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Cognitive Behavioral Therapy for Groups

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Cognitive Behavioral Therapy for Groups

As you might recall from Week 5, there are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in group settings and family settings, consider challenges of using this approach with your own groups.

 

Learning Objectives

Students will:

  • Compare the use of cognitive behavioral therapy for groups to cognitive behavioral therapy for families
  • Analyze challenges of using cognitive behavioral therapy for groups
  • Recommend effective strategies in cognitive behavioral therapy for groups

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To prepare:

  • Reflect on your practicum experiences with CBT in group and family settings.

Post an explanation of how the use of CBT in groups compares to its use in family settings. Provide specific examples from your own practicum experiences (you as the writer can make this up as long as it deals with drug addiction). Then, explain at least two challenges counselors might encounter when using CBT in the group setting.

 

SAMPLE ANSWER

Cognitive Behavioral Therapy: Group Settings versus Family Settings

Cognitive behavioral group therapy is a group approach that utilizes behavioral, relational and group practices to improve the coping skills of participants, and address the problems that they are experiencing (Wolgensinger, 2015). On the other hand, cognitive behavioral family therapy focuses on supporting members of a family to interact in a more adaptive manner; learn how to make better decisions to create a conducive environment for family interactions. Additionally, cognitive behavioral family therapy relies on reciprocal interactions between family members (Lan & Sher, 2018). During drug addiction treatment, CBT shows that emotions and harmful actions are not rational and might have come from past experiences. When a person struggling with addiction understands that their feelings lead to substance use, they are better placed to control their addiction. In practice, I work closely with individuals struggling with alcohol addiction. During family CBT, emotions and behaviors have a mutual influence on one another. For example, clients often change their addiction story when a family member is in the therapy session with them. When I encounter such clients, I recommend group CBT because they may relate better to others that are going through the same situation.

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CBT administered in the group setting posses several challenges to counselors. Clients might have limited motivations to change. Counselors should therefore establish motivating factors to help the client cope with therapy. For psychotherapy to work, the individual, the family and the group should ensure that treatment goals are met. During group CBT counselors face the challenge of choosing effective structures to use (McHugh, Hearon & Otto, 2010). Additionally, identifying proper techniques to introduce to obtain maximum results is a challenge. Evaluating techniques and consulting with other therapists assists with meeting all the needs of the parties involved.

 

References

Lan, J. & Sher, TM. (2018). Cognitive-Behavioral Family Therapy. Research Gate. Doi: 10.1007/978-3-319-15877-8_40-1

McHugh, R.K., Hearon, B.A. & Otto, M. (2010). Cognitive Behavioral Therapy for Substance Use Disorders. The Psychiatric Clinics of North America, 33(3), 511-525. Doi: 10.1016/j.psc.2010.04.012

Wolgensinger, L. (2015). Cognitive Behavioral Group Therapy for Anxiety: Recent Developments. Dialogues in Clinical Neuroscience, 17(3), 347-351.

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Fake News Outcry Is Misguided

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Fake News Outcry Is Misguided

Essay 3 will be a research argument essay. This week you will receive a course message with an article attached to it. The article will be taking a position on a current event. Your essay will be an classical argument paper that either agrees with or disagrees with the author’s of the article’s position.

You must support your argument with evidence from the academic databases found in the college library–Academic Search Complete, EBSCO, CQ Researcher, etc. Please review the library orientation videos to refresh your understanding of including reputable sources for research papers. Sources that are found outside of the academic databases will not count and may even harm your grade for this essay.

Essay guidelines:

-7-10 pages of content typed in MLA format with a work-cited page (work cited page does not count as a page of content).

-You must include at least 4 sources for you paper–these sources must be indicated in the annotated bibliography.

 

FYI: College library website enclosed:

 

SAMPLE ANSWER

Fake News Outcry Is Misguided

“Fake news” has taken center stage and has been determined to be a trending topic in the last few years. The fake news challenge has been researched by the committee to protect journalists that established that in the year 2017; about twenty-one journalists from various countries were imprisoned and charged with charges that relate to fake news. At the beginning of 2018, several countries attempted to come up with plans to introduce legislation that targeted the issue. According to the ABC news, in the year 2018, several freelance journalists were arrested in Egypt and they included May al-Sabbagh and Ahmed Moustafa who were working on providing information about the outdated trams of Egypt (Ibrahim, 1).  In addition, several technologies based companies also reported having adopted measures to address the fake news that was spread on their platforms. An example of such attempts is the introduction of a new metric called Click-Gap, which Facebook’s news feed algorithms will use to determine where to rank a given post. This effort was aimed at redefining Facebook’s authority on the internet, as well as, fighting the abuse of the platform by those who spread fake news. With regard to the actions to be taken, there has been a furore that has been created in public debates with people taking the opposing sides. Some argue that people should not turn a blind eye to the fact that the crackdowns on fake news are a threat posed to freedom of expression. This is explained to be characterized by the prospect of State-controlled information, or a situation where a dominant group sorts out the information that needs to be shared. Although the opponents of the crackdown on “fake news” have made arguments that the efforts are misdirected and that the stories are nothing new, “fake news” has several implications on the audience and especially on contemporary democracy and, therefore, the “fake news” outcry is not misguided.

The term “Fake news” is commonly used to refer to allegations that the information provided is misleading or contains significant omissions in the content. It implies that the information is false and the main purpose of the content creator is to deceive a certain intended audience. “Fake news” refers to a wide range of things including satire and parody shows, comedy news shows, as well as, news stories that are characterized by having a mix of true and false to misleading stories (Harsin, 99). These stories may be invented or may not have any basis at all. “Fake news” may also be defined as false news that is spread on the internet or any other media to influence a particular stand or political views. Fake news is a purported fact and this is mainly characterized by being either entirely false or in some cases having partial truths, or simply information that is fabricated to make a certain theory look warranted.

“Fake news” brings about anxieties especially about the complex or unwelcome consequence of democracy when people consume the information from mainstream media such as the newsrooms. However, the problem goes beyond that and includes several individuals on social media platforms and especially Facebook and Twitter. This is because of the algorithm that connects the news, which does not assess the quality of the source but instead connect users to the news by second-guessing what the user might like. This becomes a hub for advertisers to make their advertisements for audiences that are in the digital environment and are hungry for content. These people’s clicks’, ‘shares’ and ‘likes’ are tracked by Digital programmatic advertisers during their browsing sessions. When this happens, the brands may end up appearing inadvertently on “fake news” sites and other inappropriate destination. There has been criticism about the two platforms, Facebook and Twitter, mainly because they play a significant role in the spreading, facilitating, and even encouraging “fake news” (Marwick, 474).

There has been an outcry and hullabaloo about fake news and disinformation becoming more prevalent especially in the recent times with special focus in the public domain. The concerns are a result of the rise in the number of populists and anti-intellectual politicians who have become more pronounced as days go by. The “fake news” issue, however, becomes centralized when considered in line with the centrality in the political campaigns as well as regimes. “Fake news” has been used significantly in the past in various political discourses for different purposes. For instance, several parts of information that would be deemed misinformation formed part of the story that was used by western powers in an attempt to sell the weapons of mass destruction to the countries such as Iraq. False information and misconceptions have also been established to have played a role in the rationale for the cold war and other similar political issues that were faced in the past. Therefore, in the debate about fake news outcry, one needs to consider the issues that surround it keenly. A critical analysis should be made on the impact of “fake news” on the politics of different countries as well as the various epistemic and ethical concerns that come about with fake news. An analysis into these aspects will prove the fact that the “fake news” outcry is guided and there are serious implications that people, societies and even nations face as a result of the spread of false news. The implications spread to different sectors of life, including the health and education systems and most importantly the political systems, which in turn directly affect the other system within a country.

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The “fake news” outcry is not misguided and indeed, there are several reasons why people should work together to support the efforts being made to curb the spread of fake news. This is mainly because, despite the evolution and technological advancements, there are challenges regarding sieving out whether the information is true or false, there is a need to curb the “fake news” because of the negative issues that it presents. One major characteristic of “fake news” is that it produces some form of false belief about an issue and consequently, the false belief brings about confusion among the members of society. This is because “fake news” represents a particularly bad and direct avenue by which inaccurate beliefs have been propagated via social media. The confusion may lead to misinterpretations or misunderstandings of various important social and political issues because it has the ability to capture the attention of the audience and consequently, the audience views it in a particular light. In return, inaccurate beliefs pose a threat to democracy. A study by Pennycook and rand in the year 2018 established that people tend to fall prey to the “fake news” and they investigated the cognitive psychological profile. The study revealed that several people have the tendency to relate randomly generated sentences with great depth of insight or knowledge, something that they referred to as pseudo-profound bullshit receptivity. This attribute among people was positively correlated with the perception that individuals have of the accuracy of fake news. Furthermore, it showed that people did not have a satisfactory ability to differentiate between fake and real news. This lack of media truth discernment may influence the perceptions that they have and consequently contribute to the confusion or misunderstanding of the social and political issues.  As a result, there should be a critical analysis of news, as well as, media truth discernment so that individuals can consume news that is true as this will present the misconstrued beliefs that are propagated by fake news, which capitalize on the inability of people to tell the difference.

“Fake news” has received attention because of the role that it plays in the politics of a country, for instance, the last election of the USA (News Media Association, 3). “Fake news” is bad for democracy in several ways mainly because democracy is unlikely to survive when there is a poor information environment. Although the decisive role of “fake news” in determining the outcome of that election has not been established, there may be reasons to believe that some people were duped (Hubbard, 474). Unreliable information, as is characteristic of “fake news” may shape the choices of the voters and consequently the elections and economy. This action may bring about incompetent governments and have a public that is disappointed. Also, it is possible that “fake news” may in the long-term; erode civic engagement through the action of replacing real news with fictitious ones. This may be carried out through different strategies such as diverting, stories that destroy public faith in the media and displace advertising revenues that support real news media and their investment in journalism.

For these reasons, it becomes evident that “fake news” has an impact on the lives of people and, therefore, the crackdown should be enabled so that the effects are reduced. In addition to the crackdown, there should be an effective and strong real news sector that will efficiently filter the “fake news” and ensure that individuals are presented with real news. A vivid example of the scenario is as lived by the president of the United States of America, Donald Trump. The phrase “fake news” was frequently used by the president and his allies on various platforms as they addressed the critical coverage from major media organizations reporting on the president’s administration. In the year 2017 alone, the president sent out a total of 146 tweets that included the phrase “fake news.” The phrases were sent out to change the perception that people may have received from the alleged “Fake news” that sought to establish that there was a dysfunctional White House (News Media Association, 3). There may have been several people that received the information and it may have changed their perception about the president’s administration.

Misleading information has been a major issue in the political world mainly because it is used to propagate stories for political interests. However, other crucial fields such as the field of medicine have also been subject to misleading information, an action that may be detrimental to the lives of several people (Peters et al. 365). There has been a misconception that “fake news” does not affect the medical practitioners mainly because they are involved in scientific projects. As a result, the medical practitioners have for a long time underestimated the effects of misinformation on the health of the public information gets distorted and amplified between the medical community and the public. Consequently, information gets distorted and amplified between the medical community and the public. The result of such misleading information could be detrimental to the health of several consumers that require medical knowledge. Therefore, irrespective of the source and the motive, medial related information should be verified for facts because the impact would be severe (News Media Association, 3). For this reason, the “fake news” outcry is not misguided as there are facts to prove that the effects are harmful.

“Fake news” remains a significant problem and its effects can be felt even in the academic world, where students rely on several sources of information for their projects, as well as, knowledge on current trends. Although the schools require that the students make use of quality sources of information for their research assignments and papers, some assignments may require sources such as news channels, especially when addressing current issues within a given society. The spread of false or misleading information may affect the student’s assignment because they may end up spending so much time and resources on the project and they end up failing the test because of the misleading facts. Furthermore, the “fake news” outcry has led to the imprisonment of several journalists who were associated with propagating or spreading them.

The “fake news” outcry has brought about debate and although people acknowledge the challenges that the issue presents, some individuals believe that the outcry is misguided. Some argue that “fake news” stories are not nearly as significant a problem as bias and inaccuracies in mainstream reporting. However, with the advancements in technology and the fact that many people rely on social media and other platforms as their sole source of information, the impact of “fake news” will be felt by many people contrary to this belief (Hubbard, 474). Another major argument is that the internet has been successful in helping individuals to experience democracy in publishing mainly because everyone with access to the internet and a computer are able to publish content. Their thoughts are published and spread across different groups of people. The critics of the crackdown argue that carrying out the crackdown could harm the process and reverse the democratized publishing, which is viewed to have advanced.  However, owing to the negative implication of fake news, coupled with the inability by several people to differentiate between fake and real news, there is a need to come up with strategies to curb fake news.

In conclusion, there is a need to curb fake news, which is a news story that has no factual basis but is presented as news. This is because the outcry is not misguided and is instead based on the negative implications of the “fake news” on the different aspects of people’s lives. There is a need to investigate, expose and debunk all the people that share “fake news” including the ones that use social media platforms such as tweeter and Facebook. This can be achieved through an examination of the advertising supply chain and ensure that it does not undermine the news media’s sustainability. With the “fake news” detriment, the audience tends to neglect the issue of politicians who choose to create and suppress realities. The first place to begin is to have fact-checking sites and media literacy campaigns so as to prevent people from sharing “fake news” because they bring about negative implications. People make use of digital networks as a constant feed of information and, therefore, whenever there is misleading information, several people may be affected. It is, therefore, necessary to have the crackdown on “fake news” so that the perpetrators including those on social media platforms are brought to book in order to have better reporting and so that people can consume information that is true and substantiated with facts. The legislature is also instrumental in managing the issue. For instance, in Egypt, “fake news” has been outlawed and reporters of false and misleading information have not only been punished but some have been detained in an effort to deter others from following suit.

 

Works Cited

Harsin, Jayson. “A critical guide to fake news: From comedy to tragedy.” Pouvoirs 1 (2018): 99-

119.

Hubbard, Sally. “Fake news is a real antitrust problem.” CPI Antritrust (2017).

Ibrahim, Noor. “Under guise of combating ‘fake news,’ foreign governments target their critics”

(2018) retrieved from: https://abcnews.go.com/International/guise-combating-fake-news-foreign-governments-target-critics/story?id=55506470

Marwick, Alice E. “Why do people share fake news? A sociotechnical model of media effects.”

Georgetown Law Technology Review 2.2 (2018): 474-512.

News Media Association. “Culture, media, and sport select committee ‘fake news’ inquiry: New

media association response.” Wales: NMA (2017).

Peters, Alexandra, et al. “Fighting the Good Fight: the fallout of fake news in infection

prevention and why context matters.” Journal of Hospital Infection 100.4 (2018): 365-370. doi.org/10.1016/j.jhin.2018.08.001

Pennycook, Gordon, and David G. Rand. “Who falls for fake news? The roles of analytic

thinking, motivated reasoning, political ideology, and bullshit receptivity.” SSRN Electronic Journal (2017). Doi: 10.2139/ssrn.3023545.

 

 

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Part 4: Research Analysis

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Part 4: Research Analysis

  • Your topic of interest.
  • A correctly formatted APA citation of the article you selected, along with link or search details.
  • Identify a professional practice use of the theories/concepts presented in the article.
  • Analysis of the article using the “Research Analysis Matrix” section of the template
  • Write a 1-paragraph justification stating whether you would recommend this article to inform professional practice.
  • Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:
    • Describe your approach to identifying and analyzing peer-reviewed research.
    • Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research.
    • Identify at least one resource you intend to use in the future to find peer-reviewed research.

 

SAMPLE ANSWER

Part 4: Research Analysis

Step 1: Research Analysis

 

Topic of Interest: Family Interventions in Child Psychiatry
Research Article: Include full citation in APA format, as well as link or search details (such as DOI)  

Gopalan, G., Goldstein, L., Klingenstein, K, Sicher, C., Blake, C. & McKay, M. (2017). Engaging Families into Child Mental Health Treatment: Updates and Special Considerations. J Can Acad Child Adolesc Psychiatry,19(3).
Professional Practice Use:

One or more professional practice uses of the theories/concepts presented in the article

  

The journal article proposes the use of family engagement and interventions in the treatment of child’s mental health.

 

 

The authors discuss the important of family interventions in the management of a child’s mental health. According to the authors, family plays a key role in a child’s wellbeing. The article starts by providing a background information on the development of family therapy. It then offers insight on family interventions and how families should engage their children in psychiatry management. The authors note that a psychiatrist should evaluate a family in terms of their strength and weaknesses in psychiatric management.

 

 
Research Analysis Matrix

Add more rows if necessary

 Strengths of the Research Limitations of the Research Relevancy to Topic of Interest Notes
 

 

      
The article gives evidence on why family engagement and interventions are important for a child’s mental health. The article could have been more convincing by using a quantitative study that would have compared different aspects of child psychiatry.

 

 The article is important because it brings out a new way of managing child’s mental health.

 

 Psychiatrists should engage families in managing a child’s mental health

 

 
 

 

      
 

 

      
 

 

      
 

 

      
 

 

      
 

 

      
 

 

      
 

 

      

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The article should be read for professional practices since it provides some important insights in child’s mental health management. The article recommends the use of family interventions in pediatric psychiatry. From the article, it is evident that the family plays a major role in managing children mental health. A family not only impact resilience in a child but also offers protection which is a key factor in psychiatry management.

 

Step 2: Summary of Analysis

I used various databases on Walden Library to search for the peer-reviewed article. I limited the search by using key words such as psychiatry management and also selecting only peer-reviewed articles. I then examined the sources and their content and selected the one that was more detailed and could help me in doing research on the topic I selected. Some of the key qualities of the articles I was looking for included its length, its authors as well as publishers.

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  • Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research

One of the strategies for search peer-reviewed sources is the use of key words in the search. The key words that I incorporated in the search included psychiatric, pediatric, family intervention, family therapy and child mental health. The results of the search were examined and peer reviewed sources chosen from the result. Another strategy involved use of headings to find information about the authors, the editors and the publication details. This would help in determining whether the article is scholarly or not. This would involve checking the abstract, reviews of the article and how many times it has been cited and referenced.

Part 4: Research Analysis

  • Identify at least one resource you intend to use in the future to find peer-reviewed research

I will use PudMed database to find peer-reviewed sources in the future, This is because the database provides a wide range of peer reviewed sources that can help in research.

 

 

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Response letter to the author

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Response letter to the author

Just need the answers, no title page heading, and please make sure it is the correct word count required as specify in each question.  I will pay for an additional page if need it, just please let me know.

1- In 300 words write a response letter to the author. State whether you agree or disagree with their viewpoint.  Provide at least one example in your response to support your position.

2- In 100-150 words – what is the primary appeal the author uses to get the argument across to the reader? Provide an example and explanation.

 

SAMPLE ANSWER

Trump has gone off a narcissistic cliff. Does anything matter anymore?

In the recent past, one does not need to be professional in mental health to recognize that something is off with the 45th and current president of the United States of America, Donald Trump. I agree that Trump has gone off a narcissistic cliff. There has been no president in history that has been established to have shown an excessive interest in or admiration of oneself and their physical appearance. Trump, on the other hand, has prompted several discussions regarding his mental stability and connection with reality based on the excessive need for admiration, being arrogant and disregarding others. Also, he has exhibited an outright inability to effectively handle criticism making him expose his sense of entitlement.

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The issue of white nationalism in America is a serious one and requires to be addressed by the president, who is instead choosing to be egocentric and make everything to be about his life instead of handling the issue. In a world where so many items need to be addressed, trump should not be spending so much time being concerned about personal grievances on social media as well as mainstream media. An example of the things that Trump has devoted time to is to tweet about conspiracy theories and in the process, he ignores serious issues such as the three mass shootings that took place in one week. It is for these issues that other people find him mentally unstable. An example is John Kelly who referred to him as “off the rails” and “unhinged” referring to his state of imbalance. We have reached a point where no one knows what to expect from Trump anymore. He seems to change based on his moods from one minute to another as influenced by either headline on the news or even Tweeter. Nothing matters anymore.

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The Primary Appeal used in the Article

The primary appeal that is used by the author is pathos, which seeks to bring about the emotional appeal and persuade an audience to feel what the author wants. The author of this text wants the audience to feel how mentally unstable the president has become and is consequently providing examples to show how he is becoming Narcissistic. The author writes that “With America facing a rising tide of white nationalism and a world on fire, we have a leader who is dangerously unfit, makes everything about him.” In doing so, he attempts to make the audience understand how inefficient the president is and especially the fact that he has become egocentric and not showing active efforts towards handling the issues that the country is facing. The title of the article also prompts one to acknowledge the fact that nothing matters to the president anymore.

 

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Business Case for a New Economic Opportunity

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Business Case for a New Economic Opportunity

Business Case for a New Economic Opportunity

OVERVIEW

Report on risk and mitigation and the costs and benefits of a proposed initiative.

As a master’s-level health care practitioner, you are expected to consider a number of factors when analyzing the feasibility of a new initiative. For example, you need to keep in mind the various types of risk (such as patient safety, physical plant, financial, or reputation), as well as the present and future value of the service line or economic opportunity into which you are investing resources. You also must balance the competing considerations of your ethical and moral responsibility to provide quality care to patients and populations, while also protecting your care setting’s assets and economic viability in the near and long terms.

Note: Complete the assessments in this course in the order in which they are presented.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation.
    • Analyze the opportunities and risks relevant to a proposed economic initiative.
    • Analyze the costs and benefits of a proposed economic initiative over a five-year time horizon.
  • Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.
    • Propose potential ways to keep costs under control while maximizing the benefits of an economic initiative and ensuring that it remains ethical and culturally equitable.
  • Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues.
    • Justify the relevance and value of the quantitative and qualitative economic, financial, and scholarly evidence used to support recommendations throughout a report.
  • Competency 4: Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care.
    • Propose ethical and culturally sensitive solutions to address the risks associated with an economic initiative to ensure the future security of a care setting.
  • Competency 5: Apply various communication methods in order to clearly, effectively, and efficiently relate information to stakeholders and colleagues related to economic data, findings, and strategies.
    • Communicate a business case in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
    • Effectively support a report with relevant economic data and scholarly sources, correctly formatting citations and references using current APA style.

Assessment Instructions:

In this assessment, you will conduct a risk and mitigation analysis and cost-benefit analysis and report on your findings.

Scenario

The senior management of your care setting has reviewed your Executive Brief: Proposal of a New Economic Opportunity and has decided that it has merit. As a result, you have been asked to take a more detailed look at the feasibility and cost-benefit considerations of implementing your proposed economic initiative over the next five years. The senior management is looking for a 3–5-page report that builds a business case for your economic initiative by analyzing ways to mitigate the risks associated with your original proposal and a completed cost-benefit analysis using the Cost-Benefit Analysis Template, linked in the Resources.

Directions

You have been asked to ensure that your report addresses the following. Note: The bullet points below correspond to grading criteria in the scoring guide. Be sure your work is, at minimum, addressing each of the bullets below. You may also want to read the scoring guide and the Guiding Questions: Business Case for a New Economic Opportunity document, linked in the Resources, to better understand the performance levels that relate to each grading criterion:

Part 1: Risk and Mitigation Analysis

Complete the following:

  • Analyze the opportunities and risks relevant to your proposed economic initiative.
  • Propose ethical and culturally sensitive solutions to address the risks associated with your economic initiative to ensure the future security of your care setting.
Part 2: Cost-Benefit Analysis

Complete the following:

  • Analyze the costs and benefits of your proposed economic initiative over a five-year time horizon.
  • Propose potential ways to keep costs under control while maximizing the benefits of your economic initiative and ensuring that it remains ethical and culturally equitable.

Address Generally Throughout Business Case

Complete the following:

  • Justify the relevance and value of the quantitative and qualitative economic, financial, and scholarly evidence you used to support your recommendations throughout your report.
  • Communicate your business case in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
  • Effectively support your report with relevant economic data and scholarly sources, correctly formatting citations and references using current APA style.

Example Assessment: You may use the assessment example, linked in the Assessment Example section of the Resources, to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Additional Requirements

Your assessment should meet the following requirements:

  • Length: 3–5 double-spaced, typed pages. Your paper should be succinct yet substantive.
    • Be sure to include a title page and reference list.
    • Your completed Cost-Benefit Analysis Template should be included as an appendix within your final business case submission.
  • APA format: Resources and citations are formatted according to current APA style.
  • Resources: Cite 4–5 authoritative and scholarly resources. Be sure to include specific economic data and support as part of your cited resources.

Questions to Consider:

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

  • What kinds of quantitative data can support proposals for change in a health care setting? What kinds of qualitative data can do so?
  • What are the five different types of comparative economic analysis?
  • What are some realistic and feasible recommended alternatives for health care issues and problems that currently impact your work? What would be the costs of pursuing those alternatives? What would be the benefits?
  • When and how are the following methods for valuation best used?
    • Human capital.
    • Risk preference.
    • Contingent valuation.
    • Cost-benefit ratio.

 

SAMPLE ANSWER

Business Case for a New Economic Opportunity

Introduction

Mayo Clinic is a healthcare organization in Rochester, Minnesota. The clinic is a multispecialty hospital that integrates research, education and clinical practice. Mayo clinic aims to develop an Express Care Model to provide urgent care to patients. The Express Care Model helps to provide immediate healthcare services to patients in populated regions. The shortage of healthcare practitioners often leads to long queues as the patients wait to be served (Chang, Brundage & Chokshi, 2015). The healthcare institution not only aims to offer routine screening, but also provide treatment for minor injuries, treat illnesses, refer patients and conduct flue tests. Therefore, the business case outlines an economic strategy for five years by evaluating opportunities and risks for the business case and develops ways of reducing the risks associated with the business.

Part 1: Risk and Mitigation Analysis

Opportunities Associated with the Proposed Economic Initiative

To determine the risk and opportunities of the business case, both the microenvironment and microenvironment of the express care model will be examined. There are about 3.8 million people living in Minnesota, and developing an express care strategy can ensure remarkable economic growth for Mayo clinic (US Department of Labor, 2019). Therefore, creating an emergency care facility will help reduce the burden of healthcare provision and overcrowding of patients in ER departments.

Business Case for a New Economic Opportunity

The ER department often cares for about 250 patients every day. There are also patients who leave without being cared for or leave because the bills are too expensive that they cannot afford (American College of Emergency Physicians [ACEP], n.d.). The Express Care would ensure hospital services are affordable particularly for the low- and middle-income individuals. Most patients in the ER department often do require emergency care and sometimes they are forced to leave without being cared for. The Express Care Model can be used to ensure such patients receive attention of healthcare practitioners to ensure that they are treated appropriately.

Revenues from the emergency department will be critical in providing additional revenue for the Mayo clinic. The local ER departments would be able to get more patients requiring emergency treatment because of the referrals that the facility would get. Providing treatment to the locals would also help develop trust between the clinic and the community.

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The Mayo Clinic can handle both minor and critical injuries among patients. This means that the clinic can also offer more assistance to patients to guarantee positive outcomes. Such aspects set the hospital apart from other healthcare institution that provides emergency care or similar services to patients (Gurganious & Greenfield, 2015).  Mayo Clinic will ensure that patients are provided with adequate and quality care in all their healthcare needs. Improving patients’ outcomes leads to satisfaction and loyalty, and the patients would revisit the clinic every time they have a healthcare issue and also refer the clinic to other patients.

Risks Associated with the Proposed Economic Initiative

The use of the Express care model has potential risks. There are several urgent care services provided in Minnesota, and other healthcare institutions have also employed the model in their ER departments. According to the American College of Emergency Physicians (2019), about 72% of emergency physicians care for patients that need urgent care, but sometimes there are no equipment that can ensure efficient delivery of health care services. Such issues are critical that could make patients opt for Mayo clinic that will be well equipped with facilities that could help patients to save costs while attending the emergency departments. Lack of enough healthcare facilities forces many hospitals to refer patients to other healthcare institutions increasing the cost of care for the patients as well as compromising their health due to delayed treatment. Mayo clinic needs to source finances with the help of the organization’s leadership and to involve stakeholders before the initiation of the project.  Availability of equipment and facilities at the clinic would be necessary for ensuring the project is successful.

Business Case for a New Economic Opportunity

Chances of misdiagnosis is another risk that the hospital needs to consider. Because of the high number of patients being cared for on the same day, the physicians can experience burnout which would affect their efficiency. This can lead to medical errors that may put patients’ lives at risk. Therefore, the clinic needs to develop critical interventions to reduce the problems of misdiagnosis. Employing more nurses will be valuable in improving nurse-to-patient ratio to the required level. Nurses and physicians should be enough to ensure they have enough time to care for each patient. Specialized training is also critical to ensure nurses do not cause medical errors such as misdiagnosis (Sanborn, 2018). Medical mistakes may lead to critical ethical and legal issues that may put the organization’s reputation at risk. Nurses and physicians need to be advised to take breaks in the cause of treatment, report errors, and work for few hours to ensure instances of misdiagnosis due to burnouts do not occur.

Part 2: Cost-Benefit Analysis

Costs and Benefits of the Proposed Economic Initiative

            The express care model has costs and benefits that would be critical to ensure its success. To develop the express care model, the value and advantages of the project have been calculated for the next five years using the 11% discount rate. The discount rate of the present value is determined using the estimated return on that target and the standard capital costs. The capital costs include what will be required to ensure renovation of the care facility as well as the costs for purchasing new equipment and furniture. The cost of operation will consist of employee salaries, insurance, liability, furniture costs, utility costs, and equipment costs. It is projected that the project will cost almost $380,000 and this will also include marketing as well administrative costs.

Business Case for a New Economic Opportunity

According to Gurganious and Greenfield (2015), the care setting dealing with emergency services should have both part-time and full-time physicians and a part-time physician assistant (PA) or nurse practitioner and a medical assistant (MA). Therefore, Mayo clinic will operate every year based on the community needs and upon review on its performance, employees would be added if the revenue and influx of patients increase. Based on the US Department of Labor (2019), the operation costs in the first year will be $30,000 for a medical assistant, $112,000 for a PA or NP, $230,000 for a physician, and $25,000 for a secretary or patient representative. The Economic Policy Institute (2018) considers that the growth of salaries in the healthcare sector is estimated to be about 2%. Mayo clinic will base its employees’ wages by reviewing the estimated amount of salary growth every year. More funds may be needed in the future in case the organization employs more employees to care for the increased influx of patients.

The utility cost is projected to increase every year, mainly due to the increase in patients coming to hospital for services as well as the increased number of physicians and supporting staff. The present value of the hospital for the five years will, therefore, be approximately $4,649,282.47, as observed in Appendix 1. The net revenue is calculated using the charge or bill of each client. According to Qin, Prybutok, Prybutok, and Wang (2015), the average number of patients who visit the hospital for urgent care is about 60 to 80 patients. Mayo clinic estimates a total of 70 patients being served every day resulting in a cost of $135 per visit. The operation cost for the first year will be about $3,439,800 and it is estimated to increase for the next five years at a rate of 5% p.a. The 11% discount rate in the five year time is expected to be $11,150,769.42. Final calculations indicate that the net benefits for Mayo clinic will be about $6,501,486.95 indicating that the project will make an economic sense and increase revenue for the organization.

Business Case for a New Economic Opportunity

Ways to Keep Costs under Control While Maximizing the Benefits

The hospital operations need to be economically viable based on the projected net revenue after five years in order for the project to be successful. Regulatory costs control will be maintained through the managing the number of employee as well as cost of care delivery. Overhead costs that are not directly linked to the delivery of care but affects the total cost of service delivery will also be monitored. Other significant expenses that needs to be monitored include essential utilities, insurance, supplies, equipment replacement and repairs, and building maintenance.

Tracking the maintenance records and logs will allow Mayo clinic to reduce sudden breakdown of equipment. Equipment that need attention should be repaired before they completely breakdown. The utilities will be reviewed by the management team every year to ensure the clinic is running efficiently and excessive spending is control. Besides, managing the insurance, internet and phone costs throughout the five years will be critical. Costs will also reduce through monitoring daily operations regularly. Donated supplies will be accepted and reusing office supplies will be considered.  Thus, the project will ensure the facility has best equipment and facilities, and the environment is conducive for proper delivery of health care.

Business Case for a New Economic Opportunity

Conclusion

In conclusion, the development of an Express Care Model by Mayo Clinic will help the provision of urgent care to patients. The model will be imperative to provide immediate healthcare services to patients in populated regions with few healthcare practitioners. The Mayo Clinic will provide patients with regular screening and treatment to patient who needs emergency care to help reduce the burden of healthcare provision and overcrowding of patients in ER departments. In order to be successful, the model would require careful implementation and monitoring for next five years. The discount rate, capital costs, cost of operation, utility cost, regulatory control costs, overhead costs, would be critical control of excessive spending. The main risk of the project includes lack of healthcare facilities to ensure the provision of quality care. Having enough equipment and facilities to improve patient health would be necessary to ensure the project is successful.

 

References

American College of Emergency Physicians [ACEP] (n.d.) Urgent Care. Retrieved from http://newsroom.acep.org/2009-01-04-urgent-care-fact-sheet

Chang, J. E., Brundage, S. C., & Chokshi, D. A. (2015). Convenient ambulatory care —

Promise, pitfalls, and policy. The New England Journal of Medicine, 373(4), 382–388. Doi: 10.1056/NEJMhpr1503336

The Economic Policy Institute. (2018). Nominal wage tracker. Retrieved from https://epi.org/nominal-wage-tracker/

Gurganious, V., & Greenfield, D. (2015). Starting an urgent care center five essentials for success. Medical Economics, 92(11), 47–48. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26298963

Qin, H., Prybutok, G. L., Prybutok, V. R., & Wang, B. (2015). Quantitative comparisons of urgent care service providers. International Journal of Health Care Quality Assurance, 28(6), 574–594. Doi: 10.1108/IJHCQA-01-2014-0009

Sanborn, B (2018). Urgent care centers grow in number, reach thanks to comprehensive capabilities, convenience, and demand. Business intelligence Journal. Retrieved from https://www.healthcarefinancenews.com/news/urgent-care-centers-grow-number-reach-thanks-comprehensive-capabilities-convenience-millennial

US Department of Labor (2019). Occupational Employment Statistics. Retrieved from https://www.bls.gov/oes/oes_emp.htm

 

 

Appendix: Cost–Benefit Analysis over a 5-Year Period

 

Business Case for a New Economic Opportunity

Business Case for a New Economic Opportunity

 

 

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Assessing Client Family Progress

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Assessing Client Family Progress

Learning Objectives

Students will:

  • Create progress notes
  • Create privileged notes
  • Justify the inclusion or exclusion of information in progress and privileged notes
  • Evaluate preceptor notes

To prepare:

  • Reflect on the client family you selected for the Week 3 Practicum Assignment.

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The Assignment

Part 1: Progress Note

Using the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following: (My week 3 practicum assignment had to do with a 26 year old male, who is in drug and alcohol rehab who uses IV heroin, snorts oxycodone and alcohol.  He uses all of his family’s money to buy drugs and alcohol.  This particular client makes jokes about everything, he does not take take anything serious.  He has a daughter whom he says that is sad that he can’t see. Behavioral therapy is the treatment modality used.  The client needs help with self esteem issues and I feel as though he is immature and needs to grow up.)

  • Treatment modality used and efficacy of approach
  • Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the treatment plan for progress toward goals)
  • Modification(s) of the treatment plan that were made based on progress/lack of progress
  • Clinical impressions regarding diagnosis and or symptoms
  • Relevant psychosocial information or changes from original assessment (e.g., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job)
  • Safety issues
  • Clinical emergencies/actions taken
  • Medications used by the patient, even if the nurse psychotherapist was not the one prescribing them
  • Treatment compliance/lack of compliance
  • Clinical consultations
  • Collaboration with other professionals (e.g., phone consultations with physicians, psychiatrists, marriage/family therapists)
  • The therapist’s recommendations, including whether the client agreed to the recommendations
  • Referrals made/reasons for making referrals
  • Termination/issues that are relevant to the termination process (e.g., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
  • Issues related to consent and/or informed consent for treatment
  • Information concerning child abuse and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
  • Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment.

Assessing Client Family Progress

In your progress note, address the following:

  • Include items that you would not typically include in a note as part of the clinical record.
  • Explain why the items you included in the privileged note would not be included in the client family’s progress note.
  • Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why.

 

SAMPLE ANSWER

 

Assessing Client Family Progress

Part 1: Progress Note

DSM-5 diagnoses

Substance abuse: Alcohol, IV heroin and oxycodone
ASAM dimension

Dimension 3: emotional behavioral and cognitive conditions

Subjective The patient is twenty-six years of age and was involved in substance use. The diagnosis shows that he used alcohol as well as IV heroin and oxycodone.

He reports being afraid of a relapse because the withdrawal symptoms are overwhelming. He says “I have strong cravings and I should get something stronger which sill manage these cravings” However, he makes so many jokes and especially about the issue at hand. He also says “ I don’t believe in treatment”

He is also sad because he misses his daughter
Objective Patient has self-esteem issues and does not feel confident about the decisions that he makes. He is not able to effectively identify the triggers because he does not seem to take the treatment seriously. However, he believes that being in rehab has helped him stay away form triggers such as being around people that sue the substances.

There is improvement in withdrawal symptoms and most of them have resolved. He however still has strong cravings despite being on Acamprosate (Campral®).

The patient is still sad that he is unable to see his daughter because she is away.
Assessment There has been minimal progress towards the agreed-upon goal, which was to help him take life seriously and embrace life fully. Clinical symptoms of self-esteem issues are improving and the patient is becoming more confident in the process although there are several cases where there is relapse and he becomes unserious. Self-esteem issued has been established to have a connection to abuse of drugs and therefore need to be properly addressed so as to help in recovery from substance and alcohol use (Alavi, 2011).

Clinical consultations have been made with Dr. Xavier through a phone call and there was an agreement that he continues with the procedure. A consultation was made with Dr. Emma, marriage/family therapists and there is a need to have his close family support him through the session.

He should be on close observation and if he continues to exhibit depressive symptoms and sadness, it would be appropriate to provide further mental and physical health follow up.

 
Plan The diagnosis shows that he used alcohol as well as IV heroin and oxycodone. Psychotherapy is the approach that is used for treatment and the modality used is behavioral therapy.

Plan for substance use

There has been minimal progress towards the agreed-upon goal, which was to help him take life seriously and embrace life fully.

Client will continue with the medication that is provided. The patient is taking medication, which is important for two main reasons; to manage the withdrawal symptoms and to prevent a relapse (National Institute on Drug Abuse, 2019). This patient is currently taking Acamprosate (Campral®), to help with the treatment of the addiction. The main role of this drug is to reduce the symptoms of withdrawal such as anxiety and insomnia as well as dysphoria (Mason, 2015).

The patient complies with the treatment regimen although he needs to be assessed due to lack of seriousness and the tendency to view everything as jokes.

Plan for mental health

Mental health assessment is required.

 
Provider name and signature

……………………………….

…………………………

  

Date ………/……/……..

 

Part 2: Privileged Note

The privileged notes include the observations made such as the fact that this patient acts immaturely and needs to grow up and start acting like an adult. It also includes hypotheses on the treatment plan and especially how to go about the next sessions with the patient. It also includes questions to ask other consultants such as the medication options and whether to increase or decrease the dosage. The privilege notes are different from the progress notes and do not include information such as the laboratory test results, or details on medication. It also does not have information regarding the diagnosis and treatment plan summaries as well as a summary of progress.

Assessing Client Family Progress

The items listed in the privilege note are not included in the client family’s progress note because the information is usually private and is not supposed to be accessed by the patient. It is required under HIPAA that the information is not disclosed to other colleagues unless with the consent of the patient. The notes are only important to me as the counselor and they are not used by any other party including the insurance.  My preceptor made use of privilege notes. It included information such as the preceptor‘s observations and an outline of the information that occurred during the counseling session. The aim may have been to document the thoughts and feelings that they have and also come up with a hypothesis that will be useful in exploring the next sessions with the patient.

 

References

Alavi H. R. (2011). The Role of Self-esteem in Tendency towards Drugs, Theft and Prostitution.

Addiction & health, 3(3-4), 119–124

Mason, B. J. (2015). Acamprosate, alcoholism, and abstinence. The Journal of clinical

psychiatry, 76(2), 224-225.

National Institute on Drug Abuse, (2019). Treatment Approaches for Drug Addiction. Retrieved

from: https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

 

 

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Electronic Fetal Monitoring

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Electronic Fetal Monitoring

Please research medical technological advances that may be unique to the care of women and children. Discuss how this technology will improve care Electronic Fetal Monitoringto women and children. (ideas may be: genetic screening, public health initiatives, mammography, cervical screening, Fetal monitoring, Electronic medical records, telemedicine).

Which technological advances have been utilized in your local hospital? How has it impacted the care of women and children?Will need at least 2 in text citation and 2 references.

 

SAMPLE ANSWER

Fetal Monitoring

Various technological advances have been introduced in improving the quality of health that women and children receive. One such significant technology is the use of Electronic Fetal Monitoring (EFM), which has proven to be a useful tool in health provision. Fetal monitoring technology is used to asses if a child is able to receive oxygen during labor. The goal of EFM is the prevention of metabolic academia, which develops due to oxygen deprivation. According to Stout and Cahill (2011), inadequacy in oxygen supply may result due to various factors such as a decrease in placental perfusion during urine contraction, and umbilical cord compressions.

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One way of determining a baby’s condition before birth is through their heartbeat. Through EFM, the health provider is able to trace the baby’s heart rate as well as the pregnancy contractions and how they might affect the fetus (Chen et al., 2011). In high-risk pregnancies, the technology is used in reducing incidents of neonatal seizures. According to the research conducted by Stout and Cahill (2011) on the effectiveness of EFM, one neonatal seizure is prevented for every 660 women who receive monitoring during labor. It also assists in identifying possible complications that may need further examination or referral. Further through EFM, it is possible to identify abnormal fetal heart rate pattern earlier and take necessary steps in improving any condition discovered.

Nursing Paper Help

In my local hospital, one technology that has been introduced to improve care for women and children is the use of E-clinic telemedicine service. Through this, patients are able to be access diagnosis and treatment through the internet hence reducing regular hospital visits for conditions that can be treated form home. Diagnosis is also made faster thus reducing the time period and processes used in securing hospital appointments.

 

 

References

Chen, H. Y., Chauhan, S. P., Ananth, C. V., Vintzileos, A. M., & Abuhamad, A. Z. (2011).

Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States. American journal of obstetrics and gynecology, 204(6), 491-e1.

Stout, M. J., & Cahill, A. G. (2011). Electronic fetal monitoring: past, present, and future. Clinics

in perinatology, 38(1), 127-142.

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Evidence-Based Practice Change

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Evidence-Based Practice Change

Basically, the paper involves revising and merging the previous papers into one, and doing the conclusion part. Please check the previous papers you did attached

 

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA 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

Evidence-Based Practice Change

Central Line-Associated Blood Stream Infection

Central Line-Associated Blood Stream Infection (CLABSI) is a bloodstream infection that causes increased mortality, morbidity, and length of stay in the Intensive Care Units (ICU), escalating health care costs. About 260,000 central line-associated bloodstream infections are reported in hospitals in the United States (Cleves et al., 2018). Also, approximately 29,000 death cases related to the central line-associated bloodstream infections are reported every year (Savage et al., 2018). Nearly 29,000 US dollars are spent on treating each patient, which creates a burden of about 2.4 billion dollars on the US healthcare system every year (Noto et al. 2015).  Multidrug-resistant organisms (MDROs) such as vancomycin-resistant enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) are the most endemic pathogens that cause CLABSI and other bloodstream related infections (Cleves et al., 2018). These pathogens are endemic in most acute and long term care areas, and their resistance makes it difficult to treat because of the decreasing armamentarium of active antimicrobials. Significant efforts are put to prevent and reduce the rate of infections through health practices designed to decrease the transmission of pathogens. Such methods include care of devices, bundles for insertion, isolation of multidrug-resistant organism’s patients, and hand hygiene (Noto et al. 2015). Chlorhexidine can be used as one of the interventions in reducing bacterial burden, thus decreasing the rate of infections.

PICOT Statement

In patients in the Intensive Care Unit (ICU) (P), how does daily chlorhexidine baths (I) compare to baths with soap and water (C) in decrease the rate of central line-associated bloodstream infections (CLABSI) (O) after one year of the intervention (T)?

Evidence-Based Practice Change

The utilization of antiseptic chlorhexidine gluconate (CHG) can be used as the primary intervention to fight bacterial load both in the central lines and central venous catheters. CHG daily baths are imperative compared to regular baths using soap and water in the ICU unit. Chlorhexidine has a broad-spectrum topical antibacterial agent, which decreases the bacterial burden, thus reducing the rate of infections when used daily during baths (Noto et al. 2015). The antibacterial activity is also essential in reducing microbes and pathogens in patient’s skin thereby preventing both primary and secondary infections. Therefore, daily baths with chlorhexidine wipes in traditional bathing procedures in the Intensive Care Unit should be considered as a significant intervention in the prevention of Central Line-Associated Bloodstream Infections.

Evidence-Based Practice Change

Many studies have also shown the efficacy of CHG in intensive care patients, and support is increasing in caring for non-ICU patients. Daily baths with Chlorhexidine are associated with reduced skin colonization with organisms that have multidrug resistance, reduced clostridium difficile infections, and reduced bloodstream infection rates (Savage et al., 2018).  Therefore, nurses should consider the use of Chlorhexidine as a primary intervention in the prevention and reduction of Central Line Bloodstream Infections in hospitalized patients.

A study by Holder and Zellinger (2009) used a research design where nurses came up with a bathing procedure, which included bating frequency, technique, contraindications, required documentation, and bathing technique. The study method was controlled by advanced nurses and nursing leaders that ensured the accuracy of the findings. The results of the study on Daily Bathing with Chlorhexidine in the ICU to Prevent Central Line-Associated Bloodstream Infections showed that the Bloodstream Infections reduced from 3.6 per 1000 patients to 1 per 1000 patients after six months of chlorhexidine bath procedure implementation. The study findings indicated that the use of chlorhexidine baths reduces the rates of Central Line-Associated Bloodstream Infections and resistant organism’s acquisition rates in patients admitted in the Intensive Care Units.

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Johnson et al. (2019) developed an observational study to determine the relationship between Chlorhexidine baths and Central Line-Associated Bloodstream infection prevention. The groin and arm skin bacterial growth were observed in non exposed patients, and 40 Chlorhexidine exposed patients in the Neonatal Intensive Care Unit. The exposed patients were given 2 % Chlorhexidine baths for Central Line-Associated Bloodstream infection prevention. The study showed that the bacterial burden reduced after the patients took the first bath. However, the bacterial load returned to baseline after 72 hours. The concentration of residual CHG on the skin reduced with time as the bacterial burden increased. The bathing with Chlorhexidine decreases the bacterial burden on the skin. Nurses should be aware that CHG bathing twice a week may reduce the risk of CLABSI associated with using central lines and central nervous catheters. Thus, the study has shown the efficacy of chlorhexidine gluconate in intensive care patients, and support is increasing in caring for non-ICU patients.

Evidence-Based Practice Change

The study by Savage et al. (2018) applied a retrospective time series to examine the effectiveness of various prevention bundles that were developed by nurses in infection control in neonatal and pediatric intensive care units in 2006-2014. The research was subdivided in to post, peri, pre, and second peri-intervention periods depending on each bundle’s implementation status. The study showed there was a significant reduction in unit Central Line-Associated Bloodstream Infection rates where all units were less than the corresponding National Healthcare Safety Network Central Line-Associated Bloodstream Infection rates after the study. Prevention bundle for centralized Central Line-Associated Bloodstream Infection can be useful in universalizing central line care, improve and control the quality of care to help maintain low CLABSI rates in the hospital. Thus, the study showed the efficacy of chlorhexidine gluconate daily baths in reducing the risk of CLABSI associated with the use of central lines and central nervous catheters in intensive care patients.

Conclusion and Recommendations

The suffering experienced by families and patients due to the central line-associated bloodstream infections acquired in the hospitals is immeasurable. Therefore, there is a need for nurses to focus on the prevention strategies for bloodstream infections in hospitals, especially in the Intensive Care Unit. Antiseptic chlorhexidine gluconate is one of the primary measures that can be used to reduce bacterial infections in the central nervous and central line catheters. Nurses should consider the use of antiseptic chlorhexidine gluconate in the ICU since it is effective in preventing bacterial infections in patients as compared to regular soap and water bathing. Therefore, chlorhexidine gluconate daily baths are imperative compared to regular baths using soap and water in the ICU unit.

It is recommended that four strategies can be used to help implement the use of CHG daily baths for patients in the surgical or medical units to reduce CLABS rates. The strategies include increased awareness and accountability, resource availability, leadership support, and staff education (Noto et al. 2015). Therefore, targeted interventions in the ICU can reduce the risk of CLABSI associated with the use of central lines and central nervous catheters. Hospitals need to commit developing strategies to minimize the cases of central line-associated bloodstream infections, which are the primary source of high costs of care by both patients and health institutions.

 

References

Cleves, D., Pino, J., Patiño, J. A., Rosso, F., Vélez, J. D., & Pérez, P. (2018). Effect of

chlorhexidine baths on central-line-associated bloodstream infections in a neonatal intensive care unit in a developing country. Journal of Hospital Infection, 100(3), e196-e199.Doi: 10.1016/j.jhin.2018.03.022

Holder, C., &Zellinger, M. (2009). Daily Bathing with Chlorhexidine in the ICU to Prevent

Central Line-Associated Bloodstream Infections. JCOM, 16(11), 509-13. Retrieved from https://pdfs.semanticscholar.org/ace2/d11dfa4fab260bb5639c782b9baa0a1addad.pdf

Johnson, J., Suwantarat, N., Colantuoni, E., Ross, T. L., Aucott, S. W., Carroll, K. C.,

&Milstone, A. M. (2019). The impact of chlorhexidine gluconate bathing on skin bacterial burden of neonates admitted to the Neonatal Intensive Care Unit. Journal of Perinatology, 39(1), 63. Retrieved from https://www.nature.com/articles/s41372-018-0231-7

Savage, T., Hodge, D. E., Pickard, K., Myers, P., Powell, K., & Cayce, J. M. (2018). Sustained

reduction and prevention of neonatal and pediatric central line-associated bloodstream infection following a nurse-driven quality improvement initiative in a pediatric facility. Journal of the Association for Vascular Access, 23(1), 30-41. Doi: 10.1016/j.java.2017.11.002

 

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Rough Draft: Capital Punishment in Criminal Justice

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Rough Draft: Capital Punishment in Criminal Justice

Rough Draft Due Week 7 and worth 150 points Instructions: Writing Activity 3 has two sections to complete. You will use the writing templates in Webtext chapter 7 to complete them. Once you complete all templates, you will be able to download your work and submit it to Blackboard. The Webtext will guide you through the process.

 

Section 1 Rough Draft Create your Rough Draft by using the writing templates in Webtext chapter 7.

 

Your rough draft should include an introduction paragraph, 2-5 body paragraphs for all supporting points in your paper, a counter perspective, and a conclusion paragraph. While the rough draft should be complete, it does not have to be perfect. After you submit it, you will get feedback from your instructor to help make revisions before submitting the final version of your paper in week

 

SAMPLE ANSWER

Capital Punishment in Criminal Justice

Capital punishment, also referred to as the death penalty is a justice system where the offenders, when found guilty, are killed. Several justifications have been made for the penalty and against it and the debates have advanced with time. The death penalty dates back to Eighteenth Century B.C. in the Code of King Hammurabi of Babylon, which codified the death penalty for different crimes (Paternoster, 1991). The reasons for the penalty varied among different societies and they included sexual crimes, blasphemy, magic as well as a violation of religious obligations among others (McFeely, 2019). In history, capital punishment involved various ways of killing an individual including crucifixion, stripping the skin off an individual, stoning, burning, dismemberment and crushing among other methods. In the modern world, industrialized countries may use lethal injections among other modern forms. However, in the USA, capital punishment is given through the firing squad (McFeely, 2019). In the USA the punishment has been used for treason, murder, and people involved in the use of spies by governments to obtain political and military information (Vila and Morris, 1997). Although the pro-death crusaders argue that it serves as a deterrent to others who would want to engage in similar crimes, the argument is often tempered by some more critical factors.

The criminal justice system is tasked with the responsibility of reflecting the moral views of society. As a result, inflicting the penalty of death on its citizenry entirely violates religious teachings on the sanctity of life. In various religious beliefs, there is a supreme God that gives and takes life, and therefore, when one ends the lives of others, they seem to be assuming the role of God. Also, Capital punishments infringe on the inviolability, sanctity, and dignity of an individual’s life as only God should be allowed the right to take the lives of people. In addition, the action is morally wrong as it involves committing a crime as compensation for another crime or simply following the example of the criminal by carrying out an equally bad action (Binder et al. 2016). One main characteristic of capital punishment is that it ends up denying the offender the opportunity of rehabilitation, which is supposed to be the main goal of the justice system (Haney, Weill, and Lynch, 2015).

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Secondly, the criminal justice system has been filled with errors previously, and consequently, an innocent individual may be put to death for a mistake that they did not commit (Brown, & McGee, 2018). Also, the capital punishment process is expensive and there are several costs involved including special prison housing and staff costs. The governments spend a significant amount of tax payer’s money to fund such processes. The money would be used to carry out other important activities like educating the poor in society or coming up with programs that would seek to establish corrective behaviors or deter youths from getting into crime (Brown, & McGee, 2018).

The main argument that surrounds the topic is the ability of the capital punishment penalty to effectively serve as a deterrent to crime (Rice, 2017). The idea behind capital punishment is that when criminals are punished by being put to death, potential criminals will be discouraged from crime. However, this does not seem to be the case considering the proportional severity deterrent and economic theories of human nature. They establish that a penalty served for a crime is supposed to allow an individual to calculate the benefits of crime vis-à-vis the crime. If it was to be true that physiological pleasures of crime are weighed against the pain of execution, then there would be no cases of homicide as well as other cases that call for the death penalty. The growing statistics of homicides across different parts of eth United States of America dispute the fact that the death penalty serves as a deterrent to crime in modern times. Therefore this proves that there should be other methods that would be adopted to help people revert from their criminal ways and the death penalty is not effective.

Rough Draft: Capital Punishment in Criminal Justice

In conclusion, capital punishment should be abolished from the legal system because it is morally wrong and is very costly in addition to the fact that it gives man the position of God considering everyone has one life. Also, it has been established that it is not an effective tool to act as a deterrent to crime as evidenced by the increase in the levels of crime in the USA as well as in different parts of the world.

 

References

Binder, G., Fissell, B., & Weisberg, R. (2016). Capital punishment of unintentional felony

murder. Notre Dame L. Rev., 92, 1141.

Brown, L. L., & McGee, S. G. (2018). Social Work and Capital Punishment: a Call to

Action. Journal of Human Rights and Social Work, 3(4), 229-239.

Haney, C., Weill, J., & Lynch, M. (2015). The death penalty. In B. L. Cutler & P. A. Zapf

(Eds.), APA handbooks in psychology. APA handbook of forensic psychology, Vol. Criminal investigation, adjudication, and sentencing outcomes (pp. 451-510). Washington, DC, US: American Psychological Association. http://dx.doi.org/10.1037/14462-017

McFeely, W, S. (2019). Trial and Error: Capital Punishment in U.S. History. Retrieved

From: http://historymatters.gmu.edu/d/5420

Rice, S. K. (2017). Darkness to Light: Procedural Injustice as Crisis for Capital

Punishment Legitimacy. Seattle Journal for Social Justice, 15(3), 13.

Paternoster, R. (1991). Capital punishment in America (p. 20). New York: Lexington Books

Vila, B., & Morris, C. (Eds.). (1997). Capital Punishment in the United States: A documentary

history. Westport, CT: Greenwood Press.

 

 

 

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Writing Activity 2-Capital Punishment in Criminal Justice

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Writing Activity 2-Capital Punishment in Criminal Justice

Instructions:

Writing Activity 2 has four sections to complete. You will use the writing templates in your Webtext to complete them. Once you complete all templates, you will be able to download your work and submit it to Blackboard. The Webtext will guide you through the process.

Section 1 Outline

Create an outline. The outline is the plan for what to include in your essay. See chapter 4 of your Webtext for information on how to create a great outline.

Section 2 Working Thesis Statement

This is a one-sentence statement summarizing the main idea of your essay. It should tell your reader what your topic is, what your position is on the topic, and how you will support it. Use the template in chapter 4 of your Webtext to write your working thesis statement.

ENG215 Writing Activity 2 (rev. 2018-12) 2

Section 3 Starting Draft

Use the Webtext writing templates to set up your essay and write the first two paragraphs. Chapter 5 of the Webtext will provide you with guidance.

Section 4 Feedback Reflection

Use the writing templates in chapter 5 of the Webtext to: 1. List the feedback you received on writing activity one 2. Explain how you used feedback from writing activity one to write activity two 3. Discuss how the feedback on writing activity one will help you with future writing.

 

SAMPLE ANSWER

Capital Punishment in Criminal Justice

Part 1: Outline

  • Introduction
  • History of Capital Punishment in Criminal Justice
  • Crimes that required capital punishment
  • Capital punishment today across different parts of the world
  • Capital punishment in America today and methods used
  • Justification for capital punishment
  • Position against capital punishment
    • Capital punishment is morally wrong
    • Capital punishment however denies the offender the opportunity of rehabilitation
    • capital punishment process is also expensive
    • errors in capital punishments present irreversible consequences on innocent people
  • Conclusion

Chapter 2: Working Thesis Statement

The argument for capital punishment is that it serves as a deterrent to others who would want to engage in similar crimes, that argument is often tempered by some more critical factors.

Starting Draft

Capital punishment also referred to as the death penalty is a justice system where the offenders, when found guilty are killed. Several justifications have been made for the penalty and against it and the debates have advanced with time. In most cases, there have been more debates about the justifications and they seem to have taken center stage over the capital punishment issue itself. The main argument that surrounds the topic is the ability of the capital punishment penalty to effectively serve as a deterrent to crime. The idea behind capital punishment is that when criminals are punished by being put to death, potential criminals will be discouraged from crime. Although the pro-death crusaders argue that it serves as a deterrent to others who would want to engage in similar crimes, the argument is often tempered by some more critical factors.

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Since time immemorial, criminals have been executed as a punishment for the crimes that they have committed (Rice, 2017). The death penalty dates back to Eighteenth Century B.C. in the Code of King Hammurabi of Babylon, which codified the death penalty for different crimes. The reasons for the penalty varied among different societies and they included sexual crimes, blasphemy, magic as well as a violation of religious obligations among others (McFeely, 2019). In the Tenth Century A.D., hanging became the usual method of execution in Britain. In the following century, William the Conqueror would not allow persons to be hanged or otherwise executed for any crime, except in times of war. In the Sixteenth Century, under the reign of Henry VIII, the punishment was offered for capital offenses as marrying a Jew, not confessing to a crime and treason (Paternoster, 1991). In the USA the punishment has been used for treason, murder, and people involved in the use of spies by governments to obtain political and military information Vila and Morris, 1997)

Part 4: Feedback Reflection

The feedback received in the writing activity 1

  • Provides more citations for some of the information provided.
  • Provide appropriate Punctuation in compound intense
  • Work on the incomplete sentences
  • Provide more information on statistics or constitutional laws that support your argument.

The feedback will be useful in writing activity 2 because I will be keener on how I structure the sentences so that they can pass the message more coherently and effectively. The feedback is also useful in my research as I will delve into more research so that I can expand my knowledge to help me gain a better position on the topic and support my position more.

Writing Activity 2-Capital Punishment in Criminal Justice

The feedback is also beneficial for the future as I will incorporate the lessons into other different writings including those that are academic and those that are not. In doing so, I will be a more credible writer.

 

References

Binder, G., Fissell, B., & Weisberg, R. (2016). Capital punishment of unintentional felony

murder. Notre Dame L. Rev., 92, 1141.

McFeely, W, S. (2019). Trial and Error: Capital Punishment in U.S. History. Retrieved

From: http://historymatters.gmu.edu/d/5420

Rice, S. K. (2017). Darkness to Light: Procedural Injustice as Crisis for Capital

Punishment Legitimacy. Seattle Journal for Social Justice, 15(3), 13.

Paternoster, R. (1991). Capital punishment in America (p. 20). New York: Lexington Books.

Vila, B., & Morris, C. (Eds.). (1997). Capital Punishment in the United States: A documentary

history. Westport, CT: Greenwood Press.

 

 

 

 

 

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