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An Advanced Practice Registered Nurse

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An Advanced Practice Registered Nurse

Please follow this

One

A short Introduction = About APRN

Two

Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region = Example is California state and Texas

Three

Describe how they may differ. Be specific and provide examples. = At least 3-4

Four

Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience.

Five

Provide at least one example of how APRNs may adhere to the two regulations you selected.

Reference page at Least three sources

Note

This is a discussion

No tittle pages.

No running heads.

This a Masters level class

APA Format with intext citation

Required to use the reading resources, no outside resources for this one.

Heading:

Ø  Comparison of Board of Nursing Regulations between (California state and Texas)

 

Ø  How they may Differ (include examples) 

Ø  How do the Regulations Apply to Advanced Practice Registered Nurses?

 

Ø  Example of how APRNs May adhere to the Two Regulations

 

SAMPLE ANSWER

An Advanced Practice Registered Nurse

An Advanced Practice Registered Nurse (APRN) is a registered nurse with clinical competencies, complex decision-making skills, and expert knowledge critical for expanded practice (NCSBN, 2019).  APRNs can take more complex case works and have more discretion and independence than RNs.

The APRN board of nursing regulations in both California and Texas are similar in both the certification process and the application process. The states require nurses to verify their certification through clinical competency and experience in delivery of health care services (NursingLicensure.org, 20191; NursingLicensure.org, 20192). The certification process is also determined through education and a certification exam as determined by the certification agency. The application process in both states is the same as the application forms are got online from the board website (NursingLicensure.org, 20191; NursingLicensure.org, 20192). The evidence of current certification and eligibility would also be required.

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The legislations also differ in both California and Texas. For example, the education requirements for APRNs in Texas are conducted at the master’s level or higher, and the programs must be nationally accredited by the board of nursing or an accrediting agency (NursingLicensure.org, 20191). In California, the education requirement includes completing an approved California’s education programs recognized by the Board or an equivalent program through an accepted organization (NursingLicensure.org, 20192).  The renewal requirements in both states also differ. For example, in Texas, APRN must have to maintain national certification, and there must be active practice and continuing education (NursingLicensure.org, 20191). However, in California, the renewal requirements do not involve continuous education. Instead renewal is automatic and may require payment of additional fees (NursingLicensure.org, 20192) Finally, Out-of-state nurses without licensing in California can apply and become temporary APRNs, but such nurses cannot work in Texas by submitting endorsement RN applications.

The legislations selected apply to APRNs because they must attain all education, certification, application and renewal requirements to work in respective states. The legislations are important in providing a clear understanding of APRNs scope of practice based on the state regulatory agencies (Milstead & Short, 2019).

APRNs need to adhere to both the educational requirements and certification requirements by doing approved programs by the Board of nurses or other nationally accredited by recognized accrediting agencies (ANA, 2017). The education requirements will help during the certification process since it must be consistent with education and other basics for certification exams.

 

References

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).

Burlington, MA: Jones & Bartlett Learning.

American Nurses Association (ANA). (November 14, 2017). ANA Enterprise.

https://www.nursingworld.org/practice-policy/aprn/

National Council of State Boards of Nursing (NCSBN). (2019). APRN consensus

implementation status. NCSBN. https://www.ncsbn.org/5397.htm

NursingLicensure.org (20191). Advanced Practice Registered Nurse license requirements in

Texas. Nursinglicensure. https://www.nursinglicensure.org/np-state/texas-nurse-practitioner.html

NursingLicensure.org (20192). Advanced Practice Registered Nurse license requirements in

Carlifornia. Nursinglicensure. https://www.nursinglicensure.org/np-state/california-nurse-practitioner.html

 

 

 

 

 

 

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Nursing Regulations

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Nursing Regulations

  • Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
  • Consider how key regulations may impact nursing practice.
  • Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..

Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

 

SAMPLE ANSWER

A Comparison of two APRN Boards of Nursing Regulations in Illinois with those of California

The nursing profession is highly regulated and there are very regulations that are implemented by the boards of nursing and the nursing associations. The role of these bodies is to regulate inform as well as promote the nursing practice.  Although Boards of nursing (BONs) and associations have differences, they are both essential to the nursing profession. The Advanced Practice Registered Nurse (APRN) practice has its definition and scope provided by the Nurse Practice Act and implemented by the board of nursing alongside other boards. Different states may have different regulations being regulated by various boards.

For advanced practice in Illinois, the nurse must be licensed. The license to practice is provided by the Illinois Department of Financial and Professional Regulation (IDPR). According to the association ANA, APRNs that are acknowledged include the Certified Nurse Practitioners (NPs), Certified Registered Nurse Anesthetists (CRNAs), Clinical Nurse Specialists (CNS), and Certified Nurse-Midwives (CNMs). In Illinois, the above-mentioned nurse categories are also recognized by the state and it is required that the nurse holds RN as well as APN licensing. According to the National Council for State Boards of Nursing, Illinois has been listed as a state that has pending nurse compact legislature.  It is however required that the nurse holds the primary RN licensure.

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The APRNs in Illinois need to have collaborative agreements as long as they are working in the state unless in some cases where there is an exemption that is provided. In the state, there is a collaborative agreement that is provided by the Illinois Prescriptive authority. It is a licensing agency that establishes a distinction between the drugs that have been established to be legal and the other drug substances that are under control. However, in Illinois, there are no separate applications for the different categories of drugs. The collaborative agreement is expected to be signed by the physician. In the year 2017, the governor of the Illinois state signed into law a change in APRN licensure regarding collaboration. Therefore, in this state, APRNs who work outside the hospital and the affiliated settings will provide advanced practice nursing care without the career-long written collaborative agreement. Also, concerning the medication, drugs such as Benzodiazepines and some other scheduled agents will be used under an existing relationship between the nurse practitioner and the physician as a condition of prescribing authority.

A similarity exists between the regulation and that of California and in both states, it is required that a license and collaboration be provided. California’s advanced practice nurses are overseen by the California Board of Registered Nursing (BRN). Also, it is required that the nurse be licensed and registered. However, differences exist in the requirements for collaboration. A nurse practitioner in California must be able to practice under standardized procedures that are established through collaboration. The law of the state, however, does not have any specifications regarding the required level of supervision among its nurses with regards to the provision of drugs and devices

In both states, the Health Care Quality Improvement Act applies and this is an act that encourages hospitals, state licensing boards, and professional societies to identify and take corrective action for health care workers who may be found by peer review to be engaged in negligent or unprofessional conduct.it encourages the peers to work in accordance with the specified rules of conduct and provide quality care.

 

How the regulations apply to Advanced Practice Registered Nurses (APRNs) who have the legal authority to practice within the full scope of their education and experience

The action by the Illinois government to have the APRNs have a pathway to provide advanced practice nursing care without the career-long written collaborative agreement goes a long way in removing the barriers of practice for these APRNs. Consequently, nurses can practice efficiently and under Full practice authority. This means that they can utilize the knowledge that they have as well as skills and judgment that is useful to practice to a full extent. This is in line with the national call to remove barriers to full practice authority from various organizations, something that has been in progress with the ANA as well as the State Nurses Associations.

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Example of how APRNs may adhere to the Regulations

To adhere to the regulations provided, nurses will have to ensure that they are licensed before they engage in practice in Illinois. One action that they can get involved in is to ensure that they engage in professional conduct and ensure that they are not negligent in their activities. This means that they will adhere to the nursing scope of practice as stipulated by the nursing associations at different levels and specifically in the state. This is because, according to the health Care Quality Improvement Act, the hospital, or the licensing broads as well as the professional societies to take corrective or disciplinary actions on the APRN nurses that may be found to engage in negligent or unprofessional conduct. Therefore, they should try at all times to abide by the rules and regulations provide. For licensing, they should ensure that they are licensed and that the license is updated whenever it is required. In conclusion, the Nursing profession is a very highly regulated profession as evidenced by the existence of numerous boards of nursing and nursing associations across the United States of America. Regulations are carried out by the BONs and the nursing Associations. Their existence helps regulate, inform, and promote the nursing profession. Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice and there are different regulations in different states.

References

American Nurses Association. (2019). Nurses advancing our profession to improve health for

all. Retrieved from: https://www.nursingworld.org/

Arifkhanova, A. (2017). The Impact of Nurse Practitioner Scope-of-Practice Regulations in

Primary Care. The Pardee RAND Graduate School

O’Herrin, J. K., Fost, N., & Kudsk, K. A. (2004). Health Insurance Portability Accountability

Act (HIPAA) regulations: effect on medical record research. Annals of surgery, 239(6), 772.

National Council of State Boards of Nursing (NCSBN).  (2019). Illinois Illinois Board of

Nursing. Retrieved from: https://www.ncsbn.org/search.htm?q=illinois&filetype=&metafilter=&sitefilter=&btnG=

 

 

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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 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.

.

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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Qualitative Study

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Qualitative Study

Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide rationale, include examples, and reference content from the studies in your responses.

Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

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.

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

 

SAMPLE ANSWER

Qualitative Study

Study Protocol of ” Worth the Walk”: a randomized controlled trial of a stroke risk reduction walking intervention among racial /ethnic minority older adults with hypertension in community senior centers by Kwon, et al., (2015).

Background of the study

Stroke has become one of the leading causes of high mortality rates in the United States. Stroke is also responsible for disabling most of the minority seniors. Approximately 30% of the strokes are related to lack of physical activity, but most of the older generations in most of the ethnic groups in the United States tend to participate most in physical exercise.

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Significance of the study

Most of the African American, Chinese, Korean, and Latino seniors with hypertension are the most affected groups by stroke. As a result, the cost of health among the mentioned groups tends to be high, and yet the mortality rate continues to be high every year. Walking among the seniors can increase their physical activity, which can, in turn, reduce the risks of stroke, especially among those seniors suffering from hypertension.

The purpose of the study

To conduct a randomized controlled trial to assess the effects of a culturally designed walking intervention that is community-based to decrease the risk of stroke by increasing the rate of physical exercise among Latino, African American, Korean and Chinese seniors suffering from hypertension.

Research question

Does walking intervention reduce the risk of stroke among the racial/ethnic older adults with hypertension in senior community centers?

Research method

The researchers enrolled the minority seniors of the targeted groups at senior centers and used data collection with complete baseline. The selected groups were then assigned to receive the walking intervention randomly. The sample size was 120, which was obtained after a full 90 days follow up intervention. The researchers’ assigned trained case managers to conduct qualitative methods to answer the research questions. They implemented the intervention sessions two times a week for four consecutive weeks to the targeted intervention group. The measures for primary outcome included the stroke knowledge, mean steps per day for more than seven days, and self-efficacy for reducing the risk of stroke. The measures for exploratory and secondary measures include health-seeking, health-related quality of life, and biological markers for health. The researchers collected the outcome data from participants in the wait-list control and intervention participants three months after complete baseline data collection (Chiu, Bergeron,Williams, Bray, Sutherland & Krauss, 2015). The outcomes were then compared between the two groups using randomized trials data analytic methods. The facilitators and the barrios to the successful implementation of worth the walk were also assessed. The researchers did not indicate the weakness of the available studies and also did not include a conceptual framework in their research.

Qualitative Study

Results of the study

The randomized controlled trial demonstrated considerable improvements in knowledge about stroke and body exercise in the intervention group as compared to the control group (Chiu, et al. 2015). Nurses should consider the intervention as the primary prevention strategy for stroke among seniors in various minority ethnic or racial groups in the United States.

The findings of the study suggest that nursing education should highly consider training the nurses about physical exercise and implement the worth a walk intervention to improve patient outcome.

Ethical considerations

Patient confidentiality was considered in the study. Information regarding individual participants in the study was well handled to avoid its leakage to unauthorized persons. Also, the study was approved by the Institutional Review Board.

Conclusion

The risk of stroke is highly increased with the reduction of physical exercise, especially among the seniors in the minority ethnic or racial groups in the United States. Nursing practice should emphasize increased physical activity among the minority groups, especially the seniors with hypertension, to reduce the risks of stroke. It is the responsibility of the nurses to create awareness on the benefits of body exercise in minimizing the stroke cases, which can, in turn, reduce the treatment costs and reduce the mortality rates.

Quantitative Study

Comparison of the Dash (Dietary Approaches to Stop Hypertension) diet and a higher-fat Dash diet on blood pressure and lipids and lipoproteins: a randomized controlled trial, by Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015).

Background of the study

The Dietary Approaches to prevent and stop hypertension include incorporation of a dietary pattern that is high in vegetables, fruits, and low in fats, especially dairy foods. The Dash enhances low-density lipoprotein, lowering of high blood pressure and cholesterol, that is high-density lipoprotein.

Significance of the study

Hypertension is a condition that is a highly experienced condition, especially among the aging generations. The leading causes of hypertension are reduced physical exercise and poor dieting. Hypertension increases health costs and also leads to high mortality rates, especially among the senior groups in society.

Purpose of the study

The main objective of the study was to examine the effects of substitution of full-fat with low-fat dairy food products in the DASH diet with a corresponding increase in fat and a decrease in the intake of sugar on plasma lipids, lipoproteins and blood pressure.

Qualitative Study

Research question

Do the DASH and HF-DASH diet lower high-density lipoprotein cholesterol, low-density lipoprotein, and high blood pressure?

Research methods

The researchers used a sample size of three health persons to conduct a randomized crossover trial based on three periods. The individuals consumed a standard Dash diet, a control diet, a lower carbohydrate modification of Dah diet, and a high-fat diet for three weeks each which was separated by two weeks’ periods for washouts (Kwon, et al. 2015). The researchers then conducted laboratory measurements that included the concentration of lipoprotein particles determined by the mobility of ions, which was established at the end of each experimental diet (Kwon, et al. 2015). The researchers used both dependent and independent variables. The dependent variable was high blood pressure, and the DASH and HF-DASH diet were the independent variables that were presented after the tests (Kwon, et al. 2015). The variables were shown on a graph with the high blood pressure being on the y-axes and the DASH and HF -DASH diets being on the x-axes. Each of the researchers analyzed the data using the Statistical Packages for Social Sciences and compared their results to eliminate the chances of personal bias and ensure the accuracy of results.

Results of the study

The participants of the study finished the three dietary periods. The HF-DASH and DASH diets profoundly reduced blood pressure compared to the control diet. There was a reduction in the concentration of medium and large very-low-density lipoprotein particles and triglycerides (Kwon, et al. 2015). The HF-DASH diet also increased the peak particle diameter of LDL and decreased the HDL cholesterol, LDL cholesterol, apolipoprotein A-I, large LDL particles Intermediate density lipoprotein and the width of LDL peak compared with the control diet. The researchers did not mention any limitations of the study.

Qualitative Study

Ethical considerations

The Institution Review Board approved the study. Also, the confidentiality of the participants in the study was highly maintained.

Conclusion

The DAS diet significantly lowered blood pressure to the same extent as the HF- DASH diet and also reduced the concentration of VLDL and plasma triglyceride without increasing the cholesterol. The findings of the study can help improve nursing practice in managing hypertension. Nurses should create awareness among patients and the community at large about the DASH and HF-DASH diet to help reduce the mortality rates and the costs of treatments.

 

References

Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition, 103(2), 341-347. https://www.ncbi.nlm.nih.gov/pubmed/26718414

Kwon, I., Choi, S., Mittman, B., Bharmal, N., Liu, H., Vickrey, B., Song, S., Araiza, D., McCreath, H., Seeman, T., Oh, S. M., Trejo, L., … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: A randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in senior community centers. BMC Neurology, 15, 91. https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-015-0346-9

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Improving Transition to Telenursing and Telemedicine

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Improving Transition to Telenursing and Telemedicine

Telenursing and telemedicine will only be successful if patients engage in the program. You have been asked by your manager toImproving Transition to Telenursing and Telemedicine pilot a program aimed at improving transitions of care using the new telemedicine system recently implemented at your hospital. What are some of the ways that you can encourage both patient and provider engagement to ensure the pilot program success? Citations should conform to APA guidelines. You may use this APA Citation Helper as a convenient reference for properly citing resources or connect to the APA style website through the APA icon below.

 

SAMPLE ANSWER

Improving Transition to Telenursing and Telemedicine

For patients and caregivers to reap the full benefits of telemedicine, they must wholly embrace the revolutionary technology. The engagement of the patient and care-giver is paramount for the effective use of telemedicine since it relies on the ability of stakeholders to use the system (Dantu & Mahapatra, 2013, 3) Collecting from and providing information to users will increase the involvement of both patients and care providers in the integration of telemedicine.

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Educating caregivers and patients on the uses and benefits of telemedicine will increase the engagement in the pilot and subsequent roll out of the program. Dispelling myths, and providing knowledge on how to use the system provides all stakeholders with the required information to practice telehealth. Skepticism on compatibility, fear of losing face to face interactions and security concerns are some of the popular myths among physicians (Dantu & Mahapatra, 2013, 3) Providing information to the stakeholders will encourage them to get more involved because patients and providers have knowledge on how to use the system and understand the potential benefits.

Conducting research prior to designing and rolling out implementation strategies is critical in the adoption of the proposed procedures. The data collected informs on preferences and possible barriers to the acceptance of telemedicine. Collecting data from stakeholders ensures that their views are incorporated in making the pilot thus it is more acceptable. Both providers and patients will participate more knowing that their input is valued and will be included in the execution of telehealth procedures.

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Patient and provider engagement can be increased through improving communication to and from stakeholders. Transition of care is an important aspect for the recovery of patients and it can benefit greatly from the use of telemedicine While a pilot program designed to improve the transition of care using telehealth systems is a noble initiative, stakeholders in the medical field must be fully engaged in the process to capitalize on the advantage

 

References

Dantu, R., & Mahapatra, R. (2013). Adoption of telemedicine – challenges and opportunities. Retrieved from https://pdfs.semanticscholar.org/8267/cb4b468233850adfe1eab1387ef2d1202e5d.pdf

 

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Descriptive Statistics

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Descriptive Statistics

There is often the requirement to evaluate descriptive statistics for data within the organization or for health care information. Every year the National Cancer Institute collects and publishes data based on patient demographics. Understanding differences between the groups based upon the collected data often informs health care professionals towards research, treatment options, or patient education.

Using the data on the “National Cancer Institute Data” Excel spreadsheet, calculate the descriptive statistics indicated below for each of the Race/Ethnicity groups. Refer to your textbook and the Topic Materials, as needed, for assistance in with creating Excel formulas.

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Provide the following descriptive statistics:

  1. Measures of Central Tendency: Mean, Median, and Mode
  2. Measures of Variation: Variance, Standard Deviation, and Range (a formula is not needed for Range).
  3. Once the data is calculated, provide a 150-250 word analysis of the descriptive statistics on the spreadsheet. This should include differences and health outcomes between groups.

 

SAMPLE ANSWER

Descriptive Statistics

            Mean shows that the diagnosis among the blacks, including the Hispanics with a value of 70.07 per 100,000 people, is the highest, while lowest among the Hispanic with a value of 31.50. The mean presents the average of the diagnosis starting from 2000 up to 2015. Additionally, one can also see that the median value is highest for the blacks, with a value of 71.4. However, it is lowest is among Hispanics since it is 32.1. On the other hand, mode is not derived in all of the groups. However, for the Asians and Pacific Islanders, Hispanic, and whites, the modes are 36.6, 34.1, and 65.8 respectively. The other groups does not have a value that appears repeatedly.

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The variance is another element that reveals some details regarding the figures. The variance is highest among the blacks, which tends to indicate that the data points are intensely spread out from one another and from the mean. On the other hand, it is lowest among the Asians and Pacific Islanders, which indicates that data points are relatively close to each other and to the mean.  Similarly, the standard deviation is lowest among Asians/Pacific Islanders, which implies that data points are close to the mean. On the other hand, it is highest among blacks, which indicates that data points are largely spread out.

 

 

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Evaluation of Research Ethics

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Evaluation of Research Ethics

Search the GCU Library and find one new health care article that uses quantitative research. Do not use an article from a previous assignment, or that appears in the Topic Materials or textbook.

Complete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template. See Chapter 5 of your textbook as needed, for assistance.

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.

 

SAMPLE ANSWER

Article Analysis and Evaluation of Research Ethics

Article Citation and Permalink

(APA format)

 Article 1

Lori, M. (2017). Are Patients Satisfied with Telehealth in Home Health Care? A Quantitative Research Study in Congestive Heart Failure Patients. SM Gerontology and Geriatric Research, 1(2). Retrieved from https://smjournals.com/gerontology-geriatric-research/download.php?file=fulltext/smggr-v1-1009.pdf
Point Description
Broad Topic Area/Title Telehealth technology in home healthcare
Problem Statement

(What is the problem research is addressing?)

 Whether using telehealth in home healthcare enhances patient satisfaction
Purpose Statement

(What is the purpose of the study?)

 To determine the extent of patient satisfaction when the telehealth technology is used in home health care particularly with respect to congestive heart failure patients.
Research Questions

(What questions does the research seek to answer?)

 What is the difference in patient satisfaction for patients using either telehealth vs. usual home health services in patients diagnosed with heart failure after removing the effect of age, gender, prior home health services and living alone status?
Define Hypothesis

(Or state the correct hypothesis based upon variables used)

 Patients receiving telehealth care would be as satisfied or more satisfied with their home health care.
Identify Dependent and Independent Variables and Type of Data for the Variables The dependent variable was patient satisfaction score, while the independent variable was telehealth home healthcare services
Population of Interest for Study Patients with heart failure receiving home health care and aged more than 18 years
Sample 176 participants
Sampling Method Random
Identify Data Collection

Identify how data were collected

 Surveys
Summarize Data Collection Approach Surveys were sent to the participants who met the criteria of the study.
Discuss Data Analysis

Include what types of statistical tests were used for the variables.

 ANCOVA, analysis of frequencies and description
Summarize Results of Study Telehealth in home healthcare is a cost effective approach that enhances patient satisfaction particularly in the management of chronic diseases.
Summary of Assumptions and Limitations

Identify the assumptions and limitations from the article.

Report other potential assumptions and limitations of your review not listed by the author.

 Some of the assumptions include that other factors may not affect the outcomes of the study. For instance, it was assumed that other element that may affect the quality of home healthcare did not affect patient outcomes.

 

Study limitations that were identified in this research were the descriptive, quasi-experimental design with convenience sampling inhibiting the ability to generalize the findings to a larger population. This design did not support a cause and effect relationship for the findings.

 

Ethical Considerations

The study involved human subjects. As such, one of the ethical issues that would have arisen is the breach of the privacy of these patients. Ethics demands that the privacy of human subjects is preserved, hence errors or negligence by the researchers may have caused ethical concerns.  Furthermore, issues related to biases would have occurred during the sampling and data collection phases of the study. Biases involved allowing elements such as prejudice to affect a study, thus affecting its objectivity and leading to results that may be inaccurate. Additionally, another potential ethical consideration is errors during the process of data analysis. Errors during this stage may result in findings that are not representatives of the views of the study participants.

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Additionally, another ethical consideration during the study is failing to use the appropriate sampling method. In most instances, random sampling is the ideal method since it ensures that the entire population is represented, and elements such as biases avoided. Therefore, during the sampling phase, it was possible for the incorrect sampling method to be used, which would have led to inaccurate results. Moreover, when publishing the results, there was a possibility of some errors occurring, this included typing errors, which would have led to inaccuracies. At the same time, the participants’ private data may have leaked to the wrong parties during the publishing phase of the study, which would have caused ethical concerns. Therefore, it was imperative for the researcher to take various measures to ensure that the ethical considerations are observed during the various phases of the study.

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The use of SBIRT in Adolescent Population

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The use of SBIRT in Adolescent Population

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

Include the following:

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

SAMPLE ANSWER

The use of SBIRT in Adolescent Population

Problem Overview

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

The use of SBIRT in Adolescent Population

Why a Quality Improvement Initiative is Required

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

Results from Previous Research

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

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

The use of SBIRT in Adolescent Population

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

The use of SBIRT in Adolescent Population

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

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Steps to Implement the Quality Improvement Initiative

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

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

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

References

Aldridge, A., Linford, R., & Bray, J. (2017). Substance use outcomes of patients served by a broad US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT). Addiction, 112, 43–53. https://doi-org.lopes.idm.oclc.org/10.1111/add.13651

Healthy People 2020. (2018). Increase the proportion of adolescents aged 12 to 17 years perceiving great risk associated with substance abuse. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/substance-abuse/objectives

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

National Institute on Drug Abuse [NIDA]. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide. Retrieved from https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide

Schmidt, C. S., Schulte, B., Seo, H.-N., Kuhn, S., O’Donnell, A., Kriston, L., … Reimer, J. (2010.). A meta-analysis on the effectiveness of alcohol screening with brief interventions for patients in emergency care settings. ADDICTION, 111(5), 783–794. https://doi-org.lopes.idm.oclc.org/10.1111/add.13263

Singh, M., Gmyrek, A., Hernandez, A., Damon, D., & Hayashi, S. (2017). Sustaining Screening, Brief Intervention, and Referral to Treatment (SBIRT) services in health-care settings. Addiction, 112, 92–100. https://doi-org.lopes.idm.oclc.org/10.1111/add.13654

Substance Abuse and Mental Health Services Administration [SAMHSA]. (2017). About screening, brief intervention, and referral to treatment (SBIRT). Retrieved from https://www.samhsa.gov/sbirt/about

 

 

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