is the topic of the article and what is the article’s position?  Provide a key sentence from the article that supports your answer.  Provide an example of one appeal that the article uses.  Explain, how/why you feel this appeal is used successfully or not.

2- Joe has to write an argument essay supporting the right to have an abortion.  He begins his essay with a statistic discussing the significant number of cases of severe depression in teenage rape victims who gave birth to children in the past ten years.  What rhetorical appeal is joe using? Explain.

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3-Refer to the soapstone analysis handout to answer this question:

Juan is doing a research paper on the powers of the US presidency.  He has found a really good article from the library databases.  He decides to read the article closer in order to think about why the author wrote the article and what the author’s goals were for writing the article.  What type of close reading strategy is Juan using?  what other strategy from the handout would be beneficial for Juan to use also?

4- Debbie is writing an essay on illegal immigration.  Her first body paragraph uses a PBS News interview with the Border Patrol Commissioner.  What appeal is Debbie using in this paragraph? Explain.

 

SAMPLE ANSWER

Article Review

Question 1

The topic of the article is about the threats to reproductive health in the United States posed by the policies being implemented by the Trump administration. It particularly notes that the administration has been working to gut the Title X program. The program assists women from poor backgrounds to access cancer screening, birth control, and other reproductive health services. The key statement is “The Trump administration’s new Title X rule, announced in February, will lay waste to that progress. The rule bars facilities that receive Title X money from providing abortions, even with a separate source of money, as has been required by law for decades”. One of the appeals that the article uses is pathos, which is appealing to the emotions. The appeal is used successfully since it allows the article to appeal to the emotions of the readers.

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Question 2

The rhetorical appeal that Joe is using is logos. The appeal is associated with appealing to the logic of the audience, which involves using facts, figures, and reason to appeal to persuade them. Logos requires one to reason with his or her audience, which includes providing them with credible statistics and facts. Therefore, since Joes starts his article with a statistical figure, his rhetorical appeal may be described as logos since it persuades the audience using data.

Question 3

Juan tends to focus on why the author wrote the article as well as his goals for writing the article. Therefore, his strategy may be described as having focusing on the purpose of the article. With the strategy, one focuses on the purpose of a text, which includes the reasons why the author wrote the article, the message, and how the author conveys the message. However, incorporating other strategies would also be beneficial for Juan to use. This involves focusing on the subject of the article as well. The strategy includes reading closer to understand elements related to the content, topic, and ideas of the text. It also includes exploring whether there is more than one subject in the article.

 

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